Saturday 24 March 2018

Can you keep working with pneumonia?

As Hillary Clinton is diagnosed with 'walking pneumonia', our reporter investigates what the illness actually entails

'No big deal': Hillary Clinton remained working after diagnosis
'No big deal': Hillary Clinton remained working after diagnosis
Vicki Notaro

Vicki Notaro

When you hear the word pneumonia, chances are you envision someone elderly or infirm. An infection of the lower respiratory tract, it's commonly associated with older people in hospitals and nursing homes, and thought of as something that can kill.

However, pneumonia is currently in the news since Hillary Clinton's diagnosis was revealed at the weeked. The 68-year-old Democratic presidential nominee was on the campaign trail at a 9/11 memorial ceremony in New York, when she became visibly unwell and was escorted out of the event early.

News has since come out that she had been diagnosed with "walking" pneumonia days earlier by her doctor, and was recommended to rest. However she continued to campaign against medical advice, later saying: "I just didn't think it was going to be that big a deal."

But how big a deal is pneumonia? Is it possible to continue with life as normal when suffering, and how do you tell the difference between it and the common cold? After all, the initial symptoms of a high temperature, headaches, dizziness, dehydration and exhaustion can be attributed to several different conditions.

"Pneumonia occurs when a respiratory tract infection moves down and enters the air sacs in the lungs. It's a major killer worldwide, but it's also extremely common and usually very mild," says Dr Mark Murphy, the chair of communications for the Irish College of General Practitioners.

"It's usually easily treated with oral antibiotics, doesn't require hospitalisation and most patients recover quickly Normally it's treated by a GP in the community."

So it's a condition that can be quite serious, but typically is not. "It's one of the most common infections GPs come across, and it's easy enough to deal with, but if there are complicating factors it can potentially be very serious. If a patient is over 65, is confused, has low blood pressure or severe breathing difficulties, then that often requires hospitalisation."

Dr Murphy says that the term "walking pneumonia" isn't used in Europe, and that what Clinton has been diagnosed with would be referred to as "atypical pneumonia" here in Ireland.

"This is when the patient doesn't have typical symptoms, or if the pneumonia isn't showing up on an X-ray. It's usually mild, and caused by an atypical bacteria, not the usual streptococcus. It's also easily treated with antibiotics though."

So where does pneumonia get its terrible reputation from then? "When someone is extremely unwell, has a terminal illness or is in the last few weeks of their life, it can be typical for a pneumonia to occur and in that context, it can be a fatal illness."

Hence why we often associate it with nursing homes and hospitals. Dr Murphy says that smoking can make people more vulnerable to respiratory tract infections too.

However Dr Murphy also says it would be unusual for GPs to recommend bed rest for pneumonia, except in extreme circumstances.

"It would be taken case by case, but bed rest is rarely used for any condition like this. The patient may need to augment their working habits, but if they get lots of sleep, drink lots of fluids, take the prescribed antibiotics and manage any pain with paracetamol or ibuprofen, the condition should improve."

Since Hillary Clinton is 68-years-old and still on the hectic campaign trail, perhaps her doctor was erring on the side of caution advising her to take it easy. It's best to listen to your GP; if they have any doubt in a diagnosis, they can send patients for a blood test or X-ray. However Dr Murphy says very few cases would end up in hospital.

Helen Purcell, 28 from Dublin, has had pneumonia twice. "The first time I was 20, and the second time was about two years after that. I was sick for about six weeks all in all each time. I was a heavy smoker at the time, so I thought it was just a normal infection that wouldn't go away.

"I hadn't been to the doctor because I wasn't earning much and thought it would clear up eventually. My mother talked me in to going after a few weeks of me having a hacking cough in work, and I was then signed off for three weeks."

Helen says that she probably would have made herself "power through" if she hadn't been advised to take the time off, and she was surprised at her diagnosis. She was prescribed antibiotics, and says that if she were to get a similar diagnosis now, she wouldn't force herself to go to work.

Since news of her diagnosis was made public, Clinton has told CNN that she was feeling "so much better" and that she had ignored her doctor's "wise" advice. "I felt dizzy and I did lose my balance for a minute, but once I got in (the van), once I could sit down, once I could cool off, once I had some water, I immediately started feeling better," she said.

Campaign sources said she hadn't wanted to reveal the nature of her diagnosis in case her opposition attempted to exploit it - her detractors have questioned her health before. However Clinton tweeted that she was anxious to get back to work soon, and plans to release new medical records to ease any concerns the voters might have.

Pneumonia: what to look out for

• Have you had the flu or a severe cold recently that hasn’t quite cleared up?

• Have you had a bad cough that won’t go away?

• Have you had a fever or chills?

• Have you been dizzy or experiencing a rapid heartbeat?

• Have you been feeling very tired?

• Have you been having any difficulty breathing?

Irish Independent

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