condition that killed<\/a> 24-year-old marathoner Rachel Apa just hours after she ran the New York City Marathon on Sunday.<\/p>\nMadina Alam thought she was experiencing normal post-workout soreness, but four days later she was in the emergency room.<\/p>\n
A workout gone wrong<\/p>\n
In 2022, Alam was working out weekly with a personal trainer in Charlotte, North Carolina.<\/p>\n
A licensed mental health counselor, she wasn\u2019t preparing for a competition. \u201cI just like to work out,\u201d she explained.<\/p>\n
The trouble started after she completed a set of eccentric pullups, also known as negative pullups. Despite being fit and in shape, she hadn\u2019t yet mastered the exercise.<\/p>\n
\u201cI obviously did way too many,\u201d she recalled. \u201cMy arms were swollen immediately after.\u201d <\/p>\n
She remembers telling her trainer she couldn\u2019t fully straighten her arms, but says \u201che didn\u2019t really think much about it.\u201d<\/p>\n
The pain and swelling only got worse throughout the day. <\/p>\n
Unable to move much, Alam stayed home for several days, not even changing her shirt so as to avoid raising her arms. Still, she hadn\u2019t taken any over-the-counter painkillers.<\/p>\n
\u201cLooking back at it, I\u2019m like, \u2018Madina, why did you not go [get medical help]?’\u201d she said. \u201cI thought it was gonna go away.\u201d On FaceTime, even her trainer agreed.<\/p>\n
The therapist says her experience taught her that even fit, experienced athletes can push their bodies too far.<\/p>\n
But a friend raised another possibility: \u201cOh, you might have rhabdo,\u201d he told her, referring to rhabdomyolysis, a rare, life-threatening medical condition that can occur after excessive exercise without rest.<\/p>\n
However, he brushed off the thought after learning her urine hadn\u2019t changed color \u2014 a common but not universal warning sign of the condition, in which urine typically appears dark, tea-colored, red or cola-colored.<\/p>\n
Four days after the workout, Alam\u2019s swollen arms had become so uncomfortable that she couldn\u2019t sleep, waking up every few seconds. After she described her symptoms on a call to an urgent care clinic, the staff urged her to head to the emergency room.<\/p>\n
At the hospital, \u201cthey took me back immediately\u201d to get examined, Alam said. By that point, her arms had puffed up an additional 12 pounds.<\/p>\n
Blood tests soon revealed that her creatine kinase levels, a marker of muscle damage, had reached 80,000. Normal numbers are under 200.<\/p>\n
This confirmed Alam did, in fact, have rhabdo, due to damaged muscle tissue breaking down and releasing proteins and electrolytes in her bloodstream.<\/p>\n
Alam was admitted and given an IV with fluids and electrolytes to help her kidney flush the excess muscle proteins and other substances from her system, while morphine helped manage the pain.<\/p>\n
\u201cTrainers will look at me and go, \u2018What\u2019s rhabdo? Oh wow!\u2019 and that makes me honestly cringe.\u201d<\/p>\n
Madina Alam<\/p>\n
\u201cI even remember one morning they had brought in a group of student doctors just because it\u2019s kind of rare to see,\u201d said Alam.<\/p>\n
After a week in the hospital, she was discharged, her arms having returned to their normal size. <\/p>\n
When rhabdo turns deadly<\/p>\n
When Alam learned about Apa\u2019s death<\/a>, the news \u201cfelt like a gut punch.\u201d<\/p>\n\u201cIt was just like, \u2018Oh my God, I can\u2019t believe someone passed away from that,’\u201d she said.<\/p>\n
Rachel Apa died just hours after running the NYC Marathon. Michelle Apa<\/p>\n
Apa had developed rhabdo, the same condition that landed Alam in the hospital. Michelle Apa<\/p>\n
While Alam recovered, rhabdo can be fatal. As muscle tissue breaks down, the kidneys can become overwhelmed by the sudden influx of proteins and electrolytes, potentially leading to acute kidney failure.<\/p>\n
Excess potassium in the bloodstream can also disrupt the heart\u2019s electrical signals, triggering potentially fatal arrhythmias or cardiac arrest.<\/p>\n
\u201cIt just makes me sad,\u201d said Alam about Apa. \u201cIt makes me also appreciate that I caught it in time. As horrible as the story is, it will shed light on this, so more people will be aware of the symptoms.\u201d<\/p>\n
\u201cHopefully, this doesn\u2019t happen to someone else.\u201d<\/p>\n
Alam is also urging personal trainers to learn about the condition. While she doesn\u2019t blame her trainer for her rhabdo development, she believes his lack of awareness contributed to her not recognizing the warning signs or immediately seeking medical care. <\/p>\n
\u201cI\u2019ve shared [my story] actually with a lot of trainers,m and trainers will look at me and go, \u2018What\u2019s rhabdo? Oh wow!\u2019 and that makes me honestly cringe,\u201d she said.<\/p>\n
For others who look and feel fit and healthy, as both she and Apa did, Alam has one piece of age-old advice.<\/p>\n
\u201cIt sounds corny, but just listen to your body,\u201d she urged. <\/p>\n
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