Sarah Piampiano Finds Her Bearings In Kona

For rookie pro Sarah Piampiano, Kona is not just a test of hard training, it’s a sign of a healthier future.

At July’s Ironman Lake Placid, first-year pro Sarah Piampiano started off with a typical race—for her: she got out of the swim, started feeling nauseous and, before long, she was throwing up on the bike course. Unfortunately that’s the norm for Piampiano, who says, “I throw up pretty much constantly in races on the bike. A lot of the time, how my race goes depends on how sick I am.”

By mile 70 in Lake Placid, she started feeling drunk. “I couldn’t keep my bike straight, I was swerving all over the place,” she says. “I had two Ironman vehicles stop to ask if I was okay. I got to mile 111 and sort of turned my wheel and fell over on my bike and passed out.” She was pulled out of the race and slept for two hours in the medical tent. For the new few days she was still throwing up.

Before going pro and moving to Los Angeles earlier this year, Piampiano had a full-time finance job in New York City and never did bike workouts immediately after a swim. When she started doing swim/bike bricks, she had the same nausea issue. “I thought it was motion sickness, so I wore pressure point bracelets, took ginger, wore ear plugs, but it wasn’t really working,” she says.

Through race simulation workouts, she realized that until her stomach settles, she can’t get her power up—it stays 75–100 watts lower than her typical 70.3 race pace.

“The thing is, I’ve made such improvements in my swim,” Piampiano says. “And I know I have a lot further to go, but my bike is my strength and it’s really frustrating for me to be at the whim of this issue.”

At the 70.3 World Championships, a similar episode happened. She threw up more than 40 times after exiting the water.  That’s when she decided, “I have to get this figured out.” Piampiano never wanted to complain about it publicly because, as she says, “I’m not one to make excuses for myself. I don’t really talk about it that much because everyone has their own issues and struggles with their own thing.”

Fed up after Vegas, she decided to put up a blog post about her issue and received dozens of comments filled with sympathy, encouragement and suggestions for how to address the problem. She set out to take every piece of advice, putting the suggestions into a spreadsheet.

In the last month, she’s gone to an ENT specialist, a chiropractor (in case it’s nerve related), a vestibular physical therapist, a healer (more on that later) and an acupuncturist. She also recently had nose surgery done to alleviate inflamed sinuses.

For vestibular PT, about three times a day she has to walk half-bent at the waist and move her head from side to side. Then she has to walk and pretend she’s swimming. “My roommates think I have totally lost it,” she says.

Her massage therapist suggested she talk to a healer. “You could see how desperate I am, to see a healer,” Piampiano says, laughing. “It is the most bizarre thing. I called him and told him what my issues were and he said, ‘Okay I’m going to talk to your body on a cellular level.’ I sat there for two hours and he would say, ‘Cells do you want to talk to me?’ He talked to my cells for two hours and he claims that I had some traumatic event when I was five years old, and something about my ears being wet and in the wind is what causes this reaction. So he did all this stuff and claimed it was going to be okay.”

Her hope is that he’s right. With Kona approaching this weekend, Piampiano will test weeks of treatments on the Ironman course.

“I’m going into Kona hopeful and also confident that everything will be resolved,” she says. “If race day comes and I still have issues—sure I will be disappointed, because we all want to race at our best in Kona, but it’s not the end of the world.  I feel so much better and encouraged now than I did after Vegas where I simply couldn’t identify what was going on.”

“Whether good race or bad race, I am going to enjoy every moment of it.  Rest assured—next season this won’t be an issue for me.  Long gone will be the days of constant puking! “

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