Thursday, June 13, 2013

That time I went into kidney failure....


Recently I became fed up. I've gained this weight from having kids, being lazy and my RA medications...and it just sucks. So I wanted to try something both fun and challenging. I'm sure many of you have heard of CrossFit, as had I. A legit CrossFit gym had recently opened near mi casa...so I decided to try it out! The first week was free, so I had nothing to lose. Or so I thought.... {dum dum DUMMMMMMM}

My first workout was on a Monday. The prescribed workout was 100 pull ups, 100 push ups, 100 squats and 100 sit ups. Well, there was no way in HELL that MY body was going to be able to do THAT on my first day, so we modified the workout {WOD: Angie...for those of you in the know}. I ended up doing 35 of each, and although I was drenched in sweat and stringing curse words together like a sailor, I got through it all. Pre-workout BG: 94 mg/dL, post: 86 mg/dL, and I removed my pump during the actual workout, and drank water before, during and after. I dropped low later that night, which I promptly over treated with juice and then almond butter & honey...jussssst to make sure I didn't die. As soon as I came home from the gym I was immediately sore in all of the muscles I had just abused. Triceps, abs, quads...all were killing me. I upped my hydration, hit the Magnesium & L-glutamine...and a little Advil so I didn't feel like I was dying. Trainers told me to def come back the following day, that working out again would help with the soreness. Sure, ok...seemed legit..plus I loved the community feel of the gym and workouts, and how positive everyone was. Crossfit was also super appealing to me because of the connection with the Paleo diet, which Dr. C and I have dabbled with and prescribed in our clinic for the past year or so.

2nd day work out consisted of weights...jerks, lifts..and I did some modifications with a 35lb kettle bell. Again, not easy, but I never felt like I was over doing it. BG stayed ~90 again, and I also hydrated. Next day I felt pretty sore, but pushed through and did a run. Which I completed. Again with good sugars and {what I thought was} adequate hydration.

Thursday I took totally off. I was sore. I had also noticed that I was UP 10 lbs since Monday. That was a bit unnerving. I had puffiness around my eyes, in my fingers, my tummy and my ankles. Hmmmmmm. So I reached out to FaceBook....which warned me of a certain condition that I was familiar with because of my nursing background. But, again, STILL didn't feel bad...was still ok in my eyes. My sports medicine Dr suggested getting some blood work done when I came in the following day to see patients in my practice. So I did. About an hour later I get a call from the hospital's stat lab informing me that my muscle breakdown level, a "CK" or "CPK" level, was more than their machine could measure...and that they would be sending my blood to another hospital. Hmmmph. My liver enzymes were also more than quadruple what they normally are, and my creatinine {blood kidney test} was double what it normally runs. SHIT. At this point I'm getting upset. My triceps and quads had also begun to abnormally swell, and my skin in those areas became super tight. FML. Dr. C called over to the hospital, and at that point their machine was also having difficulty running my CK level, but they were guessing it was around 20,000. Ruh Roh. Normal is 60-400.

So by now, Dr. C and I have consulted with my sports med Dr {Hey, Dr. D!!! Love ya!} and an internal medicine doc in our practice. Both were recommending a trip to the hospital for IV fluids. Dr. Google was scaring the crap out of me. When you hear things like "renal failure" and you've had diabetes for 20+ years, you tend to get nervous. So I drove myself to the hospital, Dr. C followed....I turned up the music, LOUD...and cried, because I was scared, y'all.

I get into the ER and my blood pressure is abnormally high. Hmmmph. And my weight is up 15 lbs from Monday {it's now only Friday}...ERMAHGAWD. I get shown to a room, and a physician looks over my blood work. I started hearing things like "acute renal failure" and "rhabdomyolysis". At this point I'm sobbing, and feeling like I'm going to faint. I was given no choice in the matter, I was being admitted to the hospital for intensive IV fluid management and monitoring. WHOA. Seriously, I've been in the hospital for baby-having stuff and for DKA when I was 16. I used to work in a hospital. I KNOW what goes on there, I KNOW how sick the patients can be. I was fuh-rrreaking.

Fast forward. 4 days of intensive IV fluids. Peeing gallons of water and protein out almost hourly. My CK level at admission was around 25,000, and that indicated that my muscles were swelling and dying, and as they are breaking down, releasing proteins. These proteins then are being caught up by the filters in my kidneys, which overloaded them. The ER doc said to think of my kidneys like a swimming pool after a super crazy summer party: my pool filter is now clogged with hair and the pool is getting murky. Uhhhhhhhhhh.
Thankfully I have zero kidney involvement when it comes to my type 1 diabetes. My kidneys took it all in stride and immediately began to improve and heal. I was told I wasn't allowed to leave until my CK levels came down to below 1,000...remember, normal is 60-400. On Monday, my level came back at 4,300...and I whined and complained enough that I was allowed to come home and rest for a few days before returning to work. I was also told no exercise for 1-2 weeks. Y'all. This shit was craaaaaay craaaaay, and I NEVER EVEN FELT THAT BAD.

Dealing with my diabetes in the hospital was easy. After the Dr on call "placed" me on a "sliding scale" with "regular insulin", I informed all Drs that NO ONE was to even THINK about the management of my sugars, insulin or diet. Do you think that stopped them from ordering a "diabetic diet"? Or prescribing bed time snacks of sugar free pudding and cheese to "prevent hypoglycemia"? Bless it. That's all I have to say. My highest sugar there was 136 mg/dL. Funny how basal/bolus Novolog with carb counting works. Like a Champ. Pffffffft.

So now I'm home. Feeling a bit weak, having muscle cramps, and still spending hours of my day peeing. I gained a total of 18 lbs in 7 days from the fluids and swelling. Mofo 18 pounds. My face is round and puffy and I look 5 months preggo. I'm ready for this to be over!

I have spoken with the gym owners and trainers at great length. They have been awesome, and have a prescribed plan just for me, catered to my delicate, flower like self. I am in no way blaming them for what happened, as it was just a random ass shit storm that occurred in my body. I'm also not afraid to work out again. I'm sad that I have to take so much time off, but alas, my body has to heal!

I was also under the assumption that marathon runners, persons taking cholesterol lowering medications and those that experience crush injuries were the ones that were diagnosed with rhabdo. It never occurred to me that I was at risk. Going from my un-gym like status, under hydrated and working out at 5:30 in the hot as Texas heat...I set myself up for the perfect storm of bodily dysfunction.

So now, here I am...a few days after discharge. And I still feel like ass. My muscles are cramping, I'm tired and have only peed off 4-5 lbs of that fluid. My arms and legs are still
a little swollen, so I am hoping all of this will improve in days to come.

How do you prevent rhabdomyolysis? First of all, again, my diabetes status had zero to do with it. It was more like, hey...you haven't lifted weights in 3 years? How about you take it easy instead of going all Chuck Norris style.
-immediate muscle soreness after a workout
-increasing muscle weakness
-fatigue
-red, rust or tea colored pee {I never had this} {you're welcome}
-muscle swelling
-new workout routine you're not accustomed to....and you just ADR {ain't doin right}
-generalized edema
I was lucky I had peeps to ask what the fudge to do. I could have easily ignored my symptoms and blown them off...then done some major ass damage to my kidneys. That ain't cool. So, being an educator, I'm sharing my story with my public. In hopes that you share it with yours. {as in DO IT, or I will beat you}.

Thanks for all of the love, support, thoughts, prayers, food, texts and emails...I'm a blessed lady!

Time!!!