September 14, 2016
This letter is a summary update on Hillary Rodham Clinton’s health since the release of my previous medical statement in July 2015.
Mrs. Clinton has been seen by me regularly this year for routine care. She has had recurrent blood testing for Coumadin dosing and adjustments. Her blood levels have been relatively stable. She also has had several allergy flares over the past year, which has been a typical pattern for most of her life. In consultation with her allergist, she responded well to her medication adjustments.
In January of 2016, Mrs. Clinton developed symptoms of sinusitis and an ear infection, which was treated with antibiotics and steroids. Over the ensuing few weeks, she noted progressive pain in her left ear despite treatment, and subsequently was evaluated by her ENT physician. This evaluation confirmed a sinus and ear infection, with increased fluid in her left ear. To help alleviate her symptoms, a myringotomy tube was placed in her left ear in January of 2016. After the tube was placed, Mrs. Clinton had significant improvement in her symptoms. Further follow-up evaluation with a CT scan of her brain and sinuses was done in March of 2016. This scan showed no abnormalities of the brain and mild chronic sinusitis. Her symptoms resolved and she continued symptom-free for the next six months.
On Friday, September 2nd, I evaluated Mrs. Clinton for a 24-hour history of a low grade fever, congestion and fatigue. On examination, she was noted to have a temperature of 99.4; her vital signs were otherwise normal as was her physical exam. She was advised to rest, put on a short course of antibiotics and continued on her allergy medications for an upper respiratory tract infection in the setting of her seasonal allergies. Over the next several days as she traveled, her congestion worsened and she developed a cough. She was advised to see me when she returned from her travels for further testing. On Friday, September 9th, she was seen and evaluated in my office. A non-contrast chest CT scan, including a CTA calcium score, was performed. This test allowed for specific imaging of her lungs while also following up on cardiac risk stratification from 2010 given her family history of heart disease. The results of the CT scan revealed a small right middlelobe pneumonia; her coronary calcium score was again zero. She was treated with antibiotics for pneumonia and advised to rest. This was a mild non-contagious bacterial pneumonia. On Sunday, September 11 at the 9/11 Memorial event, she became overheated and dehydrated and as a result felt dizzy. I examined her immediately upon her return home; she was re-hydrating and recovering nicely. I advised her to stay home and rest for the next several days. Mrs. Clinton has since been evaluated by me several times and continues to improve.
Mrs. Clinton’s current medications include Armor Thyroid, Coumadin dosed as directed, Levaquin (for a total ten days), Clarinex, as well as B12 as needed. After consultation with her hematologist, it was decided again not to change her anticoagulation to a newer agent. Her recent testing, all of which was done within the past month, has been normal. She remains up to date on all of her immunizations, including Prevnar and Pneumovax. Her Coumadin levels have been adjusted as needed according to regular lab testing. She had a normal mammogram and breast ultrasound. She receives routine dental care. Her thyroid blood tests are within normal limits. Of note, she has remained stable for many years on Armor thyroid to treat her hypothyroidism (a low T3 level). Her laboratory testing (vitamin D, CBC, fasting blood glucose, comprehensive metabolic panel, hemoglobin A1-C, vitamin B12) was normal, including cholesterol of 189, LDL of 103, HDL of 56 and triglycerides of 159. Her vital signs showed blood pressure of 100/70, heart rate of 70, respiratory rate of 18, temperature of 97.8 and pulse-oximetry of 99%. The remainder of her complete physical exam was normal and she is in excellent mental condition.
My overall impression is that Mrs. Clinton has remained healthy and has not developed new medical conditions this year other than a sinus and ear infection and her recently diagnosed pneumonia. She is recovering well with antibiotics and rest. She continues to remain healthy and fit to serve as President of the United States.
Lisa Bardack, MD
Diplomat of the American Board of Internal Medicine
Chair of Internal Medicine, CareMount Medical