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Old 06-25-2008, 07:09 AM   #1
Rayna McGinnis
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Post Rhabdo/Compartment Syndrome

This is going to be long... sorry...

Back in April I was hospitalized with Abdominus Rectus Rhabdomyolysis with Compartment Syndrome after doing the 5 x 30 Back extensions, 25 GHD Sit Ups. I scaled the work out to 3 rounds, but obviously, not enough. They were planning on possibly surgery, but decided I didn't need it and just kept me on IV's and antibiotics for 36 hours. This lowered my cpk levels from 70k to just below 28k before releasing me.

After a week, the surgeon cleared me for minor work outs and told me I could go back to climbing, but to ramp up the intensity slowly.

I went about a month with low intensity, non overhung climbing and would work out on the bike a few times a week and I did Lynn once. After each work out, I'd have minor stomach/abdominal swelling with out any pain.

I took the week over Memorial day off because we had company staying with us and then I started ramping up the intensity, again slowly. in the past month I've managed a new PR on my shoulder press and am almost up to my max in back squat and dead lift. I have a new PR in Pull ups and am managing dips now. So I'm obviously progressing, in some ways, i'm stronger than I was before the injury.

But I keep swelling after each work out and then with in a day or two, all the swelling is gone.

I did the buttercup version of the WOD for 6/16:
20 x sit ups
20 x single unders
20 x sit ups
20 x walking lunges
20 x sit ups
20 x squat thrusts
20 x sit ups.

it felt great- didn't hurt at all and with in an hour, I looked like I was pregnant. The swellings gone now, but i was sore for two days and then felt fine.

I'm wondering if anyone else has experienced anything similar to this. There isn't really any information on post rhabdo or post compartment syndrome except "dont do the exercises that use that area of your body". Which, I of course laugh at because a) I'm an athlete b) what exercise doesn't use your stomach? and c) doctors seem to think it's easy to say don't do it than really find a resolution.

anyway- sorry this is so long- but any information on this would be useful. I've also noticed that I'm still really tired after I work out. For a while, I'd get on the bike for 30 minutes and then fall asleep on the drive home. That's improving, but I still get exhausted a heck of a lot faster than i use to and the swelling concerns me. I also think my primary doctor isn't doing to have a clue, as she works with "average" people and not athletes.

Thanks!
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Old 06-25-2008, 07:57 AM   #2
Scott Borre
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Re: Post Rhabdo/Compartment Syndrome

What is your diet like? (literally break it down, say all that you ate/drank over the last 3 days, including any supplements, vitamins, and medication). Also when you eat in relation to your exercising? Do you feel stressed out a lot?


Bloating after exercise happens to a number of people. Its possible that its due to you being nutritionally deficient. Perhaps you aren't eating enough (ever seen the starving kids, and how they bloat?) Its possible that you are diabetic, are having issues processing gluten, etc. But you may need to just reduce your consumption of salts, sugars, caffeine and alcohol. Its also possible you may need to take some vitamins (temporarily perhaps), and focus more on getting your proper fats.

Your indication of what you eat (post height/weight as well) could definitely help in determining this.

Last edited by Scott Borre : 06-25-2008 at 08:07 AM.
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Old 06-25-2008, 09:20 AM   #3
Scott Ponte
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Re: Post Rhabdo/Compartment Syndrome

Quote:
Originally Posted by Scott Borre View Post
What is your diet like? (literally break it down, say all that you ate/drank over the last 3 days, including any supplements, vitamins, and medication). Also when you eat in relation to your exercising? Do you feel stressed out a lot?


Bloating after exercise happens to a number of people. Its possible that its due to you being nutritionally deficient. Perhaps you aren't eating enough (ever seen the starving kids, and how they bloat?) Its possible that you are diabetic, are having issues processing gluten, etc. But you may need to just reduce your consumption of salts, sugars, caffeine and alcohol. Its also possible you may need to take some vitamins (temporarily perhaps), and focus more on getting your proper fats.

Your indication of what you eat (post height/weight as well) could definitely help in determining this.
I think that this is a little more than a case of bloating. We're also talking about compartment syndrome which is the swelling of muscles. Its not her stomach that is swelling its her actual abdominal muscles.


Rayna- I'm not experianced in this other than I know somone who has had compartment syndrome on his legs. He had it operated on and then promptly moved so I can't comment on the success of his surgeries. Sorry to hear what you're going through.
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Old 06-25-2008, 09:22 AM   #4
Rayna McGinnis
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Re: Post Rhabdo/Compartment Syndrome

My diet's pretty good (i'm studying nutrition)... the past three day's haven't been "ideal" so to say because we're in desperate need of a shopping trip, but as a break down:

Sunday:
Breakfast: Blueberry Wheat Pancakes, Bacon, Coffee
Snack: almonds, walnuts, craisins, dried fruit (was out climbing). Cliff Bar
Lunch: Chicken Salad w/ Honey Mustard Dressing and Hard Boiled Eggs, Lettuce, Tomato, Green Peppers.
Dinner: taco salad (flax chips, ground chicken, taco seasoning, sauce, lettuce, tomato's, alvacodo
and 1 glass of red wine:

Monday:
Breakfast: Veggie Bake- Brocolli, Carrots, Avacodo, Cheddar Cheese, two eggs, olive oil, bacon, 1 glass milk
Snack: Orange
Lunch: Taco Salad (left overs)
Snack: Crab Stuffed Flounder and a no sugar added fudgecicle
Dinner: pan fried chicken, sauted brocolli in smart balance and olive oil and alfredo sauce
1 glass red wine

Tuesday:
Breakfast: Kashi Cereal (honey flax and almond) with Skim Milk
Snack: 2 servings of walnuts and orange
Lunch: pan fried chicken, sauted brocolli and alfredo sauce ( left overs)
Snack: 8 chicken nuggets ( ran out of real food )
Dinner: Speghetti Squash with Pasta Sauce and Ground Beef, 1 peice ezekial bread and smart balance
few bites of no sugar added ice cream that the bf forced upon me ;-)
and a glass of wine...

Now.. I am prediabetic. I do however try to eat a 25/35/40 diet Pro/fat/carb. it's been closer to 30/35/35 lately though, since I've cut way back on processed carbs and no longer eat pasta/rice and the ezekial bread last night was a cheat, i haven't been eating bread either.

I'm not so sure it's diet since I'm relatively strict on that...
my boyfriend thinks maybe the tendon or muscle is messed up from the rhabdo, I had alot of muscle damage, couldn't walk upright for a few days. but I would think that would have healed by now or there would be pain.

the pain i had after the last Work out I did was more of an ache though, like bruised, than pain.

Well- maybe i'm missing something nutrionally, but hopefully this helps.
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Old 06-25-2008, 09:26 AM   #5
Rayna McGinnis
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Re: Post Rhabdo/Compartment Syndrome

for height and weight. I'm 5 ft 6 and weigh about 126/127
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Old 06-25-2008, 09:29 AM   #6
Rayna McGinnis
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Re: Post Rhabdo/Compartment Syndrome

and lastly--- all I really drink is water and milk. the milk is listed, my one cup of coffee sunday morning (though this is rare, like a cup every few weeks)... and for water, I drink about 64 oz a day.

I also work out between my snack and dinner. about 6/7 in the evening. usually swell up with in an hour or so and am sometimes still swallon in the morning. it's hard to tell. pre hospital admission, i swelled up like i was pregnant, couldn't even fit into my pants and then as the day went on, it dropped and moved around. When i was in the hospital, they thought the swelling had gone down, then when i was realised, it all "moved" back into place. essentially, it's just swishing around between my skin and muscles. (i.e. compartment syndrome) ... maybe they should have done the surgery?
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Old 06-25-2008, 11:26 AM   #7
Scott Borre
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Re: Post Rhabdo/Compartment Syndrome

Is it just abdominal swelling or more than that now?

Best thing is to ask your doctor about it. It almost sounds like its reoccurring (for reasons somebody else posted), and ya know the commercials 'could be a sign of...' Ya just need to be sure that there aren't other complications making this occur.

Your diet seems fine as you said.
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Old 06-25-2008, 01:02 PM   #8
Ben Kaminski
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Re: Post Rhabdo/Compartment Syndrome

Have you considered that it could be a hernia?
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Old 06-25-2008, 01:49 PM   #9
Frank E Morel
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Re: Post Rhabdo/Compartment Syndrome

If you had abdominal compartment syndrome... you would be either on death's door step or just plain dead.
In an accompanying editorial, Drs. Balogh and Moore add similar conclusions[9]:

"We strongly advocate that all high-risk patients should be monitored for IAH. This effort would include all shock resuscitation patients regardless of the type of shock and any patients who had intestinal or whole body ischemia-reperfusion, major abdominal surgery, major trauma and burns, and major (especially abdominal) infection."

"Once IAH is recognized, intermittent IAP measurements (every 4-6 hours) are not sufficient since ACS develops in high-risk patients within that time frame, and once the abdominal compartment is in the steep portion of its pressure-volume curve, IAPs can increase suddenly and can be easily missed."

To date no one has randomized patients with ACS to be treated versus not treated. This may never occur due to the overwhelming evidence of high mortality for untreated ACS and the ethical problem associated with randomization of patients into a group that does not get treated.

Despite all this information, it needs to be very clear that treatment for ACS does not guarantee a good outcome. Patients who end up in and ICU are CRITICAL and many die no matter what the clinician does to intervene. However, there is clear evidence that intervention for ACS definitely improves outcomes in some patients who would otherwise die.



So your still working out to hard for your body.. back off and do less. It takes nearly 6 months to bounce back from any type of Rhado


I am not sure why people here think its okay to continue to work out after having rhado ... regardless of what the doc said... start slow like real going for a walk slow.
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Old 06-26-2008, 06:25 AM   #10
Rayna McGinnis
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Re: Post Rhabdo/Compartment Syndrome

well... first off... I think I need to add that my Compartment syndrome was not in the abdominal cavity. It was in between the layers of muscle. The doctors were amazed... they stated they'd never seen fluid accumulating there before and they'd also never seen so much fluid accumulated in the abdominal rectus sheath. So i'm not a typical case by far. They're first expression after examining me was "oh my god" and "how did you do that?!?!" ... then they told me I wasn't leaving.

I'd also like to add, I did start out really slow.. as in.. all I did for the first two weeks is take very slow walks... Then i ramped it up to climbing very easy stuff... as in stuff my grandmother could climb... blind folded. I spent a month doing that. Then I took a week off and slowly ramped up. I haven't experienced any pain and the main concern is that I Swell after exercise without pain.

Pain isn't always the best judgement, but I was told to take it slow and to stop if it hurts, which I've been doing.

I'm not going to lay around on the couch because i'm "afraid" to hurt myself. That's why the average american is overweight and out of shape. I'm prediabetic and I have an under active thyroid... a few weeks on the couch and I'll be gaining weight and my insulin response will be through the roof, not to mention, I'll feel like total crap. I've been careful with any exercises that require my abs ( which is most) and I started off by doing a few sit ups and working that up slowly, as well as starting my squats at 45 lbs, which my pr is 156. Again- slowly ramped up.

I do appreciate everyone's response here, but it appears that everyone is trying to help by relating to the situation the best way they can, but it doesn't appear anyone has any direct experience with any post issues with rhabdo or compartment syndrome. ( which btw, i had.. and I'm not dead :-) ) I'm looking now for a highly recommended sports medicine doctor to check it out. They'll hopefully have a bit more experience in the area.

Again though- thanks everyone!
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