BLOOMINGTON —Barbara’s extreme efforts to intensify her exercise routine nearly ruined her life. Barbara was diagnosed with a rare, yet increasingly common form of disease that exposes a person to liver and kidney failure on Nov. 2 and this was shortly after she intensified her cardio and weight lifting workouts to a point that was strange to her body.
Rhabdomyolysis (commonly called “rhabdo”) occurs when the muscle fibers are overworked to the point that they are almost dead. These dying muscles release protein and other things like the creatine kinase (CK) enzymes into the bloodstream, depriving the muscles and stressing the kidney and as a result, muscle contents breakdown and get flushed and this is often very painful.
Barbara stated that it isn’t something she would wish on herself or anyone else for that matter. This was when she was describing her stay at the OSF Healthcare St. Joseph Medical center in Bloomington where she was treated and given intravenous fluids in her two arms while she was on her journey to a slow and painful recovery. She was 56 at the time, her husband 57 and her daughter 28 and she seized the opportunity to advice people of Central Illinois to exercise safely.
The advance practice nurse and certified nurse practitioner that diagnosed Barbara – Kim Nord – stated that it could have been a lot worse. Some conditions are fatal. Her kidney could have short down at anytime because she was really sick. He also stated how shocked he was to find out that the cause of her rhabdo was weightlifting. It was his first time seeing such.
A fitness and wellness manager at the Advocate BroMenn Health & Fitness Center for Integrated Wellness, Bloomington, Molly Smeltzer stated that this issue is one that is more common than people know but it is still under the radar because it is under reported. In most cases, the symptoms are mild and without knowing what it is, people treat it with hydration and rest. Only the Advocate BroMenn Medical Center diagnosed 148 of such cases from Jan. 1, 2016 – Nov. 29 as noted by Eric Alvin, a spokesman. At St. Joseph, another spokeswoman by the name of Libby Allison also noted that 97 cases were diagnosed within the exact same period.
Causes include seizures, being struck by lightening, crushing injuries, heat stroke and in very rare occasions, a side effect of taking statin medications to reduce blood cholesterol levels. However, Smeltzer noted that more diagnosis of people who got theirs from intense exercise is getting more common.
In these cases, people who get affected are those that exercise under rigorous conditions in very hot conditions without drinking enough water as pointed out by Smeltzer. Perhaps, the recent trend of more Americans getting involved with extreme workouts may be the reason for increased diagnosis of exercise-induced rhabdo as suggested by some medical experts at the New York-Presbyterian/Weill Cornell Medical Center.
Different studies show that the exercise-induced rhabdo is becoming more frequent among people who are getting involved in more intensive workouts and don’t give enough time for their muscle to progress gradually from a moderate to strong workout.
Barbara had excellent health and her exercise routine during summer/early fall included activities like playing volleyball and taking long walks. However, she was encouraged by her daughter to take up weightlifting and increase the intensity of her cardio knowing fully well that aging females experience loss of bone density and muscle mass.
She said she observed her mom dedicating significant amount of time to her volleyball and long walks and thought she could engage in other activities to help her achieve better result. Barbara said she started feeling she had less energy and was felling more tired. Work had been stressful for the last few years and for that reason, she felt she could engage in a more intense workout to help her boost her energy levels.
She decided to join her daughter in her gym (intentionally leaving out the gym’s name because she doesn’t blame them for what happened to her). She got involved in the half an hour cardiovascular exercise and another half hour weight training. Her first workout was on Oct.27 where she spent half the time doing her power walk on the treadmill and another half hour doing situps, squats, push-ups and weight exercises.
On the 30th of October, she returned and engaged in 25 minutes of upper body lifting just after her cardio, engaging in drill like bicep curls, triceps extension, lateral shoulder raises and chest press — using 8pound dumbbells.
She didn’t keep counts of the repetitions. She just kept lifting until she couldn’t lift anymore and she can’t recall how many sets she did. She said she just did what every other person was doing.
Her triceps were so sore by the 31st of October that she couldn’t even lift up her arms enough to put her hair in a ponytail. She had to lean her head down to put on her glasses or even eat.
She woke up to sharp pains in her triceps by 3a.m on Nov. 1. Despite this, she went to the gym after work to do her power walk on the treadmill and lower body weight lifting and even went on to play volleyball at another fitness center. She played defense, after all, she could barely lift her arms. Her legs gave out early in the match when she mad a quick move and by the time she got home, she noticed that both triceps were swollen. She applied a topical pain reliever and noted that she thought it was weird. She went on to Google “swollen arms after workout” and this was where she first learned the term “rhabdo”. After much reading, she felt she had rhabdo even though she didn’t have classic symptoms like cola-colored urine. Nonetheless, she opted to see Nord the next day.
She felt better the next morning but her family encouraged her to see a doctor anyway. Nord said he examined her and noticed that her upper arms felt tight; I immediately ordered lab work to checkout her liver, kidney and creatine kinase (CK). While at work that day, at about 2:30 p.m., Nord called her to tell her that her CK level was 2,100 times her normal level. Nord told her she needed to be taken to the emergency room immediately stating that she had damaged her muscles to the point that they were dying and the toxins released into the bloodstream from the muscles was what caused the abnormal blood test. He also told her that she was at risk of liver and kidney failure.
She visited ST. Joe and at this time, her CK level was already 2,700 times the normal level. She had to be given fluids for 5 straight days to flush out the muscle contents from her kidney, including CK.
The symptoms observed by her as a result of the damage were vomiting, confusion, nausea, headache and an increasing blood pressure. She stated that she felt completely miserable and found a new deep appreciation for nurses. After a while, her condition started improving, and with a declining CK level, she was released on 7th Nov and was free to go back to work later that week. By Nov. 28, Barbara stated that she feels 100% healthy and plans to return to the gym later but with better hydration and will stick to lifting her body, no more dumbbells. She said she’d ensure it’s very easy.
She also gave advise to everyone that cared to listen, telling them to go see a doctor if they felt any thing funny or if they think something isn’t right. She stated how happy she was that her family made her check it out, noting that she could have suffered the long-term consequences.