by Jerry Filteau
Catholic News Service

WASHINGTON (CNS) -- The possibility of pneumonia is one of the most serious dangers Pope John Paul II could face from his bout with influenza and tracheal inflammation, said U.S. medical experts contacted by Catholic News Service Feb. 2.

The 84-year-old pope, who came down with the flu in late January, was rushed to Rome's Gemelli Hospital late Feb. 1 after he suffered what Vatican spokesman Joaquin Navarro-Valls called "acute laryngeal tracheitis and a crisis of laryngeal spasms."

A spasm of the larynx, or voice box, can temporarily block breathing. Tracheitis, or an inflammation of the trachea, can be caused by a bacterial or viral infection and can also cause difficulty breathing.

Navarro-Valls said Feb. 2 that the pope's condition had been stabilized at the hospital and he had rested for several hours during the night. He said doctors had provided "respiratory assistance" but did not say whether this involved oxygen or drugs.

Italo Mocchetti, a neurology professor at Georgetown University Medical Center in Washington, said the pope's struggles with Parkinson's disease and his age would make recovery from pneumonia -- should he get it -- far more difficult for him.

Parkinson's itself does not typically affect the lungs or other internal organs, he said, but "patients with Parkinson's are known to recover very poorly from pneumonia. We can do it without problems, they can't."

Dr. Joseph H. Flaherty, a geriatrics specialist in St. Louis, said dehydration and pneumonia are the most likely dangerous complications the pope could face.

Flaherty, who practices at three St. Louis hospitals and is a professor in the geriatric medicine division of the St. Louis University School of Medicine, said the length of hospitalization would also be a concern because the longer the pope has to be hospitalized, the more likely it is that he will come out weaker.

Dr. Samuel C. Durso, clinical director of geriatrics at the Johns Hopkins School of Medicine in Baltimore, also focused immediately on pneumonia as the most serious danger.

When older patients with a chronic debilitating disease get the flu, "they are physically more vulnerable to the effects of the infection," he said.

As the effects of Parkinson's disease have advanced, the pope has gradually lost much of his mobility and muscle strength.

Since he can no longer sit up straight, "his lung capacity is diminished" by his slouched posture, Flaherty said.

"He has very little pulmonary reserve," Durso said. "His cough mechanism is less effective, which makes him at risk for pneumonia and, if he gets pneumonia, for respiratory failure."

"In geriatrics, we are all about physical function," Flaherty said. "Anything that impacts physical function impacts recovery."

Flaherty said hospitalization itself is a problem for older people. In the United States one out of three people over 80 who is hospitalized comes out weaker, and that could happen to the pope as well, he said.

"Depending on how long he's in the hospital, that will impact his physical function," he said. "Sure, we worry about whether he's going to beat the pneumonia (if he gets it), whether he's going to live or die. What I would worry about as a geriatrician is, let's try to prevent him from losing physical function because of just being in the hospital."

"The good thing about Italy is they have a very good geriatric training program," he added. "The geriatrics is up-to-date there. ... I'm hopeful that he'll recover, but I'm cautious as to how strong he's going to be after this episode."

Throwing in a medical pitch, Flaherty said he hoped the pope would tell people afterward whether he had gotten a flu shot. "And if he didn't, I hope his message to all older people will be, whatever their religion is, that they get out there and get their flu shot, because one-third to one-half of the time it can prevent these complications."