Pain and Personality Following Traumatic Brain Injury (TBI)
After writing my blog post, Elvis — A War Between Good and Evil, I found some interesting information regarding Elvis’ health condition when he died and what events led to his demise on August 16, 1977. For anyone interested, here is a brief walk-through of what I have learned, which includes a comprehensive list of his ailments and drug use according to an article published on MedCentral.com by Dr. Forest Tennant (2017, June 14), an acting witness in the 1981 trial against Dr. George Nichopoulos, Elvis’ private physician.
Some of you might know Elvis suffered a traumatic brain injury (TBI) in 1967 when he tripped over a television chord in a Los Angeles hotel bathroom and whacked his head on a porcelain bathtub. He was knocked unconscious and was never the same again.
I am not a neurologist nor a medical professional of any sort, but I have suffered multiple head injuries over the years and have been adversely affected by the effects of these injuries. This is why I find this subject so fascinating. I have also noticed patterns of behavior during my research into both the life of Elvis and the late INXS singer, Michael Hutchence, who also suffered a traumatic brain injury in 1992 that led to his declining health before he committed suicide on November 22, 1997.
Traumatic brain injuries, which are usually caused by severe blows to the head, can trigger a gradual decline in cognitive functions and physical health. According to Dr. Tennant, Elvis’s decline began around the time he hit his head on the hotel bathtub and gradually worsened over the next ten years of his life. A similar decline occurred with Michael Hutchence, although his health problems seemed to be more psychological than physical.
Both men complained of pain, and both men experienced swelling in their faces and weight gain. Both men also exhibited unusual mood swings that led to a change in personality that included irritability and physical violence at times. Both men were self-medicating with pharmaceutical and street drugs, which they were already experimenting with before their respective traumatic brain injuries. Both were living fast, unhealthy, rock-star lifestyles and under large amounts of stress and personal turmoil.
Elvis complained of headaches and body pain. He began to experience health issues as early as 1970, if not sooner, according to girlfriends, friends, colleagues, and the medical professionals who were treating him for pain. As I have observed when he was alive and through my research, Michael’s decline was noticeable to the public about three years following his injury as well. This could be due to both men aging (Michael moving through his mid-late 30s and Elvis into his early 40s) and going through personal and professional changes that were causing them stress as well as increasingly unmanageable drug addictions. Michael’s bandmates claimed he became irritable and violent during rehearsal sessions and even threw a knife at INXS bass guitarist Garry Beers during a recording session after plunking it into a floor multiple times in a trance-like state.
Michael and Elvis were working entertainers with demanding schedules and high expectations. They were also experiencing relationship problems with women and pressure to fulfill their entertainment contracts and maintain a public image. Both men were lonely and isolated.
According to several of Elvis’ close friends and family, his diet was atrocious. He ate high-fat, high-cholesterol meals and was an emotional eater. When Elvis died, he was 350 lbs. and suffered from severe constipation, high blood pressure, cardiovascular disease, and liver problems. His heart was twice the size of a normal heart, and he had a twisted colon that was also enlarged, contributing to his defecation difficulties that are believed to have triggered the heart attack that killed him. When Elvis died, the coroner found 4-month-old stool in his bowel. He was very sick, and according to his live-in nurse, Letetia “Tish” Henley, he was too embarrassed about his condition to get the help he needed.
Elvis’ autopsy records provided to Dr. Forest Tennant by Dr. George Nichopoulos’ attorney, James Neal, revealed that Elvis suffered from the following conditions:
· Hypertension
· Heart and cardiovascular disease
· Enlarged heart
· Atherosclerosis in his coronary vessels, aorta, and cerebral arteries
· Emphysema
· Morbid obesity
· High cholesterol
· Hypogammaglobulinemia — an immune system disorder
Elvis also had a high level of codeine in his body upon his death, which he was allergic to, and a mix of other pharmaceuticals. According to Dr. Tennant, only two of the drugs present in Elvis’ system were prescribed by Dr. Nichopoulos. Elvis had other avenues for obtaining various pharmaceuticals and was even known to sweet talk his way into obtaining drugs directly from pharmacies.
The drugs present in Elvis’ system at the time of his autopsy were as follows…
· Codeine 1.08 ug/ml
· Morphine .03 ug/ml
· Methaqualone 6.0 ug/ml
· Diazepam 20 ng/ml
· Nordiazepam 30.5 ng/ml
· Ethinamate 10–20 ug/ml
· Ethchlorvynol 5–10 ug/ml
· Pentobarbital 3.4 ug/ml
· Phenobarbital 5.0 ug/ml
· Butobarbital 11.0 ug/ml
Elvis reportedly began using amphetamines as early as 1953 when he was in high school. Eventually, he used uppers and downers to stay up during night patrol in the army in Germany. Following his discharge from the army, he continued to use them to cope with insomnia and his fears of not being able to sleep, according to his ex-wife Priscilla. He was seen using oxycodone as early as 1958 at a roller-skating rink and was eventually placed on methadone in the late 1960s or early 1970s to deal with his opioid addiction. There was reported use of diet pills around 1960. Elvis hired Dr. Nichopoulos in 1967 to assist in managing his “medical needs.”
Elvis’ health issues began to materialize around 1970 with an eye infection, which eventually morphed into glaucoma. Problems with back pain began to arise around 1967 and subsequently worsened. His increase in physical pain seems to coincide with his separation from Priscilla.
From 1973–1975, Elvis’ health began to decline rapidly until he died in 1977. He was hospitalized several times at Baptist Memorial Hospital in Memphis. Here is a list of reported hospitalizations and his symptoms:
Oct. — Nov. 1973 — Semi-comatose, jaundice, respiratory distress, swollen face, and distended abdomen. Liver indicating hepatitis. Excessive cortisone was found in his system due to medication for back pain, causing swelling, hepatitis, and a bleeding ulcer.
Jan. — Feb. 1975 — Megacolon, hypertension, fatty liver, and twisted intestine.
August — Sept. 1975 — Fatty liver, high cholesterol, hypertension, COPD (Chronic Obstructive Pulmonary Disease), megacolon.
April 1975 — Lower pack strain, digestive tract inflammation, and anemia.
Elvis took a combination of opioids, amphetamines, and sedatives regularly and had issues with insomnia, constipation, and high blood pressure. Some of Elvis’ ailments were also claimed to be hereditary. It is not a surprise that his health began to decline so early in his life. Add to this head trauma that, according to Dr. Tennant triggered an auto-immune response, Elvis’ eventual death was hastened without proper dietary precautions and a complete lifestyle change in the 1970s. If Elvis had been able to get appropriate health care for his various ailments and get onto a strict diet and lifestyle regimen in the early 1970s, he would likely have lived into old age.
Dr. Tennant concluded from his expertise, the documents he was provided, and peer-supported research from other medical professionals that he consulted, “… it is quite clear to me that Elvis’ major disabling medical problems stemmed from multiple head injuries that led to an autoimmune inflammatory disorder with subsequent central pain. His terminal event was cardiac arrhythmia, underpinned by drug abuse, genetic defects, and hastened along by an atrocious diet.” (Tennant F., 2017).
Not only was Elvis dealing with various physical ailments and diseases, but he was also experiencing depression, self-medicating, and over-medicating. He overdosed several times and was taking some prescription medications intravenously. It is claimed that he would not get out of bed for periods, refused to bathe, and developed sores on his body around 1975. His live-in nurse stated in her book Taking Care of Elvis (Henley, 2015) that he was “miserable” about his health condition, aging, and relationship struggles with women.
It was clear from Dr. Tennant’s article and diligent research that Elvis’ lifestyle and autoimmune disease caused him to become gravely ill and die at the age of 42. I wonder if he knew he was going to die. Perhaps singing My Way (Sinatra, 1968) in the last few years of his stage performances was his way of telling his audience it was the end.
Michael Hutchence, on the other hand, suffered in relative obscurity. Everyone knew about the drama between Paula Yates and her ex-husband, Bob Geldof, and the media scrutiny surrounding him. Yet, he was also struggling with a sharp cognitive decline due to falling back onto a hard slab of sidewalk concrete in Denmark after being punched by a disgruntled cab driver who wanted Michael out of the roadway that he was occupying with his bicycle. Michael refused medical treatment when he was admitted to a local hospital, and so his fate befell him. He swore everyone who knew to secrecy and continued like nothing had happened. By the time INXS released their 1997 album Elegantly Wasted, it was evident that he was already experiencing health issues. His face was bloated, his skin was sallow, and his lips seemed to be consistently chapped and peeling. He had put on weight, and his ability to remain articulate and form sentences in interviews was scattered and sporadic. Friends and family claimed that he also lost his sense of taste and smell, a common symptom of head trauma. He was slipping into a dark abyss without the two senses that defined his lavish lifestyle and deeply passionate personality that brought meaning to his existence.
His rock-star lifestyle was still alive and well as Michael continued to abuse recreational substances. By the mid-late 90s, he was also on Prozac and other prescription medications, which are not named publicly as far as I am aware.
Michael was known for his fast lifestyle and sexcapades with various women. It was inevitable that the drugs and poor decisions he was making were going to catch up with him. I think he felt trapped and likely was not thinking straight often. As his band members began to mature and take solace in the refuge of their native homeland, Australia, Michael was left to his own devices on the international stage and at the mercy of Paula’s love spell. Adding to his stress and turmoil, a restlessness with continuing to be in INXS and wanting to branch out on his own was eating at him.
Michael was unhappy, unsettled, and desperate for a way out or a way back into the life he used to have ten years earlier. He was ready for something different, but his drug use and cognitive impairment must have affected his ability to remain calm and rationalize his predicament with Paula, Bob, and the media frenzy surrounding him. In the end, he was tormented and isolated, jetlagged, and hopped up on alcohol and drugs. Life must have seemed futile to him in those moments before he decided to check out of his body. Perhaps he spent time thinking about this before. It is unclear what was going through his mind. The last video of Michael Hutchence before he took his life can be viewed on YouTube. His physical state is telling (10:26). He looked exhausted. His autopsy revealed lesions on his brain from severe head trauma. Now that we know more about the effects of traumatic brain injury, his decisions leading up to his death make complete sense.
Two great talents were lost to a happenstance of brain trauma and poor lifestyle choices that contributed to their deaths — gone too soon. They were men who defined their generation and still hold relevance today as worthy entertainers who were unique artists and mavericks in the music industry. Both balanced a strong masculine and smooth feminine energy that made women look, and men burn with envy. They were highly intelligent, mischievously provocative, and bold individuals. What a loss and a sorrowful fate.
The effects of traumatic brain injuries are just beginning to be understood, and so are new and drug-free forms of pain management to cope with these injuries. The psychological effects of TBIs are also coming to light, along with a greater understanding of how integral diet and lifestyle are to our immune systems.
Peter Attia, a well-known longevity physician, and former oncologist, hosted an in-depth discussion on his podcast The Drive with neurologist Dr. Micky Collins regarding concussions and brain trauma, which I found fascinating. Along with his colleagues, Dr. Collins is one of the first to research and write about the symptoms and treatment of concussions. He explained to Peter Attia that until 2000, doctors and neurologists were not trained nor educated in how to test and treat for concussions. This research is still fresh twenty-three years on without blood tests and imaging to diagnose concussions. Diagnosis is currently made through a series of physical examinations and questionnaires.
Dr. Collins and his team also realized through their research that there are six different types of concussions that require different treatments:
1. Cognitive fatigue
2. Vestibular
3. Ocular
4. Migraine
5. Anxiety
6. Neck
Concussions also trigger preexisting health conditions specific to an individual. This could be related to the auto-immune effects of brain injuries. It makes me wonder how many people are being misdiagnosed or diagnosed with general auto-immune diseases without having a history of head injuries considered and noted.
There are 21 different symptoms of concussions:
· Loss of consciousness
· Confusion
· Vomiting
· Fogginess
· Balance issues
· Dizziness
· Light and sound sensitivity
· Fatigue
· Blurred vision
· Headache
· Amnesia
According to Dr. Collins, the most insidious symptoms of a concussion are dizziness and fogginess, which can lead to ignoring symptoms and prolonging effective treatment.
Micky indicated to Peter that concussions can be treated if intervention is made, preferably early, although all concussions can be treated in time. Dr. Collins informed Dr. Attia that treatments for concussions are now readily available in major cities in North America and through telehealth doctors.
Micky says his approach is to actively treat a patient by providing treatments that retrain the brain as opposed to the conventional assumption that rest is the cure. He also advised that exercise, nutrition, and adequate sleep contribute to optimal recovery.
Imagine if Elvis and Michael had access to this research and treatment. It would have been a gift to get their lives back on track.
Peter brought up a hormonal piece, which also prompted Micky to mention downstream symptoms from brain injury that cause issues in multiple organs in the body, as well as a possible hormone imbalance. It seems from the information that Dr. Collins provided that Elvis’ severe brain injury in 1967 and several smaller head injuries he sustained from sports and physical confrontations triggered multiple physical ailments and might have also affected his testosterone production, causing rapid weight gain and emotional dysregulation as he aged.
Dr. Collins has also seen patients who are suicidal. He indicates that rumination and anxiety, lack of sleep, and exercise can cause an individual to go down a dark path. Perhaps Michael Hutchence could have benefitted from addressing these issues.
Traumatic brain injury involves a wide spectrum of research that has barely cracked the surface to date. Still, Dr. Collins relayed that there are about 10–15 fellowships for medical professionals to study concussions. It’s an excellent start, and I hope we will continue to study the complexity of the human body and mind to improve longevity.
Traumatic brain injury science is such an important issue to bring to the forefront, including public education on the adverse effects of using and abusing pharmaceutical drugs. If this helps anyone suffering from brain-related injuries and/or dependency on pharmaceutical medications, it is well worth it. I know that both Elvis and Michael Hutchence would be willing and happy to help, even if they had to divulge personal information about themselves to the public.
Our brains are the control center of our whole bodily system. We must protect it to live long, full, and meaningful lives. There is so much we do not understand about ourselves. I believe we are turning a corner in how we see medicine and health. If we approach it holistically with care, patience, and wisdom, we can improve the lives of many.
S. Angell is a published poet, writer, philosopher, video blogger, and preschool teacher by day. She explores various topics, including love, life, death, history, and society, from a philosophical perspective. You can find her at https://www.therainydaypoet.com/
References
Attia, P. (Host). (2023, July 24). Concussions and Head Trauma: Symptoms, Treatment, and Recovery with Dr. Micky Collins. (Ep. 263) [Video Podcast Episode] The Drive. Retrieved from https://www.youtube.com/watch?v=CBqBNCHOe2Q
Henley, L. (2015, January 1). Taking Care of Elvis, Memories with Elvis as His Private Nurse and Friend. Wimmer Books.
Tennant, F. (2017, June 14). Elvis Presley: Head Trauma, Autoimmunity, Pain, and Early Death. Pract Pain Manag. 2013;13(5). Retrieved from https://www.medcentral.com/pain/chronic/elvis-presley-head-trauma-autoimmunity-pain-early-death
YouTube. (2015, February 10). Michael Hutchence The Loved One. [YouTube Channel]. Michael Hutchence, INXS Last Rehearsal, 1997 Part 1. Retrieved January 4, 2024, from https://www.youtube.com/watch?v=R6M8y0q9STI
