Barbell Medicine Podcast Episode #298: Delayed Onset Muscle Soreness, Quack Watch, Mystery Case, and More
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Jul 5, 2024 In this podcast, they discuss delayed onset muscle soreness, the importance of accurate lab interpretation, a mystery medical case, and unusual causes of rhabdomyolysis. They also critique Equinox's $40,000/year membership plan and explore the complexity of lab results and muscle damage markers.
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Marathoner’s Post-Race Symptoms
- A 35-year-old man developed abdominal cramps and leg pain hours after a marathon.
- Initial suspicion was exertional rhabdomyolysis with key symptoms of dark urine and nausea.
Moderate CK and Liver Enzymes Explained
- His creatine kinase elevation was modest, suggesting well-trained status or mild rhabdomyolysis.
- Elevated AST/ALT can be muscle-derived; white count elevation may reflect stress response.
From Rhabdo to Appendicitis
- Patient’s worsening abdominal pain and vomiting with fever indicated appendicitis.
- Physical exam and labs pivoted diagnosis from simple exertional rhabdomyolysis to intra-abdominal inflammation.