It's so sad to see...especially the very end. I can't believe what Alicia must be going through, and for the second time as well. It's so terrible to see someone getting ready for something for years and have it go so terribly wrong.

Thanks for posting this. Ryan Shay seems, the more I read about him, including so many of the heartwarming posts on the remembrance thread, the more I respect and admire him. Too short a life--yet motivating thousands in that short space of time. People don't always realize the impact even a small act of generosity can have. Obviously a great deal of impact.

Here's a question though that I can't help asking after reading the article. Mention was made that he wasn't feeling right the last few weeks before the OT marathon, but that many runners can experience staleness at that stage, usually resolved by tapering, and, so it seemed, that was true in his case.

But how does one distinguish between real danger signals and the normal wear and tear signs of fatigue that come with higher volume of training? How many of you have gone into a race having similar symptoms to those described in the article and have come through perfectly fine? Or if not, certainly not at grave risk?

With a major race coming up, especially something like the Olympic Trials, there's bound to be both stress and a more positive sense of excitement/anticipation.... also a GREAT desire not to let anything interfere with running that important race--and with it very likely the desire to blow off symptoms that might or might not be signs of serious trouble. Isn't it sometimes true that we really don't want to know in such situations that some injury or illness is a real concern and we need to backpedal? While this may not be a good example, as I'm far from elite and I've never had anything seriously wrong (thankfully), I have postponed invasive medical tests until after races I've had my heart set on running.

And really, if the symptoms of over training and fatigue--and potentially life threatening illnesses are so similar, how can an athlete know whether s/he is being reasonably cautious to have something checked... or overly paranoid? I suppose with a history of an enlarged heart, concern would be in order, but given that an enlarged heart can be normal for athletes, even that plus the symptoms of fatigue might not set off alarm bells.

I suppose what it comes down to is that we don't always have the answers, and that people who have felt great before marathons have died during them, while others who have felt lousy have had the races of their lives. I feel for his family--if I'm asking all these what-if questions, I can scarcely imagine what they might be going through.

I think it's partly because someone I talked to in relation to a project I was working on later died of a heart attack during a marathon--someone who'd struck me as very fit and high-energy--and when I hear of things like this, the questions always come thick and fast.