Every athlete has their own individual story, with different struggles and triumphs along the way. More often than not these struggles are running related injuries and illnesses, but not always! Jonny, like the majority of runners, has had his fair share of injuries, but along with injuries he has also been dealing with a relatively rare blood disorder. Back in November 2014 , Jonny was diagnosed with Idiopathic Thrombocytopenia (ITP), an uncommon autoimmune disorder of the blood in which the number of platelets is reduced. Platelets are the part of our blood which are vital in helping it clot. With low levels of platelets, the clotting ability of our blood is vastly reduced. What this means is that following and injury, even something as simple as a paper cut on the finger, the low platelet level means the blood is unable to clot as well and the wound will continue bleeding for much longer than in a person with normal platelet levels. Platelets help stop the bleeding by clumping together and forming a plug at the site of the injury to prevent further loss of blood, but with low levels it can take much longer for this plug to form.
There are lots of reasons why someone might have a low platelet count, and when there is found to be no specific cause, as was the case with Jonny, the condition is called ITP; where the body attacks and destroys its own platelets. Occasionally the conditions resolves spontaneously, but it can also become chronic, which is more common in adults.
The symptoms can vary depending on the severity of the condition and how low the platelet level is. Some people have no symptoms and the condition is just picked up on a blood test, but others experience symptoms such as easy or excessive bruising, abnormal bleeding e.g. bleeding gums, heavy nose bleeds, blood in urine or stool, and prolonged bleeding from cuts. These are not the most pleasant of symptoms at the best of times, and unfortunately for Jonny, it was whilst he was away in Kenya, a country not very well known for their medical facilities, at an altitude training camp that he first started to notice the symptoms. Initially he noticed bleeding from his gums and random bruising over his body. Convincing himself it was nothing to worry about he cracked on with training until a few days later whilst having a small blood sample taken for lactate levels during a training session by the camp physiologist, he could not stop the bleeding for over 2 hours. A trip to Iten hospital followed and then down to Eldoret hospital where bloods were taken which revealed his platelet level was at 20 x 109/L (normal range 150-450 x109). After discussions with the British Athletics endurance doctor, it was agreed that Jonny needed to be flown home the next day for further tests. So sadly for Jonny this meant an early end to his altitude training camp. He had hoped to be returning from altitude with some blood rich in red blood cells, but instead he was leaving with some blood very poor in platelets!
Back on home soil the next day, Jonny had repeat blood tests which showed a further drop in his platelets until he literally had none left! Not a very good position to be in and so serious that if he cut or injured himself badly he could potentially bleed to death! He was referred to consultant haematologist, Dr Watts, for further investigations and management. For Jonny and those close to him it was quite a stressful time, because at this stage the cause was very much unknown, and certain conditions which can cause low platelet levels such as leukaemia and HIV needed to be excluded, which no doubt added a great deal of stress and anxiety.
The consequences of having such low platelet levels can lead to potentially life threatening internal bleeding so treatment was started straight away, but unfortunately it was not without side-effects. First line treatment was daily prednisolone, a steroid, that had negative side effects including weight gain , loss of bone density (12 months later he was diagnosed with bilateral sacral stress fractures – his first ever bone related injury at 28 years old). Running was out of the question at least for short while until his platelet levels were higher, because of the potential risk of bleeding if he were to injure himself out on a run. The treatment, the potential for this to be a life long condition and the lack of knowledge available as to whether he could ever compete or even run again meant it was an uncertain and anxious time, but he had some great support off his family and friends to keep him thinking positive and smiling.
Without going into too much detail, the next few weeks and months probably weren’t the easiest of his life! It involved regular hospital tips for various treatments and blood tests to monitor his platelet levels, and the worry as to how this condition could affect not only his running but also his life! Its not possible to say how long he’ll have the condition for, it could resolve spontaneously tomorrow, or he could have it for the rest of his life.
It’s almost three years down the line since he was first diagnosed, he still has monthly appointments with his hematologist to monitor his platelet levels and is on regular treatment: Eltromopag, a drug which helps stimulate platelet production. He had the option of either having a daily tablet to take orally or a weekly injection. Jonny opted for the daily tablet as he didn’t fancy a weekly trip to the hospital for an injection or one of his housemates injecting his bottom once a week! I think his housemates are glad he went for that option too! Despite treatment, his platelet levels are still well below normal levels. They tend to fluctuate between 30-80 x 109/L (normal range 150-450 x109), but they are at a level which would not cause life threatening bleeding if he were to injure himself. After the first few months of uncertainty where he was unsure as to whether he’d ever be able to get back running and competing at an elite level, he’s in a position now where his ITP is well managed. Whilst he is still not out of the woods, Jonny has impressively managed to put his condition aside in order to train and compete at an elite level. He was back to winning ways withing just 9 months of his diagnosis. He won the British 10,000m championships in the May of 2015 and was third in the British 5,000m championships a few weeks later. Towards the end of 2015 and into 2016 though he was struck down with a series of bone stress injuries that were partly related to the treatment he was taking earlier in the year. Since then though he has a stable treatment program that allows him to train properly and has had some great performances so far in 2017 including a PB 62.23 clocking at the New York Half Marathon and 28.55 for 10km on the road at Schoorl in the Netherlands. The London Marathon didn’t go as hoped in April but he learned a lot and plans to run another Marathon again in Berlin this September with a target of 2:14 to aim for qualification for the Commonwealth Games in April 2018.
Considering his bumpy road over the past few years, his performances are even more impressive, and I think Jonny would like to give a huge thank you to all those that have helped him along the way!