"The night before she did that award show, she suffered two seizures," Larry Birkhead reveals about Anna Nicole Smith

Ten years after her death, Anna Nicole Smith‘s former partner Larry Birkhead is opening up about the beloved star’s troubled life.

During an appearance on Tuesday’s Wendy Williams Show, Birkhead touched on one Smith’s most infamous, headline-making moments: her slurred, stumbling speech introducing Kanye West at the 2004 American Music Awards. (The former Playboy model starred in the music video for the rapper’s College Dropout single, “The New Workout Plan.”)

According to Birkhead, Smith struggled with severe pain and health issues: Notably, she experienced “chronic back pain” as a side effect from her breast enhancement surgery and also suffered seizures.

“The night before she did that award show, she actually suffered two seizures,” revealed Birkhead, explaining that he begged her to cancel, but she insisted on going and subsequently “tried to take something to stay awake that her doctor had given her” in order to be able to present after staying up all night.

“She also was very nervous around those things,” he added.

The 32nd Annual American Music Awards - Show
Credit: Frank Micelotta/Getty
32nd Annual American Music Awards - Press Room
Credit: Jon Kopaloff/FilmMagic

Of Smith’s substance abuse, Birkhead said that while “a lot of people had this misconception that Anna was doing street drugs,” the star was using prescription medication.

“I would see doctors coming in and saying: ‘This is legitimate for this issue …’ ” he recalled. “She had doctors treating her for these issues. Did she always take her medicine like she was supposed to? Probably not.”

On Feb. 8, 2007, Smith died at 39 after being found unresponsive in her hotel room at the Hard Rock Hotel & Casino in Hollywood, Florida. Her death was ultimately ruled an accidental drug overdose.

Smith died five months after her 20-year-old son, Daniel, died in her Bahamas hospital room, where Smith had given birth to her daughter Dannielynn just three days prior.

“You’ve got to think: My daughter was born on Sept. 7 and on Sept. 10, Daniel died,” said Birkhead, Dannielynn’s father. “So you go from that extreme high and low, and how do you process that in your mind? Although her death certificate will list a different cause — an accidental overdose — in my mind, I think she truly died of a broken heart.”

Birkhead revealed he was at the dentist’s office when he learned of Smith’s passing on the news. At the time, he recalled thinking it was “another PR stunt.”

“There were two different personalities,” he explained. “The Anna Nicole that everyone saw was kind of more an act — she would put this different voice on, it was like a baby voice… but she was always in on the joke.”

According to Birkhead, he knew and loved a different side of the embattled star.

“I came to know her at some events away from the camera … with no makeup on, just hanging out with all the kids and giving money and time [at charity events] — things that you don’t hear people talk about when they talk about Anna,” he said. “And that’s kind of when our relationship grew.”