News Column

Clinton Expected to Recover from Clot

Jan. 1, 2013

Helene Cooper and Denise Grady

Doctors said the blood clot, which seemed to take members of the secretary of state's staff by surprise, had not resulted in a stroke or neurological damage.

Doctors for Secretary of State Hillary Rodham Clinton have said that a blood clot has formed in her head, a potentially serious condition from which they nonetheless stress that they expect her to fully recover.

Mrs. Clinton, 65, was hospitalized on Sunday at NewYork- Presbyterian Hospital for the blood clot -- in a vein between the brain and the skull and behind her right ear -- and the doctors said Monday that it had not resulted in a stroke or neurological damage. They said they were trying to dissolve the clot by treating her with blood thinners.

"She will be released once the medication dose has been established," according to the statement from Dr. Lisa Bardack and Dr. Gigi El-Bayoumi.

Clots like the one Mrs. Clinton has can be serious, said doctors not involved in her care. Dr. David Langer, a brain surgeon and an associate professor at the North Shore-Hofstra-Long Island Jewish School of Medicine, said that if this type of clot were to go untreated, it could cause blood to back up and could lead to a hemorrhage inside the brain.

Mrs. Clinton's doctors struck an upbeat tone in their statement. "In all other aspects of her recovery, the secretary is making excellent progress, and we are confident she will make a full recovery," it said. "She is in good spirits, engaging with her doctors, her family and her staff."

The sudden turn in Mrs. Clinton's condition appeared to take her aides by surprise. As recently as Sunday afternoon, they thought that she was on the mend and ready to return to work this week.

"Yep, she's looking forward to getting back to the office this week and resuming her schedule (plan is Wednesday)," a close aide, Philippe Reines, replied to an e-mail inquiry.

But by 7:30 p.m. Sunday, all that had changed. Mrs. Clinton, who had been home for more than two weeks nursing injuries sustained after she fainted and hit her head, suffering a concussion, had been admitted at NewYork-Presbyterian with an ominous diagnosis: a blood clot stemming from the concussion, Mr. Reines said.

Instantly, the woman who, before even announcing, has been widely viewed as a front-runner for the Democratic presidential nomination in 2016, someone who has spent the past four years keeping up a grueling schedule in which she racked up miles as the most-traveled secretary of state and visited 112 countries, was seeming uncharacteristically fragile.

Instead of talking about who might be her running mate, or how she had, even on Monday, again been named the most admired woman in the United States in a Gallup poll, the chatter on the Potomac shifted to talk about how, at the end of the day, she is a 65-year- old woman trying to recover after falling and hitting her head.

This being Washington, there was plenty of political finger- pointing.

On Twitter, those sympathetic to Mrs. Clinton lashed out at Republican critics who had accused her of faking her illness. BuzzFeed helpfully chronicled the top "eight people who thought Hillary Clinton was faking her concussion" because she did not want to testify before Congress on the attacks in Benghazi, Libya. They included The New York Post, which called her concussion a "head fake," and the Fox News contributor Charles Krauthammer, who called her illness "acute Benghazi allergy."

David Rothkopf, an acting commerce under secretary in the Bill Clinton administration, strongly criticized the quick politicizing of Mrs. Clinton's health, both by allies and foes.

"It's a sign of the level of politicization that this woman could be lying in a hospital bed dealing with a serious issue and the first reaction of all these people is politics," Mr. Rothkopf said. "There's no politics in a blood clot."

"The point is," he added, "people should just stop and be human beings."

Mrs. Clinton's friends say they have become increasingly concerned about her since she fell ill in mid-December from a stomach virus that left her severely dehydrated. She was vomiting constantly, friends said, and fell forward, hitting her head and blacking out. The result, one friend said, was a contusion on her eye and on her brain. She was forced to cancel a trip to the Middle East and Africa that had been planned for the next week.

On Dec. 13, doctors diagnosed a concussion, and she had been kept since then to limited activity, according to a friend of Mrs. Clinton's who spoke on the condition of anonymity because he did not want to discuss her illness publicly.

Mr. Reines said that on Sunday, during a follow-up exam, doctors found a blood clot and hospitalized her. "Her doctors will continue to assess her condition, including other issues associated with her concussion," he said in a statement Sunday night.

Dr. Geoff Manley, vice chairman of neurological surgery at the University of California, San Francisco, said patients with this condition generally needed to be treated in an intensive care unit, by specialists with expertise in this kind of clot. The treatment usually begins with intravenous blood-thinning drugs, and scans to monitor the clot. After a few days, patients can usually be moved to a regular hospital floor and be gradually switched from intravenous drugs to pills.

Barring complications, after a few more days they can usually go home. But the clot may take weeks or months to dissolve, and treatment will continue for even longer to prevent a recurrence.

This type of venous clot is more common in women than in men, Dr. Langer said, particularly with dehydration. But it is impossible to say exactly what caused it in Mrs. Clinton's case -- her head injury, the illness, some other factor or a combination.

Given that she has had a blood clot in the past -- in her leg in 1998 -- she may be prone to form clots and may need lifelong treatment to prevent them, possibly with low doses of aspirin or other blood-thinning drugs.



Source: (C) 2013 International Herald Tribune. via ProQuest Information and Learning Company; All Rights Reserved


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