MANILA, Philippines – It is possible that the recent downfall of President Rodrigo Duterte from a motorcycle caused a muscle spasm that forced him to leave Japan in the midst of Emperor Naruhito's coronation celebrations last week, according to two doctors who had not treated him for anything. medical condition.
Share their insights at the request of the Investigator, Dr. Rafael R. Castillo, a senior consultant in cardiology at Manila Doctors Hospital, and Dr. Josephine G. Torres Tuason, a neurology and internal medicine specialist at the Asian Hospital, said the President's complaint about "unbearable pain" was consistent with the trauma caused by such an accident.
Both doctors stressed that their discussion of a 74-year-old patient suffering from muscle spasms following a motorcycle accident was hypothetical and did not need to refer to the President.
But while Castillo, who writes the weekly health column for Inquirer Lifestyle, urges "an elderly person with a complex medical history" like the President to consider the risks of riding a motorcycle at his age, Tuason said it was the prerogative of senior patients to continue driving "As long as he was not in pain . "
Tuason explained that muscle spasms per se "are not life-threatening and can be overcome by pain relievers." Actually, "that should not prevent" a patient "from doing his work" because painkillers and muscle relaxants "can overcome this problem," he said.
Contradicting versions of the President's fall from a motorcycle on October 16 were exacerbated by his premature return from an official trip to Tokyo six days later because of what his spokesman Salvador Panelo described as "unbearable pain."
Senator Bong Go, the President's old aide, later told reporters that the President had consulted with neurosurgeons at an undisclosed hospital in Taguig City, and magnetic resonance imaging (MRI) referred to the condition as "pure muscle spasms."
The president has previously admitted suffering from Buerger's disease, serious inflammation of the blood vessels in his arms and legs, and Barrett's esophagus, which is linked to heartburn and can cause cancer.
The latest health disclosure is to have myasthenia gravis, a serious autoimmune disease characterized by muscle weakness and fatigue.
'Most likely the culprit'
In an email interview, Castillo said a hypothetical discussion about an elderly individual with the same history as the President would show that the "most likely cause" for muscle spasms "was the downfall of his motorbike."
Castillo said the hypothetical individual "obviously" did not suffer a fracture "because if so, he would not be able to walk at all despite powerful analgesics or pain killers.
He added: "This may be due to severe muscle spasms, which can occur due to injury to the muscles, tendons and ligaments in the back."
Castillo said that while a motorcycle accident "might be the final trigger" for severe seizures, it might also be "over chronic or prolonged arthritis in the lower back."
Cardiologists cite degenerative arthritis due to elderly patients and traumatic arthritis that may have been caused by a previous motorcycle accident among several possibilities. (The president once admitted he suffered a spinal cord injury after a motorcycle accident many years ago.)
Tuason Asian Hospital clarified that muscle spasms "are a common symptom, not a diagnosis."
"It's also multifactorial, meaning that it can be caused by many things like exercise, trauma, arthritis and degenerative causes," he said. "Even though it is not life threatening, the patient will be in pain. But he can be given muscle relaxants or pain relievers to overcome the problem, and this should not prevent him from doing his work. He can travel, he can walk. "
Pain is a manifestation of muscle spasms, Tuason said, adding: "The question is," What causes it? "Motorcycle accidents are a possible and reasonable explanation. That's acceptable."
Castillo noted that a doctor who handles cases such as the President "usually requests an x-ray of the spine and other bones. [plus] MRI scans to rule out more serious injuries, including spinal (spinal) fractures, which can affect the nerves, causing pain. "
Tuason believes that anyone who has a motorcycle accident "should see a doctor immediately. And if there is something related to trauma [that is found]X-rays should be performed depending on the doctor's evaluation. "
He said it was the President's neurologist "who must announce" the findings to the public.
Castillo said that in accidents like the President, "usually, patients are prescribed rest, painkillers, physical therapy and / or acupuncture, avoid lifting heavy objects … and not riding a motorcycle anymore."
"That is too risky for the elderly with a complex medical history," Castillo said. "He can feel dizzy for a split second and if he runs fast on a large motorcycle, it can be too risky for comfort."
Tuason declined to comment on the President's other medical conditions, saying Barrett's disease of the esophagus and Buerger were both "non-neurological."
But while myasthenia gravis is a neuromuscular disease, the condition "does not explain muscle spasms," he said. "A common symptom is weakness, not pain."
Again maintaining that he was speaking hypothetically, Castillo said Barrett's esophagus could be ruled out as a cause of back muscle pain due to "symptoms centering on the stomach and esophagus, so patients usually have stomach symptoms or heartburn."
Discomfort from Buerger's disease, meanwhile, comes from inflamed blood vessels in the arms and legs, he said.
"Therefore, the arteries are blocked, and this can cause so much pain, tissue damage, and even gangrene where the toes or feet die or rot," Castillo said. "But severe pain is felt in the toes and feet, and sometimes in the forearms – not in the back. So Buerger's disease can also be removed. "
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