Two weeks ago my grandson, age 7 ½ was invited to a pool party. At the party, there was a blow up slide,a slippery slide and a pool. Also, it was very hot that day. He probably overdid climbing up and down the slide and rough-housing. When he got home his urine was dark. My daughter called his doctor in Cincinnati, and she began giving him plenty of water. About an hour later, he threw-up. Dr. Rybalski said if his urine didn’t clear up, he would have to get IV fluids at the hospital. His urine did clear up, and he felt better.
Today, the same thing happened. Only this time he did not over exert himself. He was in his backyard pool with his brother and friends. He does like going under water a lot. His mother noticed his lips were getting blue, so she had him come out. While the other children were playing, he was being very quiet, which is not like him. He told his Mom that his urine was dark again, and he had the feeling he had to throw up. He also said he felt like he had “hard burps.” All these symptoms terrify my daughter because she thinks they could be heart-related. The symptoms all dissipated in a short while, and he felt fine again. We are scheduled to go to Cincinnati next Friday, and of course will be explaining all this to the doctors there.
My questions is this: Did anyone experience anything like this with swimming activities? The first time it happened, we thought it was because he over exerted himself, but today he did not, except for diving under water a bit, which of course requires holding your breath. The last time we were at Cincy, his heart and his lungs checked out fine. I would appreciate any feedback you can give.
I'm certainly not a doctor nor have I had anything but some basic first aid training, but these sound like symptoms of heat exhaustion.
Dark urine is usually an indicator of dehydration. Nausea is also common with heat related illnesses. On hot days, I'd encourage him to drink lots of water (possibly a sports drink as well) and take breaks, either in the shade, or in an air conditioned environment.
It is very scary when it happens. My son had this a few times when he was younger, and the very first time was at an MD fundraiser, where they had a big, blow-up bouncy fire truck for the kids. It was not very hot, but since he was young and still functioning very well, I think he over did it on the bouncy structure. At that age,7, when we would tell him to take it easy, he was taking our comments almost as a challenge to keep up with the others. Now he is better able to judge when enough is enough, and he can drink more water on his own without mom and dad having to nag him.
The dark urine is myoglobin, which is released from damaged muscle, and passes through the kidneys and causes the tea or cola color. If a lab did a dipstick on his urine sample, it would be positive for blood (hemoglobin), but it is a false positive result, it is really myoglobin. In large amounts it can cause some kidney damage, and that is why it is so important to dilute it and flush out his kidneys as quickly as possible, as you did. People crushed in accidents can have it, and it's called rhabdomylosis. I also had it as a teenager (am a carrier but didn't know it yet) after an electrocution burn injury.
There have been other discussions on PPMD about this before, and one of the other boys had it on a very cold day (was well dressed but shivering, if I remember correctly). I think it is more a matter of staying hydrated when playing, which is even more important when it's hot.
Glad to hear you have an appointment soon. Good luck to the family.
Thank you for your responses. Andrea, my grandson is very much like your son was at that age. He is only now starting to learn to notice the warning signs. I'm glad we have an appointment soon also. My daughter definitely wants to discuss this with the doctors.