Snacks
Between meals, I ate constantly. Yogurt. Fruit. Pudding. Cheese and crackers. Salads. Nuts. Trail mix. Cheez-Its. Granola. Cereal with milk. Ice cream. Milk shakes. Hot fudge sundaes. Homemade goodies that friends and family brought for us: banana or pumpkin bread, cookies, pastries, coffee cake, scones, cobbler. All delicious! And I really enjoyed the fancy rolled wafer cookies; they were so delicate, elegant, and fussy—so completely opposite of how I was feeling. Having them made me feel somehow special, like a patron in a restaurant where the chef comes out to say hello, or a child whose mother knows his favorite dish and serves it on a dreary afternoon.
Sometimes, Heather would bring me Andes chocolate mints as a signal that I could stop and soon put my head on the pillow. No check to pay, just my reward for finishing the day’s mileage before turning in for the night.
Drinks
It’s been said that caffeine isn’t good for athletes, because it serves as a diuretic and can dehydrate you. It’s also been said that it’s beneficial to performance, so the jury is still out on this one, at least among the scientists. However, I’ve found that during my extreme events, caffeine’s essential. As we made our way across the United States, I had coffee in the morning, and Red Bull in the evening. During the day, I often drank Starbucks DoubleShots and Frappuccinos in my Muscle Milk, a high-protein sports powder mixed with whole milk that I drank all day long (with or without a caffeinated boost). During the 52½ days on the road, I went through twelve 2.98-pound containers of Muscle Milk, a total of 228 ten- to twelve-ounce servings, or more than four servings per day. In addition, I drank Ensure, another high-protein “liquid meal.”
Not one ounce of plain water crossed my lips, as every sip needed to deliver some of my calories for the day. I did enjoy orange juice every morning; throughout the day, I had various fruit juices, soft drinks, yogurt drinks, Kool-Aid “slushies” that the crew whizzed up (loved ’em!), and energy drinks like Fuze and SoBe; and I drank at least two O’Doul’s at “happy hour” each night. And the pièce de résistance, the treat that always made my day: a root beer float.
Appendix D
Injuries, Ailments, and Treatments
In Roosevelt, Utah, Dr. Paul told me that he’d seen more ailments during our run so far than in the entire lineup of athletes at the Western States 100 and Badwater 135 combined.
“Are they worth shooting?” Joking, I was asking if our legs and feet were bad enough to warrant us being put down, like disabled farm animals.
He laughed. “Well, I told Charlie that he’s lucky I’m not in veterinary medicine.”
We were both lucky not to be racehorses, that’s for sure. But I should speak only for myself: I stumbled, I hobbled, I broke down. Still, I maintained my form as best as I could, even walking into the hospital the one time we sought medical attention, strutting like there was nothing at all wrong with me. It was a point of pride: Okay, I may be injured, but you’re not going to tell me to stop running unless you can prove to me that I can’t continue. I sure as hell won’t give you your evidence.
God, I’m hardheaded. Case in point: herewith a general log of the injuries and ailments, along with their treatments, while I was running across the United States.
Disclaimer: I’m not a doctor, so this is a layman’s list, not medical advice. If you ever deal with any of these problems, consult your own physician to get proper, prompt treatment.
Joint Pain (Onset: Day 1)
While everything ached pretty much from the start, late during our first week, significant pain began in my right knee. Dr. Paul treated it with manipulation, and I wore elastic pullover knee braces to help stabilize the joint as I ran. I also wore a more substantial brace from VQ OrthoCare for one day. About halfway across the country, I was able to ditch the braces and use them only occasionally if the knee flared up.
My hips became an issue during the second week. Tired and overworked back muscles and my tendency to over-pronate were likely contributors, as well as the length of my stride, quite long given my height. There wasn’t much to do for this pain, and it stayed with me throughout the run. Unlike some of the other ailments, though, this one would come and go.
Heat Exhaustion (Onset: Day 2)
With temperatures reaching into the nineties during the first few weeks, I did my best to minimize the impact of the heat, but it was inevitable: the heavy sweating, the paleness, the muscle cramps, the fatigue and weakness, the dizziness and headaches. My crew kept me hydrated, I replaced electrolytes using Sustain, and I sought shade wherever I could find it. The high temps ceased to be a problem on day twenty, when we reached cooler weather.
Muscle Cramps and Strain (Onset: Day 2)
Periodically, I experienced muscle cramps, involuntary and forcible muscle contraction, including severe cramps like a charley horse, when the muscle locked in spasm. At various times, my hands, the arches of my feet, my calves, and especially toward the end of the run, my back would cramp up. This is a common problem most runners face at some point or another, usually near the end of intense exercise, or a few hours later, and in the heat because sweat drains the body of fluids, salt, and minerals. These cramps were annoying, and the more serious spasms occasionally stopped me in my tracks, but this was probably one of the more minor issues during the transcon.
Perhaps every muscle and tendon in my legs and feet was strained at one time or another, or maybe even throughout the run, from overuse. One main area of strain was in my hamstrings, which tightened up every day. Strains are more likely to happen when one muscle group is stronger than its opposing muscle group, as with hamstrings and quadriceps. The quads on the front of the thigh are usually more powerful, so during endurance events, the hamstring can become fatigued faster than the quads, leading to strain. The problem with hamstring strain—aside from the immediate issue of pain in the back of the legs—is that it can compound into lower-back issues, which it did for me later in the run (see page 276).
During the first ten days of the run, I wore Zensah compression sleeves on my calves to increase circulation and oxygen blood flow. To deal with muscle strain and reduce inflammation throughout the run, we used ice therapy on various parts of my body, including my feet, ankles, calves, knees, and thighs. Whenever possible, we elevated my legs—in fact, every night except one, when she wasn’t there, Heather put pillows under my legs and ice on the sore spots to treat injuries. Stretching and massage were both an effort to keep me as limber as possible to prevent minor strains from becoming major injuries.
Tendonitis (Onset: Day 2)
Various tendons in my feet, ankles, and legs were overworked from the start, and my Achilles became inflamed nearly immediately. Connecting the calf muscles to the heel bone, it’s the largest tendon in the human body, and can withstand forces of one thousand pounds or more. Still, it’s a vulnerable spot, a common area for an overuse injury among all types of athletes. It’s likely that my Achilles tendonitis came from my tight and tired calves, bringing some severe pain, both while running and at rest, as well as terrible stiffness after sleep.
Another serious tendon issue was posterior tibial tendon dysfunction during the first eleven days of the run, when this tendon—which starts in the calf, stretches down behind the inside of the ankle, and attaches to bones in the middle of the foot—became inflamed and tight, causing pain and swelling in the inner ankle down into the arch in my foot. This gradually developed into pain on the outer side of my ankle and foot, and tenderness over the midfoot. It’s hard to say if this ever resolved; it certainly contributed to, or maybe just graduated into, the plantar fasciitis described on page 274.
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.
Sleep Deprivation (Onset: Day 3)
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.
Blisters and Bloody Nose (Onset: Day 5)
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.
Canker Sores (Onset: Day 7)
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.
Plantar Fasciitis (Onset: Day 12)
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.
Longitudinal Tear in Tendon Tissue (Diagnosis: Day 23)
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.
Infection (Onset: Day 43)
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.
Diarrhea (Onset: Day 44)
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.
Dislocated Fibula (Day 45)
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.
Severe Back Pain (Onset: Day 38)
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.
Post-Run Recovery
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.
Appendix E
Supplies, Clothing, and Gear
Most of my clothing and equipment was kept in the crew van and RV, as described here.
Shoes and Clothing
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:• Shorts, both loose-fitting running shorts and compression shorts
• T-shirts (cotton and technical)
• Long-sleeved technical shirts of various weights
• A light fleece shirt (one of Heather’s that I found to be the right weight, although the periwinkle color wasn’t very masculine)
• Fleece vest (one Kate bought in Iowa somewhere)
• Tights and running pants of various weights
• Raincoat (Heather’s purple GoLite Gortex one, until Dave Thorpe bought me my own in Indiana)
• Warm fleece coat
• Hats (a lightweight skullcap was my favorite), gloves, and a Buff
• Socks of various types and weights, including Injinji tetra socks, Zensah compression leggings, and what came to be one of my favorites, Balega
Running on Empty Page 24