Re: Aerial Sleigh-Borne Present-Deliverer's Syndrome
From: art fougner, md (evsono@pipeline.com)
Sat Dec 23 15:22:22 2006
Ho, Ho, Ho ... A Happy and a Merry to All.
Art
At Sat, 23 Dec 2006, R. Daniel Braun wrote:
>
>Got this from a good friend and I tohought the list would appreciate it.
>Dan
>
>>From Kindred Jester: Patty Wooten RN
>
>Case Report:
>Unique Case of Aerial Sleigh-Borne Present-Deliverer's Syndrome
>
>Source: North Pole Journal of Medicine, vol 1 no.1, December 1997
>Author: Dr. Iman Elf, M.D.
>
>On January 2, 1997, Mr. C, an obese, white Caucasian male, who appeared
>approximately 65 years old, but who could not accurately state his age,
>presented to my family practice office with complaints of generalized aches
>and pains, sore red eyes, depression, and general malaise. The patient's
>face was erythematic, and he was in mild respiratory distress, although his
>demeanor was jolly. He attributed these symptoms to being "not as young as I
>used to be, HO! HO! HO!", but thought he should have them checked out. The
>patient's occupation is delivering presents once a year, on December 25th,
>to many people worldwide. He flies in a sleigh pulled by eight reindeer, and
>gains access to homes via chimneys. He has performed this work for as long
>as he can remember. Upon examination and ascertaining Mr. C's medical
>history, I have discovered what I believe to be a unique and heretofore
>undescribed medical syndrome related to this man's occupation and lifestyle,
>named Aerial Sleigh-Borne Present-Deliverer's Syndrome, or ASBPDS for short.
>
>Medical History: Mr. C. admits to drinking only once a year, and only when
>someone puts rum in the eggnog left for him to consume during his working
>hours. However, I believe his bulbous nose and erythematic face may indicate
>long-term ethanol abuse. He has smoked pipe tobacco for many years, although
>workplace regulations at the North Pole have forced him to cut back to one
>or two pipes per day for the last 5 years. He has had no major illnesses or
>surgeries in the past. He has no known allergies. Travel history is
>extensive, as he visits nearly every location in the world annually. He has
>had all his immunizations, including all available vaccines for tropical
>diseases. He does little exercise and eats large meals with high sugar and
>cholesterol levels, and a high percentage of calories derived from fat (he
>subsists all year on food he collects on Dec. 25, which consists mainly of
>eggnog, Cola drinks, and cookies).
>
>Family history was unavailable, as the patient could not name any
>relatives.
>
>Physical Examination and Review of Systems, With Social/Occupational
>Correlates: The patient wears corrective lenses, and has 20/80 vision. His
>conjunctivae were hyperalgesic and erythematous, and Fluorescein staining
>revealed numerous randomly occurring corneal abrasions. This appears to be
>caused by dust, debris, and other particles which strike his eyes at high
>velocity during his flights. He has headaches nearly every day, usually
>starting half way through the day, and worsened by stress. He had extensive
>ecchymoses, abrasions, lacerations, and first-degree burns on his head,
>arms, legs, and back, which I believe to be caused mainly by trauma
>experienced during repeated chimney descents and falls from his sleigh.
>Collisions with birds during his flight, gunshot wounds (while flying over
>the Los Angles area) and bites consistent with reindeer teeth may also have
>contributed to these wounds. Patches of leukoderma and anesthesia on his
>nose, cheeks, penis, and distal digits are consistent with frostbite caused
>by periods of hypothermia during high-altitude flights. He had a blood
>pressure of 150/95, a heart rate of 90 beats/minute, and a respiratory rate
>of 40. He has had shortness of breath for several years, which worsens
>during exertion. He has no evidence of acute cardiac or pulmonary failure,
>but it was my opinion that he is quite unfit due to his mainly sedentary
>lifestyle and poor eating habits which, along with his stress, smoking, and
>male gender, place him at high risk for coronary heart disease, myocardial
>infarction, emphysema and other problems. Blood tests subsequently revealed
>higher-than-normal CO levels, which I attribute to smoke inhalation during
>chimney descent into non-extinguished fireplaces. He has experienced chronic
>back pain for several years. A neurological examination was consistent with
>a mild herniation of his L4-L5 or L5-S1 disk, which probably resulted from
>carrying a heavy sack of toys, enduring bumpy sleigh rides, and his jarring
>feet-first falls to the bottom of chimneys. Mr. C. had a swollen left
>scrotum, which, upon biopsy, was diagnosed as scrotal cancer, the likely
>etiology being the soot from chimneys.
>
>Psychiatric Examination and Social/Occupational Correlates: Mr. C's
>depression has been chronic for several years. I do not believe it to be
>organic in nature-rather, he has a number of unresolved issues in his
>personal and professional life which cause him distress. He exhibits
>long-term amnesia, and cannot recall any events more than 5 years ago. This
>may be due to a repressed psychological trauma he experienced, head trauma,
>or, more likely, the mythical nature of his existence. Although the patient
>has a jolly demeanor, he expresses
>profound unhappiness. He reports anger at not receiving royalties for the
>widespread commercial use of his likeness and name. Although he reports
>satisfaction with the sex he has with his wife, I sense he may feel erotic
>impulses when children sit on his lap, and I worry he may have pedophillic
>tendencies. This could be the subconscious reason he employs only
>vertically-challenged workers ("elfs"), but I believe his hiring practices
>are more likely a reaction formation due to body-image problems stemming
>from his obesity. The patient feels annoyed and worried when he is told many
>people do not believe he exists, and I feel this may develop into a serious
>identity crisis if
>not dealt with. He reports great stress over having to choose which gifts to
>give to children, and a feeling of guilt and inadequacy over the decisions
>he makes as to which children are "naughty" and "nice". Because he
>experiences total darkness lasting many months during winter at the North
>Pole, Seasonal Affective Disorder (SAD) may be a contributor to his
>depression.
>
>Treatment and Counseling: All Mr. C's wounds were cleaned and dressed, and
>he was prescribed an antibiotic ointment for his eyes. A referral to a
>physiotherapist was made to ameliorate his disk problem On February 9, a
>bilateral orchidectomy was performed, and no further cancer has been
>detected as of this writing. He was counselled to wash soot from his body
>regularly, to avoid lit-fire chimney descents where practicable, and to
>consider switching to a closed-sleigh, heated, pressurized sleigh. He
>refused suggestions to add a helmet and protective accessories to his
>uniform. He was put on a high-fibre, low cholesterol diet, and advised to
>reduce his smoking and drinking. He has shown success with these lifestyle
>changes so far, although it remains to be seen whether he will be able to
>resist the treats left out for him next Christmas. He visits a psychiatrist
>weekly, and reports doing "Not too bad, HO! HO! HO!".
>
>Conclusions: Physicians, when presented with aerial sleigh-borne
>present-deliverers exhibiting more than a few of these symptoms, should
>seriously consider ASBPDS as their differential diagnosis. I encourage other
>physicians with access to patients working in allied professions (
>e.g.Nightly Teeth-Purchasers or Annual Candied Egg Providers) to investigate
>whether analogous anatomical/ physiological/psychological syndromes exist.
>The happiness of children everywhere depend on effective management of these
>syndromes.
>
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>
>--
>R. Daniel Braun
>
> "The way to health is an aromatic bath and scented massage everyday".
> Hippocrates
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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