Copy of blog post 18

Dying to Run, Episode 1: “Thirty-One Symptoms”

Matt Fitzgerald has been a runner for almost his entire life, but his running days ended abruptly in 2020 when he developed long COVID, a post-viral chronic illness that makes it almost impossible to exercise. “Dying to Run” chronicles Matt’s quest for closure in the form of one last finish line.

* * *

My right butt cheek begins to buzz, startling me. These days it doesn’t take much to make me jump. Among the more than thirty symptoms of post-acute COVID-19 syndrome (aka long COVID) I’ve experienced over the past 1,182 days (but who’s counting?) is hyperekplexia—a hair-trigger startle reflex.

I pull my phone out of my pocket and kill the alarm, which I’d set for 11:55 PM. Seeing the time, I realize that, amid the chaos of hosting a New Year’s Eve party, I’ve forgotten to take my sleep medication, insomnia being another symptom of long COVID. Most of our guests have left, leaving only Lauren, my assistant coach at Dream Run Camp; Ruby, who handles our social media; Zacchaeus, a subelite runner visiting from Michigan; and Nataki, my wife, to join me in toasting the arrival of 2024. The moment that’s out of the way I announce that I must excuse myself to take care of a time-sensitive matter. Too late, I realize that by being suspiciously nonspecific I have achieved the opposite of the effect I’d intended, which was to draw minimal attention to myself. Behind eyes narrowed in curiosity I picture mind cogs spinning, wondering, perhaps, if I have a special New Year’s gift for everyone. But no, the gift is for me, and it’s not exactly a gift.

With Nataki trailing behind me (she alone knows what I’m up to), I make my way downstairs to the casita, resisting an impulse to jam a finger in my nose, which has again clogged with crusty boogers (you haven’t experienced dryness until you’ve experienced winter at seven thousand feet), but I resist, remembering what happened last time. I can’t be certain that spontaneous nosebleeds are a symptom of long covid, but I do know I never got them before.

 Inside the casita I head straight to my desk as Nataki draws a bath. Thinking ahead, I left my web browser open to the Aravaipa Running website. Registration for the Javelina Jundred ultramarathon has been open for five minutes and I’m not taking any chances, knowing the event sells out quickly. Panic strikes when I hit the registration link and the page takes forever to load, my mind’s eye seeing thousands of other runners bent over their screens, blocking my entry. But on the second try I get through, and moments later I’m staring at a confirmation email, wondering what the hell I’ve just done.

 The most nefarious symptoms of long COVID, if you ask me, are exercise intolerance and post-exertional malaise. Physical exertion is literally toxic for me, as it is for most long COVID sufferers. When I climb a flight of stairs or lift something heavy, I feel as though I’m breathing through a straw. That’s exercise intolerance, and it has turned working out—once my favorite hobby—into an unpleasant chore. Far worse, though, is post-exertional malaise, a species of misery that far exceeds what is hinted at by the condition’s anodyne name. COVID long-haulers have taken to coining their own, more apposite names for particular symptoms, such as “brain in fire” for what doctors call neuroinflammation and what a well-meaning but clueless media calls “brain fog”. My own name for post-exertional malaise is “chemotherapy feeling.”

 Can you name the worst day of your life? For me it’s May 24, 2021. That’s the day an ill-advised attempt to ease back into a bit of light jogging landed me in bed, not blandly uncomfortable as the word “malaise” connotes but suffering in the violently paroxysmal manner of heroin withdrawal. I spent the entire day clenched in a fetal curl, hyperventilating, my soul a smoking streak of shrieking feathers bouncing off indifferent windows in the burning building of my body. I spoke four words only the entire day, to Nataki: “I want to die.”

 You’d think the experience would have cured me of any and all notions of running again, but it’s not so easy for me, and on New Year’s Day 2023—exactly one year ago—encouraged by a general abeyance of my symptoms, I repeated the experiment, more cautiously this time, beginning with a handful of thirty-second jogs separated by longer bouts of walking. I then waited forty-hours to see if I died, and if I didn’t I completed another walk-run with slightly longer jogs, and so on. This process lasted until mid-February, when a thirty-minute jog with no walk breaks devolved into a death march and I pulled the plug, having dug myself into a hole of malaise that took me months to climb out of.

 I haven’t run since, seeing no evidence that the result would be any different. The Javelina Jundred offers a choice of race distances: one hundred miles and one hundred kilometers (sixty-two miles). I choose the latter, smiling at my reasonableness. Doctors say that when a person with long COVID runs a mile, their body thinks they’ve run a marathon. If this is accurate (and it feels accurate), then a person with long COVID running one hundred kilometers is equivalent to a healthy person running 2,620 kilometers.

The race takes place on October 27, giving me about ten months to prepare. Except I can’t actually prepare, because the only way to prepare to run one hundred kilometers is to exercise, and as I believe I’ve mentioned, my body can’t tolerate exercise. Not much, anyway. Which makes my decision to register for the event reckless at best, and probably dangerous. Yet I want to do it.

That’s not true. I need to do it.


  1. Missy H. on March 8, 2024 at 10:12 am

    Every time I see an update from Matt, I am hoping he will announce his triumphant defeat of long covid. For someone who has given so much to the running/endurance community, it feels incredibly unfair. I will absolutely be following along this journey, wishing him the least amount of malaise possible!

  2. Teri on March 8, 2024 at 12:12 pm

    I will cheering you on from afar. I have benefitted so much from Matt Fitzgerald’s writing and books and plans, that I will be racking my brain to think of some way to repay him. For now, it’s motivational cheers from the interwebs.

  3. Kim on March 8, 2024 at 12:50 pm

    I have and read many of Matt’s inspirational books. I cant even imagine what he is going thru nor do I understand how such a fit and healthy athlete could have this disease. I definitely will be following his journey. I hope he takes videos of his race and makes a documentary about his inspirational journey.. I wish him all the luck and strength!

  4. Matt Cartner on March 9, 2024 at 9:27 am

    Hi Matt, like a lot of people here, I have a bookcase full of your books, your work has been a constant companion in my triathlon journey. I find it uniquely cruel that you’re unable to exercise at a time when you need it so badly. I wish you all the very best in your struggle.

  5. Andrea on March 9, 2024 at 5:58 pm

    Gutted to read that Matt is suffering from such a cruel illness. I was diagnosed with Chronic Fatigue Syndrome in 2019 after a virus floored me a year earlier. I never got back to where I was before I got ill and most days I sleep for several hours but I am back training now and I hope that Matt also recovers enough to complete his race.

  6. tessa on March 17, 2024 at 12:51 pm

    Hi Matt, Long time fellow runner who also has a similar long covid timeframe to yours. I feel this so much, I can no longer run as well. It seems like if I don’t then i have the ability to feel almost normal in my day to day life. A true privilege after the ’31 symptoms time’ I also experienced that first 1-2 years. But the grief from no longer being able to come back to running is profound and rolling. Some days I am fine with it, others as I watch people run on the beach on vacation and remember all the years I did that too… crushing. Thank you for sharing and I really hope you continue to do so. Honestly all I look for now is words from other endurance athletes going through this, knowing Im not crazy, Im not alone and its not because I didn’t try hard enough to fix it. Success in running or not, I am all ears to updates.

  7. John Lee on March 21, 2024 at 4:15 am

    Hi Matt, from one long covid sufferer to another I wanted to send you strength. I followed one of your plans for my first ever triathlon in 2022 (70.3 Marbella in Spain) and I’d have never got through that gruelling day without that plan and the knowledge I’ve gleaned from your books over the years.
    Long covid is like nothing I’ve ever experienced. Christmas just gone I travelled to family in perfect health. I’d been running 25-28 miles a week consistently all of that year and riding my bike twice a week too. I didn’t have any races planned so it was just tick over training but I was loving it. Then on Boxing Day (that’s the day after Christmas day here in the UK.. no one knows why it’s called that!) I developed ‘the covid headache’ and I put myself to bed. It was absolutely horrendous and I lay awake for 3 or 4 nights. I’d had covid before and it was bad but not this bad. On the 5th day the symptoms started to ease a bit and I was able to drive home to London and start to ‘rebuild’ with healthy food and some walking. After another week I thought I’d try to do a light run but straight away I noticed something strange.. my heart rate was 20 beats higher than before Christmas. My heart rate lacing up my shoes was 90. Something wasn’t right. So then I started going through all the other things it could be.. have I eaten enough, did I have too much coffee, maybe my iron is low, b12 might be low.. trying to ignore the fact that it’s something more sinister. Me being me..I started running most days.. the thinking was I would ‘force’ my body to perform.. but each time it seemed to get worse. I was running 9.30-10 min miles z2. My threashold pace before Christmas was 7.40 and I felt it was improving all the time.. now.. 8.40 if I was lucky. And all this because I got covid for 4 days!? It’s actually terrifying to think what that disease has done in such a short time.. I try not to think about it because endurance training is my life. Hopefully things will improve for us both Matt. Again, sending you strength and thanks for all your inspiration and knowledge over the years.

  8. Betty Jones on March 23, 2024 at 1:17 pm

    Hi Matt, it makes me so sad to read your storu… I also have long covid.. Jan ’22, started after that with infections in other parts of my body… My breathing has never been the same. My time on runs grew longer and longer,,, breathing is harder.. I’m preparing for a half marathon 2 weeks from today,,, and the most I’ve run is 10 miles, then spend afternoon in recliner….. I have so many of your books,,, you’ve helped me through these books more than you could ever imagine.. I’m so sorry this has happened to you, and I will be Praying for you….. Betty Jones

  9. Amy Benedict on May 6, 2024 at 2:26 pm

    I am a Covid long hauler. I have however done 4 marathons since 2020. The malaise as you call it is likely mitochondrial distinction. I’ve had mitochondrial disease for over a decade so my body is used to the chronic exhaustion. Not sure if you started a mito cocktail yet but it helps. And you get used to it. And train again.

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