Tuesday, October 16, 2007

Probably Rhabdomyolysis--Cochise Finale

There are six posts below this one, all created on Monday, October 15th, detailing the Cochise Classic Experience. If, however, you want a quick summary, well, here it is.

After only 27 miles, 2 hours and 15 minutes, and a 2,000 foot climb we sat on top the mountain considering options. I felt terrible so we turned around, went back to the motel, crawled back in bed at 5:30 a.m.and slept for three hours and then returned to Tucson.

It was a sign of growth in wisdom and self-care to choose to abort the effort in light of all the investment in getting that far. But it was easy for me to foresee the huge medical hole I would need to climb out of had I gone forward.

The way I've put it together is Rhabdomyolysis secondary to the crush-type injury two weeks ago (L leg), compartment syndrome secondary to the climbing effort, cumulative exertional overload; and renal struggles.

Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents into the circulation. Some of these are toxic to the kidney and frequently result in kidney damage. Some relevant possible causes:

Myoglobin is an oxygen-binding protein pigment found in the skeletal muscle. When the skeletal muscle is damaged, the myoglobin is released into the bloodstream. It is filtered out of the bloodstream by the kidneys. Myoglobin may block the structures of the kidney, causing damage such as acute tubular necrosis or kidney failure.

Myoglobin breaks down into potentially toxic compounds, which will also cause kidney failure. Necrotic (dead tissue) skeletal muscle may cause massive fluid shifts from the bloodstream into the muscle, reducing the relative fluid volume of the body, and leading to shock and reduced blood flow to the kidneys.

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