I have 26 years of experience of hard physical training within the military, there is a mentality that you keep going and persevere. It has never been a case of being macho or competition, well not for me, it shows character and endurance.
I have always hated circuits (multiple exercises in short bursts), because they are uncomfortable and painful. It pains me to say this but I now have a grudging respect for the Physical Training branch, why? Well because they know what they are doing, to me it always seemed mad, but there is a degree of balance and sense to the exercises that pushes but does not break the body.
The session last Monday took me over the safe limit for two reasons: firstly I pushed myself too far, to the point of exhaustion in fact and secondly the instructor did not balance out the session across different muscle groups. It is important to point out that the damage in this case was to my upper body, this has always been a weak area of mine and so was particularly vulnerable to this session. So what happened?
As far as I remember the exercise went something like this:
No warm up - the first part was regarded as a warm up but was already high intensity.
Sprinting on the spot interspersed with press-ups which counted down from 10 to 1 (I worked this out as 55 press-ups in around 3 or so minutes). We did this twice with maybe 90 seconds between rounds . I may have got the details wrong but the key point is that by the end of this I could no longer support my body weight whilst in the press-up position and I was struggling well before the second round ended. I should have stopped at that point.
The next part involved partnering up and doing more press-up related exercises whilst your partner ran to a point and returned. I had already decided that I would do variations on sit ups as I simply could not do the required exercise. I don't recall how many sprints we did but it was enough.
Unbeknown to me I had damaged the muscles in my upper body to the same degree that crush victims in earthquakes experience. Whenever I have done these exercises in the past I have always experienced a degree of discomfort, most do if they truly push themselves. This was different, by day three I still could not lift my arms above my head, that was not normal. In addition my urine had turned a very dark brown and had been so for a few days. At first I thought this was dehydration but it usually clears on day one. I remember remarking that I had never experienced a circuit like that in terms of intensity, there is a good reason for that. The military vary the muscle groups being worked upon and it avoids the risk of severe damage. To exercise the same group repeatedly at high intensity increases the risk. So what was it? What was going on?
There is always a danger when resorting to 'Doctor Internet' that you find you are about to die and need to rush to accident and emergency. I checked out my symptoms on Thursday and found a condition called Rhabdomyolysis. Now stop reading this blog now and go to the link below, read all of the information and be aware, it may save your life or someone else's. http://www.healthline.com/health/rhabdomyolysis#Overview1
So I was now getting concerned and considered going to Accident and Emergency in the UK. As it was I had been drinking between the exercise and my discovery of what it might be and I had to drive back to Belgium. I should have gone straight to A&E, but I didn't. Once home my wife and I had a tense discussion and decided against going to A&E, she did call the doctor who said I should make an appointment at the local clinic to get tested. I was fortunate in that there was an appointment at 08.30.
First thing Friday morning and the doctor did a urine test and took some blood. Apparently there was blood in my urine and this is more common than I thought. She reassured me and said that I could call for the results on Monday and if there was a problem she would call me immediately. I was reassured as the condition indicated that myoglobin would be present and not blood, however, both give the same result on the test. I took the call late Friday afternoon. Go immediately to A&E.
I was not scared or worried, although An was shocked. For me it was a case of let's get going and get this sorted out. I was concerned about damage to my kidneys or possible failure, so I was pretty focussed. The true impact of my experience would not hit me until I was discharged from the hospital four days later.
I was processed fairly quickly having explained several times what had happened. I was told that I would be staying, blood was taken, urine was taken and I was out on a drip. I was examined and asked about other symptoms. For me there were no other danger signs, no vomiting, nausea or pains other than my sore muscles, which were recovering by that stage. The doctors said I should look up crush victims to get an idea of what it was that I had, I didn't need to. A not so tactful nurse made it abundantly clear what my condition was, almost blaming me for it. It was self inflicted but I am no macho fitness freak. I liken it to being blind and crossing a motorway, it is bloody dangerous but you just can't see the danger. I had no idea that such exercise could pose a risk in this way and, having spread the word, no one else had come across it, apart from my medically trained friends.
Word quickly got out to the family that I was in hospital and so I was doing my best to reassure and inform them as I lay with the drip, in casualty. My Apple Watch came into its own as I made calls through my watch, it felt a bit like Star Trek. My mother, An's mother and An to start with. Then I put a message and photo on Facebook when I knew the danger had passed. On Saturday morning I had the blood test back that said there was no damage to my kidneys but that a certain enzyme was at dangerously high levels and necessitated me being on 4 litres of IV fluid per day, this is exceptional and poses other risks.
Messages started to come through thick and fast from my friends asking me if I was okay and wishing me a speedy recovery. It was warming to get such support, which was not lacking in any sense. I felt a bit of a burden on An, both in time and causing stress. I was happy with my book, in this case on the Battle of Culludon and the immediate history before and after, which I finished.
I was very lucky that there was no damage to my kidneys, it was now a case of flushing me out to unblock what had accumulated there. My stay in hospital was an experience, I had four blood tests taken and the drip was changed from my right to my left arm at one point. Now anyone who really knows me will be aware of my phobic reaction to having my blood taken. Experiences vary from going into shock to coping well enough. It is ironic that bravery is really defined as facing up to your greatest fears and overcoming them. In this case this was the equivalent of vertigo, going over the top in the trenches, facing off spiders, wild dogs, bears, snakes etc. I cannot understate how much of a trauma it can be even though I know that it is not life threatening and that there is no rational reason to shut down. I wish I could get over it but there it is. When changing the drip one of the nurses had problems spearing my vein and I could feel the needle squelching in and out as she tried to find it, I felt like a kebab but tried to keep my mind off it by examining the details of the room to the enth degree. Often resorting to humour to deal with my nerves.
One funny moment was when An said she would do anything I wanted whilst I was in hospital, at last this was the opportunity that I had been waiting for! The look on her face as I laughed about this was one of 'well sacrifices must be made'. I reassured her that I would not ask her to do anything she did not want to do but we did laugh about the possibilities.
Also whilst in hospital I got a better appreciation of the nursing and medical staff and made good use of my Dutch language skills, which they kept making me use. One of my fellow patients was told to use Dutch with me when he was heard speaking English. I am grateful and I learned a lot and was complimented on my knowledge and skills.
One of the risks with IV fluids is pulmonary edema, in essence water on the lungs. The doctors did not tell me that they were monitoring for this but it became apparent eventually. My hands became swollen and I had put on around 5 kilos, mostly fluids. I was not moving about a lot and was effectively confined to my bed, it was not helping. Eventually I was reduced to 2 litres of IV per day which eased the burden.
Eventually I met the senior consultant who said that he was happy for me to go home, this was four days later. I asked for the consultation in English so that I did not miss anything important, I asked in Dutch! He confirmed that there was no permanent damage and no long term effects. I could do exercise again in two weeks time but clearly not overdo it. There was no need to follow up or be administered medicine. At that point he confirmed that it was myoglobin in the urine and not blood. No one had actually confirmed the condition to me at any point, but it became obvious.
Whilst waiting to be discharged the heavens opened and it poured with rain, with the odd rumble of thunder thrown in. I reflected that I had no jacket and only shorts and t-shirts. I would be catching the bus as An was unable to collect me. I am certain had I called friends then I would have had a lift back but I wanted time to reflect. As I cleared my things I felt slightly down, I was dressed in my black Hard Rock Cafe t-shirt, hiking shorts, desert boots and socks. I had a small blue rucksack, laptop bag and cloth bag for my laundry. I looked like a clean homeless person and with the various puncture marks on my arm, I could have been mistaken for a drug addict too.
The bus took over an hour to get from the hospital to the home town, I almost welled up on the bus as I reflected on what I had been through and the risks. I then watched the people getting on and off, oblivious to the experience I had had. When I arrived it was raining but it did not matter, it was not important. I slowly trudged home in the pleasantly warm rain.
Upon my return the first thing I did was let An know I was back and then I was welcomed by the cats. I could not feel much when in hospital but now my body was telling me that it was a bit worn out. Maybe it was just having the relief of being home and out of danger and now I was more sensitive to the normal aches and noises of my body.
I was acutely aware of being overly dramatic about the risk but no matter how I think about it the risk of kidney failure was very real and it has now changed my outlook and made me appreciate things a bit more.