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HealthWeek No. 209

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

SHARYL ATTKISSON: Today on HealthWeek... Attention deficit disorder. It's often treated with medication. But is that really a parents' only option?

PARENT: "I want to research what else is out there."

SHARYL ATTKISSON: The latest alternatives to drugs for treating A.D.D.. He has a calling, a calling to heal the body as well as the soul.

REVEREND SCOTT MORRIS: "Taking care of patients is what my life is all about."

SHARYL ATTKISSON: One minister's mission to provide health-care to the working poor. And a morning commute that really helps get the body in gear.

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

ATTENTION DEFICIT DISORDER

We begin with a problem that's familiar to many parents: kids who can't sit still, pay attention, can't concentrate. It's a condition called attention deficit disorder or A.D.D., and the standard treatment is the drug Ritalin, which has helped many children. A lot of parents are appalled by the idea of putting their children on behavior-changing medication. So, more are checking out treatment approaches that don't involve drugs. Sheilah Kast looks at two of the most popular.

SHEILAH KAST: Twelve-year-old Chris Hynak moves comfortably on the ice -- ice hockey is his passion. He has the concentration it takes to be a goalie something his parents didn't expect.

BARBARA HYNAK: "I think he's always been sort of off in his own world."

SHEILAH KAST: When Chris moved into second grade, daydreaming was a problem in school. The Hynaks turned to a doctor, who diagnosed attention deficit disorder,' or A.D.D. and prescribed Ritalin. As Chris grew, the dosage increased and that worried the Hynaks.

MICHAEL HYNAK: "He wasn't lethargic, but at the same time, he didn't have that, that spark."

SHEILAH KAST: Looking for an alternative with fewer side effects, the Hynaks heard about a new treatment called neurofeedback. It uses electrodes to monitor brain waves and train people how to concentrate. Psychologist William Decker likens it to the information a driver gets from a speedometer.

WILLIAM DECKER, PhD, PSYCHOLOGIST: "What we are doing is giving people information, in this case about the speed with which the brain is working."

SHEILAH KAST: Speed is significant, he says, because attention deficit disorder is characterized by slow waves in the part of the brain that handles concentration. A computer displays how Chris' brain waves are moving, slow patterns represented in blue on the left, fast ones in purple on the right. When Chris concentrates well, making fewer slow waves and more fast waves, he hears a tone.

WILLIAM DECKER, PhD: "Good concentration, Chris. That's the way."

SHEILAH KAST: Intuitively Chris starts to suppress slow waves and increase fast ones.

CHRIS HYNAK: "I think I just do it automatically. I don't really remember the tone or anything."

SHEILAH KAST: Neurofeedback usually includes some counseling and lasts 10 to 15 weeks. Eventually Chris stopped taking Ritalin. And while he says neurofeedback is tiring, he also says it has helped him.

CHRIS HYNAK: "You can do stuff you couldn't do before, you can do it better."

SHEILAH KAST: "What kind of stuff?"

CHRIS HYNAK: "Stuff like schoolwork and, for example, like hockey and sports. Anything really that you want to do as far as concentration basically."

SHEILAH KAST: Another alternative treatment for A.D.D. is called the Tomatis method, after the doctor who devised it. It examines the way children hear. It uses headphones and filtered sound.

It looks a little strange, but it has made a tremendous difference for nine-year-old Tyler, according to his mother Tina Skalski.

TINA SKALSKI: I noticed more that I wasn't having to tell him over and over to do things. He was calmer, he wasn't fighting with his brother and sister. He was playing more with the kids in the neighborhood appropriately."

SHEILAH KAST: Occupational therapist, Valerie Dejean, who uses the Tomatis method, contends those with A.D.D. somehow failed to develop in the womb the right connections between the ear and the brain and therefore can't organize information.

VALERIE DEJEAN, SPECTRUM CENTER, INC: The ear functions much like the lens of a camera, or it helps us to focus on what's important, and block out what's unimportant.

SHEILAH KAST: To help the ear do that, the Tomatis method exposes the child to the kind of high-frequency sounds he would have heard in the womb, like classical music. Low frequencies are filtered out.

VALERIE DEJEAN: We want to use sounds that have a history of being soothing and calming and enhancing to the nervous system.

SHEILAH KAST: Then he learns to hear his own voice, enabling him to focus on how he's behaving. It's an intense process, two hours a day for two weeks, then a break, then another round or two. Tyler and his family say this therapy helped transform him into a boy who can organize himself to practice the cello.

TYLER: "It made me calm down a little bit."

SHEILAH KAST: Supporters of both methods claim they can improve the concentration of at least three-fourths of the children they see. But Dr. Peter Jensen of the National Institute of Mental Health is skeptical of those and dozens of other treatments he says are not backed by scientific data.

PETER JENSEN, MD, NATIONAL INSTITUTES OF HEALTH: "Very, very few of them have anything we'd call credible evidence. So I'm very concerned that parents not spend their money on things that don't have proven efficacy."

SHEILAH KAST: Jensen lists just two tested approaches: certain drugs, including Ritalin, and behavior therapies. The Hynaks and the Skalski's do not rule out Ritalin for their sons but rejoice that they found alternatives they say work better.

PARENT: I'm not anti-Ritalin. But I want to research what else is out there first."

SHARYL ATTKISSON: Here with more on treatments is Lynda Thompson, a child psychologist and director of the A.D.D. Centre in Toronto, Canada. She's also co-author of "The A.D.D. Book."

First, what's your reaction to the alternative treatments you just saw in the story?

LYNDA THOMPSON, PhD, CO-AUTHOR, "THE A.D.D. BOOK": Well, it's very encouraging to see information getting out on things other than medication for A.D.D., and neurofeedback is an approach that I've personally been involved in for a few years, and I really like the way it empowers the child to make the shift instead of everyone trying to get the situation right around the child.

SHARYL ATTKISSON: People have also been looking to diet when it comes to A.D.D. What's the latest thinking on whether diet influences the child's behavior?

LYNDA THOMPSON: Well, it's generally accepted that diet does not reduce A.D.D. However, you still want to use common sense and have an optimal diet because it may be that it will improve a child's behavior if you have the correct nutrition for that particular child. And a few of them, especially the ones who have some allergies, may in fact need some supplements.

SHARYL ATTKISSON: Say I'm a parent, probably like a lot out there who say, "I want my child to go on medication only as a last resort, I want to look into the alternatives." Where do you begin, who do you see, and what kinds of questions do you ask when you're looking for an alternative?

LYNDA THOMPSON: Well, you want to check it out with other parents. Of course you'll ask your physician if he knows of other approaches. School teachers often do. And then to evaluate them, see if it makes sense in terms of what you know about A.D.D., you've got to educate yourself. See if there's some research evidence. And also, does it make sense for your child? Does this seem to match the problems that you're having with your child and your child's strengths?

SHARYL ATTKISSON: What is your take on Ritalin? Do you recommend many of your patients go get a prescription for that? Or is that something you try to shy away from?

LYNDA THOMPSON: Medications, when necessary, but not necessarily medications, is what Dr. Sears and I say. And so it's fine to combine medication with other treatments, but don't let it be a stand-alone treatments. Still look at their sleep, their diet, their exercise, educational approaches, and of course things like neurofeedback that really empower the child.

SHARYL ATTKISSON: For more information on attention deficit disorder or any other HealthWeek story you can call our toll-free number shown at the end of the program.

Dr. Lynda Thompson, thanks so much.

LYNDA THOMPSON: You're welcome.

HEALTHFUL HINTS

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

Bad breath. It won't kill you. But as Madison Avenue likes to remind us, it sure can spoil a romantic moment. While some bad breath stems from sinus problems or other medical conditions, the most common cause is bacteria in the mouth. So, your first line of attack should be a toothbrush and dental floss. And don't forget the mouthwash. If you swish it around well, for at least 30 seconds, mouthwash can kill many of those bad-breath "bugs," freshening your breath for up to eight hours.

Some experts recommend using a special scraper to clean your tongue every day. This gets rid of the debris that feeds odor-causing bacteria. Now, if you don't have a scraper, try "brushing" your tongue instead.

Another option: munch a sprig of parsley or pop a capsule filled with parsley oil to counteract the effects of a meal. Herbal rinses containing eucalyptol or thymol might also do the trick

Now, as for prevention, try drinking more water, especially when you exercise. Washing away those bad-breath germs can help keep your breath fresh... and your friends happy.

With Healthful Hints, I'm Doctor Nancy Snyderman.

MAKING A DIFFERENCE

SHARYL ATTKISSON: Now, our regular feature on men and women who are making a difference when it comes to our health. And joining us is HealthWeek's Robert Davis.

ROBERT DAVIS, PhD: Sharyl, it's estimated that about 40 million Americans, that's one in seven, don't have health insurance. That means they often don't have access to a doctor and eventually wind up in a hospital emergency room when their condition may be much harder to treat. I met a man in Tennessee who's devoted his life to addressing that problem. And, in his community, he's definitely making a difference.

REVEREND SCOTT MORRIS: "How many people received the Holy Spirit on Pentecost? Where do we find it out? Where is it at in the Bible?"

ROBERT DAVIS, PhD: Every Sunday, you can find Reverend Scott Morris teaching Sunday School, and helping lead worship services at his church in Memphis. There's just one problem: this Methodist minister doesn't like to preach.

REVEREND SCOTT MORRIS: "It makes me bored at times, and I'm sure it would make people bored sitting out in the pews."

ROBERT DAVIS, PhD: So, across the street from the church, Morris carries out his ministry in a different way - he cares for the sick. You see, Reverend Morris is also Doctor Morris.

"You feel the church has not lived up to its obligation to care for the sick."

REVEREND SCOTT MORRIS: "If you look around and see what churches do, it's very limited. We pray for people. The pastor's expected to visit people in the hospital. And a few people visit shut-ins. That defines our healing ministry. There has to be more to it than that."

ROBERT DAVIS, PhD: And Morris does more, much more. He's the founder of the church health center, which has provided care for more than 22,000 patients since opening its doors a decade ago.

Most of the patients are what Morris calls "the working poor": they're in low-wage jobs with no health insurance but make too much to qualify for Medicaid.

REVEREND SCOTT MORRIS: "The people we take care of are the folks who make our life comfortable. They shine our shoes, they cook our food, and will one day dig our grave. They really are the lost, forgotten people in our society."

ROBERT DAVIS, PhD: Others are like Jean Gentry, rejected by private insurance companies because of health problems.

JEAN GENTRY: "Dr. Morris has brought me through a heart attack, I'm a diabetic. He's a wonderful doctor. I feel like, I really feel like he's saved my life."

ROBERT DAVIS, PhD: Besides Morris, the center has four staff physicians, six nurses, and hundreds of volunteer health care professionals, who provide a wide range of services, including tests, medications and dental care. The clinic is open weekdays, evenings, and weekends.

"This really has the feel of a private doctor's office."

REVEREND SCOTT MORRIS: "Well, that's what we want it to feel like. We're a real doctor's office. We expect people to keep their appointments. We expect people to pay their bills."

ROBERT DAVIS, PhD: But unlike a real doctor's office, this one doesn't earn a profit. Its nearly 3 million dollar annual budget comes mainly from donations. In addition, patients pay a fee, typically about 10 or 20 dollars a visit, depending on their income.

"This is not a free clinic. Why not?"

REVEREND SCOTT MORRIS: "We're not a free clinic because we believe that poor people aren't looking for a handout. They're looking for something they can afford. It's just that they can't afford the going rate out in the marketplace for health care."

ROBERT DAVIS, PhD: Besides medical care, the center offers health education classes. There's also spiritual counseling for those who want it.

REVEREND SCOTT MORRIS: "I wish I had a nickel for every person who came in and told me that their back hurt, and within literally 30 seconds they were in tears, not because their back hurt so much, but because their heart is hurting. There aren't pills that I can give people that will make that better. We have to find a way to look at their lives in its totality, both body and spirit."

ROBERT DAVIS, PhD: "When was it that you first knew that you wanted to do something like the church health center?"

REVEREND SCOTT MORRIS: "I would say I was in the 10th or 11th grade when I was pretty sure that this was the direction I was going to take."

ROBERT DAVIS, PhD: "Tenth or 11th grade?"

REVEREND SCOTT MORRIS: "Yeah. It was either that or pitch for the Atlanta Braves. And that call never came."

ROBERT DAVIS, PhD: After growing up in Atlanta, attending divinity school and medical school and training as a family physician, Morris came to Memphis to set up his clinic.

REVEREND SCOTT MORRIS: "Memphis is historically the poorest major city in America, and I felt like if we could make this work in Memphis, we could make it work anywhere."

ROBERT DAVIS, PhD: But some in Memphis didn't want it to work. Initially, Morris found his childhood dream facing stiff opposition from several doctors and from one city official.

REVEREND SCOTT MORRIS: "This particular person lived relatively close to us and was afraid that we were going to be creating something in her neighborhood that would make it where it would be less than desirable. And I wanted to go and take her aside and explain to her how this was just the opposite of what she thought. But you know the feeling at the time was one of oh my God, is it possible that the whole thing could come tumbling down before we ever take step one?'"

FLORENCE LEFFLER: "I'm real happy to say I was wrong, and I'm so glad."

ROBERT DAVIS, PhD: That city official, Florence Leffler, is now one of Morris' biggest fans.

FLORENCE LEFFLER: "He's worked a miracle I think, I truly do think that."

ROBERT DAVIS, PhD: Working miracles doesn't leave much time for leisure. The little he has, Morris spends at home with his wife Katherine or serving as coach and first baseman for the church health center softball team. The rest of the time is devoted to his dream.

And to keep it alive, he has to keep money coming in from churches, hospitals, corporations, and foundations. But, he still takes time to see patients, everyday.

REVEREND SCOTT MORRIS: "Taking care of patients is what my life is all about. Doctors are given this unbelievable privilege that people will allow them into their life in a way that they wouldn't let anybody else into their lives. I mean that is, if you can't appreciate that as a physician, then you shouldn't be a physician. I mean, that sort of privilege is just one of the greatest gifts that anybody could ever give you."

ROBERT DAVIS, PhD: And as a physician, Dr. Morris says that two-thirds of the patients he sees have problems that could have been prevented with lifestyle changes like quitting smoking or losing weight. So now he's taking on a new challenge, a community wide effort to teach people how to stay healthy. And he's relying on churches to get the word out.

SHARYL ATTKISSON: As the word is getting out about what he's doing, are other people interested in starting the same type of church-based clinics?

ROBERT DAVIS, PhD: Well, Dr. Morris says they're very interested. He gets calls all the time, and he encourages other cities to try to duplicate what he's done. The real question is whether you also have to clone Scott Morris to make it work because clearly he's the force behind this.

SHARYL ATTKISSON: Dr. Robert Davis, thanks.

ROBERT DAVIS, PhD: You bet.

FITNESS BREAK

DENISE AUSTIN: Hi. I'm Denise Austin and it's time for a fitness break.

A push-up is one of the finest exercises that you could do. It strengthens your arms, your chest, your shoulders. Let's make sure you're doing it correctly. This is Kim, and she's going to give it a try. When you're doing it, start off with your knees, that's it, on your knees to make it a little easier. Go down and up. Now, your goal is to place your hands a little further than your shoulder with that part. That's it. Go all the way down. And most important is to keep your back straight, and the who

ELECTROMAGNETIC FIELDS

SHARYL ATTKISSON: In our Behind the Headlines segment, a new advisory report on the potential health risks of electromagnetic fields. The report comes from an international panel of experts convened by the National Institutes of Health. It found that magnetic forces surrounding power lines should be regarded as a "possible human carcinogen." The panel's conclusions were based on a number of studies.

Andrew, first of all, what type of electricity are we talking about? The high voltage power lines that have been the source of so much controversy?

ANDREW HOLTZ: Really any type of electricity, the wiring inside your home, appliances put off magnetic fields at times, especially older appliances, say older analog clocks.

SHARYL ATTKISSON: What does possible human carcinogen mean? That was the term that was used in the report. It sounds rather ambiguous. What should we make of it?

ANDREW HOLTZ: Possible human carcinogen has a specific meaning to regulators, say those at the Environmental Protection Agency. They have a list of chemicals, or substances like lead, DDT, saccharine are listed as possible human carcinogens. Also the panel was given just four choices. They could say that electromagnetic fields were a certain human carcinogen, likely, possible, or no chance at all. They really picked the lowest choice they could while still leaving some uncertainty.

SHARYL ATTKISSON: Still that sounds pretty frightening if you're talking about putting electricity in the same category as lead and DDT. Should people be taking action, going to their homes and doing something to stay away from electricity?

ANDREW HOLTZ: The experts I've spoken with say immediate action is really not warranted. You can measure the electromagnetic fields in your home with a device that's called a Gauss meter. Experts also counsel what they call prudent avoidance. If you're running the microwave, say, step back a couple of feet, because most of the fields put off by appliances in the home only go for a foot or two. So if you stay back from them when they're operating, you should avoid most of the electromagnetic field.

SHARYL ATTKISSON: Other studies have found the opposite conclusion, that possibly electricity was not any sort of cancer risk at all, most notably, recently the National Cancer Institute. Why the conflict of opinions here?

ANDREW HOLTZ: Well, I think that tells you that if there is anything going on, it's very small and also very difficult to measure. For one thing, cancer can take many years or decades to develop. And determining what causes a cancer today based on some exposure that may have happened ten or twenty years ago is a very difficult job. It's hard to sort all this out.

SHARYL ATTKISSON: Andrew Holtz, thanks for helping.

DOCTOR'S CORNER

BRUCE DAN, MD: I'm Doctor Bruce Dan. Vacations in this high-stress world, they never seem to last long enough. So, if you're getting ready to hit up your boss for more time off, here's some scientific evidence to back you up.

In a recent study in the Journal of Applied Psychology, Israeli researchers questioned 76 clerks at a large electronics firm before, during and after their two-week summer vacations.

Not surprisingly, the workers' levels of job stress and burnout dropped sharply during vacation. Those reporting the greatest relief: women, and, as you'd expect, vacationers who were having the most fun. But it didn't last long once the people returned to work. Three weeks after vacation, burnout was as bad as ever.

Researchers say their findings underscore the need for shorter, on-the-job breaks for relaxation and exercise. Or perhaps what we really need is a vacation every three weeks. Try telling that to you boss! With Doctor's Corner, I'm Doctor Bruce Dan.

BIKE COMMUTERS

SHARYL ATTKISSON: Well, more vacation time would be nice. But if you can't convince the boss of that, there's something else you might try to get a break from the rat race. Here's HealthWeek's Nancy Olson.

NANCY OLSON: Looks like just another guy getting ready to go for a ride. But actually, on this rainy Monday morning, this man is setting out on a mission. He's going to bike to work. Meet Walter Brodtman, environmental engineer and bike commuter.

WALTER BRODTMAN, BIKE COMMUTER: I bike commute because it's exhilarating. I'm out there to do something that's aerobic, and when I get to work, I feel so refreshed, I get a shower, get dressed, and I'm just on a high all day long.

NANCY OLSON: Rain or shine, he's been using pedal power to get to work for five years now. He enjoys it so much, he volunteers to help new riders learn the ropes.

Today he's meeting up with Joe Salerno, who recently moved to the Washington D.C. area.

JOE SALERNO, BIKE COMMUTER: When I first decided that I wanted to bike commute, the biggest concern was learning my way around. This is a big city and there's a number of paths, but without anyone to really show you around it's kind of difficult to find your way.

NANCY OLSON: After a few navigational tips, they begin their 15 mile journey from the suburbs to downtown. Communing with nature, getting a good work-out, helping the environment -- all positive benefits these bikers share. But what awaits them when they arrive at their destination can differ greatly, depending upon their employer.

ERIC SWANSON: "I know it's really my only opportunity every day to get exercise."

NANCY OLSON: Economist Eric Swanson is fortunate. He works at the World Bank, a company that caters to bike commuters. There's a special place for riders to park their bikes, a locker room for storing clothes, and showers for freshening up before beginning the day at the office.

The bank's health director, Dr. Bernard Liese, says being bike friendly helps the company.

BERNARD LIESE, MD, WORLD BANK HEALTH DIRECTOR: On the whole the population here is healthier than a comparable population, certainly healthier than the general U.S. population.

NANCY OLSON: Eric thinks, with a little effort, other businesses could see similar results. In his free time, he advises them on how to make bike commuting easier.

ERIC SWANSON: You offer it to your employees and you might be surprised at how many people want to take you up on it.

NANCY OLSON: But with or without their employers' support, more people are giving up gridlock, opting instead for the freedom of the open bike path.

SHARYL ATTKISSON: If you're interested in biking to work, the League of American Bicyclists offers bike commuting classes in many cities across the nation.

That's all for this week. Remember you can visit us throughout the week at our site on the World Wide Web. To reach the HealthWeek home page, go to PBS Online at the Internet address on your screen. That address is www.pbs.org.

Next time on HealthWeek... the pros and cons of dental implants. More and more people are getting them, but are they right for you? We'll also have a moving story about egg donation, a procedure that enabled one woman to give her infertile friend the gift of motherhood. 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 Teresa and H. John Heinz III Foundation, and the Heinz Endowments.

To order a video or a printed transcript of this program, call 1-800-338-8440. Please ask for the program number on your screen. Program #209.


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