cass 1968 las vegas performance thru a doctor's eyes

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cass 1968 las vegas performance thru a doctor's eyes

Postby cass fan! » Tue Jan 20, 2015 2:43 pm

Sometimes there are detectives & then there's a "Lt. Columbo". Sometimes there are doctor's and even specialists.....but maybe one in a thousand become a "Dr. Columbo".I have been called "Dr. Forensic", even by other doctors! Cass fan.....your second newest member is one of those very rare doctors (and we don't even do it for money, you do it because you really do want to know everthing!!) I am double Board Certified Canada + USA + AFIP trained ( notice Dr Rhonda Wright- pathology report also mentioned Armed Forces Institute of Pathology(AFIP),the best place in the world....but then I have bias ....they helped train me as well.
Why the pre-amble......because what I am about to post will really open your eyes. The carefully formulated retrospective opinions are my own, and shouldn't be used by lawyers to criticize 1974 medicine with 2015 hindsight.
Reading this post will give you huge empathy for Cass.

October 1968- Las Vegas Disaster
public view
1. Cass had a crash diet; tonsillitis; poor singing voice ; unappreciative audience some walking out.
Dr. Forensic view
1. Holy smoke, Cass is in a pack of trouble needs 911 call, ambulance by the auditorium, ENT throat surgeon awaiting at the hospital. Tracheostomy may be needed. Have ambulance with ambubag + iv ready!!!!
2. Cass had undiagnosed sleep apnea, undiagnosed Madelung's Disease, with fatty deposits about her neck and thorax. (In obese people Madelung's Disease is missed)
3. Weight loss does not get rid of the abnormal fatty deposits in the neck + chin+ when the patient lies down, contributes to sleep apnea. Madelung's disease may be a disorder of white fat to brown fat ratios, maybe a mitochondrial DNA hereditary disorder,& has a higher presence in Jewish population.
4. What's missing by her death bed is NO SLEEP APNEA MONITOR!!!!!!Perhaps Michelle Phillips can remember...did Cass have a snoring problem?????
5. Sleep apnea is the "elephant-in-the -room", not cardiac conduction disorders. While it is possibly true about fatty lipomatous heart deposits, this is just a small spectrum of the cardiac problem. (white fat deposits happen everywhere in Madelung's Disease. Obstructive sleep apnea is the problem, not found at pathology, because it is an in vivo problem of the soft palate when the patient is supine.
6. Cass's crash diet maybe because she already has a breathing problem at night.
7. A swollen uvula is a hallmark of sleep apnea,(looks like tonsillitis;she could still have both)
Whichever, tonsillectomy, was done which was life saving to preserve the airway. The people at the 1968 concert need to be given shit!!!!
8. Tonsillectomy buys time, but only liposuction can surgically remove the white fatty neck deposits blocking her airway at night. (and NO weight loss will not fix it)Alcohol will make it worse.(but definitely worsens sleep apnea)
9. The story of Cass doing heroin before she went on stage that night is a story of "pain" control, for what must have been intense pain................like I said, she needs 911 & an ambulance !!!!!
10. Doctors still missed her sleep apnea x six more years. My own classmate ignored it and went into atrial fibrillation!
11. In 1974 a Holter monitor was available, an ECG would have shown bundle branch block, nothing of this was said in life.(by 1976 Dr. Forensic here was even an ECG technologist)While it is true there are fatty deposits in her heart, I think that's a sort of which came 1st chicken or egg kind of question)
12. The question is would she be alive today..............with sleep apnea control, liposuction of white fat deposits and the recognition of Madelung's disease almost hiding in the obese, the deposition about the trachea and neck.
The real answer is maybe , but in 1968, that tonsillectomy bought her six more years to spend with Owen.
13. If Owen has muscular myotonic weakness form a mitochondrial DNA disorder +/or sleep apnea, it may be hereditary, but that is her business not for this website.I took a long time before posting this because the 1968 concert from a doctors viewpoint is a harbinger of things to come.
14. The mid -1980's lipid metabolism research, the advent of MRI showing us graphically Madelung's disease,cannot be retroactively extrapolated backwards to 1974. Yes we doctors probably missed it & obesity hides it..
Hindsight is always 20/20.

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Re: cass 1968 las vegas performance thru a doctor's eyes

Postby cass fan! » Tue Jan 20, 2015 2:52 pm

Second post for Owen to read about.
The disorder to look up is Launois-Bensaude Syndrome. Madelung described it in 1888.
Sorry to bother the site with weird sydromes but that's probably missed in Cass; the "fainting spells" are explained as well by the sleep apnea.
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Re: cass 1968 las vegas performance thru a doctor's eyes

Postby Rbcsoup » Thu Jan 22, 2015 5:26 am

Dear Cass Fan!

Thank you for your most interesting post and observations. Also, thank you for reminding folks about Dr. Rhonda's observations elsewhere on the site.

Indeed, it is so very important to look at 1968 and 1974 with lens from that time and not the vantage point 40+ years hence. I often remind people in classes I have taught and in interviews that you have to recall the status of medicine and the culture. I imagine tobacco use and recreational drugs would also have contributed to what you have described.

If you can watch and episode of the old TV show "Emergency!" (my children love it!) it reminds you of where the world and medicine was circa 1970.

Thank you again. Welcome to the site.

Richard
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