Confabulational Confluence (Part2) with LE edema in the setting of high-calorie malnutrition suggests thiamine deficiency
Wet (CHF, edematous) beriberi: high-output heart failure w/ tachicardia, peripheral vasodilation and edema, variable pulmonary edema. Wernicke-Korsakoff syndrome: Wernicke encephalopathy: emergency, a
Clinical manifestations of thiamine (vitamin B1) deficiency
Dry (neuropathic) beriberi: peripheral motor/sensory neuropathy, muscle weakness, spontaneous pain, paresthesia, loss of reflexes
Wet (CHF, edematous) beriberi: high-output heart failure w/ tachicardia, peripheral vasodilation and edema, variable pulmonary edema
Wernicke-Korsakoff syndrome: Wernicke encephalopathy: emergency, acute confusion, vision problems (double vision, drooping eyelids, abnormal eye movements), ataxia Korsakoff syndrome: amnesia and confabulation
Bilateral LE edema
Bilateral edema in the lower extremities (LE, ie, legs and ankles) is more suggestive of heart failure or kidney/liver disease than it is of chronic venous insufficiency, although the latter is a possibility.
Progressive confabulation
However, combining the clinical picture of LE edema with worsening confabulation in a patient famous for consuming a high-calorie nutrient-depleted diet suggests the possibility of a uniting cause such as thiamine deficiency.
High-calorie high-salt nutrient-depleted diet promotes thiamine deficiency
What is the Trump diet? Fast food, lots of snacking, little vegetables, news reports say For years, Trump has had an affection for fast food. During 2024 presidential election, a campaign stop was at a McDonald's drive-thru.https://www.palmbeachpost.com/story/news/2024/11/25/trump-diet-fast-food-mcdonalds-ice-cream-diet-coke-mar-lago/76297238007/
Trump’s affinity for fast food has been well documented since the earliest days of his public life. In the nineties and early two-thousands, he filmed commercials for Pizza Hut and McDonald’s. On the campaign trail, at a televised CNN town hall, he explained to Anderson Cooper that he enjoyed “a fish delight,” referring to the Filet-o-Fish. He continued, “The Big Macs are great. The Quarter Pounder. It’s great stuff.” https://www.newyorker.com/culture/annals-of-appearances/the-pure-american-banality-of-donald-trumps-white-house-fast-food-banquet
Jared Kushner, Trump’s son-in-law, wrote in his 2022 memoir Breaking History that when his father-in-law contracted COVID-19 in 2020, ordering in from the fast food chain signaled that he was on the way to recovery. “I knew he was feeling better when he requested one of his favorite meals: a McDonald’s Big Mac, Filet-o-Fish, fries and a vanilla shake,” Kushner wrote. Former Trump campaign officials Corey Lewandowski and David Bossie said in their 2017 book Let Trump be Trump that the former President’s go-to McDonald’s order consisted of “two Big Macs, two Fillet-O-Fish and a chocolate malted [shake].” https://time.com/7095424/donald-trump-mcdonalds-love-campaign-kamala-harris-work-history/