Tetany

[nbsp]

Ok, so earlier today I went to the university gym to see what the Judo program's all about, and I ended up needed EMS. Yeah. [s:c744136a0c]They have a tournament this weekend, I ate a lot just beforehand, and they worked us really hard, and[/s:c744136a0c] ok I'll just admit it, I'm really physically unfit. But I had a strange case of something, and I was wondering if you guys have an opinion.

So because I had a late class I ate dinner basically 30 minutes before the Judo session. (bad idea). The "Sensei" guy told us to drink lots of water, but I just ate and biked really far and so my stomach wasn't completely settled and so I passed on the water. (bad idea). I'm going to put the exact workout I went through in spoilers because nobody cares.

[spoil:c744136a0c]Running (forwards, backwards, sideways) for about sideways, then we picked up the nearest guy fireman-carry style and started running like that. The guy who picked me up was not only heavier than me, while he was carrying me, his shoulder was in my stomach and I couldn't really breath. Then we did various stuffs, situps, leg lifts, jumpy thingies, pushups, wheelbarrows, some kind of judo thing, etc. At that point I felt the urge to vomit, so I left for the bathroom. [/spoil:c744136a0c]

I'm also putting the description of what happened in spoiler because it's long and tedious. Long story short: Ate dinner right before exercising, didn't drink water, did a workout I wasn't prepared for. Resulted in the need to vomit. I was dehydrated and overheated, but didn't drink because of the whole need-to-vomit thing. Afterwards, I hyperventilated, and my extremities started tingling and clenching up. spread to arms, legs, face, including eyes and tongue. Arms and legs became immobile, breathing became difficult. What helped: water, recovery position, O2.

[spoil:c744136a0c]So anyways, I had to leave for the bathroom because I really felt the need to vomit. I went to the bathroom and leaned over the sink for ~10 minutes, then walked outside and lied on the ground, and that's when my fingers started tingling. I thought it was because they weren't getting enough oxygen so I started breathing harder. (bad idea). I lied on the ground for 5 minutes, then got up and walked back to the martial arts room. The tingling spread to my legs. I sat there for 5 minutes, and the tingling was getting worse and worse, and spread to my face and eyes. My hands started to flex or clench, like when you have your arm in a weird position and the muscles on one side start flexing by themselves. I was still trying to take in more air, because I was convinced the tingling was because I didn't have enough oxygen. (that was pretty retarded, gotta admit.) I had to get on the ground (spread eagle supine), which still didn't help. The tingling was getting stronger and had spread to my tongue, and at that point I was having serious concerns about passing out or brain damage. The sensei noticed and came over to help me. He poured some water on my head, and told me that I felt very hot and was probably dehydrated. I told him that I didn't feel either, and he said "nobody every does". I felt a little better, but not much. At that point my arms were completely flexed and immobile, and my legs were starting to do the same. I was also hyperventilating. The sensei called an ambulance at this point. They had seen this happen to people before but never with clenching muscles. They knew I was most likely dehydrated and overheated, so they gave me some water to drink, but they were holding me up in a sitting position. I tried to get back down into the recovery position, but they wouldn't let me down. I finally convinced them to let me down, and immediately felt much better in that position. EMS came and asked me some questions, gave me O2, which helped a lot for some reason. They asked me some questions and I asked for an AMA, which they gave me.[/spoil:c744136a0c]

What do you guys think it was?

[spoil:c744136a0c]My initial reaction was to suspect some kind of shock, because of the whole tingling extremities thing. The paramedic told me something about hyperventilation removing CO2 from the blood doing something to the calcium in muscles and causing them to clench up. I looked it up and Tetany came up.

Low levels of carbon dioxide causes tetany by altering the albumin binding of calcium such that the ionised (physiologically influencing) fraction of calcium is reduced; the most common reason for low carbon dioxide levels is hyperventilation.

That would be my best guess, anyway

[/spoil:c744136a0c]

[Dustdevil]

This is extremely common in adults who begin a martial arts workout without being in good shape. I'm not ashamed to say it has happened to me more than once, even when I was a much younger adult. Cool, pale, diaphoretic, tachycardic, weak, nauseated, bowels screaming for release. It is an extremely intense workout to begin with. But the clincher is that you are very nervous and apprehensive too, because of the unfamiliarity with the activity. It is as much psychogenic as it is physiologic. Although, it sometimes happens even to experienced martial artists who have just been away for an extended period too. You reacted the right way. Don't let it discourage you. Yeah, it's damn embarrassing, but you just have to buck up and push on. Try it again next class. When the feeling hits you, bow out and take a rest again. In short order, your body will adapt. But remember, in order for your body to adapt to anything, it must be repeatedly exposed, so don't quit or take extended absences.

Good hydration and nutrition, as well as adequate rest, are indeed very important. Your body has to have the tools to work with in order to function optimally. But you are right, having it fresh in your stomach is a bad idea. It's even a worse idea than having an empty stomach, lol. If you take this up as a serious pursuit, then you will establish a routine that works for you. You'll know what days your workouts are on. You'll know what time you have to eat on those days, and what your intake limits are. That will contribute greatly to your body's ability to adapt. The body likes regularity and routine. That is what homeostasis is all about.

Good luck, Bro! Stick with it!

[AnthonyM83]

I thought the decreased CO2 levels and consequent decreased acid levels INCREASED free floating calcium which caused the muscle contractions (I'm guessing in similar manner as calcitonin?). But apparently it's reduced...how does that translate into sustained muscle contractions...Bueller? ER Doc? Beuller?

(Apparently, a number of medics down here think the carpal-pedal spasms are caused by the hyperventilation because one doesn't allow the air to sit in the lungs long enough for gas exchange....at least I've heard them explain that to patients...maybe they simplified it so they'd understand and slow down their breathing.)

[NREMT-Basic]

Or there is the simple answer/best answer Ockums razor explanation that Dust gave. Never hear horses and think zebras.

[AZCEP]

I thought the decreased CO2 levels and consequent decreased acid levels INCREASED free floating calcium which caused the muscle contractions (I'm guessing in similar manner as calcitonin?). But apparently it's reduced...how does that translate into sustained muscle contractions...Bueller? ER Doc? Beuller?

Skeletal muscle is just like any other contractile tissue. It will generate an action potential, the electrolytes will move into, then out of the cell as it needs them to.

Calcium is needed for muscle contraction. When a tissue becomes acidotic, the intracellular potassium is drawn out, forcing sodium and calcium in. This can also occur with a hypocalcemic state if we remember that the value is determined from the ECF.

[Doczilla]

Classic carpopedal spasm associated with hyperventilation.

'zilla

[tniuqs]

Ever see Midwifes sign, Docsilla ?

Forgive my poor spelling in advance.... my evil twin made me spell that...te he.

[AnthonyM83]

I'm still confused on the details of it, probably because different net sources are explaining it different ways.

http://www.medterms.com/script/main/art.asp?articlekey=13312 says it's low ionic calcium in extra and intra cellular spaces (that's measured as low plasma calcium in lab tests....which also confused me b/c where does the Ca++ go if not in the plasma or intra or extra cellular spaces...or does it actually go to plasma, but since it's ionic form isn't detected in the lab tests? And how does that relate to the Wikipedia article saying it affects the albumin binding ).

I'm just trying to track where acidity affects calcium levels, which types of calcium levels (bound or free), and where it goes and make that fit with the different articles.

[logos]

Most of the body's Ca is albumin bound. When you increase the pH you suddenly increase the ability of albumin to bind Ca and thus the fraction of the total Ca that is ionized drops (bound Ca is by definition not ionized). So total Ca would remain unchanged but ionized calcium ("iCal") would be decreased.

Apparently the cost of an iCal relative to a total Ca is what keeps the total Ca measurement in existence, as iCal is much more physiologically relevant.

[tniuqs]

logos:

You beat me to the punch, seriously, a very good post and explanation, most probably better than my ramblings.... cheers.

There is also "in a theoretical model" some consideration of the "Hamburger effect and Bohr and Haldane effects" and having influence in this odd phenomenon but thats making those nightmares of Chemistry come back again....

http://books.google.com/books?id=E9swm5ruD...mp;dq=hamburger

+effect&source=web&ots=NLOj4cHlqu&sig=pmSKNQwut4dNNoQA-zNzCRJraoM#PPA240,M1