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.
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Program #128.
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