Monday, July 22, 2013

I Have Rhabdomyolysis

"You have what?"  

That is the reaction that most people have had when I tell them.  I knew what it was.  And, I think I knew I had it even before I wanted to admit it.

Rhabdomyolysis or rhabdo is basically the breakdown of muscle tissue that results in myoglobin being released into the bloodstream.  The kidneys then have to filter it out.   Myoglobin breaks down into substances that can damage the kidneys.   The biggest fear with rhabdo is kidney damange.

So, how did I get it?  It's not always clear how people get it.  Exercise can cause it.  I have read case studies about people who have gotten it from swimming, marathon running, triathlon, weight lifting, football, even ultimate frisbee.  The strange thing in my case is that my workouts didn't really raise any red flags for it.  I did Crossfit last Monday.  It was not a particularly hard workout.  I had done a sprint distance triathlon the Saturday before and an easy 8 mile run on Sunday before.  On Tuesday my arms were sore.  Not really a big deal.  I ran a track workout and felt great.  On Wednesday my arms were sore.  Typically not a big deal.  But I think I really knew this was different.  

The soreness that I felt was WAY more acute than would have been warranted by the workouts leading up to it.  And, my triceps were swollen to the point that I had VERY limited range of motion.  I have a friend who had rhabdo in her arm a while back, so I knew I had it.  I didn't want to admit it, though.  I did a 9 mile easy run on Thursday.  My friend agreed that this is probably what I had.  When I got home from the run, I called my doctor and got an appointment for Friday morning.

I read that many doctors are not too familiar with this since they just don't see it often.  So, part of me thought that I would go in, tell her that I thought I had rhabdo, and my test results would be negative and the diagnosis would just be sore muscles.  My doctor is great about working together on things, and she knows that I know my body.  When I told her that I thought I had rhabdo, she did urine and blood tests without question.

Friday night rolled around, and I figured no news was good news.  I was hydrating well, peeing clear, so all seemed good.  It would be embarrassing when they called me with negative results, but that's OK.  Better safe than sorry, right?   My doctor called at 7:30 pm Friday night, so I knew the news would not be good.  She told me that I nailed it and that I did have rhabdo.    The test checks the creatine kinase levels.  The normal range is 10-120 micrograms per liter.  My number that day, 4 days after the symptoms started, was 6100 micrograms per liter.  

I was sent to urgent care for IV fluids and more tests.   My kidney function was normal and that was the most important thing for sure.  After the fluids, they sent more blood off for testing.   I actually asked if I could ride and run the next day.  The doctor smiled - not even close! I was sent home to do absolutely nothing other than hydrating like crazy. 

When the doc called on Saturday, I just knew he would tell me that my numbers were way down and I'd be totally good in a day or two.  Well, the good news is that my numbers were going down, but I was still at 5600.  So, I headed to the ER for more IV fluids and more tests.  When I left the ER, my kidney function was still normal and I was down to 4800.   Slow progress. 

So, here I sit.  On the couch.  Doing nothing.  Hydrating like crazy.  It's tough because I actually feel fine.  But, through reading and chatting with nurses and doctors, I understand that this can be a very serious illness.  I'm fortunate that my kidneys are fine.   And, I'll be back at training as soon as I'm cleared.  

The bottom line is that I KNEW that something was different and wrong.  But, I wanted to keep training.  I was feeling good and figured it would resolve on it's own.  In the end, I listened to my body and went to my doctor.  But, I wish I had gone sooner.  So, for all my athlete friends - when you feel like something is not right, something is not right.  And, what's the worst that will happen?  You'll be embarrassed about the false alarm trip to the doc or urgent care or even the ER.  But, even worse would be to ignore the signs that your body is giving you and do damage.  

See you on the roads soon!!

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