Author Topic: Re: Alexandra and her Health Part 2  (Read 160466 times)

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Offline Phoenix

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Re: Alexandra and her Health Part 2
« Reply #495 on: February 10, 2018, 11:51:23 PM »
In the list of the search of Ipatev House on the Ap main site, i found out that in IH were found 2 homeopathic remedies: ignatia & aconitum
Since i am personally interested in homeopathy & use it myself to treat me, i thought it was interesting to talk a bit about it - i didn't find anything specifical in the thread so here i am.

From the web & my personal books (sorry for the rought translation)

IGNATIA: people who need ignatia are emotionally unstable; often introvert & lonely, usually close into themselves and think again and again to real or imaginary insults but didn't want to move other's pity and feel insulted if that happens. Get easily nervous, but often don't show their bad emotions. They like contradict other, but don't want others to contradict them. Exagerrate events & are unable to bear phisical pain and usually feel exhausted.
Unstable mood: from cry to laugh without reason.
They are often unders stress (real or not), depressed, isolated, laconic, they suffer from insomnia and are ipersesitive. They generally suffer from headaches, anxiety, panic attacks, phisical pains (expecially in legs and arms and heart), feeling of too fast palpitations and a psycosomatic cough.

This seems to me a good portrait of Alix in her last months. Of course, most people don't believe in homepathy, but i think this could be a nice discussion.

ACONITUM: For peolpe with anxiety, nervousness and fear of Death. They suffer from headaches even if they could seem healthy and strong. Their posing is rigid, they have trouble breathing. They usually suffer from varius phisical pains because they always are defensive towards the whole world.

What do you think?

I think this is very interesting. It seems to me that back then people could pretty much self-medicate with anything they wanted. So different from today when everything is regulated. I wonder if some of these medicines caused some of her illnesses rather than helped her.

Offline HessianPrincess

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Re: Alexandra and her Health Part 2
« Reply #496 on: August 02, 2018, 07:44:37 PM »
One thing I rarely see mentioned as a possible explanation for some of Alexandra's health problems is thyroid disease. Doing a search on this forum, I found it mentioned only in passing and given little to no attention. I believe it should be considered as a possibility more than it has been.

I have been reading about the Romanovs for more than 20 years, since I was a teenager. I used to think like everyone else does - that Alexandra's health problems were due to a combination of migraines, sciatica, anxiety, and hypochondria. Then in my late 30s I was diagnosed with Graves' Disease. The symptoms that led me to my doctor were heart palpitations - which I had off and on for a couple of years - and shortness of breath after doing something simple like walking up a flight of stairs. My anxiety levels had skyrocketed, I felt hyperactive and "edgy". I was scattered. I would find myself with bursts of energy (which were, however, difficult to focus) and then I would crash in exhaustion, because my body was simply processing everything at too rapid a pace, and was burning itself out. I started having problems with my eyes (not the bulging you see in later stages, but rather a sensitivity to light and a general discomfort), I felt overheated, couldn't sleep, my hands had tremors. Most of these things I chalked up to nerves or stress or age until I just couldn't ignore them anymore. Of course not everyone who has thyroid disease will exhibit the same symptoms or experience them to the same degree, but anyone who has read much about Alexandra would recognize many of these. Her heart palpitations and shortness of breath are well-documented; as are her complaints about eye strain and anecdotes about how cold she kept her residences because she was intolerant of heat. Facial flushing is another symptom, as are panic attacks in some people. Alexandra exhibited both of these, as well, according to descriptions of friends and acquaintances. Graves' is not the only thyroid autoimmune disease - Hashimoto's Disease is on the other end of the spectrum, and causes hypothyroidism (which has symptoms of depression, mental fuzziness, lethargy, muscle aches, weight gain, feeling cold, etc.; basically the opposite of the Graves' symptoms). In some cases, people with Hashimoto's can fluctuate between hyper- and hypothyroid states for years before their thyroid finally gives up the ghost and shuts down.   

At any rate, after diagnosis, and after hearing from many other women - and it is 7 or 8 times more common in women than men - about their own symptoms and struggles, I began to see Alexandra's health problems in a different light. I do not know if she suffered from a thyroid condition; Graves' Disease was a known and named entity by the mid-1800s, and I believe Hashimoto's was described in the late 19th/early 20th century, as well. So I would have thought her physicians would have at least considered it as a possible diagnosis, and they didn't seem to have done that or at least didn't document it, as far as I know. I am also not sure how it was even diagnosed 100+ years ago. Now it is done with a blood test. I would assume Alexandra's physicians would have at least felt her thyroid to see if it was enlarged, but that isn't always obvious. My thyroid was only minimally enlarged; I doubt it would have been detectable on palpation alone.

It is also important to remember that a tendency toward autoimmunity is inherited, but the condition may manifest differently in different individuals, or not at all. My father also has an autoimmune disease, but it is a different one than I have. So I inherited the marker for autoimmunity from him, but mine manifested as thyroid disease, his is another condition. Then there also usually is a trigger that sets the disease in motion; often a stressful life event or an illness. The timing of Alexandra's rapid health deterioration a few years after Alexei's birth and hemophilia diagnosis follows this pattern, considering autoimmune symptoms do not begin to show overnight; it takes months to years for them to become severe enough to be noticed. Stress also exacerbates autoimmunity, and most autoimmune conditions exhibit flare-ups and periods where symptoms aren't as bad. As for Alexandra's headaches and leg pains, those were both conditions she complained of as a very young woman, before the other problems began. So migraines and sciatica were life-long problems for her, and seemingly completely unrelated to her later health issues.

Again, we will probably never know one way or the other, but it is something to consider . . .


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Re: Alexandra and her Health Part 2
« Reply #497 on: August 03, 2018, 02:57:33 AM »
Personally I never believed in the hypochondria of the Empress.

Your hypothesis is interesting. For my part, I really think she had heart problems.

My grandmother had big heart problems, and I really saw the empress's symptoms.

Among them: blue hands, shortness of breath, fear of heat, cramps in the chest, legs often swollen making walking difficult, she also frequently had red patches (I do not know if it is related but she often suffered from shingles or exczema). This generates an almost constant anxiety, a bad self-esteem "I am good for nothing" which brings some depression to the active people (my grandmother was very active), and can also make the patient agoraphobic (painful exits, crowd suffocating, afraid of a heart attack ...)

I think the empress was a vegetarian or almost, and I know the doctors also recommended my grandmother to eat little meat. Heart problems are often related to kidney problems.

Finally, let's not forget that the Empress was taking very powerful medications (veronal for example). This can explain the moments of big fatigue that she met, her reactions sometimes difficult to understand.

I know the Empress had difficulties with her eyes, but she read a lot, wrote a lot, did a lot of painstaking work. I think she's talking about glasses only in Tobolsk (in a letter to Ana Viroubova). I think she was suffering from eye fatigue in Tsarskoie-Selo, and in Tobolsk she was beginning to be presbyopic.

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Re: Alexandra and her Health Part 2
« Reply #498 on: August 03, 2018, 03:09:10 AM »
About Ignatia

I read that this plant was mostly used (and known in the nineteenth century) for the treatment of violent headache. Nevertheless, it was used in many treatments (digestion, fever, hiccups ...)

It is the same for aconite. It's hard to draw a real conclusion. These are obviously essential homeopathic medicines in a medical kit at the time.

For those who read French, I put the link of a homeopathic guide of 1860 which lists all the uses of Ignatia and Aconite.

https://books.google.fr/books?id=HBw4AAAAMAAJ&pg=PA534&dq=iGNATIA&hl=fr&sa=X&ved=0ahUKEwiCgpyPtdDcAhUyxoUKHXFbDEkQ6AEIMzAC#v=onepage&q&f=false

Offline HessianPrincess

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Re: Alexandra and her Health Part 2
« Reply #499 on: August 03, 2018, 09:09:42 AM »
Yes, I agree that the homeopathic remedies she was taking for her conditions may have exacerbated them or caused new ones, especially if she was taking them for conditions self-diagnosed or misdiagnosed. It also seems that she was taking excessive doses of some of them.

I also agree that there was really something going on with her heart; but what was behind it? She seems to have been so young to have developed a primary cardiac condition, unless it was something congenital, but in that case I can't see how she survived all of those pregnancies. The thing with the thyroid is that it affects every body system, so when it malfunctions, so does most everything else to one degree or another, though some are more noticeable than others. And, leg swelling can also be a symptom of hypothyroidism, as well. Again, I do not know if a thyroid problem was involved, just suggesting that it is a possibility that should probably be explored like any other. Even today, thyroid problems are not taken seriously by people, and some women are written off as hypochondriacs by doctors for months or years before they are finally diagnosed. And even then, it is one of those conditions people write off as if it were a "made up" excuse for weight problems or other vague complaints. For some, maybe so, but others really do suffer.

Unfortunately we will never probably know in Alexandra's case. It frustrates me that her physicians seemed to chalk most of her problems up to mental and/or emotional instability. Even when they agreed that she had some sort of circulatory or cardiac issue, they still wanted to ascribe it to her neurotic personality -  that it was simply a physical manifestation of a mental health issue. Perhaps it was simply a case of depression/anxiety/panic attacks, but I feel no really thorough physical examinations were done, or at least not documented. And, for her part, she seemed to be the type who only accepted what she wanted to hear, and likely surrounded herself with primarily sycophantic doctors. The result is likely misdiagnosis (or a non-thorough diagnosis) of what was really going on, whatever it was, and the lack of good documentation of a possible physical condition has allowed people to continue to write her off as a mentally-unstable hypochondriac. Which then plays into the larger narrative of her as a generally mentally-unstable woman whose neuroses brought down an empire. It is simply unfair - not to mention grossly simplistic and somewhat misogynistic - to frame things that way. I know that serious Romanov historians and hobbyists do not (at least I hope they do not), but in the popular imagination, she is still very much seen in that way. She deserves better as a human being, and history deserves better, as well.

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Re: Alexandra and her Health Part 2
« Reply #500 on: August 03, 2018, 09:20:50 AM »
It's probably genetic. His father died of a heart attack.

For the rest, having read Dr. Botkin's correspondence with her brother, the Empress did not look like a very obedient patient. She did not really respect the advice of her doctors.

But frankly, it's obvious that the Empress was not crazy or hypochondriac. You talk to someone convinced.

Offline DNAgenie

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Re: Alexandra and her Health Part 2
« Reply #501 on: August 03, 2018, 04:41:06 PM »
Quote
Unfortunately we will never probably know in Alexandra's case. It frustrates me that her physicians seemed to chalk most of her problems up to mental and/or emotional instability. Even when they agreed that she had some sort of circulatory or cardiac issue, they still wanted to ascribe it to her neurotic personality -  that it was simply a physical manifestation of a mental health issue. Perhaps it was simply a case of depression/anxiety/panic attacks, but I feel no really thorough physical examinations were done, or at least not documented. And, for her part, she seemed to be the type who only accepted what she wanted to hear, and likely surrounded herself with primarily sycophantic doctors. The result is likely misdiagnosis (or a non-thorough diagnosis) of what was really going on, whatever it was, and the lack of good documentation of a possible physical condition has allowed people to continue to write her off as a mentally-unstable hypochondriac. Which then plays into the larger narrative of her as a generally mentally-unstable woman whose neuroses brought down an empire. It is simply unfair - not to mention grossly simplistic and somewhat misogynistic - to frame things that way. I know that serious Romanov historians and hobbyists do not (at least I hope they do not), but in the popular imagination, she is still very much seen in that way. She deserves better as a human being, and history deserves better, as well.

I agree, though I think Alexandra was suffering from porphyria. That disease was not documented until the 1950s and is frequently misdiagnosed as hypochondria, even today. Alexandra is mentioned in the book "Purple Secret. Genes 'Madness' and the Royal Houses of Europe" by Rohl, Warren and Hunt, in which the two co-authors are molecular geneticists, and experts on porphyria.

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Re: Alexandra and her Health Part 2
« Reply #502 on: August 04, 2018, 02:03:32 AM »
What intrigues me is that acute porphyria are, in women, generally more common in adolescence (onset of menstruation) and during pregnancy (the maximum of crises occur between 20 and 40 years). However, I have never read that the Empress had especially suffered acute attacks of her illness at these times of her life. It is really from 1910 (I think) that she spends most of her time lying or sitting.

I also know that porphyria is the enemy of the sun. Yet the Empress felt much better in Crimea for example. While she was not exposing herself as her daughters in the sun, but the Crimea is still much sunnier than St. Petersburg.

The witnesses often speak of the redness of the empress, but it does not really resemble the dermic attacks of a porphyria in their description. More like a kind of stress-related eczema, developing on the arms and neck.

Porphyria usually affects the gums, with frequent bleeding. The Empress often speaks of her heart, her redness, her tiredness, her headaches, never bleeding gums.

Porphyria usually includes a mental disorder. Frankly, the Empress wrote every day between 1914 and 1917, and very regularly before and after, and nothing in her letters suggests a mental disorder. She spent her days in her hospital, and no one ever noticed a neurological disorder in her conversations or gestures. She had an excellent memory, she spoke with logical sharp religious subjects, she even gave classes to her children.

The Empress often complains about her legs. This is not a porphyrian symptom, unless it is also associated with weakness of the arms (out, the Empress never complains of her hands or arms). I think it's more related to poor blood circulation or fluid retention associated with heart weakness (which also weakens the kidneys, it goes together).

Porphyria is generally associated with serious sleeplessness, yet as much as I know that the emperor suffered from frequent sleeplessness, so much the empress, except during the war, rose rather late.

The abdominal symptom is largely predominant in porphyria (95 percent of cases). Yet here again, I do not remember reading a single line about it in the empress's letters. I know she often complains of chest pain (cramps), but very rarely in the stomach. I have read the writings of Dr. Botkin, he also does not speak of abdominal pain in his patient but of her pains in the chest.

The phases of improvement or aggravation of the empress's symptoms also indicate an intermittent illness. Acute intermittent porphyria (the one that corresponds most to the symptoms of the empress) is always reinforced during pregnancy (epilepsy, hallucination, delusions ...). Anesthetics also cause severe seizures, if administered without adequate treatment. Yet the Empress, I believe, to give birth under anesthesia. Nobody found the Empress particularly mad during her pregnancies.

Porphyria is a convenient idea, because it can be extended to other ruling families. But if the empress had suffered porphyria, it is obvious that her situation as a young woman would have been much more serious and problematic at 45 years.

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Re: Alexandra and her Health Part 2
« Reply #503 on: August 04, 2018, 02:10:58 AM »
"except that the Empress never complains of her hands or arms"

"so much the empress, except during the war, was getting up rather late".

It's better.

Offline DNAgenie

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Re: Alexandra and her Health Part 2
« Reply #504 on: August 04, 2018, 07:58:01 PM »
If Alexandra had inherited porphyria from Queen Victoria's line via her mother Princess Alice (who was frequently ill with mysterious symptoms) it would be Variegate Porphyria. This, as its name suggests, can present as a wide variety of symptoms, or be completely asymptomatic for generations. It can appear in individuals in both acute and chronic forms of the disease and is made worse by stress. It is frequently mis-diagnosed, even today, and requires a complex series of tests to confirm the disease. Alexandra's first cousin, Princess Charlotte of Prussia (daughter of Alice's sister Crown Princess Victoria) has been confirmed to have suffered the disease through DNA testing, so it would made sense if Alexandra also carried the same gene.

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Re: Alexandra and her Health Part 2
« Reply #505 on: August 04, 2018, 08:34:13 PM »
I agree, but Charlotte Prussia had the crucial symptoms (including strong abdominal pain and orange urine). The Empress did not have these symptoms (present in 95 percent of porphyria attacks).

Porphyria is a disease with critical periods, then a "normal" life outside. It corresponds to the existence of Charlotte of Prussia, but the empress was almost always sick. In the last years she could hardly walk anymore.

Porphyria is a chronic disabling disease but not very progressive, while the Empress was declining from year to year.

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Re: Alexandra and her Health Part 2
« Reply #506 on: August 04, 2018, 08:34:52 PM »
"Charlotte of Prussia"


Offline Joanna

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Re: Alexandra and her Health Part 2
« Reply #507 on: January 11, 2019, 09:32:59 AM »
Doctor visits to Empress Alexandra in the Alexander Palace and Peterhof's Lower Dacha in 1905:

https://winterpalaceresearch.blogspot.com/2019/01/obstetric-care-for-empress-alexandra-in.html

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