Weekend Reading: Side Effects May Include…

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For the first time since the inception of the CTS Endurance Bucket List in 2010, I failed to reach the finish line of an event. Thirty of the 32 CTS Athletes who traveled to Costa Rica for La Ruta de los Conquistadores completed the race – a finisher rate of 94%, compared to the race’s overall rate that’s closer to 60% – but I didn’t. If only I had read the directions on the package.

The root cause of my DNF can be traced to feeling a bit under the weather about a week before the race. I visited my doctor, who prescribed antibiotics. Normally this would be no problem but I neglected to mention that I was headed to the tropics to race in hot weather and bright sun for several hours a day over a three-day period.

Why, might you ask, would it be somewhat important to mention that fact to my doctor? Well, because photosensitivity is one potential side effect of antibiotics. This is why doctors and pharmacists and package inserts all do their best to advise you to refrain from prolonged sun exposure (ie. tanning) while you’re on antibiotics.

So… fast-forward a few days and I’m in Costa Rica for La Ruta. I felt OK on the pre-ride with the rest of Team CTS on the day before the race, the food and accommodations were great, my coaches and our support crew were totally dialed in. Everything was perfect.

LaRuta_2014_teamcts

Team CTS for the 2014 La Ruta de los Conquistadores

 

During the first stage, though, I started out strong and then faded. I chalked it up to the heat, but figured I was just not acclimated to tropical temperatures and humidity and got a little overheated and dehydrated. All things I could fix with a good recovery strategy overnight and I’d be better for Stage 2.

CC_stage2_laRuta2014

Not feeling well at all during Stage 1.

 

With the help of ProBar Bites and plenty of fluids through the afternoon and a bottle of Osmo Preload in the evening, I felt good as we rolled out the next morning for Stage 2. That didn’t last long. After about an hour I started losing power. I struggled on, but toward the end of the stage on I felt nauseous, out of focus, and completely cooked. I was so overheated – despite consuming a ton of fluids – that I stopped by the side of a road to rest in the shade. I eventually reached the finish line but still hadn’t made the connection between the antibiotics and my struggles on the bike.

CC_stage1_laRuta2014

CTS Coach Adam Pulford coaxing me through a rough day .

 

The night after Stage 2 I was wiped out. More wiped out than I should have been. But there was one more stage to ride and I don’t quit, so I focused on hydration and nutrition, used the Normatec Recovery boots on my legs, and went to bed early. One more stage. All I had to do was one more bike ride. In the morning I felt OK, not great, but good enough to start.


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Stage 3 ended unceremoniously when I fainted at the first aid station. I remember really struggling to make it to the aid station, which was at the top of a long, hot climb. Eventually I had to get off the bike and walk. As I’m told, I pretty much walked into the aid station and collapsed. One of the crew caught me as I went down, they all helped me cool off, and then later drove me to the second aid station. It was there that CTS Coach Adam Pulford helped make the connection between the antibiotics, photosensitivity, and overheating. I spent the rest of the afternoon sitting in the shade with icepacks, sipping on water and sports drink.

No finisher’s medal for me this year. I didn’t give my doctor enough information and didn’t read the warnings on the label, and I got sidelined by side effects. But I am so proud of the coaches, crew, and athletes that were part of Team CTS. I am used to leading by example, as an athlete, a coach, and a business owner. But as I felt worse and worse, it was my coaches and crew that had to take care of me.


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I have long been proud of how professionally my coaches conduct themselves at camps and Bucket List events, particularly when situations change unpredictably and they have to handle it on the fly. This time I had to rely on my team to help me in ways I’m more accustomed to helping others. Although it wasn’t a pleasant experience for me physically it was extremely fulfilling to be on the receiving end of their care and expertise, and to experience first hand the support and service they provide to CTS Athletes.

The lessons I hope you learn from my experience are:

  • Tell your doctor about any trips or events in the near future. Also inform your doctors – if they don’t already know – that you’re an athlete. Your activity level and environmental exposure can provide valuable context to their examinations and their treatment plan.
  • Read the label! At the end of the day it’s your responsibility to be aware of the side effects of medications you’re taking.
  • Have a great support crew. Not only does a great crew help you enjoy an event more and perform at your best, but they might also save your ass.

Here’s the full listing of CTS results at the 2014 La Ruta de los Conquistadores. Congratulations to the Elite Women’s Champion, Angela Parra! Great job to Elite Men’s runner up Luis Mejia and to Eddy Perez for finishing 8th in the Elite Men! And to Jordan Salman on 8th place in Elite Women. And congrats to Mary Dannelley on winning the Masters Women race, to Mike Dannelley on placing 3rd in the Masters 50-59 race, and to Tab Tollet for finishing 6th in the Masters 50-59 race! Click here for a photo gallery from the race.

Athlete NamePositionCategory
Angela Parra1stElite Women
Jordan Salman8thElite Women
Luis Mejia2ndElite Men
Eddy Perez8thElite Men
Mary Dannelley1stMasters Women
Alison Jones8thMasters Women
Angelo Brunacini48thMasters 40-49
Mike Dannelley3rdMasters 50-59
Tab Tollet6thMasters 50-59
Jimmy Railey9thMasters 50-59
Darrell Jones10thMasters 50-59
Rick D’Amico11thMasters 50-59
John Swift16thOpen Men
Andrew Bennett22ndOpen Men
David Swift76thOpen Men
Randy Potter91stOpen Men
Tom Bergman116thOpen Men
Michael Talbert119thOpen Men
Greg Carlisle125thOpen Men
Bill Smith184thOpen Men
Robin Wilkes185thOpen Men
Steven Dochey186thOpen Men
Ted Koutouzis195thOpen Men
Alec Litowitz199thOpen Men
Chris Foster201stOpen Men
Michael Widmer204thOpen Men
Patrick Lederer206thOpen Men
Jay James227thOpen Men
Mark Seaburg231stOpen Men
Chris CarmichaelDNFOpen Men
Ross StevensDNFOpen Men

 


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Comments 10

  1. CTS support team, coaches and overall approach are simply the best I have every experienced !

    Very interesting to understand the implications for athletes on antibiotics.

    Congratulations to the CTS team at La Ruta 2014…. !

  2. Not to mention the obvious, but did it ever occur to you that you were sick?
    Maybe doing a three day bike race is not such a good idea if you are ill.

  3. Another consideration would be the impacts of long-term medications, like statins for lipid management, which are often taken for life once prescribed. Statins have a reputation for potential muscle pain and muscle damage in the general population and possibly more so among endurance athletes. Doctors frequently test for the presence of markers in the blood, but many people suffer muscle pain without the markers being abnormal. Endurance athletes may want to explore other options for lipid management before starting statins or agreeing to an increase in dosage.

  4. Medications and even simple things like sunscreen can mess up a ride. While in Europe I discovered a great sunscreen that wasn’t available in the US – one that provided all day protection without having to reapply. Unfortunately it took me several races to discover that the sunscreen got absorbed into my system and caused me stomach issues. When you are pushing the envelope athletically it doesn’t take much to ruin your day.

    1. Which antibiotic he was on really is not important — ALL antibiotics are serious medicine and can have significant side effects.

      I hope that Chris has followed up with his MD to be sure that it was just the effect of the antibiotic, because these are symptoms that could be consistent with more serious problems also.

  5. Chris,
    As a physician I welcome your cautions about athletes informing their physicians about their level of activity and exploring risks with medications. My own dad got hit with a serious tendon rupture which was a side effect of an antibiotic prescribed for a fairly minor infection. This unique physical stresses of athletic performance are important data in decision making about treatment that your doc needs to know about.

    1. I am also a physician and I would also caution everyone to ask their doctor if the antibiotics are really needed for treatment. There is a frequent tendency in this country by MDs and patients alike to want to use antibiotics to treat viral infections (colds, flu, sinus infections, gastroenteritis etc). This tendency not only exposes patients to the side effects of antibiotics, but (more importantly), increases the risk of developing future antibiotic resistance

  6. Chris – thanks for sharing this. I appreciate you putting yourself out there. Glad you are ok and good to know even Chris Carmichael struggles. Will help me continue on through my bad days. Look forward to riding with you again soon – J.P.

  7. I can certainly attest to your coaches getting me through things I wouldn’t have thought possible (primarily cold/wet/awful weather during my very first mountain decent years ago); they’re the best! Hope you’re feeling better, Chris…there’s always next year! 🙂

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