My rhabdomyolysis story

 

continued from post...
Fast forward to Christmas eve of 2011. My arms, lats, upper back, shoulders, and abs are swollen. I can hardly get a dish out of the cabinet, tie my shoes, or use my arms in general. I'm starting to get anxious, nervous, and I'm starting to have cold sweats. I can't have done this much damage to my body, could I? I tell myself that I'm fine, that I will be OK. Then I see it - brownish urine. Jess convinced me that I needed to go to the hospital and I begrudgingly agree. We thought I might have to stay the night, which would be fine. But, I had hope that I could just be on an IV for a few hours and then go home so I could wake up in my own bed on Christmas. The nurse comes over and tells us (Jess and her brothers and I), there's blood in your urine. Jesus. Alright, looks like I will be staying the night. While I'm sure you're enjoying this storytelling, I'm going to cut to the point. When muscles release muscle contents, specifically myoglobin, into the blood stream, the level of CPK (creatine phosphokinase) in your blood increases and is an indicator of how much myoglobin is present. The normal value is between 80 and 300 IUnits/L. My values were at 174,000 IU/L, ~1000 times higher than normal. The only treatment is to be on an IV of fluids to constantly flush the kidneys until the levels dropped to a non-dangerous limit.  It took 9 days for it to drop below 5000, which is considered a maximum amount before kidney damage could occur. It likely took another 4 days for it to drop back to nominal. 
How on earth did this happen? I did Angie Rx'd in 24:48 while somewhat dehydrated and not in peak condition (I had a few drinks the day before, and had food poisoning the day before that). I didn't hydrate properly after Angie. I was wrecked, tired, and good god did a beer sound good after that mess of a workout, so I had that instead of protein and electrolytes. The damage was done - if I had hydrated properly after my post-workout brew with electrolytes, moderately good nutrition, and got a good night sleep, I think I would have been alright. Honestly I don't remember if I did, but I'm sure I drank a ton of water. The next day I had very limited mobility in my arms - I couldn't straighten them. I wasn't the only person Angie has done this to, and the CrossFit mantra is to never not go in because you're sore - come in and work it out (with the caveat that you are the steward of your own body and should just be safe). So I went in thinking a workout would help and did the "Surprise" workout on the 23rd of December, which included snatches, wallballs and lunges. The snatches and wallballs exacerbated my already wrecked arms and lats. The next day my lats felt like they were detached from my skeleton and my arms were permanently popeyed (and were so for 6 days after) and of course my CPK levels were 1000 times higher than usual. This was not what I wanted for Christmas. 
While my body is back to normal now, I have an unfortunate side effect of this event - anxiety surrounding muscle soreness. CrossFit and being sore 6 days a week are one in the same, so it's been a rough journey getting back on board. The past couple days have actually been the worst, following the 12.3 games workout, which left my middle to upper back, beck, forearms and parts of my legs extremely sore. The day of the workout I hydrated properly (electrolyte water, gatorade protein recovery) before and after and ate relatively healthy. This didn't stop my body from being more sore than I have been since Christmas Eve. But, it's the next day, and my body is recovering, the soreness has lessened, and my anxiety is gone. 
The moral of this story is threefold. One, hydration before a workout is just as important as hydration after one. So, if you were throwing up all night a day before and / or drank to much the previous day, either take it really easy or just wait a day to re-hydrate (water and electrolytes). Two, your body is thirsty and hungry for depleted nutrients immediately post-workout - protein, good carbs, and plenty of electrolytes. While there is evidence that the non-alcoholic carbs in beer actually aid in muscle recovery, after a super intense workout, take an hour or so to replenish your nutrients before throwing back a cold one. Three, if you can't straighten a limb, don't exacerbate it. There is no added benefit to destroying already damaged muscle. Instead, mobilize, ice it, heat it, and nurture it.  If you're unsure, ask  yourself, what's the worst that could happen? If you're 1 workout away from rhabdo and you mobilize instead of exercise, the worst that could happen is nothing, and nothing is always better than spending 8 days in the hospital.