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HOUSE CALL WITH DR. SANJAY GUPTA
CDC Monitors E. Coli Outbreak; Shortness Now Being Treated As A Disease; A Person Considered To Be In Vegetative State Somehow Understanding And Responding To World Around Her; Policies On Family in the E.R.; Pressure To Make Fast Food Chains Take Trans Fat Off Menus
Aired September 23, 2006 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SUSAN ROESGEN, CNN ANCHOR: At least 28 people are dead this morning after a car bomb went off in Baghdad's Sadr City. Iraqi police say the attack came as Sunnis began observing the Muslim holy month of Ramadan. That's because Sadr City is a largely Shi'ite district.
New signs that North Korea is boosting its nuclear weapons program. A visiting American scholar says senior officials have told him that North Korea plans to unload fuel rods from its nuclear power reactor in order to get more weapons grade plutonium.
We're watching a primary race in Hawaii today. And age is the big issue. Incumbent Senator Daniel Okaka is 82. His opponent is a youngster, Congressman Ed Case. Only 53. But age may win out here because two polls give the elder statesman a big lead.
Your next check of the headlines is coming up at the top of the hour. But first, HOUSE CALL with Dr. Sanjay Gupta starts right now.
UNIDENTIFIED FEMALE: Today on HOUSE CALL, is Dustin Hoffman sick? Does Martin Scorsese have an illness? Not really, but parents are medicating their kids so they won't be like them.
And locked inside your own head. Doctors say you're in a vegetative state. But now a stunning discovery.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: What we've shown here for the first time is that we can detect awareness.
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UNIDENTIFIED FEMALE: Inside the E.R., while a loved one fights for their life. It used to be unthinkable, but the rules are changing and some doctors don't like it. Find out why, this morning on HOUSE CALL.
DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. The E. coli outbreak in spinach has many people on edge. So far, more than 100 people have become ill. But with hundreds of farms across the country growing spinach, how can the real source the outbreak be found? Well, that's where detectives come in -- disease detectives, that is. I got a rare glimpse inside the CDC's Emergency OPS Center, where researchers are hunting for the bug that started it all. Take a look.
GUPTA (voice-over): If there's a mission control for handling the E. coli outbreak, this is it. You're getting a unique look at D.R. -- the Director's Emergency Operations Center of the CDC.
(on camera): Over here, you can see all sorts of different screens. They're monitoring avian flu. They're monitoring the weather. But right now, front and center, the E. coli outbreak.
It is very difficult to figure out exactly from where the E. coli started.
A lot of people ask exactly how does the investigation take place? I want to show you. We're in some of the back hallways of the CDC. Here, people are actually on the phone, calling some of the patients who become sick with the E. coli infection, asking them about their dietary habits, asking them about their symptoms.
In this room over here, they're taking all of that information, trying to compile it and figure out where this outbreak stands.
DR. PATRICIA GRIFFIN, CENTERS FOR DISEASE CONTROL: We ask people about everything they ate in the week before they got sick, because it's important to know for sure what's cause the illness is.
GUPTA: It sounds like it's impossible because I mean, I can't even remember what I had for dinner last night. How do you figure -- ask people what they have eaten for an entire week? Seems very hard.
GRIFFIN: Right, it's -- you figure it out by interviewing all the people that you can and asking them detailed questions. And when they can't remember exactly what they eat, you said, well, considering your habits, what did you probably eat?
GUPTA: If someone has eaten spinach over the last week, and they're hearing all of this coverage and hearing you talk now, what is your message to them?
GRIFFIN: They should relax. If they have spinach in their refrigerator, they should throw it away. And if they do develop diarrhea, they should get that spinach package out of the trash, and contact their local health department, and see their doctor.
GUPTA: When can I eat spinach again?
GRIFFIN: That's a great question. The more specific that we can get about where the contamination occurred, you know, the better it will be. And that's what we're working towards. But...
GUPTA: Definitely no spinach now.
GRIFFIN: Absolutely not. Please don't eat raw spinach now.
GUPTA: Thank you very much.
GUPTA: Appreciate it.
GUPTA: And of course, stay tuned to CNN for the very latest on the E. coli outbreak. We'll be bringing that to you as those details become available.
I want to switch gears now to a somewhat smaller medical issue.
There's a support group, there's a who's who list, there's even a song written about these people. Who am I talking about? Short people.
Because of the possibilities of teasing, workplace bias, and even diminished dating prospects, some parents are taking extraordinary measures to make sure their kids do not grow up short. Elizabeth Cohen has the story.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): Is Dustin Hoffman sick? Does Martin Scorsese have an illness? And is something ailing Robert Reich, President Clinton's Secretary of Labor?
UNIDENTIFIED MALE: This is your head.
COHEN: Well, shortness is now being treated as a disease. Tens of thousands of parents injecting their children every day in the hopes that they can make their kids taller. It often costs hundreds of thousands of dollars for one child. How old is Michael here?
JENNIFER REDA, SON TOOK GROWTH HORMONE: I think he was 3 here.
COHEN: And little boy next to him?
J. REDA: Same exact age.
COHEN: What do kids say to you?
MICHAEL REDA, TOOK GROWTH HORMONE: They told -- they call me small fry, shrimp, anything they can think of. And I just hated that.
COHEN: Michael's preschool teacher called him petite.
J. REDA: I melted. You know, it's a word you just don't want associated with your son.
COHEN: Why would you want to take something that would help?
M. REDA: Just to get taller, and so everyone would be nice to me. And all of bad stuff would go away.
COHEN: When Michael Reda was 7, his parents started him on human growth hormone.
So you got a shot with that needle?
M. REDA: Once a day, yes.
COHEN: Once a day. Wow, did it hurt?
M. REDA: Yes, I got used to it.
J. REDA: I thought he would be more challenged in the business world and even maybe in searching for a spouse.
COHEN: You think short men have a harder time?
J. REDA: I do. I just think we want to think of men as being a little bit larger and capable.
COHEN: So when Michael first came to see you, he wasn't even on the chart?
DR. FUAD ZEI (ph): That's right.
COHEN: Dr. Fuad Zei predicted Michael would grow up to be around 5'5". After taking growth hormone for two-and-a-half years, Michael grew an extra three inches. Now instead of being 5'5" when he grows up, he will be around 5'8".
Did you grow as much as you'd hoped? .
M. REDA: I grew more than I hoped.
COHEN: But bioethicists like Lori Andrews worry is it right to use a drug to make your children look a certain way?
LORI ANDREWS, BIOETHICIST: This is part of a slippery slope of parents trying to design their children. And we're starting to see it even at very early stages.
COHEN: After all, Michael wasn't sick, he was just short.
ANDREWS: Nowhere else in medicine do we take healthy children and give them an injection of something that might cause them harm.
COHEN: The vast majority of children do just fine on growth hormone. But some do suffer scoliosis, muscle pains and headaches.
J. REDA: We entered into it very cautiously. There was a lot of thought process and decisionmaking prior to giving it to him.
COHEN: Growth hormone isn't cheap. How expensive is it? One inch of growth costs more than $50,000. Want your child to grow four inches? That'll be $200,000, please. And the results are not guaranteed. Insurance paid for Michael's growth hormone. And the Redas couldn't be more pleased with the results. What do you think those three inches have done for him?
J. REDA: I know they've made him a lot happier.
ANDREWS: If the idea is to give your child self-esteem, you should be doing that through your parenting, not through drugs.
COHEN: That's nonsense, according to Steve Horowitz. At 5'3", he says he suffers every day because of his height.
STEVE HOROWITZ, FINANCIAL ADVISOR: I'm a financial adviser. I see people for a living. People judge you by your height. I would still give anything to put on a couple of inches. Even at this stage of the game, I would have done anything and I would still do anything.
COHEN: This drug wasn't around when Steve was a kid, but he did put his son Ira on it. Ten years of daily injections, and now Ira's 5'9". And Steve's thrilled his son doesn't have to go through life a very short man.
HOROWITZ: It is an extra hurdle to overcome. And why overcome that hurdle if you don't have to, if you can have it removed?
COHEN: Elizabeth Cohen, CNN, Chicago.
GUPTA: All right, Elizabeth, thanks. And just to give you a baseline, the average height of an adult man is 5'9", and an adult female almost 5'4".
More HOUSE CALL, coming up.
UNIDENTIFIED FEMALE: A vegetative state. To many, considered almost dead. And yet...
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: It's clear to us that she was constantly aware, aware of herself and what was going on around her.
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UNIDENTIFIED FEMALE: Find out about this doctor's amazing discovery, when HOUSE CALL returns.
GUPTA: Stay on top of all of the latest news on health by going to CNN.com/health. Also, don't forget to click on the iTunes. You can subscribe to my podcast. They keep you up to date on the go as well.
Now an incredible story. It's a fascinating one to me as a doctor. A person considered to be in a vegetative state, and yet somehow brain scans show that she is understanding and responding to the world around her. (BEGIN VIDEOTAPE)
GUPTA (voice-over): It is an unimaginable nightmare: tapped inside your own brain, no way to talk, no way to communicate, written off as nearly dead. For five months, a 23-year-old English woman lay in what doctors called a vegetative state. But Cambridge researchers decided to take a closer look and were stunned by what they found.
DR. ADRIAN OWEN, MEDICAL RESEARCH COUNCIL: Not only was she able to hear and understand speech, but that she was able to carry out simple tasks in her head. It's clear to us that she was consciously aware, aware of herself and what was going on around her.
GUPTA: A patient in a vegetative state will sleep and wake regularly, show some eye movements, but have no discernible response to his or her environment.
OWEN: This band of cortex here.
GUPTA: Armed with findings from a functional MRI scan, Dr. Adrian Owen thinks a lot more is going on. And he is shattering many long-held beliefs about the vegetative state.
OWEN: What we've shown here, for the first time is that we can detect awareness.
GUPTA: Owen's team placed the vegetative patient in a machine like this one and asked her to imagine playing tennis at Wimbledon.
OWEN: This is the brain of a healthy volunteer who's imagining play a game of tennis. And this is the brain our patient, when we asked her to do exactly the same thing. And as you can see, the same area is activated in both.
GUPTA: With each task, researchers look to specific parts of the brain involving speech processing or visualizing a walk through rooms of her house. Every time her scans were indistinguishable from those healthy volunteers.
DR. JOSEPH FINS, NY PRESBYTERIAN WEILL-CORNELL: It's one patient in one study.
GUPTA: Dr. Joseph Fins says there are about 25,000 vegetative patients in the United States, but says anywhere from 20 to 40 percent of them are misdiagnosed.
FINS: We have to be very cautious about generalizing her experience to all vegetative patients.
GUPTA: Like Terry Schiavo, whose brain was deprived of oxygen after cardiac arrest.
FINS: This patient was still within the window of being able to move. This patient in the vegetative state is not Terri Schiavo.
GUPTA: Schiavo's type of injury had a much grimmer prognosis than that of the study subject, who suffered a traumatic brain injury from a car accident.
Currently, there is no treatment for these patients. But doctors hope these scans may help earlier identify which patients have a better chance of recovery.
GUPTA: Absolutely remarkable stuff. From inside the brain to inside a resuscitation in the emergency room, stay tuned for that on HOUSE CALL.
UNIDENTIFIED FEMALE: A new policy that has some seeing red and others feeling comfort.
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UNIDENTIFIED MALE: Do you think it made a difference to your father that you were there?
UNIDENTIFIED FEMALE: I'd like to think that it did.
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UNIDENTIFIED FEMALE: Find out where there was just ahead.
But first, this week's medical headlines in "the pulse."
JUDY FORTIN, CNN CORRESPONDENT (voice-over): If you're losing sleep over allergies, you're not alone. A report in the archives of Internal Medicine reveals allergies can have a big impact on sleep quality. Breathing problems resulting from allergies are blamed on inadequate sleep.
Eating fatty fish like salmon and mackerel at least once a week may help lower the risk of kidney cancer. A Swedish study of 61,000 women found those eating fish, rich in Omega 3 and Vitamin D had a 74 percent lower risk than those eating lean fish or no fish at all.
Heart doctors are being asked to give flu shots to their patients. The American Heart Association says those with cardiovascular disease are more likely to suffer complications and die from influenza. The group warns people with heart disease should not receive the nasal spray flu vaccine.
Judy Fortin, CNN.
GUPTA: We're back with HOUSE CALL. Now if a loved one was fighting for their life, would you want to be there? Well, the instinct is to say yes, but what if it meant seeing some graphic, invasive procedures? Would you still say yes? Tom Foreman now with the trend in emergency rooms that is causing some controversy.
TOM FOREMAN, CNN CORRESPONDENT (voice-over): When Denise Hanlon's father Eddie was rushed to a Boston hospital, his heart failing from long illness, she expected him to die. She did not expect to be invited into the emergency room while the medical team tried to save him.
DENISE HANLON: It was traumatic to see him, although it was also heart warming to see so many people trying to do the best they could.
FOREMAN: And you never had any second thoughts about this?
HANLON: Not at all. Not one. No. It just seemed, how could we not be with my dad, if we the opportunity to?
FOREMAN: Massachusetts General is among a growing number of hospitals, by some accounts, close to half that now families into emergency rooms even at life and death moments.
UNIDENTIFIED MALE: Will somebody please call my mom?
UNIDENTIFIED MALE: No problem, just hold on
FOREMAN: The controversial idea was spurred by TV shows like "E.R." that have increased public understanding of what goes on at such times and by nurses, like Patricia Mian, who spent years working with families as loved ones fight for life.
PATRICIA MIAN, MASSACHUSETTS GENERAL HOSP.: And what they would be saying is why can't I be with him? I need to see him. I want to be with him.
JEROME GROOPMAN, DR., AUTHOR, "BEING THERE": The way it's usually posed is a nurse specialist, often a psychiatric nurse, will offer the option to the family, and say, if you would like to be with your family member while the doctors and nurses are trying to resuscitate them, I will accompany you and stand there with you, answer questions, and make sure you're there with them.
FOREMAN: It's a simple idea, yet fiercely opposed by many doctors. They argue that distraught family members can distract medical teams, may be more prone to lawsuits. And as Dr. Stephen Smith says, may find the experience of seeing a loved one cut open, shocked or more severely unsettling.
STEPHEN SMITH, DR., UNIVERSITY OF KANSAS MEDICAL CENTER: For example, many of the things that we have to do in the trauma setting are done very quickly. They require literally split-second decisions and can be quite invasive. I think that that's probably not a good time for an unprepared family member to be present in the resuscitation area.
So this is one of the resuscitation bays. And this would be one of the ones that we would use.
FOREMAN: Mass General's chief of emergency services Alasdair Conn felt the same way, but he gave it a try and says he has found families deal with both doctors and grief better this way.
DR. ALASDAIR CONN, MASSACHUSETTS GENERAL HOSP.: The family members need to understand there's a lot of things going on. And you just can't question, and you can't begin to interfere. And also, we have a nurse that goes in specifically helping to manage the patient.
UNIDENTIFIED FEMALE: They kiss the patient. They hug the patient. They stroke the patient while we're doing CPR. They aren't watching what's going on. They're so focused on being with that person.
UNIDENTIFIED MALE: We need to add him to a kits now.
UNIDENTIFIED FEMALE: Pulse is 99.
UNIDENTIFIED MALE: She's seizing.
FOREMAN: Concerns remain. On TV, patients undergoing resuscitation often live. In life, 90 percent of the time, they die. Supporters are not deterred.
CONN: If you were dying, would you want to be alone? Would you like your wife, or your brother, or your son, or daughter to be 20 feet away? Would you rather be in there, holding hands for those last three minutes.
HANLON: So on Saturday, we'll head down to the south shore.
FOREMAN: Dennis Hanlon lost her father, but found an answer to those questions.
Do you think it made a difference to your father that you were there?
HANLON: I'd like to think that it did.
FOREMAN: It certainly made a difference for her.
Tom Foreman, CNN, Boston.
GUPTA: Thanks, Tom. Great story there.
Coming up, a critical look at the fast food industry and what some are doing right.
UNIDENTIFIED FEMALE: A fast food giant bans fat from their menu. Too good to be true? You're right. But tune in and find out which type of fat Wendy's did cut out.
(COMMERCIAL BREAK) GUPTA: Welcome back to HOUSE CALL. In a fit nation, there is no room for trans fats on the menu. And fast-food restaurants are feeling the heat. A closer look at what some of them are doing.
GUPTA (voice-over): With the hiss and a sizzle, one fast food company is making unexpected health history. Wendy's has removed the majority of trans fats from the oil used to make fries in chicken.
LORI ESTRADA, SR. VP R&D, WENDY'S: This reduction in trans fat is part of our ongoing effort to improve the nutritional profile of our food without impacting taste or quality.
GUPTA: So why is this important? Scientists estimate there are over 50,000 premature deaths each year linked to eating trans fats. Trans fat is bad for your heart because it raises your bad cholesterol and also lowers what doctors call your good cholesterol.
ROBERT EXCKEL, DR., AMERICAN HEART ASSOCIATION: We know from large numbers of nutrition-based studies over decades now that saturated fats and trans fats both tend to raise the bad cholesterol. And we certainly know that people with higher levels of bad cholesterol appear to have more heart disease and stroke.
So we have no alternative enzymes that we could...
GUPTA: Dr. Exckel says Americans on average eat about three times as much trans fat as recommended. Trans fat is on the menu at just about all the fast food giants -- Burger King, Kentucky Fried Chicken, Arby's, Hardy's.
McDonald's tried to lose the trans fat. The company announced in 2002, it would reduce trans fats, but it hasn't eliminated them, at least not in the United States.
In countries like Denmark, where laws severely limit trans fat in food, McDonald's fries are trans fat food. And McDonald's issued this statement in response to CNN's questions about trans fat.
"McDonald's takes the matter of trans fatty acids seriously and we continue to work diligently on ways to reduce TFA levels in our fries. Our test procedures in the United States are taking longer than anticipated."
According to McDonald's Web site, a single large serving of fries has eight grams of trans fat. That's four times the amount the FDA says the average American should eat in an entire day.
The threat to our health from trans fat is so serious, the FDA required manufacturers to list them on nutrition labels beginning this year. Food writer Kim Severson says as soon as the labels changed, processed food makers eliminated trans fat from about 40 percent of their products. Snack like Oreos and Frito-Lay chips are now marketed as trans fat-free. KIM SEVERSON, AUTHOR, "TRANS FAT SOLUTION": The battleground now are restaurant, fast food companies. And that's, I think, where you really see the changes coming
GUPTA: The FDA doesn't require restaurants to tell customers how much trans fat they're eating, which might explain why change there is so slow.
GUPTA: Well, we'll continue to watch the battle against trans fats in the American diet. That's something you're going to want to know. But unfortunately, that's all the time we have for today. Remember, this is the place for the answers to all of your medical questions.
Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now more news on CNN.
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