Friday, February 3, 2012

Florence Nightingale Diagnosis Henry VIII: Part 3/3

This has been an amazing series by JoAnn Spears. I've enjoyed having her and I hope you learned something new about medicine during Henry VIII's time.

Baby blues
Nursing Diagnosis:  Sexuality Pattern, Ineffective
Nursing Diagnosis:  Role Performance, Ineffective
In Tudor times, one of the main imperatives on a king was to father sons. Henry’s inability to achieve this goal was the impetus behind the Reformation in England, and has been made much of in fact and fiction. The fact is, though, that his full complement of male children was two legitimate sons, and one illegitimate son. One of the legitimate boys died in infancy and the other, Edward VI, died in his teens. The illegitimate Henry Fitzroy died shortly after he was married, at the age of seventeen. Henry also fathered two healthy girls, Mary I and Elizabeth I. He was in his mid-forties when he sired his last child.
Rhesus or Kell issues, in which incongruent parental blood types can cause a stillbirth or compromised infant, have been suggested as causes of the many miscarriages suffered by Henry’s first two wives. However, his first healthy daughter was born subsequent to his first wife having a succession of pregnancies, which is quite the opposite trajectory to that usually seen with such incompatibilities.
Syphilis, which, untreated, can lead to mental health problems in both parents and offspring, is an embedded but unlikely part of Tudor medical lore. Henry’s impulsive and violent propensities were not described by contemporaries in a way associated with the dementia and deterioration typical of tertiary syphilis. Also, none of Henry’s surviving children exhibited symptoms of congenital syphilis.
Henry’s first three wives each conceived quickly after marriage and, in the case of the first two, conceived multiple times. None of his subsequent three wives conceived. Henry’s symptoms of substantial weight gain and compromised circulation became noteworthy around the period between Henry’s third and fourth marriages. Erectile dysfunction is another potential side effect of both diabetes and poor circulation, and would account for a lot of the personal history of Henry and his last three wives.
Exit strategy
Nursing Diagnosis:  Mobility: Bed, Impaired
Nursing Diagnosis:  Risk for Compromised Human Dignity
Henry VIII’s last years were anything but majestic. The handsome, charming, 6’2” blond athlete of earlier days was a bloated, irritable, sickly being who was largely confined to bed and chair. A mechanical hoist was required to get the king onto a horse once he donned his outsized armor. The purulence of his leg ulcers caused a nauseating stench. His very last days, in which he was confined to his bedchamber, were spent hammering out a succession plan for the progeny he and his sisters would leave behind.
Henry was in his mid-fifties when he died. During the era he lived in, his would not have been considered an advanced age, but a death at that age was certainly not considered untimely. The actual cause of his death is unknown. An embolus to the heart or lung has been suggested. However, either of these would probably have killed Henry quite quickly, and there were days’ worth of succession planning and priestly officiating before the death. Stroke has also been suggested, but the tenor of the deathbed activity around him is not entirely congruent with the suddenness of a cerebrovascular event. Given the circumstances, the eventual succumbing of a once-healthy body to years of chronic disease seems as likely an explanation as any of Henry’s death.
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JoAnn Spears is a registered nurse with Master’s Degrees in Nursing and Public Administration. Her first novel, Six of One, JoAnn brings a nurse’s gallows sense of humor to an unlikely place: the story of the six wives of Henry VIII.  
 Six of One was begun in JoAnn’s native New Jersey. It was wrapped up in the Smoky Mountains of Northeast Tennessee, where she is pursuing a second career as a writer. She has, however, obtained a Tennessee nursing license because a) you never stop being a nurse and b) her son Bill says “don’t quit your day job”.

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