MY STORY
As a little girl, I had this quote by Nike written against my wall: “All your life you are told the things you cannot do. All your life they will say you’re not good enough or strong enough or talented enough; they will say you’re the wrong height or the wrong weight or the wrong type to play this or be this or achieve this. THEY WILL TELL YOU NO, a thousand times no, until all the no’s become meaningless. All your life they will tell you no, quite firmly and very quickly. AND YOU WILL TELL THEM YES!!”
My anthology of ailments started at the innocent age of six, when I was diagnosed with scarlet fever and had to be hospitalised. When my fever went above 43 °C, I was rushed to ICU, where I spent an excruciating week. My family sat waiting in horror as doctors explained that large amounts of Streptococcus bacteria had burst inside my bloodstream, leaving my body in a toxic state. Fortunately, they managed to save me from the brink of death, but something else within me changed. I went from being a happy child, skipping and running everywhere I went, to the sickly little girl who was frequently absent from school.
I stopped growing at the age of eleven. Over the following years, we saw a multitude of doctors, each failing to explain the cause of my strange condition. At seventeen, in 2013, I was diagnosed with Celiac disease, which triggers an allergic reaction upon the digestion of gluten. I hoped this would finally be the answer, but my health declined even further over the two years that followed. Symptoms included fatigue, weight loss, inability to handle cold, anaemia, low blood pressure, and dizziness, just to name a few.
The answer finally came through an endocrinologist in June 2015, when I was diagnosed with hypopituitarism, a rare disorder in which the pituitary gland fails to produce enough hormones. Doctors suspect that the extreme shock my body went through during scarlet fever as a child may have been the root cause, although it is impossible to know for certain. The pituitary gland influences nearly every part of the human body, including growth, reproduction, metabolism, thermoregulation, and blood pressure. The absence of these hormones had clearly affected my development, as I am severely undersized compared to my family, in both weight and height, and lack some basic development usually undergone by a growing child. The explanation behind my still reasonable height lies in my genes.
Despite the struggles with my health, I began to excel at distance running, but initially, running was never about performance. I started running because it gave me an escape from the pain, uncertainty, and suffering I was experiencing with my medical conditions. Running made me feel strong and free at a time when the world often made me feel small and weak. It became the one place where my body did not feel like a limitation. It became the place where I could fight back.
By the age of nineteen, I had already represented South Africa twice at the World Cross Country Championships, won two SA Junior gold medals, and held provincial records. I was then fortunate enough to receive multiple scholarship offers to run in the United States and realised it would be foolish to let such a big opportunity slip.
However, I did not have a soft landing in America. A month after my arrival, I was hit by a pickup truck from behind while returning from practice. I had the right of way, but the truck did not stop. I do not remember much of the incident. The ambulance came, and the rest is a blur. I suffered another concussion, tore my meniscus, had bone bruising on my knees, and injured my back. It took two months before I could walk without pain and another ten months before I could compete again. I had no support and was alone in a foreign country.
I had to redshirt my entire first year at university, meaning I could not compete due to medical reasons, and my illness was not responding as desired to the new medication. By the end of the school year, I was medically disqualified and forced to make a decision: go home and give up on my running goals in the United States, or try to transfer and hope another university would take a chance on me.
I refused to give up. I transferred to a different university, where I was given the opportunity to compete again for the first time in a year. After one year of treatment on my new medication, I finally started to see results. I competed for three seasons and won four Conference titles: two indoor 5000 m titles, one 5 km Cross Country title, and one 10000 m Outdoor Track title. I also won two NCAA Regional titles in the 10000 m and 6 km Cross Country. In 2017, I ran the 10000 m at the NCAA National Championships in Eugene, where I became an All-American by placing in the national top twenty.
However, after the car accident, I continued to struggle with my back and could not run for more than three consecutive months without stopping again. I realised that if I wanted to continue running, I would have to strengthen my whole body and not just focus on mileage. I started resistance training, focused on strengthening my core and glutes, and became increasingly passionate about fitness while studying Exercise Science. I received my Personal Training and Fitness Nutrition certifications through ISSA, then completed the ISSA Master Trainer program with additional qualifications in Group Fitness, Corrective Exercise, Youth Fitness, and Senior Fitness.
Sadly, I went through yet another car accident at the beginning of 2018. This time, my car rolled after being hit from the side. Physically, I escaped with minor injuries, only a concussion and whiplash, but mentally, it broke me. I totalled my car and had significant financial stress to deal with. I had enough and knew it was time to come home. I know my country is far from perfect, and I often get asked why I came back, but here I am surrounded by my people, the ones who love me most.
I started increasing my mileage again at the end of 2018 and was rewarded with personal bests in the half marathon and 15 km. However, spinal injury recurrence stunted my progress, and I had to receive another cortisone shot with the hope of competing in the 30 km Bay to Bay race. Unfortunately, I had to stop 18 km in after losing feeling on one side of my body. It was a traumatising experience that kept me from running for two months. I had to return to pool training and focus on strengthening weak muscles in the hope that my body would be able to handle impact again.
My next goal was the Two Oceans Half Marathon, but once again, misfortune struck. The race started in darkness, and I slipped on a water sachet while going downhill. That incident left me desolate, as reflected in my subsequent race performances. I no longer felt the same fire to compete. I knew I had to find my spark again by taking on a completely new challenge.
Clarity came when I decided to run further than I ever had before. I completed 30 km in one hour and 57 minutes and felt ecstatic afterwards. I decided to attempt marathon training and started building towards the Sanlam Cape Town Marathon. Looking back, I now realise how little I understood about proper marathon preparation. My mileage had increased, but my training still resembled preparation for shorter distances. I received loads of conflicting information and was left confused about how to approach the distance.
I ended up being healthy enough to compete, but the race did not go as planned. Someone took my first gel sachet, and I spilled the second one, which meant I only started fueling after 30 km, when I was already glycogen and electrolyte depleted, as well as dehydrated. I realised what hitting the proverbial marathon wall meant. The last 12 km was a death march. Despite this, I still finished as the first South African woman, with the sixth-fastest South African female marathon debut at the time. Crossing that finish line was one of the greatest feelings of achievement I had ever experienced. I had found my event.
I am a marathoner.
I decided to throw everything I had at this newfound passion. At the end of that year, I travelled to Kipsiat in Kenya, 3,200 m above sea level, to train with the kings and queens of the marathon. I had the privilege of sharing a camp, and coach Erick Kimaiyo, with Brigid Kosgei, the world record holder in the marathon at the time. Being used to training at sea level, the transition came as quite a shock. The hills felt endless, and most days felt like I was breathing through a straw. But somehow, I managed. During my second week there, I eclipsed my previous highest weekly mileage by about 20 km and completed a 41 km long run.
Living in a rural township in a very basic camp was also something to get used to. I washed clothes by hand, often went without water or electricity, and cooked on a small gas stove or fire. The nearest big town, Eldoret, was a three-hour drive away, so most groceries came from the local market or the nearby township of Kachibora. I felt like I was finally adjusting to altitude when I got a viral infection at the beginning of 2020, which cost me about two weeks of training.
I returned to South Africa shortly after to compete in a 21 km race, but again, my health would not allow me to finish. I spent a week in hospital after food poisoning followed the illness from a few weeks before and threw my body into disarray. Still, I prepared for another trip to Kenya because I had been selected to run in the elite field of the Vienna City Marathon in April 2020. I flew back to Kenya at the end of February, only to return a week later when the COVID-19 pandemic struck.
The uncertainty that followed was difficult. I trained hard, increased my mileage, and ran workouts and tempo runs with the hope that I would be ready for the first race that came my way, but months passed with nothing in sight. Training became lonely, and I ran multiple personal bests in training that could have won races. A small consolation came at the end of 2020, when I won the virtual Sanlam Cape Town Marathon. It was not an enjoyable experience, having to run alone on a looped course while struggling with a lingering stomach bug, but I lowered my official personal best at the time and was grateful for that.
When restrictions loosened, I returned to Kenya in November 2020 in the best shape of my life. I was ready to run a world-class marathon at the start of 2021, but the opportunity never came. I went through two more redundant marathon build-ups before finally getting a chance to race in Italy in April 2021. But, in what had become a recurring theme in my running career, I got sick. This time it was the regular flu, and I was unable to compete.
After this, my health continued to deteriorate. I collapsed during the South African Half Marathon Championships and had to withdraw from the race that could have qualified me for the 2021 Olympic Games in Tokyo and secured the spot I had on the potential Olympic squad. I decided to step back and focus on a more conservative build-up towards the Sanlam Cape Town Marathon in October 2021. My training showed promise, but my health remained unstable.
My symptoms became alarming in August, so I sought expert help from a doctor. He suspected a rare disorder called Diabetes Insipidus, which was later confirmed during a hospital visit. I started the appropriate medication, but the weeks leading into the marathon were anything but smooth. My body went into an inflammatory state, causing swelling and pain in my calves and wrist. I took several rest days and received a cortisone shot before the race, but it did not help. On a cold, rainy morning, I stood on the start line trying to look confident while inside I was falling apart. After the gun, my body started shutting down, dizziness enveloped me, and I heard people on the sidelines telling me to stop. I also heard my mother’s voice, terrified that she would have to pick me up from the side of the road again and call an ambulance. So I stopped. The opportunity I had trained two years for slipped through my fingers.
2021 and 2022 felt like a hazy fog of uncertainty. It felt like I could no longer trust my body. I was diagnosed with Central Diabetes Insipidus and finally started receiving treatment for chronic symptoms like dehydration and abnormally frequent urination. However, the medication carries a significant risk of hyponatremia, which I now know contributed to the four back-to-back bone stress injuries and a seizure I endured during 2022. Being side-lined from competition for more than a year was devastating, but it also allowed me to obtain a master’s degree in Sport Nutrition, equipping me with the knowledge to fuel my body for both performance and longevity in the sport.
After making the necessary adjustments to my medication, I competed in the South African Cross Country Trials after only a month of easy running. I placed fourth, which felt like a victory, since the first five athletes across the line were promised spots on the South African team for the World Cross Country Championships. However, when the official team was announced the following year, Athletics South Africa selected a different team. I then shifted all my focus to the Durban International Marathon, which would also serve as the South African Marathon Championships.
After five weeks of meticulous training, I found myself on a windy starting line on 12 March 2023. Conditions were far from perfect, but I went out hard and led until the 39 km mark, when Chaltu Bedo Negashu from Ethiopia, a former winner of the Two Oceans Marathon and Soweto Marathon, tried to pass me. The pain of leaving her behind felt negligible compared to what I had endured in my life. Breaking that tape after so many years of struggle and suffering was a moment I will cherish forever. I broke the course record at the time by more than seven minutes, improved my personal best to 2:30:31, and claimed my first South African marathon title.
But the finish line in Durban was not the end of the story. In many ways, it was the beginning of the hardest chapter yet.
After winning Durban in 2023, I thought I had finally reached a turning point. The momentum after Durban International was the biggest I had ever had in my marathon career. My goals became bigger. I wanted to qualify for major international championships, see how far my running could take me, and continue learning what it would require to compete at the level of World Championships or the Olympic Games. For a while, it looked like that might happen. I was set to run as part of the elite field at the Berlin Marathon at the end of 2023, an opportunity I had worked towards for years.
I returned to training after Durban International and started putting together some of the strongest sessions and long runs of my life. I felt fit, motivated, and ready to build towards the next level, but underneath that momentum, my body was beginning to unravel again. Managing central diabetes insipidus while training at an elite level remained a constant balancing act. My fluid and sodium balance could shift quickly, and when it did, the consequences were serious. In 2023, I experienced another dangerous episode involving dehydration and hyponatremia. Then neurological symptoms began radiating down my left side and into my leg and foot. I had pins and needles, numbness, weakness, and pain that made running feel increasingly unnatural.
Eventually, an MRI showed an annular tear between L5 and S1, in the same area that had first been injured when I was hit by a pickup truck while running in America. I tried everything to avoid surgery: rest, physiotherapy, chiropractic care, dry needling, sports massage, rehabilitation, strength training, medical consultations, multiple MRIs, and several epidural injections. I still wanted to defend my South African marathon title in 2024. I still wanted to chase the Olympic qualifying window. But nothing gave lasting relief.
By early 2024, the symptoms had progressed to the point where running was no longer the only thing affected. I could not train anymore. Sitting became difficult. I could no longer drive. I was relying on strong prescription painkillers to get through my days and nights. The question was no longer only whether I could race again. It became whether I could live without constant pain.
On 6 June 2024, after more than ten months of chronic lower-back pain and debilitating nerve symptoms, I underwent L5-S1 spinal fusion surgery. My surgeon, together with the vascular surgeon, operated from the front to reach the damaged disc, create space between L5 and S1, and stabilise the structure with three screws. I knew the risks were high, but by the time surgery arrived, I was desperate for relief. When I woke up in the ICU and heard that the surgery had been successful, it felt like winning a marathon.
But the recovery was not simple. The first days after surgery were painful and overwhelming, and unfortunately, my hospital experience was not what it should have been. Less than 24 hours after the procedure, while I was still in ICU, one of the staff nurses instructed me to get out of bed and go shower. I had been told that I should not move until I had been transferred out of ICU and seen by the physiotherapist, so I was confused, scared, and in a lot of pain. At that stage, I had only just come through major spinal surgery. I was still connected to medical equipment, heavily affected by the procedure, and completely dependent on proper post-operative care.
Looking back, we will never know with certainty whether that moment contributed to the complications that followed, but it became part of the fear and uncertainty that surrounded my recovery. When I got home, I woke up bleeding. By Wednesday, I was back in hospital at the emergency room.
For the first six weeks, I was not allowed to bend, lift, drive, or sit for more than short periods. My world became very small. At a time when I had imagined chasing races, titles, and Olympic dreams, I was learning how to stand, walk, and trust my spine again.
One month after surgery, I was cleared to return to the pool. For a brief moment, it felt like the first sign that I might start rebuilding. But that hope did not last long. Only a few days later, I tried to swim in an extremely cold pool in the middle of winter. My body could not cope. I developed hypothermia and collapsed, nearly falling into the arms of one of the gym staff members.
After that, I stopped cross-training completely. For the next six months, there was no structured training, no pool sessions, no bike sessions, and no real athletic comeback. There was only walking, rehab, and trying to get through each day. For those same six months, I continued bleeding. I dealt with pain, infection, investigations, blood tests, urine tests, ultrasound scans, antibiotics, medication, and the emotional weight of watching the life I had fought so hard for feel further and further away.
It was not a clean comeback story. It was blood, sweat, and tears in the most literal sense.
By December 2024, something finally began to shift. The bleeding and recurrent infections resolved after my appointment with my endocrinologist, my pain improved, and I slowly started running. For the first time in more than a year, my quality of life felt like it was returning. My business was growing, and I was preparing for a demanding entrance exam for an advanced master’s program, a pre-PhD pathway I had worked hard to be considered for. In January 2025, I passed the seven-day exam with distinction and was accepted into the program. It felt as if life was finally opening again.
But that comeback was short-lived. The program turned out to be far more demanding than my body could handle while running my business and managing a complex chronic illness. I became chronically sleep-deprived, overstressed, and severely under-recovered. I lost weight, my immune system weakened, and my hormone levels deteriorated significantly.
At the same time, managing my central diabetes insipidus became increasingly difficult. A medication change led to my new generic medication being dosed too high. On 7 March 2025, blood tests showed that my sodium had dropped to 128 mmol/L. Three days later, I experienced my first major hyponatremic episode. I nearly lost consciousness, became confused, developed a pounding headache, and felt my body start to shut down. What followed marked the beginning of a month-long battle with chronic hyponatremia and severe immune suppression. Around 26 to 27 March, I contracted both a bacterial and viral infection.
On 31 March 2025, my sodium had dropped to 123 mmol/L in the morning and later fell below 120 mmol/L. I blacked out in the car on the way to the emergency room. My mother urgently contacted the doctor, who realised how serious the situation had become and arranged for my immediate transfer to ICU. I remained in ICU from 31 March to 2 April, receiving carefully controlled sodium correction, antibiotics, close monitoring, and frequent blood tests. The dual infection, chronic hyponatremia, hormonal suppression, and fluid-electrolyte instability created a perfect storm that nearly cost me my life.
I was discharged on 3 April, but the crisis was not over. Two days later, an at-home IV drip was administered in an attempt to help me recover. Instead, it triggered another severe deterioration. Within hours, I began losing extreme volumes of fluid. Over the next four days, I passed approximately 26 litres of urine, not including gastrointestinal losses, sweat, or respiration. This became the most severe hyponatremia episode I had ever experienced, with headaches, severe cramps, weakness, memory lapses, delayed processing, blurred vision, irregular blood pressure, elevated heart rate, sleep disruption, another loss of consciousness, and complete physical shutdown. My medication and sodium intake had to be balanced with extreme precision, and the margin for error was frighteningly small.
Later in April, I was admitted to ICU again, this time at Milnerton Mediclinic. On 17 April, after severe symptoms, urine losses between 4 and more than 8 litres per day, loose bowel movements, and another low sodium reading of 129 mmol/L, my endocrinologist admitted me directly to ICU for urgent monitoring. At first, the plan gave us hope. There was structure, monitoring, and a protocol. But over the long weekend, my care was transferred, and the original plan was not continued in the same way. My sodium dropped again, my symptoms worsened, and my family no longer felt safe under the medical care I was receiving. A critical sodium reading of 119 mmol/L was recorded, and by Sunday afternoon a correctly drawn test showed that my sodium had dropped again to 120 mmol/L.
I signed a discharge against medical advice form so that my family could take me home, because we no longer felt safe under the medical care I was receiving.
That night, my condition deteriorated further. I was nauseous, cognitively disoriented, in extreme abdominal pain, and experiencing cramping and full-body contractions. I eventually passed out from exhaustion. For a long time after that admission, I did not feel like myself. I could not work. I could not read. I could not listen to music or podcasts. My brain felt foggy and shut down. After fighting so hard to come back from back surgery, I had been forced into a different battle altogether: learning how to stay alive in a body where the margin for error had become terrifyingly small.
The winter months that followed were brutal. My life revolved around symptoms, medication, urine output, sodium, blood pressure, and blood tests. In one month alone, I had 36 blood tests. There were mornings where PathCare felt like part of my daily routine, not because I was preparing for performance, but because we were trying to keep me alive.
One morning, while sitting at PathCare, I received an email from the International Olympic Committee. I had been awarded a grant I had applied for at the start of the Paris Olympic cycle. At the time I applied, the grant was meant to support my Olympic dream. By the time I received it, I was barely holding myself together. That grant became something else. It became a lifeline.
My parents were scared. They had watched me nearly lose my life more than once and feared the cold Western Cape winter would push my body further backwards. We used the grant money to move somewhere warmer and stayed in an Airbnb in Ballito, KwaZulu-Natal, for three months. Ballito gave me back quality of life. The warmer climate helped, but more than anything, the people helped. For the first time, I became part of a real running community through Dolphin Coast Striders. After years of fighting so many battles alone, I found myself surrounded by people who saw me not only as an athlete trying to come back, but as a person trying to live again.
The return to running was humbling. At the beginning, my long runs were over a minute per kilometre slower than normal, my mileage was far lower than before, and I could not sustain what is now my marathon pace for even sixty seconds. Even walking upstairs left me out of breath. I still had symptoms, bad days, and setbacks, but slowly, something started to shift. The progress was small, fragile, and inconsistent, but it was progress. My body, which had felt so broken for so long, began to respond again.
It was only in December that things really started to click. I entered a small local 10 km race shortly before the start, with no pressure and no certainty of what my body would give me. I ended up breaking the course record. That race reminded me that the athlete inside me was still there. Soon after, I entered the 2026 Durban International Marathon. It was a quiet decision, but a significant one.
I was betting on myself again.
The build-up was not perfect. Comebacks never are. I had to rebuild my fitness, endurance, strength, running form, posture, and confidence around a spine that had been surgically repaired and a chronic illness that still demanded daily attention. I raced myself back into shape through frequent small local races, treating them as workouts without proper tapers. I focused less on times and more on becoming race fit again.
After not being selected for the WPA marathon team in February, I submitted an appeal asking the board to reconsider. I was the WPA marathon record holder and the first WPA female athlete to win a national marathon title. However, the board declined, stating that I had not run a marathon in the previous eight months and that they did not believe I would be ready by May to represent the province at the national championships.
I decided to run the Durban City Marathon on 29 March 2026, winning in 2:33:35 despite running half a kilometre extra due to there being no lead bike for the women’s race. After that result, I was fortunate enough to be selected by KZNA to represent them at the South African Marathon Championships at the Durban International Marathon.
On 3 May 2026, I returned to the Durban International Marathon. Three years earlier, Durban had been the place where I won my first South African marathon title. This time, I returned as a different athlete and a different person. I had been broken down by back surgery, chronic illness, ICU admissions, months of blood tests, infections, neurological symptoms, fear, weakness, and uncertainty. I had been forced to rebuild from a place that felt lower than rock bottom.
I finished second overall and ran 2:27:45, claiming the South African marathon title for the second time. In doing so, I became the ninth-fastest South African woman ever over the marathon distance and one of only ten South African women to break the 2:30 barrier. But that result means more to me than a time. It represents every hospital bed, every blood test, every painful step after surgery, every winter morning where my parents feared they were losing me, and every moment I wondered whether my body would ever allow me to run again, let alone race a marathon at an elite level.
If someone had told the Annie lying in ICU, or the Annie lying in a hospital bed after back surgery, that she would one day return to Durban and run 2:27:45 to win another South African marathon title, I do not think she would have believed it.
I never lost hope.
I never stopped fighting.
I never gave up.
Since the start of the pandemic, I have seen myself accomplish things I once only dreamed of, but I have also seen my body fail to support me in ways that nearly ended everything. I have hypopituitarism and central diabetes insipidus. I know I am at a disadvantage, but I also know this struggle has shaped me into the athlete and person I am today. Running gives my life meaning and purpose. When I run, I feel strong. I feel capable. I feel alive.
I know there will be more mountains to climb. I know I will have to keep managing my health with the same discipline I bring to training. I know the margin for error in my body is small, and I know the road ahead will not always be easy. But I also know this: sometimes the story is not over. Sometimes it is only being rebuilt.
You may see me struggle, but you will not see me quit. Like my Kenyan coach, Erick Kimaiyo, said, I am a soldier. I know how to fight.
Follow my journey as I keep chasing big goals, pushing my limits, striving to improve, and proving that a difficult road can still lead somewhere meaningful. The road has never been easy, but it has been rewarding. I run for more than results.
I run to overcome.
~ Annie Bothma