Post-Open WOD 14.5: A Bout with Rhabdo

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Post-Open WOD 14.5: A Bout with Rhabdo
I have been doing CrossFit for almost two years. I had been warned about rhabdo and knew about the condition, but every time it was mentioned the next words were always “Oh but it’s so rare you don’t really have to worry about it.” Wrong. Apparently, I am one in a million who is mentally capable of pushing my body to its extreme limit, beyond what it is physically able to handle.

It also seems strange to me that there is a cartoon mascot called Uncle Rhabdo which makes light of the condition and almost desensitises it, with a cartoon clown connected to a dialysis machine with his kidneys all over the floor. For someone who has suffered through rhabdo, there is nothing funny about it at all. It is also slightly disturbing that for a “rare” condition, there is an instagram hashtag #rhabdo littered with people who got it.

My Story

I love CrossFit. I am one of its biggest advocators — exposing it to all of my friends, getting them hooked — and always pushing for that feeling after a workout that I had nothing left in the tank, that I had given it my all. So when the CrossFit Open comes around, I’m excited. My favourite part about CrossFit is the community and camaraderie that comes with it, like-minded people all testing their physical and mental limits.

The workout was intense, and I did tell my judge at one point that I couldn’t breathe….I remember feeling fatigued and barely limping over the bar, angry at my bar for making me jump over it 84 times.
After completing four of the five Open workouts, I couldn’t wait to do 14.5 and finish strong. The night before the workout was released, I posted on my Facebook page “please no thrusters.” What did we get? 84 thrusters (43/30kg), coupled with 84 over-the-bar burpees, for time. It was a genius workout, programmed to separate the elite from the good. 3-2-1 GO! The workout was intense, and I did tell my judge at one point that I couldn’t breathe. This is nothing new in a CrossFit workout, where your lungs burn so much they could be on fire — I’m used to this. I remember feeling fatigued and barely limping over the bar, angry at my bar for making me jump over it 84 times. It took me 20 minutes and 13 seconds; this was a solid result for me, as my goal was under 25 minutes. I had done 20-minute workouts before and been fine, although I have never performed a 20-minute couplet with only 2 movements. I have now learned that high volume rep workouts are a recipe for rhabdo, and I believe this workout was the direct contributor to my condition. After the workout there were celebratory drinks (although I note that I didn’t drink), and everyone was happy the Open was over and ready to rest and watch the Regionals and Games, to see the best fight it out.

I woke the next morning at 5am with intense pain in my arms, which has never happened to me after a workout. I also felt a little nauseous, but didn’t really think much of it. Took a couple of painkillers and after an hour or so went back to sleep. I then got up, got ready and went to my box to support all those who were doing the workout Saturday morning. I was at the box for a couple of hours, and at this point my arms were sore and very swollen.

At one point, I was pushed slightly while I was holding a pen and it just fell from my hand; I noticed my grip had completely gone. We then went out for breakfast and I couldn’t use my knife or fork, nor could I feed myself. My arms were pretty swollen, but at this point I thought it was just delayed onset muscle soreness (DOMS), something that every CrossFitter is used to: we all feel muscle fatigue at some point and don’t think much of it. I honestly just thought I had overdone my workout and it was just DOMS and that everything would be fine in a couple of days.

More than just DOMS
However, when I got home, I noticed the pain was getting worse. I went to the supermarket and tried calling my boyfriend and ended up talking to him on speaker with my phone on the floor of the supermarket aisle because I couldn’t get the phone to my ear. Looking back, it was a pretty stupid situation but I guess I just didn’t want to exaggerate things and I thought I would get better. Somehow I managed to get the shopping bag from the car to the bottom of the stairs and had to drop it there because I couldn’t carry it any farther. It was still sitting there a week later.

From the persistence of my boyfriend, sister and mother, I went to the A&E doctor. I couldn’t hold myself together whilst talking with the receptionist and couldn’t fill out the patient card, nor could I even describe the situation. It seemed so ridiculous to say, “I worked out too hard and now I can’t move my arms.” The doctor saw me straight away. He mentioned rhabdo and tested my urine, but I had no blood in it, so he wrote me a prescription for tramadol and anti-inflammatories and sent me home. Looking back now at my symptoms, I actually can’t believe he did that; at the very least  he should have done a blood test.

I assumed I would stay one night, be on IV fluids, then go home the next day and be fine. Seven days later, I was finally discharged.
Anyway, I went home, went to bed and woke at 2am in excruciating pain, almost hyperventilating, and my dad drove me to the ED. I told them what I thought I had, although trying to explain rhabdomyolysis to someone who isn’t aware of the condition is quite difficult. Again I was seen almost straight away, and they immediately took a blood test, put me on an IV and pumped me full of fluids and pain relief. I assumed I would stay one night, be on IV fluids, then go home the next day and be fine. Seven days later, I was finally discharged.

The only treatment for rhabdo is rest and IV fluids to flush out all the toxins from your body. My initial CK levels were 10,000 — I was told normal levels are between 0-400. They continued to rise to around 16,000 and slowly reduced during my stay. After doing some research, I noted that my levels didn’t reach the extremes of hundreds of thousands like some other cases, but the pain I felt in my arms was intense. Soreness doesn’t adequately explain the discomfort of rhabdo, as the continuous morphine drip barely touched the surface of my pain.

Although I was unlucky enough to get rhabdo, I count myself extremely lucky to have gone to the ED early, self-diagnose, and not allow my CK levels to get any higher before it went to my kidneys. I have read some pretty awful stories of people in similar positions to me that ended up in kidney failure, on dialysis and fighting for their lives. My nurse told me at some point that it would be weeks before I could go back to work. I initially didn’t believe her but understand now that the recovery is the hardest part.

On my second day in the hospital, I woke to my doctor looking over me and his first words were “Did you do 14.5?” I smiled. He was a CrossFitter; he would understand. Finally I wouldn’t have to explain how I could work out at such a high level of intensity to cause rhabdo. He also did 14.5, along with 200,000 other people who haven’t gotten rhabdo. He agreed that the workout was uniquely programmed and definitely had the makings of a rhabdo nightmare.

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