Introduction
After 13 years living with a stoma, I tend not to write about it much anymore. It’s so normal for me now that – in the words of a friend – my stoma is the least interesting thing about me. It’s not a big deal and I just get on with life, working as a Pilates instructor, running, doing marathons and ultras, going skiing, snowboarding, cycling and living my life like any other normal person. Half the time I even forget I have a stoma and I don’t feel the need to shout about it.
But.. this story is a bit different.
When I had my surgery 13 years ago, I wanted to know about someone like me. I wanted proof that I could do ultras, multi-stage events and really tough races now that I had a stoma.
So I’m telling this tale for the woman that I was in 2012. I’m here to tell her that she can still do ultras and she can take on events and challenges that would push someone without a stoma to their absolute limits.
And that she can do anything she wants. If this reaches just one person and gives them hope, then my work is done.
Thank you for reading. Sarah x
P.S. and even by my nutty standards it’s a pretty crazy story too 😉 so I hope you enjoy
The Cape Wrath Ultra – My obsession
My obsession with the Cape Wrath Ultra started in 2016. I watched the documentary film of the event, and just knew I had to do this race. I wanted to be one of those runners crossing the finish, to experience the epic wilderness of the Scottish Highlands and be part of something so special. I watched the film in tears, feeling such a strong pull to be part of it.
But at the time I was only 4 years post stoma surgery.
Actually, that makes it sound WAY too simple. The reality was that it was 4 years after going through the most miserable period of my life. I’d had 5 major abdominal surgeries in close succession to remove half my bowel, 3 different stomas, experienced a perforated bowel, peritonitis, spells in high dependency and ITU, unable to eat for 8 months and extreme weight loss (I dipped under 7 stone at one point). I thought I would never eat solid food ever again and probably never run again.
Thankfully, in 2012 I finally had surgery which fixed the complications, formed a permanent stoma and allowed me to eat again and start to rebuild my health.
So, although I’d made a recovery from that utterly shitty time and gotten fit (ish) again (by then I had done the Himalayan 100 and a few other marathons), the thought of the Cape Wrath Ultra felt like a step too far.
So I parked that dream, occasionally watching the video from time to time just to torture myself of what wasn’t possible.
But then over the years I started to get a bit more confident, doing harder events and building up my distances, learning to manage my stoma in more challenging circumstances and see it less of a hindrance. And the thought started to niggle.. would CWU be possible?
The race itself is off-the-scale-hard – some describe it as the hardest ultra event in the UK. It’s basically 400km (250 miles) over 8 days (average of about 31 miles per day) taking in 45,000ft (13,700m) of ascent – which almost twice up Mt Everest.
Which on paper sounds ‘hard but okayish’.. but then you add in the terrain. There are very few paths and roads on the Cape Wrath trail.. it’s mostly pathless endless bog, dotted with sections of un-runnable heathery tufty stuff, mixed in with sharp slippery rocks. You also have to self-navigate.. nobody is out putting race arrows in place.
And let’s not forget the cut offs. The organisers create some ‘just about doable, but only if you race it hard’ cut off times to really test their participants. And they put these in place on the longest hardest days. I’m presuming they have some sort deep sadistic nature and enjoy watching people suffer.
And then there’s the matter of doing all of this with a stoma. In my case an (rather unpredictable) ileostomy.
Stoma Challenge
To provide more ‘stoma challenge’ context, the race also involves camping (for 8 nights) in a shared tent with 7 strangers. Plus there are no showers and the only toilets are ‘portaloos’ in camp.. and a bush on the side of the trail during the day. Then there’s the food. The menu is 100% vegetarian for breakfast and evening meals – something that many people with a stoma find hard (possibly blockage inducing if you’re not a veggie or vegan already). And for day time ‘hill’ food you have to take it all with you in the form of bars, packets and things that will last 8 days in a dry bag. AND.. finally, you have to source your own water during the day from streams, rivers and lochs.
For someone with an ileostomy this ticks pretty much every ‘red alert anxiety’ box that exists. The fear of night time leakage, bag changes in a portaloo in the dark, bowel blockage and some race ending gastric water-bourne illness were all very real.
But back to the story.
I finally plucked up the courage to enter the ‘scariest race on the planet’ as it was fast becoming known in our house, and set about a 12 month training and preparation for the 2022 event. I politely informed the race medics about my stoma and they were totally cool about it, offering to help me with anything I needed. Although probably secretly thinking I’d never make it.
May 2022 came around fast and I found myself not as prepared as I’d have liked. 6 weeks off with an Achilles injury and a bout of covid 4 weeks beforehand left me nervous as I toed the line for the Cape Wrath Ultra 2022. Here's the blog I wrote last year..
Long story short. I made it through day 3 within the cut off, but then retired with injury and a severe bout of hypothermia. I didn’t make it to day 4 and simply came home defeated. I’ll admit I sulked for a week or so, then grumpily realised I’d have to go back and try again. My poor husband ☹ I’m so sorry.
So I set about implementing plan Cape Wrath Ultra 2.0.
I realised I needed to do a few things differently.
1. I needed a different stoma care system. My existing system meant I had to carry a lot of stuff and change my bag twice a day. Not to mention the faff, this meant getting the medics to carry my stoma supplies and going to the medical tent morning and evening to change my bag. Firstly going to the medical tent is a dangerous thing on a race like this – it’s best to stay away! And secondly I needed a different system so that I could change the bag less often, could be self-sufficient and de-medicalise everything about having a stoma. A simple change to using a stomahesive seal was a was a game changer, as it meant I could get almost 48 hours between bag changes (rather than my usual 12-24) and even on long runs it still held out. The difference that this little reliable seal made to camp life, bag changes and sleeping confidence was HUGE.
2. I needed more leg strength. Weight training is probably THE most important thing to do to prepare for this race. Lower leg injuries are the most common thing they see on the event, and strength training helps hugely with that. It helps prevent you falling over, prevents injuries (both acute and repetitive) and gives you power to climb and stability/agility to descend. I had done a bit of weights before, but not enough. So I set about a more focused strength programme involving heavy weights and plyometric training. Some help from Mike James the Endurance Physio was huge and his support and encouragement was really appreciated.
3. I needed to toughen up in harsh weather conditions and buy some better kit. I needed to learn to look after myself in the toughest coldest and wettest conditions and be safe and prepared. So I entered the Cheviot Goat in December 2022 and The Spine Sprint in January 2023 (both delivered on all counts) and bought better kit and thought about the things that led to my hypothermia last year. Small things like fully waterproof goretex overmitts, thicker warmer waterproofs and a bigger running pack to carry more clothes made all the difference.
4. And finally, I had never gone further than 50 miles ever in one go, and I had heard lots of other people talking about having done 100km and 100 milers. So I thought I’d do a 100km in the lead up to the race. The Lakes Traverse 100km (also organised by Ourea Events) ticked that box which I did 5 weeks before.
May 2023 soon rolled around and I found myself feeling surprisingly well prepared. I had had a great year of training and races, no injuries and no illness. I was super organised in my packing and organisation and felt like I couldn’t do anything more. That was even more scary. What if I still failed after getting everything right in training? It didn’t bear thinking about.
All I knew was that there would NOT be a third attempt at the Cape Wrath Ultra.
Each day you can start the race at 7am.. and you have to be in by 10pm. Which sounds generous, but given the combination of terrain underfoot, distance, elevation and accumulative fatigue, it’s not. You have to prepare for days lasting anything between 5 and 15 hours of running/moving. And the cut offs mean cut offs.. I’d had a recurring dream about race director Shane Ohly laughing when I didn’t make the cut off by 2 seconds on day 6.
Anyway.. as for ‘race’ strategy, there’s a fine balance in pushing to go faster so you can get to camp to rest, eat and recover, but not wreck yourself by going too fast. It’s hard to know where that point lies and there’s some careful judgement and strategy involved in deciding how to approach each day.
A quick run-down of each day:
Day 1 – 23 miles 2047ft ascent
Day 2 – 36 miles 6800ft ascent
Day 3 – 42 miles 9433ft ascent
Day 4 – 23 miles 5361ft ascent
Day 5 – 27 miles 4575ft ascent
Day 6 – 42 miles 5640ft ascent
Day 7 – 37 miles 8335ft ascent
Day 8 – 16 miles 2880ft ascent
I knew from last year that the ‘pinch point’ was always going to be the cut off on day 3, and then getting to the start on day 4. And that’s the intention. Around 40% of participants get cut on the third day as the cut offs are so tight, leaving people to either retire and go home, or continue on the reduced (but still very hard) ‘explorer’ course. I knew that day 3 was going to take me around 14+ hours, and that left very little time to recover, eat and then get to the start again the following morning.
So.. on with the race. The first part is really cool as you get a little ferry across Loch Linne from Fort William to the start and it adds so much excitement and anticipation. On the other side of the loch the midges were out in full force, which was an omen of what was to come.
As for my stoma output, I manage it by taking 6-8 lmmodium before breakfast, which helps to slow my output and I can get 3-4 hours before I need to empty my bag. THIS is super important when I’m out on the trail all day without loo facilities. I have become expert at finding appropriate places, digging little holes and leaving no trace 😊 and that’s all I have to say about that apart from squatting to empty into a hole in the ground got much harder as the week went on..
Day 1 - An easy warm up and 'Tent Awesome'
Anyway.. Day 1 was a smooth and easy 23 miler in just under 5 hours, into camp and had plenty of time to eat, recover, settle in and get ready for the next day. Camp 1 was at the Glenfinnan viaduct famous from the Harry Potter movies and such a cool place to camp.
I was in Tent 4 with 6 other amazing women. Three of them had come back from the previous year as well, so we were on a mission. Combined with the other hard core nuts that made up the rest we name ourselves ‘Tent Awesome’. They were the BEST tent buddies anyone could ask for. Supportive, hilarious, sweary and kind. We cared for each other, hugged, cried, tended to blisters, taped each other, got food and made each other’s beds when we needed it. I think our camaraderie had a huge role to play in our success and strength and I’m forever grateful to those amazing women.
Day 2 - Harder than it looks
Anyway, onto Day 2. I knew from the previous year that it was harder than it looked on paper. I’d run 11 hours 40 minutes last year and so my goal was to go much slower and hold some back for the dreaded day 3. The final 10km along the loch on day 2 is legendary for taking 2 hours or more and it’s a soulless and painful trudge through bog, heather and up and down. I purposefully took my time and arrived into camp in a relaxed 12 hours 6 minutes. Back to Tent Awesome to share our woes from the day, and we were all good and going strong. Swearing was still in full flow which meant everyone was in good spirits.
Day 3 - The vomit day
The dreaded day 3 (42 miles) arrived and I knew I had to get a shimmy on to hit the cut offs. It was ‘make-or-break’ day.. and as it turned out.. it nearly was ‘break day’. The first half of the day went really well. I felt great and strong and was way ahead of the cut offs as I’d planned, loved the falls of Glomach and the tricky descent down was my strength. But, with around 15 miles to go I started feeling the onset of nausea and could feel myself slowing. Nausea made way to vomiting and I started feeling really grim. I got slower and slower, unable to eat and got colder and colder, throwing up every 20 minutes.
At the final check point of the day, I lay on the ground next to the landrover belonging to the mountain rescue team for about 20 minutes unable to get going. I felt so sick, so cold and my chest was so tight I was quite scared, thinking there was something more serious going on. The medic there gave me an anti-sickness tablet and looked me in the eye and said ‘are you sure carrying on is the right thing for you to do?’.. f*ck that. YES it is! There is NOT going to be a third attempt at this bloody race.
I somehow dragged myself up off the ground and started moving. I still had 10 miles to go. I was so so close to getting in his landrover, I still have no clue how I summoned the effort to carry on. A while later Jane from my tent appeared and she was also being sick. Together we pulled each other along, taking turns to throw up and made the final descent into camp with 20 minutes to spare! We got in at 9.40pm that night (10pm is the final cut off) meaning that it taken 14 hours 40 minutes. It was the lowest point of the whole event and I sobbed as I crossed the line.
Reading the messages on ultramail that night I was crying and crying again when I managed to speak to hubby on the phone. It had been an awful day.
Day 4 - The majesty of Torridon!
Day 4 arrived.. and I somehow I was on the start line at 7.30am.
It was a relatively shorter day at only 23 miles and the route took us through the majestic Torridon mountains and around Ben Eighe. I felt pretty tired and weak as I’d not eaten much and was dehydrated, but the less strict cut offs meant we could take our time and enjoy the views. I was with my friend Rob all day and we really enjoyed the scenery and the spectacular mountains rising up around us. The route took us up to something called the Triple Buttress which felt like an amphitheatre of rock. Breath-taking and totally glorious. The Torridon mountains are billions of years old and it’s an incredible feeling to run through them as they tower above. Day 4 took around 9 hours 20 minutes.
Day 5 - THE BEST DAY EVER
Day 5 was one of those ‘I’ll remember this as long as I live’ days. The weather was perfect. The trail was runnable and the scenery through Fisherfields was spectacular. I felt amazing and alive and so so happy. I think it’s probably the best day of running I’ve ever had in my entire life. I jogged along feeling so emotional, with gratitude for my life, my health and the ability to do this in full ‘flow’ mode. I just wished my hubby had been with me to share the moment. It was a ‘once in a lifetime’ day. A beautiful descent down into camp and plenty of time to eat, recovery and get bitten to death by midges. Day 5 was just under 8 hours but the time flew by.
But by now I was starting to feel the accumulation of the miles and camping. I had been bitten all over by midges (despite my best efforts with a head net and repellent – they seem to love me). My face and eye were swollen from fluid retention and midge bites ON MY EYELIDS and I felt like I’d been in some sort of car accident. In fact I think I felt better just after I’d had bowel surgery.. Which was unfortunate, as the next 2 days were super hard and super long.
Day 6 - The Miserable Day
Day 6 was miserable. The longest day at around 45 miles and lots of supposedly ‘runnable’ fire trail along salmon fishing rivers. Which was boring, monotonous and soul destroying. By now we had realised that each day had some sort of Shane Ohly special ‘sting in the tail’ and day 6 had a tough 3 mile descent into camp, where at one point I found myself clambering down a waterfall on legs that could barely stand. The cuts offs were also tighter again, so there was no time for faffing. Head down and go. Day 6 was a painful 11 hours 40 minutes.
Into camp and I was starting to wonder how I could manage 2 more days.
My stoma was now feeling really sore. It was swollen like a little mushroom and the edge of the bag had rubbed so much it was bleeding.
But there was nothing I could do, and it still seemed to be working ok, so I just had to stick a bag back on and ignore it. Fingers in ears.. la la la.
At this point I realised I needed some different food for the trail. I’d been using predominantly sweet food as that had worked previously well. But suddenly all I wanted was crisps, savoury snacks and cheese.. in desperation I wrote a note ‘Help I need savoury snacks, please deliver to Tent 4’ at the ‘info point’ in camp and was inundated with donations of crisps, cheese and nuts. That shows the incredible kindness and generosity of people on this event. And it helped enormously! If you made one of the kind donations, then THANK YOU.
Day 7 - The wet and wild day
Day 7 was deceptively hard. Everyone talks about day 3 as the ‘hard day’ but day 7 shouldn’t be underestimated. I was feeling pretty broken, and the thought of another 36 mile day (which everyone was now talking about as being as hard as day 3) wasn’t filling me with joy.
And then Scotland delivered the weather. The rain and wind hit just as we were climbing up to the first highest point and it was gale force. We were being battered and blown around and I started to get really wet and cold. I was running with some friends and I knew that I needed to stop and put all my clothes on. I layered up in 2 sets of waterproofs and I was still wet, cold and shivering. Wet and windy conditions are the most dangerous and hypothermia was a very real concern. I’ll admit I started to get a bit scared as I couldn’t warm up. So I just kept moving and tried to eat some food. The route was around some wild remote sea lochs and in other weather it would have been beautiful, but I didn’t look up. I just got my head down and kept moving.
Finally a big climb warmed me up, the rain stopped and I started to feel better and safer. The route then went over some pathless featureless boggy mountain and it was hard to navigate and hard to keep any pace. Luckily I spotted another runner in the distance and caught him up. We shared the navigation and took comfort in each other for the next 10 miles.
Finally we hit some road and down into camp at Kinlochbervie for the first hot shower in a week and a finish time of 12 hours 50 minutes . I knew by then that 2 of my tent mates had been timed out on the 2nd checkpoint of the day, and was absolutely gutted for them. They had both returned from last year to try again and it was so cruel. The tent felt so sad that night. Thankfully they both pulled enough together to hobble the final day and get to the lighthouse.
As for my stoma, by the end it was sore, bulging and swollen. The core strength required to tolerate literally throwing myself down mountains and running for hours on end carrying a heavy pack isn’t something that comes easy. I practise around 5-6 hours of Pilates a week and I’m pretty sure that’s the only reason my stoma can cope with such abuse.
Day 8 - Day of Joy
Day 8 dawned, and nothing other than my leg falling off would stop me. The highlight of the day was Sandwood Bay, a beach so white and beautiful and only accessible by foot or boat and then the final destination of Cape Wrath Lighthouse. The lighthouse came tantalisingly into view, but still 4 miles of bashing across heather, bog and more tufty tussocks. 16 miles still took nearly 5 hours.
Crossing the line at the lighthouse I had such mixed emotions.. thank f*ck it was over and I could stop running, but equally I didn’t want it to end. It had been the most incredible journey of my life. I had loved the camp life, the people, the trail and the mountains. The midges less so. There had been such incredible highs and such low lows.
It’s billed as a ‘once in a lifetime adventure’ and it certainly is that. The organisation is impeccable, the staff and volunteers are special human beings and the route through the true wilderness of Scotland is everything you imagine and more. But it’s the other runners that make this so incredible, such amazingly tough, thoughtful and caring folk who look out for each other and make the atmosphere what it is… and especially the ladies from ‘Tent Awesome’... you are the BEST.
Thank you Cape Wrath Ultra for giving me the experience of my life. I don’t think there’s ever going to be a way to top it.
Out of 172 starters in the ultra, there were 88 finishers – basically a 50% finish rate. I finished as 15th lady out of 55 starters. Even if I’d been last I would have still felt like a super hero. This race tests every single aspect of your mental and physical toughness and then eats you for breakfast. It’s an incredible journey and one I’ll never forget.
So if one day you find out you need a stoma (it can happen to anyone), or you have a friend or family member who needs one or has one, please remember this story (and please share it with them). Your life is NOT over and you CAN do crazy nutty stuff that would test anyone without a stoma to their absolute limit. It’s not easy and there are immense challenges along the way, but when you do finally achieve a lifelong goal, the feeling of achievement is even sweeter. And if you or anyone you know needs help with their stoma, then please get in touch.
A client gave me a beautiful gift of a book called Annapurna by Maruice Herzog, leader of the French Himalayan Expedition in 1950 and the final sentence of the book is as follows:
‘Annapurna, to which we had gone empty handed, was a treasure on which we should live the rest of our days. With this realisation we turn the page: a new life begins. There are other Annapurnas in the lives of men’.
Cape Wrath Ultra was my Annapurna.
Thank you
A special thanks to my poor long suffering husband John, who supports me every step of the way, believes in me, sometimes joins me, rolls his eyes a lot and enables my craziness. Without you none of this would be possible.
Sarah Russell sarah@sarah-russell.co.uk
Clinical Exercise Specialist
Clinical Pilates Teacher
Founder of The Ostomy Studio