You've overcome months of grueling training — the early mornings, the long runs, the battered feet and that little voice inside your head asking "Why am I torturing myself?”
But through it all, you have managed to push past the pain and fears to make it to race day.
The New York Marathon is just weeks away, and with the tragic events at the Chicago Marathon — where a runner died as a result of a heart condition and several others were hospitalized -- still fresh, safety is on the minds of many marathoners.
Dr. Lewis Maharam, nicknamed the "Running Doc,” has been the medical director for the ING New York City Marathon since 1996. He's in charge of 2,500 medical volunteers, who are placed at every mile-and-half mile along the course.
"In my mind, we have the safest environment for running in the world," Maharam said. "I have an incredibly sophisticated command center where I work with the FDNY. We have every ambulance in the city at our disposal and every hospital on alert."
This year's race takes place on Nov. 4. And while excessive heat shouldn't be an issue, Maharam and his team aren't taking any chances.
"We have a heat plan, we have a cold plan, all of this has been worked on for years in advance,” he said. "We have ordered enough ice to do a sequel to 'Happy Feet' and enough chicken broth to compete with Carnegie Deli."
Here’s what runners really need to know before they lace up to run 26.2 miles. For first-time runners, especially those whose previous physical fitness regimen consisted of walking to the mailbox to get the mail, Maharam suggests seeing a physician.
"If you're a 40-year-old man or woman, you need a stress test before you start training," he said. "You always have to be cautious, see a doctor."
Maharam said it's extremely important for runners to know the potential dangers they could face along the course. The key is knowing how much water to drink.
"New research has shown that thirst is the best way for your body to know when to drink,” he said. "The best advice — don't stop at every water station. If you get there and you're not thirsty, pour the water over your head."
This may surprise many people — but, drinking too much water can actually lead to a dangerous condition known hyponatremia, which translates to low blood sodium. Runners on the course for a long period of time losing sodium in sweat, as well as people who drink a lot of water before and during the race, are most at risk.
"When your sodium gets too low, runners can experience weakness, dizziness, fainting, seizures and, in the severest of circumstances, it can cause death by herniating the brain," he said.
But Maharam said the best way to avoid these pitfalls is education. Here's a rundown of his top five essential pieces of advice for marathoners:
1. Do nothing new on race day. Just treat it like a long training run.
2. Drink for thirst only.
3. Grab a sports drink that has some sodium in it, like Gatorade Endurance, over water.
4. Don't forget the salt. This helps runners retain water, keep sodium levels up and reduce cramps. Maharam suggested grabbing two salt packs. At the beginning of the race, pour the salt on your hand and lick it off as if doing a shot of tequila. Halfway through the race, do the same thing.
5. And take your time. Running a marathon is all about having fun and finishing the race.
Maharam said if you run into some problems along the course, don't be afraid to stop at a medical station.
"If you have some aches and pains along the way, slow down or shorten your stride, you may be able to continue," he said. "But, if you can't slow down enough, stop at a medical station. They are not there to take you out of the race, they are there to help you finish."
Mary Wittenberg, president of the New York Road Runners Club and the first female director of a major international marathon, knows all too well what it's like to be on the course. Wittenberg has been a runner for most of her life and said that she’s inspired by everyday people who have made running a marathon their goal.
"I'm pulled out every single day of the week by people of all ages and all abilities who work so incredibly hard to get fit and to pursue goals that for many people were unthinkable,” Wittenberg said.
And remember, if running a marathon is a dream of yours, work hard to make it come true.
“I think it's deep inside of all of us,” said Wittenberg. “I think everybody deep inside has the desire to achieve a major goal like this. Once you step to that start line, and once you've done any of the work, you want to cross for yourself, for you friends, for your family and our job is to help people along the way on marathon day.”