WASHINGTON — Melania Trump underwent a medical procedure on Monday morning to treat what the White House called a “benign kidney condition” and was reported to be recovering without trouble at a military hospital outside the capital.
“The procedure was successful and there were no complications,” the White House said in a statement. “Mrs. Trump is at Walter Reed National Military Medical Center and will likely remain there for the duration of the week. The first lady looks forward to a full recovery so she can continue her work on behalf of children everywhere.”
President Trump spoke with Mrs. Trump on Monday morning before the procedure and later spoke with the doctor after it was over, according to a White House official who asked not to be identified describing the private communications. In the late afternoon, the president flew by helicopter to Walter Reed to visit the first lady for about an hour before returning to the White House.
“Heading over to Walter Reed Medical Center to see our great First Lady, Melania,” Mr. Trump said on Twitter. “Successful procedure, she is in good spirits. Thank you to all of the well-wishers!”
The White House said Mrs. Trump, 48, underwent an embolization procedure. The Johns Hopkins Patients’ Guide to Kidney Cancer describes an arterial embolization as a procedure in which a special spongelike material is placed into an artery that supplies blood to the kidney. A thin tube catheter is inserted into a vessel in the leg and into the main vessel feeding the kidney.
Such a procedure would block the blood supply that feeds the kidney and might be used to stop bleeding from a benign tumor, a small aneurysm or to reverse the growth of such a tumor, according to specialists. The Johns Hopkins guide said it can also be used to make it easier for a surgeon to remove the kidney but is more frequently used to control symptoms for someone who cannot undergo surgery.
Vice President Mike Pence said on Monday that Mrs. Trump’s procedure was “long-planned,” citing her visit to Walter Reed as the reason Mr. Trump had sent him to represent the administration at a reception hosted by the Israeli Embassy to celebrate the 70th anniversary of Israeli independence.
The fact that Mrs. Trump will remain in the hospital for the rest of the week was unusual in the most typical cases, according to leading medical experts.
“It’s like literally an outpatient procedure,” said Dr. Eleanor D. Lederer, a professor at the University of Louisville School of Medicine and past president of the American Society of Nephrology. “You go in, you have it done, you lie in bed for a while to keep the blood vessel from bleeding and then you go home.”
Another doctor, however, said Mrs. Trump was probably being kept in the hospital longer because of her position. “That’s because she is the first lady,” said Dr. Jeffrey Cadeddu, a professor of urology and radiology at the University of Texas Southwestern Medical Center in Dallas. “If it was you, you’d be in and out in a day, I promise.”
Still, embolization kills some surrounding healthy kidney tissue, which causes swelling and pain as a patient recovers, so a longer stay could be helpful or necessary, doctors said.
The White House did not explain what led Mrs. Trump to seek treatment or whether the “benign kidney condition” meant she had a benign tumor or something else. Specialists said it could be that doctors had been monitoring a mass for a while and decided to act on it now because it had grown. Or they said it could be that she experienced symptoms of some sort, like noticing blood in the urine or experiencing back pain or stomach pain.
Doctors may also have discovered bleeding while conducting routine tests for other reasons.
Dr. Joseph A. Vassalotti, the chief medical officer at the National Kidney Foundation, said his guess was that Mrs. Trump had either a benign tumor known as an angiomyolipoma or a bleeding cyst. “It sounds like it was a benign tumor,” he said.
Dr. David G. Warnock, an emeritus professor of medicine at the University of Alabama at Birmingham and a past president of the kidney foundation, said doctors frequently perform an embolization if a biopsy or other diagnostic procedure causes bleeding.
“My list of benign conditions that you’d embolize is pretty short,” he said. “Ninety percent of them are to stop bleeding after some procedure like a kidney biopsy.”
But Dr. Joseph V. Bonventre, chief of the renal unit at Brigham and Women’s Hospital in Boston said that it was unlikely Mrs. Trump would have a biopsy on this type of tumor and that doctors probably decided to conduct the embolization procedure to prevent a benign tumor from growing by starving it of blood, and therefore oxygen.
“In general, you want to embolize it because you don’t want it to continue to get bigger and erode into the larger vessels of the kidney where it can cause significant bleeding,” he said. He added that embolizing in this case was “most likely a preventive thing.”
The procedure came just a week after Mrs. Trump formally kicked off a public campaign to encourage children to put kindness first in their lives, particularly on social media. She has generally maintained a low profile during her 16 months as first lady, focusing primarily on raising her son, Barron.
Mrs. Trump makes a point of leading a healthy lifestyle. In New York, she has said she would walk with ankle weights and eat seven pieces of fruit every day. “I live a healthy life, I take care of my skin and my body,” she told GQ in 2016. “I’m against Botox, I’m against injections; I think it’s damaging your face, damaging your nerves. It’s all me. I will age gracefully, as my mom does.”
The health of first ladies has long been a factor in White House life. Three first ladies died while living in the White House — Letitia Tyler (wife of John Tyler), Caroline Harrison (wife of Benjamin Harrison) and Ellen Wilson (wife of Woodrow Wilson) — and Andrew Jackson’s wife, Rachel, died between his election and inauguration.
Others have suffered serious ailments that, for much of the country’s history, were shrouded from the public. In recent decades, first ladies have been more open, although not in every instance. Betty Ford set the tone for modern times by being open about having a mastectomy to fight breast cancer. Following her example, Nancy Reagan also disclosed her own mastectomy, although she limited the details released.
Barbara Bush disclosed her Graves’ disease, a thyroid condition, while living in the White House. Her daughter-in-law, Laura Bush, however did not reveal that she had a skin cancer tumor removed from her shin until weeks later, deeming it “no big deal at the time.”
Peter Baker reported from Washington, and Gina Kolata and Pam Belluck from New York. Dr. Lawrence Altman contributed reporting from New York, and Julie Hirschfeld Davis from Washington.
source: https://mobile.nytimes.com/2018/05/14/us/politics/melania-trump-kidney-surgery.html
