February 28, 2010 MEMORANDUM FOR ROBERT GIBBS ASSISTANT TO THE PRESIDENT AND WHITE HOUSE PRESS SECRETARY FROM: CAPTJEFFREY KUHLMAN, MC, FS, USN PHYSICIAN TO THE PRESIDENT, CHIEF WHITE HOUSE PHYSICIAN AND DIRECTOR, WHITE HOUSE MEDICAL UNIT SUBJECT: The President?s First Periodic Physical Exam as President President Barack Obama completed his ?rst routine periodic physical examination as President of the United States today, at the National Naval Medical Center in Bethesda, Maryland. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The purposes of this year?s exam were: 0 to provide the President every opportunity to enjoy the bene?ts of good health, now and for years to come, and to provide the public with a candid medical assessment of the President's ability to carry out the duties of his of?ce, now and for the duration of his tenure. The President?s previous physical examination was completed in July 2008, under the supervision of the Attending Physician to Congress. This year?s examination focused on evidence-based screening prevention and primary care, targeted to the President as an individual and his occupation. With the consent of President Obama, I release the following executive health summary. Summag The President is in excellent health and ?fit for duty?. All clinical data indicate that he will remain so for the duration of his Presidency. The President completed all age-appropriate screening tests, to include colorectal cancer screening. A CT-colonography was performed with normal results. Recommendations Follow-up colorectal cancer screening is recommended in 5 years for routine colon cancer screening. Continue smoking cessation efforts, a daily exercise program, healthy diet, moderation in alcohol intake, periodic dental care, and remain up-to-date with recommended immunizations. Continue modified exercise regimen, and lower extremity muscle strengthening program, for occasional left patella-femoral pain secondary to chronic tendonitis. Recommend dietary modification to reduce LDL cholesterol below 130. Past Medical History No significant illnesses Past Surgical History None Medications Occasional use of non-steroidal anti-in?ammatory medication, associated with physical activity Malaria chemoprophylaxis associated with travel to areas with malaria Nicotine replacement therapy, self-use Jet lag/time zone management, direct physician prescribed program, occasional medication use Immunizations Up-to-date for recommended routine, global travel, and in?uenza (seasonal and 2009 H1N1) immunizations Physical Examination Vital Statistics Age: 48 years old Height: 73 inches Weight: 179.9 pounds (with shoes and workout attire) Body Mass Index: 23.7 Resting heart rate (seated): 56 Resting blood pressure (seated): 105/62 Pulse-oximetry: 98% (room air) Temperature: 97.8 degrees System-speci?c Examination Summary ENT (ears, nose, throat): Normal exam of the head, ears, pharynx, neck, and thyroid. Thyroid function tests were normal. Eyes: Full optometric exam was completed, no ocular pathology was discovered. Visual ?elds were normal. Uncorrected visual acuity (distant and near) was 20/20 in both eyes. Glaucoma screening was completed. Mild myopia, astigmatism, and presbyopia were noted, but did not warrant correction. Pulmonary: Lungs were clear to auscultation. Gastrointestinal: Normal, to include CT-colonography. Cardiology: Normal, to include EKG and EBCT. Lipid profile with Total Cholesterol 209, Triglyceride 46, HDL 62, LDL 138, VLDL 9 and Total Cholesterol to HDL ratio of 3.4. Homocysteine 11.6 and CRP ultrasensitive 0.015, PBS 87 Dermatology: Benign Musculoskeletal: Normal, except for left knee with mild patella crepitus and grind, some weakness of hip external rotation on left side with minimal weakness on ?step down? bilaterally. Neurological: No focal deficits Genitourinary System: Exam was normal without evidence of prostate nodularity or hypertrophy. PSA was 0.70 (normal 4.0). Laboratory Data A standard battery of routine screening laboratory tests was performed and were within the normal range. PHYSICIAN TO THE PRESIDENT THE WHITE HOUSE October 31, 2011 MEMORANDUM FOR JAY CARNEY ASSISTANT TO THE PRESIDENT AND WHITE HOUSE PRESS SECRETARY SUBJECT: The President?s Periodic Physical Exam President Barack Obama has completed his second periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The purposes of this exam were: to provide the public with a candid medical assessment of the President?s ability to carry out the duties of his of?ce, now and for the duration of his tenure. to provide the President every opportunity to enjoy the bene?ts of good health, now and for decades to come. The President?s previous physical examination was completed in February 2010. This examination focused on evidence-based screening prevention and primary care, targeted to the President as an individual and his unique occupation. With the consent of President Obama, I release the following health information. Daily Steps to Good Health Tobacco free Physically active Eats a healthy diet Stays at a healthy weight On occasion drinks alcohol in moderation Screening Tests Blood pressure is normal at 107/71 mm Hg Cholesterol is ?ideal? with a calculated ten-year coronary heart disease risk of low OCT 2011 DEC 2010 FEB 2010 Total cholesterol (mg/dL) 193 193 209 Triglycerides 68 48 46 HDL cholesterol 69 75 62 LDL cholesterol 110 108 138 VLDL cholesterol 14 10 9 Cholesterol to HDL ratio 2.8 2.6 3.4 Diabetes screen is normal with blood glucose of 85 mg/dL Colorectal cancer screen was negative, completed on 2/28/2010 (CT colonography) Prostate cancer screen (informed patient request), PSA 0.80 ng/mL Past Medical and Surgical Historv None Medications Rare use of non-steroidal anti-in?ammatory medication, associated with episodes of strenuous physical activity Malaria chemoprophylaxis associated with travel to areas with malaria Recommended routine, global travel, and in?uenza immunizations are up-to-date Vital Statistics Age: 50 years, 2+ months Height: 73 inches Weight: 181.3 pounds Body Mass Index: 23.9 kg/m2 Heart rate: 67 Blood pressure: 107/71 mm Hg Pulse-oximetry: 100% Temperature: 97.7 degrees System-speci?c Examination ENT (ears, nose, throat): Normal exam of the head, ears, nose, pharynx, neck, and thyroid. Well?healed lower lip laceration Eyes: Full optometric exam was completed, no ocular pathology was discovered. Visual ?elds were normal. Uncorrected visual acuity (distant and near) was 20/20 bilaterally. Glaucoma screening was completed. Very mild myopia, astigmatism, and presbyopia were noted, however correction was not warranted Pulmonary: Lungs clear Cardiology: Normal rate and regular without murmur Gastrointestinal: Normal exam Genitourinary System: Normal exam Musculoskeletal: Recurrent right trapezius myofascial discomfort, resolves with periodic physical therapy, otherwise normal, ?ill range of motion Neurological: No focal de?cits Dermatology: Benign skin tags removed from neck Summa? The President is in excellent health and for duty?. All clinical data indicate he will remain so for the duration of his Presidency. The President is current on all age-appropriate screening tests. He is at and ?staying healthy at ffrey C. Kuhlman, MD, MPH PHYSICIAN TO THE PRESIDENT THE WHITE HOUSE June 12, 2014 MEMORANDUM FOR JAY CARNEY ASSISTANT TO THE PRESIDENT AND WHITE HOUSE PRESS SECRETARY FROM: RONNY L. JACKSON, MD, FAAEM PHYSICIAN TO THE PRESIDENT AND DIRECTOR, WHITE HOUSE MEDICAL UNIT SUBJECT: The President’s Periodic Physical Exam President Barack Obama has completed his third periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted during the month of May 2014, as the President’s schedule allowed. The President’s previous physical examination was completed in October 2011. This examination focused on evidence-based health screening and disease prevention. The purpose of this exam was to provide the public with an update of the President’s current health status and to ensure the President continues to enjoy all the benefits of good health. With President Obama’s consent, I release the following health information: Vital Statistics Age: 52 years, 10 months Height: 6’1” (73 inches) Weight: 180 pounds Body Mass Index: 23.7 kg/m2 Resting heart rate: 62 bpm Blood pressure: 112/70 mm Hg Pulse-oximetry: 100% Temperature: 98.0 degrees F Physical Examination by System Eyes: Visual fields were normal. Uncorrected bilateral visual acuity was 20/20. Fundoscopic exam was normal bilaterally. No ocular pathology was discovered. Head/Ears/Nose/Throat: Normal exam of the head, ears, nose, and pharynx. Neck: Normal thyroid exam. No noted lymphadenopathy. Auscultation of the carotid arteries normal. Pulmonary: Lungs clear to auscultation. Cardiology: Heart with normal rate and regular rhythm. No murmurs or other abnormal heart sounds noted. Gastrointestinal: Normal exam. No masses, hepatomegaly or splenomegaly noted. Genitourinary System: Normal exam. Musculoskeletal: Mild tenderness to palpation of the plantar surface of the right foot (consistent with recurrent right plantar fasciitis). Remainder of musculoskeletal exam was unremarkable. Neurological: Examination of cranial nerves, cerebellar function, motor function, and sensory system all normal. Dermatology: Several small benign skin tags identified on neck. No evidence of skin cancer, acute or chronic skin disorders or disease. Remainder of skin normal. Laboratory Results Lipid Panel: Total cholesterol Triglycerides HDL cholesterol LDL cholesterol VLDL cholesterol Cholesterol to HDL ratio 213 (mg/dL) 47 (mg/dL) 72 (mg/dL) 137 (mg/dL) 9 (mg/dL) 3.0 Fasting Blood Glucose: Vitamin D: PSA: 95 (mg/dL) 22.9 (ng/ml) 1.15 (ng/ml) Other Studies Updated baseline ECG, normal sinus rhythm and otherwise unremarkable. The President is current on all age-appropriate screening tests. Past Medical History No significant past medical history Past Surgical History None Social History The President continues to focus on healthy lifestyle choices. He eats a healthy diet, exercises daily, remains tobacco free, and only drinks alcohol occasionally and in moderation. Medications Ibuprofen. Occasional use to treat intermittent plantar fasciitis. Malarone. Malaria chemoprophylaxis, as indicated during periods of global travel to malaria endemic areas. Nicotine Gum. Occasional use. Vitamin D. Daily to treat mild Vitamin D deficiency. Immunizations Routine vaccinations, to include seasonal influenza, all up to date. All travel vaccinations up to date. Summary The President’s overall health is excellent. All clinical data indicates that the President is currently healthy and that he will remain so for the duration of his Presidency. PHYSICIAN TO THE PRESIDENT THE WHITE HOUSE March 8, 2016 MEMORANDUM FOR JOSH EARNEST ASSISTANT TO THE PRESIDENT AND WHITE HOUSE PRESS SECRETARY FROM: RONNY L. JACKSON, MD, FAAEM PHYSICIAN TO THE PRESIDENT SUBJECT: The President?s Periodic Physical Exam President Barack Obama has completed his fourth periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted during the month of February 2016, as the President?s schedule allowed. The President?s previous physical examination was completed in June 2014. The purpose of this exam was to provide the public with an update of the President?s current health status and to ensure the President continues to enjoy all the bene?ts of good health. This examination focused on evidence?based health screening and disease prevention. With President Obama?s consent, I release the following health information: Vital Statistics Age: 54 years, 6 months Height: 73.5 inches Weight: 175 pounds Body Mass Index: 22.8 kg/m2 Resting heart rate: 56 Blood pressure: 110/68 mm Hg Pulse-oximetry: 98% room air Temperature: 97.8 degrees Physical Examination by System Eyes: Visual ?elds were normal. Uncorrected bilateral visual acuity was 20/20. Fundoscopic exam was normal bilaterally. No ocular pathology was discovered. Head/Ears/Nose/Throat: Normal exam of the head, ears, nose, and pharynx. Neck: Normal thyroid exam. No noted Auscultation of the carotid arteries normal. Pulmonary: Lungs clear to auscultation. Cardiac: Heart exam normal. Regular No murmurs or other abnormal heart sounds noted. Gastrointestinal: Normal exam. No masses, hepatomegaly or splenomegaly noted. Genitourinary System: Normal exam. Musculoskeletal: Normal and unremarkable musculoskeletal exam. Neurological: Examination of cranial nerves, cerebellar function, motor function, and sensory system all normal. Dermatology: Skin exam normal. No evidence of skin cancer, acute or chronic skin disorders or disease. Laboratory Results Lipid Panel: Total cholesterol 188 (mg/dL) Triglycerides 42 (mg/dL) HDL cholesterol 68 (mg/dL) LDL cholesterol 125 (mg/dL) Cholesterol to HDL ratio 2.8 Fasting Blood Glucose: 83 (mg/dL) Vitamin D: 25.5 (ng/ml) PSA: 0.84 (ng/ml) Other Studies Updated baseline ECG, normal sinus with a rate of 64, and otherwise unremarkable. The President is current on all age?appropriate screening tests. Past Medical History No signi?cant past medical history Past Surgical History None Social Histog The President continues to focus on healthy lifestyle choices. He eats a healthy diet, remains tobacco free, and only drinks alcohol occasionally and in moderation. He continues to exercise daily with a focus on aerobic ?tness and resistance weight training. Medications Vitamin D. Daily to maintain normal Vitamin levels. Nexium. As needed for occasional acid re?ux Nicotine Gum. Occasional use. Malarone. Chemoprophylaxis, as indicated during global travel to malaria endemic areas. Immunizations Routine vaccinations, to include seasonal in?uenza, all up to date. All travel vaccinations up to date. Summary The President?s overall health remains excellent and is improved from his last formal assessment. His adherence to a healthy diet and a consistent exercise program has resulted in an improved lean body mass and lower cholesterol level. All clinical data indicates that the President is currently very healthy and that he will remain so for the duration of his Presidency.