Drink Water

“Would you like a drink of water?” “Is that all the water you are going to take?” “Have you drunk any water today?” “How much water will you drink?”

Just some of the questions I have been asked all my life. And usually my answer is something like, “No, thanks. ” Or, “I don’t need any more.” “I don’t like it.” “Not much.”

Well, I learned the hard way–again!

I’m not exactly sure what happened and why, but the pain came on quick.

Initially I thought it was a pulled muscle in my back. I couldn’t lie down or sit up, standing was getting worse, and now I was starting to feel sick. I curled up in bed with all my clothes on, blankets pulled up around me, and a beanie on my head. I couldn’t get warm. I was shivering and sweating at the same time. This, I realised, was more than just a pulled muscle in my back.

My guess is that over the last few months, living at high altitude in the desert of Arizona, and drinking my usual amount of water (which isn’t much) caused long-term dehydration and now my kidneys were pissed off and talking to me.

I limped into the hospital, only an hour after the slight, dull ache set in. Now it was full-blown pain. A demon pushing a screw driver into my kidney and slowly turning it around. Then pulling it out slightly, changing his angle, and driving it in again. When I thought I couldn’t take any more, he struck again, moving now to my left kidney to work on that one, too.

Time seemed to be standing still. I couldn’t speak, I couldn’t think, I couldn’t move or sit still, tears were streaming down my cheeks, I was about to start begging when finally I got closer to the doctors with the medication.

When I was younger, I remember my mum telling me that “pain was only in my mind.” This became my mantra until finally the blood cultures were done, the medication concoctions were mixed, and they were ready to pump me full of antibiotics. As the morphine slowly trickled through the plastic tube to my arm and into my blood, I could identify with that mantra, that the pain really was just in my mind. The morphine cutting the receptors in my brain. I was now able to sit, breathe, dry the tears, and start asking all the questions that were racing around my mind.

“When will I get out of the hospital?” “Why did this happen?” “Will I make my flight?” “Will it go away?” “Will it come back?” “I have a race this weekend?” “Will this all be okay for a drug-free sport?”

The doctors and nurses just looked at me. Slightly amused, slightly worried. Without a word from them, I could tell by the look on their faces, my season was over. No TNF EC 50 Mile. Just water, antibiotics, painkillers, and rest for me for some time.

TNF 50 wasn’t an A race for me, but I had begun to feel good from a long, ‘flat’ zone after The Bear 100 Mile. Running around the Marin Headlands just over the Golden Gate Bridge is always a nice way to end the year, racing hard against a super-competitive field. But I was already really happy with my season. Apart from the fact that I was sitting in a hospital bed, connected to a drip of antibiotics and morphine, I was healthy, uninjured, and happy.

This was a serious lesson for me. And I hope for you. I don’t drink enough water. I know that and I have chosen–in the past–to do that. Kidneys are serious. They do a huge job at keeping our bodies clean. The least we can do is respect them and give them some cleaning-up love back.

I was fortunate enough to get into a hospital rapidly and only needed a night of intravenous drugs to quickly get on top of my kidney infection. But it could have been a lot worse. And if only I had gone into the doctor as soon as I felt some bladder discomfort it could have been a lot better, too. Don’t be afraid to ask for help early, even if it means taking antibiotics for a few days!

[Editor’s Note: The following advice from Anna is adapted from an article published by UltraRunning Magazine online on November 24, 2013 called “Running, Rhabdomyolosis, and Renal Failure–Who’s at Risk” by Tamara Hew-Butler and Marty Hoffman.]

How you can you prevent developing kidney problems during training and racing:

  • Avoid taking NSAIDs and/or analgesics like Advil and ibuprofen during a race and training.
  • Don’t race or train hard if you had a recent viral or bacterial infection.
  • Monitor your hydration before, during, and after training and racing. Take into account different elements such as altitude, travel, and humidity.
  • Train properly for the event. If you get injured, race only when you have regained proper fitness.
  • Listen to your body. Do not push through pain to finish a race/training session if you have any warning signs. Seek medical attention immediately if pain comes on in your lower back or you have fever type symptoms.

This is intended to scare you! A warning from me to you to not take our precious organs for granted.

Look after the simple factors in life…WATER! DRINK IT!

There are 3 comments

  1. almondine3

    How does dehydration linked with a kidney infection? Bacteria got mixed in there somehow… Independent (?) of hydration level. But good reminder to drink water!

  2. sharmanian

    An article about hydration without mentioning the most dangerous aspect of it – hyponatremia? Drinking too much is far more dangerous than drinking too little and that's a message that's still not been taken on board by most runners or race organizers. Symptoms are listed here: http://www.mayoclinic.org/diseases-conditions/hyp… but that ignores the worst one – death! This is the cause of a large proportion (most?) of deaths in endurance races.

  3. @alpine_runner

    Great article Frosty, and glad to hear you're on the mend. Are there any good ways to ensure/check you're drinking enough? I've heard of "x litres per day" and of going by urine colour, any recommendations? Obviously drinking too much is very bad too, "Waterlogged" by Prof Noakes is a good read on that subject,

  4. @TracyBethHoeg

    Very sorry to hear about your infection, Anna!! I have to agree with Almondine and Ian Sharman that a kidney infection (pyelonephritis) is not associated with dehydration. As Ian properly pointed out, it can be life threatening to drink too much water while running (due to hyponatremia), so the most important to listen to our bodies and only drink when we are thirsty. With my understanding of the kidney, drinking more water would not have prevented your infection. Get better soon, Anna! You are strong and healthy and will recover quickly if you rest and take those antibiotics. :-)

    Thanks for writing about your experience. This is an important topic for ultra runners to discuss.

    Tracy Høeg, MD, PhD

    1. @TracyBethHoeg

      I responded a bit quickly last night and there have been some great comments that made me think about what I wrote. Anna- what diagnosis did the doctor/s give you? Was it a kidney infection or was it rhabdomyolysis or a kidney stone (as Dave Mackey metioned)? And how dehyrated were you?? What I should have clarified above is that dehydration normally doesn't cause kidney infections, but that more severe dehydration can be a risk factor for problems like rhabdomyolysis and kidney stones (as mentioned).

      Anyway, as mentioned above, the most important is being in tune with our bodies and drinking when thirsty. Overhydration is what we tend to worry about and see more of in races, but that is not to say certain kidney conditions aren't associated with more severe dehydration.

  5. Max

    water is used to flush all the gunk cleaned out from the blood stream away (pee). I'm no medical person but I'd say chronic dehydration means that a fraction of the garbage stays behind in the kidneys, and over time builds up enough to cause an infection. I'm likely wrong, but that's my guess on the subject, This isn't the first time I heard of chronic dehydration linked to kidney problems.

  6. nelsonprater

    I just downed about half of the 32-ounce water bottle that's just been sitting on my desk all day. Thank you, Anna, for the reminder. I tend to otherwise get by on the liquids from coffee and smoothies – and the handheld when I'm running.

    1. __Phil__

      If you're simply talking about kidney health then it doesn't matter what the drink is. Kidneys just need the fluid, any fluid, to run through them, 2 litres a day is good.

  7. @mackeydave

    Did the provider do an ultrasound or abdominal CT to rule out kidney stones? They probably did do some sort of imaging. Sounds like stones vs pyelonephritis. If this was pyelo, then hydration will also help prevent stones, which are just as painful or worse. Good luck with the recovery.

  8. gunpowderj

    correlation and causation can be tricky words, but some have noted a correlation between dehydration and a higher incidence of UTI (10-20% increase in UTI's in the summer months in some countries). others cite dehydration as one of several contributors to UTI. whether this is a simple issue of "flushing" or bacterial dilution as max alludes to, or dehydration's impact on the immune system as a general stressor to the body, it's difficult to say.

  9. senelly

    Although I think water's noblest purpose is beer, I remember the advice of a veteran ultra runner: drink water… early and often. Of course, I'm usually well down the trail when I remember this advice… It is my understanding that chronic dehydration is "epidemic", at least in part (probably) because we have cultivated a general disdain for basic body care. Paradoxically, athletes are routinely told to "suck it up" and wait until after practice before getting a drink of water… Apparently, common sense isn't very common.

  10. @TomCinKC

    Thank you Anna for the reminder, sorry it came at a painful cost. Here in KS when its cold and super dry it is easy not to get enough water. Always good to remember to drink your water!

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