Chuck Dinerstein at the American Council on Science and Health has an intriguing hypothesis:
“This past weekend at West Point, President Trump had trouble drinking a glass of water and he displayed an unsteady gait when descending a ramp. It is possible these problems indicate some type of neuropathy. And while it’s unlikely, one potential cause is hydroxychloroquine.”
After describing Trump’s recent apparent physical problems he writes:
So now, we have issues with two sets of muscles: the legs and arms. It would be odd to have an injury that involved two areas not be reported, especially involving the president. The same holds for structural problems, and that moves neuropathy up the differential list. What could be the source of a new-onset neuropathy? I know little of the president’s medical status. That is, except for one, perhaps salient fact: he said he has been taking hydroxychloroquine.
Physicians have rightly been concerned about the cardiac effects of this medication on the heart’s rhythm. But hydroxychloroquine has some other, less frequently cited adverse effects. If you read the FDA required package insert under adverse effects, here is what you will find:
“Musculoskeletal and connective tissue disorders: Sensorimotor disorder, skeletal muscle myopathy or neuromyopathy leading to progressive weakness and atrophy of proximal muscle groups, depression of tendon reflexes and abnormal nerve conduction.” [Emphasis added]
Proximal muscles are those closest to our body, like the muscles of the upper arm that raise the arm and hand. Or the muscles of the thigh that are actively involved in all phases of walking. It is not an overly common adverse side effect. It is probably relatively rare, but a quick search uncovered a review of 10 cases of hydroxychloroquine associated neuromyopathy.
I’ve been focusing on the cardiac side effects of HCQ but there are others including retinal toxicity which are more frequent and which could contribute to uncertain gait or hand-eye incoordination.
Of course, this is complete speculation but it contributes to understanding and recognition of how known and unknown side effects of unproven medications (or supplements) can tip the benefit/risk ratio toward increased risk.
I particularly like Dinerstein’s last sentence:
Again, let me emphasize that I am not attempting to diagnose an illness without performing both a careful history or physical examination. I am trying to point out a fallacy in the therapeutic use of medications. as there is always a tradeoff between benefits and risk. Always. In reporting on the president’s decision to treat himself with hydroxychloroquine on May 18, the New York Times reported, “Mr. Trump continued, explaining that his decision to try the drug was based on one of his favorite refrains: ‘What do you have to lose?’”
What indeed? It would be ironic that the drug President Trump described as a “game-changer” might instead turn out to be a “gait-changer.”
Skeptically Yours,
-ACP
13 thoughts on “Are Trump’s Problems with Walking, Drinking Water Due to Hydroxychloroquine? ”
Actually, simply being skeptical of biased news would provide the answer to this ‘problem’ being invented…his use of leather sole shoes down the steep ramp at West Point and not wanting to ruin a silk tie are what the man himself has already explained. Perhaps the source of the ‘story’ might be diagnosed with a case of TDS….
Anyone who ignorantly Doctors himself, had a fool for a patient.
I rest my case.
Other than cardiac problems…..most neurologic side effects from HCQ would be very likely from long term dosing.
Agree.
Interesting article. However I have my doubts DT even took hydroxychloroquine as preventative treatment or otherwise. Oh well…
I wonder if there is any way to check this
There still has not been proper clinical trial done that tests the results observed by Doctors treating Covid 19 in the field using Hydroxychloroquine. This is the cocktail therapy successfully used by Vladimir Zelenko MD of HCQ 200 mg BID, Zinc Sulfate, and Azithromycin and given early when patients present symptoms. All of the trials thus far have been poorly designed ie. very high HCQ doses (so side effect propensity is higher), given when patients are crashing in the hospital and ICU instead of early intervention, manipulated by fraud or incompetence like in the Lancet scandal, and incomplete of using Zinc and the Zmax. Why?
This therapy by the way costs about $20.00 for five days.
Who, other than Zelenko, has seen evidence that he has “successfully used” the “cocktail therapy”? The road to Hell is paved with bogus medical therapies.
Precisely why this needs to be tested. Test the therapy according to the claim. The claim is that HCQ plus Zinc plus Zmax given at patient symptom onset prevents hospitalization for COVID19 patients and a faster recovery. That is the trial needed. No one has done it. A lot of shenanigans have gone on.
Antonio, a trial that includes a – therapeautic / effective – zinc dose is not likely, as the risk of succeeding it too great ! – and thus inimical to the “Saviour Vaccine” model being pushed.
For those who would rather not take the HCQ with it’s attendant dangers, zinc with Quercetin (spelling?) is a safe alternative. Both are zinc transporters, taking the Zn into cells, where it will interfere with virus replication.
There’s more money to be made in a Vaccine, hence the bias.
Opioids, properly manufactured, dosed, and ingested, are far less hazardous than hydroxychloroquine, yet the US has imprisoned millions for their possession. The system of drug controls in America, beginning with the prescription laws, is perverse.
There is no proof that Trump told the truth when he said he had been taking hydroxychloroquine.
The diagnosing of public figures with diseases and complications is an interesting game. For the purposes of this article, it would be nice to know whether this rare complication comes from chronic usage in malaria endemic areas or for its use in RA and not a (relatively) brief use during Cv19 pandemic. I don’t think he is ‘treating’ himself but is being prescribed the drug by the White House physician after discussion of the risks and benefits. We all know there is a tradeoff- I discuss/argue that concept everyday with my ‘sinusitis’ patients. The vast majority of my colleagues give antibiotics rather than spend the time to educate.
People with “skeptical” in their name might want to be a little more circumspect when dealing with rarities.