y******n
发帖数: 4527 | 1 ☆─────────────────────────────────────☆
serendip (serendipity) 于 (Thu Jul 14 15:51:58 2011, 美东) 提到:
Dear Ultra Running Community,
I am writing to the list to share my story of acute renal failure. I do
not post to the list often but I feel that this story is important for the
community to know. I would welcome any questions or comments in regard to
this report especially from any medical professionals who may be out
there.
Some people on this list know me and many do not so let me start with a
bit of background and then a brief description of what happened to me.
I am a 37 year old male ultrarunner. I am 6 feet tall and 170 pounds. I
have been running ultras since 1997. I ran my first 100 miler in 2000
(Angeles Crest) and knew from that point on that I had "found" my
distance. In five years I have run 7 100 milers (3 AC's, 2 VT's, and 2
WS's). 100 milers have become the focus of my training and the highlight
of my year. In 2003 and 2004 I ran two each (VT and AC in 2003 and WS and
AC in 2004). Aside from the usual aches and pains associated with
recovery from 100 mile races I have never needed medical intervention
following a race and have always felt pretty much back to normal about a
week after a race.
This year at AC my story was very different. I had what I felt was a very
good race this year finishing in 19:53 and taking 15 minutes off my time
from last year. After finishing I was completely wiped out but doing OK.
I spent about 4 hours in the med tent and slept pretty well. I had a
massage and was hobbling about in my usual post-100 miler daze. The first
indication that something was not quite right came at about 9:00 AM Sunday
when I had a single episode of brown, coffee colored urine. It was not
painful and it was only one episode. I told my wife about it and we
essentially passed it off as a deep, yellow urine that was simply the
result of dehydration. I continued to push fluids and felt OK. The drive
back home was uneventful and I made it it work on Monday.
That afternoon I began to feel flu-like symptoms and decided to stay home
from work on Tuesday to recover from what I thought was the flu. I had
low-grade fever and general body aches. I just couldn't seem to shake
these symptoms. I continued to urinate normally but my muscle soreness
was not improving. In addition, I felt something in my stomach and back
that felt like constipation. By Friday the pain had not increased at all
but the general malaise I felt was still present. The "constipation"
feeling persisted and I had no energy. Finally, on Saturday afternoon
(one week after the race) I went to the hospital and was evaluated in the
Emergency Room. The doctors concluded that I had a severe case of
Radbomyolysis (muscle protein in the kidneys) and that I was in acute
renal failure. After five days in the hospital, 18 litres of fluid, one
kidney ultrasound, and many hours of contemplating my future in running
100 mile races I returned home humbler and more mortal that I have ever
been before.
Of course, I have many questions about this whole thing: Why did this
happen in my 7th 100 miler? Can I run these things anymore? Are there any
warning signs besides the brown urine? Can I train to avoid this? Is
there anybody out there with a similar story?
Today my kidneys are back to 90% of normal function and the doctors
anticipate full recovery. In the hospital I ballooned to 203 pounds
before beginning to shed the fluid and now I continue to urinate every 30
minutes and I am feeling like I might even be able to go for a short run
this weekend. All in all, this was a serious wake-up call for me and one
which I will not ever forget. I hope this story can help future runners
avoid renal failure and perhaps even motivate more 100 milers to take
blood tests after races to determine myoglobin content in ailing runner's
blood.
Please do not hesitate to contact me off line with comments, questions, or
advice.
Yours,
Andy Jones-Wilkins
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whxhm1 (whxhm) 于 (Thu Jul 14 15:55:59 2011, 美东) 提到:
Thanks for sharing! We have to be sure to hydrate well in ultras.
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dynatang (no) 于 (Thu Jul 14 15:56:59 2011, 美东) 提到:
腎功能衰竭
FYI.
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vivil (running piggy) 于 (Thu Jul 14 15:58:41 2011, 美东) 提到:
我在这个版发的第一帖，就是关于肾衰竭和跑马，不知道是不是有人还记得。我当时被
狠狠的奚落了一番，哈哈。
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serendip (serendipity) 于 (Thu Jul 14 16:04:01 2011, 美东) 提到:
for most experienced runenrs here, the chance of getting renal failure from
a marathon is really low. but it's something a beginner should pay attention
to and think twice before sign up for a full marathon.
the moral of the story is actually to train harder.
see blow:
In the 2004 AC100 after finishing 2nd to G Medina I peed brown, had flu like
symptoms for 5 days following the race and ended up spending 8 days in the
hospital getting IV's and blowing up like the Stay-Puff Marshmallow man.
Turns out my CPK had been 145,000 and my creatine upwards of 8.0. Dangerous
stuff. After recovering and doing a bit of soul-searching I met extensively
with a nephrologist at Kaiser in Oakland. The end-game of the conversation
went something like this:
Me: Doc, I want to keep running these things. What do I need to do?
Doc: Well, the muscle damage you did here means you ran beyond your body's
ability to handle the pain. So, what you need to do is pretty simple; you
can either slow-down or stop the next time the pain gets this bad or you can
train harder so that the pain never gets this bad again.
You can guess which option I chose.
I also swore off Ibuprofen on that day because of this little exchange:
Me: Some people have said I got this because of Advil. You think that's true?
Doc: Look, Ibuprofen is an anti-inflammatory, therefore, it's job is to
basically shrink things in your body. The last thing you want to happen in
your kidneys is for the tubules that process the waste out of your body to
shrink.
Me: OK, so if I don't take Ibuprofen the tubules will stay open.
Doc: Yup
So, I started training harder, racing less, and getting my blood tested
after every 100 miler I ran. So far, it's worked.
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penguinfly (flying penguin) 于 (Thu Jul 14 16:05:54 2011, 美东) 提到:
这个是因为失水引起的么？跑过7个的老手，而且，应该没过一段都要量体重监测失水
程度的吧？
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dionysus816 (SILENCE) 于 (Thu Jul 14 16:06:34 2011, 美东) 提到:
100 mile的确是一件很严肃的事情。
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serendip (serendipity) 于 (Thu Jul 14 16:08:29 2011, 美东) 提到:
it seems NSAID is one reason and second is not trainning hard enough, haha
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whxhm1 (whxhm) 于 (Thu Jul 14 16:11:46 2011, 美东) 提到:
Yes, a 100-miler is no child's play. At one moment you may feel strong like
you can run forever, 5 miles later you can crash badly and no longer able to
move a step. Most people think, well, when it comes to the worst, I can
just walk. I can speak from my own experience that it isn't so. Have you
ever experienced so much pain in a race that you canNOT walk any more? Yes
it happens. And it can also happen that it hurts more to walk than to run (
which I felt in my last long training run). The 100-miler is quite a strange
world. That's why it's exciting.:)
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penguinfly (flying penguin) 于 (Thu Jul 14 16:12:18 2011, 美东) 提到:
D'oh 昨天才免费拿了一堆Ibuprofen。。。
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wangyi3 (wang3yi) 于 (Thu Jul 14 18:12:59 2011, 美东) 提到:
Bad news
"Approximately 40% of marathon runners experience a transient acute kidney
injury." (Changes in renal markers and acute kidney injury after marathon
running.Nephrology (Carlton). 2011 Feb;16(2):194-9)
But good news
Although the marathon is a gruelling physiological challenge, with races
sometimes run in hot and humid weather, acute renal failure is relatively
infrequent. From case reports, a high proportion of marathon runners who
developed acute renal failure had taken analgesics, had a viral or bacterial
infection, or a pre-existing condition. The rare cases of acute renal
failure in marathon runners may be a situation of the 'perfect storm' where
there are several factors (heat stress, dehydration, latent myopathy, non-
steroidal anti-inflammatory or other drug/analgesic use, and viral/bacterial
infection) that, in some combination, come together to result in acute
renal failure.
(Exertional rhabdomyolysis and acute renal failure in marathon runners.
Sports Med. 2007;37(4-5):361-3.)
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foolsgold (When can I do MP 165lbs?) 于 (Thu Jul 14 18:16:25 2011, 美东) 提到:
marathon runner应该还不至于有肾病吧？咱们版上有谁得了。
bacterial
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wangyi3 (wang3yi) 于 (Thu Jul 14 19:26:45 2011, 美东) 提到:
总结一下，40%只是有一过性肾损伤的血液症状，24小时内消失，不是肾病，极少数人
有肾衰，这当中大多数是有其他的诱因或合并症， 吃消炎药是诱因之一。
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serendip (serendipity) 于 (Thu Jul 14 19:28:57 2011, 美东) 提到:
关键词是transient
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Mutu (Camoranesi) 于 (Thu Jul 14 19:32:08 2011, 美东) 提到:
会不会是临时的肾脏出问题了？然后休息2天恢复了？ | R*****s
发帖数: 41236 | 2 学习了。。。
【在 y******n 的大作中提到】
: ☆─────────────────────────────────────☆
: serendip (serendipity) 于 (Thu Jul 14 15:51:58 2011, 美东) 提到:
: Dear Ultra Running Community,
: I am writing to the list to share my story of acute renal failure. I do
: not post to the list often but I feel that this story is important for the
: community to know. I would welcome any questions or comments in regard to
: this report especially from any medical professionals who may be out
: there.
: Some people on this list know me and many do not so let me start with a
: bit of background and then a brief description of what happened to me.
|
|
