A bit of a crisis after first metric century!

[the stupid one]

Evening all.

Lovely day for a ride today. I extended a planned 50-miler to a debut 100 km, got home feeling OK, had some food and a coffee, and went to slouch in front of the telly.

About 40 minutes later I went to stand up to say goodnight to our daughter and was floored by the worst cramp of my life, so bad that I shouted for help. My wife came, grabbed my feet and pushed, while I yelped and hyperventilated. Next thing I knew, she was right over me asking if I was aware of what had just happened. I wasn’t, but I’d had a bit of an episode, something like a couple of seconds of spasm.

Mrs the stupid one has skills and equipment. My blood sugar was normal, my blood pressure was very low, my oxygen saturation left a lot to be desired. I went a bit grey and clammy, felt a bit faint, so head back on the floor and feet up while she brought me calcium tablets and milk. And other drinks. And raisins. The cramp returned, almost as bad, so wife grabbed foot and son appeared to massage my solid thigh.

Anyway, when I told her I’d taken three bottles of water with me but only consumed one of them you can imagine the kind of idiots she called me. The conclusion was that the episode was either hypocalcaemic tetany or hypoxic fit (due to the hyperventilation)*.

The takeaway message from all this is that on a warm day and an unaccustomed distance, even if you don’t feel particularly thirsty, DRINK MORE WATER. And possibly take some salts onboard.

Thank you for reading. Drink more water.


* “You don’t get hypoxic from hyperventilation, I don’t know what [caused the hypoxia].” So says Mrs the stupid one.

EDIT II: On further contemplation, Mrs tso now suggests lactic acidosis may have been implicated, largely due to the magnitude of the muscle cramp.

 

[ColinJ]

And if you don't happen to have a Mrs the stupid one with equipment and skills handy, and end up feeling like that ... those symptoms are similar to what cyclists can get with a DVT/PE made more likely by dehydration!

What are the warning signs that should alert you to seek immediate evaluation?

1) Shortness of breath — typically appears suddenly and always gets worse with exertion.
2) Chest pain — Not only “heart attack pain,” but pain when you draw deep breaths, cough, or bend at the waist. It does not go away.
3) Cough — especially bloody sputum.
4) Leg pain and/or swelling — usually in the calf. This is a tough one for cyclists. Our calves always ache. One-sided swelling is a tipoff. Friedman’s was only in his right calf below the knee.
5) Clammy and/or discolored skin — Friedman’s leg took on a reddish hue.
6) Irregular heartbeat.
7) Anxiety, lightheadedness, and/or dizziness.

I ended up with all 7 symptoms when I had my DVT/PE but some appeared gradually over a period of a couple of weeks.

 

[the stupid one]

Thank you sir! She’s now asking me about pleuritic chest pain. There isn’t any.

 

[Pat "5mph"]

We are not used to hot weather!
I did similar a few years ago abroad: it was very hot, I drank my usual gallon of coffee in the morning, no much water during the day, went on a tiring train trip, fainted in the evening during a meal.
I don't like cycling long distances or doing strenuous exercise when it's very hot, even gardening makes me slightly dizzy if I don't take enough water.
You'll be fine tomorrow, lucky Mrs. TSO has the knowledge!

 

[ColinJ]

Thank you sir! She’s now asking me about pleuritic chest pain. There isn’t any.

Remain vigilant though, just in case - my pain arrived later on in the process!

I had heard of DVT before I got ill but never gave it much thought. PE was something that I'd never even heard of until I developed one.

Serena Williams has had DVT/PE twice, so it isn't something that only strikes unfit or overweight people. (I was overweight at the time, though moderately fit.)

 

[Venod]

I have a strange relationship with cramp, sometimes I can ride miles and be completely knackered but never cramp, other times a 40 mile ride will bring on the most violent cramps, I even cramp sometimes when I don't exercise, I am guilty of not drinking enough, but find it hard to drink when I am not thirsty, on an 80 mile club ride last year (at a high pace ) I cramped badly in both legs at about 70 mile it was that bad that I couldn't pedal, I told the group to carry on and I would make my own way home, I got of the bike stretched a bit got on and made a 25mph effort and caught the group up about 3 mile later, they were very surprised to see me as they moving at pace, but not as surprised as I was to catch them.

 

[ColinJ]

Funnily enough ... I did a very hilly 100 mile ride yesterday, didn't drink enough, and started to get significant discomfort in my right calf! It probably WAS the beginnings of cramp, but of all people, I should know better than to take chances with dehydration.

On two of my forum rides, riders got severe cramp on the same steep climb! Both had to leap off their bikes and walk up the hill. I'm sure that dehydration played a part there too.

 

[Cycleops]

Another long-term result of not drinking enough water is kidney stones, even more painful than cramp!

 

[ColinJ]

Another long-term result of not drinking enough water is kidney stones, even more painful than cramp!

I've had those too - yes, you're right!

 

[Heltor Chasca]

Similar plan to carbo-loading, you can also salt-load.

Few days before a long or fast ride and you know the weather forecast, drink plenty of liquid, ideally with electrolytes and salts.

 

[the stupid one]

This is all good stuff - thank you for the replies.

I just ordered a load of Dioralyte from eBay.

 

[Ming the Merciless]

Yes I did 140 hilly miles yesterday. Never drank so much. Stopped at many pubs for lemonades and fill both water bottles up. Keep an eye on whether you have peed during a ride. No pee, and feeling tired, you are probably dehydrated. I carry crisps and nuts for the salt replacement. Rolled in a little after sunset.

 

[Saluki]

Ah, so Mrs TSO is actually Mrs Clever-Woman.
Well done Mrs C-W.
Drink more, she was right. I drink tons and top my bottles too. Salt tissues are very good. I have them and they do wonders for me. Those and bananas.

 

[Dave 123]

Tonic water will help too, plenty of quinine.
The gin can still go in there too!

 

[midlife]

Not sure salt loading us a good idea, raises blood pressure and a few other side effects, plus it's not stored akin to something like glycogen The body is pretty good as sodium homeostasis, best to drink something with electrolyte as the day goes on. Dioralyte doesn't taste very nice, especially the black currant flavour. Add a bit of glucose and more flavouring and it's easier to drink.

If you had hypocalcemia you would have been Chvostek sign positive..... Blimey I've been waiting 40 years to write that, thank you Mr Ganong