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. Last Updated: 07/27/2016

Yeltsin's Cure May Stop Working at Any Time




The medical treatment that appears to have re-energized President Boris Yeltsin is a fairly common procedure for blocking a painful nerve - but its effects could wear off in a matter of days, doctors said this week.


Yeltsin, seeming more vigorous than he had in months, told journalists this week that he felt much better after treatment of an inflamed nerve in his back at the Burdenko Neurosurgical Institute.


"Imagine you have a toothache all the time for three years," he said. "You could lose your mind." He said the nerve had been causing chest pain.


The procedure was an injection that blocked pain from the nerve, the Burdenko Institute's deputy director, Alexander Potapov, was quoted as saying this week by the newspaper Sobesednik. He said the pain could return as soon as next week.


Yeltsin's health has been a topic of widespread speculation since his re-election in 1996. He had heart bypass surgery in November of that year and has spent much of his time ill or recuperating from respiratory infections and a bleeding ulcer. In public, he has slurred his speech or spoken with obvious effort, causing people to suspect everything from Alzheimer's disease to alcoholism.


But the president's obvious relief suggests that at least part of his trouble was as simple as a bad back.


It is not uncommon for spinal-related pain to be so severe that patients have difficulty concentrating and sleeping, thus causing drowsiness, said Dr. Paul Nandi, consultant and anesthetist to the pain management unit at the National Hospital for Neurology and Neurosurgery in London.


"Sometimes the medication they take for the pain is sedating," he added.


An injected anesthetic can wear off in a day; but the relief typically lasts one or two weeks. It can be repeated, but it is a fairly involved procedure, he said.


Nandi said there was no obvious medical reason for not performing the procedure earlier. One explanation is that the chest pain was misdiagnosed, given Yeltsin's history of heart troubles.


"Clearly, any physician that sees a patient complaining about pains in the chest is going to think about more serious things like cardiac problems," Nandi said.


Another possibility is that Yeltsin was taking other medication - such as blood-thinning drugs - that would make the procedure dangerous.


Yeltsin's back problem is usually attributed to a rough airplane landing in Spain in 1990, after which he underwent back surgery. But the president says he has had intense pain only for the past three years - which roughly coincides with the decline observers have noted in his speech and energy level.


Nandi said it is typical for spine-related pain to worsen over time, adding that the pain is not always related to the particular event it is ascribed to.


But Leon Aron, a scholar at the American Enterprise Institute in Washington, D.C., whose biography of Yeltsin is due out in January, said he did not believe the back injury was the key factor in Yeltsin's overall state.


He said more probable causes of Yeltsin's decline were hardened arteries affecting the brain, or depression - both conditions that can periodically abate.


From this point of view, his improvement could be related to last week's appointment of Prime Minister Vladimir Putin and the political maneuvering before December parliamentary elections.


"I think he's suffering from clinical depression," Aron said. "He must be in a political battle for him to feel good."