Sunday, April 3, 2016

American River 50-mile 2016: feeling both guilty and relieved...

For those who have followed the events over the past 4 weeks, I owe you some news about my medical conditions since I shared so much after my stroke. And then a big apology...

As I mentioned in my previous post, I had to stop running while the medical investigation is still going on. The big step this week has been another MRI and angiogram to (1) ensure there wasn't any other signs of strokes in the past 3 weeks and (2) check the condition of my arteries and vessels in the neck and inside the brain. Through the independent readings of 2 different neuroradiologists, the result came negative, no sign of plaque, and no more blockage (the team in San Francisco had detected a blockage on a CT Scan, which the team in New Jersey missed apparently). That's great news which came at the last hour on Friday afternoon.

I still wear a heart monitor 24 by 7 to check my heart rhythm against any sign of atrial fibrillation, which is the last remaining hypothesis for the formation of the clot. If that comes negative as well, which I hope, then I think we'll be left with an unknown case which, to me from day 1, could just be linked to the fact that I went 101% at the US Nationals. I've suffered the well-known exercise-induced asthma for many years until I discovered Singulair, maybe we are going to uncover the record-induced or limit-induced stroke (we could say exhaustion-induced except that I didn't feel exhausted at all when that happened in New York). Certainly, there aren't that many individuals out there who have pushed the limit against aging as I recently did and still improving after 50... Although, the field specialists would argue that I started late, so that certainly explains some of the remaining PRs. But still.

Anyway, after this update, it's time for the apology. As some of you have seen on Facebook or Strava already, yes, I resumed running this weekend by lining up to the start of no less than American River 50. For the non insiders, the 50 means 50 miles (80+ km), half on a trail with a few technical sections, and more than 4,000 ft of cumulative elevation. Now, I read your mind, here is the first question you must have: "Did you get the medical clearance to do this??!" Of course, no, and I certainly don't blame my doctors for stating that this wasn't recommended. Which doctor, with such incomplete explanation of what happened 4 weeks ago could ever say "Yes, it's just fine, go back to running, straight to race 2 tough marathons." But the thing is that this question will never been a clear cut ever from now on. Which leads me to the next thought...

I know I'm going to get a lot of push back on this decision, and probably even more from people who know less about the circumstances, from my personal fitness to what ultra running is about. To spare you the time of searching, here is a list of negative terms that can come to mind if you wish: foolish, insane, inconsiderate, stupid, dumb, senseless, absurd, crazy, silly... Yes, like you, that list came to (my) mind as well... As a matter of fact, this has been a particularly tough decision and, if it didn't appear through 470 of these blog posts yet, I'm a very rational person, don't like failure, like to base my decisions on facts. And sometimes, I can be determined too... It was also a tough decision because, until Friday afternoon, I still thought that there was potentially a big problem with my arteries and there was no way I would run with this condition then. I even cancelled on Thursday the hotel room that we had in Folsom, forfeiting the pre-race plans. Talking about some additional stress created by last minute planning... And of course, my decision was very challenging for Agnès whom I love so much for the trust she has in me in particular.

Again, I realize the gravity of this decision. I had never put much thoughts into stroke conditions before. Actually, I was very familiar with the danger of clots for ultra runners but had quite a big misconception about it. As ultra runner, our heart is getting so much stronger, it beats slower (mine often goes below 40 at rest), slowing down the blood flow which is particularly risky when sitting for hours on a plane right after a race, something I'm way too familiar with. What I didn't know if that these clots typically forming in the legs are a danger for the lungs where they will end up, not the brain. In my case, we need to find out what caused the TIA in the first place to see what the potential risk of forming another clot is. If a clot was the reason in the first place... At least I'm on a blood thinner which certainly decreases that risk (and, no, John Burton, that's not a banned substance, I checked before even taking the first pill! ;-).

Now, I'm not that crazy, I had to make deliberate concessions in order to make the decision work: what I was aiming for is what I called "jogging American River" at about 80% of my fitness capacity. That may not mean much slowing down for many, but that's a huge gap from the 101% I pushed to at Caumsett, really.

Hum, with that super long introduction, we are not even at the start line, I'm going to have to keep my race report really short (for a change... ;-). Although I have so much things to say about the support of many from the start to the finish line.

I had so many doubts about this decision obviously that I went in with a very low profile, no message to my Club mates, nothing on Facebook. Besides, with a 6 am start, it was pitch dark and very easy to remain incognito. Start photo showing that Lake Folsom was high enough this year to reach the boat ramp near the start line (well, you can't see it, that's the black background, but you got the picture... ;-):
Incognito? That is until the Master of Ceremony mentioned my name at the mic... A few people who knew about the past weeks stopped by many had no clue.
With my M6 bib (thank you Julie! ;-), a few probably thought I was here to kill it. A few days ago, one of the favorites, Chris Denucci, asked to follow me on Strava... Needless to say, I lost sight of him right off the start and was happy about it as I was trying to make my way back to a jogging pace. The bright yellow jerseys of the Excelsior team were ahead and I settled behind Ray Sanchez and Nikki Kimble. We were about half a mile in the race when I was going to check my pace and discovered I had forgotten to start my GPS. My new Petzl Tikka RXP was really helpful on the first trail section and I offered Ray to run on his side so he cold benefit from the light since he didn't have a headlamp. But the sky was so clear that the lamp wasn't needed even before we reached the levee. It felt really cool to not push and rush as usual, and even felt good to lose sight of the top runners. At the dam, I had a nice chat with Nikki (her ski season in Montana, snowshoe racing, physio therapist jobs, motivational speaking engagements about ultra running or depression). Nikki focuses on mountain 100-miles and was definitely not trying to chase Devon who was racing the boys. My pace was now down to 8:24 min/mile which was indeed much slower than usual. I picked up the pace a bit as we were now going down the bike path. Not pushing (I swear) but ended up lowering my average pace to 7:45 at the turn around at the end of Lake Matona. Between the early morning lights and the reflection on the still water, the view were stunning and I was glad to take the time to look around for a change.

Agnès was at the Negro Bar aid station and a volunteer and she helped me refill my GU2O bottle. From mile 15 it's mostly up to Auburn so the average pace keeps rising. After Negro Bar I started feeling the effect of a notorious lack of training these past 4 weeks. I was hoping that super good conditioning of January and February would carry through March but that was wishful thinking. Despite good hydration and taking an S!Cap every hour, I could feel some nagging cramps coming and had to ease up after Beals Point (which is theoretically the half-way point and the start of the brand new 25-mile race, but I'd say closer to 24 miles. I reached Beals in 3:12 (7:55 min/mile) and did a quick stop to grab a couple of GU gels. I had decided that, since I wasn't really racing, I wasn't going to do Vespa ( but I didn't realize how tough that was going to be to get back to the old school of running on carb, ouch! Besides, with all the worries about potential clogged arteries, I had cut on fat even more than usual so that mean I was likely to be fat-depleted anyway...

I was surprised no to see Agnès at Beals. She had expected me a few minutes later so she had walked down the water and barely see me passing though on her way back to the parking lot.
One runner passed me on the way to Cavitt School and I distanced another one in the subsequent roller coaster to Granite Bay. By Granite Bay I wasn't feeling so good. Not the head thankfully, but the leg fatigue and level of energy. I wasn't eating as much as I should given my choice of not running on fat calories, but I didn't feel like eating potatoes. I ate mostly GUs, one or two am hour, a few pieces of bananas, a few chips and drinking a few small cups of Coke here and there. With this regimen, no surprise that I bonk, both physically and mentally in the infamous Meat Grinder section. Not only most of my worst ultra memories have been formed in this section over the past 10 years, but the matter became even worst with XTerra throwing us full-speed mountain bikers to us. I almost got hit twice and you could tell the runners were the intruders, although the trail rules and etiquette say otherwise. I appreciate these are shared trails but that was insanely dangerous. Between all these required stops to let the bikes pass, plus the yelling to announce myself in the numerous blind turns, that really broke my rhythm and I didn't need that especially in that section. But I had promised not to push, so I tried to remain calm and savoring this opportunity to experience trail running again.

I asked for more ice in my water at Horseshoe Bar as the temperature was rising. Ray passed me in that section to Rattlesnake Bar and Tim Twietmeyer arrived in the station as I was chatting with Agnès and trying to recompose myself in the shade before the final 10 miles.
Tim is 57, I was glad I wasn't fighting for the age group title today, no stress, no pressure... ;-) (Tim is an ultra legend but here are a few stats about him for the non insiders: that was his 36th American River meaning he ran all of them. Tim ran and finished Western States 25 times under 24 hours, the only one to do so. And he even won that mythical race 5 times! And he lives in Auburn, so these trails are his backyard.).

The few miles after Rattlesnake were slow and painful. I was so worried to fall because of the risk of bleeding, I must have been super tensed as my back is unusually sore this Sunday. Despite all the efforts to raise my feet higher I tripped 5 to 6 times and fell once but landing on my hand bottles (thank you again Ultimate Direction! ;-), avoiding any bruising. I also got tired of scanning for and avoiding the numerous and invasive poison oak branches. With that, I couldn't wait to reach the final 3.5-mile climb to the Auburn Dam Overlook finish. It was 1 pm and quite warm now but I'm a good climber and these steep miles are on a fire and service road so at least I didn't have to jump over rocks anymore, just shuffle. At the mile 47 mark, my watch was showing 7:18 of elapsed time and I thought I could still break 8 hours. But I had forgotten that I had missed the start, and wasn't sure about how minutes I missed anyway.

I got more iced water at the final Last Gap aid station and, soon after, ran into Rich Hanna who was blown away to see me, even more so, running that final uphill (impressive view from the finish line down to the trail at the bottom of the canyon).
By the way, Rich is the one who broke that darn M50-54 50K American Record before me in February, the new record I was chasing in Caumsett 3 weeks later. He is so nice, he offered to run by my side to the finish and we even chatted a bit about what happened. I ran all the way to the finish but, not knowing the exact clock time, I was really unsure about the 8 hours. As the CEO of the Chip Timing company officiating for the race, Rich was pretty confident I had it and, sure enough, I crossed the finish line in 7:58:15. 21st overall (Devon took 11th overall in 7:10), 20th Men, 2nd M50-59 to Tim (7:49).

Chris Denucci won, 42 seconds from breaking 6 hours! Chris Wehan took 2nd in 6:10 and Ian Sharman 3rd in 6:17.
Karl Schnaitter finished in 8th and was the last one to break 7 hours. Team wise it was a huge show off from Excelsior again, taking 5 spots within the top 22, kudos!

After all the stress that I created for Agnès, and the short night we had as we left the Bay Area at 8 pm on Friday evening, we were both eager to hit the road and we left Auburn at 2:45 pm. By then, out of more than 600 starters, only 50 runners had finished, it was going to be a long afternoon for all, starting with all the volunteers. An extended thanks to all of them, especially as I used the aid stations much more than usual.

And a special thank to the Race Director, Julie Fingar, for letting me run this event for the 9th consecutive time (including one DNF in 2008 on asthma).
Thank you also to Tom from NorCal Ultras for checking on me after the finish, and proposing to take my blood pressure.

Here I am with Rich, after the finish (I had not realized that Rich was a 2:17 marathoner at age 29, that's way below the Olympics Trial standards! Promised, I won't be chasing Rich's record anymore, I know where my limit is now! ;-).
As closing comments, and I probably lost most of the readers that far into my post, I'd say this (for now at least, there may be more to discuss after the remaining medical tests come in): in 2014, strokes were the fifth cause of deaths in the US so this is serious stuff and I certainly want to learn more about what happened in my situation which I believe is not a common case. It certainly makes approach to life different and I'm glad Agnès found me a neurologist who also does research on strokes and has an open mindset to look at every hypothesis. With all I learned so far but also a lack of definitive explanation, I find it challenging to classify what happened to me: it doesn't seem to be a known injury, nor does it look like a sickness. It's not an injury of a body part to be fixed. And it's not a sickness in steady state. You just don't want another stroke to hit, yet it's uncertain what could be the cause. Was it a random accident, or an unknown injury of a blood vessel due to reaching a physical limit which I had never attained before? Or the result of some aging which has not been noticed before because nobody or so few have pushed that hard? I know these are big remaining open questions but, thanks to the medical care I received in New Jersey then in California, the most alarming assumptions have been tested and eliminated so far. I'm still waiting to hear about the heart monitor results, and hope they are able to leverage the recording from this 8-hour long stress test, that should be interesting (and probably not seen before!). Meanwhile the blood thinner should help and it felt really good to get ultra live again, even if it was at an 85% level effort.

There are many other ways to take risk and life and I was certainly not the only one today on the trails. Besides, it was an amazing day to enjoy the outdoors with great company and a super professional race organization, experience the blooming nature and see so much water in the area, although the drought is still far from being resolved. Life is wonderful and love and running are part of mine. I hope you will... forgive me!

PS: all picture credits to Agnès, my crew yesterday and love always!


Jon Olson said...

This QS runner supports you. I may think you're crazy, but its a family decision for you all, not a decision for us internet-followers. I have a heart device (ICD) and people think I'm crazy to have a hobby where I'm out on the trails for more than half a day. But I love it. It has helped me maintain a healthy life and pushed me mentally more then anything I ever done.
Congrats on the finish. Go QS Ultra Team! The HR data will be great for the doctors to review. I wish my 80% could be anywhere close to a sub-8 hr 50miler.

Rest and recovery.


Pierre Haren said...

Jean, you are amazing. But I think Agnes is even more to be congratulated for the support she has given you in the past... almost 30 years. We want to enjoy many more years with you Jean, please stay rational.

Unknown said...

Congrats Jean - I saw you sneak to the line front just as they called the race start!
I came to the race on the bus with Ian Sharman and told him I thought you would not be there this morning!
I applaud your decision to toe the line obviously a decision made with much thought. Yes many would call you crazy, but they are probably the same people who call us all crazy for participating at all in these events we love so much.
Yes the "Meat Grinder" was tough and hot - but I know you like that.

runstephane said...

Great! Great time on the trails, great day, great decision. Indulgence, in fact ;+)
But every ultrarunner knows that the danger is to run two marathons a year, not twice marathon in a single day!
Take care and enjoy. And...full awards to Agnès who must make difficult decisions!

Suman Ganapathy said...

Jean, you are both extraordinary!!! Kudos to your passion, determination and strength!!!

Agnes, you have such incredibly strength, love and support for Jean. The perfect husband-wife team!!!

Wishing you both the very best!!!

Suman Ganapathy said...

Ugh, the edits didn't take...pardon the crazy sentences. I should have previewed them...

Suman Ganapathy said...

Ugh, the edits didn't take...pardon the crazy sentences. I should have previewed them...

Anonymous said...

Jean - nice work out there on the AM50. I will congratulate your inspirational effort w/a hand shake when I see you at North First Steet.
Paul Sackles

Anonymous said...

Life is random. Keep on keeping on. If its not one thing, its another. Shit wears out. No one survives.