I held off all notions on what killed Michael Jackson until I was able to see his full autopsy report. The media speculations were all over the place involving Demerol, opiates, needle marks all over his body, name it and I saw it. Around the time of Michael’s death I offered up my own possibilities as it relates to lupus and the initial reports of MJ’s cardiac arrest.

After my diagnosis with lupus nephritis in 2005, I became interested in MJ because I was familiar with some of the reported illnesses he experienced and strangely enough, some of them mirrored my own. Prior to my diagnosis I had heard MJ had lupus in the late 80s, perhaps early 90s after the Pepsi commercial accident but, like many, I had no idea there were different classifications for lupus, i.e., discoid, drug induced and systemic lupus. At that time, all I knew was lupus was lupus and like many I had no clue lupus could adversely affect your body, cause you great harm or cause death from complications.

I do not have vitiligo, however, and I too was guilty of “making fun” of something I knew nothing about. Basically, I was in that category of fools who knew not what they spoke. Karma can be an awful thing.

Now that I’ve been diagnosed with lupus I now understand all too well what MJ went though. I can look back at my life and see all of the health problems I had were all due to a case of undiagnosed lupus. I can also relate to the ridicule he experienced because, when you’re a star at something and you fail, drop out, or give up because your body can’t handle it anymore, people will criticize you, poke fun, ridicule you, etc., because they can and they don’t understand.

Many did not believe he had vitiligo but he did. When news of a lung condition surfaced with reports of him possibly needing a lung transplant, no one believed the stories. Unfortunately, he did have a serious lung condition. When pictures surfaced some years ago of MJ in a wheel chair, people laughed and believed he was putting on a show. Truth is, though minimal, he had degenerative spondylosis (degenerative osteoarthritis) of the lower thoracic spine, degenerative osteoarthritis of lower lumbar spine facet joints, distal interphalangeal joints of the right index and long fingers, and distal interphalangeal joint of left little finger. Basically, he had some arthritis in his back and a couple of fingers which might have been quite uncomfortable and painful.

Lupus And Men

Unfortunately, much of the information on lupus relates to women. Very little is offered on how lupus affects men. Though lupus affects every individual differently and men may experience some of the same symptoms as women, there are differences. Just as there are differences in how men and women experience heart attacks, the same is true of other diseases as well. The following comes from everydayhealth.com:

Men with lupus face a unique set of challenges, including the following:
• Studies suggest that men may develop more severe lupus symptoms and have a slightly worse prognosis than women.
• Men may have an increased frequency of nervous system problems associated with lupus that may cause seizures. [Remember this one.]
• Men may have more lung problems associated with lupus. [Remember this one.]
• Men with lupus are more likely to have problems with their kidneys. [The jury is still out on this one.]
• Men may get more severe forms of lupus-related skin rashes.
• Men may get more blood clots and have a greater tendency to develop anemia, a condition where your blood is deficient in oxygen-carrying red blood cells.
• Because there are so few men with lupus, only a limited number of exclusively male support groups are available.
That said, what I looked for in MJ’s autopsy report were other conditions. I was primarily interested in conditions that might be associated with lupus. I also wanted to know – besides propofol – what drugs was he taking and what he took for pain.

I did not find the smoking gun Demerol or Oxycontin. It appears the drugs found in his system were drugs Dr. Murray brought in to help MJ sleep, put him under, or counteract said drugs should the good doctor find himself in deep pooh. Contrary to what I heard originally, Prednisone was prescribed for two days only – 60 mgs one day and 40 the next – on April 25, 2009. MJ was not on Prednisone at the time of his death.

My drug list is down to one drug, prednisone. If you were to walk into my house you will find the bottle of prednisone, you will also find blood pressure meds that I am no longer taking, diuretics I take every now and then but you will not know I’m on chemo. You won’t find Cytoxan in my house. If MJ was doing IV Cytoxan or any form of chemo, it was not found in the house.

Which brings me to the many rumors that MJ had cancer and was receiving chemo at some undisclosed location? That’s possible but it is not in the coroner’s report. There are some things in the report that would lead you to believe he either had cancer, was precancerous or he had benign masses. The coroner’s report, however, is not meant to diagnose a condition which means we will never know unless someone tells and under HIPAA, they should not tell.

Physical

Okay so let’s start with what everyone loves talking about, the wig and tattoos. The coroner’s examination at the hospital states “[t]he decedent’s head hair is sparse and is connected to a wig. The decedent’s overall skin has patches of light and dark pigmented areas.” The coroner also notes “There was a dark black discoloration on the decedent’s upper forehead near his hair line. Dark coloration was present on the decedent’s eyebrows, eyelashes and lips.” What this basically tells me is MJ wore either a front-laced wig or full-laced wig with a tattoo line to create a false hairline. He also may have used dark tattooing to give the impression of full eyebrows, eyeliner and a lip line. Further in the autopsy report is mention of a coloration that may have been added to his lips so they would appear pink or red.

No shocker there. I knew MJ wore wigs, I liked them, but I did not know what kind of wig he wore. I noticed the tattoos as well, particularly the hair line tattoo. At the time I thought the tattoo was designed to make him appear to have a hair line because of the vitiligo. Initially, I didn’t understand how he was wearing the wigs but now, having purchased a few lace front wigs myself, I get it.

Again, speaking from personal experience, I too have experienced loss of eyelashes and eyebrows. In fact, the first indication I was having problems – prior to my diagnosis with lupus – was I started losing my eyelashes, eyebrows and my hair was falling out. I started using eyebrow pencils like nobody’s business after that because I went from heavy eyebrows to barely having eyebrows. I’ve given up on the eyelashes and forgedabout eyeliner.

Pharmaceuticals

Starting with the synopsis, apparently MJ complained of dehydration and an inability to sleep. MJ also had no history of heart problems. I’m curious about the dehydration. What caused that?

According to the “Witness Statement”, MJ called Dr. Murray complaining of dehydration and his inability to sleep at 1:00 a.m. Murray arrived at MJ’s home and administered unknown care. Later that day, an ambulance was called and MJ was taken to the hospital where he “presented asystolic to the hospital.” Asystolic means he had no heartbeat or cardiac arrest. The witness stated MJ “was taking several prescription medications including clonazepam, trazodone, diazepam, lorazepam and Flomax but it is unknown if he was compliant.”

Interesting, clonazepam is typically used to control certain types of seizures in the treatment of epilepsy and for the treatment of panic disorders. Did MJ have seizures – as noted in the description above for lupus and men – or was this drug prescribed as a relaxant?

Trazodone is an antidepressant medication and can also be used for relief of anxiety disorders (e.g., sleeplessness, tension) and chronic pain. I expected to see other drugs used for pain, not trazodone.

Diazepam is used for the management of anxiety disorders or for the short-term relief of symptoms of anxiety. Diazepam may also be used to relieve agitation, shakiness, and hallucinations during alcohol withdrawal and relieve certain types of muscle spasms. It may also be used to treat seizures, insomnia, and other conditions as determined by a doctor. Again, did MJ have seizures or was this drug prescribed to relax him.

Lorazepam is typically used to treat anxiety or anxiety associated with symptoms of depression.

Probably the most interesting of the aforementioned drugs was Flomax. Further in the autopsy report, in a section entitled “Genital System”, it says:

The prostate is moderately enlarged, with a prominent intravesical middle (median) lobe. The prostatic parenchyma is nodular. Both testes are in the scrotum and are unremarkable and without trauma.

Flomax is typically used to improve urination in men with benign prostatic hyperplasia (enlarged prostate). Flomax also relaxes veins and arteries so that blood can more easily pass through them. It also relaxes the muscles in the prostate and bladder neck, making it easier to urinate. I now understand why Flomax. Also noted in the autopsy report was the description of his bladder as “distended and trabeculated.” I don’t know if this was as a result of death or relates to why he was taking Flomax, which again, relaxes the muscles in the prostate and bladder neck, making urination easier.

Dr. Murray (cardiologist), Dr. Metzger of Cedars (Rheumatologist) and Dr. Klein (dermatologist) were mentioned in the autopsy report as prescribing drugs to MJ. The aforementioned drugs and more were found in his home.

Two lotions found in MJ’s home were Benoquin Cream, indicated for final depigmentation in extensive Vitiligo and Hydroquinone, a topical agent/lotion used to lighten areas of darkened skin such as freckles, age spots, chloasma, and melasma. These lotions were apparently used to even out MJ’s skin tone due to the vitiligo. No prescribing doctor was listed for these drugs but I’ll assume they came by way of Dr. Klein, MJ’s dermatologist. The autopsy report does state his “skin has patches of light and dark pigmented areas.”

Another lotion found in the home was Lidocane which is a common local anesthetic and antiarrhythmic drug – suppresses fast rhythms of the heart. Interesting. Dr. Murray prescribed this lotion for MJ. I wonder why.

Clonazepam and trazodone were prescribed by Dr. Metzger. Diazepam, lorazepam, flomax, and temazepam – used to treat insomnia – were all prescribed by Dr. Murray.

Another drug, prescribed by MJ’s dermatologist of all people, was Tizanidine, a skeletal muscle relaxant typically used to relieve the spasms and increased muscle tone caused by multiple sclerosis (MS, a disease in which the nerves do not function properly and patients may experience weakness, numbness, loss of muscle coordination and problems with vision, speech, and bladder control), stroke, or brain or spinal injury. This drug can make you drowsy, cause dizziness if you get up too fast and will decrease muscle tone.

MJ had an accident many years ago where he fell off a stage. This is probably why he ended up with osteoarthritis in his back and why this drug was prescribed. I just found it interesting a dermatologist prescribed the drug.

Again, Dr. Klein also prescribed Zanaflex (a short-acting medication offering relief from muscle spasticity), and Prednisone which prevents the release of substances in the body that cause inflammation. The prednisone was prescribed in 10mg tablets with the instructions “6 tab now, 4 tomorrow.” It appears he was only prescribed 10 tablets on 4/25/09.

There were two antibiotics prescribed by Dwight James/Cherilyn Lee, Amoxicillin and Azithromycin. For one, the patient’s name was “blocked out on the label.” The other was prescribed to Kathlyn Hursey. I’m going to go out on a limb on this one and assume, like many will do, he liked having antibiotics around just in case.

Other drugs that show no prescribing doctor were Flumazenil (a drug used to reverse the effects of benzodiazepines in conscious sedation, general anesthesia, and the management of suspected benzodiazepine overdose, exactly what MJ experienced). Midazolam was another drug with “no prescription directions and no patient or doctor names”. This drug is used to produce sleepiness or drowsiness and to relieve anxiety before surgery or certain procedures. Midazolam is also given to produce amnesia (loss of memory) so that the patient will not remember any discomfort or undesirable effects that may occur after a surgery or procedure. Midazolam has been associated with respiratory depression and respiratory arrest, especially when used for sedation in noncritical care settings.

Was MJ a drug addict? Well, I didn’t see any smoking gun drugs here that would say he was a drug addict. From what I can tell from the drugs found in his home, much of it was not taken as prescribed or were seldom taken. For instance, one of the drugs prescribed by Dr. Metzger, Trazodone, was issued on 4/18/09. He was issued 60 pills at 50mg to be taken 2 at bedtime as needed. At the time of his death he had 38 pills remaining which means he only took the pills 11 days. He certainly wasn’t sucking those pills up like an addict.

Tizanidine, the muscle relaxant prescribed by Dr. Klien, was issued on 6/7/2009. The instructions given for that drug was to take one-half tablet at bedtime. He was issued 10 pills and at the time of his death 8 remained. During the month of June, MJ only took 2 pills which if taken as prescribed; he took 4 pills over the course of 4 days sometime between June 7th and June 25th. He wasn’t sucking those up either.

As for the drugs with “no prescription directions and no patient or doctor names”, we don’t know. These drugs appear to be part of Dr. Murray’s “sleep therapy” experiment.

I know nothing about drug addiction so I can offer nothing on whether MJ was a drug addict or not. It does appear he had too many medications in the house that when combined could cause death. In terms of being a drug addict, I can’t see any one drug as a favorite.

Looks to me like MJ had a problem calming down. Having finally watched the film “This Is It”, I was able to see MJ in action from the perspective of others. I can see why he might have had a problem calming down and it had nothing to do with prednisone. It appears there was always something going on in his head. I also believe he really wanted to do the concert. Additionally, at no time during that rehearsal footage did I see a “zonked out” Michael Jackson. He probably went home after rehearsals with a brain full of new things to do, new dance steps, new visuals, etc. He just could not calm down.

As an aside, many doctors have tried to knock me out for out-patient procedures. To their dismay, I’ve never gone out. Some people’s bodies or constitution just resist medications and I’m one such person. As a result, I always end up watching the blood and gore. I won’t feel a thing but I do end up seeing everything. Muscle relaxants do nothing for me, I fight against those too. Dentists hate to see me coming because nothing they throw at me works. I just grin – no pun – and bear it. One doctor hit me with so much stuff one time I felt as if I weighed 1000 tons and was nauseous but I did not go under. I wonder if MJ had the same problem.

I won’t say it’s my greatest fear but I do think about it often. If one day I should need surgery and should I encounter a doctor who doesn’t understand I’m one of the hard ones to put under, will he throw the kitchen sink at me? Will I survive it? I might not survive an impatient anesthesiologist.

So, bottom line, propofol, lorazepam, midazolam, lidocaine, diazepam and nordiazepam, were identified in blood samples. Propofol, midazolam, lidocaine and ephedrine were identified in his urine. Propofol and lidocaine were identified in his liver tissue. Propofol was identified in vitreous humor (his eyes). Finally, Lidocaine and propofol were identified in the contents of his stomach.

With the above-mentioned drugs, though they all have a particular purpose, any of them can be used for other reasons as well. It always depends on the doctor.

Troublesome Findings?

There were rumors that MJ needed a lung transplant or had some sort of rare lung disease. He truly had a lung ailment. According to the findings in one of the reports, MJ’s left lung weighed 1060 grams and the right lung weighed 940 grams. Further in the report the following opinion was given.

The above findings reflect a depletion of structural and functional reserves of the lung. Reserve depletion is the result of widespread respiratory bronchiolitis and chronic lung inflammation in association with fibrocollagenous scars and organizing/recanalizing thromboemboli of small arteries. It should be noted that the above lung injury with reserve loss is not considered to be a direct or contributing cause of death. However, such an individual would be especially susceptible to adverse health effects.

No rumor there, he did in fact have a lung problem. Is it possible the aforementioned lung ailment was a result of lupus? Going back to the above section “Lupus and Men”, Men may have more lung problems associated with lupus. Was this possibly lupus?

MJ’s right kidney (the larger one) had a “0.2 cm off-white well circumscribed medullary mass.” The report does not say whether this mass was benign or malignant. Second, they found a “1.5 cm well circumscribed off-white lobulated mass located in the periaortic region just medial to the left adrenal gland.” Again, no mention if this mass was benign or malignant. As noted earlier, his prostate was moderately enlarged, “with a prominent intravesical middle (median) lobe.”

I will also admit here that a guy 136 lbs who is 69 inches tall (5’9”) is pretty thin.

My Conclusions

Yeah, my conclusions are just enough to be dangerous. MJ was just too thin. I know he was a thin man all of his life but gee whiz, that’s thin but, big but, it had nothing to do with his death. There were no opiates in his system so the whole drug addict deal doesn’t wash. It appears MJ was shopping docs for sleep aid as he apparently was too hyper.

He did have a medical condition. Dr. Klein admits he diagnosed MJ with lupus years ago and he did have one very famous lupus doctor/Rheumatologist in Dr. Metzger. For sure, as seen in the autopsy report, MJ did in fact have vitiligo.

Of course, an autopsy is in search of cause of death. An autopsy report typically will not diagnose underlying conditions unless they are blatantly obvious. The report did point out a few disturbing findings but we will never know if MJ had cancer or was precancerous.

What I did see in this autopsy report is MJ was not a healthy man. Forget the drugs, he had a spinal injury, arthritis, arterial atherosclerosis of both legs, a whopper of a lung ailment, off-white masses, and OMG my eyes glazed over at what could possibly become big problems for him sooner or later.

After all of the talk last year of Demerol and other drugs or opiates, I did not see one listed as being in his system and they certainly were not listed in the report of drugs found in the home. Did somebody grab ‘em? Who knows.

So, MJ talked about his vitiligo and no one believed him. He talked about his lung disorder and no one believed him. Quincy Jones’ interview/article was unbelievable as well but then again, old men can be quite foolish. Did MJ have seizures? We may never know. MJ certainly had a lung problem, was it a result of lupus? We may never know. When you find most don’t believe you when you’re telling the truth, you may just stop talking.

As troublesome as it was to read, MJ’s autopsy is doing a lot of talking. Bottom line, with all he suffered in his life, he still performed at peak. All of us lazy buggers out here complaining about getting out of bed on a cold day, we need to get over ourselves. Obviously we can’t cut the mustard and we have a lot more to work with.

I will miss MJ but I still have his music. Stranger In Moscow will always be my favorite song and Rock With You is No. 2 on my list. I will cherish those songs and more forever. Though I wish MJ could have lived to the great old age of ???, considering the body drama MJ might have suffered had he lived, I believe in some odd way he was blessed. Though many wanted to believe the very worse about MJ he must have had some sort of angelic life. After watching the film This Is It, I am more inclined to believe that. To have passed away knowing he was still at the top of his game and he could still sell out arenas, that’s a big deal.

He went to sleep with his head comfortably resting on a cloud and yes indeed, everything happens for a reason. Karma is interesting and perhaps, this was my mission.