"Death" of a wrestling fan

     After closely following American professional wrestling for over 27 years, this fan's interest has pretty much died.

     I was born in 1968 and grew up in St. Paul, Minnesota, the backyard of Verne Gagne's American Wrestling Association.  As a young boy I did not have any interest in professional wrestling.  I do recall during the late '70's hearing the names of various wrestlers such as  Gagne, Mad Dog Vachon, Dusty Rhodes, and the High Flyers.  I remember taking a family vacation to visit relatives in upstate New York during the summer of 1980 and hearing my older cousins talking about the WWF and  being very excited about Hulk Hogan.  I first saw Hogan when he appeared in Rocky III in 1982.  None of this peaked my interest however.

   Everything changed one fateful Sunday morning during the summer of 1984.  I was 15 years old.  I'm not certain of the exact date, but it must have been sometime in July.  I just happened to come across the AWA's All Star Wrestling show that aired at 11:00 am on KSTP channel 9.  There they were, Animal and Hawk, the Road Warriors.  I stumbled into a brief clip showing them destroying two jobbers.  I was immediately captivated by what I was watching.

Road Warriors

     You could say that my life literally changed the moment I saw the Road Warriors on TV that Sunday. After the show was over I could not get the Road Warriors out of my mind.  I sat in complete silence, digesting what I just witnessed.  I quickly read through the TV guide to figure out when All Star Wrestling would be on next.  All week long I eagerly anticipated the next show.  I was hooked.

     Over the next few weeks I found myself fixated to the TV when All Star Wrestling was on in the hopes of seeing Animal and Hawk.  I was gradually introduced to other wrestlers such as Jerry Blackwell, Curt Hennig, and King Kong Brody.  I also found out from a friend that a rival promotion, the World Wrestling Federation (which I will refer to as the WWE from this point forward), had a TV show that aired on Saturdays at 6 pm.  He told me about this exciting wrestler named Hulk Hogan, the same guy my cousins watched years earlier.  Because of my weekend schedule I could not watch the WWE until a few months later (this was in the era before every house had a video cassette recorder).  Therefore, I headed off to the local 7-Eleven store in the hopes there would be some wrestling magazines there.  Boy, was I surprised.  7-Eleven carried several "Apter" magazines.  Not only did I get to see pictures of the WWE stars, but I was introduced to a whole new world of wrestlers from other groups such as the NWA and WCCW.  Although the AWA was the only show I could see on TV, I soon became a regular at the magazine rack just so I could keep up with all the other organizations.

     None of my good friends were into wrestling, so I convinced my Dad to take me to my first live event.  The AWA presented a card at the St. Paul Civic Center on August 12, 1984 headlined by the Road Warriors vs. the World Tag Team Champions Baron von Raschke and The Crusher.  Never mind that the old guys won (and The Crusher didn't sell at all), I still had a great time.  My Dad, at the time a college professor, made the keen observation that the audience resembled the same people we saw once a year at the State Fair.  We also attended the October 21 card that included a tag team Battle Royal.  It was also around this time that I saw the WWE on local TV.  I have to admit, I was impressed with the production quality.  No question, it was superior to the AWA.

     Beginning in 1985 I noticed that some friends were also taking an interest in wrestling.  Pretty soon I found myself attending the monthly WWE cards at the old Met Stadium in Bloomington, MN (which has since been demolished.  The famous Mall of America now resides there).  I was following the escapades of guys like Piper, Orton, and Hogan.  I quickly realized that the WWE was about show and entertainment more than sport which never really sat well with me.  Still, I was constantly amazed at the talent that was jumping to the WWE.  Wrestlers that I had only read about in the magazines were now showing up on WWE programming.  It was clear the WWE's national expansion was well underway and it was fascinating to observe the build for Wrestlemania I (which by the way I did NOT get to watch.  I was dragged that Sunday on a school field trip to see Death of a Salesman).

Ric Flair

     In 1986 I graduated from high school and started attending a local liberal arts college.  By now I was obsessed with wrestling.  I had never really been passionate about anything as a kid up until I discovered wrestling.  Throughout college I continued to attend monthly WWE  events.  I dutifully bought all the pay per views, read every magazine I could get my hands on, happily gave away $2.00 a minute to hear day old news on 1-900 lines, and drove for hours on several occasions to attend WWE TV tapings.  By now I had access to cable television and at one point there were 9 hours of wrestling on TV each week and I tried to watch all of it.  While I closely followed the WWF, I was not really a fan of the WWE.  I was always somewhat turned off by Vince's version of wrestling with all the silly gimmicks.  I found Hogan a somewhat unbelievable champion.  I got my fill of "real" pro wrestling by studying the matches of credible guys like Flair (the anti-Hogan), Windham, and Rotundo.  Nevertheless it was intriguing to see the rise of the WWE and the landscape change with the closing of the regional territories.  I also began to take notice of the death of several young wrestlers like David von Erich, Rick McGraw, and Gino Hernandez.  I started to realize that there was more to wrestling than presented on TV and in the "Apter" mags.

     As crazy as it sounds (and it does to me in hind site), I did three academic projects during my college years dealing with wrestling.  I wrote a paper for an English class addressing the morality issues displayed within professional wrestling.  I convinced my  Drama class professor that attending a WWE show satisfied the class requirement of attending a play (he agreed that wrestling was modern theater).  I also gave a well received presentation to my Speech class on the cultural impact of wrestling.

Greg Valentine

     It was also during this time that I discovered a great place to meet wrestlers was in airports.  Although I didn't travel a lot as a college student I managed to get the autographs of Rockey Johnson,  Big Boss Man, and Greg Valentine at airport terminals (I patiently waited outside the Men's room to get Valentine's at the Pittsburgh airport).   I was on a plane once with One Man Gang (he took up two seats) and Rick Martel (I told him I approved of his heel turn on Tito Santana).  Randy Savage refused to give me his autograph saying "not now little man!" At 6'0" and 200 lbs (natural, no steroids) I thought his description of me was fair.  I got the future Governor of Minnesota to give me an autograph when he played golf at the Country Club where I worked.  As it happened, his golf glove accidently on purpose (Bobby Heenan language) made its way into my pocket.

     The fall of 1990 was a pivotal time for me a wrestling fan.  I started Medical school and the time demands limited my opportunities to attend live events and watch wrestling on TV.  For the first time in years I went more than a week at a time without closely following wrestling.  In the spring of 1991 this would all change.  My Dad, the college professor who brought me to my first live event in 1984, told me about a young college student named Wade Keller who published a wrestling newsletter.  On a whim I subscribed to the Torch.  Suddenly I felt my interest as a fan was rekindled.  I was able to more closely follow the wrestling business.  I was now a "Smart Mark".  I felt I was on the inside of the business and enjoyed having a level of knowledge the average fan did not.  I started watching wrestling on TV again, ordering selected pay per views and going to the occasional live event.  Soon I was turned onto Dave Meltzer's Wrestling Observer, a newsletter I have received for the better part of the last 20 years.

     In 1994 I moved to Wisconsin where I would spend the next 6 years doing my medical residency and subsequent fellowship.  It was during this time that my loyalty to wrestling were first tested.  I thought WCW programming in 1994 featuring Hogan & Friends was beyond horrible.  WWE TV was no better with the "New Generation" campaign.   These were painful times.  I never cared for hardcore wrestling and ECW.  I began having no problem skipping weekly TV shows.  I completely stopped ordering pay per views.  I did continue to read the Torch and Observer faithfully.  The historical pieces and behind the scenes news still captivated me.

     My interest was again peaked in 1996 with the Hogan turn and birth of the NWO.  While WWE programming was still largely unwatchable, I did enjoy WCW Nitro.  Not only did I like seeing former WWE guys showing up, but it was also my first real exposure to the luchadors and guys like Benoit, Guerrero, and Malenko.  I started following the Monday Night Wars closely.  It was interesting to see the  WWE getting some competition for the first time in years.  But alas, my interest was short lived.  I think a combination of things contributed to my loosing enthusiasm for the product.  I could see the hardcore influence of ECW making its way into the big two.  I also really didn't get excited over the very popular WWE Attitude Era beginning around 1998.  I found Vince Russo's crash TV philosophy unbearable.  I didn't find Vince McMahon's bathroom humor funny.  The beginning of the new millennium was a dark period for me as WCW and the WWE seemed to go out of their ways to turn me off more and more every week.  I was relieved when WCW died in 2001.

     For the better part of the last decade I have tried to distance myself from the WWE version of wrestling.  Same goes for TNA.  I no longer watch wrestling on TV (I did go out of my way to see the Ric Flair retirement on RAW and the Old School RAW).  I have tried to get my fix through other avenues.  I read selected books (I highly recommend the books written by Jim Wilson, JJ Dillion, Ole Anderson and Bret Hart).  I ordered several old WWWF dvds over the internet which I enjoyed (this was the era before Vince Jr.).  I continue to read the Wrestling Observer (I stopped receiving the Torch around 2000), but will admit that with the passage of time there seems to be less and less I'm interested in.  The sections on TNA and WWE seem to increasingly have names of characters I've never seen or heard of. Were it not for the historical pieces, excellent obits and reflections on the state of wrestling I would probably save my money and let my subscription lapse.  I used to spent a lot of time on the internet trying to stay current.  Now I limit my time to the Observer site and Greg Oliver's Slam! Wrestling.  The only times I visit the WWE site is to see how they handle the death of a wrestler and around Hall of Fame time.  The one subject that does continue to hold my interest is the premature deaths of so many wrestlers (the impetus for the Wrestling with Death blog). 

     I appreciate wrestling when it is presented as "fake sport".  I want the athletes to be credible in the ring.  I want the action to be plausible. I want the titles to be valued.  I want the story lines to have a meaningful start, middle and finish.  The angles to make sense.  The programs to serve a purpose.  The gimmicks kept to a minimum.  I wish for the booking to have internal logic and consistency.  I want to be able to watch it without having to shield the eyes of my wife and two daughters.  Finally, I wish to be entertained without being insulted.

     I have come to realize that the wrestling I long for is gone, never to return.  I didn't outgrow wrestling, wrestling changed.  The business has gone too far in the direction of pure entertainment leaving me behind.  I also realize that my opinion just doesn't count.  At my age I am not the target audience the WWE or TNA is trying to reach.   


Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Ring related deaths of American professional wrestlers

     Over the past few decades an alarming  number of American professional wrestlers have died.  Below is a list of the ring related deaths of National and Modern era American wrestlers.


Steve Romero (Jay Youngblood)  9/2/85.   Died following a tag team match in Melbourne, Australia.  He reportedly died from complications of a lacerated spleen.
 

Owen Hart  5/23/99.   Fell to his death while performing an entrance stunt during the Over the Edge WWE pay per view in Kansas City, Missouri.


Larry Booker (Moondog Spot)  11/29/03.  Sustained a fatal heart attack during a tag team match in Memphis, Tennessee.
 

Larry Cameron 12/13/93.  Experienced a fatal heart attack during a match in Bremen, Germany.
 

Chris Candido  4/28/05.  Suffered a fatal pulmonary embolism while recovering from orthopedic surgery to repair injuries sustained during an April 24, 2005 match.

     
  

Ivan Koloff and sarcodosis

     In his autobiography "Is That Wrestling Fake?"  The Bear Facts, Oreal Perras (Ivan Koloff) reveals that he was diagnosed and treated for sarcoidosis.

     Sarcoidosis is a disorder of unknown cause.  It affects individuals worldwide and is more common is blacks than whites.  The condition is characterized by the presence of lesions called granulomas in involved organs.  While virtually any organ can be affected, the most commonly involved site is the  lungs.  Other frequently involved organs include skin, joints, and eyes. 

     When sarcoidosis affects the lungs, symptoms include shortness of breath, cough and chest pain.  Fatigue, sweats, and fever are often present.  In mild cases the individual may not have any symptoms.  In severe cases the condition can lead to respiratory failure and death.

     A diagnosis of pulmonary sarcoidosis requires finding the hallmark lesion on biopsy and excluding other disorders that could produce similar symptoms.  Not all cases require treatment.  Many times the condition will go into remission spontaneously.  For patients needing treatment the most common therapy is with the steroid prednisone.

Ivan Koloff

References

1. Koloff, I with Scott Teal. (2006) "Is That Wrestling Fake?"  The Bear Facts.  Hendersonville, Tennessee:  Crowbar Press.

Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Mike Von Erich battles toxic shock syndrome

     On August 22, 1985 professional wrestler Mike Adkisson (Mike Von Erich) underwent surgery at Brookhaven Hospital in Dallas, TX for a shoulder injury sustained while wrestling on tour in Israel.  He  did well post-operatively and was discharged to home.  However, he was admitted to Baylor University Medical Center  four days later with a high fever.  He was subsequently diagnosed with toxic shock syndrome.

      The term toxic shock syndrome has been used to describe several different clinical conditions.  A number of microorganisms, including Staphylococcus aureus, Group A streptococcus, and  Clostridium sordellii can produce a toxic shock syndrome.

     When a toxic shock syndrome occurs after surgery, it is most often due to Staphylococcus aureus.  S. aureus is normally found on the skin of humans.  If the bacterium passes through the skin barrier defenses and invades surrounding tissue it can produce inflammation and infection.  When a particular exotoxin known as TSST-1 (toxic shock syndrome-1) is released an intense inflammatory reaction can occur.  The syndrome is characterized by fever, hypotension (low blood pressure), rash, and evidence of 3 or more organ systems not functioning properly.  Individuals can become very ill and be at risk of dying.  Approximately 6% of cases that occur after surgery are lethal.  Treatment is with supportive care and antibiotics.

     Although Mike Von Erich did survive this lethal illness, it is believed he never made a complete recovery.  He later committed suicide on April 12, 1987.

Mike Von Erich

References:

1. MMWR Recomm Rep 1997; 46(RR-10):1.

The medical resource www.uptodate.com was used in the preparation of this blog.  Photographs are for illustrative purposes only, Wrestling with Death does not claim ownership.
 

Murdered American professional wrestlers

     Over the past few decades a number of American professional wrestlers have died prematurely.  While most deaths can be attributed to prescription/illicit drug overdose, some have been murdered.  Below is a list of wrestlers from the National and Modern Eras who were murdered.

Chris Adams

Frank Goodish (Bruiser Brody)  7/16/88..

Adolfo Bresciano (Dino Bravo)  3/11/93.

Chris Adams  10/7/01.

Nancy Benoit (Manager/Valet, Woman)  6/22/07.





Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

A brief history of androgenic anabolic steroids (AAS) and professional wrestling

1889:

• Charles Brown-Sequard, a French neurologist, describes the rejuvenating effects of a self-administered extract from dog testes. (1)

1931:

• Adolf Butenandt, a chemist in Marburg, Germany, isolates the gonadal steroid androsterone. (2)

1935:  

• Testosterone is isolated from the testes. (3)
• Testosterone is synthesized. (4)

1937:   

•  Clinical trials using oral methyltestosterone and intramuscular testosterone propionate begin. (5)

1940's:

• AAS are used to enhance performance in Soviet Union and German Olympian and amateur weightlifters.

1954:

• Bob Hoffman, coach of the United States Olympic weight lifting team learned of AAS use at the World Championship in Vienna.

1958:

• The Food and Drug Administration approves methandrostenolone which is marketed by Ciba Pharmaceuticals as Dianabol.

1960:

• John Ziegler, the appointed physician of the United States Olympic weight lifting team gave AAS to the team at the Rome games.
• It is speculated that William Afflis (Dick the Bruiser) may have been one of the first professional wrestlers to use AAS in the early part of the decade. (6)

1965:  

•  Wayne Coleman (Superstar Billy Graham) begins using AAS. (7)

1975:

• Terry Bollea (Hulk Hogan) begins using AAS. (8)

1982/83:

• It is estimated that upwards of 80% of professional wrestlers on the WWE roster are using AAS. (9)

1987: 

• May 26, Jim Duggan and Khosrow Vaziri (Iron Sheik) were arrested in New Jersey.  Duggan for possession of marijuana and drinking while driving.  Sheik was arrested for possession of cocaine and marijuana.
• Later this year the first WWE drug testing program is instituted.  The testing was primarily aimed at drugs such as cocaine, opiates and barbiturates.  The first offense resulted in  a 6 week suspension without pay.  The second offense carried with it mandatory rehabilitation.  A third violation resulted in termination.  It was revealed that wrestlers Tully Blanchard and Aurelian Smith (Jake "The Snake" Roberts) both were served with suspensions.

1988:

• The Anti-Doping Abuse Act is passed.  It is now a felony to sell or possess with intent to distribute AAS.

1990:

• The Anabolic Steroid Control Act is passed.  AAS are now a Schedule III drug.  The Act criminalizes illegal drug trafficking.

1991:

• In March, FBI agents raided the medical offices of George Zahorian, III, D.O.  Zahorian was the longtime WWE ringside physician in Allentown, Pennsylvania.  He was subpoenaed for shipping AAS to 43 professional wrestlers.  Thirty seven of the wrestlers were actively employed by WWE. 
• June 19: Zahaoian was formally indicted.
• June 24:  The United States of America v. George T. Zahorian trial begins.  At the trial four wrestlers testified about receiving AAS from Zahorian.  Dan Spivey reported receiving Deca-Durabolin, Anavar, Anadrol, and testosterone.  Roderick Toombs (Roddy Piper) testified he received Deca-Durabolin, Anavar, and Stanozolol.  Richard Vigneault (Rick Martel) and Brian Blair both testified to being sold  Anavar, Deca-Durabolin, and testosterone.
• June 25:  A jury finds Zahorian guilty of 12 counts of illegally distributing steroids and other controlled substances.
• July:  WWE announces the start of a new drug testing program that includes testing for AAS.  Serving as Medical Director was Mauro Di Pasquale, M.D.  Aegis Analytical Laboratories, under the directorship of David Black, Ph.D, did the specimen testing.  Wrestlers David Smith and Jim Hellwig (Ultimate Warrior) are terminated because of violating the policy.
• July 16:  WWE owner Vincent K. McMahon admits to having experimented with Deca-Derabolin.  This same day Terry Bollea (Hulk Hogan) appears on the CBS Arsenio Hall show and denies AAS use except for the sole purpose of treating an injury under the supervision of a physician.
• December 27:  Judge William W. Caldwell sentences Zahorian to 36 months imprisonment followed by 2 years of supervised release.  He was also fined $12,700.

1993:   

•  November 18, the U.S. Justice Department indicted Vincent K. McMahon for conspiracy to distribute AAS and defraud the Food and Drug Administration.

1994:

• July 5,  the United States v. Vincent K. McMahon and Titan Sports trial begins.  During the trail Zahorian testifies he sold AAS to WWE wrestlers from 1981/82 to 1989.  Wrestlers Randy Cully (Moondog Rex), Tom Zenk, Terry Szopinski (Warlord), Tully Blanchard, Rick Rood (Rick Rude), Jim Hellwig (Ultimate Warrior), Kevin Wacholz (Nailz), John Minton (Big John Studd), and Terry Bollea (Hulk Hogan) all gave testimony about illegal drug use.

• July 22, McMahon was acquitted of all charges.

1996:

• October 25, drug testing in the WWE ceases.

2000:

• August, the Indiana Medical Licensing Board suspends Joel Hackett, M.D. for providing controlled substances to 11 professional wrestlers.  Wrestlers linked to Hackett include Brian Pillman, Louis Muccciolo (Louie Spicolli), Tony Norris (Ahmed Johnson), Jim Hellwig (Ultimate Warrior), Scott Hall and Del Wilkes (The Patriot).

2006:   

•  February 26, WWE institutes the Talent Wellness Program.

2007:   

• March 19, SI.com reports 11 professional wrestlers linked to an illegal performance enhancing drug distribution network.  Specific wrestlers mentioned in the article were Kurt Angle (trenbolone and nandrolone from October 2004 to February 2005), Eddie Guerrero (HCG and stanozolol, early 2005), Oscar Gutierrez  (Rey Mysterio, nandrolone and stanozolol), Randy Orton (stanozolol, nandrolone, testosterone, anastrozole from March 2004 to August 2004), Adam Copeland (Edge), and Gregory Helms (Shane Helms/Hurricane) were reported to have received HGH. (10)
• June, 22-24,  The Chris Benoit double murder/suicide occurs in Fayettville, Georgia.
• June 27, the medical office of Phillippe Astin, III, M.D. in Charrollton, Georgia is raided by federal agents.  It is learned that during a 3 year period leading up to May 2007 Astin had prescribed Benoit, on average, a ten-month supply of testosterone every three to four weeks. 
• July: Astin is indicted on 175 counts of illegally prescribing medications.  Professional wrestlers linked to Astin included Chris Benoit, Oscar Gutierrez (Rey Misterio), Mark Jindrak, Michael Durham (Johnny Grunge), Nancy Benoit (Woman), Lawrence Pfohl (Lex Luger), Robert Howard (Hardcore Holly), and Marcus Bagwell (Buff Bagwell).
• August 30, Sports Illustrated releases the names of 14 wrestlers who were clients of Signature Pharmacy in Orlando, Fl.  Names mentioned were Randy Orton, Charlie Haas, Adam Copeland (Edge),  Gregory Helms (Shane Helms/Hurricane), Mike Bucci (Simon Dean),  John Hennigan (Johnny Nitro), Darren Matthews (William Regal), Ken Anderson (Mr. Kennedy), Eddie Fatu (Umaga), Brian Adams (Crush), Shoichi Funaki, Sylvian Grenier, Chavo Guerrero, Eddie Guerrero, and Chris Benoit.  (11)  The New York Daily News adds Robert Huffman (Booker T, ), Mike Bucci (Simon Dean), and Anthony Carelli (Santino Marella) to the list of clients.  (12)  ESPN.com reported Dave Bautista (Batista) and Chris Mordetsky (Chris Masters) were also clients.  (13)

   
    

References:

1. Lancet 1889;2:105.
2. http://nobelprize.org/nobel_prizes/chemistry/laureates/1939/butenandt-bio.html.
3. Hoppe Seylers Z Physiol Chem 1935;233:281.
4. Chemische Berichte 1935;68:1859.
5. Scientific American 1995;272(2):76.
6. Muchnick, I. Chris & Nancy.  The true story of the Benoit murder-suicide & pro wrestling's cocktail of death.  Toronto, Ontario, Canada.  ECW Press. 2009.
7. Graham, B.  WWE Legends.  Superstar Billy Graham.  Tangled Ropes.  New York, NY.  Pocket Books.  2006.
8. Hogan, H.  Hollywood Hulk Hogan.  New York, NY.  Pocket Books.  2002.
9. United States v. Vincent K. McMahon and Titan Sports.  No-93-CT-1276.
10. http://sportsillustrated.cnn.com/2007/more/03/19/wrestlers
11. http://sportsillustrated.cnn.com/2007/more/08/30/wrestlers/index.html
12. http://www.nydailynews.com/sports/2007/08/30/2007-08-30_top_wwe_names_emerge_in_doping_scandal.html
13. http://sports.espn.go.com/espn/news/story?id=2998062
    
    
    
    

Zach Gowen the one legged wrestler

Zach Gowen

     Professional wrestler Zach Gowen was diagnosed with an osteosarcoma of the left leg in 1991 at the age of 8 years old.  He underwent a successful amputation of his leg.

     Osteosarcomas are uncommon malignant tumors of bone.  Approximately 750 to 900 new cases are diagnosed each year in the United States, of which 400 arise in children/adolescents.  The tumor is more common in boys than girls.

     The most common site of osteosarcoma in children is a long bone, especially the in the leg (femur, tibia), and arm (humerus).  The majority of individuals present with pain, typically of several months' duration.  Pain frequently results in decreased movement of the affected body part. The most important finding on physical examination is a soft tissue mass, which is frequently large and tender.

     Surgery to remove the tumor is the primary therapy.  Chemotherapy is often given before surgery to shrink the tumor size.



Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Could an Ox Baker heart punch really kill a man?

Alberto Torres

     On June 13, 1971 in Verdigre, Nebraska a tag team match took place that would end in tragedy.  Douglas Baker (Ox Baker) teamed with Tom Andrews (The Claw) to take on Alberto Torres and partner "Cowboy" Bob Ellis.  The match was for the AWA Midwest Tag Team Championship held by Ellis and Torres.  As legend has it, Ox Baker delivered his famous heart punch to Torres, knocking him out.  Torres died on June 16 in Immanuel Hospital in Omaha. While promoters credited Baker's heart punch as the cause of death, it was later revealed that Torres died from complications of pancreatitis that developed before the match.

     Ox Baker was also linked to the August 1, 1972 death of wrestler Ray Gunkel.  Gunkel, the Georgia Championship Wrestling Brass Knuckles champion, and Baker wrestled in a match held in Savannah, Georgia.  During the match Gunkel was the recipient of a heart punch.  Although he went on to win the match, Gunkel later collapsed and died in the locker room.  The autopsy revealed Gunkel had underlying coronary artery disease.  It has always been controversial what role the chest trauma contributed to his death. (1)

     Nevertheless, the question still remains:  Could an Ox Baker heart punch really kill a man?


 

Ox Baker

     The answer is yes.   Such an event is known as commotio cordis (Latin for "agitation of the heart"), and is defined as a combination of ventricular fibrillation and sudden cardiac death due to chest trauma. (2)  It is a common cause of sudden cardiac death in athletes.  While the exact prevalence of commotio cordis is unknown, the following epidemiologic data have been reported: (2) 

• Young persons are most commonly affected (mean age about 15 years); only nine percent of reported cases occurred in someone older than 25 years of age.
• 95 percent of reported cases have been in males.
• 75 percent of cases have occurred during athletics (50 percent during competitive sports, 25 percent during recreational sports).
• Most cases have been reported in sports with blunt projectiles (eg, baseball, lacrosse, hockey) and/or more physical contact (eg, football, hockey).

      The trauma to the chest results in a lethal rhythm known as ventricular fibrillation.  For this event to occur the chest wall trauma must be directly over the heart and at a specific point in the heart beat cycle.  Only impacts occurring during a 20 to 40 millisecond window during early ventricular repolarization  will cause ventricular fibrillation (see figure taken from reference 3).

Part of heart rhythm were commotio cordis a risk

     Survival from commotio cordis is poor, with one registry reporting only a 25% survival.  The chances of surviving may be improved with timely emergency medical resuscitation. (2)


     In addition to Ox Baker, the heart punch was also utilized by former WWE champion George Stipich (Stan Stasiak). 


Reference:

1. http://slam.canoe.ca/Slam/Wrestling/2008/06/24/5975651.html
2. N Engl J Med. 2010;362(10):917.
3. http://en.wikipedia.org/wiki/Commotio_cordis

The medical reference www.uptodate.com was used in the preparation of this blog.

Photographs are for illustrative purposed only, Wrestling with Death does not claim ownership.

Drug overdose and American professional wrestling

     For nearly three decades there has been an epidemic of American professional wrestlers dying young.   A frequent cause of death has been drug overdose.  A summary of the recent data from the United States poisoning centers revealed the following data about drug overdose: (1)

• 95% of episodes caused minor/reversible effects.
• 92% were due to acute rather than chronic ingestion.
• 92% involved a single substance.
• 85% were unintentional. 
• 59% of fatalities occur in individuals ages 20 to 49 years old. 
• 47% involved prescription drugs.

     During the 1980's cocaine was a popular drug used by American professional wrestlers.  Cocaine is found in the leaves of the coca plant, which is abundant in parts of South America.  It can be consumed intravenously, orally, intranasally, and by smoking.  Users are at high risk for abuse and dependence.

Gino Hernandez

     Acute intoxication of cocaine can lead to a number of complications including myocardial infarction, cardiac arrhythmias, heart failure, hypertension, stroke, seizures, and muscle breakdown leading to kidney failure.  It has been reported that professional wrestlers Charles Wolfe (Gino Hernandez), Curt Hennig, and Scott Bigelow (Bam Bam Bigelow) died from cocaine intoxication.

     The 1990's saw the use of gamma hydroxybutyrate (GHB) and carisoprodol (Soma) increase among American professional wrestlers.  GHB is classified as a central nervous system depressant and is approved by the Food and Drug Administration (FDA) for treatment of cataplexy and excessive sleepiness in narcolepsy.  GHB can increase the body's secretion of growth hormone and for this reason some athletes use it.  A common side effect is drowsiness.  It is the ingredient in the so-called "date-rape drug".  Nonprescription use of GHB has been reported to result in respiratory depression, coma, and death.

Louie Spicolli

     Soma is classified as a muscle relaxant.  It is recommended that it only be used short term (2 to 3 weeks) for treatment of musculoskeletal pain because of a lack of established benefit long term.  A significant side effect is excessive drowsiness.  Sedating effects are increased when mixed with other central nervous system depressants such as alcohol.  The professional wrestler Louis Muccolo, Jr. (Louie Spicolli) died from an overdose of Soma.

     The last decade has seen a rise in deaths due to prescription opioids which are commonly used for pain management.  The death of Bobby Duncan, Jr. was linked to fentanyl.  Sherri Schrull's (Sheri Martel) and Gertrude Herd-Nash's ( Luna Vachon) deaths were connected to use of oxycodone.

     Below is a list of American professional wrestlers from the National and Modern eras whose deaths were attributed to drug overdose.

Miss Elizabeth

• David Adkission (David Von Erich)  2/10/84.
• Rick McGraw  11/1/85.
• Charles Wolfe (Gino Hernandez)  2/2/86.
• Bruce Woyan (Buzz Sawyer)  2/7/92.
• Arthur Barr (Art Barr)  11/23/94.
• Herb Abrams  7/23/96.
• Louis Muccolo Jr. (Louie Spicolli)  2/15/98.
• Richard Rood (Rick Rude)  4/20/99.
• Bobby Duncum Jr.  1/24/00.
• Randy Anderson  5/5/02.
• Elizabeth Hulette (Miss Elizabeth)  5/1/03.
• Alex Rizzo (Big Dick Dudley)  5/16/03.
• Curtis Hennig (Mr. Perfect/Curt Hennig) 2/10/03.
• Anthony Durante  (Pit Bull #2)  9/25/03.
• Michael Durham (Johnny Grunge)  2/16/06.
• Joseph Magliano (Joey Maggs)  10/15/06.
• Scott Bigelow (Bam Bam Bigelow)  1/19/07.
• Sherri Schrull (Sheri Martel)  6/15/07.
• Brian Adams  (Crush) 8/13/07.
• Chase Tatum  3/23/08.
• Gertrude Hurd-Nash (Luna Vachon)  8/27/10.
• Michael Verdi (Trent Acid)  6/18/10.

References:

1. Am J Emerg Med 2002; 20(5): 391.

The medical resource www.uptodate.com was used in the preparation of this blog.


Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Ric Flair and alcoholic cardiomyopathy

     In his autobiography, professional wrestler Richard Fleihr (Ric Flair) acknowledges being diagnosed with alcoholic cardiomyopathy. (1)

Ric Flair

     Low to moderate intake of alcohol has been shown to have positive health benefits including reduced risk of stroke and coronary artery disease.  The cut point at which alcohol intake goes from beneficial to harmful is not known.  Heavy alcohol intake is often defined as 14 drinks for males and 7 drinks for females in a week.  Excess alcohol consumption can lead to health complications such as cardiomyopathy (disease of the heart muscle leading to decreased function).

     The risk of developing a cardiomyopathy is a function of the amount of alcohol consumed on a daily basis and the total duration of drinking. The diagnosis is usually made based on an established history of heavy and consistent alcohol use and after other causes of cardiomyopathy have been excluded.  Symptoms may come on slowly and include shortness of breath, and irregular heart beat.  Many individuals do not have symptoms early in the disease course but will still have evidence of impaired heart function upon testing.  The condition can progress to congestive heart failure and death.

     The main treatment is total abstinence from alcohol.  Under these circumstances it is possible for the heart function to recover.  However, if a person continues to drink alcohol, the chances of dying as a result of deteriorating heart function are very high.





References.

1. Flair, Ric, Mark Madden (editor) and Keith Elloit Greenberg (contributor).  Ric Flair: To Be the Man.  World Wrestling Entertainment 2005.

The medical resource www.uptodate.com was used in the preparation of this blog.  Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

The death of JT Lightning

  

     On August 24, 2010 James Haase (JT Lightning) released the following statement:

 "Two weeks ago, i was diagnosed with throat cancer in my esophogus, which has spread to my lymphnods and now is in my liver. I have been through so many tests i dont know whether im coming or going. But it is uncurable and thats a hard pill to swallow, no pun intended. I just turned 40 and i never drank or did drugs and this all boils down from having acid reflux disease and not knowing it. This is a very trying part of my life because i always consdered myself a tough guy, so to speak, and this has brought me to my knees, begging for mercy. Wondering why me? I have no words to say to describe this. But if your out there and you are a friend of mine, be there for me when i need you, thats all i ask. I dont want pity. Just to be remembered for all the things ive done in my life through pro wrestling and music, punk shows or whatever. Thanks for listening".

     On August 4, 2011 JT Lightning passed away.  

JT Lightning

 

     Based on the above information, Lightning most likely had esophageal cancer as a complication of gastroesophageal reflux disease (GERD).  The most common symptoms associated with GERD are "heartburn" and regurgitation of stomach contents.  Many individuals however do not experience these classic symptoms but may still be at risk for complications of the disorder.  Reflux has been associated with a number of complications including cough,wheezing, laryngitis, erosion of teeth, chronic sinusitis, recurrent pneumonia, chronic hoarseness, pharyngitis, laryngeal cancer and esophageal cancer.

     Chronic reflux can damage the lining of the esophagus leading to a condition known as Barrett's esophagus, which predisposes to a type of cancer known as adenocarcinoma.  While GERD is common, the actual incidence of developing cancer is low.  Barrett's esophagus can be detected by a medical procedure called endoscopy.  Not all people with GERD need to be screened for Barrett's esophagus.  The American Gastroenterology Association has published recommendations for who should be screened (see Table 1).

Table 1 (1)

• Age 50 years or older
• Male sex
• White race
• Chronic GERD
• Hiatal hernia
• Elevated body mass index
• Intra-abdominal distribution of body fat

     Lightning's case is somewhat unusual because of his age and he was unaware of classic reflux symptoms.  At the time his cancer was diagnosed, it had already spread to other sites in his body.  Unfortunately, such cancer of the esophagus does not respond well to treatment.    


      

  References

1. Gastroenterology. 2011;140(3):1084.

The medical resource www.uptodate.com was used in the preparation of this blog.  

Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Watching professional wrestling on TV leads to violence

     Lionel Tate was only 12 years old when he murdered Tiffany Eunick in 1999.  Tate was later convicted of first degree murder in the death of the 6 year old.  Tate maintained that he was only wrestling with Eunick, including imitating moves he learned from watching professional wrestling on TV, when she became unconscious.  Eunick's injuries included a lacerated liver, skull fracture, brain swelling, and rib fractures.  The murder and subsequent trial received national attention and was dubbed by the media "the wrestling case".

Lionel Tate

 

     The Tate case is not an isolated incident.  In January, 1999 another 12 year old killed his nineteen month old cousin after performing a wrestling maneuver known as a "power bomb" on the toddler.  In Georgia a four year old killed a fifteen month old by jumping up and down on him.  This happened while the babysitter had a WWE video playing to entertain the children. (1)

     Despite the above cases, there is no absolute proof that watching professional wrestling on TV can lead to homicide.  However, there are data showing that it can definitely lead to violent and other risk taking behaviors.  The effects of viewing professional wrestling have been studied by DuRant and colleagues from Brenner Children's Hospital and Wake Forest University School of Medicine. (2,3)

     In the article entitled The Relationship Between Watching Professional Wrestling on Television and Engaging in Date Fighting Among High School Students, the investigators hypothesized  that the more professional wrestling adolescents watched on television, the more likely they would be to engage in violent acts such as date fighting, weapon carrying, and other fighting behavior. (2)

     The subjects studied were 2,485 public high school students from Winston-Salem/Forsyth County, North Carolina.  Students were asked to fill out a 71-item questionnaire that assessed health-risk and problem behaviors.  Multiple questions related to fighting and weapon carrying.  The frequency that professional wrestling was watched on TV in the prior 2 weeks was also assessed.  Wrestling was defined as WWE and World Class Championship (WCW) programming.  In October, 1999 2,228 students completed the survey.  In April/May, 2000 it was again administered to 1,935 of the students who had completed the survey in the fall.

     There were significant correlations between the frequency of watching professional wrestling during the prior 2 weeks and engaging in date fighting, fighting in general, substance abuse, and weapon carrying for both males and females.  The relationships were stronger among females than among males.

     In a second study published in the Southern Medical Journal entitled Viewing Professional Wrestling and Engaging in Violent and Other Health Risk Behavior, DuRant and colleagues  found similar results. (3)  This time 2,307 youths ages 16 to 20 years from 17 US states were surveyed in 2001 about health risk behaviors and watching professional wrestling on TV.  The frequency of watching wrestling was associated with having tried to hurt someone with a weapon, engaging in sexual intercourse without appropriate birth control, and cigarette smoking.  Furthermore, the more times wrestling was viewed, the more likely a youth was to also engage in date fighting.

     The authors concluded that the social learning that occurs from increased exposure to wrestling on television has a negative effect on adolescents leading to violent and health risk taking behaviors.

     The two Durant studies spanned a period from 1999 to 2001.  This falls within a critical time in the history of professional wrestling.  WWE and WCW were engaged in the Monday Night Wars.  In an effort to draw better rating the WWE changed the content of their shows to attract a more adult demographic.  This edgier version of wrestling was known as the "Attitude Era".  TV shows such as WWE RAW and WWE Smackdown  routinely depicted extreme acts of violence, racist stereotypes, sexism, simulated sexual acts, beer consumption, degradation of woman, and homophobia.

     In 2008 WWE decided top scale back on the more adult themes.  All WWE programming now conforms to "PG" standards.





References.

1. http://www.enotes.com/professional-wrestling-article.
2. Pediatrics 2006; 118(2): 265.
3. So. Med J 2008; 101(2): 129.

  Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.   

Super obese professional wrestlers

     The obesity epidemic in the United States is alarming and predicted to only get worse.  Currently 72 million Americans are obese. (1)  It is the second leading cause of preventable death, behind only cigarette smoking. (2)  Body mass index (BMI) is used as a measure of a person's fat.  It is calculated by dividing the weight in kilograms by the height in meters squared (kg/m2).   For a classification of BMI in adults see Table 1.


Table1:  BMI classification.

• 25 to 29.9 kg/m2 is considered overweight.
• 30 to 34.9 kg/m2 is considered obese (class I obesity).
• 35 to 39.9 kg/m2 is considered moderately obese (class II obesity).
• 40 to 49.9 kg/m2 is considered severely or extremely obese (class III obesity).
• >50.0 kg/m2 is considered super obese (class IV obesity).

     In general, the higher the BMI is there is an increased rate of death from all causes.  Obesity is associated with a number of serious medical problems (see Table 2).

Table 2:  Complications of obesity.

• Coronary artery disease.
• Congestive heart failure.
• Deep venous thrombosis.
• Pulmonary embolism.
• Osteoarthritis.
• Obstructive sleep Apnea.
• Dementia.
• Cancer of the esophagus, colon, liver, gallbladder, kidney, and Non-Hodgkins lymphoma.
• Hypertension.
• High cholesterol.
• Diabetes.

     Obesity is also a problem among professional athletes.  A 2006 study by Scripps Howard News Service concluded that the heaviest National Football League (NFL) athletes are twice as likely to die before the their 50th birthday than their teammates. (3)

Happy Humphrey vs Haystacks Calhoun

     Professional wrestling has always been about showcasing athletes that can capture the paying public's eye, whether it's hillbillies, farmers, cowboys, or fat men.  Table 3 is a listing of the professional wrestlers who would be classified as super obese based on BMI.  When viewing the list there are several points that need to be kept in mind.  First, professional wrestling has no national data base that keeps biostatistics on wrestlers.  Promoters have been known to exaggerate heights and weights of wrestlers.  Furthermore, a wrestler's weight may have fluctuated throughout a career.  All of these factors can impact the reported BMIs listed.




Table 3:  Super Obese (BMI > 50 kg/m2) professional wrestlers.

• Benny McCrary (Benny McGuire) 104.6 kg/m2
• Billy McCrary (Billy McGuire) 100.4kg/m2
• William Cobb (Happy Humphery) 98.9 kg/m2
• Val Puccio 73.9 kg/m2
• Rodney Anoai (Yokozuna) 73 kg/m2 
• Gary Fletcher (Man Mountain Mike) 73 kg/m2
• Martin Ruane (Giant Haystacks/Loch Ness) 70.4 kg/m2
• Jerry Blackwell 70 kg/m2
• William Calhoun (Haystacks Calhoun) 69.4 kg/m2
• Akebono Taro 56.5 kg/m2
• Nelson Frazier (Mabel/Viscera) 56.3 kg/m2
• Chris Pallies (King Kong Bundy) 55.7 kg/m2
• Scott Thompson (Krusher Kong) 54.8 kg/m2
• Leon White (Vader) 53.4 kg/m2
• Mike Shaw (Bastein Booger) 52.9 kg/m2
• Solofa Fatu (Rikishi) 52.9 kg/m2
• John Tenta (Earthquake) 52.7 kg/m2
• Mark Henry 51.7 kg/m2 
• Matt Anoai (Rosey) 50.5 kg/m2

Yokozuna

References.

1. Center for Disease Control
2. Am J Prev Med. 2010; 38(2): 138.
3. http://sports.espn.go.com/nfl/news/story?id=2313476.

The medical resource www.uptodate.com was used in the preparation of this blog.

Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Pec tears in professional wrestlers

    
     The term pec tear is often used to refer to a rupture of the pectoralis major muscle.  There is a pectoralis major muscle located on each side of the anterior chest wall (see figure 1).  Ruptures can be divided into three categories (see Table 1).

Pectoralis major muscle

Table 1

• Type I:  Rupture at tendon insertion to the humeral (arm) bone.
• Type II:  Rupture at the junction between the muscle and tendon.
• Type III:  Rupture of the muscle belly.

     Ruptures of the pectoralis major muscle were once thought to be uncommon.  The majority are due to sports related injuries, most commonly weight training/lifting. (1)  Such injuries have also been described in amateur wrestlers.  The use of anabolic androgenic steroids (AAS) have been cited as a possible risk factor for this type of injury. (2)  However, the relationship between AAS use and musculoskeletal injuries is not well understood. The little information that is available is based mostly on case reports suggesting a risk of muscle/tendon injuries. (1, 3)  There are animal models showing AAS use produces a change in collagen structure that could result in alterations in tendon elasticity.  This may place a tendon at risk for injury and rupture. (4,5)


     Whenever a professional wrestler suffers a pectoralis major muscle injury there is a suspicion that past or current AAS use may have played a role.  Such is the case with the recent pectoralis major tendon injury suffered by Matt Morgan in late July, 2011.  Other wrestlers who experienced similar injuries include John Cena (right pectoralis major injury on October 1, 2007), Adam Copeland (Edge, pectoralis major injury October, 2005 and July 2007) and Jay Reso (Christian, in September 2010).

Matt Morgan

    


     There are no studies looking at the prevalence of musculoskeletal injuries in professional wrestlers who are former or current users of AAS.  There is a study involving retired professional football players who self reported AAS and musculoskeletal injuries.  (6)  The article is from Horn, et al. from the Department of Physical Medicine & Rehabilitation and Department of Exercise and Sports Medicine at the University of North Carolina and was published in 2009 in the American Journal of Physical Medicine and Rehabilitation. 



     In this study, a health questionnaire was completed by 2552 retired National Football League (NFL) players.  Results of self reported AAS use and musculoskeletal injuries were analyzed.  Of the retired player, 9.1% reported using AAS, with the highest use among offensive line men.  There was a significant association with self reported, medically diagnosed,  joint and cartilaginous injuries (disc herniations, knee ligamentous/meniscal, elbow, neck stinger, spine, and foot/toe/ankle injuries).  There was no association with biceps, triceps, or shoulder dislocation/injury.   Muscle/tendon injures (upper and lower) were also not more prevalent.

     The authors acknowledged that limitations of the study include that it was retrospective and relied on self reported data about AAS use.  The study was not able to look at the types of AAS used, dosage, duration, or frequency.   


     It should also be appreciated that football players may not be susceptible to the same pattern of injuries as professional wrestlers.  For example, pectoralis tendon injuries typically occur in sports that require forced contractions against a resistance.  This may explain the higher incidence of this particular injury in weight lifters and wrestlers. 

    On February 27, 2006 the WWE instituted a Talent Wellness Program that includes testing wrestlers for AAS.  If AAS are a risk factor for pectoralis major muscle injuries, the number of wrestler suffering this type of injury should decrease over time.
    


    
References.
    

1. Knee Surg, Sports Traumatol Arthrosc 2000; 8:113.
2. Am J Sports Med 20 : 587.
3. Arch Orthop Trauma Surg 1993; 112: 104. 
4. Med Sci Sports Excerc 1991; 23:1.
5. Orthop 1987; 11: 157.
6. Am J Phys Med Rehabil 2009; 88(3): 192.

     

     Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.
     

The death of Frank Gotch

Frank Gotch

      

     Frank Gotch, arguably one of the greatest professional wrestlers of all time, died at the age of 39 on December 16, 1917.  While the official cause of death was attributed to uremic poisoning (kidney failure), it has long been rumored that Gotch may have died from complication of syphilis. (1)

     Wrestling historian and biographer Mike Chapman provides what may be the most accurate account of Gotch's illness in the book Gotch: An American Hero. (2)   The first signs of any health problems  came in the summer of 1916.  Gotch began experiencing stomach problems.  This was soon followed by several other symptoms including lack of appetite, pain in the back and abdomen, and headaches.   Prior to his death, Gotch developed confusion, weight loss, fatigue, mood swings, irrational behavior, nose bleeds, puffiness around the eyes, and vomiting.

     While the health issues experienced by Gotch may seem vague and can be seen with many different medical conditions, the constellation of symptoms is certainly consistent with chronic kidney failure (see Table 1).


Table 1: symptoms of kidney failure

• Fatigue.
• Headache.
• Impaired mentation. 
• Lethargy.
• Muscle cramps.
• Bruising.
• Pallor. 
• Nausea and vomiting.
• Gastroenteritis.
• Peptic ulcer.
• Easy bleeding.
• Edema.

     During the course of his illness Gotch sought medical attention with his personal physician (Dr. Arent) in Humbolt, IA and also with physicians in Glenwood Springs, CO, Chicago, IL, and Little Rock, AR.  He was told that he could be suffering from Bright's disease.  The condition was named after Dr. Richard Bright (1789-1858), an English physician who did pioneering work on kidney diseases.  While the term may have initial been used to refer to the abnormal presence of protein in the urine,  at the turn of the last century it was often broadly used to refer to most any kidney disease.  The term has since been abandoned and is not recognized in any of the current classification systems of kidney diseases.

     A variety of different conditions are known to cause chronic kidney failure (see Table 2). 

Table 2: common causes of chronic kidney failure.

• Diabetes.
• Hypertension.
• Glomerulonephritis (inflammatory condition of the kidneys).
• Inherited.

     There is nothing is Gotch's medical history to support any one particular cause. However, it is unlikely his kidney disease was due to hypertension or diabetes as both of these disorders should have been readily diagnosed in the early 1900's.  As his father died in 1911 and his mother was alive at the time of his death, an inherited disease seems less likely, although cannot be completely excluded.  This would seem to suggest that one of the conditions giving rise to a glomerulonephritis would be the most reasonable cause.  There is a lengthy list of conditions that can cause glomerulonephritis (see Table 3).


Table 3: examples of glomerulonephritis.

• Fibrillary glomerulonephritis
• Focal glomerulosclerosis. 
• IgA nephropathy.
• Lupus.
• Membranoproliferative glomerulonephritis.
• Membranous nephropathy.
• Mesangial proliferative glomerulonephritis.
• Minimal change disease.
• Postinfectious glomerulonephritis.
• Rapidly progressive glomerulonephritis.
• Thin basement membrane disease.

Frank Gotch

     Could Gotch have died from syphilis?  An argument could be made that it was possible.  However, as will be shown, it would require a number of assumptions and rare events.

     During the early 1900's syphilis was a common sexually transmitted disease that was often difficult to diagnose.  The infection, caused by the bacterium Treponema pallidum, has been referred to as "the great mimicker" because the symptoms resemble so many other diseases.  Although arsphenamine became available for treatment in 1910, the rate of infection in the United States really did not decline until the widespread use of penicillin in the late 1940's.



     Following infection with Treponema pallidum , the initial symptoms are termed primary syphilis and usually consist of a chancre (skin ulcer) at the site of inoculation.  It is possible for the lesion to go unnoticed.  Because the lesion is not painful and will spontaneously resolve, many individuals will not seek medical attention.  Weeks to a few months later, approximately 25 percent of individuals with untreated infection develop a systemic illness that represents secondary syphilis (See Table 4).  As with primary syphilis, the manifestations of secondary syphilis will usually spontaneously resolve.  An individual may then enter the latent stage where no manifestation of the disease are evident.

Table 4: symptoms of secondary syphilis. (3)

• A rash (the most characteristic finding)
• Fever
• Headache
• Malaise
• Anorexia
• Swollen lymph nodes.
• Hepatitis.
• Arthritis.
• Glomerulonephritis.

     When patients are untreated during the earlier stages of syphilis, they are at risk for the major complications of the infection.  About one third of untreated individuals will develop late complications (see Table 5).  These may occur at any time from 1 to 30 years after the primary infection and are referred to as tertiary syphilis.


Table 5: tertiary syphilis. (4)

• Central nervous system involvement (neurosyphilis).
• Cardiovascular syphilis (especially aortitis).
• Gummatous syphilis (nodular lesions which can occur in a variety of organs).

     There are limited data on the natural history of untreated syphilis, and the incidence of syphilis related kidney failure is unknown but historically was thought to be rare. (5-8)  If the kidneys are involved it typically occurs during the secondary stage of the illness and will usually spontaneously resolve.  Syphilis has been associated with diffuse proliferative glomerulonephritis (classic postinfectious) and membranous nephropathy.  There is a case report describing  a patient with syphilis who developed rapidly progressive glomerulonephritis. (9)  There are also several reports describing the development of the nephrotic syndrome due to syphilis. (10-16)  This however, is thought to be very rare, with an estimated incidence of less than 1%. (17,18)

Frank Gotch

     Assuming Gotch had contracted syphilis during his lifetime that went untreated, it is possible he could have developed a kidney disease during the secondary or latent stages.  In the era before antibiotics and supportive care including measures such as dialysis, some cases, such as rapidly progressive glomerulonephritis and severe forms of nephrotic syndrome were likely fatal.  The greatest mortality from syphilis however occurs during the tertiary stage.  Twenty percent of untreated patients with tertiary syphilis die of the disease.  Prognosis for advanced symptomatic disease in cardiovascular syphilis is poor.  There is nothing in Gotch's available medical history to suggest he had symptoms of tertiary syphilis.

 


     In the final analysis, it would seem more probable that Gotch succumbed to one of the more common causes of kidney failure as opposed to a very rare complication of syphilis.  Nevertheless,  Frank Gotch's death will forever remain one of wrestling greatest mysteries.
 

References

1. Meltzer, D.  (July 18, 2011).  Wrestling Observer Newsletter. 
2. Chapman, M.  (1999). Gotch: An American Hero. Culture House Books.
3. Gorbach SL, Bartlett, JG, Blacklow, NR. (1992).  Infectious Diseases.  W.B. Saunders.
4. J Chronic Dis 1955;2:311.
5.  J Chronic Dis 1955;1:127.
6. Arch Intern Med 1964;114:792.
7.  J Vener Dis Inform 1947;28(suppl 21): 1.
8. Goffe, JR (Ed).  (1897).   Medical News. 253. 
9. Am J Med1984;76(6): 1106.
10. Am J Kidney Dis 1987;9(2):176.  
11. Am J Med. 1970;48(5):643. 
12. Clin Nephrol. 1974;2(4):164. 
13. Br Med J. 1971;4(5784):404. 
14. East Afr Med J. 1975;52(4):172. 
15. Postgrad Med J. 1989;65(759):14. 
16. West J Med. 1992; 156(6): 654.
17. Arch Intern Med.  1946;78:679.
18. Amer J Syph Gonorrhea Vener Dis.  1946;30:463.

The medical resource www.uptodate was used in the preparation of this blog.

Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Savage autopsy

Randy Savage

     Randy Poffo (Randy Savage) died May 20, 2011 from natural causes due to heart disease according to the Pinellas County Medical Examiner's office.  Savage crashed his 2009 Jeep Wrangler after becoming  unresponsive due to what is being called a "cardiac event" while driving in Seminole, Florida. 

     The autopsy revealed the presence of an enlarged heart and severe atherosclerosis of the coronary arteries. Savage sustained only minor injuries from the crash. (1)  The toxicology report listed the presence of acetaminophen, caffeine, doxylamine, doxylamine metabolites, hydocodone, dihydrocodeine, and a blood alcohol concentration of 0.03 g/dL in Savage's system, although none were thought to play a role in his death. (2)

     The findings of an enlarged heart and coronary artery disease are suspicious for anabolic androgenic steroid (AAS) use.  Savage was known to have used AAS during his wrestling career.  For related blogs see Randy Savage (November 15, 1952-May 20, 2011) and Anabolic androgenic steroids and heart disease. 

     It is difficult to interpret the findings of the toxicology report without knowledge of what over the counter and prescription medications Savage was taking.  Several of the drugs are found in common pain medications.  Acetaminophen is an analgesic best known by the brand name Tylenol.  Acetaminophen can also be combined with other drugs such as hydrocodone (brand names Vicodin, Lortab, Lorcet)  and caffeine/dihydrocodeine  (brand names Panlor SS,Trezix, ZerLor). 

     Doxylamine is a first generation antihistamine that has sedating properties.  It is the present in over the counter sleep aids such as Unisom. It is also the sedating ingredient in Nyquil.

      The blood alcohol level of 0.03 g/dL is well below the level that would cause impairment. 

     

References:

1. http://www.examiner.com/fight-sports-in-national/final-details-on-the-death-and-autopsy-of-randy-macho-man-savage
2. http://articles.cnn.com/2011-06-30/us/florida.macho.man.autopsy_1_heart-disease-autopsy-report-sudden-cardiac-death?_s=PM:US

Photographs are for illustrative purposes only.  Wrestling with death does not claim ownership.