Evan Fernandez is a former baseball player from Jacksonville University. During his junior year, he collapsed during a baseball team workout. The next 10 days would prove even more difficult, as he ended up fighting for his life in the hospital. He wrote this story in 2017 while in recovery and has decided to publish it for the first time with The Hidden Opponent.
“You’re an anomaly, man.”
The words from my doctor resonated in my mind. It was my second day in the Intensive Care Unit at the Mayo clinic in Jacksonville, Florida.
I am writing this because it is a story that needs to be heard. It is to show other athletes that have ended up in the hospital that they are not alone. It is to educate people on how fragile the human body can be. It’s about preventing athletes from internal bodily injuries. It’s about protecting athletes from themselves and the welcomed rigors of being a collegiate athlete.
My story starts with a conditioning test the previous Wednesday afternoon at Jacksonville University. It was 1 PM and the temperature was in the 70’s. The test was appropriately named “The Crusher.” I left my 11 AM class already dressed in my JU baseball gear, eager to dominate the test in less than 16 minutes –the time limit you had to beat unless you wanted to take it again the following week.
The workout involved 9 different exercises including sled pushes, plate pushes, rope slams, and more.
I had been battling a PCL tear since last summer, but I didn’t ask for any modifications, and they weren’t offered. I wanted to prove to my teammates, my coaches, and myself that I was 100% and ready for the season in about a month.
14 minutes in and I was crushing “The Crusher.” My last exercise was a 100 pound sled pull across the length of a football field. At this point, I was leading the pack and well ahead of the time limit. Then, when I had about 30 yards to go until the finish line, everything went black.
All I can remember is telling myself is “Finish, Evan. Finish!” As my legs gave out over and over again, I found the will to pick myself up and power on. The embarrassment of knowing that I was going to come in at the worst time out of my 32 teammates propelled me forward. I am not the guy who comes in last. I have never been that guy. I am the guy who strives to shatter expectations and works hard to beat every goal that is set. But I could not beat the crusher. It crushed me. 17 minutes and 11 seconds later, with 31 teammates, 4 coaches, and 4 trainers screaming and cheering me on, I crossed the finish line and collapsed. I could vaguely hear the team having a meeting about 10 yards from me, but I couldn’t move. My legs were numb, I couldn’t see, I didn’t know where I was, and I was angry. Angry at myself for not passing this test.
“JU on 3, JU on 3, 1, 2, 3, JU!” My team broke out before dispersing for treatments and showers.
I heard my teammates, coaches, and trainers leaving, but I couldn’t call for help.
I was in a hypovolemic state (low blood volume). This is the same state that people go into when they lose a lot of blood. This is otherwise known as going into shock. In order to make sure my heart and brain continued to receive blood, my other organs would go without. As a result, all of my other organs began to shut down. I was dangerously close to death.
Two teammates approached me asking if I was OK. I couldn’t answer, but I’m thankful that they stayed. They picked me up, supported me on their shoulders and got me to the car. I don’t know if they got me off of that field because the lacrosse practice was starting, or because they recognized I was sick, but if they hadn’t got me to our trainer, I very well could’ve gone into an unconscious state, thrown up into myself and died of asphyxiation right there on that field. Those two teammates, the only people who stayed, probably saved my life.
Less than 15 minutes after collapsing on the trainer’s table, I began profusely vomiting. By this time, I had a cup of electrolytes in me and I could feel my body fighting the hypovolemic state. I wiggled out of my shirt and laid there for another hour or so, still unable to see, speak, or move my legs. I could hear some teammates and trainers standing over me saying, “Wow, he’s pale. He looks like Casper!”
When I finally came to, I was scavenging for fluids. It was like my body went into a primal mode. I found some water in locker room and chugged it. I started bargaining teammates for $1.50 so that I could buy a Gatorade out of our semi-functioning vending machine. I chugged two. I couldn’t get enough.
I showered, did some treatment on my knee, and went home to take a nap. At this point, I wasn’t thinking about my health. I was still angry at myself for not passing the test. I could not understand why my body had betrayed me.
About an hour into my nap, I woke up to awful abdominal pain. My girlfriend at the time convinced me to call my mom, and she convinced me to make the 25-minute drive home to my parents’ house where we would figure out what to do.
My parents know that I don’t complain about injuries, so when I made that call home, they knew it must be serious. The first two times I complained of pain, I ended up with shoulder labrum surgery and appendicitis. Unfortunately, I was about to be 3 for 3.
We ended up waiting until Thursday morning to go to the ER at the Mayo Clinic in Jacksonville, Florida.
When a CT scan showed hydronephrosis, or swelling, of my left kidney, the doctors decided to operate immediately. My first procedure started mid-afternoon on Thursday. I underwent a cystoscopy so that they could look for a blockage in my kidneys or urinary tract. It came back clear.
My creatinine level was 3.1 when I got to the ER and rose to 5.1 by the time the procedure was over. The normal creatinine range is between 0.8 and 1.2. Elevated creatinine levels signify that the kidneys are no longer working to filter toxins out of the blood. If these toxins were not cleared, I would eventually die. My kidneys were failing, but no one knew why.
Friday consisted of pumping me with rapid IV fluids. I was bruised from needle after needle as nurses continued to take my blood, but I was in so much pain I didn’t care. My creatinine had risen to 7.9 by the time I had a consult with the kidney doctors at around 5:00 PM.
I was developing a cough. It was wet, strong, and persistent. The doctors thought it could be from a virus or just from the anesthesia I had earlier.
By night-time, my body was so toxic that it caused me to profusely vomit. I couldn’t sleep or get comfortable, and at 4:30 AM., I woke up my mom who slept on the hospital sofa.
I wasn’t short of breath, but my monitored oxygen levels read 64%. It should have been at 100%. I remember that whenever I breathed in, it sounded like I was gargling water in my mouth. Fluid was flooding my lungs, and I was now going into respiratory failure.
Staying calm is the hardest thing to do when four nurses, three doctors, and a frantic mother (also a nurse) are circling you like sharks. An Internal Medicine resident came in and explained intubation to me. He said I would be put to sleep and a tube would be placed down my throat to breathe for me. This scared the hell out of me. They brought in the Bi-PaP machine –the last ditch effort to avoid intubation –and all I could focus on was breathing and avoiding being intubated.
Bi-PaP was an interesting experience. Imagine being told when to breathe by a rush of air being pushed down your lungs through your mouth and nose. You can’t talk, you can’t yawn, and you can’t break the rhythm. If you do, the air still gets pushed down your lungs and into your sinus’ making your ears pop and you lose your breath. It was like dancing with a respiratory machine for hours at a time. Apparently, I handled it pretty well, as I was able to breathe again on it and well enough to avoid the dreaded intubation.
However, my condition was still not stable. They moved me to the Intensive Care Unit. I stayed in ICU for seven days.
As my creatinine continued to rise on Saturday, reaching 10.1, the doctors kept asking me “what are you taking?” or “what drugs have you done?” I hadn’t taken or done anything.
My mom said to one of the doctors, “Don’t you think he would have admitted doing something when he almost died going into respiratory failure?!”
To which I responded, “wait, I almost died?” And that’s when I started to realize how bad this truly was. I wasn’t getting better. I had almost died twice within 4 days, and now I lay there in the ICU feeling absolutely miserable.
I cried for the first and only time that morning.
The doctors gave me some diuretics that morning that should have made me pee liters and liters of toxins out of my body. It didn’t work, so they turned to hemodialysis.
I didn’t exactly know what dialysis was, but they told me it would make me feel better. I was all in.
A doctor came in and placed a catheter into my neck. It was a tube about a foot long that extended down into my neck and into my internal jugular vein. The “port” had 3 tubes. One for blood to go out, one for blood to come back in, and one for the nurses to be able to draw my blood without having to stick more needles into my bruised arms.
My first dialysis treatment lasted 2 hours. Five foot long tubes of my blood were snaking across the room to a machine where the blood was cleaned and deposited back into my body. It was a weird feeling, but it made me feel the best I had since I had been there. My creatinine went from 10.1 to 9.3 post-treatment. Not great, but it was something.
Sunday was one of the quieter days in the ICU. I was still on Bi-PaP with failing lungs, my kidneys were still in complete failure, and my creatinine rose back up to 10.1. I was to undergo my second round of dialysis that night.
I begged the nurses to try to schedule my second dialysis treatment during the playoff Packers vs. Cowboys game. As a Redskins fan, I wanted the Cowboys to lose miserably. And as a two-year Aaron Rodgers fantasy owner, even though my season was over, I wanted to see some continued success for A-Rodg and the Pack. Boy, did he deliver. The throw and catch to Cook to set up the game winning field goal was amazing. It is a memorable throw and a moment engraved into my memory, as sports distracted me from the tubes of blood that I had coming in and out of me into the dialysis machine.
Monday was a big day. I was to undergo a kidney biopsy. This would answer any questions about chronic illnesses and it would give the doctors a snapshot of the surface of my organ. I was kind of nervous, as I had researched how a kidney biopsy was done. They would inject a local anesthetic into my lower back, making a track all the way down to my kidney. Once it was numbed up, the doctor would take a larger “needle-gun” with a “scooper” on the end and scoop out a piece of my kidney so they could send it to the lab.
God must’ve known I was nervous, because as I was getting rolled down to the operating room, one of my long-time buddies, Marco, strolled in with the instruments for the procedure. He was going to be in the room handing the doctor the tools! He had no idea that I was in the hospital and it was just by happenstance that he was in that room with me. Having a familiar face and voice in there with me made a huge difference as the mood was light, comforting, and we got through the procedure without a problem.
I was brought back to the ICU and began my third dialysis treatment. I got through it without a problem. A few teammates even came to visit me during the treatment. The looks on their faces when they saw my blood winding around the room were priceless.
The next morning was Tuesday morning. My creatinine had been fluctuating around 7.0 since the second dialysis treatment, but after the third treatment my number dropped to 4.2! It was still four times the normal limit, but it felt like my luck was finally turning. But, we had one more roller coaster ride to go on.
The doctors came into the room in numbers. The looks on their faces were grim and my heart dropped into my toes. I tried to lighten the mood saying, “Oh this could be juicy!” but no one said a word. The doctor began giving the results of the kidney biopsy, the good news first: “there is no chronic illness.” Phew, a sigh of relief. They danced around the bad news until my mom breathlessly urged them to get on with it.
The doctors went off on a tangent basically telling me that they found ischemic (dead) tissue on my kidney. Ischemia is caused by lack of blood flow to an organ. The diagnosis was now Cortical Necrosis. This isn’t a death sentence, but it’s as close as it gets for a 20 year old aspiring baseball player. The likely treatment for this illness is dialysis three times a week until a kidney is found for a transplant.
I was pretty shaken up. We all were. Everyone was crying, everyone was mad. But, there was hope still. We were going to do a nuclear medicine scan the next morning to confirm the diagnosis. I held on to that hope.
Overwhelmed, I kicked everyone out of my room. I consider myself somewhat of a loner, so I needed some privacy. Everyone except my girlfriend left and we laid there watching Shark Tank (my favorite show). We didn’t talk about what we feared. I was finally able to eat and not vomit, so I ate for the first time since Wednesday and slept through the night for the first time since Thursday.
Moment of truth.
It was Wednesday, exactly a week after my dreaded workout. The nuclear scan was quick and easy and not even 30 minutes later the doctors came into the room.
The long faces of yesterday had vanished. In their place, pure joy and disbelief.
“Your scans lit up like a Christmas tree!” they exclaimed.
So it isn’t cortical necrosis. No transplants.
My twin sister jokingly sighed a sigh of relief saying that she had already spent the night coping with the prospect of giving her kidney to me assuming we would be a perfect match.
This was great news, but I was very confused. The doctors explained to me that what the biopsy showed was that during “The Crusher,” I pushed myself so hard, that I put my body into hypovolemic shock. There was little to no blood flow in my body and my organs started to shut down. This explained the ischemia in the kidneys. Because I am 20 and healthy, my body fought like hell to keep my kidneys. They were finally kicking back in and blood flow had been restored!
I was finally recovering.
I stayed at the Mayo Clinic for another 3 days, totaling my stay to 10 days and 9 nights. I was in the ICU for 6 of these days.
I stared death in the eyes twice, but now I am on the road to recovery.
The final diagnosis was Acute Tubular Necrosis caused by my body entering a hypovolemic state. We are praying that there are no residual damages other than annual visits to my nephrologist to check up on my kidneys.
I am lucky.
Too many NCAA athletes are ending up in hospitals or worse. A teammate of mine also ended up in the hospital with rising creatinine levels after our workout.
A similar incident made national news during the same week I was in the ICU. Three Oregon football players ended up in the hospital with rhabdomyolysis. A Northern Michigan football player died hours after a workout.
These injuries are happening all over the country, whether it is at a power 5-conference school, a mid-major school, or even junior college. We cannot let these incidences get brushed under the table. As athletes, we all want to get back on the field and get back into routine. But, this induces silence and a shrug of the shoulders.
All of these hospitalizations could have all been avoided. This should never happen. EVER.
I feel compelled to educate. To tell my story. To call for action. Medical staff with IV’s need to be available for student-athletes that push themselves past their limits. Doctors need to approve the conditioning we do. Coaches, trainers, and even players need to be educated by medical professionals to recognize when one of their brothers or sisters are in need of help.
NCAA athletes are special people. We will literally work ourselves to the point of death for our sports. I almost killed myself for baseball.