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!
![[-]](https://forums.bikeride.com/images/flatty/collapse.png "[-]")
