Press Statement Re: The Medical Condition Of Prime Minister, The Hon. David Thompson
By Dr. Richard G. Ishmael GCM, FAAP, FACC, FRCP C, FCCP
Fellow Barbadians, the Prime Minister, The Hon. David Thompson has requested that I bring Barbadians up to date with his medical condition and explain to you what has transpired over the last several months. Prime Minister Thompson has been a patient of mine for the past 20 years, having seen him professionally for the first time in 1991. He was about to turn 30 years, an election was at hand and he wanted a check up. I have seen him on a fairly regular basis since then, with periodic examinations and evaluation and tests done. He had no major health issues throughout the years except for periodic symptoms related to Gastro Esophageal reflux. He developed mild hypertension a few years ago, requiring a small dose of antihypertensive medication. When he became Prime Minister in 2008, he had a full check up with physical examination, as well as full cardiac evaluation including ECG, Echocardiogram and treadmill stress test and comprehensive blood test, all of which were normal. In July 2009, he had a similar evaluation and no abnormality was found.
In March of this year, he started to complain of abdominal (stomach) pain which did not respond to the usual Gastro Esophageal reflux medications. After seeing him in consultation, I ordered a number of tests including a CT scan of his abdomen. The CT scan suggested a problem with his pancreatic gland. Because of his position as the leader of the country, I thought that the best possible care should be made available to him. Because of my contacts in New York, having trained, practiced and lived there for 10 years and having maintained my relationships there, I referred him to colleagues at the New York Presbyterian Hospital of Columbia and Cornell Universities, one of the leading hospitals in the world, and accompanied him there. There the Prime Minister underwent a number of test and procedures not available in Barbados. A definitive diagnosis was not made initially, as the first two biopsies of a suspect area in the pancreas were non diagnostic. We were at that point, when we returned to Barbados in May and gave the first press statement. On return to New York, a third biopsy was done and this confirmed the diagnosis of Carcinoma of the Pancreas manifesting in the form of a tumor of the pancreas.
The usual treatment for this condition is a pancreatico-duodenectomy (the Whipple's procedure) which entails the removal of the tumor and part of the pancreas, along with part of the intestine with re-implantation of the pancreatic duct into the small intestine. However, because of the position of the tumor (it was surrounded by several important blood vessels which made its removal technically difficult), surgery was not feasible, and after consultations with three world renown pancreatic surgeons, it was decided that the best course of action was for him to undergo intense chemotherapy to try to shrink the tumour first, to enable its safe removal. So far, he has had four rounds of chemotherapy, followed by repeat abdominal CT scan which has shown moderate shrinkage of the tumour with no new spread. We were at that point when he returned to Barbados at the end of August, with the intention of returning to New York in three weeks for another round of chemotherapy, followed by repeat CT scan and then surgery, if feasible.
However, last week Sunday, after having been quite well for the entire week, performing his duties as Prime Minister, having chaired Cabinet and having had a number of meetings during the week, he developed intense abdominal pain and vomiting. An urgent CT scan of the abdomen revealed that he had developed a thrombus (clot) in the veins surrounding and traversing the pancreas. After consulting with my colleagues at the New York Presbyterian Hospital, we decided that it was his best interest to return to New York for immediate treatment of this problem and we left for New York the next night. He has had a number of new investigations done and treatment has been started to dissolve the thrombus.
The PM is feeling better now, is in good spirits and is scheduled to return to Barbados next week.
Because of the intense chemotherapy, the Prime Minister has lost a considerable amount of weight. He also feels tired at times and needs to rest more than usual to regain his strength. His mind, brain and intellect are as sharp as ever and from a medical standpoint, there is no reason why he cannot continue to perform his duties as Prime Minister, albeit at a reduced pace.
As the Prime Minister's personal physician, I would like to thank the people of Barbados for their kind understanding and respect for the privacy of the Prime Minister and his family, and the respect for the doctor/patient relationship between the Prime Minister and myself during this very trying and challenging time. Even though he is the Prime Minister and a public figure, he is also a family man, being a husband, a father of young children and a son to elderly parents and we expect that the respect of privacy will continue.
Thank you very much.