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HealthWeek No. 128

ANNOUNCER: Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

SHARYL ATTKISSON: Today on HealthWeek... They were the best of buddies, the kind of guys who shared a lot of things. But would the friendship hold up when one needed to "borrow" a kidney?

PETER THOMAS: "I couldn't live with myself if I didn't do this for Tom. It's really that simple."

SHARYL ATTKISSON: How new technology is making it easier to give the gift of life.

Gone in a flash? The latest medical "magic" for making unsightly veins disappear.

And a cooking school that's got the recipe for eating healthy without breaking the bank.

Hello. I'm Sharyl Attkisson. Welcome to HealthWeek.

ACUPUNCTURE
We begin with news about one of the oldest, and least understood, forms of medicine: acupuncture. Those intimidating needles have been standard therapy in China for more than 2,000 years. But is there any role for them in high-tech Western medicine? In our Behind the Headlines segment, we focus on the latest effort to determine whether acupuncture really works. HealthWeek's Robert Davis reports from the National Institutes of Health.

MICHAEL KAPLAN, PhD, MD, ACUPUNCTURIST: "What I want to do is get you to lie on this side and face that wall if that's okay."

PAT EVANS: "Okay."

ROBERT DAVIS, PhD: Pat Evans is in pain.

PAT EVANS: "I've just been dealing with this pain for many, many years. I've gone for physical therapy and taking pain medication and I've gone to a lot of different doctors."

ROBERT DAVIS, PhD: She's now going to Dr. Michael Kaplan, who's trying something different... acupuncture.

MICHAEL KAPLAN, PhD, MD: "I think it accelerates the healing process, it accelerates the sense that people feel better. And I find that when we do a combination of acupuncture and medications, we can often wean them from things that I would have thought would never have happened before."

ROBERT DAVIS, PhD: This week the National Institutes of Health brought together a panel of experts to assess such claims and look at what's known and not known about this ancient practice.

DAVID RAMSAY, MD, PANEL CHAIRMAN: "Acupuncture is used by millions of American patients for a variety of health conditions."

ROBERT DAVIS, PhD: They concluded acupuncture reduces nausea related to pregnancy and chemotherapy; it relieves pain after dental surgery, and may help with a host of other types of pain, ranging from menstrual cramps to tennis elbow.

DAVID RAMSAY, MD: "There is sufficient evidence in the literature that we have looked at to show a positive effect between the technique of acupuncture itself and things which happen, like the release of substances within the brain, which we know to be associated with the relief of pain."

ROBERT DAVIS, PhD: Several HMO's and insurance companies have begun to pay for acupuncture, and supporters hope the vote of confidence from here at the NIH will encourage others to follow suit.

But Dr. Kaplan, who combines acupuncture with traditional medicine, warns patients to beware of acupuncturists who promise too much.

MICHAEL KAPLAN, PhD, MD: "I've run into one person that told me they felt it could cure cancer, which is clearly ridiculous. It can't work in severe situations. When people have severe disease, it won't cure them."

ROBERT DAVIS, PhD: Pat Evans says acupuncture hasn't cured her migraines, or completely gotten rid of her shoulder and neck pain, but she definitely feels better.

PAT EVANS: "It's easing the pain. It's tolerable so that I can go on my trips and do things, work in my garden, things like that that I like to do."

SHARYL ATTKISSON: Joining us from Washington to discuss the issue further is Abigail Trafford, health editor of The Washington Post.

We heard a lot about what acupuncture might be able to do, but there must be some risks and side effects, as with anything. What about them?

ABIGAIL TRAFFORD, THE WASHINGTON POST: There are some side effects. But what's great it seems about acupuncture is that it's really relatively safe. It doesn't seem to have any major, major side effects. Now, there are some rare complications, and this has to do with a needle puncturing a lung or the heart. Now that's a terribly, that's a devastating complication. It's very, very rare. The biggest concern I think of a side effect is contamination of the needles, and that you could pick up an infection.

SHARYL ATTKISSON: So if you're going about choosing a practitioner, some of them are medical doctors also offering acupuncture as an option. Some are not doctors at all. How do you decide who to go to?

ABIGAIL TRAFFORD: Well, you should really check to make sure that the person is licensed. Most states have requirements, licensure requirements, certification requirements, and you should make sure that the person has the proper certification. And it's true that a lot of medical doctors, Western doctors are also expanding into acupuncture, so that you can often go to your general hospital and they will offer acupuncture.

SHARYL ATTKISSON: A brief comment, if you will, on the fact that the National Institutes of Health, the Federal Government's body that is considered the pillar of traditional medicine, the fact that they even were willing to look at acupuncture. What does that signal?

ABIGAIL TRAFFORD: Well, it's an exciting moment. I think it's really East meets West, West embraces East. We talk about the globalization of the economy. We really have a globalization of medicine. And it is a turning point when the NIH has a consensus conference. Now, this isn't a court of law. This is not health policy. But it's a group of experts that have been convened to look at the evidence.

SHARYL ATTKISSON: Abigail Trafford, thank you so much for your perspective on acupuncture.

HEALTHFUL HINTS
NANCY SNYDERMAN, MD: Hello, I'm Doctor Nancy Snyderman with this week's Healthful Hint.

If you own contacts, you've probably been tempted to use tap water to clean them. How bad can it be? Well, plenty, it turns out. Besides damaging most lenses, washing contacts with tap water can lead to serious eye infections.

The results can be redness, pain, or blurred vision. And in serious cases, damaged corneas and even blindness.

So to avoid this, you should use a special lens cleaning liquid to wash your contacts off and then immerse them in an overnight solution. And get in the habit of doing it every night, not just when you happen to think about it.

Also remember to wash your hands before handling lenses, especially if you smoke. Cigarette tars on contacts can really irritate your eyes.

And every 6 months or so, you should get a new case for your contacts, sooner if it leaks.

Finally, don't be afraid to break out that spare pair of glasses if you want to give your contacts, and your eyes, a break. A few days rest won't hurt you or the lenses.

With Helpful Hints, I'm Dr. Nancy Snyderman.

KIDNEY TRANSPLANT
SHARYL ATTKISSON: If you go by what you see in movies and TV dramas, transplants are frantic affairs with organs being rushed around by helicopters in the middle of the night. But for one type of transplant, kidney transplants, the drama is increasingly being played out at a less hectic pace. A new procedure is making it easier for living people to donate kidneys. HealthWeek's Bettina Gregory has the story of how that option has touched two men's lives.

BETTINA GREGORY: Tom McNamee is well enough this fall day to enjoy the garden with his wife Linda and daughter Casey. But his health has been in a downhill slide for the past two years.

TOM MCNAMEE: Well, I've got polycystic kidney disease. And basically what it is, it's the cysts that grow around your kidneys eventually shuts down the function.

BETTINA GREGORY: In fact, it was this genetic disease that killed Tom's dad, James.

Medically, Tom's situation is simple: he too will die if he doesn't have a kidney transplant. But - unlike the 37,000 Americans waiting for a kidney - Tom has a special friend. Meet Peter Thomas. He works with Tom's wife and has been Tom's buddy and ski companion for 20 years.

PETER THOMAS: He told me that he had been placed on the transplant list to receive a kidney, but it may be several years before he would receive one and he was concerned that, you know, he might not make it.

BETTINA GREGORY: So Pete decided to donate one of his kidneys.

PETER THOMAS: I couldn't live with myself if I didn't do this for Tom - it's really that simple.

"Hey, Tom. How you doing?"

TOM MCNAMEE: "Hey, Pete. How you doing, bud?"

PETER THOMAS: "I'm doing fine."

TOM MCNAMEE: "How's that kidney?"

LINDA MCNAMEE: It's wonderful that another human being would do something for us to prolong Tom's life -- to give Tom life.

BETTINA GREGORY: Their surgery is tomorrow, and while Tom will undergo the traditional operation for a kidney transplant, Pete's surgeon will be using a new procedure for kidney donors.

JOHN FLOWERS, MD, DIRECTOR, LAPAROSCOPIC SURGERY: This operation is really very similar to a traditional kidney transplant, except for instead of using about a ten-inch flank incision on the patient's left side, we're able to do it through really four small puncture wounds that are about a centimeter in size, and then of course we need another incision to extract the kidney from, so we use something that's about 6 centimeters or about 2 1/2 inches that we place right at the belly button.

BETTINA GREGORY: At the University of Maryland Medical Center, Pete goes into the operating room first.

TOM MCNAMEE: "Take care."

LINDA MCNAMEE: "You do the same."

TOM MCNAMEE: "And you be careful."

BETTINA GREGORY: Tom goes into surgery about an hour later, where he will be readied to receive the kidney as soon as it's available.

In a dimly lit operating room, Pete's surgery is done with a laparoscope - which means specialized instruments, including one attached to a tiny video camera, are inserted into his body.

SURGEON: "Okay, it looks pretty good."

BETTINA GREGORY: The surgeons work from a T.V. monitor, manipulating their instruments to free up the kidney and place it in a plastic bag.

SURGEON: "And the next thing I'm going to do is put this bag in and open it up so that when we disconnect the kidney, we just drop it right in and then pull it out."

BETTINA GREGORY: Then the kidney is pulled out of Pete.

It's dumped into a bowl of slushy ice and rushed to the adjoining operating room where Tom is waiting. The kidney is prepared for transplant. Next the surgeon puts the kidney into Tom's abdomen and attaches the veins and arteries. When the clamps are undone, blood begins to flow.

SURGEON: "It looks like a beauty."

BETTINA GREGORY: Pete's kidney is now Tom's.

For the donor, this new procedure has a huge advantage.

STEPHEN BARTLETT, MD, DIRECTOR TRANSPLANT SURGERY: The donors recover far quicker. They're going home in one day and going back to work in an average of 16 days. And that is substantially less with the old open incision that meant usually three to four days in the hospital, sometimes five, and an average of 51 days off work.

BETTINA GREGORY: For the recipient, anything that encourages living donors is a plus.

STEPHEN BARTLETT, MD: The data really demonstrates that kidneys donated from living donors do substantially better than cadaver kidneys. And that's been true for 20 or 30 years.

BETTINA GREGORY: There are downsides, as there are with any pioneering procedure. The surgeon must be a highly skilled specialist in laparoscopic surgery. And patients who have had certain kinds of major surgery, on the stomach or spleen for example, are not eligible -- nor are those who are obese.

Dr. Bartlett credits the new procedure for at least a 40% increase in the number of living donors at his center. In addition, new anti-rejection drugs are allowing more unrelated donors - like Pete - to offer their kidneys. All donors must undergo counseling to ensure the kidney is a gift and not an organ sale.

STEPHEN BARTLETT, MD: We definitely utilize that kind of consultation here to make sure there is a true emotional relationship between the two individuals and not one that would be obviously unethical.

TOM MCNAMEE: "I've been feeling great."

PETER THOMAS: "You look a lot better."

BETTINA GREGORY: For Tom and Pete, it's been more than a week since their successful operations. Tom's wife Linda says the experience has given Tom and the whole family new life in more than one way.

LINDA MCNAMEE: Perhaps this will be a sensational learning experience and not only for us, but for others, too. It's really opened up our hearts and our minds.

SHARYL ATTKISSON: If you're interested in becoming an organ donor, either now, or later, when you die, one of the things you need to do is get your family's support. The non-profit Coalition on Donation offers this guidance: Have your family witness your decision. Sign your organ donor card or the organ-donor section of your driver's license in their presence. Or, if that's not possible, show them the documents at a later time.

VARICOSE VEINS
Now for another HealthWeek quiz... one that tests your knowledge on something you probably learned back in high school. The question is: "What do veins do?" Do they carry oxygen-rich blood away from the heart? Return oxygen-poor blood to the heart? Or do they carry lymphatic fluid throughout the body?

The answer is B. Veins return oxygen-poor blood to the heart.

You might not have known what veins do. But you probably know how veins look when they don't work right: twisted, blue, and ugly. They're called varicose veins, and getting rid of them is now the number one reason women have cosmetic surgery. With more on the latest ways of making veins vanish, here's HealthWeek's Doctor Barry Kaufman.

BARRY KAUFMAN, DMD: Lots of people spend lots of time on their feet. People like waitresses and nurses and hairdressers. The result can be not only tired, aching limbs, but varicose veins.

It's a common problem that runs in families. Brenda Blattner is a registered nurse. After years of walking hospital corridors caring for her patients, she's developed varicose veins.

BRENDA BLATTNER: Sometimes when I play tennis it will swell. And it just looks bad. I didn't like it.

BARRY KAUFMAN, DMD: Blood is delivered to the legs through arteries and it returns to the heart through veins. To help the blood flow up against gravity, veins have one-way valves that prevent blood from flowing backward. If the valves fail to function properly, the blood returns to the lower legs and feet, causing veins to become enlarged. The result is varicose veins.

ROBERT WEISS, MD: We're going to be using this doppler ultrasound to see if there's a problem in this vein. And there's a large amount of reverse flow, which indicates that this vein is malfunctioning and will lead to varicose veins and pain.

BARRY KAUFMAN, DMD: The problem affects more women than men, as many as one in ten. It's most common in women who have gone through pregnancy.

ROBERT WEISS, MD, JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE: Progesterone is well known to cause a stretchability of the veins. During pregnancy, you have high levels of a similar hormone. That's why most of the damage is done during pregnancy.

BARRY KAUFMAN, DMD: In extreme cases, varicose veins can lead to bleeding and leg ulcers that don't heal. That's when surgery is necessary to remove the bad vein.

For decades an operation called vein stripping has been the standard method for removing large veins. It's a tedious process that can be painful to watch, as Dr. John Bergan, a leading expert in vein problems, inserts a wire through an incision near the groin. The wire is attached to the vein to pull it out.

JOHN BERGAN, MD, UNIVERSITY OF CALIFORNIA, SAN DIEGO: The procedure actually makes the patient have a sore leg. The return to normal function is regularly after 72 hours.

BARRY KAUFMAN, DMD: Brenda chose a new, less invasive procedure to remove the varicose vein in her left leg. It's called ambulatory phlebectomy. Under local anesthesia, Doctor Robert Weiss makes tiny punctures in the skin. Then a small hook, similar to a crochet hook, pulls the vein out in sections.

ROBERT WEISS, MD: This is an ideal alternative to do it through very, very tiny punctures. We should most likely not leave any marks on her skin.

BRENDA BLATTNER: It went much quicker than I thought. It was very painless. It was wonderful.

BARRY KAUFMAN, DMD: For smaller varicose veins and for spider veins, the cluster of tiny purple-blue veins near the surface of the leg or face, the most popular treatment is a procedure known as sclerotherapy. A chemical is injected into the bad vein which closes it down.

ROBERT WEISS, MD: Sclerotherapy, just like the other forms of therapy, do have side effects, that the solution may be too weak and the blood vessel may not disappear, the solution can be too strong, and there can be bruising.

BARRY KAUFMAN, DMD: Two pregnancies took their toll on Marianne Weyen's veins. Five months ago, Marianne decided to have the spider veins on her face removed.

Like this woman, Marianne chose laser therapy. The laser emits a high intensity light beam that passes through the skin and is absorbed by blood cells. The intense heat vaporizes the veins. Lasers are still in the early stages of development for vein removal and can cause skin discoloration and scarring. For Marianne, the laser removed her veins without any side effects.

MARIANNE WEYEN: They are completely gone. Completely gone.

RAYMOND KONIOR, MD, LOYOLA UNIV MEDICAL CENTER: And every year we see a new laser device introduced on the market, and we see continued refinements within existing laser technology. And as those refinements come along, we are better able to manage different types of blood vessel disorders.

BARRY KAUFMAN, DMD: As lasers continue to evolve, so is other technology. One that's gaining popularity is a new computerized vein treatment that can be adjusted to the patient's skin color, skin type and vein size. It's call Photoderm.

ROBERT WEISS, MD: "One, two, three, pulse."

BARRY KAUFMAN, DMD: Photoderm uses intermittent pulses of intense light to heat the blood vessel. The walls of the vein collapse without harm to the surrounding tissue.

ROBERT WEISS, MD: It's more of a gentle heating so you have much less risk of bruising.

BARRY KAUFMAN, DMD: For many patients, like Marianne, getting rid of varicose and spider veins requires more than one type of treatment. So it's important, experts say, to find the right doctor who can offer a wide variety of therapies.

MARIANNE WEYEN: I'm so happy with the results. I really am.

SHARYL ATTKISSON: Those procedures may not be necessary at all if you prevent varicose veins in the first place. Doctor Margaret Weiss of Johns Hopkins School of Medicine offers these tips.

MARGARET WEISS, MD, JOHNS HOPKINS UNIV SCHOOL OF MEDICINE: "Well, you can't change the legs you may have gotten from your mother or the fact that you're a woman, but there are a number of things that you can do to help prevent them.

One of the most important is not to stand or sit for prolonged periods of time in any one position.

But if you can move your legs to activate the muscles in your legs so that they're compressing, and you can even do little exercises, move your legs up and down, get up, sharpen a pencil, do something to try to keep moving.

Try not to expose your legs to excessive heat if you can by avoiding really hot baths and don't get your legs sunburned.

If you can, put your legs up during the day to keep them a little bit, even if it's just a stool, or if possible above the level of your heart.

If you can control your weight to really avoid being obese, that's helpful because excess weight puts a big burden on the legs.

Another thing that is really helpful is to avoid crossing your legs, especially for long periods of time, because that really cuts off your circulation.

And if you've got a strong family history of varicose veins, the earlier you can start wearing support hose the better it is. I'm talking about special medical grade hose. They're tighter at the ankle, they get looser as they go up the leg. And that's the kind of hose that actually help your venous system to work better."

SHARYL ATTKISSON: One final suggestion... If you wear knee-high hose, look for ones with wide bands at the top, like this. The bands should not be so tight that they leave a mark on your leg when you take them off.

For more information on varicose veins, or any other HealthWeek story, you can call our toll-free number shown at the end of the program.

DOCTOR'S CORNER
BRUCE DAN, MD: I'm Dr. Bruce Dan. Scientists love to study wild animals, watching savage beasts defend their territory. It's interesting to consider what they've learned about the territorial behavior of one untamed creature, Homo sapiens, inside his natural habitat, the mall parking lot.

A recent study in the Journal of Applied Social Psychology looked at how 200 people responded to another car intruding on their parking spot.

On average, people took about a half a minute to leave a parking space. But when another car appeared ready to swoop into their spot, drivers stayed about 20% longer.

To confirm their results, the researchers did another study in which they aggressively honked at people to see how they responded to a threatening intruder. What they found was that after being honked at, people took 40% longer to pull out of their parking spot.

So what's the solution? Well, according to the study's results, maybe buying a more expensive automobile. It seems men tended to move faster if the person waiting for their space drove a fancy car.

With "Doctor's Corner," I'm Doctor Bruce Dan.

THRIFTY COOKING
SHARYL ATTKISSON: When people don't have a lot of money, diet is often one of the first things to suffer. Cheap foods that aren't very nutritious may seem like the only choice. But there's a cooking school in Portland, Oregon that proves it doesn't have to be that way. HealthWeek's Andrew Holtz shows us how some "upper-crust" chefs are sharing their secrets with low-income people.

ANDREW HOLTZ: Putting big knives into little hands is a daring tactic, part of a strategy to re-direct a lifetime of eating and cooking habits.

TEACHER: "Very good."

ANDREW HOLTZ: But today these kids, who say they often cook for themselves at home, are making healthy quesadillas piled high with beans and vegetables.

TEACHER: You're just going to cut it in half. That's it. And just cut it. That's very good.

ANDREW HOLTZ: Yes, there were a few minor casualties. But the final product got a thumbs up.

"Operation Frontline," a national program run by the Anti-Hunger Organization "Share our Strength," isn't just kids stuff.

More than 5,000 mostly low-income students have taken the cooking and nutrition classes.

CHEF: "They're putting the stuff away from lunch and getting everything ready for dinner."

ANDREW HOLTZ: Studies indicate people with lower incomes often have less-healthy diets, in part because of a lack of money, but more often because of a lack of information.

VALERIE KELLEY, REGISTERED DIETICIAN: Operation Frontline does address those concerns, by teaching increasing fruits and vegetables in the diet and lowering fat and also just preparing more foods instead of buying convenience foods.

ANDREW HOLTZ: Many of the volunteer chef-instructors come from elite restaurants. But they say eating well doesn't require an expense account. For example...

RANDY ROSECRANS, CHEF, HALL STREET BAR & GRILL: Beans and rice, that's not just a good, one of the best Southern dishes in the world, it's also a real good combination of proteins that are non-meat based.

CRYSTAL STUEBNER: "I want to show everybody how you can try to crawl."

ANDREW HOLTZ: Crystal Stuebner hopes her infant son, Elijah, also will benefit from the Operation Frontline class she took with a group of other teenage mothers. Now she looks beyond her old standbys of burgers and fries to some lower fat, more nutritious recipes.

CRYSTAL STUEBNER: The chicken was good, so was the corn and potato soup, I'd never heard of it before, and also I'd never heard of putting yogurt and mustard on chicken.

ANDREW HOLTZ: She says she always thought healthy food meant more expensive food, but not anymore.

The class includes practical tips on eating well while staying on a limited budget, such as looking for the "reduced" meats. They're still good, if you eat them soon, and they'll save you some money.

Crystal prepared pasta with fresh zucchini for her graduation class. And while each student received a certificate, the true reward was displayed in the bountiful buffet of the students' own healthy cooking.

SHARYL ATTKISSON: If you'd like the recipe for the quesadillas the kids were making, visit us at our World Wide Web site. To reach the HealthWeek home page, go to PBS ONLINE at the Internet address on your screen. That address is www.pbs.org

That's all for this week. Next time on HealthWeek... Noise! Find out what it's doing to your hearing and what you can do about it. We'll also give you some tips on caring for aging parents who live far away, and show you how horses are helping some people learn how to walk again.

Until then, I'm Sharyl Attkisson. Be well.

ANNOUNCER: For general information about stories in this edition of HealthWeek, please call 1-888-562-8300. Or write to the address on your screen: HealthWeek, Maryland Public Television, 11767 Owings Mills Blvd, Owings Mills, MD 21117.

Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

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