Author Topic: Alexandra and her Health Part 1  (Read 202691 times)

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Offline Greg_King

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Re: Alexandra and her Health
« Reply #30 on: June 01, 2004, 11:26:34 PM »
Alexandra's health is a complex issue.  Never particularly strong or vigorous, she entered her marriage with increasingly ill health; having inherited her fragile health from both her mother and from her grandfather Prince Albert, she also inherited their fragile mentality that often aided in exacerbating any physical complaints.  There's no doubt, as Olga Alexandrovna recalled, that Alexandra was “indeed a sick woman.  Her breath often came in quick, obviously painful gasps.  I often saw her lips turn blue.”  She obviously suffered from real, physical symptoms, but what was the cause?  According to Princess Naryshkin-Kuryakin, Dr. Fischer and Dr. Dranitzin and eventually diagnosed “a severe nervous disorder.”  In 1910, the Empress traveled to Nauheim in Germany, where she spent a month attempting to recover her health at the famed spa, and consulted with several specialists.  Madeleine Zanotti recalled that Dr. Grotte, “did not find in her any signs of heart disease, but symptoms of a nervous ailments for which he prescribed quite a different treatment from the one which she had been following.”  Dr. Eugene Botkin confirmed this diagnosis.  In a letter to his brother Peter, written from Nauheim, Botkin reported: “I am very pained about the malady of the Empress; it is a nervousness of the heart related to the cardiac muscles.  This is affirmed by the physicians here that I have consulted.  I spoke without restriction because I believed it to be in the best interests of the Empress.  I like to let my imagination free to search for different names for the Empress’s condition.”

As this letter indicates, treating the Empress was a difficult matter, for she refused to consider any suggestion that her illness derived from any cause other than an organic disease of the heart.  But Botkin's letter seems to confirm that while the physical symptoms were real, the cause was not organic but psychological.  On her return to Russia, Dr. Fischer, as Zanotti recalled, “presented to the Emperor a secret report on the condition of the health of the Empress.  Fischer foretold accurately what happened later on and insisted on treating not her heart, which he found in good condition but her nervous system.  In some way or other the Empress heard about this report of Fischer and he was instantly dismissed and replaced by Botkin who was on her express desire appointed her physician.”  As the years passed, Alexandra’s ill-health became more pronounced, and during the First World War it seemed to prey on her already highly-strung character, though she unwittingly revealed its true nature to intimate members of the Imperial Court.  “When she found herself among congenial people,” recalled Zanotti, “she was quite well and never complained about her heart, but the moment anything displeased her or people she did not care for came near she immediately began to complain.”  So were the symptoms organic or psychological, as this suggests?  Alexandra didn't do herself any favors by taking veronal, which only exacerbated her fatigue.  It's an interesting conundrum, because the root of the symptoms seem to be a synthesis of both actual, physical ill-health coupled with psychological strains that enhanced and accelerated her symptoms.  But the evidence, such as it is, seems to suggest that there was no organic heart disease involved.

Greg King

Offline Alexandra

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Re: Alexandra and her Health
« Reply #31 on: October 01, 2004, 04:29:40 PM »
Hello, everyone,


I am so glad to find this aspect of the site especially devoted to AF's illnesses, and to read all of your posts. A book which may interest some of you who expressed interest in what you found a refreshingly 'modern' attitude on the part of Nicky and Alix to contraception is Peter Gay's *Schnitzler's Century: The Making of Modern Middle-Class Culture, 1815-1914** [I'm sorry, can't figure out how to italicise the title properly]. I have long suspected that they practised some form of birth control after Alexei's birth, but only recently found confirmation of the fact in King and Wilson's *The Fate of the Romanovs,* p.341.
A propos of AF's medical conditions, today's physicians have a far better understanding of the fact that the body and mind are not two discrete entities, but rather form one unified whole. The question of whether or not an illness is has a 'physical' or'mental' aetiology is thus, in many cases, quite irrelevant, since the suffering has real, physical consequences. [One need only consider that stomach ulcers are caused by stress, but have very real physical sequelae.] Depressive and anxiety disorders are now known [at least, by more intelligent sectors of the population] to have their origin in dysfunction of neurotransmitters, and thus, a range of other processes and symptoms may rise from them. AF's weight appears to fluctuate quite dramatically in her photos; King and Wilson also mention that she had'merkins,' or pubic wigs; and both eating disorders and alopecia may be connected with endocrine or hormone derangement.
The large babies AF produced might have been indicative of a pre-diabetic state, and any and all of her other symptoms can easily be explained by a diagnosis of severe depression and anxiety disorders. Her daughters, too, seemed to experience considerable pre- and post-menstrual tension [AF mentions their irritability when they had 'Madame Becker' in a letter to Nicky in Lifelong Pasion]. I, too, am interested in the possibility of porphyria, but I rather think it unnecessary as an explanation of her condition.

Best to all,

Katherine Alexandra M. Hines

Offline pushkina

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Re: Alexandra and her Health
« Reply #32 on: October 03, 2004, 12:07:09 AM »
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A book which may interest some of you who expressed interest in what you found a refreshingly 'modern' attitude on the part of Nicky and Alix to contraception is Peter Gay's *Schnitzler's Century: The Making of Modern Middle-Class Culture, 1815-1914**


peter gay's books are so good; he is knowledgeable in so many topics that seemingly don't connect (just a few: german and jewish history, the history of medicine and psychiarty, psycho-social history, art history) yet he makes them so accessible and understandable.  he is a universally valuable commentator on the 19 and 20th centuries.

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A propos of AF's medical conditions, today's physicians have a far better understanding of the fact that the body and mind are not two discrete entities...since the suffering has real, physical consequences.


we know that suffering created alix' persona and in a true victorian manner, it seems (to me at least) that suffering was paramount to her and the suffering of alexei's illnesses and  her own illnesses came before any joy that she could have found.  i know there is a xtian component: that suffering makes one come closer to christ and guarantees salvation. her suffering was such that i found it always to picture her marital relationship with N.: most times when the wife is an almost total invalid, marital intimacy is forgotten and lost.  and yet, there it remained in her life and not in a "lie back and think of england " sort of way.  i find that amazing. so many women of that period (and  i suppose any other) sometimes would maximise their illnesses to be able to gracefully get out of 'wifely duties'. but not A.  

another thing that sometimes happens when one is unwell, is that one uses one's illness as a means from escaping unpleasant life.  being wheelchair bound/bed-ridden means that one cannot possible carry out other responsibilities which mean leaving home, or see outside people. being sick allows one to escape totally or to choose what one is willing to do.  as a shy woman, i've often though A. did just that once she began to be sick; when she was sick, she was excused from seeing unpleasant (or just different) people.  she could stay in and just be herself.  it seems that as she got older and the girls were able to sub for her she did just that, claiming to be more unwell as time went on.  was she really so unwell?  after the revolution, when she had to, was she was able to "rise" to the occasion when she had to?

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Depressive and anxiety disorders are now known [at least, by more intelligent sectors of the population] to have their origin in dysfunction of neurotransmitters [and]... both eating disorders and alopecia may be connected with endocrine or hormone derangement.


funny how these tendencies travel in families: did no one ever look at victoria's descendants (after her breakdown after albert's death) and wonder if they had inheirited her tendencies toward melancholia?
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The large babies AF produced might have been indicative of a pre-diabetic state, and any and all of her other symptoms can easily be explained by a diagnosis of severe depression and anxiety disorders.

how much we've changed as a culture!  now we understand that big babies can be/are dangerous and a sign of ill-health in the mother and possibly in the baby.  when i first read N&A, i asked questions about the babies, my grandmother told me quite proudly that she had almost died having such "big, healthy" babies, as big as and bigger than
A.'s. last year, when i was expecting my daughter, based on my remembered history of granma's, i wasn't allowed to gain any weight, my baby was brought early becasue they were afraid of diabetes and pre-eclampsia.

are there any specific  medical articles / literature looking at A. retrospectively and trying to sort out her many ailments?  not that it would change history, but it would be interesting to try and parse them out.  i assume that N. & A. (and of course the children) had extensive medical notes / records.  have any of these been found and published on their own?
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Offline Alexandra

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Re: Alexandra and her Health
« Reply #33 on: October 03, 2004, 12:56:46 AM »
Hi, Pushkyna,

Yes, I am looking for such medical records, too, if any survived. It will be interesting to see if they have been among the material due to be declassified in 2005.
I can't figure out how to have your text and this reply form before me simultaneously, but you asked about whether AF simply withdrew from unpleasant people and situations or ever rose to the occasion, so to speak [if you will forgive me for paraphrasing you]. Yes, in the war years, you will recall, she trained as a nurse and assisted at very gruelling treatments and surgeries, her day often beginning at 7 am and continuing well into the night. GD Olga and Tatiana also did so.In AF, matters of religious response and those of health, including sexual and reproductive matters, are very intricately enmeshed - as indeed they are in many persons, whether on not they ever present for formal psychotherapy. A seventeenth-century book, Robert Burton's *The Anatomy of Melancholy,* does not go amiss as part of one's background reading on the last Tsaritsa, and there is plenty of modern material to provoke thought, as well.

Best wishes,

Katherine Alexandra M. Hines

Dashkova

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Re: Alexandra and her Health
« Reply #34 on: October 03, 2004, 01:01:14 AM »


Pushkina wrote:  now we understand that big babies can be/are dangerous and a sign of ill-health in the mother and possibly in the baby.  when i first read N&A, i asked questions about the babies, my grandmother told me quite proudly that she had almost died having such "big, healthy" babies, as big as and bigger than
A.'s. last year, when i was expecting my daughter, based on my remembered history of granma's, i wasn't allowed to gain any weight, my baby was brought early becasue they were afraid of diabetes and pre-eclampsia.

******I think you make some very good points in this post, particularly regarding Alix, but I wanted to stress where you wrote: "can be/are" with regard to big babies.  As someone experienced in this realm, on a personal level :) I can vouch that such babies and moms certainly *can* be very, very healthy.  I've got two grown up babies in absolute perfect health and know of many, many others.  I wonder if good nutrition may have anything to do with it.  Certainly Alix had the best possible nutrition of the day, whereas many others during that period did not.  The current young generation up to babies being born this year tend to be on the larger side, but also healthy, perhaps due to widespread better nutrition than in generations past.
Just a thought.

Offline pushkina

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Re: Alexandra and her Health
« Reply #35 on: October 03, 2004, 01:30:18 AM »
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Yes, in the war years, you will recall, she trained as a nurse and assisted at very gruelling treatments and surgeries, her day often beginning at 7 am and continuing well into the night.


i find that SO amazing: prior to the war, in the years after alexei's birth, A became an invalid, travelling to take the waters a number of times, being seen by botkin daily and by his specialists called in when needed.  then the war breaks out and A trains to be a surgical nurse (!) and literally rises from her couch and sickbed, to spend gruellingly long days on her feet, doing things that defy logic.  one could look at her and either think, "the will of that woman! what a saint!" OR " if she can stand and do this, was she not really sick all those years?  can she make up her mind please?"

i bet that made problems for people to understand her.  i remember a conversation she had with a soldier after the revolution, during which she explained why she hadn't been seen in public;  not because she shunned "the people" but becasue she was sick!
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Offline pushkina

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Re: Alexandra and her Health
« Reply #36 on: October 03, 2004, 01:38:41 AM »
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I wonder if good nutrition may have anything to do with it.  Certainly Alix had the best possible nutrition of the day, ...  The current young generation up to babies being born this year tend to be on the larger side, but also healthy, perhaps due to widespread better nutrition than in generations past.
Just a thought.


better nutrition, absolutely BUT as we learn more about metabolism and endocrineology, and even perhaps things taht don't have names yet, we are learning that bigger isn't necessarily better and  can mean, there is / could be  a problem lurking.  

i think that once we get over 10 pounds, unless the babies parents are giants, that isn't necessarily better nutrition.  and families can have a history of big babies but also later, a history of silent diabetes or heart disease.
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Re: Alexandra and her Health
« Reply #37 on: October 03, 2004, 02:14:43 PM »
Good points.  I'd like to know if large babies run in certain families, too. In my own case, my family always had babies between 6-7 pounds, so when I had larger babies no one could figure it out until we learned on my husband's paternal side of the family babies of 11 and 13 pounds were the norm. This, too, could be merely a metabolic family history, yet all those in question lived long healthy lives.

Were Alix's large babies deemed remarkable in either family, and were other women in those families also producing larger babies?

 It is interesting to learn about the research in this field, so thanks for the info!
« Last Edit: December 31, 1969, 06:00:00 PM by Dashkova »

rskkiya

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Re: Alexandra and her Health
« Reply #38 on: October 03, 2004, 04:25:14 PM »
Dashkova...Hello!

   Well I was curious, as I have read that Alix suffered from Sciactica (Sp. :-[) would this have been a condition brought on by this sort of "big baby" childbearing? Or was this a preexisting condition? I do know that she often found walking difficult and needed to be carried upstairs on a number of occassions.

R.

 PS. Were all the children as big as Olga?

Sergio

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Re: Alexandra and her Health
« Reply #39 on: October 03, 2004, 05:06:23 PM »
Hello, Rskkiya.
Quote
Were all the children as big as Olga?

When Alexei was born his measures were:
Weight-- 11 pounds (4.6 kg)  :o
Lenght--  58 cm
Head--    38 cm
Chest--   39 cm

rskkiya

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Re: Alexandra and her Health
« Reply #40 on: October 04, 2004, 09:14:32 AM »
Thanks AanastasiaFan :)

I was under the impression that Alix suffered more from Aniexty and emotional stress and any cardiac condition-that really her heart was fine- but when the doctors disagreed with her about this, it only made her more "stressed". I can understand both possibilities.

R.

Offline Michelle

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Re: Alexandra and her Health
« Reply #41 on: October 04, 2004, 04:57:00 PM »
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Dashkova...Hello!

    Well I was curious, as I have read that Alix suffered from Sciactica (Sp. :-[) would this have been a condition brought on by this sort of "big baby" childbearing? Or was this a preexisting condition? I do know that she often found walking difficult and needed to be carried upstairs on a number of occassions.

R.

  PS. Were all the children as big as Olga?


I believe I remember reading possibly on the internet somewhere that (along with Alexei) Maria was around eleven pounds as well, and that Anastasia was also quite large.  Tatiana seemed to have been the only "normal" weight of OTMAA, however even she was  bigger than I was.  I was seven pounds seven ounces. So yes, I do think Olga was definitely surpassed.  I'm deeply sorry that I cannot provide you with the
source(s), but I just can't remember considering I've read SO MUCH over the past few years.

rskkiya

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Re: Alexandra and her Health
« Reply #42 on: October 04, 2004, 09:04:14 PM »
Thanks Michelle...
Sergio had the information!
(thank you too, Sergio.)



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Offline Sarai

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Re: Alexandra and her Health
« Reply #43 on: October 16, 2004, 04:12:44 PM »
Quote

I believe I remember reading possibly on the internet somewhere that (along with Alexei) Maria was around eleven pounds as well, and that Anastasia was also quite large.  Tatiana seemed to have been the only "normal" weight of OTMAA, however even she was  bigger than I was.


On the "Children's Births" thread, the birth weights of the children are given as:

Olga - 10 lbs.
Tatiana - 8-3/4 lbs.
Maria - ?
Anastasia - 11.5 lbs :o
Alexei - 11 lbs.

So it seems Anastasia was the heaviest baby! This weight is directly from Nicholas's diary. Looking at her baby pictures, to me she didn't look quite so big; instead, she seemed like a smaller baby, similar to Tatiana, and not large and chubby like Olga. I can't find the weight for Maria, though - does anyone know?

Offline Michelle

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Re: Alexandra and her Health
« Reply #44 on: October 16, 2004, 06:13:22 PM »
I could've sworn I read in perhaps "The Last Empress" (not that I own it, I was just reading it in Barnes and Noble one day ::)) that Maria was around 11 pounds as well.  :-/

Olga didn't seem to be an exceptionally large baby, none of them did.  She just had a really big head and that's probably why she seemed so big.  I kind of think she was a rather pretty infant, second to Maria whom I think was the prettiest infant.  Anastasia was cute, but not quite 'pretty.'  Tatiana just (in my opinion) looked plain weird.  Please no one be offended. :-[

Tatiana