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Wednesday 8 November 2023

Dysautonomically disgruntled.... but qualified for the GB sprint duathlon team again!

 I would love to write that since my last blog I have had a better run of luck on the health front and been able to get back to some consistent training and racing.... sadly, not so. In July I ran the Snowdon Race whilst suffering from what we later found to be our 3rd bout of covid. I set off up the mountain and my whole body just said "NO"! This year the race was cut short due to 90mph winds and freezing temperatures at the summit (typical July weather...), so with this knowledge I plodded on as I knew it was only two thirds of the usual distance. I was gutted to cross the line as 2nd vet 40, just 5 seconds behind the category winner. I had no idea and, knowing that I had taken it easy, was frustrated as I could have easily found those 5 seconds. But that is racing, and I made a judgment call on the day as my body gave out warnings, and so ultimately I did the right thing.

Snowdon Race / Ras yr Wyddfa in driving wind, hail, rain etc.

I had a lot of post-viral fatigue in the weeks after so took a full week off any exercise. Then, shortly after racing Totnes 10k at the start of August we got struck down with the next lurg doing the rounds, which started out as a tickly cough but then entrenched itself and the most hideous, harking, unshiftable cough I have ever had the displeasure to experience ensued. For all four of us - me, husband and both children - it then turned into a chest infection and we all required antibiotics. It lingered on for 12 weeks for me and 15 weeks for my husband, who also needed steroids and further antibiotics to shift his. This meant that for the duration of August, September and October I had to have multiple rest periods and the only exercise I was able to manage was some very low-key plodding. I did get carried away at a couple of parkruns and, at one at Eden Project in September - at which I miraculously managed a sub 20 minute clocking - I massively set myself back and flared up my post-covid dysautonomia: don't push your body when your body is still coughing up half the contents of its lungs people!

I was diagnosed with dysautonomia after seeing a cardiology specialist back in late May / early June. I am only just starting to get my head around what it is and what it means long term. Crucially, it is deemed "incurable". This sounds like a death sentence, but in reality I have learned that although once you get it you are stuck with it, in practice it is like having arthritis, whereby you have to live with it but you can manage it and there will be times of flare ups (triggered by further viral infections, fatigue or stress) and times where you barely notice it and the symptoms fade. For me it manifests itself as tachycardia (fast and also erratic heart rate). I also have symptoms compatible with POTS, so it is exacerbated by standing, walking, running (upright) activities, and relieved by sitting and recumbent activities. At night, my resting heart rate is only about 10 bpm above its previous normal (50 instead of 40) during a dysautonomia flare up, but when I get out of bed it shoots up from 50 to around 120bpm within 10 minutes of waking. Eating large meals also exacerbate it, as does stress and adrenaline. So when you think that racing spikes adrenaline levels plus is an upright, highly aerobic activity, you basically have a recipe there for a truly bonkers heart rate that goes off the scale of my previous parameters and makes any form of heart rate based pacing completely useless! The weirdest thing is, I don't feel any different. My garmin tells me that my h/r is spiking at 185bpm just doing an easy 9m/m warm up jog, but I feel totally comfortable, not out of breath, able to hold an easy conversation and essentially feeling like I do on a normal day when it is around 125bpm at this same pace and effort level. And no, it's not a faulty Garmin as it's been confirmed by ECG and holter monitoring. 

A dysautonomia day: 50bpm in bed, get up and suddenly I'm in zone 2 just preparing and eating breakfast and sat in the car driving to the race. Then start an easy warm up jog and it shoots up to the high 170s. 

At first I didn't really know if this spelled curtains for my competitive sporting ambitions. I am a Mum now first and foremost, so staying healthy and avoiding any undue risk is my top priority to ensure I am able to care for my children. Once the cardiologist did further checks to establish that this is not an actual heart issue and is an autonomic nervous system problem and that exercise is in fact one of the recommended treatments for autonomic dysfunction, I felt happier about starting to push myself again. And what I have noticed is that my heart rate spikes within the first ten minutes of exercise, then the exercise actually kicks it back into a more normal rhythm and rate. So I just have to make sure I do a proper warm up now so the spikes can occur and it can then calm down before the race and real effort begins. That's not to say it doesn't still affect me - I know it does. Mostly it winds me up as, as an athlete, I am used to training my body so it responds when I ask something of it. With this condition, my body does what the bloody hell it likes and I have very limited control over it. But I am starting to see patterns in it and becoming aware of its triggers and also some little fixes, so hopefully going forward I will just learn to live with it and ignore it. I hasten to add, the cardiologist I saw was privately through the Nuffield.... I am still waiting to se an NHS cardiologist after being referred on 9th April this year as an "urgent" case... which I think highlights the shocking state of our health system currently. 

So, that boring tedious health gubbins aside, this weekend just gone I lined up for my first multisport race since the European champs in Bilbao in September 2022. As we have pretty much been plagued by illness ever since then, all the ambitions I had for the 2023 season had to be jettisoned: no Euro sprint champs in Venice; no world champs in Ibiza; no half-iron triathlon in North Wales; no Euro champs standard distance qualifier at Thruxton. None of it. I was ill for every single one of these events. So I left signing up for the Devon Duathlon (a qualification race for the 2024 Euros) until the last minute. I almost didn't do it as I knew I had done such little training (just 2 bike rides outside on the actual road this entire year and very very few wattbike sessions in which my watts were down by around 40 - 50!), and a few slow 9m/m plods and the occasional parkrun. Hardly perfect race prep! But my husband encouraged me as he pointed out that for years I have had to travel hundreds of miles to attend qualifiers in Nottingham, Cambridgeshire, Derbyshire, Hampshire etc, and now finally we have a qualifying race in Devon, and in East Devon just 7 miles from my house no less, and I am considering not bothering! Truth be told, I was nervous to sign up to a local race for fear of being crap! Yes, there are reasons for that, but, for me, I would feel the pressure to perform and so maybe I'd rather not bother than trail in behind athletes that I am capable of beating when in good health and better trained. My husband said that this was my ego talking and to man up and get on with it and who cares what other people think as I know the truth. Sound advice! My phsyio and long-time supporter, Nigel Wilman, also pointed out that I am notoriously hard on myself, so when he asked where he thought I was at, and I said 70% fit, he said in reality that is probably more like 80-90% and I will probably still manage to pull of an age group win.... I lacked his faith and him saying that put a whole load more pressure on me to perform! But you only need top 4 to qualify and I hoped that I could do enough for that at least.

Race day and, thanks to waking up with a bucket load of pre-race nerves and adrenaline, my dysautonomia went totally batshit crazy and gave me the most erratic heart rate readings I've had since when I first got hit with this in the initial aftermath of covid in April this year. 125bpm just sat in the car driving to the race! In fact, I spent the entire morning in training zones 1 and 2, just having breakfast, getting dressed, doing all the normal life activities. My training zones are meaningless when my heart goes off piste like this! In warm up I felt comfy, though a heart rate of 180bpm suggested otherwise. I just try to ignore it and trust that it will settle. 

Off on the first run and I feel comfortable, tailing friend and local age group competitor Emilie Brock. I know she is in great shape at the moment and honestly, I wouldn't have expected to be able to stay with her, so when she isn't pulling away, I figure I am doing ok.... but can I hang on?! There is an interesting off road section through Woodbury Common, which is pebbly and muddy and rather dicey when wearing Nike Alpha Flys! Into T1 neck and neck with Emilie. Onto the bike and off on a rather technical, hilly, wet and pot-holey bike course. A lot of competitors later said that they considered it a dangerous route and not really suitable for a GB qualifying race, but I think for those of us who live and train on these Devonshire roads, it is just what we are used to, so I didn't actually find it that bad! Again, I found myself trailing in Emilie's wake for the entire length of the bike. I would draw her back on the uphills, and she would pull ahead again on the downhill sections. We arrived into and left T2 together. We didn't know if there were any other vet 40 ladies up ahead of us, but in fact there weren't and we were actually competing against each other for 1st and 2nd spot. I haven't done any brick sessions at all, so the last time I ran off a bike was in Bilbao in September 2022! So it took my legs a little while to work into their rhythm, but once they did I found myself feeling stronger and my pace picked up as the run went on. Coming back into the grounds of Bicton College, Em and I are still neck and neck. My "sprint finish" is never to be relied on as my fast twitch muscles gave up twitching about 10 years ago, so I went for a sustained push from about 200m out. Luckily I got a gap and crossed the line as 1st vet 40 and 6th female overall, just 5 seconds ahead of Em. Both of us therefore comfortably qualified for a spot on the GB sprint team. 








Whilst I was overjoyed with the result, which was far better than I would have expected given all my health setbacks this year, it also left me wondering what I could achieve if only I could have better health on my side. To think I managed 6th overall in a strong women's field on the back of no quality training and a year of endless bugs and fatigue is both encouraging but also frustrating. The location and date of the Euro champs has yet to be announced, but I just hope we have a better winter on the germ front and I am able to finally string some consistent training together to get fit for it. I might be able to wing a category win at a qualifying race on no preparation, but I won't be able to medal on the same appraoch!

Thanks go as always to my amazing phsyio Nigel of Honiton Physio. My body doesn't respond well to enforced illness layoffs as residual weaknesses and postpartum niggles start to creep back in, so it's thanks to him and his expertise that I have been able to keep on top of those. 

Next up, hopefully some fun off-road races in the build up to Christmas, then assess my goals for next year once the details of the champs are announced.