So! My review of rhabdomyolysis (rhabdo = something like "rod-shaped" in Latin, a reference to the structure of skeletal muscle cells; myo = something to do with muscle; lysis = breaking; I think of it as tearing cellular membranes apart). Which, like everyone in the hospital, I'm going to shorten to "rhabdo" from now on.
Imagine you wake up one day feeling weak. Your body hurts, especially around the shoulders, thighs, and calves, though rarely to the point where you can't move. But you do feel crappy as you head to the bathroom, and by chance you look down at the toilet before flushing your morning urine -- and your urine's brown!!!
The textbooks say "tea-colored" urine, but patients are usually freaking out because my piss turned black (or red!!!!) holy shit, do something!!! Though if they're screaming, it was a mild case and they'll probably be fine.
Why is the urine dark/"tea-colored"/black/red? Because skeletal muscle cells have lysed, releasing myoglobin into the bloodstream, which then deposits in the renal tubules. Picture time:
This is acute tubular necrosis of the kidney following rhabdo in nineteen year old marathon runner.
The early damage is caused by constriction of the afferent arteriole, the blood vessel that feeds the glomerulus (kidney's functional unit). This leads to ischemia and acidity in the kidney. There's also deposition of myoglobin in the renal tubules, which can only be seen with special stains.
Myoglobin is related to hemoglobin, the protein that carries oxygen in the blood. Interestingly, heme proteins in blood do not seem to cause renal injury in the absence of aciduria and hypovolemia (we always have hemoglobin after all), both of which tend to caused or be caused by rhabdo.
Oh and there's also the hyperkalemia. Like all cells, skeletal muscle cells have a lot of potassium, and if it makes it into the blood, it can cause a heart attack. (I believe the USA uses or used potassium chloride in the lethal injection cocktail).
In response to your blog question, for me, it's going to depend on how realistic the rest of your story is. Like in my superhero/paranormal settings, I've got one that follows traditional world-building setups (bad science/don't know don't care) and another that goes with more philosophical stabs at it. The latter also looks at what some realistic support powers or gear a person might actually need to, say, run fast enough to run on water. But they're not so realistic that I need to go into the aftereffects; that falls under "don't know, don't care". Lol.
ReplyDeleteBut it could be neat if that's part of your focus :)
The way I'm structuring it now, the plague is happening in "our" world, so we have the technology/knowledge to see what it's doing. The problem is that it's impossible to see how it's doing it, hence the speculative fiction part of it. We'll see how it works out once I finish the story.
DeleteAnd of course, the technobabble needs to be kept to a minimum because even I'd get bored of reading about BUN/Cr ratios eventually.
Well, then, if part of the story is looking at the side effects, this would be something you should include.
ReplyDeleteI can just see the super strength guy completely trashing his bathroom when he sees the brown.
I wrote a scene where the first super strength person dies of this thing, and since I was still at the "set up" part of the story, the effects of what happened where somewhat quieter.
DeleteIt's an interesting exercise to write this study. It's certainly prompting me to study stuff. Some of my characters are doctors, so they would think about things in these terms.
Speaking as a lover of science and science fiction, I don't think it's too technical. Your characters who are doctors should be able to talk about these sort of things in a way that will make the reader go--wow, I never knew that. If they're going--wow, I have no idea what they're talking about--you might need to simplify it, but this doesn't sound that technical to me (although I do have a history with biology and the like, so am not necessarily a layman reader.) I ran into a similar issue during the beta-reading of Augment, and adjusted my doctor character's talk about genetics so it was more easily understood by my readers who didn't have a background in genetics. You may find tweaking is needed in scenes where the characters are getting technical, but all your readers will thank you for it--either for making it understandable, or for using science properly.
ReplyDeleteRight now, I'm sprinkling the doctor's dialogue with some technical knowledge (which is hardly technical to them), and explaining some stuff either via making them clarify things for patients/curious laymen, or just having the narrator do it. It's a delicate balance, but I hope to get better at it as I go along.
DeleteThis comment has been removed by a blog administrator.
ReplyDeleteI don't think it's too technical. The symptoms are pretty clear anyway. I think a doctor explaining it will be better than the narrator. Of course, it depends on the kind of voice you are using.
ReplyDeleteI don't think it's too technical. The symptoms are pretty clear anyway. I think a doctor explaining it will be better than the narrator. Of course, it depends on the kind of voice you are using.
ReplyDeleteHopefully, it's not too technical because it's a plot point in my story.
Delete(Tried to delete one of your duplicated comments, but the comment just sort of stays there with the "this comment was deleted" mark. Sort of defeats the purpose of deleting. My bad.)
Nah. Dan Brown is too geeky. When the book becomes about the technology, then it's too geeky. But if it's merely a background, I think you're good :)
ReplyDeleteWe'll see how the beta reading process goes with the book. I'm 1/3 of the way there.
DeleteI've read two books by Dan Brown and care remember maybe one scene in total. But hey, he's a bestseller! Maybe I should go read more carefully.