IS THIS HOW THE STORY ENDS?

In this second post, I dive deep into what really happened towards the end of 2023, why I didn't race Berlin Marathon and why I have been absent from the racing scene since then. I also share where I am now in my journey and the perspective I have gained from going through these major health and injury setbacks over this past year.

Disclaimer: I will be going into detail about my chronic health struggles and injuries, but I also speak openly about my mental health. I am not giving advice or guidance in this post with the hopes it will make someone else feel less alone in their own struggles with mental health. This is my personal experience; it is best to seek professional help/support.

THE BEGINNING OF THE END

I started August on a strong note with one of my fastest 40 km long runs yet. It was a regular Tuesday morning, but I was fueled by my goals and had work to do! With sights on the Berlin marathon, I was fired up and motivated. On a solo mission in my neighbourhood, I clocked a 2:27 for the 40 km.

Four days after that long run, I planned to squeeze in a short workout before racing the Totalsports Ladies Race the next week. But, during the first rep of this straightforward 8 x 1 km session, I felt one of the weirdest sensations ever. My whole body went numb. It felt like my heart was beating out of my chest, and my head was going to explode. I collapsed on the sidewalk shortly after hitting the 1 km mark. I was completely out of it. What happened?!

I could hardly jog during the following few days, but I still boarded the plane in hope of racing in Durban on the 9th of August.

Needless to say, I endured the race and clocked my slowest 10 km time since my junior years. It was even slower than the 10 km splits of my most recent marathon, and most of my long runs. Throughout the race, I grappled with symptoms like dizziness, fatigue, fogginess, headaches, and skyrocketing heart rates.

After returning home, I did some testing to find out what was going on. An ECG revealed abnormal spikes in my heart rhythm, potentially signalling an electrolyte imbalance. The next day, it was confirmed by blood tests: I was severely dehydrated and had clinically low sodium levels, indicating Hyponatremia*. The results were severe enough to put me at risk of a seizure, like I experienced in 2022.

I try my best to manage my Diabetes Insipidus**, but when you lose litres of fluid every day it is hard to keep up. I take salt pills daily to offset the sodium losses from my prescribed medication. Instead of plain water, I opt for electrolytes. I am constantly trying to learn more about this condition and how to manage it. However, chronic illness can be relentless: it doesn't care about your goals. There's no easy fix or cure. It's something I'll have to manage for the rest of my life.

*Hyponatremia is a medical condition characterised by a low concentration of sodium in the blood. Sodium is an essential electrolyte that helps regulate water balance in and around cells. Hyponatremia occurs when the sodium level in the blood falls below 135 millimoles per litre (mmol/L). This imbalance can be due to various factors, such as excessive water intake, certain medical conditions, or medications. Symptoms of hyponatremia can range from mild to severe and may include nausea, headache, confusion, fatigue, and, in severe cases, seizures or a coma. It's a condition that requires careful medical management to correct the sodium imbalance safely.

**Diabetes insipidus is a rare condition characterised by intense thirst and the excretion of large amounts of urine. It occurs when the body cannot properly balance fluids. This imbalance is typically due to a malfunction in the production, storage, or release of antidiuretic hormone (ADH), also known as vasopressin, which is produced in the hypothalamus and stored in the pituitary gland. ADH regulates water balance in the body. There are two main types of diabetes insipidus: Central Diabetes Insipidus: Caused by damage to the hypothalamus or pituitary gland, affecting ADH production, storage, or release. Nephrogenic Diabetes Insipidus: Occurs when the kidneys don't respond properly to ADH.

Symptoms include excessive thirst and urination, which can disrupt sleep and daily activities. Treatment depends on the type and involves either replacing ADH (for central diabetes insipidus) or taking medications that reduce urine output (for nephrogenic diabetes insipidus).

POWERLESS

I think the reason this part took me so long to write was due to the fact that I didn’t understand what was happening in my body. Pain is a clear indicator that something is wrong, but I didn’t have pain. My symptoms were unlike anything I have experienced before.

The first signs of weakness came shortly after I ran the Total Sports Ladies Race. I started experiencing weird sensations. I was losing power and feeling in my left leg. At first, it was subtle. It only happened on certain days, but it gradually became a daily struggle.

I intitially thought it was something I needed to fix. In my stubborn endurance mindset, I told myself to just work harder. I went to see a biokineticist, who gave me a couple of plyometrics and strength exercises to correct the supposed power imbalance. I worked hard in the gym, but that only made it worse.

My symptoms progressed to a point where I could no longer execute speed workouts or finish long runs. I felt like my left leg would collapse underneath me – my whole foot would go numb and would tingle with pins and needles.

Ultimately, that was the primary factor in my decision to pull out of the Berlin Marathon. You can't show up on race day if you didn't do the work. Confidence comes from knowing you've prepared well for the task ahead.

I was not prepared.

I couldn't run my race pace without feeling like I was hobbling on one leg. I didn’t know if I would be able to finish the race anymore. It was one of the hardest decisions I've ever made, but I knew it was the right one.

Pulling out of the Berlin Marathon was so painful. It was my first opportunity to run in a major overseas marathon amongst the best athletes, like world record holder Elliud Kipchoge. It is one of the biggest, most prestigious races in the world – and flat as a pancake. Most of the South African races are too hilly to run times comparable to fast marathons like Berlin and Valencia.

I had this big opportunity standing in front of me, and I couldn't seize it.

THE STORM

On the weekend of the Berlin Marathon, a storm woke us during the night. Gusts rattled the windows and doors. On the morning of the race, I went for an easy run in one of the craziest wind storms I have ever experienced.

There was damage everywhere: scattered leaves, trees blown over, and even garbage bins lying around. It was one of the worst runs of my life. I felt like I had no power in my left leg.

My diabetes insipidus was rearing its head, leading to an onset of neuropathy: the cold caused constant swelling in my hands and feet. It was torture. I was chronically dehydrated, which led to relentless fatigue and headaches.

My hands and feet were constantly swollen and very painful as a result of my diabetic neuropathy

Running no longer felt natural and effortless like before; it felt forced and uncomfortable – the fun was gone.

Conditions worsened the next day, and we had some of the heaviest rain of that winter. The river overflowed, which added to the already severe flooding and damage to the town.

Between my symptoms, this injury, and just trying to survive, the storm felt eerily symbolic of my life.

ROCK-BOTTOM

The reason why sharing this whole experience took so long was that I found myself in one of the darkest places I have ever been… and I have been to some pretty dark places. This time I was in so deep, I didn’t really have the energy or courage to share it with anyone.

Who would want to hear something this depressing? I didn’t want people to feel sorry for me. I wanted people to just forget about me.

I wished I could just disappear.

In fact, for a couple of months not a day went by without overwhelming thoughts of self harm. The burden became too heavy. Not only was I suffering through severe daily symptoms, my largest source of joy and meaning suddenly made me feel weak!

I was also under immense financial pressure. I lost my major sponsorship at the end of 2021, during the pandemic. I really hoped that claiming the national title by winning the Durban International Marathon would lead to another sponsorship. The feedback I received after the race was that it was not good enough for sponsors or elite clubs. My 2:30:00 effort was too slow. It fell short of both the Olympic qualifying mark of 2:26:50 and the World Standard of 2:28:00.

‘Simply work harder,’ I told myself, setting my sights on the Berlin Marathon. But, when that too slipped away, I became desperate. And being desperate often leads to poor decisions.

After withdrawing from Berlin, we tried to find a new marathon that would have given me more time, which led to acceptance into the elite field of the Abu Dhabi marathon in December.

I should have just taken a step back, allowing my body to reset. Yet, I pressed on, striving to lift some of the financial pressure I was placing on my parents, due to extreme medical costs.

I didn't have pain, therefore. not running at all felt unjustifiable, but it was incredibly uncomfortable. There were pins and needles running through my left leg, which would lead to a complete loss of feeling towards the end of a run.

PICKING UP THE PIECES

Barely afloat and we're taking on water

Still chasing the high that I felt the whole summer

Being buried alive with a smile on my face

A drink in my hand and a day to erase

I'm picking up the pieces, please just look the other way

I'm picking up the pieces, please just look the other way

I go off the rails every chance that I'm given

Is it worth my life if it means I might fit in?

I look at the wounds that I choose to inflict

While I hold my tongue and I tighten my grip

I'm picking up the pieces, please just look the other way

I'm picking up the pieces, please just look the other way

I'm not falling asleep, wish my heart would beat slower

Thinking back on my year, wanna start it all over

I wake you up and I tell you I'm losing control

I'm barely surviving, but I need you to know

I'm picking up the pieces, please just look the other way

I'm picking up the pieces, please just look the other way

'Cause baby I'm afraid I'm slowly pushing you away

By showing you the deepest, darkest, weakest part of me

You said you'll always be right here to keep me company

When I don't even love myself you love me anyway

When I don't even love myself you love me anyway

~ Look The Other Way, By Baretooth

While cross-training on my ElliptiGo, I listened to this song by Baretooth. The lyrics really spoke to me at the time. I longed for a reset button for this year – something to undo the mistakes I made, to prevent this all from happening.

But, even if I could have gone back, I was still puzzled. What were those strange symptoms I felt during runs? How did I suddenly become so weak? What happened to the marathoner I used to be?

The one thing I did know was that I had reached my breaking point – both physically and mentally.

I needed to start picking up all the broken pieces… even though they seemed beyond repair.

We finally decided to get testing done. The pain wasn’t unbearable, but I knew the experience was not normal. An MRI showed an annular tear in my back, in the exact same location that got hurt during a car accident in America. My spine looked healthy when we compared the scans to the ones done in 2018, but the disc between L5 and S1 was badly compromised. This time, there was a significant tear in the disc, which explained the severe nerve irritation that was radiating down my entire left leg.

The doctor deduced the cause to have either been falling or lifting something heavy. It could have been the fall in August or a gym session, or something else entirely. I honestly don’t know, but playing the “what if” game never helps.

EMBRACING THE SUCK

Ultimately, I knew I had to let go of trying to race another marathon in 2023, and had to focus on getting my injury sorted. I underwent two medical procedures of which the first did not bring any relief in symptoms.

I was at a point where I couldn’t even drive anymore! In fact, simply sitting caused a loss of feeling in my leg and extreme pain in my left upper-hamstring glute insertion. I depended on my parents to drive me to appointments for the entirety of December, which included a physio who specialises in nerve pain and back injuries.

Embrace the Suck = The ability to gut out the tough times; to find happiness and even fulfilment during difficult times – an indispensable skill and mindset.

Once the festive season rolled around and my family went on holiday, I decided to stay home alone with my pup, Nike. The thought of sitting for long hours in a car sounded painful. It gave me the chance to reflect on the year that had passed.

I needed to bide my time, allowing the story to unfold.

I spent hours strolling in the beautiful vineyards and mountains with Nike, listening to my favourite podcasts. How I dreamt of running up those hills instead – and flying down on the other side.

I also did a lot of journaling, focusing on writing down my core values and coming back to my WHY. I had to admit, to myself, that I was no longer living as my authentic self, and not showing up in the world the way I aspire to.

I am not a victim of my illness or this injury! I have learned to embrace the suck.

While I could not run, I poured my energy into my coaching and nutrition business, Annie’s Athletes. At least I could help others achieve their goals and dreams. I could support and guide them through their training journey, as well as teach them good nutritional habits that will not only lead to their best performance, but also give them longevity in the sport that we love so much.

YOU MAKE PROGRESS IN DROPS AND YOU LOSE IT IN BUCKETS

On the first of January, I ran on the grass for 20 minutes and finally felt the ground underneath both my feet for the first time in almost 6 months! I gradually increased my distance such that I was ready to start transitioning back into marathon training by the end of January.

I started making great progress and was preparing to defend my title of South African Marathon Champion at the Durban International Marathon, but then, on the 12th of February, during my first long run in months, all my symptoms came flooding back. I was only 3 km into the run when I started losing feeling in my left leg and feeling pins and needles in my foot. By the 10 km mark I was basically running on one leg and was forced to stop and walk back home.

You make progress in drops, and you lose it in buckets.

My dream was over. It was time to let go.

In 2015, when that car hit me in America, my whole life changed.

IS THIS HOW THE STORY ENDS?

This is the most serious injury I have experienced in my running career, and what makes it so hard is that it wasn’t even caused by running. No amount of rehab or strength work can fix it.

There is nothing I can change in my diet to help me heal faster. It was an accident that injured my back, and only time will tell if I will be able to overcome it.

Right now, I can only walk and do some strength training. I don’t know how the journey back will look…

BUT, I do know that I am not ready to give up just yet!

Is this possibly a career ending injury? Have I considered retiring and stepping away from the sport?

Absolutely.

Honestly, sometimes I wish I cared less and didn’t love it so much.

It’s a part of me. I really can’t imagine my life without it. I also know I have more to give. I do not believe I have tapped into my full potential. I have not achieved the goals I set for myself. In practice sessions, I have seen glimpses of the times I think I am capable of, but it means nothing until I clock them in an official race.

I have unfinished business.

I may not have a lot to show for 2023, or 2022 for that matter. In fact, since 2020, it has been a wild ride, both personally and professionally. However, I have gained so much knowledge about my own body, my medical conditions, nutrition, and training. I believe it will set me up to make better decisions moving forward; decisions which will not only benefit my health, but also my athletic performance.

“I’ll never be as great as I WANT to be. But, I am willing to spend my entire life trying to be as great as I CAN be.” — Kenny Aaronoff

If you’ve made it this far…

THANK YOU!

Thank you for taking the time to read my story and following my journey. It really means a lot to me.

I do hope this post helps someone out there who may also be struggling with some dark demons or battling through an injury, illness, or some other setback. Know that you are not alone in your fight.

#RunToOverCome

~ Written by Annie Bothma, edited by Francois Bothma