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Wednesday, August 8, 2007
He’s just fine, thanks for asking
It’s annual physical time for President Bush and, once again, the docs have declared him “fit for duty” and, all in all, a superior physical specimen.
Here’s the summary released today by the White House:
President George W. Bush Summary of Medical History August 7, 2007
With a date of birth of July 6, 1946, the President is 61 years old.
Past Medical History
There is no past medical history of hypertension, diabetes, tuberculosis, sexually transmitted disease, or stroke. The President benefits from a “low” to “very low” (favorable) coronary artery disease risk profile with a favorable family medical history, absence of modifiable risk factors; superior fitness, favorable CAD markers (e.g. CRP, lipids) and functional studies (“stress echocardiogram”), and “minimal/mild” coronary artery calcification noted on anatomic study (coronary artery computed tomography, 12/2004). Erythema migrans consistent with early, localized Lyme disease, treated, with complete resolution and without recurrence, 8/06. Seborrheic keratosis. Actinic keratoses identified and treated with liquid nitrogen. Telangiectasias, nasal bridge, consistent with solar damage; treated 8/03. Vasovagal syncope, 1/02; solitary episode with identifiable precipitating event superimposed on longstanding, non-pathologic sinus bradycardia (consistent with a conditioned heart); evaluation 1/02, no sequelae, and no recurrence since 1/02. Adenomatous colonic polyps (5 tubular adenomas, each < 1.0 cm without advanced features) removed on surveillance colonoscopy 7/07. Repeat colonoscopy is indicated in 3 years.
Mild high frequency hearing loss documented and stable on prior exams; speech frequencies excellent. Currently no symptoms. History of seasonal allergic rhinitis; asymptomatic this spring with preventive seasonal use of nasal corticosteroid spray. The President has a history of activity-related injuries as noted below, which resolved without sequelae and do not impact his current duties. He continues a vigorous aerobic, weight training, and flexibility program. Musculoskeletal low back pain secondary to heavy lifting and tight “hamstrings”; fully evaluated in 1990; asymptomatic due to current exercise and flexibility program. Intermittent bilateral anterior knee pain, activity-related, with a left medial meniscal injury and subsequent surgical repair in 1997. Orthopedic and radiographic re-evaluation in 12/03 confirmed an old incomplete tear of the PCL of the right knee with resultant patello-femoral chondromalacia, post-traumatic degenerative changes, and asymptomatic medial meniscal damage, all most consistent with a remote athletic injury and physical activity. Symptoms resolved with quadriceps strengthening, cross-training (biking), and elimination of routine impact exercises (e.g. running) from his routine.
Right “calf”; running injury (strain/tear), 4/03, most consistent with overuse. Symptoms resolved. Minor abrasions and lacerations secondary to injuries sustained while biking, all healed without sequelae. Gastroesophageal reflux with well-defined triggers, 2005, without recurrence. Vitreous floaters, infrequent, evaluated by retinologist 3/06; examination normal for age (non-pathologic age-related changes only). Mild hyperopic astigmatism/presbyopia, fully correctable. Uses reading glasses as-needed. Blood transfusions: none.
Past Surgical History
Appendectomy 1956 Left medial menisectomy as above, 3/97
Medications The President takes a daily multi-vitamin. He does not routinely use prescription medications.
Immunizations The President’s immunizations are current for worldwide travel.
Social History Tobacco: An occasional cigar Alcohol: None Caffeine: Diet sodas and coffee Exercise: The President exercises six times per week. Workouts include cycling, elliptical trainer, resistance training, and flexibility exercises. Other: A viral illness prompted rearrangement of the President’s schedule at a morning session of the G8 in June. The President has not otherwise missed work due to illness since his last physical exam.
Physical Examination
Vital Statistics
Age: 61 years old Height: 71.50 inches (without shoes) Temperature: 97.8 degrees F (oral) Weight: 192.0# (last year 196.0#) Body Composition: Body fat 16.6% (last year 16.8%; normal for age 16.5-20.5%; Cooper data) Resting heart rate (seated): 52 bpm Resting blood pressure (seated): 117/71 System-specific examination summary
ENT (ears, nose, and throat): Physical examination of the head, neck, and thyroid are normal except for a serous otitis media as well as signs and symptoms consistent with maxillary sinusitis and recovering mild vestibular neuronitis. Audiogram shows bilaterally symmetric high frequency sensorineural hearing loss consistent with age and without significant change from previous exams. Thyroid function tests were normal.
Eyes: No ocular pathology was noted on dilated ophthalmoscopic examination. Visual fields were normal. Distant visual acuity was 20/20. Corrected near visual acuity was 20/20 in both eyes (the President uses reading glasses as needed). Intraocular pressures were normal bilaterally.
Neurologic exam: Comprehensive examination normal.
Pulmonary: Normal.
Gastrointestinal: Normal. Colonoscopy was last performed in July 2007. No recurrence of previously described symptoms consistent with occasional gastroesophageal reflux. Abdominal examination normal.
Cardiology: Physical examination of the circulatory system was normal. The resting EKG revealed sinus bradycardia consistent with previous exams and aerobic conditioning. Fasting lipid panel: total cholesterol: 170 (last year 174; “desirable”;<200); HDL: 51 (last year 60; >40); LDL: 106 (last year 101; “optimal”<100, “desirable”/”near optimal”<130); total cholesterol/HDL ratio 3.3 (last year 2.9); Triglycerides: 61 (last year 71; <150). hsCRP: < 0.012 (range 0.0-0.5). Homocysteine: 12.5 (range 7.6-20.8).
The President underwent Balke protocol exercise treadmill testing (ETT) with echocardiogram. He exercised for a total of 25:01 minutes achieving a maximum heart rate of 184 bpm with a 1-minute recovery of 150 bpm (34 beat differential). No signs or symptoms of cardiovascular pathology were noted. Stress echocardiogram was normal.
Dermatology: Seborrheic keratoses and lesions consistent with solar damage (e.g. telangiectasias) noted as in past. History of past actinic keratosis was noted but none discovered on this exam.
Musculoskeletal: General musculoskeletal survey was unremarkable.
Genitourinary System: Normal. PSA was 0.6 (normal < 4.0).
Laboratories A standard battery of routine screening laboratory tests was performed and was unremarkable.
Summary
The President remains in excellent health and is “fit for duty.” All data suggest that he will remain so for the duration of his Presidency. Based on an overview of his examination and history the following clinical diagnoses are made:
The President remains in the “superior”; fitness category for men his age (greater than ninety-seventh percentile for 60-64 year-old men; Cooper). “Low” to “very low” coronary artery disease risk profile. Coronary artery disease (CAD) “activity-marker” evaluation (including C-reactive protein, homocysteine, and lipids), and “functional”; studies (exercise treadmill test) stratify the President to a “low” to “very low” coronary risk category. Continued “therapeutic lifestyle measures” (i.e. reduced intake of saturated fat and cholesterol, regular physical activity, and weight control) are appropriate. Sinus bradycardia, asymptomatic, non-pathologic, and consistent with a conditioned heart. History of vasovagal syncope without pathology, sequelae, or recurrence.
History of vitreous floaters, infrequent, nonpathologic, normal for age. Mild hyperopic astigmatism/presbyopia, fully correctable.
Seasonal allergic rhinitis, well-controlled.
Serous otitis media and maxillary sinusitis with mild viral vestibular neuronitis, recovering.
History of mild high frequency sensorineural hearing loss unchanged from previous examinations.
History of gastroesophageal reflux without recurrence.
History of colonic adenomas, removed 7/07.
Repeat colonoscopy indicated in 3 years.
History of activity-related musculoskeletal injuries currently without symptoms or limitations.
Skin lesions consistent with solar damage. Recommend continued sun-protection measures (e.g. sunscreen, wide-brimmed hats, etc.). Seborrheic keratoses treatment not indicated nor requested. History of early, localized Lyme disease, treated without recurrence or sequelae. Recommend standard precautions in endemic areas.
ACLU demands secret court cough up evidence
While Congress vacations, the American Civil Liberties Union is working at a warp speed to find out everything possible about the scope of the president’s terrorist surveillance program.
The ACLU files legal papers today with the Foreign Intelligence Surveillance Court requesting that the secret court disclose recent legal opinions discussing the scope of the government’s authority to engage in secret wiretapping of Americans.
The civil liberties group wants to gather as much information as it can to persuade Congress to pass new legislation that would restrict wiretapping without a warrant. In a last-minute blitz, Congress gave the Bush administration expanded authority to tap international phone calls and e-mails.
“Over the next six months, the public and Congress will be debating one of the most important matters of our time: under what circumstances the government should be permitted to use its profoundly intrusive surveillance powers to intercept the communications of people inside the United States,” said Anthony D. Romero, executive director of the ACLU.
The FISA court must disclose the documents that prompted the legislation last week that gave the administration more power to eavesdrop so that the public can be privy to an informed debate about why this is necessary, Romero said.
“Unless the FISA court discloses the documents leading up to the recent law and shedding light on the government’s claimed surveillance authority, an informed and meaningful debate — the cornerstone of our democracy — cannot occur,” Romero said. “A conversation about a threat to our most precious constitutional rights and liberties should not occur in a factual vacuum.”
The court’s orders have played a critical role in the evolution of the government’s surveillance activities over the past six years, according to the ACLU.
Bush authorized the National Security Agency to eavesdrop on phone calls and e-mails of suspected terrorists and people living in America shortly after the Sept. 11, 2001, terrorist attacks. The New York Times revealed the program’s existence in December 2005, prompting an outcry from civil liberties groups about surveillance without a warrant from the secret court.
In January 2007, just days before an appeals court was to hear the government’s appeal from a judicial ruling that ruled the program illegal, Attorney General Alberto Gonzales announced that the NSA program would be discontinued.
At the time, Gonzales said that the FISA court orders issued on Jan. 10, 2007 made it possible to bring the terrorist surveillance program under its jurisdiction.
Government officials have spoken publicly about the court’s orders in congressional testimony, to the media and in legal papers - but the orders have never been released.
They have also indicated that the FISC issued other orders in the spring that restricted the administration’s surveillance activities. House Minority Leader John Boehner, R-Ohio, said the court had issued a ruling prohibiting intelligence agents from intercepting foreign-to-foreign calls passing through the United States.
A copy of the ACLU’s motion to the FISC is available online at:
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Leahy warns White House
Senate Judiciary Committee Chairman Patrick Leahy, D-Vt., told the White House today to have all of the documents it requested in its investigation of the president’s terrorist surveillance program ready by August 20 — or else.
The Judiciary Committee issued subpoenas on June 27 and granted an extension on July 18 for documents and testimony related to the program, which allowed the National Security Agency to eavesdrop on telephone calls and e-mails of suspected terrorists and people living in America.
The panel wants to find out what legal justifications the administration used to violate the 1978 Foreign Intelligence Surveillance Act, which requires a court warrant to conduct such surveillance.
“Despite my patience and flexibility, you have rejected every proposal, produced none of the responsive documents, provided no basis for any claim of privilege and no accompanying log of withheld documents,” Leahy wrote in a letter to Fred Fielding, the president’s chief lawyer.
The latest Quinnipiac University Polling Institute survey of “swing state” voters puts Sen. Hillary Rodham Clinton and former New York City Mayor Rudy Giuliani in a virtual tie.
The polls in Florida, Ohio and Pennsylvania show the two New Yorkers comfortably atop the Democratic and Republican fields in all three states, but within the poll’s margin of error in a hypothetical head-to-head matchup.
For instance, in Florida, Clinton leads Giuliani 46-44 percent, within the margin of error of 3.2 percentage points. That’s a flip from the 46-44 percent by which Giuliani led the poll two weeks ago.
The poll’s most important finding may be that Clintonis slowly shedding her negative image, said Peter A. Brown, assistant director of the poll, which is fully funded by the Hamden, Conn.-based university.
“In the last two months the share of voters who view her favorably has increased to about 50 percent, an important milestone, while the number who view her unfavorably has dropped,” Brown said. “It is not huge movement, but it is consistent across all three states.”
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Bush and Bonds
After some morning White House wordsmithing about why President Bush hadn’t called to congratulate Barry Bonds on breaking the home run record, we’re now told the two have indeed chatted today.
“He’s a really good hitter,” Bush told reporters after an economic briefing today. “I said ‘Congratulations.’”
He called it “my honor” to chat with the new home-run king.
Earlier today, White House spokesman Tony Snow said Bush did not stay up to watch the historic home run last night and had not yet called Bonds to offer congratulations.
The reason: “The president was asleep when Barry Bonds hit his home run. And Barry Bonds was asleep when the president came to work today. You know, I mean, it’s one of those things where baseball players, especially after setting records, tend to stay up late, and especially when you’re three time zones away.”
Earlier today, Snow sidestepped questions about whether Bush - a former baseball executive whose childhood hero Willie Mays is Bonds’ godfather - thought the record is tainted by suspicions about whether Bonds used steroids.
“Right now there is a league-wide investigation going on into steroid use and questions about Barry Bonds will be answered certainly in the fullness of time.” Snow said Bush “commends” Major League Baseball and former Sen. George Mitchell for “taking a good, hard look at a problem that needs to be taken a look at.”
“They obviously have taken steps to test for steroids and other performance enhancing drugs, and at the same time, as the president said in the State of the Union address, the use of these drugs sends the wrong message,” Snow said. “It’s dangerous … kids worship athletes, and athletes who endanger themselves through the use of these drugs send not only a wrong message to the kids, but they also do damage to their own lives.”
Earlier today, Snow sidestepped questions about whether Bush - a former baseball executive whose childhood hero Willie Mays is Bonds’ godfather - thought the record is tainted by suspicions about whether Bonds used steroids.
“Right now there is a league-wide investigation going on into steroid use and questions about Barry Bonds will be answered certainly in the fullness of time.” Snow said Bush “commends” Major League Baseball and former Sen. George Mitchell for “taking a good, hard look at a problem that needs to be taken a look at.”
“They obviously have taken steps to test for steroids and other performance enhancing drugs, and at the same time, as the president said in the State of the Union address, the use of these drugs sends the wrong message,” Snow said. “It’s dangerous … kids worship athletes, and athletes who endanger themselves through the use of these drugs send not only a wrong message to the kids, but they also do damage to their own lives.”
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