I Don’t Know, I Just Can’t Swallow That

“Pay attention to your nutrition and your pace, and your time and place take care of themselves”

— Al Truscott’s favorite mantra for Ironman racing.

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“I’m worried about how you’re going to get enough to drink at the race. You’d better practice that while you’re here.”

Cheryl usually doesn’t offer me advice on my training or racing – anymore than I would tell her how to take a picture or print it out.

“I mean, you have had trouble before not getting enough – remember when you ended up in the Med Tent in Hawaii? I just don’t want anything like that to happen to you again.”

She’s right, of course. I’ve been so focused on my arm and hand weakness and slow swimming, that I have been a little cavalier about the potential impact of one of my other injuries: my esophagus just doesn’t work right.

When I hit that tailgate with my chin, my head got forcefully flung so far back that a number of terrible things got ripped up. My larynx got jammed against the front of my spine, and now I have a raspy, octave-lower voice. Several small bones, spinous processes, which hold the supporting ligaments of the neck in place, got wrenched from their moorings. My spinal cord got damaged in some unknown way, affecting sensation in my middle and index fingers, and weakening certain muscles in my hands, arms and shoulders. And, my esophagus muscles or the nerves leading to them got disrupted and have not returned to good functioning.

I can eat and drink OK. Solid food goes down, but the last little bit seems to stay up top, never making it down the chute. Same thing with fluids; I can guzzle as many swallows as I like, but the last one I take just sits there, tickling my larynx and having me flirt with drowning unless I try some awkward manipulations of hacking, tilting my head up or down, or, as a last resort, coughing things up and spitting.

The good news is, I don’t rely on on any solid food while racing. And, while running, I usually slow to a walk when I take a drink, and don’t start running again until I’ve finished. But while biking – while biking, there are a lot of issues which conspire to make getting fluids in problematic.

First of all, I am riding along bent over so my upper body is almost parallel to the ground, with my head tilted up a bit, extending my neck. Not a good position to be drinking in even if everything worked properly.

Many triathletes, valuing aerodynamics over comfort, will have a source of fluid with a straw or other delivery tube near their face so they don’t have to come up from the aero tuck to drink. Others will use a bottle attached somewhere to the bike that they can grab and drink from.

Both of those present problems to me. Trying to swallow while in the aero position means first, locating the straw, second, being able to get the fluid out, and third, swallowing it. The first and third I can’t really do unless I let myself get more upright, so I can put my neck in the best position for getting fluid in and down. And getting the fluid out is tough to do with only my upper teeth to manipulate the dispensing mechanism, as I don’t want to use the lower gums, where new bone is still growing prior to the fake teeth being implanted.

With a bottle, the same issues come into play. Usually, one would open the bottle with the teeth – again, no go. And second, if I try to drink while leaning over too much, it just ends up dribbling out.

At the moment, I’ve been practicing using the bottle system, but it takes twice as long. I can’t just leave to bottle top open, as I want to shake my fluids up to mix them better. I have nutrition calories mixed with the water, and that powder would settle at the bottom if it were’t shaken before drunk.

So I have to first pull the bottle out of its cage. Then, I have to shake it, and shift it around, holding it with my weaker hand while holding the bike steady with the same weak hand, so the strong one can open the top. Then, I have to shift the bottle position in my weak hand, steering the bike with my strong (left) hand, tilt the bottle up a bit, and slug down 3-8 sips.

The fun is just beginning then. SInce I can’t breathe while slurpping and swallowing, and since it takes about five swallows at the end to make sure I get the fluid off of my larynx, I end up getting out of breath each time I take a drink. All this makes me want to just say “Fuggetaboutit, it’s too much trouble.”

But that’s not an option in a six hour bike ride, so I just have to slow down and get it done. I’ve survived so far, but I’m still not satisfied with the process. I could just skip the on-board fluids, and use the aid stations every 10 miles, meaning I’d get drinks every 30 minutes or so. But they only have water and some God-awful PowerBar concoction which I just can’t stomach. More than half the calories I get on the bike come from that powder mix, and I have to have that on the bike at a minimum.

In addition, most of the rest of my calories come from gel I carry in a flask, and it presents the same bottle top and swallowing issues as a drink bottle. Also, my esophagus and orophaynx has become more sensitive to concentrated irritants like a sugary solution, or the alcohol in beer and wine. So I have to immediately follow the gel with some water to dilute it and get the last glob down the hatch.

ARGHHH – such a simple thing, drinking on the bike, has now become one of my biggest challenges. Oh well, it’s what I like about Ironman, all the little issues that have to be dealt with to get a successful end result.

I’ve got another option for adding calories and getting fluids in, the SpeedFil system, which I’ve tried a bit but haven’t really figure out how to use; I may give it another try in the next two weeks before settling on a final strategy. Updates to follow.