Post 36 - Ironman UK dissection

It’s 8 days after Ironman UK. What a nightmare it turned out to be. I thought it would be a good day. A great day. I had worked hard enough for it. I was in shape to qualify. Training had gone as well as it could have been expected to go, given my circumstances. I was really pleased, until I had that massage and ended up in hospital. The three weeks from having the massage, going to hospital, being in a very bad way, trying to recover, agonising over whether or not to start the race, travelling up to Bolton for the race weekend, racing and ultimately pulling out were a total nightmare, and I’m so glad and relieved it’s over, and disappointed with how it turned out.

I knew when I was in hospital that my Kona chances were severely diminished, but I having talked with quite a few experts, I finally arrived at the decision that it was worth starting to see if I had the performance in me. That way, there would be no “what-ifs”. Before I got sick, I’d have said that I had a really good chance of qualifying. I would never be complacent, but I knew I was in great shape. After getting sick, I knew that there wasn’t much chance. That’s nothing to do with doubting my physical or mental capacities, but if medically I am unable to perform, no amount of prior physical fitness or mental toughness can return those lost percentages. It needs time and patience. To qualify for Kona, everything needs to be perfect, or as near as dammit, and I knew things were a long way off perfect.

The Saturday at Ironman UK is a logistical nightmare. There is so much driving and setting up to do. The key areas (start/T1, T2, finish area) are all miles apart and it takes ages to set up. Plus, the new bike course had to be driven and viewed. So Saturday wasn’t a fun, feet-up type of day.

Bags in T1

 

 

Race morning stuff, for the swim and bike

 

 

Herded in...

Anyway, race morning came, and it all felt so surreal, like it wasn’t really happening. To be honest, I was crapping myself. Scared of it. I got in the water and swam my first lap. I kept away off to one side and out of the scrum. I felt OK on the first lap, and when I exited the water for the first time I had a glance at my watch. It said 28-something. Last year at halfway through the swim it said 27-something, so my initial reaction after half the swim was “not too bad”. I continued to swim at the same effort level, thinking I’d finish the swim in 57 or 58 minutes. Last year I did 55. It started to drag a bit, my goggles leaked a bit, sighting became difficult, and when I got out of the water and completed the swim, my watch said 61. Bummer. Not what I wanted. Again, I didn’t feel terrible, I felt I had put in a decent effort, but I just didn’t get back the speed that I normally would if I was 100%. 61 minutes was a poor swim. I was 6 minutes down on last year after only an hour.

If my physical sharpness was down, so was my mental sharpness. I did things in the wrong order in transition. I took my goggles off before trying to get my wetsuit off. Normally you would leave them on your head, but I was struggling to get out of my wetsuit with my goggles in my hand. Silly. I finally got out of my wetsuit and struggled into my tight bike jersey and got out onto the bike.

 

Swim start scrum

 

Come off!

At this point, I got a first look at my heart rate. Normally a few minutes in transition would bring it down, and I was hoping it would be 130 or so. It was 165. Really high. It took about 30 minutes of very easy cycling to bring it down to 150. And that was the story of the bike – I had to cycle easier than I wanted to maintain a suitable heart rate. If I tried to go at the speed I wanted to, the heart rate would climb. So again, I wasn’t getting back the speed that my effort would normally get me. I soldiered on, kept eating and drinking, and it was a tough cycle.

Last year it was a 3-lap route with one major climb on each lap. Three climbs in total. This year it was a 2-lap route on tighter, twistier, bumpier roads. With loads more climbing. And wind too. No chance of getting into any kind of a rhythm. The absolute antithesis of the Icknield 100 mile time trial. I had some words with a Belgian guy who was sitting in my slipstream on a really exposed part of the course. My heart rate was over 170 going into a strong headwind. It was tough. I could sense someone sitting on my wheel, getting a free ride. Drafting/slipstreaming is illegal in Ironman races, and should result in disqualification. Ironman UK was not particularly well marshalled.

He was on my wheel for long enough to get me annoyed. At the same time as I dropped back to give him an earful, an English competitor started telling him to ride his own race. I told him to get off my wheel and stop cheating. He seemed to plead ignorance, but dropped off. A few miles later, he came past me. “Hey crazy Irish guy, you are f*cking crazy….” The English guy was still in the vicinity and between the two of us we told him to respect the rules. He kept arguing, claiming the roads were too tight and there were too many cyclists around to keep the required 10 metre distance. This was total rubbish, as we had been on the widest and most open part of the course when he was doing his wheelsucking. My heart rate was spiking with all the chit-chat, so I decided not to waste any more energy on him. I just gave him a growl and rode off.

 

 

Going up Sheephouse Lane (the main climb) for the second time, I had reeled in the female pros. I went up side by side with Joanna Carritt, and we rode together over a massive cock-a-doodle-doo someone had painted on the road, in obvious defiance of the pre-race warnings: “Do not mark the road, you will be prosecuted.” Joanna and I looked at it, and laughed, and she said, “Nothing like a massive knob to inspire you!” And with that, she took her inspiration and off she went. For the remaining ten minutes of the climb, she must have taken about two minutes out of me. Who needs names painted on the road, when a big cock-a-doodle-doo makes you climb like she did…?!

And so the ride passed in a haze of mediocrity. The final big climb at 95 miles or so was an absolute killer. It kicked up to a 17% gradient, which I went up at about 5mph. Painful. It was a much tougher bike course that last year, and comparable to the Ironman Wales bike course for toughness. I finished in 5:39. I had been hoping for something like 5:20. Bummer.

I really screwed up T2. I didn’t loosen my shoes coming into transition. In the transition tent, I forgot where I had hung my T2 bike-to-run bag. Then I forgot what number I was. Then the marshal could see I was totally lost in a sea of red bags, and asked me what my number was. And I told her the wrong number, and lifted the wrong bag. Then she saw my number on my back, and I finally got the right bag. Then I proceeded to put my run top on inside out. I don’t know how I managed this. Then I ran off leaving my sunglasses on the chair in the tent, and thankfully the marshal yelled after me, and I picked them up. There was a horrible hill on the first half-mile up to the main course, then after that I actually felt that I was running reasonably well.

 

 

However, given that I was between the second and third female pros, and given that I’d had such a mediocre race, I guessed I was some way off where I needed to be to qualify for Kona. I’d have guessed I was in the top twenty in my age group at that stage. Maybe top 50 or 60 overall. Still in the top 3% overall, but a long way off what I needed for Kona. After a few miles, I felt I had it in me to finish, and probably to finish pretty well, but I knew I wasn’t going to run a sub-3 hour marathon to get me to Kona. When I got onto the looped part of the course, I could see runners heading back into town when I was still heading out to the turn. I could tell by their race numbers what age group they were in, and this confirmed that there was no way I was going to qualify. There were too many of them ahead of me.  

I had pretty much realised on the bike and swim that today wasn’t going to be my day. There’s no way my level of output was good enough to qualify. So I made the decision to call it a day. I wouldn’t call it giving up. I would call it keeping an eye on the bigger picture and thinking about my future options. There was no point in destroying my legs for 26 miles of a marathon. I had been thinking about Ironman Wales, 2 months away. If I was to enter Wales, hopefully with the infection and illness well and truly behind me, then running the full marathon in Bolton wouldn’t have been a good idea. Only having run 10 miles of the marathon will mean I won’t need much recovery time, and this will be better for my Wales preparation.

I wasn’t too disappointed in calling it a day. I’d already suffered the emotions in hospital. I’d had quite a few people travel long distances to this race to support me and I was disappointed for them – my parents, Elise, Steve, Natalie and Kim. Particular thanks to Elise who endured the entire awful race weekend, all the driving, and all the annoying stressful details. It should have been such a good day, but things just didn’t work out. For the third race in a row, I’ve had Kona within reach and it has been derailed.

 

Ugh

I went to the medical tent and had a full check-up, including an electrocardiogram. I was given the all-clear. By this stage, the first finishers were starting to come through. I saw the first 3 finishers in my age group come through within a minute of each other, in 9:45. I didn’t feel that 9:45 would have been beyond me on a better day. But none of this matters. All that matters is that I didn’t/couldn’t perform at Bolton. Which means that I won’t be going to Hawaii in October 2014.

 

The elusive finish

 

Bikes in T2

 

So yes, I’ve entered Ironman Wales, on 14^th September. It’s probably the toughest Ironman in the world. I did it last year and was one position off qualifying. I will battle jellyfish, cold rough seas, obscene hills, bumpy roads, wind and rain (probably), cobblestones, lonely roads, and endless miles, and I’ll try again to qualify for Kona. I still believe I can do it. I hope I will be better recovered. I will know the course in Wales this time, unlike last year. Logistically, Wales is much easier. If I qualify at Wales, I’ll be going to Hawaii in October 2015. I don’t know where I’ll be based in October 2015. I might be in London, I might be in South Korea with work, or I might be elsewhere. However, it looks like I will get an unbroken 6 or 7 weeks until Wales, and I’ll deal with the consequences of what happens in Wales when Wales is over.

It’s a tough gig, this Ironman business… You fight and fight and try and try and put so much in, and you can just be dealt the most ridiculous curveballs that can totally derail everything. But, you can also dust yourself down and try again…

Post 35: Post-race

...Another DNF. The third Ironman in the past year that Hawaii has been there for me, and the third Ironman in a row that has gone pear-shaped. I just didn't have the top-end performance that I needed today, because of what I've been through in the last 3 weeks and because I'm obviously not fully recovered. 

For the level of effort I was putting in today, I wasn't hitting the speeds I should have been in the swim and on the bike. I ran 10 miles of the marathon and called it a day. I didn't feel terrible and I wasn't sick or anything, I just didn't think there was any point in destroying myself for the full marathon, for no real reason. 

Then I went to get checked out in the medical tent. I got the all-clear, and it could have ended a lot worse today to be honest. I could have soldiered on and finished in a time that many would consider to be pretty good, but I wouldn't have achieved anything other than needing a month to recover if I had done the full marathon. Only running ten miles means my legs won't need much recovery time.  

I have a notion that Ironman Wales in September might be on the radar, so from that point of view, only running ten miles today was sensible. I've seen the results from today and there's no doubt I would have done it if I hadn't had the problems in the last 3 weeks.  I'm sure I'll dissect it in more detail later and put some thought into what I'm going to do in the months and year(s) to come. 

For now, I'm going to bed. I wish I hadn't had that massage.

Post 34: Pre-race

So, everything is racked and ready.  I wonder what I'll be blogging about in 24 hours. A google search for "Ironman live tracker" or "Ironman UK athlete live timing" or words to that effect will bring up the live race tracker. I'm number 537... The swim starts at 6am BST...

Post 33 - Decision

So, I am racing on Sunday. I'm at the race venue now. I have registered. I've got my race number, swim hat, bike stickers, official programme, and so on. It was a long drive from London to Bolton. The roads were really congested. It was a roasting hot day. Storms are forecast tomorrow but race day should be OK.

I'm not particularly happy about racing, but equally I wouldn't be particularly happy about not racing either. If I didn't race, I'd never know. If I do race, I won't fulfil my potential, regardless of how I do, and I also don't want to do any long-term damage, or end up collapsing or something.

But, I've done a few sharp training sessions in the last week, and they have seemed OK. When I'm not training, my heart rate has been a bit elevated and has been fluctuating, and I've also had a sore head. Stress is probably not helping, as it has been a stressful time since my hospital stay.

A couple of days ago I was medically checked out and I've been told that everything seems normal - chest, lungs, blood pressure, heartbeat and so on. So, I'm going to give the race a go, and I'll be monitoring my heart rate and my body really carefully, and if it doesn't seem right, then I will pull out of the race, and be on the safe side. Hopefully I will live to fight another day if this happens, most likely in Wales in September.

Sleep time now...

Post 32 - Hmmmmmmm

My Twitter account is on https://twitter.com/Tri4Kona2014

One week before race day and I thought I'd be blogging about how well my taper is going and how great I feel, both physically and mentally. How things change. I've tried to ease back into training this week, but I have had to be aware that I've had a pretty serious infection, that I'm not long off the very strong antibiotics that I was prescribed, and I have to accept that the recovery from this is going to take time. Ideally more time than the week I have left before Ironman UK. My plan was to do some really easy training in the first part of this week, and then push myself at the weekend. If I'm hoping to compete at Ironman UK next week I needed to push myself in training to see how I would go.

Training done this week was as follows:

Monday 7th July 2014: 30 minute turbo, 20 minute run
Tuesday 8th July 2014: Rest
Wed 9th July 2014: Swim 2km
Thurs 10th July 2014: 30 minute turbo, 20 minute run
Friday 11th July 2014: 1 hour turbo (single leg drills: 6 x 3L, 3R, 3B)
Saturday 12th July 2014: 2:10 turbo (progressively tougher), 30 minute run
Sunday 13th July 2014: Swim 2.5km, 40 minute fartlek run

Totals: Swim 4.5km, Bike 84 miles, Run 15 miles

Earlier in the week, my training intensity was intentionally very, very low. I was probably not doing enough to stop my muscles gradually de-toning and wasting, but on the other hand, I was still probably doing more than I should have to optimise my recovery. It has been a very difficult thing to judge, balancing the recovery with the attempts to maintain fitness and muscle tone. My body feels really strange at the minute. I've developed lots of little niggles: a sore left groin. A sore right knee. A sore right hamstring. A sore left foot. A sore upper back/lower neck. Everything is a bit haywire at the minute. It really doesn't feel like a week before an Ironman.

 My legs are improving - no more pus...

I kept a close eye on my heart rate during the tougher sessions at the weekend. When training, it wasn't much elevated above what I would expect. However, I still have a sore head, and running seems to make it worse. It turns into a pounding headache when I run. My resting heart rate is usually 40-45bpm. Right now, I would expect it to be 40-45, but it is currently 64bpm. 20 above normal. This is a bit worrying, and a sure sign that I'm not yet recovered, particularly for high-level, top-end, prolonged endurance performance. I've still got another week, but the waiting game and the unknown factors are tough.

I had a 13-hour sleep on Friday night, and then didn't sleep well last night. Perhaps this was because I was only awake for 10 hours on Saturday, or perhaps my sleep is still disrupted because I'm not totally recovered.

Realistically, it's looking like qualifying at Bolton next week is slipping away. I need to be operating as close to 100% perfection with regards to my top-end performance to have a chance of qualifying. I'm not sure in my state that I can operate at the level needed, the level I was at a few weeks ago. That's not defeatist, that is circumstantial and a medical fact. An Ironman is a tough thing to do, especially at my intensity level. I'm very lean at the minute, not much fat, I was really fit, my legs and muscles feel good, but if my body needs time to recover after fighting a serious infection and after having had strong antibiotics, there's not much I can do. Sure, I could go to the race, cruise round, finish in 14 hours and pick up a medal. But I'm not interested in doing that.

Since the start of 2014, I have swam almost 150km, cycled almost 4000km and run nearly 700km. I've done endless stretching, weights, core work, foam rolling, I've eaten such a good diet. I've done everything I could. It's so frustrating to see it slipping away.

If Bolton doesn't happen, it looks like Ironman Wales in September might be a Plan B. However, this is where things get complicated. Ironman Wales in September 2014 is a qualifier for Hawaii in October 2015. I have the opportunity to go to South Korea with work, starting pretty soon, for up to 2 years. From a career and a financial point of view, Korea would be a good thing. Plus, Korea is not London.

However, things have changed in the last year and I have become a reasonably good Ironman triathlete. I have got high ambitions beyond Kona that will require another year of tough training to fulfil. Going to Korea would probably kill my triathlon ambitions, for a variety of reasons - long hours, strange diet, very limited access to physios/osteos etc. It has taken me 2 and a half years to get myself a good training set-up in London and to find a decent house to live in. I'd be giving up a lot to go to Korea. My Ironman triathlon career is a lot more finite than my actual work career.

So, big decisions to make, and I might not even have a result at Bolton to factor into the decision...

Post 31 - Recovery

My current situation is not something I could ever have foreseen, and not where I want to be a week before the race. On a day-to-day basis, I'm fine. Even when I was in hospital, I was "fine" for getting about, eating, and so on. My legs are healing, although the skin is still damaged and itchy. I still have a bit of a sore head. I'm still a bit tired.

However, from the point of view of doing a high-level Ironman, it's now a complete unknown. I'm probably not "fine". I haven't pushed myself hard since 22nd June. That's a long time ago. If possible, I'd still like to compete at Ironman UK, but I don't want to go there and destroy myself to come in 10th or 20th position. It doesn't feel real any more. It's a strange feeling. It's a very different mentality now. Damage limitation.

So, because I would still like to compete, this week I have been trying to do all I can to promote recovery. I took Monday and Tuesday off work and spent most of those days in bed, even though I wanted to be up and about and training. I had to force myself to do nothing. I've been sleeping a lot. I've been drinking a lot (of water). I've been eating really nutritious food. I've been doing stretching. And, inevitably, to whatever degree, I have been losing fitness and muscle tone.

Lots and lots of sleep...

On Monday I made a pile of food for the week. I made wholewheat pasta, loads of onions, loads of peppers, loads and loads of fresh ginger, 2 lemons, loads of garlic, loads of broccoli, chilli and tomato sauce. Served with chicken, with an orange for dessert. I don't think I can do anything to make this any more nutritious..!

A nutritious mix

I've been on strong antibiotics. Antibiotics kill all the bad bacteria in your system, but they also unfortunately kill all the good bacteria too. This can leave the intestinal system very depleted. So I've been doing some research and I've been taking more glutamine the usual to try to boost myself back up. I've been eating probiotic yoghurt. I've also started taking probiotic tablets to help boost the good bacteria in my guts. Every day I take a probiotic capsule that contains 20 billion live bacteria. I take quite a few supplements each day, and they all smell fairly benign. These probiotic tablets smell different. They smell alive, somehow. I'm a little reluctant to be taking them, as they are another unknown for my body, but I think the benefits will be worth any risks.

Probiotic ingredients

I've been doing some very light training in the latter part of this week. However, I need to push myself, to learn how I will feel when I go hard, and to learn how I will respond and recover. So, this weekend I am going to do a hard bike ride on the turbo for about 2 hours, I am going to do a hard swim, and I am going to do a hard run. None of these will be absolutely flat-out, but I will be pushing myself and keeping a close eye on my heart rate. I hope it will be normal. I will then monitor how I feel in the day or two after the weekend, and this will help me to decide on whether to race or not.

I've also been in touch with a sports doctor, via Des (who gave me the massage 2 weeks ago). The doctor's opinion will also have a big bearing on my decision.

I had been worried that with the lack of training, I'd have put some weight on, but my empty weight this morning was 66kg, which I was happy with.

That'll do

I'd like to think that I will feel well enough and will receive medical clearance to start the race in Bolton. I won't know for sure until next week. If I decide to go for it, I'll get through the swim, and I'll probably get through the bike, and after a short time running, I'll know if I'm strong or not. If I'm strong and in a position to challenge for Kona qualification, I'll go for it. If I'm not strong, I will treat it as a training day and will pull out after maybe 10 miles of the run. I'll then have to look at a Plan B, which could well involve Ironman Wales in September...

For now, I need to get through the weekend, and push myself in training, and see how I feel, and keep getting lots of sleep, keep eating good food, keep drinking lots, and keep giving myself every opportunity to recover from a horrible, freak occurrence. But at least I am still here, still in one piece. At least I knew I was in trouble and knew to go to hospital - I can be quite stubborn and can fight through a lot of things that most other people wouldn't - if I hadn't gone to hospital when I did, then, well, I could have died. So at least I am still here...!

Post 30 - Hospital

A couple of weeks ago, I did a metric Ironman and was really pleased with my fitness. I thought that things were looking really good for race day on July 20th. I then took an easy week, and at the end of this easy week, had a couple of sessions of sports massage on the Saturday and Sunday. The week that has just passed was supposed to be my final tough week of training, before a 2-week taper prior to race day. Everything was looking good, and I had put so much effort in - training-wise, I hadn't missed a single session, I had been really consistent, and I had also put huge effort into controlling everything else, in an effort not to get sick or injured. So I felt that I was in great shape and ready for a really good performance at Ironman UK.

The day after this massage, my legs felt great. Or rather, my leg muscles felt great. They felt light and fresh and strong, in a way that they haven't done for a very long time. Because of all the training I do, and because I don't really get anywhere near the amount of sports massage that I should, my legs are usually very tight, but they had been well loosened out by the sports massage.

My leg muscles felt great, but my legs themselves (or rather the skin on my legs) didn't feel so great. During Monday, the skin on my legs gradually worsened, on the fronts, backs and insides of my thighs, and on the backs of my lower legs.

Monday morning...

 

Tuesday morning...

It was obvious that the hair follicles had become irritated and sore, but I put some E45 cream on my legs and went to bed at 7:30pm on Monday night, thinking that a good long sleep would help things. I didn't sleep a single wink on Monday night. My legs got worse and worse, and because very painful. I developed an excruciating headache that left me curled up in a ball, in agony. I started alternating between hot sweats and cold shivers. My bed ended up soaking wet with the sweat.

However, the athlete mentality is to shrug problems off and get on with things, so I carried on. As it turned out, I was on a course at Westminster on the Tuesday and Wednesday. I got through Tuesday, although I was struggling. Any pressure or touch on my legs was very sore, and wearing trousers meant that there was constantly pressure and pain. I got home from work, having snapped at an arsey taxi driver, and continued to carry on as normal. I got on the turbo trainer and did an hour, but I kept it easier than normal.

By Tuesday evening, my legs were tuning septic and the skin was going yellow. They looked like this:

Disgusting

I had another terrible night on Tuesday night, and started to think that I might have serious problems that weren't going to resolve themselves in a few days. After my course had finished on Wednesday afternoon, I went to a local pharmacy and showed them the photographs. The head pharmacist said I should go to the doctors' surgery around the corner and request an emergency appointment. I said that I wasn't registered with that particular surgery, but the pharmacist assured me that I would be able to get an emergency appointment.

So I stood in a queue in the doctor's surgery, listening to people in the waiting room coughing and spluttering. It's the last place I wanted to be, even for 5 minutes. It turned out that they wouldn't give me an emergency appointment, but they suggested I go to St Thomas's, the nearest hospital, to the Accident & Emergency (A&E) reception.

I knew I needed answers, but I also knew that I had training planned for this evening, I was hungry and thirsty, and didn't want my routine to be disrupted. I knew that A&E waiting times can be hours and hours. I needed sleep, and didn't want to be getting home at 2am, having missed the last train and been forced to pay a fortune for a taxi.

Anyway, I went to A&E and explained myself. It took about 3 hours to see a doctor, which was better than I thought. I still hadn't eaten, and I had resigned myself to not training this evening. The A&E doctor was a no-nonsense Spanish or Portuguese girl, not much older than me. I started off by explaining about my Ironman training, and upcoming event in less than 3 weeks, and that I was aspiring to compete at the sharp end of this race and qualify for the world championships. She seemed to understand my mentality.

She looked at my legs. "Oh my God", she said. Not exactly reassuring. I told her about my other symptoms - the sweating, the shivers, the sore heads. I was shivering now and had to put my coat on, despite it being the warmest day of the year. She did some quick tests, and established that I had got a temperature, although she said that my heart rate seemed normal. It was 75bpm. I almost laughed. I told her my resting heart rate is usually about 40bpm.

She said that I needed treating as soon as possible. She asked me how I would feel about staying in hospital for a course of IV antibiotics. I was still clinging to a faint hope that this wouldn't be so bad, that it wasn't going to compromise my Ironman, that she could give me a pill or two and send me on my way.

And now she's asking me how I feel about them shoving an IV line into my veins, and pumping me full of drugs, sticking needles into me and taking blood, and she's asking me would I like to stay in hospital for a few nights with people who are truly sick, and give up control of my sleeping and diet, everything that I've worked so hard for.

How do I feel about all this? "No, I'd really rather not do that if possible..." is what I say. But in truth, the prospect is appalling. Horrific. No way do I want to stay in hospital. I've never been in hospital in my life. I can't bear even having my blood pressure taken. A hospital stay? Less than 3 weeks before the biggest day of my life? No way. I ask about the alternatives. Can she not just give me a course of oral antibiotics and send me on my way? What if I do nothing, how long will it take me to recover?

She tells me that doing nothing isn't a viable option. In her opinion, oral antibiotics aren't a viable option either. She advises me again that in her opinion the best thing is to stay in hospital and have the IV antibiotics. She can see that I really, really, really don't want to do this. I think she understood the training mentality, and could see that I'd worked hard to get fit. I'd stood half-naked in front of her, and I know that I look lean and fit. Veins bulging everywhere. No fat anywhere. Muscles bulging out. Bones protruding everywhere. She knows by looking at me, and from what I've said, that I am a pretty serious triathlete, and she seems to understand that the upcoming race is a big deal for me.

She is also a medical professional, she knows what I need, and she can see that small talk isn't going to work. So, the head-in-hands moment arrives. Similar to Ironman UK last year, when I had just puked and crapped uncontrollably at mile 16 of the marathon when leading my age group, and when I flopped down, tried to get up, couldn't, and sat with my head in my hands. Similar also to Ironman Wales last year where I didn't pace well and couldn't summon more than 17mph in the later stages of the bike, on the flat. The horrible realisation that what you've worked so hard for, for so long, is falling apart and there's nothing you can do.

So, she got a bit tough. "Fucking hell man, this is serious shit. You've got serious problems, you have a serious infection that I think has developed into septicaemia and you need treatment NOW. You need to stay in hospital and have IV antibiotics to hit this hard. You are an intelligent man. If you choose to walk out of here, I think you might die. You have what you need to make your decision. Please make your decision." (I learned that hospital staff can only recommend treatment, patients must agree to it, and they can choose to disagree or walk away).

Head in hands. Blood drains away. Shit, there's no way out of this. Septicaemia? I don't want to die. Bloody hell. Dead silence. Finally I relented: "OK, do what you have to do."

She got straight on the phone, rattling off my condition and diagnosis, and what she thought I'd need treatment-wise. None of it sounded good. She also stressed to whoever she was talking to that I have "hospital phobia". I'm sitting in the corner, falling apart. And shivering even worse. I got taken to a temporary ward, and had blood taken for analysis. By this stage it was getting late, and when asked, they tell me that the blood results may not be back until tomorrow morning. Great, so I have all night to worry about what is actually going on.

Then they put the IV line in. It goes in my right arm, where my forearm meets my upper arm. It feels and looks horrible. This hideous thing sprouting from my arm. I can't look at it. I can't bend my right arm. Then they wheel over an IV pole, and bring the drugs. It's exactly 10pm. I have to grit my teeth and bear it and let them do what they have to do. First they flush out the IV line with saline. It feels terrible. A horrible unnatural cold, spreading up inside my arm. They hang a bottle of paracetamol from the pole and it drips into me. It takes 20 minutes. Then they flush the line again, and bring a syringe full of antibiotics. In they go, too. Then they flush the line again, close the port, and it's finished. For now. It's now 10:30pm.

Urghhhhh

It's after midnight before they bring me to my ward for the night. The emergency care short stay ward. They try to wheel me up in a chair. I'm not having that, I'm fine. So I walk. I get admitted, I get my bed in a little 4-bed bay on he 9th floor, overlooking Big Ben and the Thames. It's not a bad view. I do more blood tests, more admin, and they ask me if I need anything. I haven't eaten for ages and ages. I ask for some food. "What would you like?" "As much as you can bring me..." They say it's late and there might not be much left, but they'll try.

Some watery chicken soup and white bread corned beef sandwiches arrive. It doesn't look very appealing, or nutritious, nor does it look a lot. I wouldn't ever choose to eat this. I like my pasta, sweet potatoes, cabbage, broccoli, chicken breasts, peppers, onions, ginger, garlic, chillis etc. And I like big quantities of it. But, I've no choice and so I eat it. Now it's after 1am and I have no idea what I'm supposed to do. I ask the nurse if I can go to bed, and she says yes of course. But she also says that I might not sleep much. I have already established this. Not only am I in hospital, and I can't put any pressure on my legs (so lying down is impossible without pain), I'm stressed, and pissed off if truth be told, it's also noisy, and not very dark.

But there is worse in terms of the sleep deprivation. In my bay of 4 beds, there is one other guy. He's a mental patient, and he cannot keep quiet. He talks to himself, loudly, incessantly, incoherently. Sometimes in English, sometimes in another language. Sometimes he swears. He has a carer with him who is independent of the hospital, but she can't control him. He's agitated, and frequently gets up out of bed, tries to pull his IV line out, and walks around. I pull the curtains around my bed and try to make the best of it.

At about 3am, he swipes open the curtains around my bed, and stands over me, swearing. It's very intimidating, and I'm stressed enough as it is. This is too far. Too much. I shout at him to get away. The nurses come. I end up getting moved to another sub-bay.

Morning comes. I have more IV drugs, and breakfast. The other two in my sub-bay are foreign and don't talk much. One has a tube coming out of his chest, running into a sealed bucket of blood that they are draining off. Nice. I gather that this is because he smokes. Later in the day, someone smokes in the toilets. No-one can prove it was him. The other guy has a stomach ulcer. Later that day, they bring in an old guy who has fallen over. Scans and analysis reveal he has prostate and bone cancer. He probably doesn't have long to live. This helps to give me a sense of perspective. I may not get to compete in my Ironman in 2 weeks, but I'm not dying. This also makes me question why I continue to subject myself to breathing London's disgustingly polluted air. I don't want lung cancer, or any other disease, and living in London certainly doesn't decrease one's chances. I won't be here forever. It's short term now. I've been 2 and a half years here. Hopefully no more than a year left.

I start to learn that there's a routine to hospital life. You get your treatments, you talk to your nurses, you get your meals, you go and wash, and by and large you are left to your own devices to pass the time as best you can. I was totally unprepared for hospital, all I have is Chrissie Wellington's book, which I soon finish. She was on antibiotics until a few days before her final Kona triumph, having crashed her bike 2 weeks before the race and developed a leg infection. I take some comfort from that. I got in touch with work to let them know I wouldn't be in. I've never missed a day of work, or university, or school, and I was disappointed to break this.

I didn't have any clean underwear, so I was given plastic disposable Y-fronts and socks. I had nothing else to do. My phone had died and they couldn't find a charger. Someone gave me a newspaper and I polished off the easy, intermediate and tough Sudoku puzzles in a single sitting. I went down to the hospital shop. I wandered around the hospital. It was boring.

I spoke to the doctor later that day. He had my blood results. Thankfully, I didn't have septicaemia, but I did have a very bad infection and I was lucky that I had got treatment when I had. Another couple of days without treatment could have had far worse consequences. He said I needed to stay in hospital another night, and continue with the IV treatment. He took more blood, to see how I had responded to the treatment so far. He came back later in the day and was pleased with the results. Admittedly, I did feel better in that I wasn't sweating or shivering any more, but my legs were worse again. Horrible green pustules all over my legs were oozing pus and blood, the legs were red, swollen and angry, and very painful with any kind of touch or pressure. The worst parts were the backs of my thighs.

And so it went on. Treatment, eating, and killing time. There were TV units above each bed that looked expensive. You had to pay to use them. No-one was using them. Despite a fortune obviously having been spent on these TV/internet machines, the blood pressure machines were ancient and didn't work properly. It took four tries on one occasion to get my blood pressure reading. I can't help but think instead of fancy unused TVs, better blood pressure machines would be more useful in a hospital.

Night came. I actually managed to get some sleep this time, although fitful and interrupted. I think I was just so tired that it would have been impossible not to sleep. Morning came and I had my 6am treatment. They told me that I might get out of hospital later that day. They took more blood. I managed to borrow a phone charger. The doctor came round that afternoon and again my blood results were showing that the internal infection was subsiding, even though my legs still looked horrendous. We went through a few questions I had, medically and with regard to Ironman. Medically, my questions were answered. I just needed to give everything time and rest, and to keep taking oral antibiotics for another week. My legs would clear in time. My infection was already clearing. I no longer felt ill, although I was very tired and very hungry.

My discharge notes officially stated that "John has been advised that participation in the Ironman event in 2 weeks is not advised." Unofficially, they told me I can see how I feel, and speak to a doctor before the race. So they haven't completely forbidden me from taking part, but they have told me that if I do, my performance will be compromised.

I was released from hospital that evening, and I have to say that I was really well cared for. I've spent the weekend trying to rest as much as possible. It's so frustrating. So gutting. I want to get on and get back in training, but I know I can't. I know I have to rest. I know that no matter how well I recover, my performance will be compromised in the race. 1% of my race time is about 5 minutes. If I'm even a few percent down, I'm going to lose 10-15 minutes. I can't afford to lose that time. I'm not interested in destroying myself to come 10th. I had set out to qualify for Kona and try to win my age group, and in doing so I would have been one of the top non-pro finishers, if not the top non-pro finisher.

More than anything, I wanted to finish the race and say "That was as good as it possibly could have been." If I was able to say that, it probably would have been good enough for Kona and there's no reason to think I wouldn't have placed really highly overall. Regardless of how well the next 2 weeks go, I won't be able to say that.

On the other hand, the body is capable of amazing things and I might get to race and I might yet qualify for Kona. It's just frustrating being in this limbo situation right now, not really knowing. I'll make some enquiries about seeing a proper sports doctor next week and getting a good opinion.

And the big question, why on earth did this all happen? Where the infecting bacteria came from is open to debate. The doctor said that the most likely scenario was that the massage oil or the masseur's hands were probably infected. There are natural bacteria on the skin. Maybe my trousers or bed were harbouring bacteria that got in through the irritated hair follicles. I don't know. It should never have happened. A sports massage shouldn't be life-threatening.

My really high level of fitness meant that my immune system is weak and on a knife-edge, leaving me less able to fight off infections. Waiting 3 days before getting treatment didn't help. Also, having such a sports massage is stressful on the body because it releases muscle toxins into the system, to be processed and removed, and this would have put an additional strain on my body. Maybe I sat beside or talked with someone with a bug on the train or at work. Maybe I didn't wash my hands properly. An unfortunate combination of things might have conspired and caused the problem. It should never have happened. But it has happened, and these are the cards I have been dealt, and I'll deal with them as best I can and hope that I can still compete strongly on July 20th.

Urgh.

Post 29 - Bad days

Apart  from  the back pain I experienced earlier in the year, I've had a pretty trouble-free few months. Yes, I've had the stresses and challenges of business trips, commuting, full-time work, avoiding illness and injury, but I've managed everything pretty well, and done everything in my power to maximise my athletic ability and minimise my chances of illness and injury. I've got 2 and a half weeks to go until race day. I was really pleased with how it all had been going, and I had high targets for Ironman UK.

On Monday, the day following my massage, my legs were very irritated. The irritation got worse and worse as the day went  on. I went to bed early on Monday night, planning on getting at least 10 hours  of sleep. I didn't sleep at all. My legs were really flaring up, oozing pus and blood. My body was obviously very depleted in trying to fight this, and combined with an on-edge immune system, has led to a very sore head as well as feeling pukey.

I tried a few different creams, ended up being referred by a pharmacist for an emergency doctor's appointment, and from there I have ended up at hospital. What a nightmare. So I'm sitting in the Urgent Care Unit facing a wait of an indeterminate number of hours.

The massage helped my muscles, but my legs have basically turned septic, and in my depleted state, at maximum peak fitness (and maximum immune system susceptibility to anything), this has caused all sorts to kick off in my body - splitting headaches, hot sweats, cold shivers, and an awful feeling of weakness. Maybe a virus has been stirred up, or the flushing out and circulation of muscle toxins/lactic acid has been too much for my body to deal with, or maybe I've caught a bug. I'm gutted.

I'll do the best I can to get through it, but it's something I really could do without....