u/Tart_Beginning

I enjoyed the long race retrospective someone else posted on here a while ago, so I figured I’d do one of my own and share important information I gleaned from my first attempt at an Ironman 70.3. Feel free to skip to the end for the TDLR.

Background
I am a mid-20s F with a background in running and swimming. I’ve run 7 half marathons, one of which I hold an age group course record for and several of which I decided to do spontaneously and without really training. I’ve also completed a marathon (unofficial, did it on my own) and was a varsity cross country runner in high school so I’m no stranger to the pain of distance running. I swam competitively as a kid in the pool and am from Hawaii and grew up in the water. I participated in the junior lifeguard program and won states with my team several times, so I am also used to open water racing.

About 6 weeks ago I decided spontaneously to sign up for the Kohala Coast Ironman 70.3 affectionately called “the Honu.” I’ve always known I would do an Ironman at some point in my life and given that I currently have ample time to train, I figured now was as good a time as any. I primarily focused on training for the run and the bike as I honestly barely knew how to ride a bike and wanted to be sure I could finish strong on the run. By the end of my running training, I could run 10 miles at a 9 min/mile pace at the hottest part of the day in conditions comparable to Kona. I didn’t own a bike at the time, so I bought the cheapest working road bike I could on Facebook marketplace and started training. The roads where I live are dangerous to ride on so I was pretty much forced to do one 20 mile loop over and over. The longest bike ride I did was a bit over 40 miles and I was feeling good, although it was considerably flatter than the course. I got to the point where I could drink water while on the bike and use the aero bars without crashing. I have a family friend who is an avid bicyclist living in Kona and I arranged to borrow a bike from him. I’m 5’7 and the bike I was training on was 54 cm; he had a 54 cm bike, so I told him I’d love to use that one. However, he thought I might do better with a smaller bike (my bike didn’t say it was 54 cm and he thought it looked smaller than that in the pics), so he borrowed a smaller one (~51 cm) from a friend for me to use. It had aero bars and two bottle holders and I brought my seat from my other bike to use on it. I tried it out on a trainer and did a lap in the driveway with it the day before to make sure the adjustments were right. We both agreed it was a little too small, but assumed it wouldn’t be too much of an issue.

I didn’t train for the swim at all; I was confident that I could do a 2000m ocean swim pretty easily at a decent enough pace and opted instead to focus my training for the bike and run. I did laps in my condo’s tiny pool for about 45 minutes one time and swam around in the water at the beach for about 20 minutes another time, but otherwise didn’t get in the water at all before the race.

Race morning
My boyfriend and I stayed with family on Ali‘i Drive in Kona, about 45 minutes away from the Mauna Lani, where the race took place. The race started at 6:25 am, so we woke up at 3:45, ate breakfast and got ready, left at 4:30, and got there around 5:15. We took the shuttle and got to the swim start at about 5:30. I warmed up a bit by doing dynamic and static stretching. Then around 6:15 I seeded myself at the swim start. I wasn’t nervous at all, and was very confident that I indeed would be able to do this.

Swim
I seeded myself in the 43-50 minute pace range. This ended up being a mistake; I underestimated my pace and spent most of my swim trying to maneuver around the other people in my group. I ended up swimming for a bit more than 40 minutes, but I think I could’ve swam it 35 minutes or less had I seeded myself faster. I definitely felt like I could’ve swam another 2000m without issue once I was out of the water.

A mistake I made leading up to the swim was not having more to eat while I was waiting to start. I had finished my breakfast around 4 am, so by the time I started my swim around 7:10 I was hungry and knew that was a sign I was already behind on nutrition. People were eating gels in line, which I wish I had decided to do.

Bike
T1 went well; I dried off with a towel, quickly sprayed myself with sunscreen, put on my helmet, socks, and shoes (never mastered clipless shoes so opted for normal pedals and the shoes I’d be running in). I stuffed my nutrition (stinger energy stroop waffles and fruit smoothie gel) into my trisuit, eating a stroop waffle along the way and then drinking Precision at the transition aid station. I had purposefully packed more nutrition than I thought I would need, and I was glad I did given I started the swim hungry. I had trained with this nutrition and planned to eat the stroop waffles whenever I could on the bike and save the gels for the latter half of the ride and the run. For hydration, I started without water bottles because I didn’t want to have to take the time to stop to fill up the nice bottles my family friend lent me and obviously couldn’t abandon them. This in retrospect was stupid - I should’ve bought two disposable bottles and filled one up with an electrolyte solution and the other up with water and ditched them at the first aid station, but on my bike rides I would first drink water at the 10 mile point, so I figured I’d be fine.

I grabbed my bike and finished the transition and rode onto the road. About half a mile in, I came to a flat section that felt fast and grabbed my aero bars and IMMEDIATELY crashed. I couldn’t steer to avoid some bushes and went into them face first. By some miracle I was fine, but it took me several minutes to grab all my nutrition that fell out and make sure I was alright. Not a great way to start.

I wasn’t really sure what had happened, but I decided not to try grabbing the aero bars for a while. When I went to eat another stroop waffle, I almost crashed again. I realized at this point that this was happening because my bike was much smaller than I was used to and my center of gravity was so high that taking my hands off the handlebars at all threw my balance off completely. I had to dismount my bike completely to eat anything. Eventually I figured out that I could manage to rip the top off of my gels, stuff the trash quickly in my sports bra, and then hold the gel in my mouth and eat it slowly while biking, but I couldn’t eat the stroop waffles I brought at all. When I pulled over to eat another stroop waffle, it was so dry and chalky without water that I couldn’t swallow it and had to spit it out.

The first aid station was a lot farther in than I was expecting, so by the time I got there I was very dehydrated. I of course had to completely pull over and stop at the aid station to drink and had a full bottle of precision and ate a stroop waffle. I filled my bottle holders with two bottles of precision and after about 10 minutes I got back on my bike and continued.

While waiting for the swim start, I had heard a guy from Oahu say he went with a group of triathletes about 3 weeks before the race to ride the bike course and out of 30 people they’d gotten 15 flat tires from thorns along the roadside. I knew the thorns were from Kiawe trees, so whenever I saw one I would make sure no one was trying to pass me and then swing wide to the left to get as far away from it as possible. I also looked out for branches on the ground and dodged those as best I could. I avoided flat tires but saw many athletes along the way that ended up with flats.

I was kind of worried about the big hill before the turn around that I had heard about and seen on the elevation map, so a ways after mile 20 when I still didn’t see any steep hills I was getting worried.
We had gone up some long hills and I was getting a bit tired from those, so I was trying to mentally prepare myself for the brutality of a super steep climb. Before I knew it though, I was at the turnaround point. As it turns out, the long hills that had gotten me “a bit tired” WERE the increase in elevation. I kind of laughed at myself because I had been so filled with dread. At that aid station I replaced the two bottles of Precision with another two bottles of precision and a water I put in my trisuit.

The way back started out pretty well. By that point my back was really starting to hurt from how much I had to bend to reach the handle bars, but the decline from the turnaround point was a nice break and I realized just how much elevation I had actually gained riding up it, which was encouraging. I also managed to eat several more gels, but my water bottle slipped out of my trisuit and I had to dismount to run back and get it (no littering, malama aina!). I still also had to pull over and dismount to drink anything because my high center of gravity on my small bike would mean risking crashing if I didn’t, and at this point I had been passed by so many people as I was stopped to eat and drink that I was solidly at the back of the pack.

The hill back up from the harbor was the worst part of the race up to this point for me. I had to stop two more times to drink during it where I got passed by everyone I had passed earlier, which was disheartening. My back was killing me at this point and it was difficult to stave off the negative thoughts. The final 10 miles felt quick but also felt like they couldn’t be over soon enough due to my back pain. I switched out my two empty precision bottles for two new ones at the last checkpoint and drank most of them. By the time I was finally back to the transition, I was almost crying from how badly my back was hurting.

Run
The second transition was pretty quick. I already had my running shoes on so just docked my bike and ran to my gear bag and downed 6 ibuprofen. This may have been what saved my life. I put on a hat and grabbed some water to splash on my face at the transition aid station, drank some Precision, and started running.

The first two miles of the run went well. I was conscious of the cutoff time but still had a bit over three hours to finish and was able to hold a 10 minute per mile pace (including walking the steeper hills). It was nice to be able to run and chat with other people! I stopped to pee when I found a non-portapotty bathroom along the course. I was stoked about that, it was super clean. Around mile 3 I realized I should probably hydrate more, so I stopped at the aid station and drank as much water as I could, about 5 cups, and continued running.

About halfway through mile 4, my lips started to feel funny, I got really itchy all over my body, and my hands were looking a bit swollen. I have a thing that happens sometimes where my hands swell up a little and get itchy randomly, so I thought maybe that was happening. Over the course of about 3 minutes though I felt my lips swell and when I looked down at my hands I realized they were swelling rapidly and turning white. As I approached the aid station around mile 4, I realized my eyes were swelling too.

At this point I realized something was VERY VERY wrong and thought I might be having an allergic reaction (although I have no known allergies). I had begun to run past the aid station but thought better of it and stopped and told a volunteer I needed medical help. The volunteers were amazing and got me a chair to sit on and put ice packs on me while I focused on staying calm. After about 5 minutes my tongue had swelled up so much I was having difficulty speaking. I checked all over my body for signs of a sting or anything that could’ve possibly triggered an allergic reaction but saw nothing.

Then I realized my throat was closing up. No one had Benadryl or an EpiPen. My vision was starting to get brown and staticky around the edges and was narrowing. The volunteers laid me down on some chairs and I had to focus all of my energy on breathing and staying very, very calm. All the volunteers were incredibly kind and I was so incredibly grateful for them. I think someone may have asked passing runners if anyone had medical training and a runner who introduced himself as Dr. Burke checked me out and asked me questions. He couldn’t really do much to help except for keep me calm but I think he also came to the conclusion I was going into anaphylactic shock. My vision was almost entirely gone at this point and I was convinced I was going to die and told the people around me to please tell my family I love them.

After what felt like forever, a golf cart came and got me onto a stretcher. I couldn’t even move myself onto the stretcher because whenever I tried to do anything but breathe my throat would close more. Eventually an Ironman van met us and took me to the medical tent. I was able to take a benedril pill orally (barely) and I thought maybe it helped a little bit but my throat was still extremely tight. The nurses (who were absolute angels) then put in an IV. They took my blood and my sodium levels were normal but my potassium was slightly low. Then the doctor asked if I’d peed at all throughout the race and I said only once. She said that made sense and my reaction was caused by an electrolyte-water imbalance.

I guess after drinking around 6 bottles of Precision total I had a ton of electrolytes in me and very little water comparatively. When I drank a bunch of water at the aid station, my system was suddenly flooded with water and I started swelling rapidly. I think if I hadn’t taken such a high dosage of ibuprofen (which is anti-inflammatory) my throat may have closed all the way. I had initially wanted to do a sweat test to figure out my what my electrolyte intake should be but there were no facilities near me, so I figured I would do it before my full Ironman in October and hydrate with electrolytes as needed like I had done during my half marathons. In truth, that plan kind of went out the window when I started the bike and wasn’t able to eat or drink while on it. I had focused so hard on just making sure I was eating and drinking that I didn’t really consider WHAT I was drinking.

They gave me some sort of fluid through the IV, not sure what, and eventually my swelling went down to the point I was no longer having trouble breathing. My throat was still very swollen and I sounded like Jennifer Coolidge for another hour (no shade to her, she’s the best) afterwards but eventually it went back to nearly normal. My Face ID has finally started recognizing me again 24 hours later. My hands and feet are still very swollen.

I obviously didn’t get to finish the race and am devastated. I had so much more left in the tank - the run was going really well and I was planning to try to pick it up to an 8:45 pace around mile 8 and finish strong to make up for how poorly I felt I did on my blunder of a bike ride. I am not even sore today. My only consolation is knowing that the only reason I came off that course willingly was because I was literally about to die. I know I was fit enough to finish because usually at the end of these events where I’ve given my all I find myself saying “I’m so glad that’s over, I’m never doing that again!” But second it was clear I wasn’t immediately going to die in the medical tent the emotions hit and I started sobbing because I wanted to go back out and run SO BAD. I was so proud of myself and how far I’d gotten despite all the things that went wrong and to have it all end so abruptly and to not have that pride at the end knowing I’d finished… I’m heartbroken. And a little embarrassed by how stupid of a mistake that was. Of course drinking SIX bottles of a concentrated electrolyte mixture and only a tiny bit of water was not going to end well. I just wasn’t thinking at all.

I am doing the Ironman CA in October and am really looking forward to redeeming myself twice over. In a strange way I feel a lot more confident I’ll be able to finish it because I’ll be better prepared and I know my body can handle it. The Kohala Coast course is really tough comparatively from what I’ve heard, so I’m happy I did as well on it as I did up until I had to get medical attention. I had some issues with my Achilles heel and was only able to solidly train for the run about four weeks out, and I had to taper for the final two weeks.

All in all, I’m a weird mix of proud, embarrassed, disappointed, and excited for my full Ironman. I’ll train a bit more for the swim and significantly more for the bike and the run and will iron out all the technical kinks in my bike performance.

TLDR; balance your electrolyte and water intake (you can go into what feels like anaphylactic shock if you don’t), look out for Kiawe trees if you’re riding on the west side of big island, and practice on a similar sized bike if you aren’t able to use your own bike for the race.

Also huge thank you to all the volunteers, nurses, and doctors at the Ironman. You guys are the absolute best and you saved my life. And thank you to Dr. Burke, I really hope helping me didn’t mess up your race too much.

ETA: the aptly named user u/MedicalTent suggested it was likely exercise induced anaphylaxis. That makes a lot more sense to me because it felt exactly like anaphylaxis and my throat began to open after I begged the doctor for benedril and she gave it to me. I attributed my swelling decreasing to whatever was in the IV they gave me at the same time but this makes a lot more sense.

In retrospect, I realize I may have been having minor episodes of exercise-induced anaphylaxis for years now. As I mentioned in the write up, I “have a thing that happens sometimes where my hands swell up a little and get itchy randomly” that usually has happened when I exercise and/or it’s hot. The past couple times it has happened has been when I’ve been hiking/backpacking and I think I took ibuprofen (a reasonable amount, not 6) both times. Taking NSAIDs can contribute to the onset of an attack, as can hot or cold weather, according to Wikipedia. So I really may have created the perfect storm this race. Honestly I’m glad it happened during this race where there were medical professionals present instead of on one of my 20+ mile solo hikes in the mountains (I usually carry Benadryl on those though in case I encounter another hiker in trouble). I have an appointment with an immunologist this week to determine if I’m able to do the full Ironman in October, and won’t be exercising at all until the appointment.

Still, electrolyte imbalances are dangerous, so have a better plan than I did. And don’t take 6 ibuprofen during your race or use a bike you’ve never trained on before.

Hi there, I will be competing at the Honu in Kona on May 30 and later doing the full in CA. I was wondering: does anyone have any advice regarding calf cramps? I am a first time triathlete and for the past two weeks I have been unable to run because my left calf has been cramping every time I run up even a slight hill. It’s fine on the bike and while swimming, so I can’t figure out what’s wrong, but seeing as I’m a month out and I haven’t trained much at all for the run I’m getting worried. I’ve switched out my shoes and have been chugging electrolytes but still no dice. I don’t think I’ve been overdoing it on training; I do two bike rides a week (one ~80 minutes and one gradually increasing in mileage, got up to 29 miles over the weekend) and I try to run three times a week but lately my runs have ended after just about 3 miles because of the debilitating cramps. I’ve also tried foam rolling and stretching but that hasn’t helped a ton. Epsom salt baths helped but the results weren’t enough for me to do much of a longer run before cramping up. That’s the only place I’m cramping as well.

I have done a half marathon before completely without training so I’m not worried about not finishing, but I’d rather the run not be an absolute slog and I’d also love to have a positive experience to set me up for my full Ironman in October.

Thank you in advance for any advice, I’m willing to try anything at this point.

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