Michael Roeger knows the pain barrier better than most. He usually runs straight through it, like he did when ran the entire 42 kilometre marathon at the Tokyo Paralympics with a stress fracture in his leg.
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So the projectile vomit of blood while on a run in Canberra was definitely a warning sign that something wasn't right, but he didn't expect it to almost kill him.
He also didn't expect that moment, almost exactly two years ago, to be a pivotal moment in his running career. But it was. And is. Because Roeger - the four-time Paralympian - says having to confront his own mortality has made him a better person and athlete.
"The most scary thing ... I tried to get up to go to the bathroom and I collapsed," Roeger says as his voice starts to crack.
"When I came to there were 10 doctors and nurses around me, and when they told me how serious it was, that I was so close to death ... it makes me emotional now.
"They told my family to fly in from Adelaide. I was losing two or three litres of blood. Scary stuff.
"At that moment running didn't concern me, it was survival. I felt like I was fighting for my life for 48 hours. It was just shit. I didn't want to be sick, I just wanted to live."
Roeger had suffered a gastrointestinal bleed while on training run in the capital in May 2022.
It wasn't the first time it had happened. As he was preparing for his race at the London Paralympics, Roeger ducked away from the rest of the field and vomited blood there as well.
But determined not to let down family, he ran. Or staggered. And ended up in hospital after the race, losing four litres of blood along the way.
The difference a decade later when it happened again was that doctors couldn't find the source of the bleeding. Every time they gave him a blood transfusion, he ended up losing it.
"My body was bleeding out," Roeger said.
The doctors eventually located the problem, and identified the reason behind his illness. The result is Roeger has told to never take anti-inflammatories again because if he does, he risks more time in hospital.
"The competitive bastard I am, I never thought I'd not think about running," Roeger said.
"But in those couple of days I was fighting for my life, watching blood go in and come out and they couldn't find the issue.
"I've always been pretty resilient. Whether that's growing up in the country or with a disability, I've been able to bounce back. So to now be going to my fifth Paralympics, I'm a more rounded human being. And that's bloody great."
Roeger's smile told that story this week. The Canberra-based runner feels "bloody great" after being one of the first athletes picked in Australia's Paralympic team for the Paris Games later this year.
The announcement of his official selection was at the AIS athletics track, which is, ironically, just a stone's throw away from the hospital bed where doctors feared he would die.
It was a massive moment for the 35-year-old, who was born without the lower part of his right arm, as he sets his sights on finally winning the gold medal he's been chasing for the best part for 20 years.
He's already a multiple world record holder and a world champion, but Paralympic gold has so far eluded him.
The difference this time is he's coming off a near-death experience, and he's armed with the lessons of four previous Paralympic campaigns.
"I think everything I've been through is a huge advantage for me, and I'm bringing family over with me for the first time," Roeger said.
"That's pretty special for me. I haven't had that at a Paralympic Games before. And going into my fifth Paralympics, I know - and I really feel - like the best is yet to come."
Roeger has been working with coach Philo Saunders to redesign his preparation to avoid the illness and injury hurdles of the past.
They have incorporated a recovery day ("I don't like the term 'day off'," Roeger says, "so we called it a recovery day) into his training week to give his body a break. They're tapping into the AIS resources to monitor every aspect of his preparation - weight, skin folds and more - to be firing on race day.
Roeger has also dropped back from the marathon to the 1500m, which is the race that started his Paralympic journey back in 2008.
He set a world record last year and won silver at the world championships, but his sights are firmly set on gold after watching his hopes end in heartbreak three years ago.
Roeger was the marathon world record holder and the gold medal favourite with a time almost seven minutes better than his rivals. His injury meant he couldn't keep up, and it haunted him when he returned home.
"Watching them run away from me, that was hard," he said.
"I had to really work with my sports psychologist to open up and get through that period. No regrets. I was so fixated on winning gold, and I still am, but I know I can look in the mirror and be pretty content with my career.
"I've got to get there, be happy, be smiling and not have the world on my shoulders. But the fire is there and the dream is to win in Paris."