Case studies

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All tips/advice given in this website are not to be taken as medical advice or interventions. Always seek professional advice from a doctor before you engage in any strenuous activities or exercise.*

Case study #1

Warning - long read ahead. 

Training with special medical conditions -

Thalassemia. What is it? Genetic mutations in the DNA of red blood cells (RBC) that make hemoglobin, which is a substance that assist RBCs to carry oxygen throughout your body. This mutation is inherited from your parents.

Individuals attempting to train with the condition should be aware of the possible dangers as well and the benefits of doing so.

Case study: Client with no known medical conditions had an onset of sudden and extreme fatigue right after executing a Dumbbell squat, working at 6 / 10 RPE (Rate of Perceived Exertion, self-reported). This had happened twice now. But the first episode happened early in the training phase where the client was assessed to be unconditioned. Both times, the symptoms were pretty serious - with the client having pale lips and face and the need to rest immediately. Training ended there, with the trainer placing himself in close proximity. After assessing the facts, a quick check on past family medical history was done and thalassemia was confirmed on one side of the family. This lead to the high possibility of it being inherited by the client, given the circumstances. Client would then proceed to go for a test to confirm for thalassemia. 

Take away points:

- Closely monitoring your client throughout the session is important as it allows you to provide aid where necessary (spotting, breathing cues, etc.)

- Knowing your client's abilities will allow you to identify any "unusual reactions" they might have during trainings and make appropriate assessments

- For individuals training with thalassemia, do remember to train with a buddy, so you have immediate help when needed and in the event of fainting, you won't go unnoticed.

Other signs and symtoms of thalassemia (Source):

- Facial bone deformities

- Slow growth

- Abdominal swelling

- Dark urine

My personal opinion is that exercise prevails over the dangers. I could not find an article that measured the benefits of weight training for individuals with thalassemia, but landed on an article that measured the effects of of aquatic exercise on quality of life (QoL) and certain blood indicators in Beta-thalassemia major individuals.

Indeed, the study did find positive changes in QoL of these individuals. But we must also note that regular exercise was used in conjunction with drug therapy (Dehkordi et al., 2020). 

But because of the different degrees of thalassemia, I have had friends and close ones who have trained well and hard with minimal or none of the symptoms mentioned above. One of them was also able to build muscle and successfully bulked up.

More details on Thalassemia below.

Reference:

Dehkordi, A. H., Hasani, T., Fekri, K., Deris, F., & Etemadifar, S. (2020). Effects of aquatic exercise on dimensions of quality of life and blood indicators in patients with beta-thalassemia major. International Journal of Preventive Medicine, 11(1), 128

Training with special medical conditions (cont'd) -

Thalassemia (Source)

This condition exists in Alpha and Beta forms. Both having various degrees ranging from mild to severe, determined by - the number of gene mutations you inherit.

Alpha-thalassemia

Has 4 genes. You inherit 2 from each of your parents.

If you inherit:

1 mutated gene, presents no signs or symptoms. But you carry the disease and may pass it on to your children.

2 mutated genes, also known as alpha-thalassemia trait. It presents mild symptoms.

3 mutated genes, signs and symptoms range from moderate to severe.

It is rare to inherit 4 mutated genes. In this event, there's a very high chance of stillbirth or infants with high mortality rates. If the infant does survive, lifelong transfusion therapy is required.

Beta-thalassemia

2 genes make up the beta hemoglobin chain. You get 1 from each of your parents.

If you inherit:

1 mutated gene - known as thalassemia minor or beta-thalassemia. It presents mild signs and symptoms.

2 mutated genes, your - also known as thalassemia major, or Cooley anemia. It presents moderate to severe signs and symptoms.

Babies born with 2 defective beta hemoglobin genes are usually born healthy but develop signs and symptoms within the 2 years. A milder form, called thalassemia intermedia, may also result from 2 mutated genes.