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Clinton's doctor cites 'mild' pneumonia, good overall health

WHITE PLAINS, N.Y. - Hillary Clinton's campaign released a letter from her doctor Wednesday describing her treatment for "mild" bacterial pneumonia and painting an overall picture of good health in an attempt to put to rest concerns about her medical condition following her illness over the weekend.

WHITE PLAINS, N.Y. - Hillary Clinton's campaign released a letter from her doctor Wednesday describing her treatment for "mild" bacterial pneumonia and painting an overall picture of good health in an attempt to put to rest concerns about her medical condition following her illness over the weekend.

The letter, from Clinton's doctor, Lisa Bardack, noted that she received a CT scan confirming the pneumonia diagnosis and is now about halfway through a regimen on the antibiotic Levaquin. It came three days after Clinton's illness caused her to stumble out of a memorial service and forced her off the campaign trail. Clinton's campaign said the information updates a health history released last year.

The campaign came under fire on Sunday, when Clinton fell ill at a Ground Zero commemoration of the Sept. 11, 2001, terrorist attacks. For 90 minutes after her abrupt departure, when she was seen buckling and stumbling into her van, the campaign offered no information on Clinton's whereabouts or condition. It was many hours later before aides revealed the pneumonia diagnosis, which had come on Friday.

"The remainder of her complete physical exam was normal and she is in excellent mental condition," Bardack wrote in the letter. "She is recovering well with antibiotics and rest. She continues to remain healthy and fit to serve as President of the United States."

Issues surrounding health and transparency have swirled around Clinton and her Republican rival, real estate mogul Donald Trump, in the past several weeks. Clinton, who turns 69 in October, would become the second-oldest president to enter the White House (after Ronald Reagan, who also was 69), while Trump, who turned 70 in June, would be the oldest. Neither has any known major medical problems.

Clinton had previously released more extensive health information than Trump. She has also been the subject of persistent rumors and conspiracy-minded claims about her health. Although her campaign has dismissed such theories as bunk and even sexist, Clinton fed into them by ditching her press corps Sunday and not releasing timely information on her health or whereabouts.

Trump discussed his own health during a taping of "The Dr. Oz Show" on Wednesday morning. He shared some of the results of his most recent physical examination, according to the show, even though earlier top campaign aides told reporters that he would not release any records on set and planned to talk about general wellness, not his personal health history.

At one point during the show, which is scheduled to air Thursday, host Mehmet Oz asked Trump why he has not yet released his medical records, given that his health seems so strong.

"Well, I really have no problem in doing it," Trump said, according to a brief clip released by the show on Wednesday afternoon. "I have it right here. Should I do it? I don't care. Should I do it?"

Trump then pulled two pieces of paper out of his suit pocket that he said contained test results from his latest physical examination and a letter from Lenox Hill Hospital in New York. In the video clip, Oz is shown studying the two pieces of paper. Reporters were not allowed to attend the taping, and the campaign has not released the documents. The campaign also would not say what sort of medical records Trump plans to release or how many years they cover.

Bardack is the chair of internal medicine at CareMount Medical in Mount Kisco, New York, and has served as Clinton's personal physician since 2001. Her letter also described various medications that Clinton is taking, including Coumadin, a blood thinner. And it describes Clinton's normal-ranging vital statistics: blood pressure of 100/70; a pulse of 70; and a total cholesterol level of 189.

Bardack examined Clinton as recently as Wednesday and has done so several other times since she was diagnosed with pneumonia Friday, according to a campaign aide.

The letter shows that Clinton has normal-ranging vital statistics, according to several doctors who reviewed the information but have never treated her. Her blood pressure and cholesterol levels are "good" or "excellent" and place her at low risk for illness for a woman her age, the doctors said.

Clinton has received two vaccinations against pneumonia - Prevnar and Pneumovax - according to the letter. The new information also reveals more about Clinton's pneumonia diagnosis. She was tested with a non-contrast chest CT scan, which discovered a small right middle-lobe pneumonia.

David Scheiner, who was Barack Obama's physician for more than two decades until his election in 2008, praised Clinton's doctor for conducting a chest CT scan, which typically would not be done to diagnose pneumonia.

"I have to give the doctor credit for that one," Scheiner said. "Because she has had blood clots, I think in the back of the doctor's mind was, could she possibly have pulmonary embolism? That was a very smart move on the doctor's part."

But Scheiner said he was perplexed by some of the medications that Clinton takes. He said the blood thinner Coumadin can be hard to regulate and that better alternatives exist. In addition, the Armour Thyroid tablets she takes for hypothyroidism is used on only a small percentage of patients.

"That's a bit unusual," he said, noting that doctors rarely prescribe it.

Other doctors noted that while Levaquin is an appropriate treatment for her pneumonia, one of its side effects is dizziness and lightheadedness. That could have been a contributing factor to her fainting on Sunday, said Greg Rosencrance, an internist at the Cleveland Clinic.

Overall, Scheiner said the disclosures by Clinton's campaign on Wednesday were "in the right vein." But he argued that the current patchwork system that relies on campaigns to decide how much medical information to disclose, and often by a candidate's personal physician, too often leaves Americans in the dark.

"The question is how much info is enough? . . . I think we need to know everything about the candidates, and not just because these are two old geezers," said Scheiner, who has advocated for complete, objective health reports from any candidate who wants to serve as commander in chief and lead the world's largest economy.

Clinton had previously released a letter from Bardack containing information about her health, medications and past health conditions, including a history of hypothyroidism and deep-vein thrombosis.

After Clinton's pneumonia diagnosis, she kept the information secret and ignored her doctor's advice to rest and modify her schedule. Instead, Clinton continued with a full day of campaign events, choosing to "power through" despite her illness.

But by Sunday morning, Clinton became severely dehydrated during the outdoor memorial at Ground Zero, according to the campaign. She left the event early and was seen in video footage buckling as she was helped into her van by her aides and security detail.

The campaign's long delay in providing information to the media and the public prompted criticism from Democrats and Republicans alike.

Clinton canceled three days of scheduled campaign events and has been resting at home in Chappaqua, New York. She is expected to return to the campaign trail with an event in Greensboro, North Carolina, on Thursday.

"Obviously I should have gotten some rest sooner," Clinton said on CNN's "Anderson Cooper 360" on Monday. "I just didn't think it was going to be that big a deal."

Clinton previously suffered from severe dehydration in 2012, fainted and suffered a concussion. She was later diagnosed with a blood clot in her skull, discovered during routine testing while recovering.

At the same time, Clinton has criticized Trump for releasing a letter from his physician earlier last year that contained virtually no objective health information. Trump has since said that he would release more medical information from a physical he received last week.

Edward Geltman, a cardiologist at the medical school at Washington University in St. Louis, said the information released shows Clinton to be healthy, with normal range for vitals. Her blood pressure is on the "low side of normal," he said, so she would be prone to fainting and sensitive to dehydration.

Geltman observed that the letter contained no information about the health of Clinton's heart, such as an electrocardiogram. Those are fairly standard tests, and as people age, it is important to establish a baseline, he said. Heart disease is the number one killer in the United States. But because she does not smoke, does not appear to be particularly overweight and has good cholesterol levels, Clinton does not appear to be at risk for a heart attack, he said.

Doctors also noted that Clinton is on minimal medications and has had appropriate breast cancer screening - but there is no mention of colon cancer screening.

According to the letter, Clinton was diagnosed with a sinus infection and subsequently an ear infection in January, in the lead-up to the critically important Iowa caucuses and New Hampshire primary.

She was treated with antibiotics and steroids. Later, a tube was placed in her left ear as part of the treatment.

Bardack wrote that the symptoms improved, and a follow-up CT scan showed mild, chronic sinus infections but no abnormalities of the brain related to those illnesses.

The campaign also released a comparable letter about Clinton's running mate, Sen. Tim Kaine of Virginia, who was said to be in "overall excellent health," according to a letter released from the attending physician for Congress, Brian Monahan, who recommended only that Kaine, 58, add a daily vitamin D supplement to his diet. Monahan has been Kaine's physician for three years.

In his letter, Monahan noted that Kaine's past surgical history is limited to tooth extractions. Kaine's most recent electrocardiogram showed his heart appeared normal with the exception of a "mild left atrial enlargement." No other problem areas were identified.

The Washington Post's Brady Dennis, Jenna Johnson and Lena H. Sun in Washington and John Wagner in Las Vegas contributed to this report.

Abby Phillip is a national political reporter for the Washington Post.

Anne Gearan is a national politics correspondent for The Washington Post.