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Difficulty to sleep, short of breath, chest tightness and light headed. All test normal with high Creatinine. Suggest?

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
3 weeks ago I tried getting to sleep but unable to..felt short of breath, tight chest/ribs, warm sensations and light headed. Lasted about 2 hours. went away, then on/off. Been to the ER twice to rule out heart. First EKG showed a U wave, 2 follow ups were normal.
I'd been working out with an Insanity program over the past 3 months with no issues, taking Spurotein protein shakes..haven't done so since this episode 2 weeks ago.
initial Creatinine of 127, eGFR of 55, UREA 8.0, CK 206
a day later: Creatinine 110, eGFR 65, UREA 7.4, CK 147
Blood work a week later: Creatinine 109, eGFR 66, lipids, normal, thyroid normal, sodium, potassium, cholesteral within normal limits.
I'm going for more blood work tomorrow for pancreas, kidney, + ultrasound on stomach.

Symptoms over past 2 weeks: at times feel bloated/tight ribs, low to mid back after eating. Eating and drinking water - belching more than normal.
UNABLE to fall asleep...try to get to bed for 11pm, unable to fall asleep until 3or4 and up at 7ish...more difficult to breathe if it's damp/humid/warm.
Sometimes still feel constipated, bloaty, lack of energy, warm sensations/light headed. At times I feel I'm not getting enough O2 to lungs have to walk around...can't lie down on my stomach..sleep (try to) more upright...also noticed I'm becoming hypersensitive (particularly to higher pitched noises) and I've never had that before. The past 4 days I've eaten more veggie based foods, miinimal meat, symptoms not as severe as initially, but still have 1-2 episodes of dizzy/light headed, feeling short of breath. Unable to breath (almost anxiety type feeling) upon entering an indoor water park yesterday (never happened and i've been many times). Also felt dizzy (vertigo like) in a wave pool. My GP is on a medical leave of absence unsure when returning. I now have to wait for him to get back to see my latest blood work (prostate, pancreas, kidney, etc) + ultrasound and Barium enima. New school year around the corner, and I need to be ready to teach in a couple of weeks!

Any ideas on what it could be?
Posted Tue, 10 Sep 2013 in Medicines and Side Effects
Answered by Dr. Shanthi.E 8 hours later
Brief Answer:
Probably you have worked out more than required

Detailed Answer:

I have read your query with diligence - Every single line of it.

I am sorry; I did not understand this statement - "I'd been working out with an Insanity program over the past 3 months". What program is this? Did you try to lose weight? Did you do hard energy consuming aerobic activities? May I know your current height and weight?

I am glad that you stopped this since the episode 2 weeks back.

Here is my opinion:

- To me, it seems like there was a serious and heavy breakdown of energy from the muscle mass. This probably lead to the increase in Creatinine of 127, eGFR of 55, UREA 8.0, CK 206. One week later, this seems to have stabilized.

- There was probably a high catabolic or energy consuming phase in your body when this episode happened.

- Good that your subsequent EKGs came back to normal.

- I hope your blood pressure and pulse rate are normal. Please do get an echocardiography of the heart as well.

- Post this event, anxiety started building up within you, which caused lack of sleep, hypersensitiveness, and panicky attacks.

You must relax to the maximum now. Do deep breathing exercises. Try to meditate.
You should be fine by the time the schools open in a couple of weeks.

I would be more interested to know about your Insanity program. Let me know the details to help you further.

Wish you quick recovery.

Above answer was peer-reviewed by
Follow-up: Difficulty to sleep, short of breath, chest tightness and light headed. All test normal with high Creatinine. Suggest? 19 hours later

I'm 38 years of age, 5'-6" and approx 180lbs. Insanity is an 8 week high intensity workout program created by XXXXXXX T. The Each week consists of 6 workouts, with a recovery workout on day 4. The first block of workouts consist of:
pure cardio - 10 minute warmup and stretch followed by 16 minutes of continuous 1 minute exercises (pushups, running lunges, hops, etc)
Plyo Circuit - 2 sets of 3x3 minute strenuous exercises with 30 sec cooldowns in between..approx 18 minutes of workoutin total
Power and Resistance - similar to above but less cardio.

the second half (where I would often get short of breath by the end) is double the first half.
I also worked out in the basement and did not run my humidifier and it was often humid down there..I did sweat a lot, at times feeling very exhausted. I would drink 20oz of water immediately after very quickly, then have my protein shake for breakfast.

My family doctor is on leave, so I won't be able to get the latest bloodwork. I should be getting the results from my Stress Test and holter monitor. I do have a copy of my heart images from the stress test, but I don't think it's in a format to send you...

At times heavy breathing in and I'll feel a 'funny' pain on left side chest to my throat. I did the less strenuous workouts this weekend, I'm not sure if that or eating a small amount of meat contributed to a short breath/light headed episode last night. I have not taken the protein shakes. My diet is now: cereal, fruit, toast breakfast. lunch XXXXXXX sandwich or soup or a pasta. Dinner salad and a pasta or chicken or salmon...if hungry at night 1-2 slices of toast , nuts.
B12 high potency daily with magnelevures at night. Digestive enzyme b4 meal and probiotic after. I think this along with the odd drink of fibre laxative/prune juice helped with bowel movements...more poor difficult previously. Sleeping better than before but still not even 5 hours straight...takes a couple of hours (10-midnight) to fall asleep then 1-2 hours, wake up to breath then from 3-7...wake up a bit light headed, tingly then usually fine by late moring...
Stopped having medium sized coffee to a small coffee 1/2 decaf with milk/sugar.

Now, I don't know if this is lung related, heart related (i guess i'll know when i get results and then I'll let you know) or if this was from over exercise as you have suggested or if it's gastro. One ER doctor where I was admitted stated it could be gallbladder or Hiatal Hernia (tight ribs, certain foods, short breath, can't sleep on my stomach). Even prior to these episodes, i did have occasional bloated feeling after meals, having to take deep breaths and less than normal stools + belchy.

Sometimes it feels like my sternum is sensitive. Could a hernia or gall bladder bring on attacks shuch as shortness of breath/lightheadedness, tightness in rib/chest area? The other odd thing I've noticed is difficulty breathing in humid places. I need my room cool at night and find it harder to breath in warm places. I was unable to stay in an indoor water park last week and I've been many times!

Follow-up: Difficulty to sleep, short of breath, chest tightness and light headed. All test normal with high Creatinine. Suggest? 7 minutes later add, my HR was at 40 pbm a few times when I was in the ER 2x. ER doc said not to worry as athletes have this rate..But i'm NOT an athlete.. Blood pressure varied from 165/85 to 130/85. my SpO2 went down to 94% at times and my respiration rate went as low at 8/minute...ER doc said not to worry.
Answered by Dr. Shanthi.E 3 hours later
Brief Answer:
You seem to be lucky

Detailed Answer:

Thanks for writing back. In my view, the insanity program does not seem to be working for you. I suggest you to stop this workout.

I am surprised about the ER doctor's opinion. Yes, you are NOT an athlete. Then, how is it possible to be normal and not to worry?

You were in life-threatening situation when this happened. Luckily, you overcame it. Touch wood!

Neither the HR at 40 nor the blood pressure at 165/80 is normal. Even in athletes, it could lead to something known as sudden cardiac death. Respiration at 8/ min is XXXXXXX Spo2 at 94% is still acceptable.

Please stop the insanity workout, and eat and drink healthy. Rest well. Do relaxation exercises; do not strain your muscles and body. Omit the XXXXXXX and chicken from your diet. Salmon is good. Too much of pasta is not good.

Yes, hernia or gall bladder can bring on such symptoms. But, it is less likely in you.

Consider taking antacids like Omeprazole 20 mg early morning daily to reduce the stomach acid secretion. This is available over the counter. I am sure, you would benefit from this.

P S: You just recovered from a life-threatening situation. Please relax and take these measures. You must be ready in a couple of weeks to do the good dead.

Wish you best of health and good luck.

Above answer was peer-reviewed by
Follow-up: Difficulty to sleep, short of breath, chest tightness and light headed. All test normal with high Creatinine. Suggest? 12 hours later
wow! That scared me. Not sure if I just had a bit of anxiety or flush/lightheaded from a less intense workout. I will not continue with this workout. I did complete one yesterday and today, though not at the intensity prior to these symptoms. I will forward blood work results/cardio results when they become available to me.

As an aside, can high intensity plyometric/resistance workouts cause sperm count to be low?
Any suggestions on food/supplements to increase sperm count, motility and morphology?
My sperm count a few days after this first episode was 5 million/mL, 40% motility and 52% abnormal. My wife and I are trying to conceive.

thank you
Answered by Dr. Shanthi.E 10 hours later
Brief Answer:
These can cause low sperm count

Detailed Answer:

I appreciate your decision of not continuing this workout. Sure, please do forward the reports to me. I shall look into them.

Your other concern - yes, high intensity plyometric/resistance workouts can cause a low sperm count. These exercises are strenuous. They burn a lot of body calories, and produce excess heat. This is a high catabolic state. This could increase the scrotal temperature and cause disturbance in sperm genesis or formation - Ultimately leading to low sperm count.

Milk is excellent source for spermatogenesis (sperm formation). A glass of milk twice daily would definitely increase the sperm count. Along with this, almonds also help in spermatogenesis. So are the cashews, raisins and pistachios. Salmon is good too.

20 million/ml is the normal sperm count. Make lifestyle changes accordingly as suggested by me, and you would soon have a healthy baby.

Just to add, smoking is harmful for sperms - it affects the count, motility, morphology of the sperms. If you do smoke, you may want to quit.

Alcohol in moderation is fine, more so with wine. Avoid the hard liquor like whisky, rum, etc with high alcohol content.

Please do not be scared. I was trying to give you information based on my clinical experience, and the outcome of such patients I have treated.

I just want you to be cautious the next time. You still have a long way to go.

I wish your wife and you a happy and healthy life ahead. Good luck!

Above answer was peer-reviewed by
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