Former President and NDC Flagbearer, John Dramani Mahama, has recently undergone a comprehensive medical consultation following a four-month period of persistent abdominal pain, fatigue, and associated symptoms.
The consultation, dated October 21, 2024 at the Summit Medical Care, New York, sheds light on the health challenges faced by the 65-year-old politician and offers an in-depth look at his condition and recommended management plan.
Symptoms and medical history
Mr. Mahama sought medical advice after experiencing intermittent upper-right quadrant (URQ) abdominal pain, characterized as dull and radiating to the back, alongside worsening fatigue and occasional nausea and vomiting. The symptoms reportedly worsened with meals, affecting his appetite and daily activities. Although he reported feeling feverish at times, he had not recorded his temperature.
During the consultation, Mr. Mahama disclosed a significant history of alcohol use beginning in his early 20s, particularly during his postgraduate studies in Moscow, Russia. He admitted to consuming approximately 1–1.75 liters of liquor per occasion and described his drinking pattern as consistent rather than binge drinking.
The patient also noted occasional cigar use but denied cannabis or other recreational drug use. His CAGE (Cut down, Annoyed, Guilty, Eye-opener) score of 3/4 raised concerns about alcohol dependence.
Physical examination and laboratory findings
The physical examination revealed signs consistent with possible liver disease, including scleral icterus (yellowing of the whites of the eyes), mild caput medusae (visible abdominal veins), and hepatosplenomegaly (enlargement of the liver and spleen). Notable findings included tenderness in the upper-right abdomen, mild asterixis (flapping tremor), and bilateral lower extremity edema.
The patient’s general condition was noted as moderately obese but otherwise well-developed and nourished.
Lab results
The laboratory results revealed a concerning health situation. Elevated liver enzymes, with AST at 280, ALT at 89, and GGT at 208, indicate significant stress on the liver. The total bilirubin level, recorded at 9 mg/dL, alongside a low albumin level of 2.5 g/dL, further suggests impaired liver function. Additionally, abnormal clotting parameters, including a prolonged prothrombin time (PT) of 19 seconds and an international normalized ratio (INR) of 2.5, combined with a low hemoglobin level of 10.2 g/dL, highlight potential complications such as coagulopathy and anemia.
The medical team identified Alcohol Use Disorder and likely Alcoholic Hepatitis as key components of Mr. Mahama’s condition. Recommendations included a multifaceted approach focusing on lifestyle modifications and medical intervention.
The recommended lifestyle changes included a gradual reduction in alcohol consumption, with the ultimate goal of achieving complete abstinence. Weight management was advised through moderate aerobic exercises, such as brisk walking, for at least 30 minutes a day, five days a week. A nutrient-rich diet was also emphasized, focusing on low saturated fats, high fiber, and adequate protein intake. Additionally, improving sleep hygiene and maintaining consistent meal patterns were suggested to support overall health and recovery.
Medical interventions
The medical team implemented several interventions to address the patient’s condition. Medications such as Campral, Naltrexone, or Disulfiram were introduced to manage alcohol dependence effectively. Prednisolone therapy was initiated to reduce hepatic inflammation. Further evaluation included imaging studies, such as ultrasound or CT scans, and a liver biopsy to gain deeper insights into the extent of liver damage. Referrals were made to an addiction psychiatrist and support groups to provide psychological and social support for recovery.
However, the prognosis remains guarded to poor, considering the compromised state of Mr. Mahama’s liver. Physicians stressed the importance of stringent monitoring to prevent complications such as hepatic encephalopathy, a severe condition associated with liver failure.
