Editing Dr. Arnold Isaak Burgelstein (section)

=== Medication and experimental treatment ===

In addition to supervising Rambam's adrenochrome use, Burgelstein maintained a long-term regimen that changed as Rambam's cardiovascular condition deteriorated. His known treatments were:

# '''Ramipril''' – Burgelstein began prescribing ramipril in 2007 after finding persistent hypertension during his first examinations of Rambam.
# '''Bisoprolol''' – Introduced in 2007 to control Rambam's heart rate and reduce cardiac workload after Burgelstein observed an irregular heartbeat.
# '''Vitamin B-complex and vitamin B12''' – Burgelstein regularly administered these by injection during periods of exhaustion and after prolonged adrenochrome use.
# '''Intravenous glucose''' – Given when Rambam had eaten poorly or was recovering from prolonged adrenochrome use.
# '''Temazepam''' – Prescribed intermittently when Rambam experienced insomnia following prolonged adrenochrome use.
# '''Pantoprazole''' – Used regularly to treat gastric irritation and reflux during Rambam's long-term drug regimen.
# '''Spironolactone''' – Added after the near-fatal cardiac episode in 2019 as part of Burgelstein's treatment of the developing heart failure.
# '''Furosemide''' – Initially used temporarily after the 2019 cardiac episode. Burgelstein made it a daily treatment in 2022 after pulmonary congestion became recurrent.
# '''Danicamtiv''' – Introduced in late 2022 as an experimental cardiac myosin activator after Rambam's heart failure continued to progress despite conventional treatment.
# '''Istaroxime''' – Administered intravenously from 2023 during severe episodes of acute cardiac decompensation.
# '''Allogeneic mesenchymal precursor cells''' – Administered in a single transendocardial procedure in 2023. Rambam temporarily showed improved functional capacity before the progression of his heart failure resumed.
# '''[[Isaacamtiv]]''' – A proprietary cardiac myosin activator developed by Burgelstein and introduced in mid-2024 after the earlier experimental treatments failed to stop Rambam's decline. It temporarily improved his cardiac output and exercise tolerance. The effect weakened over the following months, and Burgelstein reduced the dose after Rambam's arrhythmias worsened.

Despite repeatedly attempting to restrict adrenochrome when Rambam became unstable, Burgelstein continued administering it at Rambam's insistence. He remained loyal to Rambam and falsified medical reports to hide his decline from Glöbbery and the [[Bucharest Butchers]]. He remained Rambam's physician until Rambam was captured and executed on 1 May 2025.<ref name="snubable-collapse"/>