The Deplorables Are Having a Fiesta

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    Sep 12, 2016 2:38 PM GMT
    The alt-right and KKK/Nazi-loving Trump supporters (the "Deplorables") are having a "fiesta" trying hopelessly to fabricate lies about President-Elect Hillary Clinton's weekend episode. Fortunately, one cannot extract raw silk without silkworms. Perhaps that's too deep. So, let's simplify it: one cannot make a mountain out of a molehill without looking stupid. Perhaps that's still too deep. But here's an article that explains it all. See http://www.cnn.com/2016/09/11/opinions/hillary-clinton-health-vox/index.html (visited 9/121/16).

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    (CNN) — Feeding into the alt-right narrative questioning Hillary Clinton's personal health, Sunday's near-fainting spell, caught on camera, is more than enough to make her fervent opponents a little lightheaded. The social media commentary following the episode demonstrated more glee than concern. But neither emotion is warranted.

    As it turns out, fainting spells (and near-fainting) are quite commonly seen in healthy people. The information we have favors Clinton's wobbly moment as nothing unusual, particularly since we now know she's battling an infection. The video is dramatic, showing Clinton wavering back and forth and supported by her security staff into a waiting SUV that drove her to her daughter Chelsea's nearby apartment. The Clinton team's initial poor transparency, leaving it to reporters to figure out she was MIA from a New York City 9/11 memorial event (which Donald Trump also attended) and then supplying an incomplete statement, didn't do anything to help tamp down conspiracy theories about Clinton's health. Late Sunday, the campaign issued a statement from Clinton's personal physician Dr. Lisa Bardack reporting that she'd diagnosed Clinton with pneumonia on Friday and advised her to lighten her schedule. Bardack stated the episode occurred due to the combination of that diagnosis, dehydration and overheating.

    I'd certainly agree these are all factors. That the Clinton campaign didn't release the diagnosis of pneumonia on Friday is symptomatic of its own problems. The video clearly shows someone who's on the verge of fainting (medically, the term for such temporary loss of consciousness is syncope, or if the person doesn't actually pass out, it's pre-syncope). Yet Clinton's spokesman Nick Merrill said the candidate "felt overheated so departed to go to her daughter's apartment." "Feeling overheated" lacks the important detail that she couldn't hold herself up on her own as she got into the waiting vehicle. But while the Clinton campaign once again managed to foster the perception that they're preoccupied by information over-control, we shouldn't let their odd behavior get in the way of interpreting the facts we have now.

    The "differential diagnosis" list, or range of potential problems to consider, when someone faints is huge. But about half the time doctors don't need to do any special testing to figure out the problem. A simple physical exam, or even the history alone (or story) of the event settles the diagnosis in such cases. Hillary Clinton's episode Sunday looks like one of those straightforward cases, and it's not surprising Bardack is confident in the factors at play.

    The video clearly shows someone who's on the verge of fainting (medically, the term for such temporary loss of consciousness is syncope, or if the person doesn't actually pass out, it's pre-syncope). Yet Clinton's spokesman Nick Merrill said the candidate "felt overheated so departed to go to her daughter's apartment." "Feeling overheated" lacks the important detail that she couldn't hold herself up on her own as she got into the waiting vehicle.

    But while the Clinton campaign once again managed to foster the perception that they're preoccupied by information over-control, we shouldn't let their odd behavior get in the way of interpreting the facts we have now. The "differential diagnosis" list, or range of potential problems to consider, when someone faints is huge. But about half the time doctors don't need to do any special testing to figure out the problem. A simple physical exam, or even the history alone (or story) of the event settles the diagnosis in such cases.

    Hillary Clinton's episode Sunday looks like one of those straightforward cases, and it's not surprising Bardack is confident in the factors at play. First, Clinton experienced warning symptoms, namely the sensation of overheating (and perhaps other symptoms her team hasn't supplied), which prompted her to decide to leave an outdoor event in the summer sun after she'd attended for about 90 minutes. Each of these facts is crucial.

    The most important job doctors face when evaluating a brief fainting spell is figuring out whether the heart is involved. Did the heart skip into a bad rhythm, one that wasn't able to get enough blood supply to the brain? If that happens, in most cases, the event is sudden and with no warning, unlike in Clinton's case. In such situations the person also rebounds fairly suddenly. They don't need a rest and recovery period to gradually return to baseline like Clinton did. Clinton's gradual onset of symptoms also come in the context of her attending an outdoor event for an extended period that involved a lot of standing. This is key medical history that points to a blood pressure drop, and the most common cause of that is a so-called vasovagal episode. In typical vasovagal syncope, there's less blood in the upper body when you're standing because it's pooling in the lower body, and maybe you're dehydrated to boot. Your heart tries to forcefully contract to make up for the lack of sufficient blood in its chambers, so much so that it overstimulates itself into activating an arm of the nervous system that's normally responsible for bringing down the heart rate and blood pressure (the parasympathetic nervous system, which connects to the heart through the vagus nerve - the "vagal" in vasovagal). Prolonged standing is just one of many common causes of vasovagal syncope, another is overheating, which also dilates blood vessels and drops blood pressure. While the New York air itself wasn't particularly hot Sunday morning (lower 80s), the air temperature doesn't dictate your surface temperature in the sun, which can still send plenty of heat into your body and clothing (especially if dark like Clinton's outfit). Anyone who's enjoyed Southern California's wonderful weather has experienced this phenomenon.

    Beyond the pneumonia, I also suspect that Clinton's allergies, which her doctor described in her medical attestation last year and which we've all heard about thanks to the candidate's periodic coughing fits, played a role. Coughing, whether due to pneumonia or allergies, can itself kick off a reflexive surge in the parasympathetic nervous system that drops the blood pressure and causes you to faint. In short, if Clinton came into an emergency room with this history, most ER doctors wouldn't see the need to refer her for advanced testing.

    But of significant concern to me is that Clinton told reporters Tuesday that she "just upped my antihistamine load to try to break through" her latest allergy exacerbation. Antihistamines need to be used in moderation. The potential side effects are broad, they're a brute weapon in the battle against allergies because they interplay with the nervous system. The drug class is well known to play a role in fainting spells, and if Clinton just increased her dose this week, that's a factor her doctor should consider in her future allergy management.

    To continue reading the article, see http://www.cnn.com/2016/09/11/opinions/hillary-clinton-health-vox/index.html.
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    Sep 12, 2016 5:45 PM GMT
    UMayNeverKnow saidFor the sake of the country I hope she dies before the election. I'm not wishing. I'm just hoping.

    Stay classy.
    I'm not a clinton fan, but against trump she is obviously the only choice.
    But stay deplorable.
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    Sep 12, 2016 6:28 PM GMT
    both candidates (in their 70's) are as old as dirt and just might die trying.
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    Sep 12, 2016 7:33 PM GMT
    UMayNeverKnow said
    For the sake of the country I hope she dies before the election. I'm not wishing. I'm just hoping.

    Yep, Trump's supporters are deplorable. And what a wondeful semantic non-difference between hoping and wishing.
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    Sep 12, 2016 7:36 PM GMT
    They couldn't get her on email so then they attack a cough and now an infection. What's next, yeast? The GOP just gets progressively more lame.

    Here, have a taco bowl....

    tumblr_o6rgsbUbSO1thkor1o1_1280.jpg
  • mybud

    Posts: 11829

    Sep 12, 2016 7:43 PM GMT

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    Hey...That's what the President of Mexico's ass tastes like....Eat up Mr. Deplorable
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    Sep 12, 2016 7:46 PM GMT
    Art_Deco said
    UMayNeverKnow said
    For the sake of the country I hope she dies before the election. I'm not wishing. I'm just hoping.

    Yep, Trump's supporters are deplorable. And what a wondeful semantic non-difference between hoping and wishing.


    Your such a bigot Bobby Boo boo. There simply was no depth to the depravity of the Libtards, when it came to Sarah Palin. You even participated in on the depravity. You sad little man.