Dysentery...What to Know Before You Go

Dysentery Sucks.  If you are planning on racing in a Desert Ultramarathon in a foreign country...then there are some basic things you need to know before you go.  In this blog I want to share my experiences with you so that you can do what you can to avoid getting sick, and know what to do should you get ill.

My very first ultramarathon ever was the Marathon des Sables in 2000.  I came down with Dysentery before the race started.  Dysentery is an inflammatory disorder of the intestine that results in severe diarrhea containing blood and mucus in the feces.  The night before heading out to the race, I lay on the floor in the bathroom.  I alternated between throwing up in the toilet and passing diarrhea.  It was brutal.  I had experienced something like this before when I travelled to Mexico.  In that country the illness is called Montezuma's Revenge.

But here I was in Morocco...getting ready to run my first ultramarathon, and I was feverish and weak heading out to the race.  During this particular year I was heading out to the race bivouac riding inside an old army truck with bench seats.  We were driving over rough terrain in the dark and bouncing around all over the place.  Every once in awhile I would have to get someone to bang on the window behind the driver to get them to stop...and I would climb out and do my business off to the side.

When I arrived in camp I collapsed in my tent.  My new friends that I was bunking with had to put up with me getting up and down all night to go to the bathroom.  In the morning they told me there was no way I should start the race...that I was in really bad shape.  But how could I not?  I toed the start line and managed to struggle through 4 days.

The fourth day of MDS is always the long stage (80 kms) and I was falling further and further behind as the day progressed.  I just had no strength left and was seriously dehydrated.  A passing race vehicle stopped and I decided that I was too sick to carry on.  I had put up with diarrhea and cramping for days...and was starting to get delirious from not drinking enough water to replace the fluid I was losing.

After pulling out I knew that I would be coming back the following year to finish the race.  It was the only thought that kept me going.  The following year I returned and got Dysentery again... but this time it did not show up until Stage 4.  I continued on and managed to finish the competition but I was miserably sick.

Dysentery is the most common traveller's disease.  Dysentery results from viral infections, bacterial infections or parasitic infections.  It usually reaches the large intestine through ingesting contaminated food or water.  You can also get it through oral contact with contaminated objects or hands, and so on.  This means you can simply touch a contaminated door handle and later touch your mouth...and you can get sick.

The result is damage to the intestinal lining leading to inflammation.  This can elevate your temperature, cause painful spasms in your intestines with cramping, and lead to further tissue damage.  There is frequent diarrhea, sometimes in severe cases as much as 1 liter of fluid an hour.  Vomiting and delirium can also occur.  This results in impaired nutrient absorption and excessive water and mineral loss.

So what can you do to prevent getting it?  The bad news.  In many ways it is unavoidable.  No matter how fanatical you may be in what you eat, food is still sprinkled with millions of airborne bacteria.  But there are certain rules you should follow to reduce your chances of getting sick.  There is the old adage...

                              BOIL IT...COOK IT...PEEL IT, OR FORGET IT...

Avoid tap water, ice,and milk, along with fresh fruits and vegetables.  Avoid meat, fish and shellfish. And avoid chicken. Meat is often purchased from unsanitary open-air markets where the chances of  it harboring germs or disease is greater.

Drink only beverages from untampered bottles and cans, and check the seals to make sure they are unbroken.  Some drinks are kept cold in ice.  Well right there you have unsanitary water coating your bottle.  One miniscule drop and you are screwed.  Also, avoid milk.  It may not be pasturized.  Remember that even your dishes that you eat off of have been washed in unsanitary water.  If my plate or glass is still wet...I dry it off.

So the more you travel... the more likely it is that your luck will run out and that you are going to get sick.  I told you about the two times I got Dysentery at the Marathon des Sables.  There was also a third time I got sick in Morocco... and I also got sick while I was at a race in Mauritania.

I mentioned that race in my last blog.  Luckily I got Dysentery after the race.  I spent the entire flight back to Paris sitting on the toilet ... having blow outs every few minutes.  I briefly felt embarrassed, because I knew the people in the seats around me could hear the explosions...but when you are that sick... you get beyond caring.  You are in your own private hell.  Luckily when the plane landed I didn't have far to go.  I had booked a room at the airport hotel because I was flying back to Canada the next day.

You would think I would know all the tricks that I wouldn't be having these problems anymore.  Well, as I said earlier, the odds are that when you travel to these places you are bound to get sick sooner or later.  I have taken every precaution I can think of while travelling.  I only drink bottled water.  I only eat cooked food.  I avoid milk.  I don't eat any fruits or vegetables.

I bring disinfectant wipes with me and wipe down all surfaces I am in contact with.  I wipe down the plane arms and trays.  I use a wipe to open and close the bathroom door in the plane.  I am constantly using Purel on my hands.  When I get to the hotel I wipe down all common surfaces with wipes.  Door handles, TV remote controls, light switches, cupboard handles.  I am manic about cleanliness... and yet STILL... I get sick.

I landed in Oman for the race on Saturday morning at 6am.  By Saturday evening 6pm... I was sick as a dog.  My body only needed 12 hours to begin shutting down.  That is crazy.  By the time the race started on Monday night I had lost so much fluid and much-needed nutrients... that I was too weak to function.  I tried to go through with it...but the writing was on the wall.

There is just this sort of disbelief that occurs.  How can this be happening to me again.  How can it be again that I am the only one sick?  There has to be something wrong here.  I am not an idiot.  I am doing everything I can to avoid being ill.  Short of wearing a white hazmat suit complete with gloves and breathing mask... I don't know what else to do.  There have been some races where I have even brought over all of my own food to eat before and after a race.  But none of this has helped.

Once you get Dysentery... it is really, really important to stay hydrated.  Make sure your urine is running clear and not dark yellow or worse.  You can get oral re-hydration solutions from a pharmacy and they are good to keep on hand.  I do not take any antidiarrheal drugs.  This just keeps the poison in you...and you need to get it out.  I usually take an antibiotic like Cipro...but some Doctors don't believe you should use it.  Consult with your own Doctor to determine what is right for you.  Make sure you have a good medical kit heading overseas.  It is just as important as having Traveller's Health Insurance.

If you are sharing a room with someone who has Dysentery and you want to avoid getting sick...try to avoid Them!  Keep your hands clean, and everything else as well.  Don't share.  Don't share the same food.  Don't use the same toilet.  Don't use the same towels or facecloths.  Dysentery usually runs its course in about 5 to 10 days I have read.  I got sick on Saturday and was feeling better by Thursday, which is also when I had my first solid bowel movement!  Hey, in my world...that is a big deal!

When I got home from TransOmania I hooked up with a friend of mine who happens to be a genius.  I'm not kidding about this.  He is an extremely intelligent man who is a Doctor, Specialist and Consultant.  He travels all over the world in his work as a medical consultant.  He had taken an interest in my training and preparations for TransOmania.  He knew that something had gone wrong while I was away, but did not know what happened.  When I told him about the Dysentery we began to talk.

I told him about my race history with Dysentery and how discouraging and frustrating it was to have a constantly reoccurring sickness rob me of the events I trained so hard for.  Then the subject switched to my general health.  I have always known that I have a weak stomach.  I deal with certain issues daily... and have always put it down to food allergies.  But I have never wanted to go through the allergy testing process, and certainly wasn't interested in getting the preventative treatment with all the shots.  But the Doctor thinks otherwise.  What I deal with on a daily basis in not normal apparently.  He wants me to get in to see a gastrointestinal specialist right away.  He thinks I may have an undiagnosed problem that should be addressed before I head off to my next race.  He thinks there is a problem and it is possibly making me more susceptible to Dysentery when I travel...compared to other people.

So that is now my next course of action.  I have been referred to the best gastrointestinal specialist in Florida...who happens to be right here in Miami.  I will go through whatever testing is recommended...and hopefully find out why I am so susceptible to getting sick.  And what would really be great, is to feel better on a daily basis at home.  All of a sudden I am realizing that the stomach issues that I have been putting up with for years...may be part of a problem that can be fixed.  Isin't it amazing that something you just grow to live with...isin't normal at all?  That this is a problem that can be fixed and I can experience a new normal?  Wow!!!!

So I leave for TransArabia in November.  As a result of not being able to compete in Oman this year...I am going back to do the race next year.  So I am still on track to crack 4,000 kilometers of Desert Competition...I am just doing The Desert Challenge in the reverse order.  So here is my schedule for the next year...

NOVEMBER 2014.................TRANSARABIA ......300 KMS

JANUARY 2015.....................TRANSOMANIA.... 300 KMS

LATER IN 2015......................MAURITANIA.........300 KMS

If you would like to do any of these events ... please let me know.  I am the Race Representative and can help you out with any questions you may have or line you up with anything you need.  I love these desert races... and I'm always excited about introducing people to how great these events are.  Each desert has its own beauty and it is fun to explore them through running.

So once I go through all the testing I will let you know the results.  I am actually hoping there is a problem... but only a problem that can be fixed...that would be great!  I need some peace with my body.  I already put it through enough by training for these events and competing.  I don't want to completely break it down before its time.  I still have many great years left...many more desert miles to log before I throw in the towel!