03-07-2021, 03:08 AM
I recently completed my occasional ride to work at the hospital. Approximately 40 miles of flat to moderately rolling hill terrain. I don't do it often due to my leaving work after midnight. It normally takes about 2.5 hours given the traffic lights and various slow downs. I do not crush it since I will be on my feet for 9 hrs during work and need to do another 40 mile return trip.
I left with ample time to spare (30 mins) and started my ride at noon under sunny, but cool (for Florida) and windy conditions; low 70s, 10-12 mph headwind the entire ride. I noticed that I was feeling like I had little energy and attributed it to the wind. This was in the first 3 miles! Not normal for me, but I just thought I had a very strong headwind and would just have to slog against it the whole way. I WAS NOT CARRYING ANY WATER, but I knew I had plenty of places along the way if I needed to get some. After 15 miles I felt absolutely knackered, and although I did not feel the need for water I stopped and obtained a sugary beverage with a little caffeine boost in it (I will not name the brand). It was not an "energy" type beverage, those of which I have never used, and I generally never drink caffeinated products either since I am hyperactive enough without it. I just thought I was a little low on energy so I drank a couple of ounces, maybe 2 swallows, and was back to riding after about a 3 minute stop. During the next 10 miles I took another swallow, and at about 25 miles I stopped for a another swallow and a 2 minute break. I do not utilize a computer so I really had no idea what my average speed was, but I knew I was slow with the wind against me, and I was riding an average of 2 gears lower than my norm. I never got, nor felt hot; and at 30 miles I ran into a cold front with more wind and some very light rain. I actually zipped up my jersey because I was feeling cold even though exerting myself more against the wind and having just gone through the hilliest part of the ride. I barely had to slow down at any intersection and about 2 miles away I sprinted to beat a traffic light which I did without issue. Never a drop of sweat the whole ride. Upon arriving at work I found out it had taken me nearly 3.5 hours, one hour longer than normal! I could not figure out what was wrong, but I was beat; breathing not heavily, but shallow and rapid. I felt light headed and started feeling nauseated. I started working, but my respiration was not recovering (my normal recovery time is 5 minutes). After about 1.5 hours my breathing was still abnormal, I drank about 8 ounces of water (slowly), and then had to sit down. A nurse asked me if I was okay and I said no. At that point I was feeling cold, and the nausea increased; as I told the first nurse that I was feeling more nauseated, another grabbed a vomit bag and within seconds I was emptying my stomach to the point of dry heaves. Only threw up liquid since I don't eat before a long ride. I was hooked up to a vitals monitor and my heart rate was tachy, again way out of my normal range, my blood pressure was off, my oral body temp was a full degree below my normal, and my O2 saturation was way low. I thought at this point that I might be suffering from COVID due to my work environment and the increased exposure I have with patients. I had just gotten my second vaccination dose 2 weeks prior and considered that I might be having a delayed adverse reaction to it exacerbated by my ride. I got wheeled off to the emergency department where I was immediately tested for the SARS COV 2 virus (it was negative!), given a chest x-ray (clear, no issues), and put a on IV drip. After about 2 more hours my vitals started to return to a more normal state, my breathing was better, no nausea, and the chills were abating; but my lab work showed a super high white blood cell count, and there was an indication of renal damage. Almost two days later everything was back to normal, labs and vitals. I had taken about 7 liters of IV fluids, not counting the liquid only meals I was allowed. Diagnosis: acute renal failure due to severe dehydration!
I had not felt ill prior to the ride, nor did I feel exhausted, hungry, or thirsty. I had not been exerting myself under any conditions which would have attributed to my condition. I regularly drink about 2 liters of water each day.
I believe that this resulted from a side effect of my second vaccination (I had no ill effects after the first dose) which had caused me to have chills for about 18 hours; and I think that during that period of time when I had my house at about 8-10 degrees hotter than normal so I didn't feel cold, I had not properly kept myself hydrated while in bed, and I was sweating a lot during that time. I never brought myself back to a normal hydration level which the long ride exacerbated. Less than one hour after being discharged I was back on the bike taking a short but speedy ride, and I felt like nothing had happened, and three hours later I was working my full shift. That ordeal started on Monday, I worked my normal hours from Wednesday through to Friday, and today I just took my first over ten mile ride (into a strong headwind) without any problem.
This was a first for me and hopefully a last. I have ridden 50 or more miles in over 90 degree heat and over 80% RH without issue. I know I'm getting old, but this still has me shaking my head.
So final word: make sure you are well hydrated no matter what; and especially if you have not felt well even weeks prior since it can have a cumulative effect, and it can hit you when you don't expect it. I have not had any health problems prior to this other than the normal bruises and broken bones of a crazy cyclist.
Please continue to be safe both on and off the bike!
I left with ample time to spare (30 mins) and started my ride at noon under sunny, but cool (for Florida) and windy conditions; low 70s, 10-12 mph headwind the entire ride. I noticed that I was feeling like I had little energy and attributed it to the wind. This was in the first 3 miles! Not normal for me, but I just thought I had a very strong headwind and would just have to slog against it the whole way. I WAS NOT CARRYING ANY WATER, but I knew I had plenty of places along the way if I needed to get some. After 15 miles I felt absolutely knackered, and although I did not feel the need for water I stopped and obtained a sugary beverage with a little caffeine boost in it (I will not name the brand). It was not an "energy" type beverage, those of which I have never used, and I generally never drink caffeinated products either since I am hyperactive enough without it. I just thought I was a little low on energy so I drank a couple of ounces, maybe 2 swallows, and was back to riding after about a 3 minute stop. During the next 10 miles I took another swallow, and at about 25 miles I stopped for a another swallow and a 2 minute break. I do not utilize a computer so I really had no idea what my average speed was, but I knew I was slow with the wind against me, and I was riding an average of 2 gears lower than my norm. I never got, nor felt hot; and at 30 miles I ran into a cold front with more wind and some very light rain. I actually zipped up my jersey because I was feeling cold even though exerting myself more against the wind and having just gone through the hilliest part of the ride. I barely had to slow down at any intersection and about 2 miles away I sprinted to beat a traffic light which I did without issue. Never a drop of sweat the whole ride. Upon arriving at work I found out it had taken me nearly 3.5 hours, one hour longer than normal! I could not figure out what was wrong, but I was beat; breathing not heavily, but shallow and rapid. I felt light headed and started feeling nauseated. I started working, but my respiration was not recovering (my normal recovery time is 5 minutes). After about 1.5 hours my breathing was still abnormal, I drank about 8 ounces of water (slowly), and then had to sit down. A nurse asked me if I was okay and I said no. At that point I was feeling cold, and the nausea increased; as I told the first nurse that I was feeling more nauseated, another grabbed a vomit bag and within seconds I was emptying my stomach to the point of dry heaves. Only threw up liquid since I don't eat before a long ride. I was hooked up to a vitals monitor and my heart rate was tachy, again way out of my normal range, my blood pressure was off, my oral body temp was a full degree below my normal, and my O2 saturation was way low. I thought at this point that I might be suffering from COVID due to my work environment and the increased exposure I have with patients. I had just gotten my second vaccination dose 2 weeks prior and considered that I might be having a delayed adverse reaction to it exacerbated by my ride. I got wheeled off to the emergency department where I was immediately tested for the SARS COV 2 virus (it was negative!), given a chest x-ray (clear, no issues), and put a on IV drip. After about 2 more hours my vitals started to return to a more normal state, my breathing was better, no nausea, and the chills were abating; but my lab work showed a super high white blood cell count, and there was an indication of renal damage. Almost two days later everything was back to normal, labs and vitals. I had taken about 7 liters of IV fluids, not counting the liquid only meals I was allowed. Diagnosis: acute renal failure due to severe dehydration!
I had not felt ill prior to the ride, nor did I feel exhausted, hungry, or thirsty. I had not been exerting myself under any conditions which would have attributed to my condition. I regularly drink about 2 liters of water each day.
I believe that this resulted from a side effect of my second vaccination (I had no ill effects after the first dose) which had caused me to have chills for about 18 hours; and I think that during that period of time when I had my house at about 8-10 degrees hotter than normal so I didn't feel cold, I had not properly kept myself hydrated while in bed, and I was sweating a lot during that time. I never brought myself back to a normal hydration level which the long ride exacerbated. Less than one hour after being discharged I was back on the bike taking a short but speedy ride, and I felt like nothing had happened, and three hours later I was working my full shift. That ordeal started on Monday, I worked my normal hours from Wednesday through to Friday, and today I just took my first over ten mile ride (into a strong headwind) without any problem.
This was a first for me and hopefully a last. I have ridden 50 or more miles in over 90 degree heat and over 80% RH without issue. I know I'm getting old, but this still has me shaking my head.
So final word: make sure you are well hydrated no matter what; and especially if you have not felt well even weeks prior since it can have a cumulative effect, and it can hit you when you don't expect it. I have not had any health problems prior to this other than the normal bruises and broken bones of a crazy cyclist.
Please continue to be safe both on and off the bike!
Take care,
Jesper
"I am become Death, the destroyer of bicycles." NJS
Jesper
"I am become Death, the destroyer of bicycles." NJS