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Nutrition and hydration before, during and after events

Nutrition and Hydration

“Do you know your name? Who do you work for? Where are you from?”

This is what I was bombarded with when I half opened my eyes and came back into the world of the living. I laughed at Linda, my adventure buddy and spluttered out, “What are you on about? What’s happening, where the hell am I and where is our Irish coffee?”

I quickly realised that I was in a hospital bed, hooked up at every end and butt naked, they even managed to get my belly button piercing out! The last thing I remember was going in the direction of the Irish coffee bar in Chamonix where myself, Linda and my trail running friends from Nantes had arranged to meet after the 55km mountain run in the famous ‘hills’ of Mont Blanc.

Linda repeated, “What’s your name? Just tell me!”

I was wondering whether I was dreaming or whether Linda had lost the plot.

“Rachel” I said, laughing, “now tell me where am I and what am I doing here?”

With a sigh of relief Linda explained the story.

The OCC (Orsieres-Champex-Chamonix) is a spectacular 55km trail run climbing over 3,300 meters in the French and Swiss Alps. This was a ‘soft’ event compared to what we had already done that year – La Marathon des Sables (254km across the Sahara desert in extreme conditions), numerous ultra-trail marathons, a 3 day non-stop multi-sport event, 24 hour mountain runs – the list goes on. We saw this as a nice sporty holiday to enjoy with some of our French friends.

Rachel Nolan Ultramarathon in the Alps

We normally stay together during events and our objective is always to have fun, meet new people and enjoy the experience. After 15km, I was feeling strong and Linda encouraged me to push on. I stepped up a gear, and at one point I was told that I was the third female and the second was not too far away. It was 32 degrees and with the combination of the heat and altitude, good hydration was a necessity. Thinking of nutrition and hydration I ate a few sugary bars, jellies and refilled my water at a food station, however I didn’t add in more electrolytes or salt. Little did I know but this was a big mistake! At the 35 km mark, I started to feel a little dizzy and had to stop to pee twice.

I continuously felt like I needed to pee but in reality I didn’t and it was just my body telling me something was not right. I slowed right down and lost the momentum, the focus was now just to cross the finish line. It’s difficult to know the difference between feeling exerted and naturally under pressure, and whether there is actually a serious underlying problem. Sprinting across the finish line in Chamonix with lines of people cheering and against the backdrop of the humongous mountains, the adrenaline was pumping! I fuelled up and decided to go to the nurse to get checked out before meeting my buddies in the Irish coffee bar. This is where it stops for me. I have no recollection after this moment.

Apparently, I went into the massage and medical area and told them I felt a little dizzy. They gave me soup and I lay down for a while.

Patrick Basset who is in charge of Dokever Medical happened to be there and assessed the situation. Dokever is the world number one sporting medical company, providing full medical aid for the Paris marathon, Dakar rally and many more international events. After a half an hour, I convinced them that I was fine and wanted to leave. Believe it or not, I have absolutely no memory of any of this. I then wandered down the streets of Chamonix, possibly in search of the Irish coffee bar.

I collapsed on the main street beside McDonald’s and had a seizure, my body bouncing off the street.

Clearly this created a scene and attracted the attention of everyone. Patrick heard on his walkie-talkie that a girl was having a seizure and realised that he had seen me earlier. He ran to the scene and after seeing me, quickly analyzing the situation, he decided that I must have Hyponatremia. This is where the body lacks sodium and can in extreme cases lead to death caused by brain edema.

I was put into an ambulance and 3 doctors tried to pin me down to prevent me from banging around the place. I was told after that I have some serious strength as they were unable to control me, I think a few of them went home with bruises! Following this, Patrick who luckily happens to be an anaesthetist intubated me with a general anesthesia to protect my brain. I was then helicoptered to Annecy hospital where I was in a coma for over 40 hours.

They were unsure that I would wake up and were concerned that if I did wake up there would be serious brain damage and possible memory loss. Fortunately, I  came out of it 100%. The staff in the hospital were just amazing; the attention to detail, the friendliness, the professionalism, I actually felt as though I was in a luxury hotel. They carried out lots of tests to ensure I was in a fit condition to leave. When they put me on the weighing scales and I was 8 kg heavier that my normal weight, they explained they had drain fed me with a mixture of glucose, water and salt to replenish the reserves.

The aftermath and the importance of nutrition and hydration

A week earlier I had just started a new job with SKINS compression and was conscious that I was due to have a meeting with my new boss. After they let me out, I drove 5 hours to Montpellier and all the drama was in the past!

I think the moral of the story is to listen to your body, to research the profile of events and ensure you are fuelled and hydrated appropriately before, during and after any event. I know that the OCC was not the cause of the problem. The salt levels in my body were slowly decreasing throughout the year and this just topped it off! I was very lucky that the Dokever medical team were so attentive and responsive when making their decision. If they had not been so well prepared, professional and fast, the outcome would not have been so positive.

This dramatic situation has in no way slowed me down when planning long endurance events, however, I now plan my nutrition and hydration for events with more precision. I also get regular medical checks for sodium, potassium and protein.

Oh yes – any excuse for lots of salt and vinegar Tayto …

Conclusion : La science n’est pas un don

This article was originally published on the website of the Foundation for Medicine & Science in Ultra Endurance Sports – you can view it here.


  1. avatar

    […] with salt, one where I finished in a coma for 40 hours (you can read this story in my blog on nutrition and hydration) so I knew that I needed to consume large amounts to keep the balance. Within a minute the salt […]

  2. avatar

    […] In my 20s I did a lot training; mainly ultra-running and my period had stopped for over 10 years. I went to a few physicians and they told me it is normal for a woman that trains a lot. Only years after I found out that there is a name for what I experienced Low Energy Availability syndrome (LEA). I was basically constantly under fuelled for the training I was doing. Even though I was eating normally I didn’t pay that much attention to what ended up on my plate and sometimes skipped meals when I was busy with work or something came up. After a year filled with lots of long distance running events I collapsed after a race in France ended up in a coma. Read up more about it here. […]

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