The Sörmland Ultra Marathon is a 50km trail race which starts in one of the southern suburbs of Stockholm and follows a variation of the Sörmlandsleden trail through some truly stunning scenery.
On the day of the event this was enhanced by some lovely weather – quite mild (12-14c?) and dry for the whole way round. This was a blessing as the paths can become treacherous as I found out on a training run on part of the route the previous week. No injuries to speak of and in fact my long road to redemption since January finally saw me shake off a pretty miserable calf injury which had kept me out of so many events in Scotland. However, there was a somewhat different complication in the form of an infected thumb.
In the weeks leading up to the race I found myself with a severely infected digit which required lancing (twice) and a course of antibiotics. But since I could still walk, I thought no more about it and spent the last week building up to the race resting, having a lovely massage, eating well and hydrating. But that poisoned thumb….
I woke up on the morning of the race after a good night’s sleep (something of a rarity for me pre-race) and fed myself the usual porridge and banana breakfast. On our way to race registration at Björkhagen Alexia and I met in with a couple of other runners and had a general chat about the event. We passed a chilly hour re-checking kit, looking over the course routes and understanding where, if at all, public transport wold make it feasible for Alexia to meet up with me. She carried some spare gear in case I needed it (as had proved the case at the Speyside Way Ultra last year). As usual I carried more medicines, water and carbs than most, never knowing how the asthma and diabetes would affect me this time.
About 180 of us set off through the Nacka nature reserve on an undulating course on paths with the speed bunnies disappearing into the distance allowing the likes of me to settle into a pace and get the breathing right. Today was a good day in terms of asthma with only one puff of the inhaler required during the race. The easy pace settled the lungs quite nicely. Around the 6-7km mark the event became properly ‘trail’ rather than path in nature and negotiating tree roots (or worse, tree roots obscured by leaves) became a feature of the day.
The way to the first check point at Alby was smooth given that I had run this section of the course only two weeks previously. There were some stunning meadows, tight forest paths and idyllic looking traditional red wooden houses / small farms.
When I got into Alby I was about 10-15 minutes ahead of schedule and not thinking that I’d see Alexia who I believed could not possibly have got there by public transport in time. Nevertheless, there she was. I discarded my hat and jacket, took on about three cups of water as well as some of the lovely food provided at the check point. As I headed off back into the trees, Alexia set off on an improbable attempt to get three separate buses from Alby to Tyresta farm. We both thought this unlikely and that we’d probably see each other at the end. There was some cracking scenery round by Tyresö Flaten and a steep descent down by the edge of the loch. Then more trail until eventually emerging onto a long tarmac section just before the second water stop and checkpoint. Still feeling fine by this point, and once again took on the usual quantities of food and water. However just before Åva I stopped for a pee. I never really paid much attention until the end, but noticed that my urine was darker than it should be. Ok, dehydration, get some more liquid on. I had the Camelbak with me and took a few hefty gulps and pressed on down the road towards the checkpoint at Slipängen. Still feeling quite comfortable, I thought it best to take on another three cups of water and more banana. Although I’d slowed since the first third, I was quite happy with my pace. I pushed on up the hill another couple of hundred yards and thought I’d take another leak. This one shocked me.
Having taken on what I believed to be sufficient water I thought I’d have rectified the dehydration. And the fact I could take a long pee suggested in some ways that I had, only this pee was VERY dark and to me looked like I was pissing blood. Bollocks. This was at the 20 mile mark – a distance I have covered easily, faster and in hotter climates probably 40 times, but I have never had anything like this. Had I still not hydrated enough? Was this Diabetic Ketoacidosis (DKA) kicking in? I took a couple of minutes to gather myself and consider the options available. I contemplated going back down the hill to the check point and retiring from the race. But then what? – there was no medical staff there, I was unlikely to get a lift to hospital given I looked OK and ( ….. only foreigners who have lived in Sweden will get this …. ) I had no photo ID on me or personummer I could give to anyone. In Sweden, this is problematic. OK, so plan B. I called Alexia to see where she was. Having lived with my previous diabetic episodes she has become an expert in telling if I am hypo or high. Despite the odds she had made it to Tyresta Farm which was only about 5-7km away. I gave myself another once over: I felt strong, there was no nausea and no pain in either my head or body beyond “tired legs”. I decided on another flush through so took a good half litre from the Camelbak and then pressed on to discuss the situation with Alexia. I took it easy, just keen to get there.
When I got to Tyresta Alexia was standing waiting for me. She looked me up and down and said I was looking strong (and if I wasn’t, believe me she’d have said something). After another quick check of how I was feeling and finishing the rest of the Camelbak I decided to carry on without letting on I had something on my mind. After all, from here I could probably get to the train at Handen quicker than if I waited around for public transport to Stockholm from Tyresta.
The last 7-8km passed quickly. I actually felt stronger than in the middle section and kept company with a couple of runners most of the way, even having some conversations over the last 4-5km. Despite the enforced break, I crossed the finishing line in 5:08:38 (Garmin Stats) happily splashing my way through the big puddle someone had kindly put in the way, and crossed the line feeling quite delighted in 86th position. I was also about an hour ahead of my projected time. Yet again, the wonderous Swedish public transport system had worked and Alexia had made it. I headed straight for the water to keep flushing my system.
As has become traditional Alexia handed me a beer which I was happy to take. I made myself a sandwich and also grabbed a coffee, but I found my hunger had left me. I was still uncertain whether the urine issue was caused by my BGL being too high, so I thought I’d lay off eating until I got home. I also promised myself that if there was no more change after two more trips to the loo, then I’d have to go to hospital.
Once home I checked the internet and found a very valuable essay by searching on “Dark Urine Ultrarunner” which returned an interesting hit on an article “Running, Rhabdomyolosis, and Renal Failure – Who is at Risk”
In some ways the article is both comforting and disturbing. Comforting in the sense that the problem is not uncommon in ultrarunners, but chilling in the potential consequences. I noted a sentence at the end “Do NOT race if you had a recent viral or bacterial infection“. I looked at my healing, yet still tender thumb – “Ah, now I understand”. I had to go to the loo, and for the first time since the start of the race, my urine was clear (for the record, this was about six hours after the first ‘episode’). For the moment then “whew!”, but in the long-term a valuable lesson had been learned.
So how did this effect the views of the race? While there is no doubt that I got a bit of a scare, my memories of this event will be the great organisation, the stunning route and the excellent company on the way round. Naturally, while still uncertain of diagnosis on Saturday night, I swore off any more long races. About an hour after the “clear pee” I promptly started looking up other events. On the Sörmland Ultra Marathon FB Page, Jan-Erik Ramström posted “Jättelångt | Från A till B för egen maskin” – So, once the course of antibiotics is finished, I suppose I’d best get back in training 🙂
NB: This ultra was run with this tune in my head: The Vatersay Boys version of ‘The Gael‘