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May 23, 2008
Posted: 08:43 PM ET

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

As a doctor, I have never reviewed medical records quite the way I did today. Senator McCain’s staff gathered a handful of reporters to Fountain Hills, Arizona at a small hotel. It was sort of a strange day. For starters, it was raining today, and from what they tell me, it hardly ever rains here in May. Then, after days of getting specific rules and regulations about how exactly this would work, the McCain staff decided to leak the records ahead of time to the Associated Press. Nice. Gather reporters from all over the country on the Friday before Memorial Day weekend for a super secret document release, and then leak them beforehand. Needless to say, a few of the reporters were pretty frosted.

At promptly 7:30 a.m. PT, we were taken to a conference room and handed three stacks of paper, nearly 1,200 papers in all and told we had exactly three hours to review them. I am still not sure I understand why there was so little time given to review so many papers. Having said that, I am pretty convinced there was no “smoking gun” about the Senator’s health. I reviewed his cancer history carefully, as well as his cardiac, lung, prostate, kidney and liver history.

He takes 6 medications, including a multivitamin, which is actually a little less than average for a man his age. He has been extremely diligent about getting skin exams, which is important given his history of malignant melanoma. Back in 2000, he had an extensive dissection of his left neck and the removal of 34 lymph nodes, along with a stage 2A melanoma. That was the worse of his at least 5 skin cancers. He was told at the time that it had a 66 percent chance of recurrence over 10 years. That was 8 years ago, and he has done pretty well.

His heart seems to be in good condition, as evidenced by two stress tests, the last of which was this year. And, he even lost 6 pounds while campaigning. Many candidates put on weight with the crazy schedule. He was a 2 pack a day smoker for 25 years, and quit in 1980. He has received chest x-rays and CAT scans, which showed no evidence of lung cancer. His prostate seems to be alright, and aside from kidney stones, I could not find much else wrong with him.

There was mention of his time as a prisoner of war. It was hard to read about the time he was tortured and beaten to the point of breaking both of his shoulders. I read that they never set properly, which is why to this day, he cannot reach above his head. Someday, one of the doctors wrote, he will likely need to have his shoulders replaced.

I looked diligently for any mention of his mental health, and found hardly any. Every doctor’s note began, “he is a pleasant and cooperative”gentleman. No doctor’s note included a question about depression or substance abuse. He apparently does have trouble with sleep, and occasionally takes ambien. Today, I even saw pictures of a presidential candidate’s colon. Now that is some detail. His height, at one place in the chart, was listed at 5’6”, and a year later it was listed as 5’9”. Hmmm.

So far, Senators Obama and Clinton have not released their medical records. Let’s hope when they do, the day is not nearly as strange.

Candidates and Presidents for that matter are not required to release their medical records, but almost all of them do. Is it important to you that they do? Do you worry about cover ups or do you take everyone at their word?

Programming note: Watch Dr. Sanjay Gupta’s Special Investigations Unit presentation “The First Patient – Health & the Presidency” this weekend on CNN. The program airs at 8 p.m. and 11 p.m. ET Saturday and Sunday.

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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Filed under: Dr. Gupta • Health & Politics


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Citizen Chris   May 24th, 2008 9:02 am ET

Good, okay as for a presidential candidate’s physical examination. However, how about the psychological examination? If psychological exams are given to law enforcement applicants who will have the authority to pull the trigger, then why not for our prospective president who will have the power to push the red button.

Charlotte Blyn, MD   May 24th, 2008 11:20 am ET

Comments about McCain’s health by the media seem to have been politically motivated. From the records that have been given, it seems to me that a comment of “very good” would be more appropriate to describe McCain’s health..

stephen h pollock, md   May 24th, 2008 5:44 pm ET

With all due respect.. you do not know if his cardiac status is ” healthy”

heart disease is the #1 killer, and the first symptom is your last 1/3 of the time..
did Senator Mccain have a CORONARY CALCIUM SCORE
DID he have a nuclear stress test..

remember.. bill clinton was found to have severe 3 vessel cad, and that was only a few years after leaving the white house…!!!!

why not ask if he has had those tests… which are std to determine whether or not a pt is a high risk for a heart attack?

shp

EJ   May 24th, 2008 11:27 pm ET

Dr. Gupta,

I watched your special on the Presidents’ health, and I have been pondering something for a while.

Although Hillary does not look like she will get the nomination in ‘08, it’s possible she could in later years.

My question is — regarding the health of Senator Clinton — are the records to be treated the same way as the other candidates? If she were to one day become President, is there anything off limits because she is female?

I figured anything potentially deadly or disabling has to be revealed but what about checkups that may reveal fibroids or endometriosis or things like that? Would that be kept private? And how far back would she have to release them? Would she even have to release records about her pregnancy with Chelsea? Just curious how it would all work.

Thanks,

EJ – Ohio

Chula   May 25th, 2008 2:10 am ET

Dr Gupta
When you were reviewing the medical records – did you notice any narcotics that Senator Mccain may be taking to control the shoulder pain ?

James Dylan   May 25th, 2008 2:55 am ET

Dr. Gupta, Granted you had little time to fully examine senator McCain’s medical records and it’s difficult know the kind of stress running a country, but do you see any reason his preexisting conditions( shoulders and possible reaccurance of skin cancer) could affect his presidential duties should he be elected?

seah   May 25th, 2008 8:13 am ET

It is not required to release Medical records.

Obama has a History of demanding private records be released to find something to use against someone.

Obama should release his Birth certificate and other records to prove who he really is. He has gone by several names in his life time, Which can be more of a national threat, then someones medical records.

Lary   May 25th, 2008 12:06 pm ET

Hello Dr. Gupta,

I think it is should be incumbent on all party nomination candidates to make their complete and accurate medical record history available; as well as those of immediate family going back a minimm of three (3) generations.

Chula   May 25th, 2008 4:03 pm ET

Is Sanator Mccain taking Strong pain medications to control the pain originating from the Osteoarthritis of his shoulder joints ?

This may affect his decision making abilities

Frank Ianniruberto   May 25th, 2008 4:05 pm ET

I was watching your report on the health of Sen. John McCain. You mentioned that he has kidney stones. I have of history of them myself. Do you know the name of the medication he takes. I would like to give it to my urologist and get his opinion. I am calcium retententive. Or do you know the name/s of any medication that you could provide?
Incidentally, I will be watching “First Patient” tonight.
Keep up the good work.
Frank

luke P   May 26th, 2008 7:42 am ET

Mccain’s age will be a critical and major factor in his would-be presidency. Job of a president is enormously stressful mentally, emotionally and physically. … most especially now that he would be inheriting from Bush tons of problems- domestic alone- world’s crisis not included. Based on his debilitating medical history, I would say he has a fair health condition but would entail constant medical attention just to make sure he is fit to face the greatest challenge of his life in handling the country’s economy and international terrorism with competence, mental acuity and sound judgement. I am just wondering what would he look like after 2-3 years in the white house. Surely, being a president accelerates aging 10x. Good health and God bless.

CAROLYN HERON MD   May 26th, 2008 7:51 am ET

RISK OF VASCULAR EVENT OF CARDIAC OR CEREBRAL NATURE INCREASED IN MC CAIN WITH HIS CHOLESTEROL RESULTS. AND ALSO MAYBE FURTHER INCREASED WITH THE TUMOR SURBERY , SCAR TISSUE WHICH COULD ALSO BE COMPROMISING VASCULARN CEREBRAL FLOW. I THINK VASCULAR STUDIES TO HEART AND BRAIN VIA CAROTID VISION NEED TO BE DONE FOR HIS PRESIDENTIAL SAFETY AND SURVIVAL FORECAST AND I THINK DR GUPTA WOULD AGREE, DR CAROLYN HERON,PM&R

GripperDon   May 26th, 2008 1:46 pm ET

Great health for his age and what he has been thru. His life has not been easy but as has been said said before but bears repeating. What does not break your spirit makes you wiser AND stronger. McCain does not suffer fools easily and a lot of the reasoni is he has traveled a line, that included a lot ofhealth impacting places in the road, that he is so outstanding strong attests to his outstanding genetic base AND resivour of mental health.

Karla   May 26th, 2008 2:06 pm ET

I loved the show on the Presidents’ health. I’d love to see you do a piece on how strange Bill Clinton has been acting… and the link between bypass surgery and brain damage.

In 2001, an article in the New England Journal of Medicine reported that 5-years after bypass surgery 42% of patients showed decline in mental function of approximately 20 percent or more. A study published this year (2008) in the Annals of Thoracic Surgery using MRI testing just after bypass surgery found brain damage in 51% of patients.

Bill is not acting normal or rational. Definitely he’s had way too many missteps for one of the savviest guys in politics in recent memory.

kala lange   July 15th, 2008 10:29 pm ET

I just have a question about McCain’s health. One thing I didn’t see you comment on was his neurological health. I have been watching his speeches and notice he often has trouble finding his words unless they are written out and he can read them. Was there anything discussed about any potential neurological problems – possibly even early stage dementia? Thank you.

Merla Long   September 27th, 2008 9:51 pm ET

Dr. Gupta

It seems odd to me that no pain meds were found to be one of McCain’s health maintenance issues. He has to be having pain and further at his age and the way he acts with impulsive acts he also may have been ADD
when he was younger , most certainly beginning to enter dementia.
I read several of his latest actions today on another website and The Dementia can cause these irregularities. Look at RReagan how he began to slow way down in his second year, Nanci at his side helped him out of a jam more than once, telling him what to say.
It is my opinion he, McCain be checked for Dementia specifically

Eileen RN APN   October 5th, 2008 3:39 pm ET

Dr. Gupta; given Sen. mcCain’s POW history of atrocious beatings, one must ponder about the long-term neurological effects. His recent “erratic” behavior begs for a complete neuro assessment. He probably has had multiple concussions due to the head trauma. As you well know, it can take decades for the clinical sequelae to exhibit themselves. His choice of VP is out-of-character for a man who always put his country first and “would rather win a war and lose an election” rather than the opposite scenario. there appears to be some recent judgement impairment and other cognitive defects that he is no longer able to cover. he also might be demonstrating some early parkinsonian symtoms with the facial “tics”. To his medical resume I might add “R/O cerebral concussion effects secondary to repeated head injuries.”

And Sarah Palin most likely is Borderline Personality disorder. it’s a shame the American people are so unaware of the BPD disorder and how it can run havoc in any system (family, workplace, White House policies). Feel free to truncate my second paragraph. I know it’s probably over the limit, but it is so true. Thanks.

Michael   October 9th, 2008 3:24 pm ET

I don’t think McCain is showing signs of dementia, as some comment was made back in July, and then again in September. I think it is more simply, normal age related mental slowing, perhaps if you really want to label it, early senility. His campaign has overwhelmed his ability to manage and he can’t cope with the information flow, so he’s turned over most everything to his handlers and campaign staff. He’s reading and stumbling over words because he didn’t write them, and he’s being ’scripted’ by his campaign. He seems unaware and contradicts his VP candidate and sometimes his own campaign staffers, because he IS unaware, or doesn’t remember the details. He’s not comfortable with the negative attacks, but didn’t make the decision to go that way. He might not even be aware of the ads that are actually running or what his VP is saying in some of the stump speeches. Like R. Reagan, and GWB he is becoming a ‘figurehead’ for a group of people who are actually running the show.

Dan   October 9th, 2008 9:45 pm ET

Dear Dr Gupta,

I am a cardiologist who specializes in rare forms of inherited disease. In that context, I wonder about Senator McCain’s shoulders. I’ve read that he is limited due to war injuries, though pictures from several years ago show greater shoulder ROM. Another very plausible reason for his shoulder weakness, abnormal gait (like his), and facial muscle weakness is facioscapulohumeral muscular dystrophy (FSHD, OMIM # 158900). In this disorder, serum CK levels may be mildly elevated. Did you see any records of CK elevation while reviewing his records? If he’s on simvastatin, I expect routine CKs are checked. Normal CK does not rule out a rare form of skeletal myopathy.
If he has poor ROM due to prior injury, hasn’t surgery been considered, such as shoulder replacement? If it’s due to muscle injury, that would have resolved with proper therapy. If due to nerve injury, why are his distal UEs spared?
I certainly expect his facial muscle weakness may be due to recurrent melanoma surgeries, and his abnormal gait may be due to old age, but FSHD could provide a single answer to all 3 findings.

Dan

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Get a behind-the-scenes look at the latest stories from CNN's chief medical correspondent, Dr. Sanjay Gupta, and the CNN Medical Unit producers. They'll share news and views on health and medical trends -- info that will help you take better care of yourself and the people you love.

Editor's Note

Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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