# Rhabdomyolysis



## TB1077 (Mar 21, 2013)

I searched this site, as well as many others, looking for any long term issues with Rhabdo.  I'm sitting in the hospital for the 3rd day, and unfortunately it looks like I'll be here at least 2-3 more days.  Prior to admitting myself to the ER I researched and realized my symptoms sounded like Rhabdo but I haven't seen much on the long term effects. 

Mine seems to have been brought on by a bit of dehydration mixed with a heavy pullup crossfit workout ("Angie" for anyone curious).  I've never had kidney issues and so far the blood tests are showing the kidneys appear to be in great shape as the CPK levels are dropping.  I haven't been able to get much as far as long term concerns from the docs (other than making it sound like sitting on the couch is much better for me than working out...).

Just curious if anyone has any experience or insight.  Thanks in advance.


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## Muppet (Mar 21, 2013)

Jesus dude. Rahbdomyolisis, as I am sure you know now is muscle breakdown resulting in kidney failure from myoglobin clogging up the kidney tubules. I see this alot in urban search and rescue stuff BUT it can also occur in lots of other stuff including working out ALOT, illness, dehydration (which can mimic rhabdo) and other things too far for this lesson. Long term can be, kidney failure, EKG issues such as pottasium / sodium issues and death. I am not a doctor but that what I know. What are your docs saying? What are your CPK's / myglobin saying? Are you getting LOTS of I.V. fluids and did you need other meds, such as Bicarb and other stuff? FWIW, I took a SWAT medic course in N.C. 2 years ago and got really dehydrated and thought I had rhabdo (from what I learned) and thats why its a mimic. I.V. fluids usually fix it if its minor and lots of people go home with rhabdo (so I am told my my USAR medical director) when it's minor. Its important that your docs reconize it, treat you for it but dehydation is usually the working diagnosis and I.V. fluids fix that also. As long as you are peeing, you should be fine BUT again, I am NOT a doctor and make sure your docs get on this! DISCLAIMER: I am not a doc. Get on your docs!

F.M.


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## AWP (Mar 21, 2013)

First, as a person I want to wish you a speedy and full recovery.

Second, as an Admin, we'll discus Rhabdo here and if you want to interject "Crossfit", please do so in one of our other Crossfit threads.


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## TB1077 (Mar 21, 2013)

FM- yeah I read all about it and also was briefed by my docs and nurses.  Sounds like Rhabdo is somewhat common with CF especially their WODs, and the workout I did gets a lot of people due to the quantity of pullups.  I had read potential long term conditions, but I didn't find long term based on different situations (i.e. older patients, pre-existing kidney or muscle issues, etc.).

 My CPK numbers are high still.  The hospital's lab can only test to 40,000.  All 4 of my tests are over that number.  My kidney specialist assumes that I started out well over 100,000 and I've been dropping significantly even though I'm still over the 40,000.  I am pushing for them to send my panel to an outside lab to test to a much higher level.  He doesn't seem too concerned since my kidney readings (can't remember their names) look very good.  I started out on just a saline solution and then advanced to sodium bicarbonate.  And yes, they said without a doubt it is Rhabdo.  But as you said, IV is really the fix as it dilutes the CPK to make it easier for the kidneys to process.  And I'm peeing like a racehorse, which has them happy.

I was just curious if anyone knew of someone that had it and ever had any long term problems from it.  From what I've seen, it seems to be more of a one time problem when it is a case like mine.


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## TB1077 (Mar 21, 2013)

Freefalling said:


> First, as a person I want to wish you a speedy and full recovery.
> 
> Second, as an Admin, we'll discus Rhabdo here and if you want to interject "Crossfit", please do so in one of our other Crossfit threads.


 
Thanks Free.  And I apologize for the inference of crossfit.  I didn't think it was a big deal as it wasn't the main point of my post, just a possible cause.  I won't discuss it anymore in this thread.


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## AWP (Mar 21, 2013)

TB1077 said:


> Thanks Free. And I apologize for the inference of crossfit. I didn't think it was a big deal as it wasn't the main point of my post, just a possible cause. I won't discuss it anymore in this thread.


 
You're good and in the context of what's going on it is relevant. I don't want to see the thread devolve into a Xfit bashing session because we have enough of those. That's all.


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## TB1077 (Mar 21, 2013)

Got it.  I will definitely do my part to keep this thread on the topic of learning from anyone who has had, or knows about, rhabdo.

For the record, I don't blame the workout for what happened.  I personally believe it was my fault for being slightly dehydrated as well as not being smart about how I took on the workout.  In hindsight I should have been smarter with my water consumption the day before as well as been a little more conservative on my approach to the workout since it was my first week back since getting home from OSUT and Airborne.


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## TB1077 (Mar 21, 2013)

Just got my exact CPK levels from this morning.  78,000 after 3 days of IVs.  Doctors seem happy (or at least not freaked out about it).


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## bublik (Mar 21, 2013)

TB1077 said:


> I searched this site, as well as many others, looking for any long term issues with Rhabdo. I'm sitting in the hospital for the 3rd day, and unfortunately it looks like I'll be here at least 2-3 more days. Prior to admitting myself to the ER I researched and realized my symptoms sounded like Rhabdo but I haven't seen much on the long term effects.
> 
> Mine seems to have been brought on by a bit of dehydration mixed with a heavy pullup crossfit workout ("Angie" for anyone curious). I've never had kidney issues and so far the blood tests are showing the kidneys appear to be in great shape as the CPK levels are dropping. I haven't been able to get much as far as long term concerns from the docs (other than making it sound like sitting on the couch is much better for me than working out...).
> 
> Just curious if anyone has any experience or insight. Thanks in advance.


 
I went through a similar thing a few months ago. Similar as in dehydration, heavy duty functional WOD situation after heavy lifting day prior. Plus I had deconditioning in my favor after rehabbing my completely avulsed/reattached right hamstrings. I followed the rehab protocol and after being confined to a rigged up sling and crutches x 6wks so was in the worst condition I've been in in years.

This is all background for the fact that I went WAY too hard, too fast and have trouble dialing it back (and my brain recognizing I'm not 18 anymore). Hence the rhabdo. I started w/intense soreness in my distal bicep insertion and then over the course of 2 days the swelling was so bad I couldn't bend my arms or wear normal shirts. Numb fingers, nausea, vomiting, all of it. It was fugly for about a week...to the point I had a friend bringing me food b/c I couldn't drive, bend my arms to wash my hair, etc...hot mess basically.

I have access to medical care and was able to bypass the ER as I knew the treatment and when to call for help. I've taken care of rhabdo patients in the past and so long as hydration (IV and PO) is replaced massively and no underlying kidney dysfunction, most do a-ok. I mostly felt like a moron and was upset that I'd gotten myself into trouble, especially after the hamstring deal.

Now 3mos+ later I feel back to normal and took the time to slowly work back into things. There are plenty of similar examples online and even articles written about this exact topic.

I hope you're feeling better and recover well.


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## TB1077 (Mar 21, 2013)

Bublik, thanks for the info.  From what I've seen so far, the stories of symptoms and treatment sound pretty similar.  Recovery seems to vary and it sounds like most don't have any long term issues.  As much as it sucks to be in the hospital this long  and the fact that I won't be able to workout for quite a while, I'm hopeful that I will be completely healthy soon enough.


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## Dame (Mar 21, 2013)

Keep doing whatever it takes to get well and keep us posted.


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## bublik (Mar 21, 2013)

Sounds like you did the right thing and I'd bet you'll be healthy soon. I was surprised how long my arms felt weak after working out. It's only been in the past month that I don't feel abnormally fatigued. As far as working out, I was cleared pretty early and started back relatively reasonably...as opposed to full bore, work out til I collapse.

Good luck and enjoy the hospital gowns :)


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## TheSiatonist (Mar 23, 2013)

Speedy recovery to you, TB. Let us know how it goes.


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## amlove21 (Mar 23, 2013)

Rough go of it. Stay as aggressive with your treatment as you were to find yourself in the position you are now, and you'll pull out ok. Keep us updated!

Just a warning to anyone out there- be careful how you ramp the intensity up in your workouts. I have personally seen rhabdo 4 or 5 times, and while the majority was from like-programmed "high intensity interval/circuit training" types of things, there are literally hundreds of cases that have nothing to do with Xfit, MA, or the like. Rhabdo avoidance is simple- program your workouts safely, add intensity only when able to handle additional stressors, and proper hydration/nutrition are paramount to performance.


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## Muppet (Mar 23, 2013)

TB1077 said:


> Just got my exact CPK levels from this morning. 78,000 after 3 days of IVs. Doctors seem happy (or at least not freaked out about it).


 
My head was up my ass because I forgot to tell you to get better and be careful also.

F.M.


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## TB1077 (Mar 24, 2013)

Waiting on my labs this morning, but its looking like I'll be out of here soon.  Yesterday my CPK levels were down to 21,000 so they were expecting me to be low enough to be released soon.  The kidney specialist has been involved and feels that I probably came in with levels around 200,000, so he is very happy with my progress.

I have been advised to take it easy working my way back to my fitness level, but haven't been given my exact orders yet.  I'm hoping I'll be told I can get some cardio in soon.  Sitting in a hospital room for a week has me feeling pretty out of shape already.  I will be following my orders though as I don't want any long term issues.


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## amlove21 (Mar 25, 2013)

TB, as a dude that has spent a considerable amount of time in a hospital bed, please heed my warning- TAKE A DAMN BREAK. I know how you feel. Maybe, just maybe, I might even know how you feel and then some. It sucks, you feel like you're slipping, and a lot of your personal worth is based on your physical readiness, if I was to guess. I had to take 6 weeks off, with the threat from a LtCol that if I didn't listen, she wouldn't help me. Life sucks, but take some time off.


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## TB1077 (Mar 25, 2013)

I will definitely take your advice.  I was given some basic guidelines on my return to physical training by my docs.  It is going to take longer to come back than I expected, but I understand that rushing it can end up slowing me down even more.  I'm still in the hospital and still have another day or two before they let me out of here.  That will be about a week and a half of doing nothing more than walking laps around my floor pushing my IV.  That plus the muscular damage equates to needing to take baby steps coming back.  Good news is the kidneys did amazing through all of this and I've been told I'll have no residual issues.

My main concern is getting to SFAD, and then hopefully to SFAS, in a timely manner.  This pushes me back, which is not great news for someone my age.  I also am going to a new unit now that I want to impress as long as I'm there.  So I have to balance things to minimize risk while being intelligent and efficient with my rehab.  I will be patient.  Thanks for that lesson amlove.


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## amlove21 (Mar 25, 2013)

It's not a lesson, it's a "learn from my mistakes, because I want you to do it better." You'll get there, and we all support you. This thread is proof of that.

Patience and persistence equal production. Just keep pressing.


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## bublik (Mar 29, 2013)

How's recovery going? I hope you're feeling better and take care of yourself as you return to training.


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## TB1077 (Mar 29, 2013)

Got out on Wednesday.  I've been taking it easy, which has been easier than I expected since just being up and moving around takes quite a bit out of me.  I'll get a couple of good walks in before my follow up appt next week.  As long as CPK levels are good I'll move up to some jogging and work up from there.  As far as weights I'll follow doctor's orders and start very easy and light.  I'm not going to rush anything.  I've also been staying well hydrated.  All in all I feel good.  Thanks for all the well wishes.


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## Muppet (Mar 29, 2013)

Good. Feel better and stay safe.

F.M.


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## TB1077 (Apr 15, 2013)

Update- Ran a blood panel at my follow up appt and my CPK level was almost down to normal, but it was about 40 points over the max (I think I was 240ish and max was 204) so the nurse wouldn't release me to workout until I followed up with my kidney specialist.  Saw him the following week and he said I should have been allowed to start excercising a while ago (have to love communication in the medical field...).  He said my kidneys are just fine and I need to follow up with him later this month after I've worked out a bit just to make sure there is no problem with my CPK production.  Went for a run yesterday and I'll be hitting the gym this week (slow and scaled back of course).  Feel like I'm way behind, but excited to get back at it again.


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## 8654Maine (Apr 15, 2013)

Great news about your recovery.  
Brings a sobering reality to the "no pain, no gain" mantra.
Your last post about your nurse not releasing you because of your 240 vs 204 level just has me shaking my head.


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## Red Flag 1 (Apr 17, 2013)

TB1077 said:


> Update- Ran a blood panel at my follow up appt and my CPK level was almost down to normal, but it was about 40 points over the max (I think I was 240ish and max was 204) so the nurse wouldn't release me to workout until I followed up with my kidney specialist. Saw him the following week and he said I should have been allowed to start excercising a while ago (have to love communication in the medical field...). He said my kidneys are just fine and I need to follow up with him later this month after I've worked out a bit just to make sure there is no problem with my CPK production. Went for a run yesterday and I'll be hitting the gym this week (slow and scaled back of course). Feel like I'm way behind, but excited to get back at it again.


 
I understand the annoyance directed at your nurse for holding you up a little longer; there is a reason. All too often folks get out of the hospital and have the idea that all is well now. That thought will see countless patients blowing off any and all follow-up care; it is called noncompliance. Noncompliance leads to relapse. Relapse puts you back in the hospital, and the nurse gets reamed out because of the relapse. Your follow-up visit with the Dr.,was forced compliance, in a way. Now the Nephrologist comes along and says you are just dandy, and you could have started earlier; bad, mean nurse. Not really. It was the safe call for you at the time.

That's my $.02. Now, back into my wee little cave here The Valley.

RF 1


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