Running on Empty (34 page)

Late in the run, after I'd reached two thousand miles and crossed the Mississippi, I also experienced severe shin splints, a pain in the lower part of my legs, that was most likely medial tibial stress syndrome, an irritation to the tendons and the attachment of these tendons to the bone in the front of my lower legs. I worried that this would put me out of the running, just as it had Charlie. So we removed all pressure from the front of my shin, even pinning up the leg of my running pants, and I shortened my stride and iced it regularly. Luckily, I was able to stave off a more serious injury but continued to have lower leg pain on and off for the remainder of the run.

To deal with all these tendon issues, I fooled around with various orthotics and was very selective about shoes. I cut a notch in the back of my shoes and socks to keep them from rubbing against and irritating my Achilles. We iced various parts of my body, massaged my legs, and stretched. All of these efforts, and ibuprofen, helped some, but the Achilles continued to plague me until New Jersey, where Tom Triumph gave me a pair of soft, heel-cup inserts that helped immensely, not just with the Achilles pain, but also with other, more serious foot and lower back pain detailed on page 276.

Notable effects of lack of sleep—most pronounced during the earliest days of the run, when I was on the road up to twenty hours a day—included periods when I wasn't able to think straight or stay alert. It was most acute that night in Nevada, on day eight, when I was babbling incoherently and Heather pulled me off the road to get some sleep.

We used a prescription sleep aid to help me rest, because, aside from the fact that we allotted only a few hours for time in bed, it was difficult to actually sleep, as a result of my aches and pains. (The nightmares didn't help, either.) The Ambien was a mixed bag: It did help me rest, but because I often got up before the recommended length of sleep, I was groggy and disoriented.

The best treatment for this problem was more sleep, and it helped some when we instituted a naptime, just after I finished my first marathon of the day, which we started doing regularly in eastern Utah. After we decreased the daily mileage goal from seventy to sixty miles per day, I also got a little extra sleep. However, this issue persisted across the country, contributing to my emotional fragility. Rarely did I sleep more than five hours a night.

The tiny annoyance of both of these is almost not worth mentioning, as I sustained so few blisters (prevented with Sportslick and ENGO patches, and easily treated by draining them), and only one bloody nose. The nosebleed happened when we were east of Fallon, Nevada, and it was probably brought on by the intense, dry heat of the day. It took a while to get under control, but it did stop. I had no more trouble with this during the rest of the way across America.

Caused by constantly eating and drinking, my mouth became raw, and I developed open sores. At Dr. Paul's direction, we cut out salsa and citrus snacks for a while, and I rinsed my mouth several times a day for the next several days with a mixture of Mylanta and a squirt of Orajel. That did the trick, and I used the rinse occasionally throughout the rest of the run, as needed.

Diagnosed by Dr. Paul in Delta, Utah, this injury to my right foot occurred after I'd run just over seven hundred miles . . . and still had more than 2,300 to go. A relatively common and painful runner's ailment, this affects the sole or flexor surface (plantar) of the foot when the fibrous band of tissue (fascia) that connects your heel bone to the base of your toes becomes inflamed. One of the primary causes is tight calf muscles, no doubt a contributing factor in my case. Usually, rest is the first treatment for this condition, but that wasn't happening. I did take some time off on day twelve; after running just 12.8 miles, I went to a hotel and stayed in bed for the rest of the day. Dr. Paul also administered Kenalog, an anti-inflammatory drug, by injection to my gluteus maximus. I wore a night splint for a couple of nights after that, then replaced it with the Strassburg Sock. We managed the pain with ibuprofen and frequent icing during the day, and Heather iced my foot (and other aching body parts) for me at night while I slept.

An injury that can take months to heal, and even stops some people from running altogether, the plantar fasciitis persisted the rest of the way across America. We learned later, when I had an MRI in Sterling, Colorado, to diagnose a different injury, that it was likely that I didn't just irritate the fascia but actually ruptured it. The injury caused persistent pain and swelling in my foot, made my toes go numb, and created a hard, golf ball–sized knot of scar tissue in the arch of my foot that remains unresolved.

After an MRI in Sterling, Colorado, the doctor advised me that I had inflamed tendons in my right foot, and that I'd torn the tissue along the length of a tendon on the outside of my foot—not a torn tendon, per se, but a tear “in” the tendon. (He also told us about some other mild strains to the muscles in my foot.) It wouldn't heal without rest, he said, and he was right. It did not improve as I ran, but I did get better at ignoring the pain. We upped my dosage of ibuprofen, and I disowned my foot.

The big toe of my left foot became infected when one of the few blisters I got didn't heal properly. Dr. Paul diagnosed the problem when I showed him the red, swollen, and warm toe, and prescribed a course of antibiotics. The infection cleared up.

Although the antibiotic was effective in ridding me of the infection in my toe, it also caused an annoying side effect: diarrhea. Not too severe, but inconvenient: I had to stop frequently to relieve myself, and the diarrhea also caused some chafing, which I treated with Sportslick. The problem lasted about six days and then was resolved when I was off the antibiotic.

In Wooster, Ohio, I stepped off a curb and . . . snap! There was immediate, severe pain in my knee and calf. After Dr. Paul examined my leg, probing it to find the precise problem, he grabbed, pulled, and pushed and then—presto, change-o—I felt better! Heather iced the knee for me while I slept, and when I woke up, I was able to run without problems. Dr. Paul confided in Heather and Robert Spieler, but didn't tell me, that I had slightly dislocated my fibula, which he popped back into place.

Throughout the run, I often experienced low back/lumbar pain, which Dr. Paul attributed to tight hamstrings. It didn't gain much of my attention, however, as other physical issues were more pressing and painful, and I seemed to be able to overcome some of this discomfort by just waiting it out. However, by day thirty-eight, my back began to spasm and couldn't be ignored any longer. Dr. Paul attended to it with stretching and manipulation.

The morning of our last day, waking up in New Jersey, my back was a complete mess—I thought I'd have to crawl into Times Square—but a chiropractor gave me an adjustment that completely eradicated the pain, and I was able to run to the finish.

After I stopped running, it took several months for my body to stop aching—it was always hurting somewhere, all the time. But I have recovered from nearly all my injuries. Every now and then, some of my joints ache, but whose don't? The plantar fasciitis and tendonitis have had the longest-lasting effects: There's still scar tissue in my arch, and I have yet to regain feeling in either of my big toes. But that doesn't necessarily mean I've sustained permanent damage, just that I need to give it time. I've been hurt before and, even though it's taken years in some cases, regained full sensation. The body has a miraculous ability to heal itself.

Most of my clothing and equipment was kept in the crew van and RV, as described here.

The crew kept a variety of shoes in the van for me, as I often switched them out during the day, depending on how my feet were feeling, the terrain (uphill or downhill), and how much cushioning or pronation control I felt like I needed. Usually, though, the shoe changes were about making sure that whatever was on my feet wasn't broken down, that the structural integrity of the shoe was intact. My favorites were from Pearl Izumi. I also wore, and wore out, at least fifteen pairs of Nikes supplied by Champs.

In the back of the van, the crew kept my “closet,” a tall collapsible laundry basket that contained almost all of the clothing I would wear during the run. Heather kept a few items in the RV, like street clothes I would finally wear again after I finished, but most everything was in my closet. To make it easier for the crew to find what I needed, my clothes were put into large ziplock bags, labeled with black marker and separated into the following categories:

This closet went with us at night, into the RV or hotel, to ensure that I would have access to all of my options in the morning.

Every morning, I strapped on my GoLite Slant pack, with one holder (I cut the other one off) for a GoLite water bottle to carry my Muscle Milk. In the pack, I kept my rescue inhaler in case of an asthma attack, a lightweight GoLite wind jacket, a pocket-pack of tissue for toilet paper, and hand sanitizer. My orange SPOT tracker hooked onto my Slant Pack belt, along with (most often) one of two Sirius satellite radios, which I usually kept tuned to The Spectrum.

We had a medium-sized plastic container, with a lid, that the crew called my “murse,” short for “man purse.” Truth is, I didn't like that name much, but a crew person had come up with this the previous year at Badwater (the same year Dr. Paul started using the term “gimp”), and it just stuck. After all, it contained all of my daily necessities, frequently used items like those you'll find in most women's purses. Items in the murse included:

The murse would also follow me for naps and at nighttime, as it seemed that I would always need something from it.

In the front of the van, the “wheelman” would keep the logbook, recording the following information: