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Pope John Paul II is again breathing on his own following surgery to ease a breathing crisis that caused him to be rushed yesterday to a hospital in Rome.
Doctors and spokespersons give what amounts to be positive news about the pope. But the messages and information has been mixed and from a medical standpoint, confusing.
According to Vatican officials, the frail 84 year old pope is now doing well and resting comfortably. Yet, the initial reports were that he had significant respiratory distress and a fever. It was said he had a flu rebound, which most medical experts will say does not happen. Either one can get another viral or flu-like illness, or they have another infection, such as a bacterial pneumonia.
Because the Pope has an advanced case of Parkinson’s, it would not be surprising if he was producing more oral secretions, a problem with Parkinson’s, and that he was having trouble keeping those oral secretions out of his airway and lungs.
That’s because the muscles that keep food and water out of the breathing passageway lose their function with Parkinson’s. And those secretions can be a set-up for a bacterial pneumonia, an infection in the lungs, which is what many experts believe happened to the Pope.
So, Thursday, he had a tracheotomy, a surgical procedure where a hole is cut in the windpipe and a plastic tube is placed, bypassing the mouth and vocal cords. This cuff is inflated, which seals off the airway and thus, protects the lungs from the mouth secretions.
The pope will not be able to speak because the air does not go through the vocal cords. To speak, he will have to deflate the cuff, but this is not easy, and patients often need to be trained to speak with a trach. Long speeches would be difficult, if not impossible to perform.
But the pope will be more comfortable.
Dr. Jordan Josephson, a throat specialist at Lenox Hill Hospital, says, “When you do a tracheostomy and you put a patient on the ventilator they can be pretty alert, and they can be eating on their own.”
Officials at first said the pope had a fever, but now they say he does not, and does not have signs of pneumonia. It is possible, that even with a normal appearing x-ray, a bacterial pneumonia is present, especially seen in older patients who are dehydrated.
But the fact the Pope is eating well is an overall positive sign of a patient who is doing well. And this trach might be the answer to getting him finally back on the road to good health.
“I’ve seen these patients turn around. In the best of all worlds the medicines work, he gets better, they take the tracheostomy and he’s back to himself. And that’s what we’re hoping for,” says Dr. Josephson.
Doctors have advised the pope not to speak for several days.
It is also said we would not hear anything more about the pope’s condition over the weekend.
It’s not completely clear if the pope was put on a respirator, or ventilator, but they say he was at one point he began breathing on his own, implying that at one point he was not. Being on a respirator would be a significant problem, because getting him off the ventilator is not so easy for someone who is old, with an infection and Parkinson’s. But apparently he is indeed breathing on his own.
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