My letter to the Ultra List back in 2004

Dear Ultra Running Community,

I am writing to the list to share my story of acute renal failure. I do
not post to the list often but I feel that this story is important for the
community to know. I would welcome any questions or comments in regard to
this report especially from any medical professionals who may be out
there.

Some people on this list know me and many do not so let me start with a
bit of background and then a brief description of what happened to me.

I am a 37 year old male ultrarunner. I am 6 feet tall and 170 pounds. I
have been running ultras since 1997. I ran my first 100 miler in 2000
(Angeles Crest) and knew from that point on that I had "found" my
distance. In five years I have run 7 100 milers (3 AC's, 2 VT's, and 2
WS's). 100 milers have become the focus of my training and the highlight
of my year. In 2003 and 2004 I ran two each (VT and AC in 2003 and WS and
AC in 2004). Aside from the usual aches and pains associated with
recovery from 100 mile races I have never needed medical intervention
following a race and have always felt pretty much back to normal about a
week after a race.

This year at AC my story was very different. I had what I felt was a very
good race this year finishing in 19:53 and taking 15 minutes off my time
from last year. After finishing I was completely wiped out but doing OK.
I spent about 4 hours in the med tent and slept pretty well. I had a
massage and was hobbling about in my usual post-100 miler daze. The first
indication that something was not quite right came at about 9:00 AM Sunday
when I had a single episode of brown, coffee colored urine. It was not
painful and it was only one episode. I told my wife about it and we
essentially passed it off as a deep, yellow urine that was simply the
result of dehydration. I continued to push fluids and felt OK. The drive
back home was uneventful and I made it it work on Monday.

That afternoon I began to feel flu-like symptoms and decided to stay home
from work on Tuesday to recover from what I thought was the flu. I had
low-grade fever and general body aches. I just couldn't seem to shake
these symptoms. I continued to urinate normally but my muscle soreness
was not improving. In addition, I felt something in my stomach and back
that felt like constipation. By Friday the pain had not increased at all
but the general malaise I felt was still present. The "constipation"
feeling persisted and I had no energy. Finally, on Saturday afternoon
(one week after the race) I went to the hospital and was evaluated in the
Emergency Room. The doctors concluded that I had a severe case of
Radbomyolysis (muscle protein in the kidneys) and that I was in acute
renal failure. After five days in the hospital, 18 litres of fluid, one
kidney ultrasound, and many hours of contemplating my future in running
100 mile races I returned home humbler and more mortal that I have ever
been before.

Of course, I have many questions about this whole thing: Why did this
happen in my 7th 100 miler? Can I run these things anymore? Are there any
warning signs besides the brown urine? Can I train to avoid this? Is
there anybody out there with a similar story?

Today my kidneys are back to 90% of normal function and the doctors
anticipate full recovery. In the hospital I ballooned to 203 pounds
before beginning to shed the fluid and now I continue to urinate every 30
minutes and I am feeling like I might even be able to go for a short run
this weekend. All in all, this was a serious wake-up call for me and one
which I will not ever forget. I hope this story can help future runners
avoid renal failure and perhaps even motivate more 100 milers to take
blood tests after races to determine myoglobin content in ailing runner's
blood.

Please do not hesitate to contact me off line with comments, questions, or
advice.

Yours,

Andy Jones-Wilkins