Parkinson's Disease Remains Pope's Main Health Threat

With Pope John Paul II breathing on his own after being placed on a respirator following a tracheotomy Thursday, experts say the main threat to the pope's health now is what brought him to the hospital in the first place — frailty made worse by Parkinson's disease.

The Pope still faces infection or other complications from Thursday's procedure. But experts say his general weakness is what made him vulnerable to the breathing difficulties that made that operation necessary.

One medical professor says the pontiff is "clearly somebody who can get ill very easily because of his Parkinson's and his inability to cough" — adding that he's "fragile, to say the least."

Even if the breathing tube stays in, the pope will likely be able to talk in about a week, after doctors switch to a tube with a speaking valve.

The pope's flu-like illness may have exacerbated his Parkinson's disease (search), not only making him weaker but also reducing control over his breathing muscles, said Dr. Charles Hales, chief of pulmonary and critical care at Massachusetts General Hospital in Boston.

The report that he had been put on a respirator came from Italian news agency ANSA. Earlier, the Vatican announced the pope had undergone a tracheotomy, a standard procedure to help people who are having trouble breathing.

The Vatican said the procedure was done not only to aid breathing immediately but also to help in fixing a narrowing of the larynx.

The procedure involves making a small hole in the windpipe just below the Adam's apple. A plastic tube can then be inserted to give access to the lower airway. That way, air can bypass an obstruction in the throat. The tube can be connected to a respirator.

Patients generally cannot talk while the tube is in place, but regain speech once it is removed.

Experts including Dr. Mark Rosen, chief of pulmonary and critical care medicine at the Beth Israel Medical Center in New York, said Parkinson's patients sometimes have trouble with muscles in the larynx, including spasms, which might have contributed to the breathing problem. A respiratory infection could have exacerbated the narrowing through inflammation, experts said.

So the tube may only have to stay in until the infection is successfully treated with antibiotics, said Dr. Momen Wahidi, director of interventional pulmonology at the Duke University Medical Center.

But the basic larynx narrowing could prove to be a long-term problem that worsens as Parkinson's progresses; if so the tube might stay in "for the remainder of his life," Wahidi said.

In that case, the tube might be altered with a valve to allow the pope to speak, he said.