Ann Robinson 

Should Hillary Clinton be back at work so soon after a blood clot?

A doctor on whether the US secretary of state should be taking it easy after her health scare
  
  

State Hillary Clinton leaves New York Presbyterian Hospital on 2 January.
Hillary Clinton leaves New York Presbyterian Hospital on 2 January. Photograph: Joshua Lott Photograph: Joshua Lott

Hillary Clinton is back at work today with 12 meetings scheduled this week, just four weeks after a blood clot on the brain. What advice would I give her if she pitched up at my GP surgery in north London?

Her problems apparently kicked off at the beginning of December with a nasty European tummy bug. She became so dehydrated that she fainted and banged her head. She was admitted to hospital on 30 December and diagnosed with a right transverse venous sinus thrombosis (a blood clot in the large vein that runs in the space between brain and skull, just behind her right ear). It was only picked up because she had a routine MRI scan after the fall. She didn't have a stroke or any neurological symptoms.

The clot probably developed because her blood was more sludgy than usual as a result of dehydration. Without the fall, she wouldn't have had the MRI and this rare type of blood clot may never have been discovered. Mind you, it's just as well they did discover it because, without treatment, it could have extended and broken off, causing a stroke. Now she's on blood-thinning drugs (anticoagulants) and will be having regular MRIs to make sure the clot is shrinking.

Doctors will also be doing regular blood tests to make sure she's not over-anticoagulated which could lead to a risk of haemorrhage. (Or she may be on one of the trendy new anticoagulants which don't need constant dose adjustment.)

Clinton won't be pitching up at my surgery in Finchley, which is a relief. Having her as a patient could be a bit daunting: you really wouldn't want to get it wrong. And in truth, she's unlikely to come to any harm by sitting behind a desk or lifting a phone. But, intuitively, I feel that I would say to her: "Hillary, do yourself a favour. Cancel those meetings, stay at home, take it easy, watch some daytime telly, keep your blood pressure low and give yourself a break. The world can surely wait a couple more weeks."

 

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