Press Briefing by Mike McCurry, Dr. Connie Mariano and Drs.

Bethesda Naval Hospital

Bethesda, Maryland

3:05 P.M. EDT

MR. MCCURRY: Good afternoon, everyone. The President has just undergone his fourth annual physical examination here at the National Naval Medical Center. And, not surprising, the President is in excellent overall health and feeling very good, feeling very good about his exam, the more you'll learn about in a minute.

This year's evaluation was performed by a very distinguished panel of specialists, both military and civilian. They are here with us. We've had such a good working relationship with the folks here at Bethesda Naval that, having gained some expertise because of the knee surgery, we decided this year that we would both make the results of the President's annual examination available and then also, after a couple of introductory statements here, make them available to you if you have any questions.

As I said, the overall examination was under the supervision of the President's personal physician, Dr. Mariano, who is here, and she's going to introduce the panel. Let me say at the outset that the President thanked Captain Frank McGuire, who is the Deputy Commander here, for the excellent job done today. Admiral Bonnie Potter is out of the office today, but the President thanked the excellent staff here. He said, they do a great job here, but it's nice being here in less pain and not having to stay.

The President also said that it's clear that all his exercising and huffing and puffing has paid off. And the President also says that the results today shows what happens when you follow doctor's orders.

And so with that, let me turn it over to the doctors -- Dr. Mariano.

DR. MARIANO: Thank you, Mike. I'd like to introduce our panel of specialists who participated in the President's physical examination today. To my left I have Dr. James Suen. He's a Professor and Chairman of the Department of Otolaryngology, Head and Neck Surgery, University of Arkansas Medical Center. He's a Fellow of the American Academy of Otolaryngology, Head and Neck Surgery.

Beside him is Dr. David Thompson. He's the Chairman of Otolaryngology, Head and Neck Surgery here at Bethesda Naval Hospital and a Fellow of the American Academy of Otolaryngology, Head and Neck Surgery. Mr. Earl Brown, Master of Arts in Audiology. He's the Chief of Audiology here at Bethesda. Beside him is Dr. Michael Jones, the program director for the Gastroenterology training program here at Bethesda and he's a Fellow of the American College of Gastroenterology. And Dr. Talal Nsouli, Associate Professor of Allergy Immunology at Georgetown University Medical Center. He's a fellow of the American College of Allergy, Asthma, and Immunology.

On my right I have Dr. David Atkison. He's the Chairman of the Department of Orthopedics here at Bethesda, and a Fellow of the American Academy of Orthopedic Surgeons. Beside him his Dr. Richard Morrissey, Chairman of the Department of Cardiology here at Bethesda and a Fellow of the American College of Cardiology. Beside him is Dr. David Corbett, who is the Chairman of the Department of Dermatology at Bethesda and a Fellow of the American Board of Dermatology. Beside him is Dr. Kevin O'Connell, former Chairman of the Department of Urology here at Bethesda and currently the Commanding Officer of the Hospital Ship, USNS Comfort. He's a fellow of the American College of Surgeons. And, finally, Dr. Sushil Jain, former staff optometrist here at Bethesda and currently the officer in charge of the Navy Yard Clinic. He's a fellow of the American College of Optometry Physicians. So we are here with all the fellows.

I would like to go ahead and proceed giving you the findings from the President's examination today. This year's examination took about six hours to complete. It included an audiogram, an eye exam, and an exercise treadmill task. The President weighed in 196 pounds on his 6'2" frame. His weight last year was 216 pounds. His blood pressure was 122 over 68, with a pulse of 60. On the President's annual exercise treadmill exam this year he completed 13 minutes on the treadmill and reached a speed of 5 miles per hour, at 18 percent grade, using the Bruce* protocol. His total cholesterol was 179, down from 191 last year. His triglyceride count was 37, down from 72 last year. His HDL was 43, with a ratio of 4.2.

During the President's skin evaluation, a 1 centimeter sebaceous cyst was excised from his chest. During the 5-minute procedure, the President received a local anesthetic to the skin and received two sutures.

The President, who turned 51 years old this August, had a thorough hearing evaluation. A high-frequency hearing loss noted in his previous examination had worsened on this year's exam. His physicians recommended the use of a hearing aid. He was fitted for completely in the canal devises.

Our orthopedic surgeon pronounced the President fully recovered from his quadricep tendon care. His physical therapy had been discontinued in early August and he followed a self-monitoring regimen.

MR. MCCURRY: What we'd like to do is, before we turn we're going to go off camera for any questions. But if there is anything that any of you need before we shut the cameras down?

Q: -- you noted two things, the hearing loss and we noticed this morning that he still had some stiffness in his knee. How does he feel about -- what did the President say to you about how he felt about the progress in his knee, and particularly about the whole hearing --

Q: And the cyst.

MR. MCCURRY: We'll both share this. But on the hearing loss, the President has said for -- I think we've reported to you in the past that he has had some high-frequency hearing loss. And the complication it causes for him mostly is when he's in a crowded room situation like a reception, sometimes it's hard for him to hear. And it's also hard sometimes when he's giving a speech if there is -- we've had a couple instances recently when he has been heckled or something, and he says that actually makes it hard for him. He mentioned those two problems in particular.

But he says, with the technology that's available today, which I think you'll hear from Dr. Sung* a little more about later, it's very easy to compensate for that high-frequency loss, and the President will have a device that he can use. He says he plans to use it in those situations in which he normally experiences some of this loss.

As for the knee, I think he was feeling very good about it. He has expressed some concern about stiffness, but maybe Connie --

DR. MARIANO: He occasionally, with temperature changes, will complain his joints feel stiff. But today, when Dr. Atkison examined him, he had full range of motion. In fact, if I can get Dr. Atkison to comment briefly about his findings today on his orthopedics exam.

DR. ATKISON: Certainly. His strength was normal. His range of motion was exactly equal on both sides. We noted absolutely no stiffness or soft tissue problems at all.

MR. MCCURRY: We left him on camera because he's an accomplished star already.

DR. ATKISON: Yes, we're very happy.

Q: Dr. Mariano, the sebaceous cyst, is that pre-cancerous? Is it tested for --

DR. MARIANO: He had this, actually, as you recall, last year, '96. He had a noticeable cyst -- I think it was on his left side -- and Dr. Corbett excised that cyst and briefed you on it. Same type of thing on his chest today. It's been there for a while, it was bothering him. He says, well, why don't you take it out since it's here. Dr. Corbett wants to explain a little bit what he did in that 5-minute procedure.

DR. CORBETT: The cyst was exactly the same, almost even the same size as the cyst he had on the right neck. This was on his left chest today. He basically just had a little local anesthetic, very small incision and the cyst was removed. It will be sent for pathology. But again, with the other one, I would be amazed if anything were to show other than totally benign. This was a very common type of cyst, but we send everything to pathology, and Monday there will be a path report available.

Q: And, of course, the other --

DR. CORBETT: Absolutely.

Q: And this is different than the actinic keratosis that was taken off last year as well, was it not?

DR. CORBETT: That's correct.

Q: There was no recurrence of that?

DR. CORBETT: We found no actinic keratoses today.

MR. MCCURRY: Let me go off camera now and we'll continue if you've got any other questions about anything --

Q: What about his diet, his weight loss? What do you attribute to? The exercise regimen from the knee surgery?

MR. MCCURRY: He certainly does. He said, as I quoted him saying that he certainly thinks it's because he followed the good instructions from the doctors and because he's been very conscious of both his diet and his exercise regimen that was recommended as part of the therapy from the surgery. Again, he pays a lot of credit to the folks who helped work on the knee, Dr. Atkison and Dr. DeMaio and others that they really did a great job and all the training I guess all the therapists and others that helped him after the surgery really, I think accounted for some of the pretty good results.

All right, let's turn the lights down, and then we can go on and continue with anything else you want to get into. We still want a feed back to the White House. We can still do that.

Q: -- for his hearing is done, but he doesn't have them in now, he'll use them only when he thinks he needs them? Is that it?

MR. MCCURRY: Let me ask Dr. Suen to tell you more about that, because I think that's probably an area of interest, and we had anticipated that. So let me turn it over to Dr. Suen.

DR. SUEN: Actually, Mr. McCurry did a very nice job summarizing what he has. This hearing loss is a common hearing loss. It's the most common type you hear -- or you see. And it's a high frequency hearing loss. It's just a moderate-severe. It interferes with his understanding of certain words. It's not anything like profound deafness or anything. And he will wear it just for selected occasions such as a small party gathering where there's some background noise that may interfere with him understanding words.

Q: -- account for a hearing loss of this nature?

DR. SUEN: It's probably a combination of an aging process. You do get a little bit of hearing loss secondary to that. Also, high frequency hearing loss is mostly due to noise exposure. And that noise exposure is usually as a teenager listening to rock and roll music or playing in bands, such as he did.

Q: -- shouting reporters? I don't know.

DR. SUEN: That's possibly a cause.

Q: -- look like? Can you see -- will it be visible when he's wearing it?

DR. SUEN: The hearing aid? Actually, I have a hearing aide on right now that's the same type he'll be wearing, and it's called "completely in the canal" hearing aid, which means that it's hidden and you can't really see it. So most of you will never know when he's wearing it.

Q: Is it difficult to put in?

DR. SUEN: No, it's very simple. Pop it in, pop it out.

Q: Is it comfortable?

DR. SUEN: This is a high-tech type of hearing aid that does not have to be adjusted.

Q: Is it in one ear or the other, Doctor, or both?

DR. SUEN: He has symmetrical hearing loss in both ears, and he'll be fitted for hearing aids in both ears.

Q: Was he at all reluctant to admit to this sign of aging?

DR. SUEN: Actually, most of this has been present for a long time, just a very slight change over the last two years. And he's just seeing that he cannot understand as much as he needs to understand as far as hearing words. And he, at our urging, just changed.

MR. MCCURRY: Anything else? Any other areas of interest? Very good. Thank you. See you all back at the White House. You're free on the way out, if any of you want to say hello to any of the doctors.

I want to thank all of you for your participation, and I know that the President passed on to Captain McGuire his thanks.

But I'd also like -- Commander Dodge over here helped us out today a lot and took care of the pool while they were here. So we were able to staff with all the excellent help that we got, both from public affairs and from the whole group here. Thanks to all of them.

END 3:40 P.M. EDT