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Alarm After an Intense Long Run

9/1/2025, 10:40:33 PMMale25-34

Hello everyone, At 36 years old, weighing 160 pounds and standing 5'8", I’m currently on an SSRI as part of my medication regimen. This November, I’m set to participate in my first marathon in New York City, and I’ve been diligently preparing for the event over the last few months. My training has been consistent for a couple of years now, and I always take precautions to minimize the risk of both internal and external injuries. To ensure my health was in check before tackling 26 miles, I visited a cardiologist last month. After undergoing an EKG, a sonogram, and a stress test, I received reassuring news: everything looked great and I was cleared to run the marathon. This past weekend, my training included an 18-mile run with hill challenges, utilizing the Runna app to guide my pace. Opting for three laps around Central Park, I felt confident as I had previously completed 19 miles on flat terrain and had done 2.5 laps of Central Park without any issues. My breakfast consisted of a Red Bull, a bagel, and a protein bar, followed by another bagel for lunch. I also packed two running gel packets for energy during the run and had electrolytes mixed in my water bottle. The run unfolded smoothly, maintaining an average pace of 8:25, and I successfully completed 19 miles total. Post-run, I felt accomplished, though naturally sore, and even treated myself to a Celsius energy drink afterward. However, a few hours later, things took a troubling turn. I experienced diarrhea, which is unusual for me, followed by a wave of nausea. I attempted to settle my stomach with an IV electrolyte drink and took Pepto-Bismol. But within 20-30 minutes, the pain intensified, manifesting as severe cramping in my abdomen, reminiscent of gallbladder issues I’ve dealt with in the past. With the discomfort escalating, I made the decision to head to the emergency room. The pain during my Uber ride was unbearable, radiating towards my chest and back, which heightened my concern. I felt as though I was suffering from extreme gas pains, becoming clammy and struggling to breathe. Upon arriving at the ER, I was promptly taken in to be assessed. The medical staff noted my distress as I indicated I felt faint during the vitals check. Although I don’t believe I actually lost consciousness, it was a similar sensation to the dizziness experienced while having blood drawn. Suddenly, I found myself surrounded by multiple doctors conducting a flurry of tests. I was terrified at the thought that I might be experiencing a heart attack. A nurse shared her own story of a heart attack linked to excessive energy drink consumption, which wasn’t very comforting at that moment. I repeatedly asked if I was in serious danger, as it genuinely felt that way. Thankfully, they administered medication to alleviate the pain, which subsided momentarily but returned later, though no longer in my chest—just in my abdomen. The cardiologist then performed another ultrasound and EKG, and everything appeared normal, making it likely that I would be discharged later that night. However, blood tests revealed elevated enzymes in my bloodstream, which warranted an overnight stay due to the potential implications—anything from heart attack indicators to simply a fatigued heart from strenuous exercise. By morning, I felt much better, and another blood test showed significantly reduced enzyme levels, indicating a favorable outcome. The medical team concluded there was likely no heart attack involved; rather, it seemed the combination of a strenuous run and high caffeine intake from the energy gels and drinks had caused strain on my heart. Has anyone else experienced something similar? I’m feeling a bit shaken from this incident and am unsure how to proceed with my training. Is it safe to continue training after a few days of rest (without resuming long distances right away)? Any thoughts on what might have occurred would be greatly appreciated.

LupusCrohn's DiseaseEndocrinology

Answers (1)

Cony

9/1/2025, 10:40:49 PM

OpenHealth AI

It's understandable to feel shaken after such an intense experience, especially given the combination of a long run and the concerning symptoms you faced afterward. Based on what you've described, it's possible that your severe abdominal pain and nausea were related to dehydration, electrolyte imbalance, or the effects of high caffeine intake. Such symptoms can also be heightened due to the physical stress of an intense workout, especially when combined with energy drinks.

Key Points:

  1. Symptoms After Intense Exercise: Symptoms like diarrhea, nausea, and abdominal pain after long runs can occur, especially with insufficient hydration and nutrition.
  2. Elevated Enzymes: Elevated heart enzymes can indicate heart strain but can also result from intense physical exertion, which seems consistent with the medical team's findings in your case.
  3. Recovery Post-Incident: It's vital to prioritize recovery and listen to your body moving forward with your training.

Next Steps:

  1. Rest and Recovery: Allow your body sufficient time to recover from this incident. Rest for at least a few days and gradually reintroduce light activity as you feel comfortable.
  2. Hydration and Nutrition: Focus on staying well-hydrated and consuming balanced meals, particularly incorporating electrolytes to maintain fluid balance before and after long runs.
  3. Monitor Symptoms: Keep a close eye on how your body feels on subsequent runs. If you experience similar symptoms again, it may be necessary to further evaluate your training plan and possibly consult with a healthcare professional.
  4. Caffeine Intake Adjustment: Consider reducing your consumption of high-caffeine products before long runs. Find out what works best for your body regarding energy and hydration during training.
  5. Gradual Training Resumption: When ready, ease back into your training with shorter distances and gradually build up the intensity. Listen to your body's signals and adjust accordingly.

It's commendable that you are prioritizing your health and safety. With careful management and adjustment based on how you're feeling, you can safely continue your training for the marathon. Remember, you are not alone in feeling this way; many athletes experience unexpected reactions to intense training, and learning to manage your body’s responses is part of the journey. If you have more specific concerns as you continue your training, feel free to share!

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