Written on June 4, 2018
By now most of my Cornerstone family has heard that I was hospitalized for rhabdomyolysis (aka rhabdo). This can be a scary syndrome that can lead to kidney failure and death if not treated right away so I felt compelled to share my experience in hopes I can be the last person at Crossfit Cornerstone to ever get it. Keep in mind I am not a clinician so while I would be happy to have further discussions with anyone about my experience, only a physician can provide medical advice and treatment.
So what is rhabdo? I will begin the explanation like a cheesy graduation commencement speech. According to WebMD, rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents (myoglobin) into the bloodstream. Myoglobin typically has no business in our bloodstream so our kidneys and liver are not efficient at removing the toxin and quickly get overwhelmed. When this happens you must get medical treatment immediately to flush your body of the toxins using an IV drip of basic saline solution.
That’s enough of the boring medical details, let’s talk about how it relates to us. This syndrome is extremely rare in the overall population and is still quite rare in the Crossfit and fitness industries. In fact, only one nurse during my hospital stay even knows what it was and she was a personal trainer and had heard of it through her training. I’m on the kidney unit so if anyone has heard of it, it would be here. First and foremost, don’t be afraid to train hard out of fear of rhabdo because you are extremely unlikely to get it. We all know I’m special and this is no exception.
Here’s how to avoid an overpriced hotel stay:
· HYDRATE. Keeping your body hydrated is extremely important because the fluids flush out toxins and help you body to recover from the physical stress of Crossfit. I don’t mean stress about whether Seneca is going to make fun of you again but rather the normal, minor tearing of muscle which leads to the big gainz we all want.
· LISTEN TO YOUR COACH: Nobody is more stubborn than me and every one of the CFC coaches will confirm that I have better selective hearing that a toddler. The problem is my condition could have been avoided if I had just listened to JD as he begged me to scale in the moments leading up to the Murph workout. Believe it or not, they know more than we do. They are an unbiased third party who will tell you to slow down or scale when your mind says to push harder.
· EASE BACK INTO WORKOUTS: If you take time off entirely or refrain from certain movements due to an injury, don’t jump back in with full force. I sprained my wrist a couple months ago during the clean cycle and have avoided push-ups and pull-ups to give it time to recover. It has been feeling a bit better so I decided to get back into those movements during Murph with a plan to scale if needed. The flaw in this logic is I still had the muscle capacity to do 100 pull-ups and 200 push-ups but the time off meant my muscles didn’t have the ability to recover from such an extreme workout yet. I have been doing a lot of research on this syndrome and it seems the most common cause of rhabdo is due to taking some time off and then trying to come back to your old capacity right away. That is stupid, don’t do that.
· AVOID GOING TO MUSCLE FAILURE: There is a fine line between pushing hard and pushing too hard. Feeling exhausted is normal and you may even feel like you “left it all on the floor” during a workout. But when you are absolutely miserable and getting just one more pushup seems like an impossible feat, you are probably in the danger zone. I broke Murph up into 20 rounds of 5/10/15 and by round 15 I was doing single pushups and each one seemed like it was my absolute max. But I had music pumping in my headphones, a gym full of people cheering us on, and had watched Lone Survivor the night before so I was in a mindset that no matter how bad it hurt, at least I’m still here for my family. I now know what it feels like to go to muscle failure and I guarantee you I will never come close again.
Ok, so now you know how to avoid rhabdo. But what if you forget all this and try to keep up with your gym buddy and think you may have gone too hard? It can be difficult to tell the difference between rhabdo and just typical sore muscles that don’t seem to go away. My symptoms didn’t begin until Wednesday evening, a full 2.5 days after completing Murph. My pecs and shoulders were quite sore, but that is expected right? Wednesday evening I looked so jacked that Kama and I were talking about how amazing my body reacted to a single hard workout. Then I realized it wasn’t normal I couldn’t raise my arms above shoulder level. Then I peed. OH MY GOD, WHY AM I PEEING PEPSI? It was dark brown, almost black. It was this point everything came together and I realized I was in trouble. So I immediately went to the ER right? Well no, I’m an idiot and drank a ton of Pedialite and went to bed. Don’t do that! The next day I made a doctor appointment and they got me in right away. STAT lab tests were ordered, I went home, then they called and my CK results were extremely high so I was told to come to the hospital to be admitted. I have now been here 5 days and will likely be discharged tomorrow. The treatment is large amounts of saline via IV to give your kidneys enough fluid to safely remove the myoglobin.
It is important to note that dark urine only occurs in about half of the cases. This is unfortunate because it is the best kick in the rear to make you accept your fate. The full list of symptoms include:
· Cola/Tea colored urine
· Decreased urine production
· Muscle pain
· Muscle weakness
· Muscle tenderness
· Irregular heartbeat
Again, not all of these symptoms will show up and I only had muscle pain/swelling and dark urine. It’s also common for the symptoms to show up 24-72 hours after the workout.
If you do go too far, notice the symptoms, and get early intervention then it’s highly likely you will come out of it with no lasting effects. If you ignore the symptoms or try to self-treat, on the other hand, you can quickly slip into kidney and liver damage and end up on dialysis for life.
If you have any questions about my experience feel free to ask. I’m an open book and no question is too personal. I’ll even show you the picture I took of my Pepsi pee if you want.