Clinton campaign releases doctor’s letter describing ‘mild’ pneumonia – Washington Post

Democratic presidential nominee Hillary Clinton speaks at a rally at University of South Florida in Tampa, Fla., earlier this month. (Andrew Harnik/AP)

The letter, from Clinton’s doctor, Lisa Bardack, is intended to put to rest concerns about the Democratic presidential nominee’s health after the illness caused her to stumble out of a memorial service Sunday and forced her off the campaign trail for days. Clinton’s campaign said the information would update a health history released last year.

The details in the letter show that Clinton has normal-ranging vital statistics, according to several doctors who reviewed the information but have never treated her. Her blood pressure and cholesterol levels are “good” or “excellent” and place her at low risk for illness for a woman her age, the doctors said.

[Hillary Clinton’s new doctor’s letter, annotated]

The campaign came under fire on Sunday, when Clinton fell ill at a Ground Zero commemoration of the Sept. 11, 2001, terrorist attacks. For 90 minutes after her abrupt departure, the campaign offered no information on Clinton’s whereabouts — and it was many hours later before the campaign revealed the pneumonia diagnosis, which had come on Friday.

“The remainder of her complete physical exam was normal and she is in excellent mental condition,” Bardack wrote in the letter. “She is recovering well with antibiotics and rest. She continues to remain healthy and fit to serve as President of the United States.”

Issues surrounding health and transparency have swirled around both Clinton and her Republican rival, businessman Donald Trump, in the last several weeks. At age 68, Clinton would become the second oldest president to enter the White House (after Ronald Reagan, who was 69) while Trump, at 70, would be the oldest. Neither has any known major medical problems.

Clinton had previously released more extensive health background than had Trump. She has also been the subject of persistent and apparently baseless rumors and conspiracy-minded claims about her health, most rooted in the claim that she is hiding a serious health issue. Although her campaign dismisses such theories as bunk, and even sexist, Clinton fed into them by ditching her press corps Sunday and not releasing timely information on her health and whereabouts.

Trump discussed his personal health during a taping of “The Dr. Oz Show” on Wednesday morning and shared some of the results of his most recent physical examination, according to the show, not long after top campaign aides told reporters that he would not release any records on set and planned to talk about general wellness, not his personal health history.

At one point during the show, which airs on Thursday, host Dr. Mehmet Oz asked Trump why he has not yet released his medical records, given that his health seems so strong.

“Well, I really have no problem in doing it,” Trump said, according to a brief clip released by the show on Wednesday afternoon. “I have it right here. Should I do it? I don’t care. Should I do it?”

Trump then pulled two pieces of paper out of his suit pocket that he said contained test results from his latest physical examination and a letter Lenox Hill Hospital in New York. In the video clip, Oz is shown studying the two pieces of paper. Reporters were not allowed to attend the taping, and the campaign have yet to release these documents to the public. The campaign also would not say what sort of medical records Trump plans to release or how many years they will cover.

Bardack is the chair of Internal Medicine at CareMount Medical in Mount Kisco, N.Y., and has served as Clinton’s personal physician since 2001. Her letter also described various medications that Clinton is taking, including Coumadin, a blood-thinner. And it describes Clinton’s normal-ranging vital statistics: blood pressure of 100/70; a pulse of 70; and a cholesterol level of 189.

Bardack examined Clinton as recently as Wednesday, and has done so several other times since she was diagnosed with pneumonia Friday, according to a campaign aide.

According to her doctor, Clinton has received two vaccinations against pneumonia — Prevnar and Pneumovax — although it is not clear when she received those vaccinations.

The new information reveals more about Clinton’s pneumonia diagnosis. She was tested with a non-contrast chest CT scan, which discovered a small right middle-lobe pneumonia.

[It pays to read the warnings when you open up a prescription]

Clinton had previously released a letter from her doctor Bardack, which contained information about her current health, medications and past health conditions, including a history of hypothyroidism and deep-vein thrombosis.

After Clinton’s pneumonia diagnosis, she kept the information secret and ignored her doctor’s advice to rest and modify her schedule. Instead, Clinton continued with a full day of campaign events, choosing to “power through” despite her illness.

But by Sunday morning, Clinton became severely dehydrated during the outdoor 9/11 memorial at Ground Zero, according to the campaign. She left the event early and was seen in video footage buckling as she was helped into her van by her aides and security detail.

The campaign’s long delay in providing information to the media and the public prompted criticism from Democrats and Republicans alike.

Clinton cancelled three days of scheduled campaign events and has been resting at home in Chappaqua, N.Y. She is expected to return to the campaign trail with an event in Greensboro, N.C., on Thursday.

“Obviously I should have gotten some rest sooner,” Clinton said on CNN’s Anderson Cooper 360 on Monday. “I just didn’t think it was going to be that big a deal.”

Clinton has previously become severely dehydrated in 2012 and fainted, suffering a concussion. She was later diagnosed with a blod clot in her skull that was discovered during routine testing while recovering from her concussion.

At the same time, Clinton has criticized Donald Trump for releasing a letter from his doctor earlier last year, which contained virtually no objective health information. Trump has since said that he would release more medical information from a physical he received last week.

On Wednesday, Trump taped an episode of the Dr. Oz Show, in which he discussed his overall health with host Mehmet Oz.

When Oz asked why he had not released his medical results, Trump replied: “Well, I really have no problem in doing it.”

“I have it right here,” he said, brandishing two piecies of paper that contained his most recent results from his physical. “Should I do it? I don’t care. Should I do it?”

Clinton has taken the blood-thinner Coumadin at least since last year. A partial health history released by Clinton’s campaign last summer refers to the drug but does not say precisely when it was prescribed. A letter from Bardack released July 31, 2015, said Clinton had been prescribed Lovenox, a short-acting blood thinner, when she was flying for long distances. Bardack said then that the medication was discontinued when Clinton began taking Coumadin.

David Scheiner, who was Barack Obama’s physician for more than two decades until his election in 2008, praised Clinton’s doctor for conducting a chest CT scan, which typically would not be done to diagnose pneumonia.

“I have to give the doctor credit for that one,” Scheiner said. “Because she has had blood clots, I think in the back of the doctor’s mind was, could she possibly have pulmonary embolism? That was a very smart move on the doctor’s part.”

But Scheiner said he was perplexed by some of the medications that Clinton takes. He said the blood thinner Coumadin can be hard to regulate, and that better alternatives exist. In addition, the Armor Thyroid she takes for hypothyroidism is used on only a small percentage of patients.

“That’s a bit unusual,” he said, noting that doctors rarely prescribe it.

Overall, Scheiner said the disclosures by Clinton’s campaign on Wednesday were “in the right vein.” But he argued that the current patchwork system that relies on campaigns to decide how much medical information to disclose, and often by a candidate’s personal physician, too often leaves Americans in the dark.

“The question is how much info is enough? … I think we need to know everything about the candidates, and not just because these are two old geezers,” said Scheiner, who has advocated for complete, objective health reports from any candidate who wants to serve as commander-in-chief and lead the world’s largest economy.

Edward Geltman, a cardiologist at Washington University’s School of Medicine, said the information released shows her to be healthy, with normal range for vitals. Her blood pressure is on the “low side of normal,” he said, so she would be prone to fainting and sensitive to dehydration.

Her medications include medicine for an underactive thyroid, a blood thinner, an antihistamine (Clarinex) for seasonal allergies, and B-12 for mild anemia.

She has gotten the standard vaccine for bacterial pneumonia, but that only prevents certain strains, and wouldn’t protect her from picking up other strains from “shaking hands on a rope line,” Geltman said.

The one main health item that does not seem to be included is information about the health of her heart, such as electrocardiogram. Those are fairly standard tests, and as people age, it’s important to establish a baseline, he said. Heart disease is the number one killer in the United States. But because she doesn’t smoke, and doesn’t appear to be particularly overweight, he said, and has good cholesterol levels, she doesn’t appear to be at risk for a heart attack.

Doctors said the Levaquin, which she is taking to treat her pneumonia, is an excellent and appropriate treatment. Her blood pressure and cholesterol are excellent and seem to place her at low risk for a woman her age. She is on minimal medications. She has had appropriate breast cancer screening, but there is no mention of colon cancer screening.

According to the letter, Clinton was diagnosed with a sinus infection and subsequently an ear infection in January 2016, in the lead-up to the critically important Iowa caucuses and New Hampshire primary.

She was treated with antibiotics and steroids. Later, a tube was placed in her left ear as part of the treatment.

Bardack wrote that the symptoms improved, and a follow up CT scan showed mild, chronic sinus infections but no abnormalities of the brain related to those illnesses.

The campaign also released a comparable letter about Clinton’s running mate, Sen. Tim Kaine of Virginia, who was said to be in “overall excellent health,” according to a letter released from the attending physician for Congress, Dr. Brian P. Monahan, who only recommended that Kaine, 58, add a daily Vitamin D supplement to his diet. Monahan has been Kaine’s physician for the past three years.

In his letter, Monahan noted that Kaine’s past surgical history is limited to third molar teeth extraction. Kaine’s most recent electrocardiogram showed his heart appeared normal with the exception of a “mild left atrial enlargement.” No other problems areas were identified.

Brady Dennis and Lena Sun in Washington and John Wagner in Las Vegas contributed to this report.