Understanding the Risks of Extreme Sports and Ultra Running with Eugene Bingham

Pushing The Limits

Whether you are a beginner or experienced ultramarathon runner, you need to be well-prepared for every run you do. Ultra running has its bright side — the uplifting community, the sense of accomplishment, and the goals of becoming stronger. However, there are certain risks involved in the sport, and as an athlete, you need to keep yourself informed.

In this episode, Eugene Bingham joins me to explain the dangers of extreme sports and marathons. We share personal stories about the damage it could do to the body — experiences that should serve as a warning to runners. Eugene also discusses things to be aware of before and during races that can endanger us, giving us five specific tips for preparation and self-management.

Don’t miss this episode and learn more about the risks of and preparations for ultra running and other extreme sports!

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Here are three reasons why you should listen to the full episode:

1. Learn about the risks and dangers of extreme sports and ultra running.
2. Gain valuable insight into the things you need to be aware of before and during marathons.
3. Understand the importance of listening to your body.

Resources

• Death of a runner: The rare condition that tragically claimed a life by Eugene Bingham
• Desert Runners on TVNZ

Episode Highlights [04:01] The Dangers of Extreme Sports and Ultramarathons

• Eugene participated in the 2020 Tarawera 100-mile race where an experienced runner died.
• The runner’s death certificate showed that he had a multi-organ failure, acute respiratory distress syndrome, and rhabdomyolysis.
• However, it was difficult to pinpoint the true cause of death since it can be a result of accumulated health conditions.

[09:50] What Is Rhabdomyolysis?

• Rhabdomyolysis, or muscle breakdown, is quite common for runners.
• As the muscle breaks down, myoglobin from the muscle is released into the bloodstream, clogging the kidneys.
• It can be difficult to tell when this happens since symptoms can be easily mistaken for simple muscle soreness.
• This can happen to everyone, not just those who do extreme sports and ultra running.

[16:27] Importance of Self-Management

• At some point, we have to ask ourselves if the damage we’re doing to our body is worth it.
• There are risks, and you have to be prepared for them.
• There is a culture of not quitting unless you’re taken by the ambulance. However, we have to listen to our body before it gets to that point.

[20:19] Mental Toughness and Listening to Your Body

• As we grow, our physical abilities and mental maturity changes. Accept that the body may not be able to take what it could years ago.
• The goal of pushing your limits is good but keep in mind that you also need to train and prepare yourself.
• Being mentally tough also means knowing when to stop and rest.

[22:53] Ultra Running: 5 Tips to Remember

• Do not take drugs like ibuprofen and Voltaire.
• Drink when you’re thirsty and do not over drink.
• Be prepared for a range of weather conditions.
• The race does not end at the finish line. Replenish yourself after every race.
• Look out for each other.

[28:08] Always Have Support

• Eugene shares his experience of having hallucinations but was kept safe by his companions.
• Form connections and friendships with the people you meet in races. They are bonds that last forever.
• Listen to the full episode to hear Eugene and Lisa share more stories about how people have helped them during races!

[38:33] Conditions to Be Aware of

• We need to be careful about dehydration.
• Symptoms of hyponatremia (having low sodium levels in your blood) are swelling, nausea, and lightheadedness.
• Low levels of potassium and electrolyte imbalance can result in tetany seizures.
• Electrolyte tablets are beneficial — make sure they have all the nutrients you need.
• Having no appetite after a race is dangerous. We need to replenish our bodies straight away.

[47:10] Risks Are Exponential

• When you exponentially increase the distance you run, you exponentially increase our risks as well.
• All races are relative to pace. Never underestimate a race by distance.
• Take every race like a big deal and don’t become complacent.
• Recovery after a race is also crucial. Don’t succumb to peer pressure and sign up for a race immediately after.

[51:53] Quick Checklist

• Do not expect that you can do it just because you’ve done it once before.
• Be aware of conditions such as rhabdomyolysis, heat stroke, hyponatremia, dehydration, seizures, electrolyte imbalances, and breaking ankles.
• Plan well — note altitudes and paths.
• Running is just like driving. Driving is considered dangerous but we don’t avoid it; we just take extra measures and precautions to make sure that we are safe.

7 Powerful Quotes from This Episode

‘People need to be really conscious of the risks — they need to be prepared to put the time in. You've got to prepare your body and you've got to know your body’.

‘Having lined up at the start line with someone who didn't make it home — that really reinforces that these are real risks and you have to be prepared for them’.

‘The race doesn't end at the finish. Some of the most dangerous time is after that: when people get to the finish line and drive home, they're tired — you can crash easily’.

‘Sometimes there's a bit of competition, isn't there. But, number one, you've got to look out for each other. You are comrades — you've got to have each other's backs’.

‘It is incredible, those connections you make. Even if you don't see each other again, but yes, you've got that bond. That's forever’.

‘Take those precautions. Just be a bit careful. We want to push ourselves. Yes, we want to be out there. Yes, we want to find new limits, but we also want to get back home’.

‘Respect the distance. You cannot run something like this without respecting it’.

About Eugene Bingham

Eugene Bingham is a senior journalist at Stuff, co-host of the Dirt Church Radio trail running podcast with his mate Matt Rayment and an ultramarathon runner. In a career of almost 30 years, he’s reported and produced news and current affairs, winning multiple awards as an investigative journalist. His work has taken him to three Olympic Games, and a number of countries including Afghanistan, the Philippines and the Pacific.

No matter where he goes, he always packs his running shoes. He has a marathon PB of 2h 43m and his longest event is the Tarawera Ultra 100-mile race which he ran in February 2020. Eugene is married to journalist Suzanne McFadden and they have two grown-up boys.

You can listen to their podcast on Dirt Church Radio. You can also follow and support them on Patreon, Instagram, and Twitter.

Have questions you’d like to ask? You can reach Eugene at his email.

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To pushing the limits,

Lisa

Full Transcript For The Podcast!

Welcome to Pushing the Limits, the show that helps you reach your full potential, with your host, Lisa Tamati. Brought to you by lisatamati.com.

Lisa Tamati: Well, hi, everyone, and welcome back to this week's episode of Pushing the Limits. Today, I have journalist and ultramarathon running legend, Eugene Bingham, to guest. And Eugene is the host of the podcast, Dirt Church Radio, which I hope you guys are listening to. It's a really fascinating insight into the world of running and trail running. And he has a really unique style, him and his friend, Matt Raymond, run their podcast. So I hope you enjoy this interview.

Today we're talking about the dangers of extreme sports, not just ultramarathon running, but doing—pushing your body to the limits. While, you know I'm definitely a proponent of going hard and mental toughness and pushing the body and all that sort of good stuff. We also need to know about the downside. We also need to know about the risks. And recently there was a death, unfortunately, at the Tarawera Ultramarathon of a very experienced ultramarathon runner. And so we're going to dive into some of the dangers and some of the things that need to be aware of when it comes to pushing the body to the limits. And so you have an informed consent and an understanding of what you're getting into when you're doing these sorts of things.

Before we head over to the show, though, please give them a rating, review to the show if you enjoy the content. Really, really appreciate the comments and the reviews and if you can do that on iTunes, or wherever you're listening, that would be really, really appreciated. And if you haven't sold your Christmas stocking yet, please head over to my shop and check out my books, Running Hot, which is chronicling all my running adventures in my early days, Running to Extremes. Both of those books bestsellers, and my new book, Relentless - How A Mother And Daughter Defied The Odds, which is really a book about overcoming incredible obstacles, the mindset that's required, the stuff that I learned while I was running and how it helped in this very real world situation, facing a very dire situation within the family. I hope you enjoy those books and if you have read them, please reach out to me, give me a review. Again, if you can, I'd really appreciate that you can reach me at [e-mail].

And just a reminder too, we are still taking on a few people, on one on one health optimization coaching, if you're wanting to optimise your health, whether it be with a difficult health challenge, that you're not getting answers to mainstream health and you're wanting some help navigating the difficult waters that can sometimes be, please reach out to us. And we deal with some very intricate cases. And I have a huge network of people that I work with that we can also refer you out to. I am not a doctor, but I am a health optimisation coach and an epigenetics coach. And we use all of the things that we've spent years studying to help people navigate and advocate for them, and connect them to the right places.

And this is a very different type of health service if you like and it's quite high touch and it's quite getting into the nitty gritty and being a detective basically. And I'm really enjoying this type of work and helping people whether it be with head injuries, with strokes, with cancer journeys, thyroid problems, or all these types of issues. Not that we have it or every answer there is under the sun. But we're very good at being detectives working out what's going on and referring you to the right places where required. So if you're interested in that, please reach out to us [e-mail]. Right, now over to the show with Eugene Bingham.

Well, hi, everyone, and welcome back to the show. I have Eugene Bingham. I know he's so famous, he actually sit down with me to record this session. So fantastic to have you here. Right? How are you doing?

Eugene Bingham: I'm very well, thank you. And thank you for having me on. Such an honour.

Lisa: Fantastic. Yes. Well, I was lucky to be on your show. And you've been on mine, and we just really connected. So I wanted to get you back on because you've just written an article, which was very, I thought was an important one to discuss. And it was about the tragic death of an ultrarunner last year or this year in the Tarawera Ultramarathon. And while we don't want to go too deep into the specifics of that particular case or we'd like to know what you know about it...

Eugene: Sure.

Lisa: ...but wanted to have a discussion around the dangers of extreme sport or ultramarathon running and some of the things we just need to be aware of. So, obviously Eugene and I—neither of us are doctors or any of this should be construed as medical advice, but just as—have to give them out there...

Eugene: Absolutely.

Lisa: But as runners and people who have experienced quite a lot in the running scene, and I've certainly experienced enough drama, that it is something that we need to talk about. So Eugene, tell us a little bit about what happened? And what are you happy to share

Eugene: Sure.

Lisa: ...and what you wrote about in your article, which we will link to in the show notes, by the way.

Eugene: Yes. Thank you. Sure. Yes, so I was a competitor in the Tarawera hundred mile race in February, which as you said—when you said last year, it does feel like last year, doesn't it? Oh gosh, it feels like it was five years ago. But it was February 2020, all those years ago. And in that race was sort of about 260 of us lined up. And then that race was a runner an older—oh, he’s 52. So from Japan, a very experienced runner, had run Tarawera previously, had run lots of other miles, and ultraraces. And unfortunately, about a kilometre or so from the finish, he collapsed, and about 34 hours into the race. And although people rushed to help them, and he was taken to retro hospital, and eventually to Auckland City Hospital, he died. And I remember, I remember the afternoon we heard about it, and Tarawera put it up on its Facebook page to let us all know that one of our fellow runners had died and I stopped. It was a shock.

Lisa: Yes.

Eugene: You know we do this thing, because we love it.

Lisa: Yes.

Eugene: And because we get enjoyment from it. And he was someone who paid the ultimate price.

Lisa: Yes.

Eugene: So I—we're a couple of hats, and one of them is a journalist, and so I—but really, what first kicked in was, I really want to know what happened. I really wanted to know what happened. I've had health issues myself, had a few scares and so on. A few wobbles and races, and I thought—just from my point of view, I was really curious to find out. But I also thought it was important to find out for other runners...

Lisa: Yes, absolutely.

Eugene: ...or say, I listen for others. And so I started to see if I could find out. COVID got the way a little bit and distracted me. But eventually I did manage to track down what happened there. Yes.

Lisa: And what was the result of the findings in this particular case? I mean, we're gonna want to discuss a few.

Eugene: Sure.

Lisa: I think, in this case, it was a couple of things, wasn't it? But this is without picking—and we're certainly not picking on anybody or any, not race, or anything or saying this is bad or anything. But what was it that you discovered in it?

Eugene: Yes.

Lisa: So with that, research.

Eugene: Sure. So initially, I remember the talk was that he might have had a stroke, or there might have been some sort of underlying condition.

Lisa: Yes.

Eugene: But I got a hold of his death certificate and it shows that he had multiorgan failure, and acute respiratory distress syndrome, which are both conditions that they can be in multiple causes of those sorts of things. But the one that jumped out to me was Rhabdo. You're gonna make me say that? The proper name for it.

Lisa: Rhabdomyolysis

Eugene: Thank you.

Lisa: I'm an expert in rhabdo.

Eugene: So yes, that was the third one on the list. And that was the one that really jumped out at me.

Lisa: Yes.

Eugene: Months earlier, I'd spoken to Dr Marty Hoffman, who's in a University of California Davis in the States, and he's sort of recognised around the world. Basically, if there's an ultra—there's a paper about medicine involving ultrarunning, you'll find Marty Hoffman's name on it, he knows this stuff.

So I'd run to him months ago, at the suggestion of a friend, Dr John Onate, and I had a good chat with him. And he sort of ran through the list of what we could be looking at here, but he was really—it was a stab in the dark at that point. But he told me then that they’re hipping no deaths from rhabdo, knowing deaths from rhabdo from ultrarunners.

Lisa: Yes.

Eugene: Yes. And no knowing deaths from ultrarunners of the AH, exhausted and just talking it, ‘How can I train you’?

Lisa: Yes.

Eugene: So we were kind of that, like, ‘What could it be’? Yes. So when rhabdo appeared on the desk fit, I rang him back and said—I actually emailed him and said, ‘Hey, this is what it says’. And he was very surprised because he keeps track of deaths of ultrarunners around the world. And as he said, there hadn't been one recorded before, doesn't mean there hasn't been one, of course.

Lisa: Yes, it doesn't mean.

Eugene: It's just no one, yes, no one knows what causes.

Lisa: And I think a lot of these things will have contributing factors in—completely unrelated but going through the journey with my dad recently it was at the end, he had multiple organ failure.

Eugene: Yes.

Lisa: He had sepsis however, and before that he had an abdominal aneurysm.

Eugene: Yes.

Lisa: So it shows the progression like it. What did he actually die off?

Eugene: Yes. Yes.

Lisa: He was born with the failure probably, or zips as chicken or eek scenario.

Eugene: Yes.

Lisa: So these things, one leads to an acute respiratory syndrome

Eugene: Yes.

Lisa: And they all lead on from one to the other when the body starts to shut down, basically.

Eugene: It's a cascade isn’t it?

Lisa: It’s a cascade. That is a very good way of putting it. So rhabdo—and while there is perhaps no documented case of a death from rhabdomyolysis, I don't know if they—I know in my life, I've had rhabdo. I can't even remember the number of times I've had rhabdo.

Eugene: Yes.

Lisa: I took away kidney damage from it and the last few years, I've been trying to unravel that damage and undo that.

Eugene: Yes.

Lisa: I'm getting there slowly.

Eugene: Yes, yes.

Lisa: So it is a very as if quite a common thing.

Eugene: Yes.

Lisa: So we don't know whether in this case that was actual final, what actually did it? It certainly would have been a major contributing factor.

Eugene: Yes.

Lisa: Well, what is rhabdo? I suppose we better explain what rhabdos are.

Eugene: Yes. So I mean, well, from your experience, you will know better than me. But I spoke to Dr Hoffman and to Dr Tom Reynolds, who's the race doctor for—one of the race doctors for Tarawera.

Lisa: Yes.

Eugene: And they explained it as the muscle started to break down and the myoglobin from the muscle being released into the bloodstream. And then it basically just starts clogging up the kidneys and just causing real damage in your kidneys. The problem with it is the symptoms for sort of sound like a lot of other things and also can just sound like what you might expect running an ultramarathon.

Lisa: Yes, the kind of that also.

Eugene: Yes, tenderness of muscles, a bit of confusion, and so on. And then even some of the blood tests that you can do to pick it up. So they look for CK—you're much more proficient in the medical world than me.

Lisa: Not more.

Eugene: But the thing that they test for—it basically there was an experiment at Western States a number of years ago, where they tested bloods of people in Western states and they tested something like 160 runners, all of them had elevated CK levels.

Lisa: Yes.

Eugene: So in part, it's just a function of ultrarunning, your muscles are gonna break down to some extent. So that makes it very, very tricky to find out, to discover it. And Dr Hoffman said, ‘Sometimes the first sign that you get that someone's got rhabdo, is they have a seizure’.

Lisa: Yes.

Eugene: So it can be a tricky, tricky condition to pick up. Yes, that's really—it's hard, isn't it? It's really hard.

Lisa: It is hard and—but when you are going for—and some of these races are 24, 36, 50 something hours, you're going to have some breakdown of muscle and you…

Eugene: You are.

Lisa: I mean, keeping an eye on the colour of your urine or if you are not producing…

Eugene: Yes, that’s an important one. Yes.

Lisa: It is probably the easiest thing to think about. Because like you say, the nausea and headaches and confusion and fatigue are all very general parts about running anyway. So keeping an eye on it, like getting a pouch of fluid. What I would find is that in the lower abdomen, and I don't know if whether this is an actual medical symptom or not. But in the lower abdomen, I've developed this pot gap running and, it wasn't fat, obviously.

Eugene: Yes.

Lisa: ...within a couple of hours. It was fluid, and would usually coincide with my kidneys—they’re not producing or producing very little output. So I think there might be a sign that something's going on there.

Eugene: Right.

Lisa: In rhabdo, like, we're talking ultramarathons, but I have seen a case of rhabdo in a half marathon in summer.

Eugene: Yes.

Lisa: Yes. So a mild case, but enough to be taken to hospital. So it's not even just people doing the extreme extreme stuff.

Eugene: Yes.

Lisa: But it is a very—and you have to ask yourself, how much damage are we doing every time we do and I often asked, ‘Why are you not running anymore’? ‘Why are you not doing it anymore’? And apart from life's gotten a bit crazy. Am I? Indeed yes.

Eugene: Yes, yes.

Lisa: Should I have not got the time to be doing offers? I want longevity and while I love ultras, and I love the culture. And I love what I got to do. And I'm certainly not, I mean, I train lots of ultrarunners. I for myself, don't want to put myself at that risk anymore. Now that I'm also 50 and I want longevity. And therefore my health comes before my sporting ambitions now. It didn't when I was younger, but now with—unfortunately, one of the side effects of studying medical stuff for the last five years, is that I'm now a little bit more cautious.

Eugene: Yes.

Lisa: Because ignorance is bliss.

Eugene: Yes.

Lisa: What you don't know, you just go and do.

Eugene: Yes.

Lisa: You don’t actually know the implications and sometimes, you don't actually know the implications until well down the track, like, you use to check.

Eugene: Yes. yes, sure.

Lisa: That's where I'm sitting at the moment, as far as the sort of the dangers and the risks. I mean, how did you feel as a runner, who—you were in the same race doing the same distance? You're a little bit north of 25 now.

Eugene: Jump 47.

Lisa: You're 47?

Eugene: Yes. 47, yes.

Lisa: And did this make you stop and think about, ‘Do I want to keep doing this stuff? How do I feel about it’?

Eugene: Yes, it sure does. It sure does make your family think of that, doesn't that? I think it reinforces that you need to have really good self management. You need to be well prepared. I spoke to—when I spoke to Dr Reynolds, and I said to him, ‘We had this big conversation about all the cold coloured urine and all that sort of stuff’. That sounds a bit odd, and a little different other conditions that can come about. Yes, and so on. And I said to him, ‘Boy listen to all of that. Do you recommend people run ultramarathons’? And he said, ‘Look. At three o'clock when the medical team is full. And I've got my hands full, I look around, and I go, What the hell have we been doing this for’? But he says, ‘But it's a small proportion that gets badly affected. And as long as you manage your risks, and you're aware of it’, he said one of the things that he's really concerned about is people jumping up the distance too quickly.

Lisa: Yes.

Eugene: Or the runner suddenly, ‘Wow, I'm gonna run 100 miler’, because it has become, I think it's…

Lisa: The new marathon.

Eugene: I told him, I spent more time trying to talk people out of doing milers than I do in trying to talk them into doing milers. I don't think I talk to any other or talked anyone into doing a miler. It's a very personal choice. I spend a lot of time talking to people out of it, makes me so again. But again, I don't know if that's a good idea, mate.

Lisa: Me too.

Eugene: Yes. And it sounds bad.

Lisa: Yes.

Eugene: Try running podcasts.

Lisa: I know. You know, my buddy out running.

Eugene: Yes. But I just think people need to be really conscious of the risks.

Lisa: Yes.

Eugene: And they need to be prepared to put the time in. And that's one of the things that you've identified. You've got to prepare your body. And you've got to know your body. I mean, I took—I've been running my whole life. And I didn't take the decision to enter the miler, lightly, certainly would now knowing what I do know now. And when I say no, I mean, I'd always heard of rhabdo. I'd heard of AIH, I'd heard of dehydrational systems.

And you sort of think about you sort of like, ‘Yes, yes, yes’. But having lined up at the start line with someone who didn't make it home that really reinforces that these are real risks, and you have to be prepared for them. You have to be ready for them. So, I'm not gonna stop ultrarunning, I don't think. But I'm certainly going to be a hell of a lot more careful. And listen to my body.

Lisa: Exactly.

Eugene: Sometimes you can get that. I find one side of ultra running that I struggle with a little bit is the whole kind of ‘You're not going to quit unless the ambulance takes you off the course’ kind of thing. I don't like that. I don’t really like that.

Lisa: I totally agree.

Eugene: You know, I agree. I love the whole mental toughness thing out of it. Don't get me wrong. That's one of the things that I enjoy about it. But you have to listen to your body. You have to listen to your body. I've pulled out of a 100k race, where I could have pushed on. You know. Looking back, it's like, ‘Yes, I could have pushed on, at what cost’? You know?

Lisa: Yes.

Eugene: Yes, it just wasn't worth it. Could I push through and be out there for another hours and hours and hours and hours? Putting myself...

Lisa: Yes.

Eugene: Yes, sure. I could have but what was the risk? What could have happened? And what do I get out of it? Instead I actually came away from that race having learned a hell of a lot of lessons. And they prepared me for the miler, actually.

Lisa: Yes. And I think that’s some beautiful attitude and in a very wise mind. Some of the things that I did in my younger years or even—I’m talking 40s.

Eugene: Yes, yes.

Lisa: We're stupid. There is no other word for it. And especially in the 30s, my 30s, I thought I was bulletproof and I could push and I had that mentality, you're going to have to drag me away, framing and I have seen lots of others. And I have nearly pushed my body on a number of occasions to the point of death and I've been very, very lucky not to have died.

I've had tetany seizures, which is where your potassium level and your electrolytes are so out of whack that the whole body cramps and so I'm having a heart attack. I was luckily at that at the point that I head out, I was in Alaska, and I'd been for six weeks out in Yukon with poor nutrition and so on and pushing the body every day. I just come off a mountain when this tetany seizure hit. Luckily, I was two minutes from a hospital, and they saved my life.

Eugene: Wow.

Lisa: But that would have been deadly very quickly. I've experienced extreme levels of dehydration in the Libyan desert where we only had like one and a half to two litres of water a day in 40 plus temperatures. And gone to the point where I no longer was in control of my body, and my—not only just hallucinations but the central nervous system starting to shut down. Massive kidney damage, and taking nearly two years to recover from that.

I’ve had food poisoning while running across Niger, and again bleeding at both ends pushing it to the absolute limit I did pull out of that race at 64 hours after 222Ks but that was way too late. I've gotten away by the skin of my teeth. Not to mention going through war zones or military body areas

Eugene: Yes.

Lisa: Or being in really dangerous situations and that's a whole podcast in itself. But it wasn't worth it. Now I think I was just so afraid of failure I was so afraid of not achieving that, which I'd set out to do that. And I have to think about it now and go I wasn't in—people who are in war scenarios or some survival situation where you have to freakin go to the limit alive.

Eugene: Yes.

Lisa: But I wasn't in there. This is a—well, Libyan desert ended up like that, but you know what I mean?

Eugene: Midnight summer bitches.

Lisa: Oh yes, it’s some stupid shit. It really was. But at what costs? Now, I've had a lot of health issues in the last five to six years and a lot of that comes from—I haven't been able to have children you know and so on and so forth. And these are the contributing factors

Eugene: Sure enough.

Lisa: That's the only reason for certain things, but now as a coach and as an older wiser woman, I don't want to see people pushing their bodies to that point where they actually close to dying or causing major damage to the body.

Eugene: Yes, yes.

Lisa: It really is not worth it.

Eugene: I mean this pushing the limits isn't there. And mentally, I think there's a lot to be said for having a goal that's going to stretch you when you are going to go for it. But the key is to be prepared, isn’t it? To actually have done the training...

Lisa: The training

Eugene: ...to prepare your body. To test—so that you know when your body's screaming at you, you know it’s saying, ‘Okay, you know what, you know to pull the pen or you know to stop and rest or whatever’. I think there was some good—Tom Reynolds had some five tips which are really good.

Lisa: Yes. Let’s hear them

Eugene: To prepare yourself for an ultra especially ultras but even marathons I suppose

Lisa: Absolutely.

Eugene: Number one on his list, and I think he would make this number 1, 2, 3, 4, 5 is don't take drugs like Ibuprofen and Voltaren and those sorts of things.

Lisa: Super important.

Eugene: Do not take them. Yes, super important. The second one is drink to thirst. You know that you can have problems—your own problems if you have too much liquid.

Lisa: Yes, which we’re talking about in a sec.

Eugene: Yes. Be prepared for the conditions. Have a plan for a range of conditions. So make sure you've got thermals. Make sure you've got your jackets and sawn and layers that you can take on and take off especially if you're going to some of these remote areas that we go to as ultrarunners.

Number four, the race doesn't end at the finish. Pack warm clothes, get some food ready that you can eat, some liquids. And another thing that he pointed out to me is actually some of the most dangerous times is after that finish line. When people get to the finish line, and drive hard, and they're tired.

Lisa: It's so true.

Eugene: You can crash easily for a second crash.

Lisa: Yes.

Eugene: And number five is look out for each other. and I think that's so important. Sometimes there's a bit of competition isn't there? But number one, you've got to look out for each other

Lisa: Yes.

Eugene: You are comrades in this together and you've got to have each other's backs. And there's little relationships that you build up with someone you've never met before. I still remember having a good chat to a farmer from Jordan. I spent a lot of hours with him at Tarawera. Haven't spoken up since, never met him before in my life, but there we were together at Bizmates on the trail.

Lisa: Awesome.

Eugene: Keeping an eye on each other. Looking out for each other. You make sure they've got their bottles filled at the aid station. You make sure that they're not getting confused or anything like that—just looking out for each other. Simple isn’t it?

Lisa: That’s gold.

Eugene: And that was the five tips that he gave. Actually, they're pretty good tips.

Lisa: They are very good tips, and a couple other ones to pick out like the training. In my early days as a coach, I remember taking an athlete who went from half marathon to running the Big Red Run 250Ks.

Eugene: Wow.

Lisa: Inside a month.

Eugene: Oh.

Lisa: Now on a red mat, that was stupid.

Eugene: YeS.

Lisa: He came over to do 100k to be fair, and he was doing so well. He just decided to carry on and to do the whole thing. And it was an incredible achievement.

Eugene: Oh, yes.

Lisa: However, broken my butt. Like, it never was quite the same afterwards. And he wasn't ready. He wasn't, like, his body wasn't ready. So when you prepare your body, when you're training, you doing these long runs, and you're doing back to back running, and you're doing strength training, you're doing mobility work, all these things are preparing the muscles so that they don't break down so quickly and they don't need—you don't need about rhabdo.

And another big piece of the puzzle is the experience side of things. Because then you can actually start to feel when your body's doing a chick or not. As I run, I used to do like little chickens every half hour or an hour I'd go right I'm doing a control like a pilot would before he flies the airplane. ‘How is everything? How am I feeling? Have I ever drunk in the last 10 minutes? Have I eaten anything? When was the last time I weighed? When was the last time’... Just doing a mental checklist as often as you can.

Now one of the hard things with ultra though is that you start to lose your brain function, so all the blood flow is going away from your executive function up here and you become like a bit of a moron. You’re like, ‘Oh, oh’.

Eugene: Absolutely. Solving maths? Impossible.

Lisa: Impossible. Or maybe doing a 24 hour race, the one at the Millennium Stadium, and there was some guys they’re testing us just for a laugh, doing Noughts and Crosses as we run around the track and our brain function is a day and night wore on just we weren't even able to add up one plus one anymore. We just completely like, ‘Eh’?

He’s got low blood and my brain is not functioning. So what that does mean is that your ability to make good decisions is also impaired. I remember saying to one of my friends who was a paramedic and she was with me in Death Valley, in the second time I did Death Valley. And she says, I said to her, ‘You are responsible for my health’. I was lucky I had a crew in that situation. If you pull me out, you pull me out. I know that you won't pull me prematurely because you know what, it's taken me to get here. But my life is in your hands and I respect that. I respect you. I respect your knowledge as paramedic. If you tell me it's over, it's over. And she will be able to make that decision because I knew from my personality and from my matter that cost me to get there wasn't going to be pulling out anytime soon.

So sometimes if you can have in the case where you have a crew have somebody say, ‘This is now getting dangerous’. And it's a fine line. Like I pulled my husband out of a race once, Northburn, a race that I co-founded a few years ago in the South Island. And he was doing the 100k and he actually rang me on the cellphone, and it seem the case, we had a massive storm up in the mountains. It was wild. It was his first 100k, he was in the mountains. He was scared shirtless. He was hypothermic. And I was like, ‘Oh my god, darling, just come home’. You know? So that was—and he could have pushed on.

Eugene: Yes.

Lisa: And mentally that cost him a lot because he pulled out, and he didn't push over that hub. So there's this fine line between it should’ve been ours...

Eugene: But he lives to tell the story.

Lisa: Exactly, and he's done that, so it wasn’t...

Eugene: Exactly, that doesn't matter, you know? We love those stories. I love reading your books. I love reading the things that you've been through. But, my gosh, when you think about the risks as you say and the cost, and that's a common story. You're not alone in there, That's the sport we’re in.

Lisa: Yes.

Eugene: It's ridiculous to me. But you know, it's a tough one. And it's, I think that's a really good idea. Having someone who's who's got your back. Someone who you can trust, like you say, they're not going to pull you out you know just because you stub your toe. Oh gosh...

Lisa: Just because you’re...

Eugene: Exactly. Exactly. Who hasn't? But you can trust them so that when you've gone to that thin line, bang!

Lisa: Yes.

Eugene: Come on my area.

Lisa: Yes.

Eugene: And I was lucky to have a really good mate who phased me. I went through some hallucinations. Nothing major. But he thought it was—I had my mate. And he was looking out for me. In fact, he laughed at me.

Lisa: What did you see in your hallucination?

Eugene: Oh, I hit home. So we were running around on an unfamiliar course. We were coming around the back of Blue Lake. Up towards the Blue Lake aid station. So about 120km. And it was just before sunrise. So, you get that funny light.

Lisa: Yes.

Eugene: It's still dark, but the light is changing. And I swore coming up to the aid station, I swore I saw a robot sitting off to the side of the trail. And in my photo frame mind, I justified it as ‘Oh, it must be like reading, it must be scanning us telling the aid section that we're coming’. And so I saw it. And said to my mate, ‘James, there’s a robot. It's pretty cool’. And he's like, ‘The what’? ‘The robot there’. And he's like, ‘There’s nothing, man’. And I think it was a tree or something. I don't know what it was. But it's funny how I justified it to myself. So it was fine. And then after the light changed, I got a couple of situations where it's quite unlikely to cause hallucination or is vision going. But I—the ground was just like liquid glass.

Lisa: Wow, that’s cool.

Eugene: I was like, ‘Oh, should I put my foot down or not’? And James said, ‘What are you doing? Come on’! It was like, ‘What's going on with the ground’?

Lisa: [32:58] inaudible the glass. Well.

Eugene: So that was but—people have some great hallucinations, don't know. But the point of that was, I had my mate there. It was never unsafe. And I'm grateful for that. So I think that's a really good tip, Lisa, to have a crew with you.

Lisa: I think hooking up. Or if you're in a race where you don't have crew—which most of them are. And that you do hook up with somebody. If you can try and not too many people because then your pacing will be all out. But if you can just hook up with one person or maybe two at the max.

I remember running the Gobi Desert in the Sahara with same gash who was in the desert runners movie together and this is great footage and desert runners is playing at the moment on TVNZ if anyone wants to check it out, it’s a cool movie. And yes we're running along holding each other's hands, bawling our eyes out, and but we got each other through both of those messiest days, both in the Sahara, and in the Gobi. And we ran together in India as well but with crews in that case. But that comradeship that we have there was just gold. It just helped.

When you [34:17] escaped shirtless you hit someone the and we did get lost and we did fold our paces and we did have all sorts of dramas and we kept each other going through all those hard times and I think that's one of the beautiful memories for me that I take away from that. And there were other people I've done the things with... And the depth of connection that you have with a human being when you've gone through something like that it's just next level. And that's one of the beautiful things because we’re talking about all our negatives here but it is just like—she’s a very amazing woman that one. She’s done incredible things.

Eugene: It is incredible, isn’t it. Those connections you make.

Lisa: Yes.

Eugene: The friendships you forge. Even if you don't see each other again, but you've got that bond. That's forever.

Lisa: Yes.

Eugene: Those moments that you shared when you're vulnerable.

Lisa: When you're up [35:11] Creek and literally. Guys who didn't even speak the same language or a woman I remember running in the Sahara at one point with a—I was crying, she was crying. She was from South America somewhere, didn't speak a word of English, or another French guy picked me up in Jordan when I was running across there and I'd passed out and he came along, picked me up, got me into the next checkpoint. The French guy and Niger, it's just like, ‘Wow’. The stuff that you help each other through. It's gold, but does this do happen, you know?

Eugene: They do. They do. Yes.

Lisa: We have one in the Gobi Desert. We had a young man, Nicholas Kruse was only like 30 or 31, I think. And he was first time doing it. And he wasn't trained enough, I don't think. And he—I think he underestimated the thing. And he unfortunately probably paid the ultimate price. And then you've got also the dangers. I mean, you got cases like with Turia Pitt, the forest fires in Australia, or there are things that could go wrong.

Eugene: Yes, absolutely.

Lisa: Even in these organisers' races. You have falls where you've hit your head and concussions and... Just because you're in an organised event, do not think that there isn't an element of danger, or that you're going to have to be self-reliant, you cannot. And inside these countries is beyond the abilities of the organisers actually to cover every base.

Eugene: Absolutely. Well, even in races in New Zealand, we go to some remote places, and races route is difficult to get. You're not just going to be able to ring up 111 and get an ambulance there.

Lisa: No.

Eugene: It's not like that. I've been in a 100k race where—because there have been lots of runners going through this. It was a narrow bit of the trail. And it was really dry there. And runners have been going over this bit of land. And basically, as the day wore on, it sort of started to break down a little bit. And I was just the unlucky one stick on the trail in a way. And I slid down this bank...

Lisa: Oh my god.

Eugene: ...and down, down, down, down down, thinking, ‘Uh-oh, when's this going to stop’? Luckily, I hit, I came to a stop on a tree, not badly. And then basically had to scrape my way back up. Now, I was fine. But you know, those sorts of things can happen if I stumbled in a wrong way as I came off the trail and hit my head, whatever. So you are—yes, you will, I mean, it’s not... Well, I mean, when we've been out on a run in a cotton wool, so [37:57] do we. But we don't want to go everybody. But you don't need to be conscious.

Lisa: I'll be conscious of it. I think...

Eugene: And even when you're training too, when you're training, when you are going out in remote areas. Make sure you tell someone where you're going. Preferably run with some other mates. Maybe think about taking a locator beacon with you if you're going somewhere really remote.

Lisa: Absolutely.

Eugene: Have a phone with you, do those sorts of things. Take those precautions. Just be a bit careful. Yes, we want to push ourselves. Yes, we want to be out there. Yes, we want to find new limits. But we also want to get back home.

Lisa: Yes, we want to come home to our families and not die on the way.

Eugene: Yes.

Lisa: If we can. I mean, people can take it to the level that they want to go to, but just don't want people going and thinking that everything's safe because it's an organised event or because hundreds of other people have done it, means absolutely nothing.

Eugene: Absolutely.

Lisa: I’ll tell you, like how many thousands of people have climbed Mount Everest, but it's still a frickin dangerous thing to do.

Eugene: Absolutely.

Lisa: Doesn't mean it's safe just because lots of people have done it. I think like—if we just went through a bit of a list now of some of your things that you'd like from a medical perspective, that you should gone this research on and find out about.

One of them, so we've talked about rhabdomyolysis. Dehydration is the opposite, is well known, dehydration is what we think about more, and that's certainly something that can then can lead to troubles. And you've got hyponatraemia or EAH, so hyponatraemia let's just talk about that one briefly because it's a biggie. Hyponatraemia is a low sodium level in the body. I've had it. Lots of people give this. And it's again, a hard one to diagnose because it is very similar to the opposite problem, which is dehydration. So hyponatraemia you've actually got too much water on board.

One of the signs of this I'm even doing was 100k, one of those Oxfam ones. And because we'd been walking for so long, it was a walking running situation thing. And I got really bad hyponatraemia in that one. I was drinking a lot. I wasn't having my electrolytes, right. And my hands were like elephant hands.

Eugene: Wow.

Lisa: So that's an indication that there's something going on. So look for signs like that, look for swelling, edema. And yes, that could like...

Eugene: Nausea, lightheadedness, those sorts of things as well.

Lisa: Coordination, going haywire. And the problem with hyponatraemia is you don't want to just be thinking it's dehydration and then drinking more. So it's an—it's a low sodium. So, your potassium and your sodium are having antagonistic relationships in your body. And you have, for every three bits of sodium that gets pushed out of the cells, three bits of potassium come into the cells. And it's like, it acts like a pump. And it's actually what helps your muscles contract.

So if you get that sodium, potassium, ainger, other electrolytes out of whack, there's a whole lot of things that can happen. hyponatraemia being one of them. In another one being a tetany seizure, which is what I mentioned what I had in Alaska.

Eugene: Yes, so what's that?

Lisa: So this is where—in my case, it was a potassium that was really, really low in the body at 1.4. Like it’s deadly...

Eugene: Wow.

Lisa: Deadly low. And I'd had in the couple of weeks building up to this actual seizure. My hands were doing this, and I was cramping all the time. And that was so—if you ever start doing that, like this weird thing where your hands are starting to spin.

Eugene: So, like dinosaur hands on.

Lisa: Yes, so your fingers—for those listening can't see me do my funny thing here. It's the muscles contracting and your fingers are pulling in. So I remember, swimming at some point, and the lead up to this with this was happening to me. I was like, ‘What the hell's that’? And then it would go off again. But there was a sign that I didn't have enough potassium as I found out later.

Eugene: All right.

Lisa: So then I had, a couple of weeks later, this tetany seizure, and it started with the whole body. Just like every muscle in the body cramping all at the same time, the most painful thing you can ever—like really bad pain, including your face muscles, including your heart, which is the problem.

And in there, the pain was horrific. I thought I was dying, I was. Luckily I just come off a mountain, or was taking shelter in a public library because it was pouring with rain and freezing cold. And this happened in the library. And there was a paramedic in the library who just happened to be fixing a light bulb. He saw me go down.

Eugene: That’s one of the 43:10 [inaudible] moments.

Lisa: Yes, that was very lucky. He put a gel straight into my mouth. He just happened to have a gel on him. And that gave a little bit of glucose and stuff too, and managed to release the seizure for a couple of minutes before it happened again. But by then he got me into the ambulance and around to the hospital pretty quick, smart. And they were able to save me. But that could have been deadly. That could have been a massive heart attack on the way out.

I've seen that also happen and we were in the outback of Australia with friend Chris Ord. And he had a seizure at mile, coming in at 90 sort, and we've been running in 40 odd degrees heat and he'd been taking electrolyte tablets. So people electrolyte tablets are absolutely crucial. You've got to have them. The ones he was taking didn't have potassium. They had everything else in them but their ratios weren't right. And he ended up—we had to—again incredible pain, whole body seizing, racing him into the hospital Alice Springs.

What I did do and what you can do in a case like that is give him three cans of Redbull—not advertising for Redbull or because generally that’s a shit thing to be drinking. And this case, with what it's got in it and the sugars and stuff that helped. So yes, but that's just a potassium sodium balance.

Eugene: Yes .That's the thing, isn't it? We're missing with our chemistry. We're missing with the body's chemistry. I don't know what it was but I had one race where I just finished and as soon as I finished, I started shaking.

Lisa: Oh, yes.

Eugene: Shaking and shaking. I couldn't stop for hours. And it wasn't cold. I wasn't cold.

Lisa: Oh, I know what it is.

Eugene: Well, what is it? Because...

Lisa: I don't know the name of it. But I've had that many times. It's basically where you've just got nothing left in the body.

Eugene: Yes, somebody said to me, glycogen. Yes, just the glycogen is gone.

Lisa: You just got nothing, you got nothing to heat because you know we heating ourselves all the time with our glycogen supplies and our glucose is running out of their body. And you were just on absolute zero basically, taking your blood sugar, I bet you’re in a really, really low

Eugene: Right.

Lisa: And so like, in Death—I’m telling my bloody stories, but...

Eugene: Why not?

Lisa: A member in Death Valley. We be head like 55 degrees during the day, I’ve had heat stroke and had all that. And then at nighttime, it was 40 degrees. And I got shivers. I was doing that. I was like this and it was 40 degrees.And I was like, ‘Really, what the hell is going on? It's 40 degrees’. It was a lot colder than it had been, but I just had nothing left in the tank and therefore I was shaking.

And that can be a real danger when you say in the Himalayas, which I've also done and that's where you just cannot warm up. You can't keep your heat going. And these can run into other problems where you just stuck—your blood sugar just keep dropping, and you can end up when—going into a coma just because your blood sugar is too low, and you got hypothermia.

Eugene: The other problem that happens. And I've had this a couple of times after ultras is I just have zero appetite, I can't, I just can't face the thought of food. You got to get something into you, you go start replenishing your body, you got to look at soups or something to get some nutrition back into it. Because like you say, it can be dangerous.

Lisa: And that's a recovery too, like, if you can get something in it will help you recover a heck of a lot faster even like just generally fully training runs, if you can get something in within an hour. But usually within an hour, you just do not feel, you just feel like vomiting if you eat too much. So you just have to take a little, little, little nibble, nibble, nibble. And something that you're really—usually savoury salty things that you will get have a taste for. So soup or things or something like that. Just trying to eat something in. My gosh, there's a lot to be worried about.

Eugene: And that's the thing, that's the thing. These are all things that you need to be conscious of. But you manage your rests, don't you? You can manage them. And what one of the other things that Dr Reynold said, and I think is pertinent today, what just what we're dwelling on the bad things is that these risks are exponential. So he says, ‘Don't think that you run 100k all year, well, then 160Ks, that's only another 60k’. It's an exponential increase, and an exponential increase in those risks as well. So conscious of those things as well.

Lisa: So watch when you're jumping up in this.

Eugene: Yes.

Lisa: And also don't fall into the trap of thinking, ‘Oh, I did it once. Therefore, it's a piece of cake. I could do it either’. I've run into this where I came off the back of a Himalayan one. I just done 222Ks. I thought it was the bee's knees. And then I went and did it just a couple of weeks later and I hadn't recovered properly a 50k in Australia. And the wheels freakin came off at 25k. It wasn't the—I had to be risky for some beer drinking Ausies in the middle of the bush. I'll tell you your ego suddenly deflated.

Eugene: Yes, absolutely, Lisa and it's—I learned that lesson even just with the map just for the marathon.

Lisa: Don’t say that.

Eugene: But just for the marathon. I ran my first marathon when I was 21 and I trained for it. And so I found it actually quite easy. I don't mean that—I wasn't fast but but it was I got to the end of it. I can't keep waiting for the wall. The wall never came. I got—I thought, ‘Ah’! So I made the mistake thinking marathon is easy. A piece of cake. Yes, run up on the next one. [49:13] ecruzi hardly did any training.

Lisa: Oh.

Eugene: My bad, so bad. And it was like it was just the marathon telling me, ‘Sunshine’...

Lisa: Respect.

Eugene: ‘Respect the distance’. You cannot run something like this without respecting it. And it was a good listen.

Lisa: Good listen.

Eugene: Good listen, I'll let my listen. But I let my listen.

Lisa: And in by that token, respect any distance. People often say to me, I'm just doing it, I'm just doing half marathons, or I'm just doing marathons and because I've done lots of ultramarathons they think, ‘Oh, that would be nothing for you’. And I'm like, ‘Hell no’.

Eugene: Hell no. Absolutely.

Lisa: Every distance has to respect because it’s sort of basic thing for starters. 100 metres is a long way when you're going at Usain Bolt and 5k is really fast when you're going at your maximum. And a team K is an attunity. It's all relative to pace for status. And the second thing is never think because you did it once. Next time, it's going to be sweet. And Eugene has given us an absolute good example of that. And it is. It’s like take every race is that first is a big deal. And you have to prepare your body for it.

And don't—oh, another mistake I made this was awesome. Another embarrassing thing. So you know. Done 25 years of stupid stuff and then when my mum got sick I didn't train obviously properly for 10 months and then I ran across the north on and raising money for charity a friend who’ve died, Samuel Gibson a wonderful man that we lost. And I was so moved. I decided I'm going to run anyway. And I have not been training for 10 months because I've been looking after my mum and I sort of thought out, this sweet, have done this backwards and upside down. I can do this.

Oh my God, my ass got handed to me. And I got through it. But oh, hell, it was hell. It was not funny. So prepare. And even though you've done it a100 times doesn't mean you still got it.

Eugene: That's right. That's right.

Lisa: I assume I don't got it now.

Eugene: And that point you made earlier about recovery, too. I did a 100k race and then you had this plan to recover, to take weeks off, got peer pressure. Mates we're doing a 50k. ‘Come on. Come on, man. I don't want peer pressure. Peer pressure’. ‘Okay. You’re already lined up to this 50k race’. Oh boy. And it just set me backwards. It set me back so far, you know?

Lisa: Mentaly too.

Eugene: Yes. Absolutely. Absolutely. Yes. Yes. Yes. So, yes, respect things.

Lisa: We've got to respect things. We've got to not expect that our bodies got it just because we've done it once before. Be aware of things like rhabdomyolysis, heatstroke, hyponatraemia, altitude if you're doing altitude, podcasts in itself, be aware of burnout...

Eugene: Hypothermia.

Lisa: ...hypothermia, dehydration. All of these things are things that we can and do happen to be seizures, electrolyte imbalances, getting lost, going through dangerous places, breaking ankles, and all that sort of thing. So part, it is, can happen. So, be aware of that. And we're not saying don't go out and have adventures, because that'd be really critical. But prepare for those adventures. Get proper training. Get proper coaching. Know what you're in for.

Eugene: It's like driving a car. One of the most dangerous things we do. But we make sure we wear our seatbelts, we make sure our cars have got a Warrant of Fitness and the service, and everything. We make sure there's air in the tires, we make sure there's fuel in the tank, and our bodies have got to be like that as well.

Lisa: Exactly.

Eugene: That driving is so so dangerous. You know, so many people a year die on our roads.

Lisa: Yes, more than ultras.

Eugene: Yes, so we don't not drive. We just make sure that when we drive we are prepared and our cars are prepared. Well, that's the same as running. There are risks, not as much as driving. But there are risks, but we just make sure we've got air in the tires, we've got fuel in the tank, that we're serviced, and ready to go when we line up for races.

Lisa: Brilliant. Eugene, you've been fantastic today. And now you've got another thing to get to. So I want to thank you for writing that article. And thank you for your honesty and openness about this because it's really important that we do talk about it in our running community and to share the good, the bad and the ugly. So I think it's important. And keep up the great work. Of course, people should go and listen to Dirt Church Radio. It's a fantastic podcast that

Eugene: We have great gear that’s wireless.

Lisa: Honoured to be on your show, mate. And I love talking to you and I love what you do. So thanks very much, mate for being on the show today.

Eugene: Anytime. Thanks, Lisa.

That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com

The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.