To say that my (hopefully) last training stint at Fort Benning went worse than expected would be an understatement. After two trips to the hospital, weeks spent following up at the medical center, and countless sticks for lab draws, I am in the process of clearing out from ABOLC and returning to Minnesota 3 months too soon.
This long charade began on Friday, July 13 (fitting), when we conducted our first ruck march of ABOLC. Having already spent 12 weeks at Benning during OCS and having performed four separate 3, 6, 9, and 12 mile ruck marches with little issue, looking back I feel like I may have underprepared thinking our first 3 mile would be a breeze. To say weather in Georgia is a 180 from summer to winter would also be a massive understatement. Essentially the entire month of July was 85-95 degree weather from dawn til dusk, and on this particular ruck morning, I could tell as I was bringing my ruck out to my vehicle to head to squadron that the humidity was killer. Not only that, but simply the pace of the ruck was something I was not quite prepared for, and being a 62 inch female in the fifth out of six platoons, I spent the majority of the back half of the route shuffling to keep up. I have always been adamant about drinking enough water throughout the ruck itself, and never felt like I was physically overheating, just that I was never able to catch my breath and caused myself anxiety over that.
Long story short, I ended up falling out near the end of the ruck (embarrassing, I know), and being taken to the emergency room and diagnosed with mild heat exhaustion. I sat in the ER for about three hours while they pumped me with fluids and sent me on my way. Not a big deal. People recover from it all the time, and at this point, my labs were slightly elevated but nothing to be too concerned about and I had barely missed any training. I went to our classroom instruction that afternoon and spent the rest of the weekend doing virtually nothing. The following Monday was I told to follow up at the Harmony Church TMC (Troop Medical Center) with one of their providers where they would re-draw labs and make sure things were trending downward.
I would come to learn the importance of creatine kinase (CK) labs in upcoming weeks. When my labs were drawn at the ER on the 13th, my CK level was 213 which was just slightly above normal. I began my journey with Lieutenant Colonel Davis at the TMC, a huge man with a booming voice and bright smile–a silver lining to this entire experience. The rest of that week I was put on my first ever profile (a title I was hoping to carry with me, well, forever), where I could do no PT at all. Unfortunately, that week was the first week we started doing actual hands-on work with the Abrams. We spent every day, all day at the motor pool, and Thursday, July 19 we were to take the ABOLC HPDT (high physical demands test), involving a random assortment of physical assessments including carrying/transferring tank training rounds (those bad boys weighed probably ~60 lb?), grenade throwing, simulating lifting a casualty out of a tank, etc., all in full kit including IOTV, ACH, et al.
Feeling pretty good, I asked cadre if I could attempt the HPDT as this was the first major task I was going to face falling behind in. To say things went awful was ALSO an understatement (I’m sensing a pattern here…). Our platoon began with the simulation of transferring training rounds from storage to gun tube, and aside from the movements being awkward and cramped, I simply wore down extremely quickly. It definitely would have been a challenge for me without having been a heat cat the week prior, but I think it would have been doable. Instead, I spent five minutes attempting the motions before actually being tested, wearing myself down harder and harder to the point where I could barely catch my breath again and ultimately not being able to test.
Throughout the entire process, cadre were more than willing to work with me to catch up on things I had missed. This was the first, and should have been the last instance, of trying to climb back into the saddle and do everything everyone else was doing before I was ready. However, the following Monday (the first day I was ‘cleared’ to START doing PT) was the straw that broke the camel’s back.
The second phase of the heat exhaustion profile was to start doing bare minimum PT–I wasn’t supposed to be doing troop PT yet and was limited to walking and light weight work. I tricked myself into thinking everything was A-okay again just because I was feeling good. That morning’s PT was a modified Murph (when I say modified, I mean really modified), where we ran one mile, did 25 pull ups, 75 push ups, 100 air squats, and finished by running one more mile. I went into the first mile telling myself I wasn’t going to go full out, however ended up running faster than I would have liked simply because it’s hard to slow the pace down when everyone around you is going full speed. The first mile was a bit of a challenge but not too bad, and then proceeded to the full body exercises. I finished them all (with some help on the pull ups obviously…I suck at pull ups), and began feeling the repercussions. I did what I could to take extra water breaks and not wear myself down too quickly, and knew I was the last one to start the second mile. At that point, I was hurting. Running absolutely has never, and will never be, my strong suit, but for God’s sake, an APFT is two miles, and I was majorly struggling the second mile.
I was to follow up at the TMC the following Tuesday morning. Even though PT was a challenge the day prior, I woke up feeling pretty good again, and figured I was going to have to go out of my way to push myself to get back to normal. Boyyyy, was I wrong. My CK levels on Tuesday were over 5,000 and AST/SLT levels (indicative of liver function) were also slightly elevated at 95/32. Looking back, I am slightly surprised I wasn’t put on bedrest, but instead allowed to go to the motor pool so long as I stayed in a “cool environment”. Well…that wasn’t exactly going to happen at the motor pool, but the fear of already starting to fall further and further behind in training took over and I did everything everyone else was doing–including sitting in a tank for hours outside in 95 degrees.
During most of these TMC follow ups, I wasted hours and hours of my life in a bed being given fluids and given hope that this was the highest my CK levels were going to be, to follow up in a few days unless I felt worse. Tuesday afternoon, after feeling awesome in the morning, it was all downhill. It became harder and harder to haul myself out of the gunner’s hatch in the Abrams, and I felt massively fatigued. When I got home that evening, my arms and shoulders were so sore that I couldn’t lift them to brush my hair without significant pain. The next morning was when the leg pain and back pain began to start.
For those that are unaware (as I was before this all happened), the classic triad of pain in rhabdomyolysis is the shoulders, lower back, and thighs. Rhabdomyolysis can happen as a result of a variation of events including muscle trauma, drug usage, and (ahem) extreme physical activity. In short, rhabdo (per WebMD) is extreme muscle breakdown, which releases myoglobin into the bloodstream. The problem is that, depending on the severity of muscle breakdown, the kidneys have to filter all this myoglobin out and can ultimately lead to renal failure if it gets too out of the control.
Wednesday morning, feeling as awful as I did, I went back to sick call at TMC to see my ‘ol friend LTC Davis, where my CK levels were over 14,000 and AST/ALT 196/63. While I spent another four hours being given fluids, LTC Davis spent that time calling hospital staff to see if I needed to be admitted. I was sent home and placed on bedrest, to follow up at sick call on Thursday where I was told if my CK levels were the same or lower I would be hospital-free, however if they had continued to rise I would be admitted to Martin Army Hospital on base.
Thursday morning arrived and my CK levels had risen to over 30,000. By Thursday, the pain in my arms and legs had slightly subsided and I felt more pain starting in my back (however, I’m convinced laying in bed for multiple hours at a time everyday didn’t help). I was admitted Thursday morning where I was told my CK levels had peaked at 32,450 and AST/ALT at 429/118, indicating some liver damage (but Dr. says good thing the liver regenerates itself so we can all continue to drink so I guess I’m fine). I was given around the clock fluids from Thursday morning to Saturday afternoon when I was released, with labs drawn every six hours (not to mention having to get up to pee every hour and a half). And with that, my stay at ABOLC had virtually come to a close. Because I am National Guard, I am being sent home (eventually) and will have to be cleared to come back at some point in the future.
I want to make it clear that I’m not looking for advice nor sympathy with this tale. I am writing it because this nonsense happens all too often. Another female from a prior class was inserted into our cycle before I was ever dropped because she also ended up with rhabdo. If there are any takeaways for those that are starting any military training:
- Heat injuries are no joke. I actually don’t recall any heat injuries during basic training at Fort Leonard Wood despite starting training in August. And because I attended OCS in the fall/winter, heat injuries weren’t a concern and we never faced any cold weather injuries either. For the love of God, follow the doctor’s orders. Profiles are there for a reason, and just because you feel okay does not mean your body is ready to jump back into training.
- To follow up on that, profiles are also not a joke. I don’t think virtually anyone was on profile during OCS. And during basic training, the unspoken rule was that if you went to sick call for any reason, you were put on a profile, and at the point it become a revolving door of being on profile. For that reason, I felt like being on a heat exhaustion profile was a sign of weakness and like I was dramatizing what had happened. Well sure shit, Sherlock. My body WAS weak. And it needed time to rest. But that didn’t make ME weak. I guess I would just really urge people to take care of themselves while they have the option to. If that meant I couldn’t participate in PT for a month with my class because I needed to ease myself back into it, that’s what needed to happen, because the short duration of a heat exhaustion profile turned into a multiple month long rhabdo profile that sends me home.
- Listen to the people that matter. Doctors matter. LTC Davis mattered. The cadre, classmates, and other assorted people that continually told me that drinking more water was going to solve all of my problems didn’t know shit about it. I don’t know how many times I was lectured on wearing two pairs of socks on that ruck (for the record, every single day of my military career I have worn two pairs of socks while wearing combat boots. Just because Sergeant Stuffy and 2LT Joe Schmo really think one pair of socks was the answer to my prayers….I do not, and never will care. And also! I didn’t ask for your advice in the first place!). So take your time, do what your providers tell you to do, do what your BODY tells you to do, and fuck the rest.
That’s all I got. See you soon, Minnesota.