IBD Stories- Fran Brown IBD Paralympian
by Fran Brown
My journey as a Para athlete started in 2012 where is was competing in climbing as a Para athlete. During my time as a competitive climber, I was using swimming and cycling as cross training, which led me to try triathlon, and in 2016 I made the switch to a full time Para triathlete.
“Para sport”? You may be asking, what is that? …
For some background, I have an incomplete C4 spinal cord due to an injury which occurred in 2006 as a result of an accident at work. This means that the muscle strength in my arms, legs and trunk are reduced, even absent in some places. I have reduced sensation down my body starting from approximately the neckline level below, which affects my bladder and bowel function, as well as impacting the dexterity in my hands and increasing spasticity in my muscles (basically tight, cramping muscles that contract on their own at times especially after training).
Fran Brown at Tokyo 2020
Initially after my spinal injury, I was a wheelchair user, and it took me a number of years to get begin to walking again with crutches and leg braces, which I still used to this day like.
After my accident, I began to use a hand-cycle for a couple of years but found it hard going as I’m so small and light and it was so heavy so I decided to try a normal bicycle. (I didn’t know adult tricycles existed and anyway I’m not sure that would have helped my street cred much).
At first, when I began to try riding a traditional bicycle and found I could balance but couldn’t keep my feet on the pedals. Using tape and then clip in shoes solved that issue as I rely a lot on pulling up with my hamstrings to generate power. I still struggled with the pedal rotation, as I have no control over my ankle movements. But, with the use of carbon fiber braces that fitted in my cycling shoes and stabilized my legs below the knees, I discovered I could ride a traditional bike setup. This allowed me to ride an essentially un-adapted bike with normal pedals.
My journey post accident took another turn, for the 13 years since my accident all had been well, and I rarely had issues. In early 2019 this changed, I started getting abdominal pain, on and off and found maintaining my weight more difficult. My gut started to bother me, and bowel function is always a bit embarrassing to talk about and with my spinal injury using the restroom was not exactly how everyone else goes to the bathroom.
This change in bowels in 2019 meant that I had to involve a planned program and some medication along with manual assistance each day. I contributed this change to doing more training and ignored the signs I was experiencing. I also started noticing I had to do my bowel program more frequently to avoid accidents which I starting having a few of, which was none short of mortifying. IBD plus lack of control bowel wise was a bad combination. Things eventually got worse over that summer and I had a couple of races where I struggled with hydration, and abdominal pain on the run segment, resulting with after the race seeing blood in the toilet.
Did I tell anyone? … Err no, its super embarrassing as an adult and I was away from home a lot, didn’t get the chance to see my GP and I needed to race to acquire qualifying points for the Paralympics plus confirm my classification.- All great excuses to stupidly ignore it. At the world championships that year I won, a truly epic result given the state of my gut but once we came home and the season ended I had to bite the bullet and own up to the pain and toilet issues to our team doc. They sent me to my GP and I was off to the hospital for a capsule endoscopy and scans.
That was when I was diagnosed with Crohns. I was initially put on meds, which eventually seemed to help but not completely solving the issues. Regardless, I went away on my usual pre-season training camp for the upcoming 2020 Paralympic games. Then COVID hit and the stress of running home before the boarders closed straight into having to shield (I’m high risk because my spinal injury affects my ability to cough effectively), set up a massive flare.
The Paralympics being delayed a few weeks later was a massive blessing for me as it brought me time to get my IBD under control. This started with a course of medication, a liquid only diet for 10 weeks (wow that was challenging) and eventually surgery to remove narrowed sections of my bowel to treat two fistulas, and form a stoma. I was initially super despondent about having the stoma, thinking I’d not be able to train with one. However, its actually transformed my bowel care meaning all of the issues caused by my spinal injury are eliminated and now I’ve found bags that work for sport and daily life- I have to say it has made my life better.
Fran out training
Things have not easy since the op though, as I was left with a quite short bowel leading to high stoma output and therefore I struggle with nutrition and hydration around training. Its not impossible but it takes a lot more planning. I did manage to go to the delayed 2020 Paralympics where I came 4th in the Para triathlon. I had a bit of a rubbish build up due to side effects from my IBD meds and the heat was a challenge with my short bowel. But with all that, we succeeded in getting to the start line and finishing the race well and with no lasting impact on my health, which was a massive plus and testament to the Para triathlon medical and nutrition team.
Since 2021 and the Paralympics, it’s become quite evident that my IBD doesn’t cope well with running. Whether it’s a blood flow issue or due to the intestinal movement of running, I really struggling to run enough to be competitive. My stoma is still high output and so for the last few months due to this and another health issue that has impacted my ability to swim and run, I’ve been focusing on cycling.
I enjoy the fact that I can push myself hard on the bike without affecting my gut as long as I fuel and hydrate correctly. Riding outside also allows me to visit places I couldn’t get to on foot due to my limited walking stability from my spinal injury. I also enjoy the challenge of a hard session or a long ride and the fact that there is always something to work on and improve. Without cycling at the moment with the other health stuff I have going on and the frustrations around running, I’d be really lost. It really has a massive positive impact on my mental health.
I recently competed at a Para-cycling world cup in Belgium and am hoping I might get to do some more Para-cycling races this summer. The rest of my future is less certain with the other health stuff but at least I have some potential cycling races to focus on. Oh, and I’m also a physio. I didn’t treat patients during the pandemic due to shielding, but did manage some locum work last year and am currently working on a couple of clinical trials in an advisor capacity. It fills the time nicely between training sessions and gym sessions.
Fran Brown is a United Kingdom Para Triathlete and Paralympian.
Find out more about Fran Brown and follower her on Instagram @franrbrown