I finally did it. I knew my husband would still be home before leaving for work in the early morning hours, so I slept in my workout gear and woke up bright and early on a Monday morning to attend my very first spin class at the local gym. I wasn’t too nervous, as I already knew everyone that would be attending, and know the instructor pretty well. (Small town livin’.) I was excited for the opportunity to get my workout on early in the morning, three days a week, with the accountability of showing up to exercise with others.
You see, I am not new to working out and fitness. Since March of this year (2019), I have completed several workout programs; some of them quite advanced/intense. I have worked out fairly regularly, as in anywhere from 3-7 days a week, only taking a couple of weeks “off” here and there, since March. I have done quite well with eating clean and partaking in an 80/20 diet. I drink at least 90 ounces of water daily, most every day. I have lost weight and really toned up. The reason I mention this is to point out that it wasn’t like I was totally unprepared and out of shape to take on trying a spin class.
I showed up to class a bit early to get a bike set up and see just how it would all work. Everyone was super nice and knowledgeable. BONUS: Your first time trying a class at the gym is free! I was told to definitely take it easy, as I’d be using muscles I may not be used to using, and that I should feel no shame in taking things a little slower, sitting down rather than standing, keeping resistance down, etc. when it got to be too much for me. They made sure I knew not to push myself too hard, and made sure my bike was as comfortable as possible for me.
Once we got started, there were a few times I sat when they stood, and kept my resistance down when we were instructed to turn it up. The sweat was pouring, the music was playing, and I was thoroughly enjoying myself. Eventually, my legs did start to burn, as to be expected when working out. I then noticed my right leg was hurting me a whole lot more than my left, but I attributed that to the fact that my back was out and my right leg was a bit shorter than my left, so I was having to reach just a bit further on that side when pedaling. I always push myself, whether it’s a workout or any other given task in life. I am an all or nothing kind of gal. I do feel I pushed myself in class, but not a lot harder than I do in my other workout programs.
After a cool down and some upper body stretches we got off of our bikes for some leg stretches. Before I got off of my bike, the others warned me to be careful because my legs would be wobbly. They weren’t lying! I just about went down and had to use my bike for support, but I was able to do my stretches and change out of my workout shoes and into my street shoes.
I headed out right after class knowing I had to get home and showered quickly in order for my husband to get to work and to take my son to speech/OT therapy at the school. I walked out of the gym and went to step off the curb to get to my vehicle and fell to the ground with a loud crash as my metal water bottle hit the asphalt. My legs were tired! I just hoped no one saw me, and got up as quickly as I could and got in my car and headed for home. I wasn’t injured. I caught myself with my hands. No harm done; at least not from the fall.
I wore my fitness tracker/heartrate monitor to class. I was impressed by my calorie burn, and had done workouts with fairly similar results before. I was pleased.
I took my son to therapy later in the morning, and after that, I knew I had to keep moving (or so I thought) to keep my sore muscles from getting stiff. I went up and down the stairs to my basement at least 12 times washing and drying laundry and putting said laundry away. Granted, I had to take the stairs one at a time, one leg at a time, and very gingerly; holding onto the wall or the railing. I also deep cleaned the kitchen and living room. I kept busy all day, and drank lots of water.
Later in the day, I received messages from the instructor and fellow spinners asking how I liked class. I had nothing but good things to say, other than that my legs were sore. Sore is kind of like a badge of honor after a workout, though; am I right? It means you pushed and should see results over time.
Tuesday morning I woke up VERY sore and decided I would go to the chiropractor to get that straightened out. I was having a lot more soreness in my right leg than my left. My back was out pretty badly, and it felt good to get that back in place.
I took my daughter to preschool and had a really hard time getting in and out of the car, and felt like I was going to collapse taking the three steps to get in and out of my house. Ow! Then, I noticed both of my upper legs were swollen, my right far worse than my left. I pushed through, and took my son to his appointments out of town. I did try taking 3 or 4 – 200 mg ibuprofen, but it didn’t even touch the pain.
Needless to say, I didn’t sleep much, if at all, Tuesday night. I was in pain; so much so, that I couldn’t rollover or move my legs in bed without excruciating and unbearable pain. I am a stomach sleeper, and could not sleep on my stomach because by that time my legs hurt to the touch and with any movement at all.
You’d think at this point I’d be concerned. I was a little, but at the same time thought maybe I was just a wuss and kept thinking it’d feel better in the morning.
I woke up Wednesday morning in pain at rest and even more so with movement. I could barely bend my knees due to pain and swelling. I couldn’t step over even the smallest things on the floor. I had to put one hand on the toilet seat and carefully lower myself to use the toilet and would cry out in pain with having to sit down anywhere. I had trouble getting my underwear, pants, and socks on. My husband was able to accompany me to take my daughter to preschool and my son to appointments out of town. I was glad, because I was afraid I would fall carrying my son, or that he would get away from me and I wouldn’t be able to catch up. I was starting to get a little worried. This definitely wasn’t normal. Did I pull or damage muscles?
Getting into the car was a great feat in itself. I had tears streaming down my face and had to lift my legs in. Wow, now I was getting concerned.
My husband and I dropped our son off at his appointment, and went to grab some lunch. Before we left the facility to grab lunch, I needed to use the restroom. I noticed my urine had a very darkish red tint to it. Hmmm…
After lunch, I hit the can again, and my urine looked even worse-DARK BROWN. I knew I was not okay, as by lunch I had already drank 90 ounces of water, and even added some apple cider vinegar to some that morning, just to see if it would help my pain. I also took a bunch of ibuprofen that morning with absolutely zero relief.
I told my husband I definitely was not okay and contemplated whether I should go to an Urgent Care or just hit the clinic when we got home. You see, I do not have health insurance, so I wanted to keep this as affordable as possible. Therefore, I decided to call the clinic back home, and was able to get an appointment for right when we would arrive back in town.
I shared my symptoms with the nurse and PA and gave a urine sample (dark brown, ew) and a blood sample, and waited for results.
The first result I was given was that my urine had “a lot of blood” in it. I didn’t know what that would mean, but I was told to sit tight and wait for my bloodwork results.
Apparently, some of my blood lab readings were so high that the facility’s machines could not read them. Normally, the blood would be sent off and levels taken at another facility, but that facility was closed for the day, and there is a 2 hour limit on when certain levels can be read in the blood. Therefore, we never got an exact level on a few things, but knew they were concerning.
This is when the term RHABDOMYOLYSIS (aka rhabdo) came up.
Rhabdomyolysis is defined as: A breakdown of muscle tissue that releases a damaging protein into the blood. This muscle tissue breakdown results in the release of a protein (myoglobin) into the blood. Myoglobin can damage the kidneys.
This causes your creatine kinase (CK) levels to rise, as well as your liver enzymes.
Per my studies, a “normal” CK level is 38-314 U/L. A CK of 1000 indicates rhabdo, while a CK of 5000 indicates a severe case of rhabdo.
All we knew was that my CK levels were 2000+, as that is what the machines at the facility maxed out at. Not to mention, this was even after trying to dilute my blood sample.
They really wanted to hospitalize me and get definitive lab numbers in the morning, but I refused, agreeing to get IV fluids and IV pain medication outpatient and return in the morning. I was told they were VERY reluctant to let me go home, and that the only reason they were even allowing me to go home was because my kidney function looked okay per lab results. I had to promise to come back immediately that night if pain worsened etc. etc.
I received 3+ bags of IV fluids and supposedly some morphine. I say “supposedly” because I never felt it hit if they did administer it, and was in so much pain I didn’t pay any attention to what was going on around me. If they did give me morphine, I didn’t get an ounce of relief. I was lying there crying, and hoping I would go home and feel better in the morning.
I got home sometime after 9 PM. I did end up calling the nurse later that night because my legs ended up being even more swollen later on. I was told it was likely from all the fluid, and that I could come in if I wanted, but that there was really nothing to do differently than we already had until we had definitive lab results. I was good with that, and stayed home with strict instructions to come in the next morning for repeat labs.
I felt like my legs were logs (upper legs) on top of toothpicks. It was just ridiculous and so damn painful. My husband had to help me on and off furniture and into bed, etc. Needless to say, I didn’t sleep a wink. I physically couldn’t.
Morning came around, and my husband and I took our daughter to preschool and went back to the clinic where there were already orders in for me to repeat my labs. My mom graciously agreed to take our son to speech therapy at the school while we went to get some answers.
The doctor came out to the waiting room and asked us to come back to a room. He gave it to me straight and said I absolutely needed to be admitted, no ifs, ands, or buts, about it, and that I most definitely had a case of exertional rhabdomyolysis. My urine was no better than it was the day before, even after the IV fluids the night before, and my labs were not good.
At this point, I required a wheelchair just to get to my hospital room. The doctor gave the nurses orders to start very extensive IV hydration. They, in fact, questioned him and said “Our machines won’t even put out that much.” He told them to put an IV in both arms. Therefore, I was connected to 2 IV poles running full bore.
The doctor came into my room after I was settled and asked how I felt about a catheter. I was all for it! I did not want to have to get up to use the bathroom with so much pain and have to navigate with 2 IV poles.
Needless to say, no sleep that night. I was SO uncomfortable and in a lot of pain.
The next morning (Friday) they took repeat labs. My urine was still brown. My labs had worsened. The doctor informed me not to be “delusional” or “get my hopes up” thinking I would be going home anytime soon.
It was homecoming in town, and I did convince them to let me go watch the parade in my wheelchair, IV pole in tow with my fancy hospital pants and urine bag to boot, that afternoon.
I suffered a TERRIBLE headache late Friday afternoon and into that evening. I could not utilize Tylenol or ibuprofen because my liver enzymes were so high. Therefore, I was given a dose of hydrocodone with no relief. I was later given more hydrocodone with no results. I was then given tramadol with zero relief. I was then given a double dose of tramadol, and finally had relief, although I don’t know if it was because of the tramadol or that the headache was just over at 3 AM.
Saturday morning, labs were taken again and had again worsened. My urine was still dark, although not brown. My doctor consulted with a kidney specialist, and they made the decision to back my fluids off, and I was therefore down to just one IV, although they kept the other intact, just in case. They attempted to flush the IV site not in use later in the evening, and it blew. So, I was down to just one IV in my left arm.
I did sleep a tiny bit better Saturday night, although didn’t sleep much.
Sunday morning I woke up in a bad mood. Can you blame me? A CNA took my vitals, as they did many times throughout the day and night, but this time the blood pressure cuff caused my IV to blow. I got sick of waiting for a nurse to arrive, so I just took the damn thing out myself. I then got a little owly with a couple of CNAs, which my husband found hilarious and says he wished he had recorded. I will not go into detail, but my owliness was warranted. They then had trouble getting another IV in, and I ended up with one in my right hand. Great.
That evening I was able to hobble around on my own, and even sat in a chair for a while.
I finally slept fairly well for my circumstance that night. I was even able to sleep on my side and stomach.
Monday morning my labs were taken again. The doctor came in and said there was a mixup and that my labs didn’t get sent off for absolute counts. I tell you, I about jumped out of that bed and tackled him. Argh! He said the labs they could get in-house were trending downward nicely, and that once he saw my total counts after the delayed send off, if they were trending down, too, that he would let me go home.
My catheter was removed, and I was able to use the restroom on my own. My pain was down considerably, and I mostly felt just sore and very weak.
That afternoon, the doctor stopped back in and told me my total counts were trending down nicely, and that he would let me go home if I promised to rest and push fluids until a follow-up in a week. I agreed.
I think a lot of times they make you stay in the hospital until your CK levels are down to 1/10th of what they were at their peak, but they cut me a break. (Remember, no freaking health insurance here.)
I missed my kids a whole lot! I did not allow them to visit, because I did not want to scare them or have them catch something, since I did have a roomie. I did video chat with them a couple of times, which only made me cry a little. They faired well without mom. Dad was able to stay home most of the time (awesome boss) and grandpa & grandma and aunts were willing to pick up the slack. For that, I am forever thankful.
I so appreciate the prayers, flowers & gifts, the meals after home, and everyone that came to visit or messaged me and offered a helping hand and encouraging words.
The odds of getting exertional rhabdo are 0.016%. I guess I should buy me a Powerball ticket.
I did ask my doctor if he thought spin class was the culprit. He told me that yes, I pushed my muscles too hard for too long, and likely used some new muscles that weren’t as conditioned.
Do I plan to hit up spin class again? Yes, when and if I am able to again. Me, my luck, and my body are the only things to blame for this. It’s very rare. It’s just my luck.
The outlook? I am not sure. Some say their muscles and endurance are never quite the same after rhabdo, and some make a full recovery.
Right now, my legs are very weak, and I get tired and wore out very easily. I have been doing my best to take it easy, and the state of this house is driving me bonkers! I am a clean freak, and this has put that to a halt. My husband has been kind in helping with supper and bedtime in the evening. The kids…well they’re kids. They don’t understand that mommy needs rest. We are doing the best we can.
I guess it’s safe to say that no one can ever say I don’t give things my all.
For a little perspective: Remember how I mentioned a CK of 1000 is considered rhabdo and 5000 severe rhabdo? Take a look at my peak labs below. I was absolutely SHOCKED, and am so thankful my kidneys and liver held on, and that I did not wait any longer to be seen by a doctor.
While this condition is quite rare, and more often happens due to crush injuries, snakebites, and drug and alcohol abuse, please listen to your body! I do not wish this condition on anyone.
ADDENDUM: This Wednesday (day 2 at home) I decided I could handle taking my daughter to preschool and driving my son to therapy 80 miles away. My son has a half hour break between therapies, so we were playing outside at the facility in the fenced in playground area. I was sore and weak, but managing. Some kid decided to open a door that was not in my line of sight. He then looked at me and said “He just went inside.” very casually. Not to mention, his teenaged sister was standing right there with him, but did nothing to prevent this. Anyway, I go trucking inside and don’t see my son anywhere. He is a bolter, and has zero fear or safety awareness. My legs are killing me. I’m hobbling around in a panic. I cannot find him! I am so worried he walked out the automatic front doors of the facility and is outside somewhere. I met his ABA therapist in the hall, and she helped look for him and reassured me we would find him. Pretty soon, it was a facility wide search. Everyone was calling his name and looking for him. His ABA therapist eventually found him in a dark room in a corner playing with some toys. He just looked at us like “What’s all the fuss about?” I sat down in the waiting room and cried. I cried in relief. I cried in pain. I cried in frustration.