For Your Health

[mr40]

There is a deadly disease that most of us have never heard of.

Two years ago my cousin almost died from rhabdormyolysis, aka Rhabdom. He has no clue how he got it as he was not involved in any exercise except walking. They were on vacation in their RV and he woke up, unable to walk to the bathroom! They called 911 and he was taken to a hospital ER.

Many things can cause rhabdo, including trauma, drug use, statins, severe dehydration, and extreme temperatures. But the growth in exercise-induced rhabdo is getting more attention.

Rhabdomyolysis is a condition that may occur when muscle tissue is damaged due to an injury (rhabdomyo=skeletal muscle + lysis= rapid breakdown). There are three types of muscle in the body, including:

skeletal muscles that move the body;
cardiac muscle located in the heart; and
smooth muscle that lines blood vessels, gastrointestinal tract, bronchi in the lung, and the bladder and uterus. This type of muscle is not under conscious control.

Rhabdomyolysis occurs when there is damage to the skeletal muscle.

The injured muscle cell leaks myoglobin (a protein) into the blood stream. Myoglobin can be directly toxic to kidney cells, and it can impair and clog the filtration system of the kidney. Both mechanisms can lead to kidney failure (the major complication of rhabdomyolysis).

Significant muscle injury can cause fluid and electrolyte shifts from the bloodstream into the damaged muscle cells, and in the other direction (from the damaged muscle cells into the bloodstream).

As a result, dehydration may occur. Elevated levels of potassium in the bloodstream (hyperkalemia) may be associated with heart rhythm disturbances and sudden cardiac death due to ventricular tachycardia and ventricular fibrillation.

Complications of rhabdomyolysis also include disseminated intravascular coagulation, a condition that occurs when small blood clots begin forming in the body's blood vessels. These clots consume all the clotting factors and platelets in the body, and bleeding begins to occur spontaneously.

When muscles are damaged, especially due to a crush injury, swelling within the muscle can occur, causing compartment syndrome. If this occurs in an area where the muscle is bound by fascia (a tough fibrous tissue membrane), the pressure inside the muscle compartment can increase to the point at which blood supply to the muscle is compromised and muscle cells begin to die.

Rhabdomyolysis was first appreciated as a significant complication from crush and blast injuries sustained in a volcano eruption in Italy, in 1908. Victims of the blast injuries during the first and second World Wars help further understand the relationship between massive muscle damage and kidney failure.

https://www.emedicinehealth.com/rhabdomyolysis/article_em.htm#what_causes_rhabdomyolysis

Exercising Yourself to Death: The Rare Risk of Rhabdo

Feb. 22, 2018 -- Nancy Weindruch wouldn’t have called herself an athlete in 2015, but she was a regular gym-goer who loved to ski, golf, and do yoga. She was excited to try something new when her sister invited her to a cycling class for the first time. Within 15 minutes of getting on the bike, she knew she was in way over her head.

The lights were dim. The music was blaring. Everyone was in sync with the high-energy, intense exercise -- except her. “The instructor was encouraging everyone to give it your all, and I was looking around the room and thinking, 'I can’t do this.' I realized very quickly my body didn’t have the endurance for this,” Weindruch recalls.

She was on the opposite side of the room from the door, too embarrassed to get up and leave and unsure she could unlock her shoes from the bike without causing a disruption. So the then-30-year-old sat down on the bike, turned its resistance to the lowest level, and slowly pedaled through the rest of the class.

“When I got off the bike I felt weak in my legs, but I didn’t really think anything of it,” Weindruch recalls. “I just figured it was a new class for me and it will pass.”

Three days later, she could hardly walk and was struggling to sit in a chair. “My intuition kicked in, and I thought something isn’t right,” she says.

A quick Google search turned up a story about a 30-year-old woman who had similar muscle pain after a cycling class and was hospitalized with something called rhabdomyolysis, or rhabdo for short. Weindruch didn’t have all the symptoms described in the story, but she had enough that she went straight to the emergency room.

Once there, lab results confirmed she too had rhabdo. She was admitted to the hospital for a week. “The pain was so excruciating that it contributed to nausea,” Weindruch recalls. “It was unbearable. The worst pain I’ve ever experienced.”

The disorder is dangerous but rare. In one study, 22 people out of 100,000 were known to have it.

What Is Rhabdo?
Rhabdomyolysis is a syndrome involving muscle breakdown and damage. When muscles are injured, they release their contents, including a muscle enzyme, into the bloodstream. The enzyme can harm the kidneys and can cause kidney failure in up to 40% of cases. It also can harm the kidneys’ ability to remove urine and other waste.

Rhabdo can be even more dangerous in children when they're pushed to extremes in sports or other physical activities.

Patients generally recover when they get prompt treatment, but the condition can lead to death in rare cases.



https://www.webmd.com/fitness-exercise/news/20180222/exercising-yourself-to-death-the-risk-of-rhabdo