Wednesday, July 13, 2011


Well, this is the topic of the month for me and will be one of a series of posts I'm sure (assuming my computer starts functioning again).

Once I heard a gastroenterologist say that the average person with an ostomy is approximately 2% dehydrated at all times. For a person with a high output ostomy, this could be higher. Also, because people with active Crohn's, Colitis, or other intestinal disease may be malabsorptive to some degree, electrolyte balance can be more difficult to acheive. It may be impossible to follow a standard hydration regimen and expect the same results as your peers without intestinal disease.

For myself, I notice that I require a drastically higher concentration of electrolytes, and more water intake, than other people who are cycling at the same effort. I've been known to concentrate my gatorade to the point of it being gritty because no more salt and sugar will go into solution! Gross! But, the alternative is getting terrible leg cramps early on. I had this happen on approximately mile 20 of the NY Get Your Guts In Gear Ride, and have had terrible calf spasm on hot days in Pittsburgh when I have skimped on gatorade mix since then. Increase salt and potassium, and magically my cramps go away.

But, it's not that simple. Hydration is not something you can make an afterthought without getting into trouble and not being able to get out fast enough. When you notice you're dehydrated, it's often too late. How do you stay ahead of the game?

1. Prehydrate: I carry around my tall bike bottle all day and make sure I'm drinking enough. If I feel foggy, my electrolytes are probably a little out of wack. If my symptoms improve after some gatorade or Emergen-C (has more potassium than sports drinks, little sugar), then I've validated my suspicions. Some guys who race drink Pedialyte the night before a ride. This is great, but you can do it for a lot cheaper by mixing up your own balance of gatorade and Emergen-C.

2. Eat enough carbs: Carbohydrates help you stay hydrated, beleive it or not. I don't eat immediately before riding, but will eat a rice cake with some peanut butter, or some tortilla chips and mild, fine cut salsa, about two hours prior to a training ride. Both of these food items also have a little bit of a salt kick to them as well.  Your body doesn't hydrate well if you are running on too few carbohydrates. It just doesn't work out well. Plus, we all know that carbs equal quick energy, which is important for feeling up for an up pace ride!

3. Hydrate on the ride! Bring more water than  you think you need. Drink every time you stop. Get more gatorade at every chance you can. I have started carrying extra gatorade powder in my jersey pocket, so I can add it to water or mix it into gatorade that I've bought at a convenience store stop on a longer ride.

4. Don't forget to bring your 'lytes! Headlights and taillights are usefull as well, but I'm talking about quick sources of electrolytes, just in case you start getting into trouble. Bouillion cubes are small, portable, don't melt and are a great source of sodium. I went to a local natural food store and got some vegetable broth ones because I couldn't quite get past the fake chicken smell and taste of regular ones. The veggie cubes have just as much sodium in them, and taste intensely like parsley... which does nice things to your breath for a while as an added bonus!  Although they are more expensive than some boillion cubes, I've also become quite fond of the Margarita flavor of Cliff Shotblocks. This flavor in particular has 3x the sodium of others, and shuts down those calf cramps quickly the majority of the time. If I'm starting to feel slow and foggy on a ride, I eat a few and suddenly feel alive again. It's amazing what a difference it makes!

5. Know your stats: Know what effort you can expect to maintain in what conditions, and what sort of feul you need to keep yourself going. When you plan a route, especialy one off of main roads, it only takes a few minutes to google gas stations in the area. Put them on your map in marker.  Using a cyclocomputer helps me keep track of my effort and pace myself. I use a computer with a heart rate monitor built in, and I know what I can expect my heart rate to be at different speeds and percent grades. If my heart rate is higher than I know it should be, and there is no other good reason (too much coffee at work, getting over a cold, etc) then I can assume it is because I am dehydrated enough to jack up my cardiac effort. Keeping track of my heart rate does more than help me pace myself, it also helps me set my rate for hydration and rehydration.

6. Be willing to readjust your plan: Be aware of your hydration status, and how much longer you can go on. If you are really truly getting into trouble, maybe it's time to consider how much longer you MUST keep on going. If I'm cycling in town and am a mere 12 or 15 miles from home, that is a very different situation than finding myself getting dehydrated or with electrolyte abnormalities out accross the West Virginia or Ohio state border. If you are close to home and can plan on getting back to your end point before hydration, go for it if you can do it safely. But, with 50 or 60 miles to go, it may be time to start planning a longer stop of an hour or two. Depending on how far out of wack you are, you may need longer, or a real exit plan. But, that's the worst case scenario. Probably a few bottles of gatorade in the shade of a convenience store and a snack will get me back on the road to home. If others on the ride will absolutely not wait, that's ok. It's better to ride home alone and make it home, then have a major emergency while trying.

7. Rehydrate! Agressively rehydrate sooner than later. Drink more than you think you need to, eat some salty snacks (especially if you are craving them. That means your body is telling you that you need it!), and cool down. V8 is suprisingly effective in replacing electrolytes and micronutrients. Get some good carbs in after a ride too, it will help you recover for next time. With so much attention to protien in popular media, it's easy to forget the carbs after a workout.

Even with all of that planning and thought about hydration, I am still trying to figure it out. I like to ride hard, and this past weekend rode myself right into the ER (well, figuratively, not litterally...) by getting seriously dehydrated and running a low potassium because I was not replacing it as well as sodium.  I've also started seeing a sports nutritionist for some guidance on making these subtle tweeks to my daily diet and hydration during cycling.  More on that to come!

Oh, and, want to see who joined me on a ride yesterday evening?

Check out these guys!


  1. Yep...learned this the hard way this week...a few weeks post surgery #2 (ileo + jpouch creation)...BP 60/40-->hospital for IV fluids!!!

  2. Oh, yikes!!! How are you doing now?

    Speaking of dehydration emergencies, I found myself needing IV rehydration this past weekend. I'm currently trying to figure out what is different about the days when I end up falling apart versus the days when I'm able to stay hydrated.

    Also, when do you get to the burgh? We should go biking when you're all healed up.

  3. Doing better...surgeon is making me take an imodium before every meal and at night, and eat metamucil fiber cookies (cookies!) twice a day. I had been drinking soooooo much water even before this...and no coffee, coke or alcohol, but as you know, there's only so much you can do when the ostomy is working against you!

    Oh I'm IN the burgh!!! I got back mid-June, then I went to my other home NYC for a week and then I had the 2nd surgery mid July. So basically the whole time I've been back I've been an invalid! I could probably do a tiny bike ride by next week? I'm just getting back to walking after the weeklong dehydration/blood pressure drop left me unable to stand up... email me!