Diet, diabetes, and male chauvinism.

Abstract

Massive muscle breakdown Tests of renal function were taken four days after the incident. All electrolyte concentrations were normal, but the measurements of muscle breakdown aspartate transaminase and creatinine kinase were 1540 IU/l (normal 2-40 IU/l) and 45 860 IU/l (normal <170 IU/l) respectively, indicating massive muscle breakdown. Death from acute tubular necrosis because oftraumatic myolysis has resulted following concentrations of creatinine kinase as low as 3500 IU/1.5 The creatinine clearance as a result was 148 ml/min. Friday saw some recovery as I was now able to stand unsupported for up to five minutes at a time. The urine had returned to a normal colour and I was able to put my socks on (with difficulty). I had clearly a large mass of muscles in my chest, shoulders, and abdomen caused by my strenuous efforts to stand on the water and the prolonged high speed battering while'in the water. Massive release of myoglobin occurred as it does in the crush syndrome,6 and there was a risk of blocking the glomerulus of the kidney with the sequelae of acute tubular necrosis. Fortunately, this was avoided. This potentially severe injury has not been previously reported in barefoot waterskiing yet is a real possibility given the speed and trauma that the torso suffers as it is pulled through the water. Adequate body protection must be worn and repeated exposure to many high speed attempts should not be permitted. Doctors are often accused of playing God in their dealings with patients. This is one orthopaedic surgeon who will no longer attempt to walk on water.