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Singer Lisa Marie Presley’s daughter Riley Keough is shedding new light on some of the health challenges her mother faced throughout her life in a new memoir titled “From Here to the Great Unknown.”

As Keough writes in the book’s foreword, Presley asked her daughter to help write the book shortly before her death in January 2023.

The finished product features reflections on Presley’s fascinating life from both mother and daughter, and outlines the star’s struggles with opioid addiction, body image and heart health.

Below, learn about the various health challenges Presley encountered before her death.

Presley had an opioid addiction

Following the birth of her youngest children, twin daughters Harper and Finley in 2008, Presley began taking the opioids she’d been prescribed for pain following her C-section, Keough writes in the memoir. Over time, she also began taking them to help her sleep.

Before then, Keough, Presley’s oldest child, said her mother had only had a “brief stint with drugs as a teenager” and “had never touched them again.”

In the memoir, Presley reveals she “started upping the pills” after she left the church of Scientology.

“I thought, ‘Oh my God, I’ve lost my religion and it’s been my only pavement to walk on, my replacement family.’ Everything was gone—all my friends, everything,” she wrote. “I knew it was over. And I was so devastated, I used the drugs as a coping mechanism.”

Keough also notes that her mother started “drinking more, taking more opioids.”

“At one point she found an article that said cocaine can help people get off opioids, so she began to do cocaine to get off the opioids and then opioids to get off the cocaine. Her addiction would continue through all of the stints in rehab on the basis that she was always in severe and life-threatening withdrawals that no doctor could understand,” Keough wrote.

The evolution of Presley’s addiction

Presley admitted to taking as many as 80 pills a day as her addiction worsened.

“It took more and more to get high, and I honestly don’t know when your body decides it can’t deal with it anymore. But it does decide that at some point,” she wrote.

A court ordered Presley to attend rehab in Los Angeles and doctors gave her medications to wean her off opioids. As Keough explains in the memoir, these new drugs “only served to make her even more high because whatever the normal dose was, she would somehow get five times that amount from the doctors.”

After rehab, Presley was on “mood stabilizers” that Keough says were “dimming her light.”

Presley would later have a seizure that helped her gain more perspective on her addiction.

“One day she said to me, ‘That’s enough. I really need to change my life.’ She had been very chastened by the seizure—in fact, she had a deep phobia about them,” Keough writes.

Presley went into cardiac arrest before her death

Before she died in January 2023, Presley went into cardiac arrest.

Per the American Heart Association, the heart “malfunctions and suddenly stops beating” during the medical event. It differs from a heart attack, which occurs when “blood flow to the heart is blocked.” However, a heart attack can result in ventricular fibrillation, which can lead to sudden cardiac arrest.

Keough writes about the cardiac arrest and notes that her father had gone over to Presley’s house on Jan. 12, 2023 to bring her Tums since she’d said her stomach was “hurting worse than ever.” Later, Keough’s father told her Presley was in an ambulance and the paramedics thought she had a heart attack.

After resuscitating Presley and finding a pulse, hospital staff did a scan on Presley. Keough later learned that her mother had been in cardiac arrest again. Shortly afterward, Presley died.

Presley had family history of heart issues

Dr. Sheila Sahni, cardiologist with Hackensack Meridian Health’s JFK University Medical Center, previously told TODAY.com that a family history of heart disease can increase women’s risk for heart problems.

Presley’s father, Elvis Presley, died from a heart attack at the age of 42. According to NBC News, the heart attack may have been related to his addiction to prescription drugs.

“There is family history related to cardiac arrhythmias (irregular heartbeat), and there is family history related to coronary artery disease, and it’s very important to know the age at which it manifested in one of your bloodlines,” Sahni said.

“In the case of Lisa Marie, it’s very important (for her doctors) to know that her father also (died) at a young age and what his cardiovascular condition (was),” she added.

Presley’s prior heart failure is outlined in the book

Elsewhere in the book, Presley and Keough write about Presley experiencing heart issues before she entered rehab.

Presley noted that she had done “a bunch of blow and a shot of tequila and a bunch of pills” and her children urged her to see a doctor because her body “was not doing well.”

When she arrived at the hospital, she was “at 30 heartbeats per minute” and was “scared to death.”

“My echocardiogram came back bad. I was literally losing my heart. My heart was dead, just in pieces,” she wrote.

Keough elaborates on her mother’s condition in a follow up passage and said her mother was “in heart failure” and went “straight from the emergency room to the ICU.”

Presley had her uterus removed in 2022

In the memoir, Keough also reveals Presley had her uterus removed in 2022.

“Though she was fighting to keep it together for my sisters, my mom’s health was deteriorating—she had started to say that her stomach was always bothering her. She would have spells of fevers. She was trying to stay inspired and hold on to hope, but underneath everything, there seemed to be a heartbreak that was only growing. And despite my constant scheduling of appointments, she would never see a doctor,” she wrote.

An infection later resulted in the removal of the star’s uterus.

“It was incredibly hard for her,” Keough writes.

Afterwards, Presley’s health problems persisted.

“One day in October that year, we all went to Disneyland. As we were about to get on a ride she sat down on some stairs and said she didn’t feel well, that she was really nauseated. Again, I urged her to go to the doctor, and again, I got no response,” Keough wrote.

Presley’s cause of death was a small bowel obstruction

An autopsy that was made public six months after Presley’s death in 2023 revealed that the star died from complications from a bariatric weight-loss surgery she’d undergone years before.

More specifically, Presley’s cause of death was a small bowel obstruction, a condition that occurs when part of the small intestine is blocked.

Presley’s bariatric surgery

Keough mentions her mother’s bariatric surgery in the memoir, writing, “While in rehab, Mom had decided to get bariatric surgery. Her entire life she had been harassed for being fat. The surgery was something she’d always wanted.”

Bariatric surgery is a category of weight-loss surgeries that alter the digestive system. Types of bariatric surgeries include gastric bypass and sleeve gastrectomies, per the Mayo Clinic.

“While bariatric surgery can offer many benefits, all forms of weight-loss surgery are major procedures that can pose risks and side effects. Also, you must make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of bariatric surgery,” the website reads.

In the memoir, Keough explains that she thought it was a “strange time to decide to have surgery” since her mother was in rehab for substance abuse and wasn’t done with her program.

“I remember worrying that it was a way to stay on medication a little bit longer. I didn’t feel she was ready to be sober,” she wrote.

Presley’s small bowel obstruction

Bariatric surgeries can sometimes result in a small bowel obstruction. Per the Cleveland Clinic, the condition most often occurs in the small intestine and involves “a partial or complete blockage.”

“Your small intestine connects to your stomach at one end and your large intestine at the other. In addition to moving food and water along to your large intestine, your small intestine breaks down foods and absorbs water and nutrients from them.” the website reads.

When a blockage occurs, “waste, gas and digestive juices can get stuck behind the blockage, damaging the tissue.” This can result in “dangerous complications.”

Presley’s autopsy report noted that her obstruction was “caused by adhesions (bands of scar tissue) that developed after bariatric surgery years ago.”

Signs of sickness before Presley’s death

Per the coroner assigned to Presley’s case, the star had abdominal pain on the morning of the day she died and for months beforehand. She also reported bouts of nausea, vomiting and fevers.

Before her death, Presley’s abdomen was extremely swollen, per the autopsy report. She also had severe metabolic acidosis, which the Cleveland Clinic describes as a condition in which too many acids build up in your body’s fluids.

In her mother’s memoir, Keough writes about some of the warning signs that Presley was unwell leading up to her death, saying there was a “strange energy at the end of 2022.”

“Unusual things kept happening with her health. She developed an infection and had to go to the hospital in November…. Things started cascading. She would constantly complain about her stomach, about feeling nauseated. She would drink lots of Pepto-Bismol, which was always by her bed. I could tell my sisters were worried, too—they’d often ask me, ‘Is Mama going to be okay?’ she writes.

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