Friday, November 16, 2018

La Ruta Chapter 2: El Hospital

On Thursday night I went to bed with a bottle of electrolytes on the pillow next to me. The pain in my legs (which seized my quads, hamstrings and calves immediately following my massage that afternoon) prevented me from sleeping much, as did the frequent times I needed to pee from trying as best I could to hydrate all evening. Early on in the evening I noticed my pee was reddish brown.
I've seen the movie '24 Hours Solo', I knew in the back of my mind this wasn't good. 

At breakfast Friday morning multiple people re-assured me that my legs would come around once we started. I wasn't really sure what to do, but as I was winning (by 29 minutes) everyone just encouraged me to take it easy and complete the stage, then ride hard on Saturday in the last stage to seal the win. I boarded the bus to the start feeling uneasy. 

Stage 2 took riders straight up a volcano, and then back down the other side, a roughly 23 mile climb up 8,000ish ft followed by a 22 mile descent. It was supposed to be easier than day 1, and everyone reminded me this over and over. You'll be ok, it's easier. 

When we arrived at the start, getting off the bus was impossible without the use of my arms to lower myself to the ground, and standing at the start line, straddling my bike I wondered how I would get ON and start moving forward on my own. somehow I was able to get enough momentum to move off the line, and then I poured everything I had into pushing the pedals. I told myself that pain is just a sensation in the mind, I hoped that it was true that my legs would start to feel ok after warming up. I pushed myself to stay with Lance and his group, and eventually, since I couldn't see the second woman, I eased off to let her catch me. When she did I rode on her wheel for a long time. Having expected it to feel easy I got worried when I started struggling to keep up. 

Photo from a spectator
I did all the things ultra endurance racers do to cope with mental challenges, I split the climb into chunks in my mind, watched the feet tick by on my Garmin, found landmarks to focus on, told myself that I liked it, and tried to enjoy the pain. But at some point it became too much, I dropped off the wheel of the woman I was following and went into survival mode, hoping the buffer I had from day one would be enough to maintain the leaders jersey.

Every time there was a descent (there were a few fun, fast ripping breaks in the climb) I struggled to support my weight with my knees bent, meaning I could only ride either seated or with my legs locked. If you've ever ridden a bike down a hill you know that descending with locked knees is not fast, and seated is even slower. This was incredibly frustrating as the descents are where I usually increase my advantage in long distance races. I started to dread the 23 mile long descent that was to follow our ascent of the volcano. 

When I got to the first aid station, some 4,000ft up the volcano, I stopped to talk to the CTS guys (about the brown pee and the pain) but they didn't speak enough English to understand, so I took a bottle and pushed on. Soon after, close to tears, the route passed by an elementary school where something like 300 little kids stood at the fence yelling 'Si Se Puede!" 'I hope so' was all I could think. 

By the time I had climbed 5,000 of the 8,000ish total feet of the day I knew I needed to stop. I was just looking for someone who spoke English so I could have a chat and determine if I was making a terrible decision by continuing on. Fortunately for me at the 5k from the top sign I spotted a group of women from the US who were there with a large group of friends some racing and some supporting! I slowly pulled over and broke down with the emotion of potentially dropping out of the race. It's really hard to describe the feeling of knowing you need to stop when you are winning. Of making that judgment call that this is the point when your health is at risk, that winning is less important than stopping to potentially mitigate damage. And on top of all of this, knowing you've traveled all this way for the last race of the year, the biggest race of your season... and this means you will go home empty handed, of all the people who I wanted to deliver this win to like my coach, Felt, and Bonk Breaker. I've never dropped out of a race before, I've never needed to in 5+ years of racing bikes. It was a crushing feeling.  

Emotionally I explained what was happening and Heather and her nice friends listened, texted Taryn, gave me a coke, and helped me sit on the side of a ditch (since I couldn't sit on the ground, too painful). Eventually it was decided that I should NOT continue on, and long story short, we ended up at the hospital in Cartago thanks to translating help from Tatiana. After a brief wait in the crazy crowded waiting room I was taken back, blood was drawn and I was hooked up to an IV of fluid, the IV I had wanted so badly the day before. When my blood work came back it was clear that there was a dangerous amount of protein in my liver, and three of the things the tests measured were alarming (CK 3000, AST and ALT both pretty high). By this point I had told Tatiana it was ok if she left. I felt bad keeping a complete stranger in the hospital with me, and she had friends and a life to live outside. The bad thing though was this left me alone, in a hospital where 99% of the staff only spoke Spanish, with a dying cell phone, unsure of how long I was going to be there. 

I sent out a pathetic tweet, emailed everyone I could think of to help me get my things (since all I had was bike shorts, a rain jacket and a sports bra, no shirt, no passport, no money...) and prayed the IV fluids would fix everything so I could get out of there ASAP. 

Problem is, my liver function was crazy messed up, and nothing passes slower than time spent watching fluids drip through an IV bag. 

The hospital was small, and it was most likely short on resources. I stayed in the ER, on a bed surrounded by all the other ER patients the whole time I was there. I was 'forced' (I mean I guess I could have tried to hold my pee) to use a bedpan, a first for me, and was informed that there was no water for me to drink when I told a nurse I was thirsty (I guess there was water but no cups or bottles). I passed a lot of the time trying to conserve cell phone battery in case of emergency, which meant not communicating with the outside world. As a result I felt incredibly lonely. Sorrow about not getting to finish the race, loneliness, regret (of having gone out too hard on day 1), as well as frustration and anger washed over me in waves. A steady stream of tears ran down my face for the entire 8 hour ordeal, and as much as I wanted to 'be strong' and stay positive, nothing could block the feeling of hopelessness that I didn't even have money to pay for a cab if I COULD or NEEDED to leave. I knew in the logical part of my brain that back home Brendan loved me, that Taryn and my family and even my students cared about me, but it was hard to deal with the immediate feeling that no one in Costa Rica (even the NUE director who had brought all us NUE winners down there) cared enough to visit or help transfer me to a closer or better hospital. The day before dozens of people had been yelling 'Championa' at me, and now I was alone, unable to speak the language in a ragged hospital, not sure how long I would be there, what liver damage meant, or what I would do when it came time to leave. 

Shortly before my phone died Lance texted me 'do you need anything?' I wish I had said yes, an apple empanada, a ride to the hotel, a bottle of water, a friend. The loneliness was worse than the illness. 

There was a dr. on site who spoke English, he wasn't on duty, just filling out paperwork, but he came and explained to me what he thought was wrong, that I needed three more bags of fluid before more blood tests might show improvement. The IV bags continued their glacial dripping. hours passed. I tried to sleep. 

Eventually, around 6:30pm, the La Ruta organizers sent a young man to deliver my Tupperware of clothes and help me get a cab to the hotel. The doctor didn't want me to leave, but I couldn't handle the idea of spending the night in the hospital, after hearing a man get his leg amputated with little pain meds (in the not sound proof trauma room), and seeing a man die in the bed across from me, and feeling the weight of the loneliness for all that time. 

Getting out of the hospital bed was a feat of sheer will, and hobbling to the cab, while avoiding the NP who disapproved of me leaving, alarmingly painful, but I told myself it was because I had just been sedentary for so long (although I learned later that it was a result of my body continuing to metabolize muscle). 

Lots of misunderstanding along with my unhappiness/loneliness resulted in the decision to leave the hospital. I know now it was the wrong choice, but in the moment I just felt like I needed to get out of there. I'll conclude this ridiculously long recount over the weekend, but this is the bulk of the story, basically Friday sucked. 

TLDR: Larissa rode too hard Thursday, continued to race Friday, ended up in the hospital with Rhabdo, was lonely, 


  1. Usually your stories make me tear up because they are so great. This one made me tear up for an entirely different reason . So glad you are back in the us and on the mend. Wasatch_ray

  2. Can you post the rest of the story if you were able to write it over the weekend?? So anxious to read the conclusion. Glad that you're OK! Holy hell....

  3. Interesting article. Glad to see sites like this are making a lot of effort in producing these kinds of posts. Keep it up