Posted on 12/08/2001 5:26:22 PM PST by Proud Canadian
Saturday, December 8, 2001 – Print Edition, Page A10
A Canadian scientist has diagnosed and treated the condition of the most infamous figure in the Who's Who of the Christmas season.
Erica Weir of McMaster University said the 53-year-old male, known to millions but whose name is being withheld to ensure patient confidentiality, is suffering from Addison's disease, with secondary congestive heart failure. He is responding well to therapy, and should be joyful by Christmas, she added.
According to a case report published in the lighthearted holiday edition of the Canadian Medical Association Journal, the patient sought medical help after many years of suffering from tightness in the heart and swollen feet. He was seasonally troubled by insomnia, loss of appetite and irritability, symptoms that left him cranky and grinch-like. He finally went to the doctor because his shoes were too tight.
Dr. Weir said a physical examination revealed that the man's skin was hyperpigmented, giving him a greenish hue. He had also developed a strong aversion to meat, in particular roast beast, coupled with a craving for salty popcorn.
The patient had a mild stutter, "demonstrating a slight tendency toward monosyllabic whole-world repetitions -- 'noise, noise, noise, noise; feast, feast, feast, feast; sing, sing, sing, sing.'" A close examination of the patient's head and neck revealed mild exophthalmos, pronounced micrognathia and a slight torticollis, leading him to complain that "his head wasn't screwed on quite right." But the most disturbing part of the examination, Dr. Weir reported, was auscultation, which revealed faint to barely detectable heart sounds.
The researcher ordered a series of laboratory and radiological tests but, due to long waiting lists and an absence of diagnostic equipment, she had to rely on a local illustrator.
"He was able to provide a clear image of the heart, which could only be described as two sizes too small," Dr. Weir writes in the journal.
This led to a diagnosis of Addison's disease, a rare hormonal disorder that affects about one in 100,000 people. The condition is marked by muscle weakness, darkening of the skin, salt craving and microcardia, or an undersized heart. Addison's occurs when the adrenal glands do not produce enough of the hormone cortisol, which is key to helping the body deal with stress.
The patient reported being highly stressed by holiday rituals, in particular the singing of Christmas carols. His condition has been documented in a Hollywood movie.
Dr. Weir prescribed cortisol replacement therapy, and the man's appearance and symptoms improved, though he began to experience dyspnea, or shortness of breath. This side effect, however, was quickly cleared up whenever the green man travelled from his mountaintop home to a village a short sleigh ride away.
In a footnote to the article, an unidentified CMAJ reviewer notes that he treated a patient with a similar condition, but had access to sophisticated diagnostic equipment.
The scientist reported that imaging with a new type of equipment known as the tickerpiccer, "revealed a plum-tomato-sized heart covered with mouldy purple spots and, as suspected, atria and ventricles clogged with unwashed socks." The lesions were debrided and the socks surgically removed and the patient's condition greatly improved, the reviewer writes.
"In fact, his heart grew not one, not two, but three sizes that day."
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