The following post was written by Rebecca Price.
It was the perfect storm.
Never in a millions years did I think I would be someone that would get Rhabdomyolysis. I’m sure no one ever thinks they will. I had been an athlete my whole life surfing, running, triathlons, swimming, weight training, snowboarding and then CrossFit.
I started CrossFit in 2010 and I was training pretty consistently for most of that time. I made a lot of progress and as a mother of two young boys I placed 111th in the CrossFit Games Open NorCal Region in 2013. After that I had my sights set on qualifying for regionals in 2014. I decided to train even more seriously and started following a competitive training program, eating clean and doing all the things I thought were making me stronger and healthier. Then one summer day I pushed it a bit too hard. I felt my back surge with pain, doing heavy cleans and walking lunges but I pushed past it; pain was part of the process after all.
I went home feeling sore and iced but the next day I was back at the gym. It was my last day of my official training, and I had no idea. I couldn’t bend over for weeks. At this point you are probably asking how is this about Rhabo….well it’s all part of that perfect storm I mentioned before.
I tried to take it slow and rest my back. I withdrew from competition and stopped lifting. I came back slow to workouts but the pain returned. I backed off more, I did only gymnastics movements and body weight hoping the mobility would help and I would still maintain some of my strength.
Yet my back was still in pain, I thought I would just train once a week at the most and then surf, hike and do yoga on the other days. Months passed by and my training decreased even more. Work became more stressful and life got even more stressful and busy.
My health and fitness were on the back burner as life and work took over. I was drinking coffee to keep me going all day and then wine at night to de-stress from the day. Each day I got out of bed I could feel the pain in my back from the abuse I had put on my body through over the years. I was only 36, yet it felt like my body had been put through a hundred years of abuse.
Memorial day was rolling in and for me in the past that had always meant doing “Murph” with friends trying to get a faster time then the year before. In 2013 my time was 41 minutes with a weight vest.
The day unfolded like this. I drove out to a gym that was hosting an event, not my normal box, but I had no plans of participating that day. I was just there to support the event and athletes. I spent most of the day chatting with people and watching others make it through the grueling workout that is Murph (1 mile run, 100 pullups, 200 pushups, 300 squats, 1mile run)
I thought maybe just maybe I might join the final heat. It had been a while since I had a good sweat, and Murph has no weights so I figured I should be fine. Then I realized the box was not allowing people to (scale) partition the workout. I was shocked. I had always done it partitioned. I jokingly harassed the owner and coaches by asking them to let me do it partitioned. I knew at least that way it wasn’t that painful. They would not allow it, he did offer to have me do it with a partner or use bands for the pullups. (At that point I had a choice if I wanted to participate). I choose to suck it up, as we are told (taught) to do in CrossFit.
The first mile run was easy, 100 pull-ups pretty doable I just broke them up. The 200 pushups took a while but I got through them. I got through the 300 squats in sets of 50 and 25, these became pretty painful near the end. Then all hell broke loss on the run. I felt like death. My legs wouldn’t move, it was hot and humid and my head felt like it was on fire. I actually walked a bit, which I never do, but I could not force my body to keep running.
Then I did what I always do in a tough work out. I visualized quitting and how crappy that would feel. I told myself that pain was just perception and that my body could push through anything. The faster I got it done the better. I limped along slowly, starting to feel my legs again and made it back to the gym in 51 minutes. I collapsed on the floor immediately. It took me a while to even be able to open my eyes, I laid there in front of the fan for at least 20 minutes. Someone brought me water and an ice pack. I was done. I finally managed to pull myself off the floor, but still felt nauseous, light headed and pretty terrible. I drank more water, coconut water and recovery drinks. Soon I was ok enough to drive home. That night I felt fine, I made cupcakes for my sons birthday had a glass of wine and fell asleep.
The next day I started to get really sore, I figured it was because I hadn’t worked out in a while so it was all good. I worked all day and as the hours wore on things got more painful. I knew from experience soreness is always worse the second day, so when I woke up on Wednesday to t-rex arms and legs I wasn’t that alarmed. I brushed it off as just part of the pain of coming back from some time out of the gym. Later that day things changed; the soreness intensified and my arms and legs started to swell. I verified it with a few people because I wanted to make sure I wasn’t crazy, but that my arms did actually look swollen.
That’s when I started to research Rhabdomyolysis online. I was familiar with the condition but no real understanding of it. I had always thought of it as something really out of shape people got. I read through a number of articles and I had some of the symptoms but no brown urine so I came to the conclusion that it was just extreme muscle soreness.
That night I couldn’t sleep, breathing was painful, tears rolled down my cheeks from the sheer pain. I made some late night calls and at the urgency from those closest to me, I very reluctantly drove myself to the ER. I walked in sat down and told them I had Rhabdo. Sure enough I peed into the cup and there was the brown urine. After an hour waiting for the tests results, the ER doctor opened my curtain and congratulated me on having the worst case of Rhabdomyolysis they had ever seen. My CK levels were not even readable on the hospital labs. I was admitted to the hospital at that point.
Rhablmylosis can kill you if not treated in time. It can also cause kidney and heart failure. My kidneys were in good shape but my liver had taken the brunt of the beating. I was hooked up to an IV drip that pumped me full of water so that the proteins in my blood would be diluted enough not to damage my internal organs.
Exercise induced Rhabomyolysis is caused by intense workouts especially with eccentric exercises like pull-ups, pushups and GHD sit-ups. The resulting rapid degradation and tearing of the muscle fibers can result in cell death and muscle injury causing myoglobin and other cellular contents to spill into the bloodstream.
“The hallmark of muscle damage is elevated creatine phosphokinase, or creatine kinase (CK). Normal CK levels are between 20 and 200 units per liter (U/L), perhaps slightly lower in females. CK levels begin to rise 2 to 12 hours after muscle injury or extreme muscular exertion and may rise as high as 20,000-300,000 U/L.” http://www.ideafit.com/fitness-library/exercise-overexertion
I thought I may be in the hospital for a day or possibly just overnight. Yet, the next day my levels had not improved. In fact, they were still off the hospitals test charts. They sent the labs out for further analysis. When the results came back with my CK levels reading over 100,000 micrograms per liter (mcg/L) alarm bells started ringing everywhere! Normal range is 10-120 mcg/L according to the United States National Library of Medicine1. The doctors were amazed, they brought in a host of residents to check me out, and reached out to doctors at Johns Hopkins Hospital on the mainland to make sure they were taking the right courses of action.
The pain in my head got so bad that they sent me for a CT scan and my heart rate dropped low enough that I needed an EKG. The strongest painkiller they had were administered and they weren’t enough to relieve the agony. Eventually I developed an allergy to the drugs so I had to be given more new drugs to combat my body’s natural reaction to the old drugs, then even more drugs to keep the nausea at bay and pill after pill to sleep. I felt like a toxic waste dump. Good times. Yeah.
The IV was keeping me alive, every second pumping me full of 250 milliliters of saline per hour. I started to bloat and swell until I looked like a stuffed sausage. I was so full of water that my lungs started to fill up with it. Days dragged on and finally my levels started coming down. After nine days in the hospital, my CK levels finally were down to 6,000 mcg/L and I decided it was time to go home. I wanted my own bed, and I wanted to be with my sons to let them know I was better. They were the brightest spot for me in that hospital room.
On my last day in the hospital my doctor came to see me, we hugged and she told me that I had kept her up at night many nights in a row over the past nine days. I was incredibly thankful to have such an amazing doctor that I knew truly cared about me and my well being.
I gathered my things and waved goodbyes to the staff who had cared for me feeling as though I was escaping a prison. The double doors parted and I felt the warm sun and tropical breeze on my face. Tears of relief rolled down my cheeks.
It’s been a slow road back. The first two weeks I was just allowed to walk to my car, that was about it. It was six weeks before I felt I could get back to doing real exercise, and even then I was warned to take it very slowly.
People always ask me if I had any revelations in the hospital. The answer is No, not exactly, but what I did spend a lot of time pondering is, why? Why did I push my body so hard? How could I do this to myself? Why didn’t I listen to my body when it screamed at me to stop? What was I running from that I had to punish myself like that? What did I have to prove?
I resolved to myself to start being kinder to me. To treat my body with respect and find out why I kept beating her down so much. I also thought about my kids and how much more time I wanted to spend with them. Less time working and working out, more time playing and watching them grow. All I dreamed about was holding their little hands in mine.
Rhabdo is a real and scary thing. It’s no joke. I do not hold CrossFit accountable for what happened to me, I do have a brain and I chose to do a workout I knew was questionably dictated. I chose to follow the pack, and against my better judgement I jumped into something I had hesitations about doing.
In the CrossFit culture I was a part of the ; you do not quit, you never give up, pain is perception, quitting makes you weak philosophy. There are so many quotes meant to encourage and push people past their limits I would hear floating around the gym. Quotes that would dance in my head as I crushed my body daily training myself to the extreme.
I have to say that I am done with quotes, all of them for that matter. Everyone around me has asked if I am going to continue to CrossFit. I hesitate in answering. I was completely broken down by this sport (CrossFit) that I love. I am going to spend a lot of time building my body back up in a more balanced way, instead of beating it to a pulp in the attempts to lift heavier, move faster and become the best at CrossFit. I intend to become better at life by being kinder to my body. Also this thing called quitting…I plan on seeing how that feels for once.
The Apex Predator Athletics Team would like to thank Rebecca Price for telling her story here. Surviving rhabdomyolysis, and having the courage to talk about how and why it happened is commendable. Thank you for your story.