Rachel Apa was running her first New York City Marathon in honor of her late grandfather when she collapsed two miles from the finish. Doctors are now warning about the rare condition that killed her.
Rachel Apa collapsed and died just two miles from the finish line of her first New York City Marathon on Sunday, November 1.
The 24-year-old was running to raise money for Parkinson’s research in honor of her late grandfather. According to the New York Times, she died of rhabdomyolysis, a rare but dangerous condition that can be triggered by intense exercise.
According to her family she had been in “perfect health.” She had trained for months and also had a background in sports having played Division I field hockey in college.
Two texts to her dad
Her father, Steve, had been checking in with her at every mile. At mile 18, Rachel texted him one word: “Ow.” At the end of the next mile, she wrote: “Ow ow.”
Then she stopped replying.
Her mother, Michelle, who had watched her run past earlier in the race, saw on the tracking app that Rachel had stopped moving after mile 24.
She had collapsed just after passing Michaela Nichols, a hospital social worker who was there to cheer on runners. Nichols rushed over but couldn’t feel a pulse. Three other people, two of whom said they were doctors, started CPR, and marathon medical staff used a defibrillator before an ambulance arrived.
Rachel was taken to Mount Sinai Medical Center, where doctors tried to save her life for six hours, but she could not be saved. The cause of death was rhabdomyolysis.
The symptoms are easy to miss
Rhabdomyolysis is an acute medical emergency. It happens when muscle tissue is damaged and breaks down quickly, releasing substances into the blood that can harm the kidneys and heart.
“The internal components of muscle cells, which include various electrolytes, proteins and enzymes, spill out, and those in turn can be toxic to the kidneys and dangerous to the heart,” nephrologist Dr. David Mariuma, who was not involved in Rachel’s care, told Yahoo.
There are around 26,000 cases a year in the US, according to the Cleveland Clinic, and most are caused by injuries rather than exercise. It’s more common in men, smokers and people with obesity, but it can affect anyone, regardless of age or fitness. Dehydration, heat, being sick, recent alcohol use and certain genetic conditions can all raise the risk.
The early signs are easy to miss, because they can feel like normal race pain. Doctors say to watch for pain or weakness that feels far worse than usual, confusion, nausea, a general sense that something is wrong, or dark, tea-colored urine.
“This is the kind of thing where sometimes everything could go right, you could do everything you’re supposed to do and it still happens,” Mariuma said.
If you notice the symptoms, experts say you should stop, call for help and get out of the heat. Still, they stress that it is rare and shouldn’t scare people away from running.
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