Medical sleuths investigate overindulgence during the Holiday Season

HARRISBURG, Pa., Dec. 2, 2014 — Written by Randy Brooks and originally released by Dr. Elmo and Patsy Shropshire in 1979, “Grandma Got Run Over by a Reindeer” has become a popular holiday song.

It tells a family tale about a Christmas season which goes horribly wrong for the grandmother. Apparently, on Christmas Eve, Grandma finds trouble on the streets while walking home. Allegedly, she gets run over by one or more of Santa’s reindeers. The injuries, it is assumed, causes her death.

So, what went wrong that night? Could there be a medical explanation for Grandma’s unfortunate accident?

To find the answer, the Pennsylvania Health News Service Project asked several medical sleuths to investigate and offer opinions.

Key leads from the song

Possibly some of the biggest clues to this investigation come very early in the song …

She’d been drinkin’ too much egg nog

And we’d begged her not to go

But she’d left her medication

So she stumbled out the door into the snow

According to medical sleuths, this verse may offer some angles to investigate. From this section of the song, we know she may have been intoxicated, she forgot her medication, and she may have had difficulty walking.

Medication and missed doses

Dan Kimball, MD, president of the Pennsylvania Chapter of the American College of Physicians, says it’s easy to forget a dose of medication, particularly around the holidays when there are so many festivities happening. While missing one dose might not do harm for many illnesses and diseases, there are some that can be worrisome.

Diabetes is one such disease.

Several factors could cause a person to develop low blood sugar – hypoglycemia. They include drinking alcohol excessively without eating, changing when or how much is normally consumed, and becoming more physically active than usual.

“If Grandma is diabetic and maybe drank too much alcoholic egg nog, I could see this as being a possibility,” says Dr. Kimball, an internist from Wyomissing, Pa. “Severe hypoglycemia is also known as diabetic shock and it can cause fainting, seizures, coma, and unconsciousness. If she was walking home by herself and had any of these happen, it’s possible that something bad could happen. Maybe she collapsed during her walk home and Santa’s lead reindeer didn’t see her when they were landing somewhere?”

According to Alan Yeasted, MD, an internist from Pittsburgh and governor for the Western Region of the Pennsylvania Chapter of the American College of Physicians, the body naturally makes insulin and healthy individuals make enough to help control blood sugar levels. Unfortunately, some people don’t have the ability to make enough insulin and must either inject insulin or take another medication to increase insulin production.

But, as Dr. Yeasted describes diabetes risks, he also believes it would be out-of-character for Santa to leave the scene.

“Santa is one of the kindest gentlemen on the face of the earth,” he says. “I’m sure if he realized one of his reindeer just hurt Grandma that he would have called an ambulance.”

Regardless, Dr. Yeasted suggests that all diabetic patients pay special attention during the holiday season.

“Work with your health care team to understand your medications and be sure you’re always taking the recommended doses,” says Dr. Yeasted. “If your routine changes, as it may during the holiday season, ask your health care team if your diabetic management plan should be adjusted.”

Food allergy?

Todd Green, MD, FAAAAI, president of the Pennsylvania Allergy & Asthma Association suggests that possibly a food allergy could be blamed.

“Maybe there was some almond milk in Grandma’s eggnog and she had an allergic reaction,” Dr. Green, who practices in Pittsburgh, says. “If she realized she was without her epi-pen, maybe she darted out of the house and was attempting to get home to where her medication was?”

Dr. Green says his group and others including the Pennsylvania Medical Society recently helped pass legislation in Pennsylvania that will make epi-pens more available in school settings for students and staff who may have allergic reactions.

According to Dr. Green, common food allergies include eggs and tree nuts. “If it turns out that Grandma was allergic to something she came into contact that evening, she could have had a reaction that would cause her to have difficulty breathing or for her blood pressure to drop,” he says. “Maybe during her walk home she fainted in a landing path of Santa’s reindeer team?”

“Of course, knowing Santa, I’m sure he would have stopped and helped her,” Dr. Green concludes. “So I have doubts that Grandma had an allergic reaction.”

But, Dr. Green and the Pennsylvania Academy of Allergy & Asthma Association believe there is a lesson to be learned if it would be a food allergy situation. When throwing a holiday party this season, they recommend letting guests know in advance what’s on the menu just in case anyone would have food allergies. That way, your guest will know to avoid certain dishes.

Road Safety?

Michael A. Bohrn, MD, FACEP, president of the Pennsylvania College of Emergency Physicians, says there’s an additional clue towards the end of the song. He points to the line that reads “they should never give a license to a man who drives a sleigh and plays with elves.”

Does this suggest distracted driving caused the accident?

According to Dr. Bohrn, who practices in York, Pa., dangerous events can happen when distracted driving occurs, so this is a realistic possibility.

Furthermore, he says, accidents can happen even when a driver is not distracted, particularly at night if pedestrians are not dressed to be easily seen.

Assuming it was a distracted driver situation, Dr. Bohrn says operating a vehicle – including a sled with a team of reindeers as an engine – takes significant concentration.

“I’ve seen my share of car accident victims as the result of drivers not paying attention to the road,” says Dr. Bohrn. “If you think you can text and drive at the same time, think twice. It doesn’t take much for an accident to happen.”

Furthermore, Dr. Bohrn says that if you must walk outside at night, it’s best to carry a flashlight, walk with a friend in well-lit areas, and wear reflective gear to help drivers see you.

But, while these may be the cause of Grandma’s demise, Dr. Bohrn thinks the likelihood is low.

“We know that Santa’s lead reindeer can navigate the sleigh through the worst of foggy conditions,” he says. “Surely Rudolph would have seen Grandma since his nose can light up an entire neighborhood. Also, Santa is a very reliable driver and wouldn’t break the law by texting and driving at the same time.”

Never-the-less, Dr. Bohrn and the Pennsylvania College of Emergency Physicians offer these tips for being safe on the roads this winter.

– Never text and drive

– Do not drink and drive

– Stay off the roads during inclement weather, but if you must venture out, make sure you dress warmly, keep a blanket in your car, and carry water.

No need to worry about Santa’s eyesight

According to Drew Stoken, MD, president of the Pennsylvania Academy of Ophthalmology, there’s no evidence that Santa’s vision played a role in the hit-and-run.

“Santa’s been around for years, and gets an annual eye exam,” says Dr. Stoken, who practices in Carlisle, Pa. “He may wear glasses to read, but otherwise he has pretty good eyesight.”

Dr. Stoken knows exactly how well Santa sees. In fact, the Pennsylvania Academy of Ophthalmologists are the official ophthalmologists for the North Pole.

“I can’t go into specifics because of HIPAA,” says Dr. Stoken, “but trust me, his vision meets the requirements to drive a vehicle.”

Dr. Stoken says the example Santa sets with eye care is one that others should follow.

“At Santa’s age (1,744 years in 2014) it’s important to get an annual eye exam. This is also the recommendation for anyone over the age of 60,” Dr. Stoken stresses. “We often think the annual eye exam is just to determine a prescription for eyeglasses or contact lens, but an ophthalmologist will also look for early signs of many ocular diseases such as macular degeneration, glaucoma, and cataracts as well as systemic diseases including hypertension (high blood pressure), cancer, diabetes, sickle cell anemia, and arthritis.”

Dr. Stoken does note that Santa could be at risk of diabetes due to his weight. Downing too many cookies on his rounds along with the stress of the holidays could lead to hyperglycemia and blurred vision, which could account for Grandmas unfortunate demise. However, there was no sign of diabetes during his last eye exam.

For those who like a good conspiracy theory

With medical clues exhausted, and knowing Santa is a caring individual, many medical sleuths say pointing the finger at Kris Kringle, his elves, and his reindeer is wrong.

“Sure, when they found Grandma Christmas morning at the scene of the attack, she may have had hoof prints on her forehead and claus marks on her back,” says Karen Rizzo, MD, president of the Pennsylvania Medical Society. “But I know a forensic investigation could be used to prove those marks didn’t come from Santa’s team.”

Dr. Rizzo and many others suggest that it’s too suspicious that Grandpa was taking it so well, watching football, drinking beer, and playing cards with Cousin Mel.

And, additional research through a special animated holiday show based upon the song suggests Cousin Mel was up to no good.

“It’s a set up … 100 percent set up,” says Dr. Rizzo.

But, Dr. Rizzo says we can learn from this story, particularly in caring for the elderly. This winter, Dr. Rizzo and the Pennsylvania Medical Society are encouraging those with elderly friends and relatives to check in with them regularly. These tips are suggested

– Ask them if they need rides to doctor appointments, church, grocery stores and other locations

– Make sure your elderly neighbors are staying warm as the temperature dips

– Help them shovel snow

“Be neighborly and keep an eye on your elderly friends and relatives,” says Dr. Rizzo.

Does “Got run over by a reindeer” mean something else?

While it’s fun to look at the lyrics and launch a medical investigation on what may have happened to Grandma, there’s a more serious message hidden behind the words.

According to a December 2011 interview on KMXJ Mix 94.1 in Amarillo, Texas, Dr. Shropshire, a veterinarian, told on-air personality Lori Crofford that “Grandma got run over by a reindeer” is about overindulgence and hangovers during the holiday season. Apparently, the song’s writer, Randy Brooks, had a grandmother who was known for her hangovers due to too much holiday cheer.

Jon Shapiro, MD, who runs the Physician Health Program at the Foundation of the Pennsylvania Medical Society, says that drinking can be a simple pleasure if controlled, but it can reach a point in which it is a problem.

According to Dr. Shapiro, whose PHP program helps health care professionals struggling with addictions, it’s easy for someone to slip further into a drinking problem and create potentially dangerous situations for themselves and others.

“When you have friends and family members worried about how much you are drinking,” says Dr. Shapiro, “it could be a sign that you have a drinking problem.” Other signs, he says, may include forgetting what you did while drinking, hiding drinking habits, and regularly drinking more than planned.

“Holiday parties often involve alcohol,” Dr. Shapiro adds. “This can be a tough time of the year for someone suffering from alcoholism.”

For those with drinking problems, it may be best to avoid parties where alcohol is served. However, if someone must attend a holiday gathering, Dr. Shapiro and the Physicians’ Health Programs at the Foundation of the Pennsylvania Medical Society offer these tips:

– Mentally prepare yourself before the party by developing a plan to avoid alcohol consumption. Then tell a reliable friend or relative to help you stick to the plan.

– Don’t bring a bottle of alcohol as a gift for the party’s host. Other ideas are better and could include food items, coffees, and teas.

– If there is a bar at the party, do not hang out near it.

– Stay busy during the party with friends and family members.

– Set a time limit to stay at the party.

– Bring your own non-alcoholic drinks just in case there are no options.

If you are throwing a party, says Dr. Shapiro, there may be guests with drinking problems. Have food and non-alcoholic drinks available. Don’t let anyone drink to the point of intoxication. And, don’t pressure anyone to drink.

This news release is brought to you by the Pennsylvania Health News Service Project, consisting of 19 Pennsylvania-based medical and specialty associations and societies. Members of PHNS include Pennsylvania Allergy & Asthma Association, Pennsylvania Dental Association, Pennsylvania Academy of Dermatology & Dermatologic Surgery, Pennsylvania Academy of Ophthalmology, Pennsylvania Academy of Otolaryngology, Pennsylvania American Congress of Obstetricians and Gynecologists, Pennsylvania Chapter of the American College of Cardiology, Pennsylvania Chapter of the American College of Emergency Physicians, Pennsylvania Chapter of the American College of Physicians, Pennsylvania Chapter of the American Academy of Pediatrics, Pennsylvania Medical Society Alliance, Pennsylvania Medical Society, Pennsylvania Neurosurgical Society, Pennsylvania Psychiatric Society, Pennsylvania Society of Anesthesiologists, Pennsylvania Society of Gastroenterology, Pennsylvania Society of Oncology & Hematology, Robert H. Ivy Society of Plastic Surgeons, and Urological Association of Pennsylvania.

SOURCE Pennsylvania Medical Society