(Continued from Part One)

I started researching why people get sick particularly after marathons and discovered that all of my symptoms pointed to a condition called “hyponatremia,” which is caused by low sodium in the blood. Hours of sweating and the intake of a lot of water and sugar (to “fuel” the marathon) both contribute to the loss of sodium, and without being properly replaced, it can cause severe physical reactions like those I experienced, and can even result in death. I was especially at risk for this as I tend to lose a lot of salt in my sweat (I can see it on my skin!) and had always maintained a low-sodium diet. Now I know that I really should have sought medical help after Florence and Frankfurt. I had assumed that I was experiencing a “normal” migraine and that medical personnel would likely misjudge the symptoms as in the past. And then a light bulb went on in my head: What if all of my migraines are somehow related to a lack of sodium?

So I did a Google search on something like “migraines and low sodium” and came across Dr. Angela Stanton and her book, Fighting the Migraine Epidemic: How to Treat and Prevent Migraines without Medicine – An Insider’s View (Bloomington, 2014). As it turns out, Dr. Stanton is a scientist who has been studying the migraine brain and shows that an imbalance of potassium and sodium causes migraines. She proposes a detailed protocol and nutritional guide to achieve a proper balance, which helps to control the onset of migraines in those who are susceptible to them. She was kind enough to communicate with me directly and helped me to understand that in addition to not properly replacing the salt I was losing, other habits that I thought were healthy were actually detrimental. All forms of sugar must be avoided, and this applied to the “nutrition-packed” smoothies I was consuming almost daily and carbs in the form of pasta and other grains that many marathoners have been taught are essential to fuel the marathon distance. The reality is that these foods quickly transform into sugar in the body, which in turn prohibits the proper absorption of salt (Longo DL, et al. Harrison’s Manual of Medicine 18th Edition, McGraw Hill Medical, New York, 2013). Understanding how to change my diet to find the proper balances took months and some trial and error, but the results were immediate. I haven’t taken Imitrex since the day of the Frankfurt marathon last October. That is indeed a major breakthrough for me!

Of course, this had a big impact on my running, as well. While it took some time to train my body to perform on a lower-carb diet, it was amazing to finish a long run or a race and to have a clear head for the rest of the day and then to wake up the next morning feeling fresh. After a few months, I built up enough confidence to run a race one morning and play a concert the same evening, something I would never have risked before. I felt like a different person! Already in 2016, I have run personal best times in 10k, 20k and half-marathon races, and these experiences increased my confidence that I could push myself harder without fear of triggering a debilitating episode. For my long runs and races, I have replaced energy drinks and sugar-packed fuel with salt pills and natural fruits and nuts. I was always told that I couldn’t survive long distance running without “carb-loading,” but now I see that I function even better by consuming no sugar and fewer carbohydrates.

And so I signed up for another marathon – the Helsinki City Marathon on August 13. I’m excited but also nervous. All of this will be put to the test; will I really come through okay this time? The nightmare of Frankfurt still haunts me, but I am hopeful that the experience will remain only a memory that will fade with time. Helsinki will be a difficult route and I’m not sure of what I am capable at this point, but I intend to push myself harder than before, confident that I am now more in tune with what my body needs in order to successfully take on 42.2 km/26.2 mi and stay healthy. Of course, I won’t be setting any world records, but I’m so thankful that I can now pursue this passion without the physical barrier that tormented me for most of my life. I feel more alive than ever!

Perhaps it seems counterintuitive that an activity like running, which for me often triggered migraines, actually led me to the cure for them. But indeed, it is true.

I first experienced migraines as a young child, from the age of 7 or 8. Too often during my childhood, I would spend hours or the whole day confined to a dark and quiet room, usually vomiting and in agony until the pain passed. On several occasions, they landed me in the emergency room and then when I was 17, a migraine halted my life for two months.

At the age of 22, they got even worse and would start with stroke-like symptoms (loss of vision, numbness in the hands and face, seeing lights, confusion, inability to speak or understand) and would proceed to a violent migraine that would last for hours or days. On several occasions, a friend or family member took me to the emergency room when I was in such a state and the medical team tested me for stroke, spinal meningitis or a brain aneurysm by performing a spinal tap, cat scan and MRI before treating the pain. I learned to beg my friends to NOT take me to the hospital when such symptoms hit and would instead take a powerful drug called Imitrex, which sometimes worked and sometimes did not. During certain seasons, I would have fewer migraines and during others, they would more frequently interrupt my life.

At some point, I developed a passion for running long distances. It was often a direct trigger for migraines, but I wanted to keep going so badly that I put up with the consequences. Yet I could never plan anything important on the same day or the day after a long run because I knew a migraine could follow. Even if I didn’t develop a migraine, my head often felt cloudy and dizzy after running long distances, putting me in what felt like a “pre-migraine” state.

Several friends and family members encouraged me to stop running, arguing that perhaps my head just couldn’t handle it. While I knew that there was an obvious connection, I couldn’t stop. Pushing harder felt to me like a way to fight my physical limitations, to move forward in spite of them. So I kept running long distance races and kept training for marathons to the extent that my body would allow.

There were some scary moments, though, like once when I was out on a long run, miles from home, and started losing my peripheral vision. I knew I only had minutes to get home before I would be incapable of finding my way. I flagged down a taxi and begged him to take me home even though I had no money on me. Not knowing when these episodes might start was destabilizing. After the Florence marathon, I was hit with a migraine that wiped me out for days. And after a great experience of running the Frankfurt marathon last October, I was a complete mess. I spent the rest of the day in bed and was vomiting all night. During those awful hours, I didn’t ever want to confront a marathon again, but I also didn’t want to give in to such defeat. It took weeks to recover from that episode. The Frankfurt marathon had truly broken me.

And then, everything changed.

(Continue to Part Two)