George H.W. and Barbara Bush Both Hospitalized

Former President George Herbert Walker Bush and former First Lady Barbara Bush are in a Texas hospital being treated for respiratory illnesses. Bush, 92, was admitted last Saturday with difficulty breathing. Although he initially appeared to be responding well to his treatment, on Wednesday morning, he “took a turn for the worse.” According to Bush spokesman Jim  McGrath the elder Bush was suffering from  “an acute respiratory problem stemming from pneumonia”. Doctors performed a procedure to protect and clear his airway that required sedation.” He was intubated and transferred to the Intensive Care Unit.

Mrs. Bush was admitted to the same hospital Wednesday morning as a precautionary measure. She experienced “fatigue and coughing.” Subsequently, she has been diagnosed with bronchitis and is receiving antibiotics.

This morning, McGrath says that “both [are] on the upswing,” adding, “they may not be out of the woods yet, but we can see the edge of the forest.”

President and Mrs Bush had already informed President-elect Trump that they would be unable to attend the inauguration:

“My doctor says if I sit outside in January, it likely will put me six feet under. Same for Barbara,” Bush wrote, in a letter first reported by ABC News. “So I guess we’re stuck in Texas.”

President Bush 41 has suffered from declining health over the past few years. He suffers from a form of Parkinson’s Disease which forces him to use a wheelchair.  He has been hospitalized 4 times in the past 5 years for respiratory difficulties. In July 2015, he fell while at his home in Kennebunkport, Maine, breaking the C2 vertebrae in his neck.

Pneumonia

Source: National Heart Blood and Lung Institute

Pneumonia is an infection in one or both of the lungs. Many small germs, such as bacteria, viruses, and fungi, can cause pneumonia. The infection causes your lungs’ air sacs, called alveoli, to become inflamed. The air sacs may fill up with fluid or pus. This causes symptoms such as a cough (with phlegm), fever, chills, and trouble breathing. Pneumonia can be a complication of upper respiratory infections, such as colds or flu, because the mucus in the airways is an excellent growth medium for germs.

Doctors listening to the chest with a stethoscope may hear a bubbling or crackling sound (called rales) or a harsh rumblings (called rhonchi) if pneumonia is present. Confirmation of the disease is made with an x-ray, which will show an area of increased “whiteness” in the infected area (normal lung tissue is mostly black on x-ray).

Symptoms of pneumonia can be mild to severe. Treatment is dependent on the organism causing the pneumonia- viruses can be treated symptomatically or with anti-viral medications, bacteria with antibiotics specific to the organism present. Pneumonia tends to be more serious for:

  • Infants and young children.
  • Older adults (people 65 years or older).
  • People who have other health problems like heart failure, diabetes, or COPD (chronic obstructive pulmonary disease).
  • People who have weak immune systems as a result of diseases or other factors. These may include HIV/AIDS, chemotherapy (a treatment for cancer), or an organ or bone marrow transplant.

Pneumonia and the Elderly:

Pneumonia is the leading infectious cause of death and the fourth overall cause of mortality in the elderly. There are several reasons for this:

  • The elderly often have other coexisting illnesses, such as heart disease or diabetes.
  • The ability of the mucous membranes that line the respiratory system to move mucus out of lungs decreases with age. This is called mucociliary clearance and is explained in more detail below.
  • The immune system also becomes less efficient over time, leaving the elderly more susceptible to certain infections.

What is mucociliary clearance?

The main bronchi down to the alveoli are lined with a respiratory epithelium. On that, cilium is present, bearing hair-shaped structures on its surface (cilia). The cilia are surrounded by a thin fluid film of mucus. On top of that is a second viscous film of mucus, in which foreign particles and microorganisms get stuck. Within the thin fluid film of mucus the cilia act out movements coordinated in direction towards the pharynx. Thereby the viscous film of mucus including its freight is transported off in direction towards the mouth, where it is either swallowed or expelled via coughing.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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