Marathon des Sables – Long and Winding Road
“OK, so what’s got you all excited?” asked Donna when I got home.
“Well,” I said, as I hesitantly began the sales pitch, “I was reading in the paper on the way home that there’s a big walk that I was thinking that I might do.”
“Hmm?” she said, cautiously inviting further information.
“The thing is” I continued, “it’s quite a big deal, and it won’t be cheap.”
“Yes?” she prompted.
“It’s a 240km endurance race over in the Sahara in Morocco.” Donna looked at me with eyes that were slightly narrowed.
“When you say won’t be cheap, how not cheap are we talking about?”
“Well,” I said, “I was thinking that we could turn it into a holiday for us. You know, make it an opportunity to see a place we haven’t been to yet. And Marrakesh has always been one of those exotic places that ……. “. Donna held her hand up.
“You’re starting to babble. If you’re going to do this, you’re going to do it properly. I would have some strict rules and would expect you to stick with them.”
“Yes, of course.” I blurted.
Donna continued. “Firstly, you’re going to train properly. Secondly, you’re going to go see the diabetes doctor and find out what you need to do to be prepared. Thirdly you’re going to go see a sports nutrition expert so you can work out the food. And last, you’re not going to cut any corners. If you’re going to do this, you’re going to do it properly.”
“Yes, OK” I said. What else could I say?
And with that, the Marathon des Sables adventure was underway.
Marathon des Sables – Preparation
I’d always been a bit of a walker. I enjoyed bushwalking and “went bush” on the rare occasions when time and circumstances would allow. I had even had a stint at distance running when we were living in Brisbane. That only lasted for a year or so, until my knees and hips started to give me problems. From that experience I learned that the diabetes makes distance running difficult. Obviously with the number of marathon runners who have type 1 diabetes, distance running is not impossible, but it does have an extra dimension of difficulty and risk that, when combined with the deterioration of my knees and hips, meant that walking the Marathon des Sables and not running was a no-brainer. However that wasn’t going to be a problem because the event has been designed to allow for those who wished to walk. So long as you could maintain an average pace of 3.5kph, you could complete each section within the allowed time.
The training started that same weekend. Now that I had the bug in my ear, I couldn’t wait to get into it and was itching to get out there to start preparing. I had given myself two years to train, even though I thought that twelve months would have been ample, but I soon came to realize that I was going to need the whole two years. There was just so much to do.
The main lesson I learned from my first few walks, which were only short stints of 5km, was that I had a heck of a lot of work to do. I was old and wise enough by then to have realized that, even though I had been bushwalking for years, that didn’t mean that I knew everything there was to know about endurance walking. Some years previously, in what could be looked at as a false start for the Marathon des Sables adventure, I had participated in the Oxfam Trailwalker 100km walk for charity. I had trained hard for that and had thought that I was fully ready. Heck, at the start I even felt a bit sorry for the two young ladies who were part of our team of four, because they didn’t have the bushwalking experience that I did and I thought they might not even finish. Well, did I end up eating my words?! They had been waiting at the finish line for myself and the other fellow for around an hour as he helped me stagger over the line in a state of almost complete collapse. To parody the words of Jack Nicholson to Tom Cruise in the movie “A Few Good Men”, “Do you have a memory of that?”, with Tom Cruise answering “Crystal!” The memory of the finish line of the Oxfam Trailwalker was my base line for the Marathon des Sables. I must not put myself in that situation again.
From those early training walks, I reluctantly realized that the gear I was using was not good enough. My initial intention had been to not change a thing and dress in similar clothing, use the same boots and have the same backpack as I had always used for my bushwalks. I had many fond memories of delightful walks with this gear, both in Saudi and in Australia, so I considered it had been tested and proven. Looking back now, that was an absurd thought, as were many of my initial thoughts as I was to learn. My boots were simply wrong, being too heavy and nowhere near tough enough. My backpack was all wrong, so needed to be upgraded. My clothes were wrong as they were too heavy and just not fit for purpose. And the food I was eating as I walked, to keep my sugar at an acceptable level, was also wrong. So after four weeks of training I had learned:
- My boots needed replacing
- I needed a whole set of new clothes
- My backpack needed replacing
- I needed to learn about my food requirements for the desert
- I needed to learn about my insulin requirements during endurance walking
- I needed to toughen my feet and/or learn how to deal with blisters
In essence, I was back to square one.
Entry to the Marathon Des Sables is not as easy as you may think. After hunting around on the internet I was able to learn that, as the event is a French event, its primary focus is on having French people participating. Next in the order of preference were countries close to France, such as Spain, Germany, The Netherlands etc, so people from those countries received next preference for participation. This was followed by Great Britain then the rest of the world. Over the years the organisers had learned that the best way to manage who could be part of this incredible event was to allocate spots to regions of the world. There was Western Europe, North America, South America, The Middle East etc. Each region is allocated a number of places in the event and an agent is given the job of managing the booking process for each region. In 2008, Australia was part of the North American region, I suppose for reasons of language and simplicity, so I needed to work with a fellow in Colorado to get myself a place.
Unsurprisingly, my diabetes quickly became a potential sticking point. The agent in Colorado strongly recommended that, before progressing too far with the process, I get confirmation from the central management of the event in Paris that I would be allowed to participate. That was certainly easier said than done. First of all I had to find a contact for the central management group, then I had to overcome the language barrier. I came to find that, in a similar way to my French being effectively zero, not many French people speak English.
After many emails and a few late night phone calls to Paris, I was finally able to contact someone in the management team who spoke English. Then I had to explain to them why I was contacting them and that it was important that they understood the reason. All of this took a number of emails and phone calls, all the while with me fretting that I would miss out on making it onto the waiting list with the Colorado agent. He had explained that he ran the list on a first come / first serve basis, but even though I was one of the early ones to contact him about the 2010 event, there were already names on the list. So I was also racing against time to obtain confirmation from Paris.
Eventually I either got lucky, or my persistence wore them down, but I was able to get a team doctor on the phone in Paris who was able to confirm that, so long as I fulfilled their extra requirements for fitness tests, related to my diabetes AND my age, they would not stop me from being part of the 2010 event. They would email me details of the extra fitness test requirements. It had taken a long time and a lot of frustration, but I had finally made it over that hurdle. I immediately passed that news back to the agent in Colorado so my name could be added to the list. It was then that I found that the marathon aspect of this event had already started, because before he could put my name of the waiting list, I had to get a 25% deposit to him.
I almost cried in frustration.
Once I calmed down, I thought about this latest road bump and decided that it was a reasonable request. The agent was running a business which spanned the U.S.A., Canada, Australia, New Zealand and one or two other countries, so it was quite reasonable for him to want a financial commitment from people before putting their name on the list. But getting the money to him became the next issue.
As you can see, the marathon had already begun, without me even leaving my chair. Roadblocks like this littered the pathway in those first few months as I went through the paperwork and over hurdles just to get on the list. I was to find out later, after the dust and drama had settled from these early days, that the agent had quietly been holding a spot open for me. I think he was as intrigued as the team doctors in Paris to see how I would go in the Sahara.
Doctor, I’m Walking Across The Sahara
One of Donna’s requirements for giving me her permission to pursue this adventure was for me to have a full review of my diabetes management with a proper diabetes doctor, known as an endocrinologist. As I hadn’t seen one for, ummm, way too long, that was a reasonable request.
“Hello Alex. How can we help you today?”
“Hi. I’m planning to walk across the Sahara desert and I’m here to find out what I need to do, so I can complete this adventure without dying.”
“You are planning to do what?”
“Walk across the Sahara.”
“You have type 1 diabetes. You do know that you shouldn’t be doing something like that, don’t you?”
“Yes I do. That’s why I’m here, so I can learn what I need to.”
This was how the “Endo” and I started our discussion. She knew simply from the fact that I had been living with type 1 diabetes for thirty four years, and was planning on walking across the Sahara, that I must have been doing something right for all those years. Many of the people with type 1 diabetes she saw daily, who had less years living with this illness under their belt, were in a much worse state of health than I was. Many would have been suffering with failing eye sight, failing kidneys, problems with their feet resulting in amputations along with other complications. And yet here was I proposing this wild adventure. So she let the normal doctor / patient routine drop and we began discussing the logistics of what I needed to do more on an even, one-to-one basis.
We talked about my history with type 1 diabetes so she could get a feel for how I manage it. She was also judging how much I knew about the biology of the illness and its management. I asked some questions to do with food, which she answered in a very matter-of-fact way. I could tell that she had concluded that even trying to talk me out of this would be a waste of her time, so she dropped any thought of doing so.
“So how do you do your injections?” she asked.
“Disposable syringes.” I answered. At this she sat back and said “Oh well, there’s something we need to change.”
“I’m quite happy with the syringes, but I’m prepared to consider other options.”
“Well,” she said, “I advise that you go onto an insulin pump, but I get the feeling that you’re going to resist that suggestion.”
“Yes, I’m afraid I am.” I said.
“Do you mind if I ask you why?”
“Not at all. For thirty four years I have been in total control of my existence. I manage my food, I manage my injections, I take responsibility for when something goes wrong and that’s the way it needs to be. If I go over to using a pump, I’m giving up some of that control and responsibility to a machine and I can’t have that. I can’t rely on a machine to keep me alive, not when I’ve been doing it every minute of every day for the past thirty four years; especially when I’m putting myself in danger over in the Sahara. I need to be in more control, not less.”
“That’s fair enough,” she said. “Then I have another suggestion that I strongly encourage you to consider.”
That was when she introduced me to the insulin pen.
“Hmmm, I’ve heard about these.” I said.
“They’ve been around for quite some time now” said the doctor, rolling her eyes slightly. “This is how they work.”
She then proceeded to go through the workings of what I had been resisting for many years. A lot of people had been recommending that I swap across from syringes to the pen, but I had been resisting. I had been working on the “If it aint broke, don’t fix it” life philosophy.
She worked through the mechanics of the unit, the vial of insulin that it used and the various advantages that it had over the syringes. But it wasn’t until she brought out one of the needles, screwed it on to the pen then pulled off its cover that I was finally convinced. The needle was so fine it was actually a little difficult to see. And the fact that each pen comes as a complete, self-contained kit was the final selling point. I was convinced.
So after thirty something years of using disposable syringes, I was finally convinced to modernize the next step. I had started all those years ago with the glass syringe and their tram track needles. They were cumbersome, would often stick as you pushed the plunger and rather painful. The needles were reusable and quickly became blunt. The whole process, while a life saver, was wrought with pain and on-going management problems. I had progressed on to the disposable syringes after a couple of years. These were a vast improvement on the glass syringe but, having hundreds or thousands of injections every year for decades resulted in growing problems, even with them. The fat under the skin gets hard and lumpy and becomes impossible to inject in to. Also the insulin can stop being absorbed, which of course then affects the ongoing management of the diabetes. So progressing to the pens and their ultra fine needles would be a significant move.
Next on Donna’s list of requirements was a visit to a sports nutritionist. I didn’t rush off immediately to find one, really not being sure of how they would be able to help. I just continued on, week after week, with my ever more demanding training walks.
By now it was late 2008 and I was walking twenty or thirty kilometres each weekend, often walking on both Saturday and Sunday. Plus I was leaving an hour early for the trip to work most days, getting off the train at an earlier station and walking into the city from there. All of this was taking a toll on my diabetes management, with my sugar levels sometimes swinging wildly. One morning, as I was walking to work, I was ducking across a busy road. This road is a main thoroughfare in Melbourne, carrying trucks around the city centre. As I was half way across, judging the timing of the traffic lights at each end of the bridge I was on, I realized that my vision was wobbling and I could no longer clearly see what the traffic was doing. I was able to duck between two cars that were momentarily stopped in the traffic and get to the other side. I was rapidly losing control as a severe low sugar episode swung into action. My legs were now starting to wobble and cave at the knees, so I took off my backpack and dug into my emergency food for a fruit juice box. That was enough to get me the last ten minutes of walk to the office, where I again dug into my emergency food.
Worryingly, that sort of situation was becoming more and more common. If it had been two minutes later when I was on that bridge, the chances are good that I would not have been able to judge the gaps in the traffic, or the speed of the oncoming vehicles, or have been able to see clearly enough to get through the line of traffic without being hit by another car or truck. Being killed crossing a road in peak hour traffic was not why I was doing this, so something needed to be done. The situation I found myself in at this stage of the training, when I was only a quarter of the way towards the event, was only going to get much worse as I upped the distances and the times.
Meanwhile, with the increasing distances I was covering every weekend I was starting to suffer foot problems. When I first noticed it I considered that it was temporary and would fix itself. One day I’ll accept that magic like “It will fix itself” rarely happens in the real world. I persevered for a few weeks until it became obvious that it was getting worse, not better, and this was when I was doing fifty kilometres per week, not two hundred and fifty.
I hunted out a sports podiatrist whose practice was close to work and made an appointment. Being a sports specialist, he wasn’t overly surprised by a type 1 diabetic attempting to do the Marathon des Sables. Over the years he had treated many people from the strange world of extreme sports.
His help was invaluable. He was able to show me on a model exactly where my foot pain was coming from and what was causing it. From his many years of treating runners, jumpers, sprinters and many other people wearing lycra, his understanding of the engineering of the foot was unquestioned. From my two, rather expensive, sessions with him, I was able to continue my training with the confidence that I knew how to manage the errant ligament that had been damaged in a childhood accident when I was eight years old. He showed me how to tape my foot to replace the job that the damaged ligament was unable to do.
In retrospect, my second visit to the podiatrist was a little bit cheeky on my part, although at the time I didn’t think twice about it. Keep in mind that I was preparing for an event in the Sahara desert on the other side of the planet, where I would be isolated from normal civilization for a week.
As soon as I had got home after the first visit, Donna and I carefully stripped off each piece of the strapping tape. We measured it and I made a diagram of where it had been on my foot. I then proceeded to tape and re-tape my foot numerous times, in order to learn how he had done it and to understand the purpose for each piece of the complex taping process. A few weeks later, after I had done numerous training walks and had gone through the taping process many times, I made another appointment with the podiatrist. My reason for the second appointment was to get his confirmation that my taping efforts were good enough and that I had correctly remembered the process. I figured out while I was there that his understanding for why I had made the second appointment was so he could tape my foot again. When I told him quite proudly that I had undone his taping and made diagrams of it, the look on his face told me everything. It was only at that moment that I realized that he saw his job as being my ongoing, official taper.
Oops. I still haven’t worked out how he expected me to tape my foot when I was in Morocco. Maybe he thought he would do it before I left Melbourne, and it would last all the way through until the end of the event. Oh well.
Meanwhile, normal life still continued. We still went shopping for groceries each week, went to work and drove the kids to their sporting events. Donna and I were also working on another part of our “agreement”, being to turn my extreme marathon effort into an exotic holiday for both of us.
The plan so far was that we would fly to England and spend a few days with Donna’s sister in London. I would then fly to Morocco and join up with some of my tent mates in Marrakesh, from where we would travel to the meet up point of Ouarzazate (Wah_za_zat) to join the rest of the competitors managed by the Colorado agent. The original plan was that Donna and our friend Nick would, a few days later, fly to Marrakesh then travel on to Ouarzazate, to be there when we all returned after the event. Everybody who knew me knew that I’d be a physical wreck, plus also facing potential medical difficulties. Managing type 1 diabetes during extended periods of exercise has an added complexity, in that the body uses up some, most or all of the natural store of glucose that is stored around the liver. Everybody has this storage, but the process of using and rebuilding it is automatic for people who don’t have type 1 diabetes. For me, as my body automatically rebuilt the storage around the liver, it needed to use some of the carbohydrate that I was eating daily, meaning that there was less available hour by hour for my normal living requirements. Does it sound complicated? Once you understand it, it’s not so complicated, but as none of the rebuilding can be controlled or managed, making allowances for it in the days after the event was going to be very tricky, and potentially dangerous for me. The coach trip back to Ouarzazate from the Sahara was going to take five hours, and I would need to still eat like I was doing the event. But once back at Ouazazate and back to normal eating, I was going to need the safety of somebody to be with me.
After the reunion at Ouarzazate, the plan was then that the three of us would return to Marrakesh, spend a few days or a week, then all fly back to England and spend some time in The Lakes District with Nick.
Meanwhile, normal life in 2008 continued.