Overheated, Underhydrated and On An IV
This past weekend I had the unfortunate luck of having to deal with a situation that I had yet to experience to this extreme. I’m sure you’ve all read, heard and are aware of what it can be like to be dehydrated. I know, this is not some new topic, but even over the last seven years I have never personally experienced anything quite like what happened during my group run last Saturday that landed me squarely on the table of the East 86th Street City MD Urgent Care. As a public service announcement, if you cannot handle some serious running TMI involving a potpourri of bodily fluids then this is NOT the post you should be reading. Consider yourself forewarned.
On the morning of the Saturday in question (July 7, 2012), I was going about my normal Saturday morning routine preparing for my weekend long with runners from the Paragon Sports running group, Juvenile Diabetes Research Foundation NYC Marathon team, and my own Team Sasquatch crew. I got up, washed my face, got dressed, made race weight, had a pint of water, hammered down a Honey Stinger waffle, threw on my shoes, grabbed my Amphipod belt and headed out to meet the group. I jogged it up to Engineer’s gate, getting there promptly at 7:28 am, and saw a couple of runners already there waiting.  As I stretched, I could feel how strong the sun was, the news mentioned triple-digits repeatedly heading into the weekend and I made sure to remind everyone to keep on their hydration and prepare accordingly. How ironic.
Once the group assembled, I noticed I was missing my other pacer, but had others to help me out with keeping tabs on the group for this course (7 & 11-mile options), which included the East River Greenway path, as well as Ward’s and Randall’s Islands. I enlisted a couple of regulars to help guide the 7-mile runners while I took care of running with a faster paced group and chalked the 11-mile route. I just have to take a moment and thank Huge (aka Eugene) and Maura (aka @RunnerNYC) for their help this weekend; I couldn’t have done it without them. Needless to say, the group ended up a bit spread out and I was forced to do some nifty shifting about to keep tabs on everyone whilst still marking the course and keeping everyone rolling.
After about 4-miles of running, which included starting with the faster pace group on the Greenway, connecting with the first group doing the 11-miler and heading onto Ward’s Island over the foot bridge, I start to feel like I need to piss like a race horse (I’m not really sure what that even means, come to think of it). It’s hot out, but not terrible with the variable cloud cover overhead. I head along the Southern tip of the island with a couple of runners chalking the turns as we go and then stop to hit the bathroom just North of a couple of soccer fields. I get in there and there are no problems, all systems go.
I continue about my running duties, trying to catch up to the small group ahead of me, and start to feel a weird abdominal pain, a burning sort of feeling, like athletes foot of my intestines or something. I keep on running and I start to feel like I have to pee again, not like, “eh, I can hold it,†but more like, “if someone is using the toilet right now I hope they are standing up otherwise they’re going to be taking a showerâ€-type of emergency bad!! I finally catch the group and send them off on the final out-and-back section onto Randall’s Island and re-confirm the directions for those just arriving to do the section we just finished. I start running again, looking desperately for a bathroom and see NOTHING. Sadly there is no place to go and not a lot of places to hide with people walking their dogs along the paths or sunning themselves in the quiet “solitude†of the grassy areas along the route. After about 200 meters I just can’t keep going without stopping and taking care of this as discreetly as possible.  I get to a pair of tall bushes, take a look around to make sure I don’t get in trouble, and just take care of it. Um, Houston, I think we have a problem. I barely go at all but feel a bit better … but for how long?
After making that very unexpected pit stop and yielding little to no result my brain quickly shifted gears to breaking down symptoms and some self-assessment as I ran to the nearest water fountain, which was well within eyeshot. I get to the fountain and have some water, even though I’m not thirsty at all … wait, why am I not thirsty and it’s like 90-degrees and I’m running? Yah, not good. I looked down at my arms and I can see dried salt but I’m not really sweating anymore nor do I feel like it is particularly hot out, even though everyone I see is dying in the heat.  Once again, not good! I start “running†again, and running needs to be in quotes, because I also notice that I am no longer really running, I’m more shuffling along … dammit, so not good. I get about a quarter of a mile further, just over the footbridge onto Randall’s when the fire ants in my lower abdomen continue to pour molten lava through my tubing and I have to stop again to pee. What the hell?! This time it kinda hurts even to go and I know what I have to do next, but it will have to wait.
I make sure to catch my group, despite what was becoming an unbearable discomfort with every stride and once we finish the little out-and-back I stop so I can guide the last group correctly for this segment. This time I duck off into the bushes and decide I need to see how bad the dehydration is, cause it shouldn’t be painful or with this feeling like I need to go every eight seconds. Once in the bushes and out of sight I cup my hand and just piss into it so I can check the color. Yes, this is pretty gross, but with neither a place to go, nor a means by which to assess the situation it was a necessary evil. What I discovered much to my chagrin was that I was basically pissing Newcastle (I apologize for those that enjoy the Brown Ale). In that moment, I was just really upset with myself and started working out the ‘why,’ but it was immaterial given the current situation.
Knowing full-well what needed to be done I waited for my last runner to come through and I started jogging back with them, letting them know that I wasn’t feeling well and was going to just run home rather than head all the way back to Central Park. She listened and simply told me, “I wasn’t going to say anything, but you really don’t look good.â€
I cut the run short and struggle home. I get in the door and right into the bathroom so I can really see what the color damage is and what is going on … this time, it was like nice red wine sangria, minus the fresh fruit … “CRAP!! Is that blood?!“ My mind immediately went to the possibilities: 1) Dehydration 2) UTI 3) Delayed onset Syphilis (F-You House MD for making my mind go there!!!!).
Quick, Squatchman … to the Urgent Care!!!
I showered off quickly and I was off to the CityMD Urgent Care on East 86th street, which, if you’ve never been, is actually a pretty good place to go for such things. It’s a clean, efficient and nice place to go by all accounts. I rolled in there, checked in, sat for about three minutes and was brought right in to have my vital signs taken. Blood pressure was good. Temperature was a little low, but that’s normal for me. The doctor told me I have an incredibly strong heart, which I was happy to hear, but to be honest I was more worried about my kidneys. I explained everything to them and they said they’d need some urine and blood to go test. I gave them their samples, this time I was more like Shipyard IPA (once again, apologies).
After a little while they informed me that, 1) It wasn’t a UTI or Syphilis (God, how I hate House MD), 2) It wasn’t Lupus, cause it’s never Lupus (thank you House MD), and 3)Likely what I was experiencing was heat exhaustion, dehydration and rhabdomyolysis. The first of those two most people know, but the last one I needed explained.
Rhabdomyolosis “is the breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream. When muscle is damaged, a protein called myoglobin is relased into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells.â€
So it wasn’t really blood in my urine, but this was still pretty distressing to hear, interesting but distressing. Without further ado they tapped an IV on me. Within about 20-minutes I started getting my color back, apparently I had started turning a little grey during the whole process.
When I was finally released I was told to hydrate like crazy and to keep tabs on my urine color and that they would call me with my test results later. I did as I was told and my urine fluctuated for a while as my kidneys worked on filtering out all of the myoglobin that had built up.  I spent the rest of the day indoors with the a/c cranking and taking it easy. Needless to say this was not what I had anticipated for a nice, slow Saturday morning long run.
What caused it? A perfect storm of factors: my tempo run just 12-hours ago the night before in the crazy heat, not replenishing well enough afterwards, not doing my usual routine to prepare for a hot, sweaty run, not enough water before and during, and the heat the day of. The culmination of all these factors got me some crazy colored pee and an IV. Yuck.  Now, I have to deal with “no strenuous exercise for at least a week and continue to hydrate well,” as prescribed by the MD.  Kinda sucks, but it could be a lot worse.  Pretty thankful I had my whits about me enough to not make it any worse.





















