President George H. W. Bush in ICU, Wife Barbara in Same Hospital

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In an all too common turn of events, former President George H. W. Bush and his wife Barbara were admitted to the same hospital for respiratory issues-- pneumonia and bronchitis, respectively. President Bush is reported to be in the ICU (aka intensive care unit) implying a more serious bout of disease than his wife who as per the latest announcement by spokesman, Jim McGrath, feels "1,000% better" as of the morning of January 19, 2017.  

As the nation gears up for today's inauguration of the 45th President Donald J. Trump of the United States, sadly, the Bushes will be unable to be in attendance. Wishing them the speediest of recoveries, they are clearly where they need to be and, hopefully, will return to good health expeditiously.  

Bush implied the state of his condition in a letter to President-Elect Trump expressing the concerns of his personal physician:

 

 

To which 45 tweeted:

On January 18, 2017, McGrath had released a statement about the eventful progression of their medical conditions:

The trajectory of public release continued detailing the hospital courses:

With the latest word being:

As we recently witnessed with the tragic deaths of Carrie Fisher and her mother, Debbie Reynolds, it is not a rarity to experience simultaneous or staggered illness with a loved one. In these events, there was a presumed element of broken heart that contributed to Reynolds surprising passing. To read about Broken Heart Syndrome, click here.  

In other situations, infections can spread throughout a household— especially in the winter months during flu and cold season. How things manifest is highly variable between individuals. A common misperception is that a person can spread pneumonia to another person or an ear or sinus infection specifically. There exists a nuance often misunderstood. In reality, the offending bug albeit a virus or bacteria, for instance, if contracted will prompt symptoms that are not necessarily identical in severity. As a result, one person will develop pneumonia, another might simply get a runny nose. And another may remain asymptomatic.  

Why? Because we all have unique immune systems and fluctuate with our abilities to be resilient and mount a robust response. Sometimes our reserve is run down, other times it is optimized. Those with chronic disease or are on certain medications that weaken or suppress their immunity often are more susceptible to significant impairment and severity of illness. Extremes of ages, in particular, have specific challenges that make them more vulnerable.

Our capacity to walk around and not be bedridden is immensely protective in warding off insurmountable disease. Our ability to move, swallow effectively, and cough forcibly enough prevents pneumonias or substantial ones at the very least. When a person is limited in his or her mobility, the aforementioned might be impaired from issues ranging from spinal cord injury to other neurologic conditions, for example, so he loses a natural layer of defense. He is placed at risk of aspiration and potential consequent pneumonia. Whatever is not intended to enter the lungs— like food— when aspirated serves to cause a major issue for the patient. When secretions are permitted to pool and sit in the lungs, they become a source of infection. That’s why as much as we desire to stop a cough, the preserved ability can be a lifeline. To read about the risks of cough suppressants, review here.     

But, anyone—sick or well— can get a pneumonia or bronchitis. Frequent hand washing and not sharing food, drink or utensils are a couple ways to remain healthy. Also, not being around someone who is sick or actively coughing, but we all know this is not often realistic. If that’s the case, then sensible measures can be put in place that at a minimum reduce risks.    

Otherwise healthy people can enhance their chances of avoiding complicating pneumonias by obtaining the flu and pneumococcal vaccines, if eligible. A discussion with your doctor about all vaccines that would benefit you is always worthwhile. The elderly and very young along with those suffering from chronic disease (e.g. diabetes, heart or lung problems, kidney or liver disease, neurologic disorders) are particularly at risk of complex courses. Not smoking and not living with a smoker are other ways to reduce your chance of bronchitis and pneumonia, in general. Many have occupations that amp up their risk, so exploring mechanisms for reduction of it is advisable.  

Pneumonia can range from mild to severe. The former is colloquially referred to as “walking pneumonia” because people are minimally affected and walk around with it. It appears given that former President Bush is in intensive care and intubated (aka a tube is in place to maintain patency of the airway, provide support and permit proper ventilation) his would be on the more severe side of the spectrum.  The latest statement from his team mentions he remains stable, is undergoing active evaluation for extubation (aka removing the breathing tube) and there is discussion of discharge planning — all reflect optimism about his condition.  

When a person —for whatever the inciting event —experiences imminent or present respiratory failure or distress, efforts are taken to protect the airway and ensure they are getting the oxygen they require to maintain all organ systems and, most importantly, effective distribution to the brain. Sometimes intubation is necessary. When it is, like most things in medicine, the sooner a person is returned to their baseline (aka their normal) state the better.    

As always, speak with your doctor about proactive ways to maintain your personal health and well-being.  We at ACSH wish the Bushes a quick, uneventful return to good health.