When it comes to shit you can do on a Saturday night, karaoke seems like a pretty low-risk activity. Unless you get super-aggro with your choreography, it's safe to assume that you're not going to dislocate a shoulder, or sprain an ankle, or have to contend with anything worse than a lingering resentment of anyone who can sing Dolly Parton.
But a 65-year-old Chinese man recently became a cautionary tale for what can happen when you go heavy on the high-notes, suffering a collapsed lung after what was described as "a marathon karaoke session."
The South China Morning Post reports that the man, identified only as Wang, started feeling pain on the left side of his chest while he was still holding the mic and belting out songs. "I was very excited in the heat of the moment and after singing a few songs with very high notes, I found myself having breathing difficulties,” he said. He still powered through 10 straight songs, ignored the pain, and went home that night.
The next day, he decided he needed to go to the hospital—and apparently, that was the right decision. "The patient suffered from a lung collapse because of the high lung pressure caused by singing high notes,” an emergency room doctor named Peng Bin-fei said, adding that a collapsed lung could be life-threatening.
According to the American Lung Association, a collapsed lung (also called a pneumothorax) occurs when air escapes into the space between the lung and the pleural cavity, or chest wall. “Because that air has nowhere to go, it keeps accumulating inside this space and builds up pressure between the chest wall and the lungs," an American Lung Association spokesperson explains. "As the pressure and amount of air in this cavity increase it compresses your lung further and further, making it unable to expand when you breathe."
Sometimes a collapsed lung can heal itself, other times a chest tube is required to help remove the air from the pleural space and to allow the lung to re-inflate itself. (The Post did not specify what kind of treatment Wang required.)
Peng Bin-fei suggested that men, especially older ones, probably shouldn't spend more than two hours singing karaoke. We're not doctors, but unless you're the second coming of Freddie Mercury, then you might need a prescription for Knock It Off With the High Notes, too.
This article originally appeared on VICE US.