So, It's Kind of a Funny Story...and What You Don't Know About Hypothermia Can Hurt You

Humans are pretty crafty, but will fold quickly in severe cold. -- Henry Rollins

The weather plays a very big role.  I have run very few races in the raining and the cold.  -- David Rudisha

So, it probably isn't really a funny story, but sometimes, after the fact, all you can really do is laugh about it.  Yesterday I did not finish (DNF) the DC Rock 'n' Roll Marathon due to hypothermia - I was pulled off the course by medical just shy of 14 miles.  Hypothermia is totally not a laughing matter, although I didn't realize how serious it was until I was talking with the EMTs (eventually, after getting rewarmed).  I mean, heck - I live in Virginia, I had been racing one of the hottest IM Louisville years - I know all the signs, symptoms, and preventative measures for HYPERthermia...but who the heck thought I'd get too cold?  How did this happen...

Well, it starts like all horror stories - it was a dark and stormy morning.  Temps in the low 40s.  Prior to race time, the rain went anywhere from none to fairly heavy.  And it was cold.  Cold rain, cold air.  I stayed warm until I checked my bag (no rain), but then it started to rain again before we had to get in our corrals.  For the first couple miles, it was just steady rain - nothing too heavy.  And then, after mile 4, pouring rain.  Then around mile 7, lighter.  Then around mile 10, heavy.  It didn't matter - after the first couple miles all of my layers of clothes were soaking - you could literally wring water out of my water-resistant rain jacket.  Not a good sign.

Anyway, I passed where the marathon peeled off from the half-marathon and with fewer humans around, it felt colder.  Or I felt colder.  I don't know.  But I knew I was starting to feel cold, so I stopped at the medical tent around mile 14 to see if they had any mylar blankets that I could wrap around my torso while I ran to warm up a little bit.  They told me they didn't have any, and they started asking me questions - what was I feeling?  Was I dizzy/having palpitations/confused/etc.?  They sat me down, wrapped me in a garbage bag (the closest thing they had to a mylar blanket), and started wrapping me in their jackets and hugging on me.  It was then I realized that I was uncontrollably shaking - could not stop shivering to save my life.  The EMTs told me I was going to be transported back to main medical, that I was done for the day, and that it was a good thing I stopped - this did not make any sense to me at the time.

For whatever reason, the transports from main medical were not very swift, so after a while, the EMTs begged a police officer to let me sit in the back of her cruiser to get warmer and try to stay dry.  Thankfully, she was a dear - so she let me (first time in the back of a cop car!).  But I couldn't stop shaking.  Eventually she had to turn her heat down because she was dying...but I was still cold.

Then after a bit, the last runner came by with the tailing sag wagon - and immediately, a truck came and took down the medical tent.  Not only was I stranded by the race, but so were the EMTs.  They asked the cop if they could sit in the cruiser too, and then I'm not sure exactly what happened, but the EMTs got very concerned and starting pulling off my clothes.  They decided at this point that I would never get warm if I was wet, so they wrapped me in a RnR Sports Med t-shirt and their jackets and scarves.  Then they took off my shoes and socks - blue feet!  OMG - my toes were blue - I saw them.  One of the EMTs took off her boots and socks and gave me her socks to wear.  Both of them were piling themselves on top of me.  At some point they called an ambulance...which also didn't hurry itself along.

The roads were starting to open up, so the cop we were with got called to another post - she didn't want to leave us, but she couldn't not go to her post (and they were ignoring her requests to transport us to main medical because of liability or something - I don't know - the EMTs were talking about it and I was confused).  Anyway, right before she pulled away, the medical shuttle from the race appeared and picked us up.  He starts to drive to main medical at the finish line and the EMTs radios are chattering with all kinds of field medical tents having the same issue - being stranded by the race after the last runner, having multiple patients needing transport and waiting 30-45 minutes for the shuttle, etc.  I warmed up a little bit, but then started shaking again, so the EMTs decide that I need to lose my leggings too.  Whoo whoo - me, wearing the EMT jackets tied around my waist like a makeshift skirt, another jacket of the EMT and their t-shirts, another person's socks, and a scarf tied around my head like a babushka.  Yeah.  I'm a sexy beast.

The shuttle driver did not know what he was doing, so we took the longest possible route to main medical, including having to make a loop twice because he was afraid to pull in where the cops were - on the 2nd loop, the EMT jumped out of the door and got the cops to let us through all the closed road.  Very exciting adventure.  Not.  I was getting warmer but was still very confused.

When we finally got to main medical, it was clear that they had not planned for hypothermia, despite the fact that the weather was forecast for the whole week.  They only had 2 heaters (with multiple cots piled around each) and no warm fluid to drink.  They put me on a cot, took off the clothes that the EMTs needed back (one just literally gave me a jacket off her back - she took the EMT coat but gave me her actual jacket), wrapped me in mylar blankets, got my bag from bag check (where I at least had a dry sweatshirt and socks) - and thank goodness, because I heard people were waiting in line for 45 minutes-2 hours to get their bags...I imagine my EMT (my EMT) pushed her way to the front, because they were both all kinds of awesome.  Anyway, main medical had no warm fluid, no dry paper clothes, etc.  They made me stay on the cot until I wasn't blue and seemed to be relatively stable - I actually got up myself because they brought in someone who looked worse than me and they were all out of cots.  Plus I decided that I earned my damn finisher jacket - I may never wear it, haven't decided yet, but I feel like I earned my dues - plus I wanted something else to put on.  I tried to buy dry pants/shorts/something from the merchandise tent, but they only had shirts and shot glasses....you have to admit - some of this is a little bit funny.  Me, being stripped in the back of the cop car (I kicked her gun once or twice when they were trying to warm up my feet).  The getting lost on the way to main medical (since I was mostly stable - if I wasn't, that wouldn't really be funny at all).

So that was my race day - I am fine - I don't think I ever had heart issues (at least that I realized) from it, but I learned that your heart rhythm can flip with hypothermia just like it can with hyperthermia.  Dang - that's scary.  I just thought I was cold.  I did some research to figure out what I could do different, but the answer is...not too much.  Most of this wasn't my fault - so that kind of sucks.  But here's what I know.

Hypothermia is more likely to happen if:

• You are super skinny or tall.  (I am neither - so not my problem)
• You are slow (because you are outside for longer than other racers...yeah, that's me - plus apparently when you're slow you don't work up as much body heat).
• It is cold, windy, rainy - any one of the three can cause it, but all three together makes it super special.  And I had all three.
• You are dehydrated or underfed.  I may have been both - because I was cold and wet, I may not have drunk enough at the aid stations.  Plus, I am not sure I was thinking clearly, so I may have screwed up my nutrition plan.  Not sure about that one.
• You are old, young, or feeble.  Nope, that's not me.

I also learned that shivering is better than not - because at least your body is trying to get back to regulated.  So that was a good sign - the blue skin/lips?  Not so much a good sign.  Confusion, withdrawn, crabbiness - bad signs...but who isn't crabby partway through a marathon?  Thankfully the EMTs are smarter than me.  And thankfully I stopped to ask for a blanket - a stupid request, but it gave someone else the opportunity to help me.

If you're going to be running in the cold/rain/wind - take a few minutes to learn about hypothermia.  I had no idea it was something I would ever be affected by...but now I know.  And so do you.