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Reagan Resting Comfortably After Hip SurgeryAired January 13, 2001 - 4:07 p.m. ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
GENE RANDALL, CNN ANCHOR: Now we go to St. John's Health Center in Santa Monica, California -- a briefing on Ronald Reagan's condition.
JOANNE DRAKE, REAGAN FAMILY SPOKESWOMAN: My name is Joanne Drake; it's J-O-A-N-N-E D-R-A-K-E. I'm the chief of staff and official spokesperson for President and Mrs. Reagan. I will read a short statement from the family, and then turn the microphone over to Dr. Kevin Ehrhart; and it's K-E-V-I-N E-H-R-H-A-R-T. He was the lead orthopedic surgeon who operated on President Reagan this morning.
Dr. Ehrhart was assisted by Dr. Ramean Modabber (ph), Dr. Kent Yinger (ph) and Dr. Jonathan Cole (ph), the anesthesiologist. Also with me today is Sister Marie Madeline (ph), president of Saint John's Health Center, Dr. Krisloff (ph), who is one of President Reagan's private doctors and Dr. Jim Blake (ph), who's part of the team as well. Dr. Ehrhart will provide you with the details of the operation and a prognosis for President Reagan, then take a few questions.
As we have done since 1994, when President Reagan announced that he has Alzheimer's, we respect the privacy of the Reagan family, and neither Dr. Ehrhart nor I will comment on any aspect of President Reagan's Alzheimer's.
President Ronald Reagan underwent surgery this morning at St. John's Health Center in Santa Monica, California to repair his right hip. He is out of recovery and resting comfortably back in his room. The doctors who performed the operation told Mrs. Reagan that the surgery was successful and without complication. Mrs. Reagan was with him through the night, has remained strong throughout, and is with him now in his room.
Our office will remain the officials spokesperson for the Reagan family. St. John's will not be releasing any information or responding to questions on the president's condition. When visitation restrictions have been lifted, Mrs. Reagan is looking forward to having his family visit with him. Mrs. Reagan has asked me to request all others wishing to go express their good wishes to send them to the Ronald Reagan Presidential Foundation at www.reaganfoundation.org, or send them to 40 Presidential Drive, Simi Valley, California, 93065. Of course, we will keep you posted on his progress as circumstances warrant.
I'm now going to turn the microphone over to Dr. Kevin Ehrhart. I would ask your indulgence, as he has reminded me that he is an orthopedic surgeon, not a spin doctor. He will take a few questions at the end of his statement, but the doctors do need to return to the care of their patients.
DR. KEVIN EHRHART, ORTHOPEDIC SURGEON: Good afternoon; I'd like to read a statement, then take the questions afterwards.
President Reagan fell on Friday, January 12, 2001 while at his home. He broke his right hip. He was brought to the emergency room and admitted to the hospital. Today, on Saturday, January 13, after undergoing a very thorough preoperative evaluation by his team of physicians, he underwent surgery which consisted of placement of a screw and plate and a series of smaller screws to repair the broken bones.
He remained in stable condition throughout the entire surgery and remains in stable condition now up in his room in the hospital. Mrs. Reagan, though obviously concerned for his welfare, has been calm and has been at his side to the emergency room, last night, today in surgery, and in the recovery room, and she's with him now.
The surgery was performed under our general an anesthesia. The president is likely to remain in the hospital for another week to 10 days before returning to his home. We would like to comment on the surgery itself that, although the patient, 90-years-old, he has very healthy tissue; very strong, healthy bone. And we were very happy with the end result at this point in time.
Now he is in his postoperative phase. As is typical for anyone with a broken hip, it's a long, uphill struggle; and he's doing fine at this point in time.
And I would be happy to answer any questions that you might have.
QUESTION: Dr. Ehrhart, can you talk about the complications that might arise -- I don't want to know about his Alzheimer's condition, but for any patient that has Alzheimer's, the complications that that presents in recovering from this operation?
EHRHART: The hip fracture patients have a series of complications; there is the healing of the fracture that has to take place. There is the rehabilitation that has to take place, the strength to do that; they have to have a good heart and lungs so they don't have problems with pneumonia or heart failure. And these are all complications that people 90 years old are very susceptible to, and the president certainly is, himself.
QUESTION: (OFF-MIKE) the fact that he is a patient with Alzheimer's complicate it even more than if he didn't have it?
EHRHART: I'm sure it will complicate it somewhat more. It's a bigger challenge, but it's one that is not uncommon in orthopedics.
QUESTION: What exercises will you have him doing (OFF-MIKE)
EHRHART: He's doing no exercises at this point in time, but he will. In the next 48 hours he will be up into a bed, begin transferring; and then, over the ensuing days he'll start to begin weight training, which is weight-bearing as he walks. It will be a long period of time.
QUESTION: Can you describe...
QUESTION: Is he in pain, and how are his spirits? Has he spoken at all to you?
EHRHART: He was in pain, very definitely, which is typical for this kind of injury. He was medicated throughout the night to try and ease the pain. He is much better right now; he's with Mrs. Reagan. He's very calm with Mrs. Reagan and she feels he's back to himself, so she's happy at this point in time.
QUESTION: Can you describe the difference between what you did today and a hip replacement?
EHRHART: What was done today was the various parts of the various parts of the fracture were put back together with a series of implants -- pins and screws, and then the fracture heals in that position. The patients hip bone remains the same.
Hip replacement -- you replace the ball and put a metallic implant in its place. Nothing has to heal in that case; in this case, the fracture has to heal.
QUESTION: (OFF-MIKE) how severe was this (OFF-MIKE)
EHRHART: This was a fairly run-of-the-mill hip fracture. I mean, it's a significant injury because it occurs in an older population that have all these complications we addressed earlier. But it was, from an orthopedic point of view, a fairly straightforward hip fracture.
QUESTION: Doctor, do we know that the president fell and broke the hip, or did the hip break, as often happens (OFF-MIKE)
EHRHART: Well, you know never know that. We can't tell that; but it looks, from all our inquiries so far that he stood up and had a mechanical fall, and in the fall he broke his hip. The type of fracture would suggest that he fell and the hip broke.
QUESTION: (OFF-MIKE) expected that he would make a full recovery? And what is the recovery rate for such an operation?
EHRHART: It's expected and hoped, although no guarantee that he'll get back to the level he was before this happened. That's the goal with all hip fractures.
QUESTION: Are we talking about weeks or months in terms of rehab?
EHRHART: There's a variation. It's probably closer to months, though, I would imagine.
QUESTION: The president will be hospitalized for a week to 10 days; is that standard for a man in his condition?
EHRHART: That's very standard, yes.
QUESTION: Doctor, going back to the Alzheimer's for just one second -- in terms of rehabilitation, following directions -- does that present a problem when a patient has that disease?
EHRHART: It presents a challenge. patients who have hip fractures have a lot of challenges, this is certainly one of them. And it is a challenge, yes.
QUESTION: Doctor, what about the president's mobility? He had been losing mobility, it's our understanding; will this make a difference? Will he be able to get up and get around?
EHRHART: He will, at the end, we're hoping. Right now he's not able to get up and get around.
QUESTION: Doctor, when do you expect other family members may be able to see him?
EHRHART: That's not something I'm able to tell you the answer to that.
QUESTION: (OFF-MIKE) Joanne tell us more about Mrs. Reagan? We have heard that she was there every step of the way. Was she there when he was X-rayed before, after the operation? Just give a timeline of her presence.
EHRHART: Since I've been involved, which was yesterday afternoon, she's been with him the entire time. She's been with him all last night, all day today. She came down to surgery with us when we actually went into the surgery suite itself she stayed back in one of the other surgery rooms. She met us in the recovery room and has been at his bedside since that time. So, except for the hour and a half or so that we were in the surgery room, she's been with him.
QUESTION: (OFF-MIKE) a lead apron during the X-ray procedure? "The L.A. Times" reported that this morning.
EHRHART: She was not in at surgery itself.
QUESTION: During the X-ray procedure did she don a lead apron?
EHRHART: She steps out of the room for those two minutes.
QUESTION: Doctor, can you clarify when you expect him to begin to walk -- to have him start walking for the first time -- a rough idea?
EHRHART: We would hope within a week to two weeks.
QUESTION: You said you were going to have him get up in two days, what does that imply?
EHRHART: Well, we would hope to, by tomorrow or Monday, be up into a chair at his bedside.
QUESTION: Will he start out walking with a cane or a walker, I assume (OFF-MIKE)
EHRHART: When he starts walking, it will be with a walker.
QUESTION: (OFF-MIKE) the screw?
EHRHART: Just happen to have it.
QUESTION: Would you describe what you did while (OFF-MIKE)
EHRHART: Excuse me -- it is a very standard orthopedic implant for this type of hip fracture. The large screw at the end goes into the side of the bone across the fracture and into the head of the femur, and then the plate, here, goes along the side of the shaft of the femur. They're connected and then the plate is screwed to the shaft of the femur to hold the two pieces rigidly together so that there will be, one, lack of pain and the patient will feel better and be able to be mobilized and, two, to hold it in the correct position while it heals.
QUESTION: When would you expect to allow other family members and friends to visit?
EHRHART: That would be determined by his whole team of physicians and especially Mrs. Reagan's decision.
QUESTION: (OFF-MIKE) have at the hospital? Within the next day? Two days?
EHRHART: Next two to three days.
DRAKE: We have time for two more questions.
QUESTION: (OFF-MIKE) hospital, or will he (OFF-MIKE) at home?
EHRHART: No, the majority of it will occur at home.
QUESTION: His condition -- could you put it in terms of good, fair, serious, along those lines?
EHRHART: Probably all three; he's doing well, we're happy; it is serious -- it's a serious injury. And it's guarded since he's a patient with -- 90 years old with other medical problems. But you can't just say it in one word.
DRAKE: Thank you all.
QUESTION: Our understanding is that 20 percent of these patients don't make it within a year. What is the most serious risk factor involved? What does he need to worry about the most? EHRHART: Not making it. I mean, the most serious problem would probably be his lung and heart; that would be the biggest concern we'd have to worry about.
QUESTION: Can you explain what that means?
EHRHART: Well, you get trouble with heart failure or pneumonia.
DRAKE: Thank you all.
QUESTION: How often can we expect updates on his condition?
DRAKE: They're not going to be consistent. We'll just let you know when there's something...
RANDALL: The word from Santa Monica, California is that former President Ronald Reagan, 89 years old, is resting comfortably in his room at the St. John Health Center. He is in stable condition -- that was said to be his condition throughout the surgery today, which we were told was successful and without complications.
Elizabeth Cohen is in Atlanta for us.
Elizabeth, that sounds to be like the most important thing we heard: no complications.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Absolutely, because, especially with a man who's almost 90 years old, you could have complication; you could have infections or nerve injury. And so, of course, it's good news that there were no complications.
What we heard from Dr. Kevin Ehrhart, the head of his surgical team, is that a large screw and a plate were put into his hip and then several smaller screws as well and that the surgery was done under general anesthesia. They expect him to be discharged in a week to 10 days, which they say is standard for this kind of surgery.
Dr. Ehrhart also said that President Reagan was in pain yesterday when he came in with the injury. He made it sound like a great deal of pain; they gave him medication. They said now that he's done with the surgery he is in less pain with his wife Nancy by his side.
He also mentioned that there's no guarantee that President Reagan will go back to the way he was -- will go back to the kind of mobility that he had before this injury. That would not be unusual if he didn't. In fact, only 25 percent of patients who undergo this kind of surgery end up having a full recovery and going back to the way that they were.
Of course, they hope that he will make a full recovery -- Gene.
RANDALL: Elizabeth, the doctor also said that recovery will be a long, uphill struggle and he touched on something you said before: It will be complicated by the fact that the former president has Alzheimer's disease. COHEN: That's right; now these doctor do not treat his Alzheimer's and so they weren't willing to take questions on it. But we know from speaking with other doctors that it's well-known that these kinds of recoveries are hampered when somebody has Alzheimer's.
There's several things -- there are several reasons for that. One is just purely physical. When someone without Alzheimer's has this kind of a surgery, you can tell that patient, you know what, you don't have the same hip you had before the surgery, before the fall; you need to be really careful. An Alzheimer's patient won't remember, necessarily, that you told him that, so he may get out of bed in the morning and not remember that he had the surgery. He may not react to his pain in the way that you would expect people to react to their pain.
Another thing that doctors look out for with Alzheimer's patients after this kind of a surgery: They don't want the patient to become delirious; in other words, he already has dementia, but he still has some connection to the world. He still knows who his wife is, he still -- many patients like this, we don't know about him in particular -- can put a spoon to their mouth.
But when a patient becomes delirious, all of that goes away and they can't do those very, very basic things. And that happens after surgery sometimes because patients are on pain medication and they've just had anesthesia, and that can turn a case of dementia -- a case of Alzheimer's -- into a case of delirium on top of that. And so those are the two big things that doctors look for when they have an Alzheimer's patient who's just had this kind of a hip surgery.
RANDALL: Elizabeth, thanks very much.
Former President Ronald Reagan resting comfortably in California at the St. John Health Center in Santa Monica after successful surgery for a broken hip. He is 89 years old; recovery, we are told, will be a long, uphill struggle. Back in a moment.
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