Insights

An Open Letter to Chelsea and Ivanka – Worry about Your Parent’s Health

Dear Chelsea and Ivanka,

As first born daughters of the candidates for President, we suspect that you are ultimately responsible for your parent’s health. Knowing that, we urge you to keep a close eye on your parent’s well-being right now. Running for President is an exhausting endeavor. We worry that with the accelerated fundraising, 24/7 coverage and multiple battleground states, that both of your parents are putting their health on the line. It’s possible that 68 and 69 is beyond the age when running for President (as in the campaign, not the actual job) is a good idea.

As we have all just learned, Hillary Clinton has pneumonia. The press has qualified it as “walking pneumonia”, although footage of her leaving a 9/11 Memorial ceremony suggested that she could not walk well at all. Secretary Clinton’s campaign staff, advisors, doctors, friends and family have reason to be concerned about her blistering campaign schedule in light of her pneumonia diagnosis. Donald Trump, who is also over age 65 should be careful, too. Let us explain a little more about pneumonia in those over 65 to illustrate why this campaign is such a risky endeavor.

Pneumonia after age 65 is a more serious condition for several reasons:

  1. Our immune systems are not as strong when we get older.
  2. There are likely to be other medical conditions that will complicate the recovery (although we have no indication that that is the case for Hillary Clinton).
  3. People over age 65 are more likely to reside in “health care facilities” such as nursing homes that breed resistant bacteria (clearly not the case for Secretary Clinton, we have to wonder about all the airplane travel).

When evaluating an older patient with suspected pneumonia, doctors pay attention to things like blood pressure and mental acuity. Any indication of low blood pressure or confusion could be a sign of a very serious condition called sepsis. Sepsis kills about 500,000 people per year, so these are symptoms that should be carefully monitored in any older person with pneumonia, including Secretary Clinton.

Most viral pneumonias are treated with antibiotics not to get rid of the virus, but to prevent a more serious bacterial infection.

While most community acquired pneumonia is viral in origin (so called, “walking pneumonia”), it’s important to remember that some of the most deadly pneumonias are viral, too (eg. influenza).  Furthermore, many believe that viral pneumonias can predispose the sufferer to a bacterial pneumonia as the bacteria take advantage of the inflamed lung and weakened human. Most viral pneumonias are treated with antibiotics not to get rid of the virus, but to prevent a more serious bacterial infection from occurring.

Get influenza vaccines every year, and especially don’t forget to receive a pneumococcal vaccine at age 65

Here are some things you should know about preventing pneumonia, although it’s almost certain your parent’s physicians have this covered. In the past, streptococcal pneumonia (Pneumococcus) was a major killer of people over age 65. Therefore, everyone over age 65 receive a pneumococcal vaccine (PCV13 or Prevnar Vaccine). As a follow up, a second shot which covers more subtypes of pneumococcus should be administered one year later (PCV23 or Pneumovax). (ref) In fact, people of all ages should receive annual influenza vaccines in addition to getting the one time pneumococcal vaccine at 65.

Apart from pneumonia, there are other hazards of “burning-the-candle-at-both-ends” over age 65:

  1. dehydration: this can lead to kidney stones, or worse; kidney failure. (Ref)
  2. blood clots: over age 65, we are more likely to form clots that can be deadly if they travel to the lung. (Ref)
  3. stroke and heart attacks: older people are more likely to have a cardiovascular event over age 65, especially during stressful periods. (Ref)
  4. depression and cognitive deficits: There has been unsubstantiated speculation that Mr. Trump’s memory lapses and outbursts may have to do with an underlying disorder. Even if there is no evidence of that, both he and Secretary Clinton are at risk due to their age and stress levels. (Ref)

We have elected Presidents (JFK and FDR for example) with more serious health problems than either of your parents appears to have, but none of them underwent the demands of the modern day Presidential Campaign.

You see Chelsea and Ivanka, although your parents are mega over-achievers who have always accomplished more than what seems humanly possible, the modern campaign for President at their age is a real risk to their health. Although the public seems to demand super-human strength from our Presidents, we hope you can acknowledge privately that your beloved parents are getting older, and must act accordingly. We have elected Presidents (JFK and FDR for example) with more serious health problems than either of your parents appears to have, but none of them underwent the demands of the modern day Presidential Campaign. Come January, one of your parents over age 65, will be inaugurated as President. But, only if they make it through the campaign.

Jennifer Brokaw, MD
Kim Garlinghouse-Jones, RN MPH

 

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