High Sierra Topix

Not sure if this is the right place to post this question but here goes. During a recent trip on the JMT this summer I began to experience hematuria (blood in the urine). After all of the tests were completed they found everything was clear and no problems exist. The doctor suggested in may have been joggers or march hematuria and in reading up on it it is also related to hydration. My condition would flare up after stress (long climbs or long day of hiking) and also when I noticed my hydration level was down. After rest and hydration, the condition would clear. I was wondering if others have experienced this situation as well.

Somehow I missed this post, but Allyn if you're still there...

In addition to being a chronic kidney-stone former, I also occasionally have hematuria after an especially long jog. I'm *very* good about keeping hydrated (because of the stones, of course), but I still sometimes get the blood in the urine. My urologist poked around in my bladder with a camera on a (damn thick -- ouch!) tube and concluded that there's a benign area of many veins being very close to the inside of my bladder wall, and that under the stress of constant pounding minor veins occasionally rupture. He said there was nothing to worry about and that this condition was rather common. Your mileage may vary, of course!

The dehydration thing is quite another matter, and in my humble opinion if that's what's causing your hematuria you *really* need to stop and drink more often! On long hikes I try to time myself and drink one liter per hour. That's a great deal of fluid, but on a warm day going uphill I pee surprisingly seldom, even with that intake. (Going down Whitney on a cool day was another story -- it seemed I had to run off the trail to pee every few minutes, greatly embarrassing my poor son, who was 15 at the time .

Interesting. I didn't know this condition had a name. I've had this occasionally, and especially after one long march out of Emigrant Wilderness years ago. Like BSquared, I'm a stone-former. My doctor didn't buy my hypothesis that it was due to the 13 mile downhill pounding and he put me through an IVP, thinking I had a stone on the move. He would have liked to give me the tube treatment as well, but I talked him out of it.

I have had a chance to look into the condition more over the past year. It seems when you do not have much fluid in your bladder (hence my comment on dehydration) the walls of the bladder will tend to rub together and the blood cells will rub off and into the bladder. It is also exaggerated by the pounding of the bladder when you are on the move (hence joggers hematuria). It is very common among marathon runners but not so common among backpackers or at least those of us who have experienced it don't talk about it much. I too had the camera, cat scans, ultrasoudns and xrays and they all came out negative but not something you want to ignore.

I've read somewhere that hematuria is prevelant in about 80 to 90 percent or long distance runners and about 20 to 30 percent get the visible type (properly called gross hematuria). I have posted similar messages on other boards, including trail journals for the long distance thru-hikers and have had only about 2 to 3 replys. One guy who did the PCT this year had to pull off the trail after the Sierras due to similar conditions.

It is pretty scary discovering blood down there when you are out in the wilderness and many days away from civilization. You read about preparing for all kinds of emergencies, but I never read about this one!

Thanks for the input and BSquared good luck on your trip next year!

Thanks, Allyn. I didn't realize that an empty bladder was more prone to producing those symptoms, but the way you put it, it certainly makes sense. I'm going to have to postpone my next JMT jaunt yet another year, however, as there's an important family event this coming summer at just the time I'd need to be out there. Sigh. There always seems to be *something.* The good thing is that the family event will involve a trip to the Snowy Range (near Laramie, WY), perhaps my second-favorite mountain range, so I won't go completely without my mountain fix.

Something I really meant to mention is that the first time you do see blood in your urine, it really is extremely important to get the scan/camera thing done! It could be a sign of bladder cancer, and of course that's something you want to deal with immediately.

I played alot of soccer when I was young, thats 6=7miles of wind sprints and I learned from a Turkish player that you need to Pre-hydrate. If I had a game at noon, I start drinking water at 8:00am until game time. I try to drink 40-60 oz before the game. Yes Hitting the bathroom alot, and maybe I over do it a little. I try to drink 100-120 oz a day normally, with no ice.. I pre-hydrate before running or biking, haven't had a dark yellow pee in years..

Hugely interesting. Many thanks to all for description of causes. Over the years, I've run into a number of people with blood in the urine. One of the other rangers medivaced two people this year with those symptoms. One was released right away, the other went into kidney failure. On something like this, we'd get a base hospital contact and let Regional Medical Center in Fresno figure it out. Of course, flank pain is a clue for the kidney problems as the cause, but there's no point in taking chances.

When in doubt: stay hydrated... .

thanks,

g.