OBEY YOUR THIRST!

A runner, the other day, asked me how many water stations would be available during tomorrow’s Cebu City Marathon. I was quick to the draw and said, “13.” Before I say any word, she quickly said, “Would that be enough?”
That stopped me on my track! I thought for a minute and finally said, “Of course, that would be enough. You’ll pass through those stations twice if you’re running the full marathon, so that’s 26 in all. That means roughly a water station for every two kilometers which is standard for a marathon.”
The runner left before I could ask if she intends to drink water from all those water stations. Reason I asked is that runners seems to forget that water – as it is – is only good as a thirst quencher, and most often runner drink too much.
Can’t blame runners if they drink too much water. They probably read somewhere, or heard people say to replenish 100 percent fluid (weight loses) during strenuous activity such as running a marathon. Russ Tucker and Jonathan Dugas in their book “The Runner’s Body” warned: “The 1996 guidelines instructed athletes to avoid dehydration at all costs and to drink as much as tolerable during exercise. Runners often followed this advice to their detriment, because they usually exceed their sweat rate (often by an enormous volume) and ended up gaining weight during the marathon and diluting their blood.”
A runner with diluted blood, means that he has taken too much fluid, and may suffer from hyponatremia – a critical medical condition. Hyponatremia causes imbalance inside and outside body cells causing the fluid to shift inside the cell. The area most affected by overload of fluid is the brain which is very sensitive to changes in pressure.
Typical symptoms of hyponatremia are headache, nausea. Problem is that headache and nausea are also symptoms of dehydration, so how could a runner determine what is hitting him? The sure way to find out, as pointed out by Tucker and Dugas is “bloating and swelling.” Like the “runner’s watch or ring might be very tight, because there will be swelling in the arms and legs...Also if you’re throwing up large amount of fluid, you can’t possibly be dehydrated.”
In sever cases, the runner will continue to vomit and will appear incoherent. “The technical term is altered mental status, and it means that the swelling is affecting the brain and causing some mental dysfunction. The runner probably will not know where he or she is, what day it is, or even who you, a friend, or family members are. If someone you know has these symptoms go immediately to the emergency room of the medical tent, whichever is closer. This condition may worsen at any moment; seizures might develop. If the sodium concentration is low enough, then perhaps respiratory arrest, coma, and eventual death could follow.” again according to Tucker and Dugas.
Tucker and Dugas cited several cases of fatal hyponatremia. I’m still quoting from the their text, unless indicated. This is not to scare runners, but only to share some facts.
“The first reported case of hyponatremia in the scientific literature was in 1986. It was a runner in the 90 kilometer Comrades Marathon in South Africa. The woman was in grave condition and was hospitalized; ultimately she recovered.
“Kelly Barrett was running the Chicago Marathon in 1998 when she stopped just a mile from the finish. Paramedics picked her up and, believing her to be dehydrated, reflexively administered IV fluids. After just four ounces, Barrett stopped breathing. She survived long enough to be admitted to the hospital, but sadly, she died three days later – her brain had been damaged when she stopped breathing, and the functions never returned.
“Four years later, in the 2002 Boston Marathon, the tragedy played out once again. This time it was another young woman. Cynthia Lucero, who collapsed around mile 20 and was taken to the hospital in an ambulance. Unlike Barrett, Lucero never made it to the hospital and died on the way. According to friends supporting her on the course, Lucero drank large amount of _ _ _ _ _ _ _ _.
“Unfortunately, the story doesn’t end here, and cases of hyponatremia continue to appear. Just a few months after Lucero’s death, it was another woman at the Marine Corps Marathon, and in 2007, a runner in the London Marathon was hospitalized and died from drinking too much.”
So when will runners drink?
The surest formula is drink according to thirst! In other words if you’re not thirsty don’t drink. You may still pick-up one or two of those cups at those water stations but use them to douse yourself to regulate heat.
If you follow your thirst, you will never drink too much or drink too little. Remember it’s drinking too much that is fatal. I still have to find a report wherein a runner has died of dehydration!