I must be mad..

2 and a half weeks to go to the Himalayan 100. To say I'm petrified would be the understatement of the Century.  This will be the biggest challenge and the craziest adventure of my life. 

I reckon it'll be up there with surviving peritonitis and 5 major bowel surgeries. Although I guess if I can get through that lot, then maybe I've got a chance with the Himalayan 100. A new concept in how to prepare.. experience a bit of life threatening surgery to toughen you up? not sure if it'll catch on. 

I'm becoming a Himalayan 100 bore (I really am sorry!) and every waking (and sleeping) moment is consumed with thoughts of the not only the race, but the logistics. Actually.. it's all about the logistics. Consider preparing for a 100 mile race, and the distance becomes the last thing on your mind? Well that's where I'm at. 

The logistics of flying to Delhi, then onwards to Bagdogra airport is enough to keep me awake at night, let alone the thought of what will come when we get to the Himalayas. Then there's the visa, the jabs, the altitude training.. oh and did I mention the actually running training?! and not forgetting organising the kids and work back at home whilst I'm away.

The 57 page race booklet arrived from the organisers last week. It includes a baggage flow chart, a long list of essential medical and first aid supplies (I have just purchased a sterile first aid kit including needles and a canula) and a kit list that would make Bear Grylls panic.  And that's without packing all my ileostomy supplies! one thing even Bear Grylls doesn't have to worry about..

I'm beginning to question my sanity if I'm honest. Reading other blogs from previous participants indicates that vomiting, pain, exhaustion, illness and tears are regular features. Good God. What am I letting myself in for?! (Mum I hope you're not reading this). On the flip side, I get to participate in what is considered the most beautiful trail race in the World with views of Everest, Kanchenjunga, Lhotse and Makalu - 4 of the 5 highest peaks on the planet. It'll likely be one of those 'once in a lifetime' experiences and will be worth every bit of pain, lack of sleep and vomit! or at least it better had be. And this is the view that will hopefully make the whole thing worthwhile...

But in the meantime, I've still got plenty of training to do. Holding myself together with a combination of CEP Compression socks, massage from my friend Richard and physio from  the wonderful Michelle Trott and an excessive intake of Quest Immune Biotix vitamins I've got some more long runs to knock out over the next couple of weekends. So far things are going ok (dare I say it!) and without wanting to tempt fate, I'm feeling stronger, fitter and healthier than I have in over 4 years.  But there's still plenty that can go wrong. All it'll take is a calf tweak, a hurty knee or a sore throat or cold to put a spanner in the works. 

The whole thing is exhausting, stressful and beyond scary. And I'm not even there yet! Why do we do this to ourselves?! 

Follow me on twitter @runfitsarah

Altitude Training

Last week I took a trip to TheAltitude Centre in London to get some advice from the experts about how I might cope with the altitude in the Himalayas.

I will be running at a maximum of around 3500m for half of the event. At that level oxygen is around 13% compared to 21% at normal sea level. It will add another dimension to the challenge and could make things very uncomfortable, so I was keen to find out how I might cope and what strategies I could take to prepare better.

The higher you go, the oxygen level in the air decreases and your body has to work harder to sustain the same pace. Some people have an unfortunate reaction to altitude and suffer mountain sickness, nausea, headaches and is often so debilitating, they don’t make the summit or complete the event. 

The Altitude Centre, London boasts the biggest altitude chamber in England and is situated near Cannon Street in the City. Staffed by experts in sport science it is used by all manner of mountaineers, marathon and ultra runners looking to improve performance, but also by every day runners trying to lose weight or just to get an extra edge to their fitness. 

The benefits of training at altitude mean that when you then exercise at ‘normal’ oxygen levels, your body is more efficient and able to utilise oxygen more effectively. Precisely the reason why elite runners train at altitude in the Rockies or in the USA, so when they return to sea level their performance is enhanced. Training in a hypoxic chamber is also vital to prepare if, like me, you’re going to be running at altitude or mountaineering.  Even for recreational runners, training in a hypoxic state will raise your metabolism, aid weight loss and improve your fitness.

The main chamber (which contains a number of treadmills and spin bikes) is set at just under 2800m, which is around 14% oxygen. Immediately upon entering the chamber it felt cold and my breathing rate felt just a little higher, but nothing dramatic. Sam, a sport science student from Bath Uni, explained that my heart rate and blood oxygen level would start to decrease in response to the lack of oxygen, just by being in the chamber. 

He then took me through a hypoxic sensitivity test to see how I’d respond to higher altitude.  I had to breathe normally wearing a mask which delivered only 11% oxygen – the equivalent of being at 5000m. My heart rate and blood oxygen level started to drop immediately and I could feel myself need to suck in more air and breathe more deeply. Sam watched to see how quickly my blood oxygen level dropped to 85%. Average time is around 60 seconds. Longer is better. Mine took 130 seconds which means that (hopefully!) I’m won't be particularly sensitive to altitude sickness. Result! Sadly I can’t claim it’s because of any superior fitness or anything I’ve been doing, it’s just good luck and down to good genes. 

In fact there is some evidence that elite athletes may actually suffer more at altitude. Onto the treadmill and I had a gentle run in the main chamber at 2800m. Interval training brings about the best results, so I’ll be going back to have a crack at some harder stuff to try and acclimatise before I go to the Himalayas.  Fascinating stuff and another tick in the 'confidence' box. 

How to train for the Himalayan 100

The Himalayan 100 is a stage race comprising 5 days of running - 24, 20, 26, 13 and 17 mile stages. Day 3 is actually the Everest marathon and a full distance of 26.2 miles. 

But like any ultra event, the distance is only part of the challenge. The terrain in the mountains will be rough and rocky and the altitude will be a major hurdle to deal with. The highest point is around 3500m, which is high enough to cause some issues, possible mountain sickness and headaches. Then there's the issue of lack of sleep, change in food, risk of stomach upset and dehydration. 

At only 4 weeks away, I'm in that horrible phase where I can't afford to catch a cold, get ill or pick up an injury. I'm eating, breathing and sleeping the Himalayas and my entire life is being consumed by preparation and training. It's a very fine balance between doing enough training but not too much which will tip me over into injury. If you've ever run a marathon or an ultra you'll know exactly what I'm talking about. 30% of people who enter a marathon never make the startline. I'm pretty sure most of them will be because of injury, doing too much too soon or pushing too hard and burning out/getting ill.

I'm a firm believer that training doesn't need to be complicated and to a certain extent that 'less is more'. Having run the Jungfrau marathon only 12 months ago I know that I can still do the distance and on challenging terrain. But this isn't just one marathon. It's effectively 4 marathons split over 5 days. Piece of cake then..

So, what sort of training am I doing? Well it's not as you might think. I'm not following a classic 'marathon' training plan, or indeed any sort of plan. I'm pretty much making it up as I go depending on how I feel and how I'm recovering. All my running is at a comfortable pace and I'm running through lovely countryside and challenging terrain. No speed work and lots of jog/walk on the trails. Training really doesn't need to be difficult.. keep it simple. Just think about the demands of the event then match your training to those demands.                                                                                            

So, I'm trying to focus on building up my long trail runs, up to 4-5 hours. Just easy steady pace, walking up hills and concentrating on time on my feet, not on distance. Much of the Himalayan 100 will be un-runable due to the altitude and elevation, which suits me as I'm quite happy hiking up a mountain in the Lakes for hours on end. To address that I'm doing lots of squats on my TRX and plenty of walking outside of my running training. 

But it's not just the 'long run' that needs focus. I'm also trying to build up consistency and the ability to run long back to back. This requires rapid recovery after a run, then out again the next day for another long trot. This weekend just gone, I did 2 hours on Saturday, then 3.5 hours on Sunday. Then a 90 min hike after that. I have no idea if this strategy will work! I'll let you know in 5 weeks time.. 

But staying injury free is the biggest hurdle. Putting in the miles is all very well, but the stuff we do outside of training is just as important. I'm virtually living on my foam roller and trigger ball and try to spend 30-60 mins a day doing various exercises and myofascial release techniques. I'm fairly sure this is the only reason I can still run well and (touching wood) injury free so far. If you're a runner and don't own a ball or foam roller, then you're missing a trick. Go and buy one immediately! My weapon of choice is The Grid from Trigger Point therapy and also the trigger ball by the same company. Great products and great online advice. 

It's true. The more we run, the more 'stuff' we have to do outside of running to support the extra training. Massage, strength work, nutrition, sleeping and foam rolling all takes even more time, but it's worth it for an epic 'once in a lifetime' event.

Yes, preparing for an event like this is overwhelming and stressful. There's so much to think about and so much that could go wrong, not just now, but at any time over the next 4 weeks and during the event itself. It's like living on a knife edge and I could fall off at any time (I did back in 2010 when I was training for the Ironman, got ill and never made it).  All I can do is prepare, get organised, look after myself and pray that nothing goes wrong. But with each successful run (and recovery) my confidence grows and I'm beginning to feel like this might be possible. All I need to do is stay balanced on that edge.. and not fall off.

My craziest adventure yet..

You know those running events that when you first discover them, it takes your breath away? You just know that you HAVE to do it - no matter what. Maybe not tomorrow, but definitely one day. 

Well for me that's the Himalayan 100 mile stage race. 100 miles of trail running over 5 days. Considered by many to be the most stunning race in the whole World. Strangely achievable - so they say - and without doubt a 'once in a lifetime' experience. I get goosebumps just thinking about it.

It was top of my 'to do' list long before I ever got ill, and it's never gone away. Strangely enough my illness has only made me more determined to live life to the full. To tackle those things that seem a bit out of reach and not to wait until tomorrow, next week or next year.. because when you've been through a major trauma.. you know it might never come. 

So, when I was invited to participate in the Himalayan 100 as a journalist and to write a feature for Running fitness magazine, who was I to say no!? So in 6 weeks today I'll be on a plane to Delhi to take on what will undoubtedly be the most challenging and epic adventure of my life.  I'm going to the Himalayas!!! Oh. My. God.

It would have been an immense undertaking before I ever got ill, but now with a stoma in tow, there will be a whole additional set of challenges. The biggest being dehydration, the risk of low electrolytes (which seems to be my biggest problem) and my limited diet/nutrition. For the average person a stomach upset might throw a spanner in the works, but for me it could be a show stopper, if not hospitalisation or worse. 

Friends and family ask me how far I have to run.. and when I say 100 miles - in the Himalayas - at altitude - with a stoma - they shake their heads in disbelief, as if I'm some crazy lady. And perhaps they have a point. There can't be too many 42 year old mothers with ileostomies who would even consider it. But then that takes me back to my original point.. life is just too damn short not to do things you dream of. Even if you have a stoma. 

So.. over the next few weeks, I'm going to be blogging about my preparation, training, and plans as I get ready for the trip and the race. I'm going to share the ups and downs, the good bits and the ugly bits..  and for anyone else living with a stoma, or about to have surgery to create one, a little bit of hope and inspiration that anything really is possible. 

Life really does go on after such horrible illness and surgery - and for some people it can even be better with an ileostomy. 

And just a quick recap, if you're still not sure what a stoma or ileostomy actually is.. check out an old blog http://bagthatruns.blogspot.co.uk/2013/10/me-and-my-fake-stomach.html

That fantastic quote above just about sums it exactly where I'm at. Cue more goosebumps... 

Please share, follow and stay tuned.. the best is yet to come. 

A line in the sand

I'm in a really good place with my training and running at the moment. I feel like I've reached a state of calm acceptance. Not so much about my stoma - I've never really had a problem with it - but rather about how it fits into my life and it's relation to my running and training. 

To begin with, my instinct was to fight and be strong. I just wanted to 'get back' to where I'd been before and prove to the world it wasn't going to stop me. But over time (in June it will be 4 years since I first took ill), I've realised it's more healthy to accept things as they are and be content with where I am and not put too much pressure on myself.

For anyone else (especially athletes) going through anything similar - be it cancer, illness, trauma or after an accident or long standing injury - I think it's important to step back and try to forget the past and what you used to be able to do. Things have changed, your body has changed. There's a world of difference between 'giving up' and calmly 'accepting' where you're at and being at peace with it and moving on from there... possibly in a new - and even better - direction.

I've finally drawn a line in the sand and moved on. I don't need to prove anything to anyone or myself. I'm happy just pottering about, enjoying my running and training and having some fun races to take part in. I feel calm and proud of my achievements, rather than fighting for the next PB or beating myself up that I haven't achieved what I used to be able to do.

I'm coaching some fantastic clients training for spring marathons and getting as much enjoyment out of training them as I would myself. I've also decided not to take part in the London Marathon nor the Half Ironman I had my sights on later in the year. And I don't feel bad about it either! It's taken a while, but I'm finally there. Who knows what the future will hold and where it will take me. In itself that's exciting! I fancy some adventure racing, some orienteering, maybe some other mountain marathons and night races. Just fun stuff. What I have decided though is never to run a race that I've ever done before. Who needs that sort of comparison!? far too depressing.

Don't get me wrong, I still have some great events lined up, but there's no pressure or focus on PB's or time. I'm doing the Adidas Thunder Run with the Ostomy Lifestyle Athletes team - everyone in the team has a stoma - which is probably a first. The event is a 24 hour non-stop team relay where we have to run as many 10km laps as possible. It'll be great fun and a 'doable' challenge. I can't wait to be part of a team of likeminded folk who all understand what we've gone through to get where we are.  I'm also doing the South Downs Relay marathon with my running group Sarah's Runners - again another team effort and focus on fun and enjoyment with some really lovely people. And in May I'm dressing up as a superhero to run 10km. No pressure, no PB hunting and no competition. That's what I need at the moment and I'm really happy with that.

The Kubler Ross curve sums up this process, but it's easy to forget it when you're in the middle of it. You may not be aware of the stage you're at, but it can be helpful to understand this natural reaction to shock/change/grief. This applies to bereavement, major life changes, tragic and traumatic events but also simple change in life, at work or in business. 

And that is the fantastic thing about running. It can fit into your life and adapt with you as you go through various life challenges or changes. The trick however (and possibly the harder part) is to ALLOW it to adapt and use your running to support you rather than battling with it. Like the quote in the image above says:

'Surrender to what is, Let go of what was, Have faith in what will be'. Sonia Ricotti

And I think we can apply that to many areas of life actually, not just running.

Onwards and upwards? not quite

Brighton 10km 2013

Brighton 10km is an annual event for my running group and one we look forward to with great excitement. Last year I'd literally just had major surgery, so couldn't go and spent the day feeling glum and missing out on all the fun.

This year we had a gang of around 35 runners take part - some of them their first ever race. It's a nice race, flat and straight along the seafront. Perfect for your first 10km and a fab day out with some great friends. 

On a personal level, I'd love to say that I'd run another PBPB (post bag PB) but it seems my new running journey is going to be strewn with new and different challenges and the odd annoying spoke in the works.

I'd not been feeling 100% for a few days leading up to the race. Struggling to get my electrolyte levels balanced and suffering from high output losses from my stoma. Feeling spaced out, headachey and cold and jittery are sure signs that something isn't right. Sometimes it goes through phases like that we haven't quite figured out why - or how to treat it properly.

It's frustrating, especially given I'd run a really good 10km earlier in the summer in Rye and then the Jungfrau marathon, where thankfully I wasn't having the same sorts of issues. I had felt like things were moving onwards and upwards! 

Anyway, just prior to the race as I was leading the warm up, one of the ladies quietly said to me 'You're not feeling well are you?'.. incredibly perceptive, kind and intuitive of her, given that she was focused on her own race, but took the time to notice I wasn't firing on all cylinders.  Up until that point I'd been trying to ignore it. It shook me out of my denial and I confessed that 'no I wasn't'. But with only 20 mins to go before the race I still wasn't sure how to tackle it. Should I go all out and just see what happened? or jog along with one of the other ladies and forget all about it? I guess I never really got that bit clear in my head and found myself on the start line without any sort of plan.

After 2km it was clear that it wasn't going to be great. I felt really nauseous and weak. My heartrate wouldn't go higher than 158bpm and I just didn't really care anymore. I backed off the pace and decided I just had to endure it and get round. I didn't look at my watch once the whole way round and was a little surprised to see 48 mins when I crossed the line.. it had felt much much slower.

Straight away afterwards though I realised I wasn't feeling too great at all. Very tearful, shivery, cold and shaky. I managed to drink some electrolytes and some great friends got me sorted with clothes, hot chocolate, hugs and salty chips which helped and I perked up fairly quickly. 

But it certainly knocked the wind from my sails and I felt a little scared that I'm still not on top of things.

I was just starting to rebuild a little bit of confidence in my body, but something like this is enough to shatter it again. How on earth will I ever manage a marathon or the half Ironman I've got planned later in the year if I can't manage my electrolyte levels properly?

There's part of me that want's to be 'fine'. I've got a stoma now, it's fixed everything and I can do whatever I like.. I don't like making excuses for poor performances.. but sometimes I need to give myself a break and realise that there is a valid reason.

It's time to get my head out of the sand and seek out some consistent medical support to help me manage things - especially since I want to train and compete. So.. it's back to see some specialists I think. I need to address why I have such high output and electrolyte losses and get to grips with that first. 

Today I'm feeling a mixture of frustration, anger.. and also a little fearful that this might be as good as it gets. But that's probably just the 'post race blues' talking. 48 mins for a 10km still isn't bad in the scheme of things. But its' just frustrating when I know I can achieve much more.

Despite my own poor race however, the rest of the group were just fantastic with some amazing results and lots of 'first 10km' performances. They were all chuffed to bits with themselves! I'm so very proud of all of them and it's an absolute honour to be their coach and leader.

Me and my 'fake stomach'

I'll be honest. I'd never heard of an ileostomy before I had one - and I consider myself to be pretty knowledgeable about medical stuff.  I'd heard of people having a 'bag' but hadn't really stopped to think how it worked or what it was. I also didn't know anyone who had one.

Now of course I know lots of people - both locally and virtually - and it's quite interesting how common it actually is. I even have a running friend who has an 11 year old daughter with one. I read a stat somewhere that around 150,000 people in the UK have either an ileostomy or a colostomy. Despite that however, it's not the normal topic of conversation at your average dinner party and still something people feel uncomfortable talking about. Mention the word bowels or poo and people start to squirm. 

I was asked by a lovely well meaning friend the other day how I was getting on with my 'fake stomach'.. so on that basis, I thought I'd make this blog post a little more educational. 

I have something called an ileostomy. It was required to 'bypass' my colon (large bowel) which had decided to stop working properly. Some people have an ileostomy when they have crohns, colitis or cancer. Mine was due to diverticulitis which I didn't know I had.

My small bowel (at the ileum - hence the name ileostomy) has been brought out through a hole in my stomach wall. The surgeon stitched the bowel to my skin to create an opening called a stoma. This photo shows what it looks like (this isn't MY actual stomach but a fairly nice looking stoma). By the way NEVER google 'Ileostomy images'... especially if you're about to have surgery for one! 

All the waste from my digestive system comes out of my body through this little stoma (basically I don't poo normally). It outputs waste all the time and I suppose a bit like having diahorrea 24/7. I have to wear a bag over the stoma to contain the 'output' and then empty the bag a number of times a day. Apologies if that's a little too much information... but hey! we all eat and poo. Just now I do it slightly differently.

A colostomy (sometimes used as an overall term) is slightly different and is where the large bowel is used to create the stoma. It's usually on the left side of the body and lower down. A urostomy is where a stoma is made to empty the bladder to a bag on the outside. Basically someone who has one of these procedures is known as 'ostomist'.. although we prefer 'optimist'.. which is sort of the same thing :-)

Anyway.. that's about it really. Kind of amazing when you think about it. For the most part it works pretty well.. other times, it makes very inappropriate noises! occasionally the bag peels off and leaks and that's not much fun AT ALL (especially when you're out on a bike!). Other times I get very high output and feel a bit ill due to lack of electrolytes and sometimes the skin around the stoma can get sore which itches like crazy. But generally it does what it's meant to and I hardly notice it's there. Which suits me just fine :-) It's one of those things that sounds and looks pretty grim, but the reality is that it's nowhere near as bad as you think it's going to be.

My friend Helen at the Ostomy Lifestyle Charity has created this great little video to explain exactly how our digestive system works and what's involved in creating a stoma.