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HOUSE CALL WITH DR. SANJAY GUPTA

Overweight Backpacks; Diabetics Skipping Insulin to Lose Weight; Are Schools Improving Diet and Exercise?

Aired August 25, 2007 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


SANJAY GUPTA, HOST: Thanks, guys.
This is HOUSECALL. We're making the rounds this morning of some of the most interesting medical stories of the week. First up, millions of Americans living in pain. What's behind what some call the silent epidemic?

And backpacks, find out why they're sending kids to the emergency room and how you might be able to prevent it.

Then dying to be thin, inside the world of diabetics who skip their insulin. Why? To lose weight.

Finally, we're checking up on schools to see if they're getting healthier and making the grade, though.

We start with a startling number, 124 million. That's how many prescriptions for painkillers containing hydrocodone were written in 2005. The Associated Press analyzed government figures and found retail sales of the top five painkillers nearly doubled between 1997 and 2005. The Drug Enforcement Agency is now considering reclassifying drugs containing hydrocodone. Why? That would make it harder for them to get refills and require doctors and pharmacies to keep more stringent records.

But for tens of millions of people for whom painkillers may actually be necessary, these people live with something called chronic pain. It can be hard to diagnose. It can be even harder to treat.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): This is Timothy Connick now, living an active life, playing with his grandson, working full-time. It's a life he wasn't sure he'd ever be able to return to.

TIMOTHY CONNICK, CHRONIC PAIN PATIENT: So it was pretty much a no-win situation as long as that pain was going to be there.

GUPTA: About 11 years ago, Connick fell at work. He shattered his heel. And he began six years of living with debilitating pain.

CONNICK: I turn over at night. It's like there's a pair of scissors sticking out of my foot.

GUPTA: Connick was just one of millions struggling. In fact, according to the American Chronic Pain Association, nearly 1 in 3 Americans suffers from chronic pain, which can be caused by an injury or be ongoing pain from arthritis or cancer. Dr. Ann Louise Oaklander says many of these patients end up bouncing around the healthcare system, looking for help.

ANNE LOUISE OAKLANDER, DR., MASS. GENERAL HOSPITAL: It's devastating to have chronic pain. We're just not set up to experience moderate or severe pain on an ongoing basis.

GUPTA: Oaklander says pain medications can help most patients, but there are exceptions.

OAKLANDER: Some patients sustain nerve damage from their tissue injury. And that even very small amounts of damage to the pain neurons that transmit the pain signals will leave some patients with severe chronic pain.

GUPTA: And that's what happened to Timothy Connick. His foot healed, but he still lived in excruciating pain. After six years of suffering, he met with Dr. Oaklander, who offered an alternative, an implanted electronic stimulator that overrides pain signals to the brain.

CONNICK: At home I couldn't make the stairs the day before surgery. But the day they put that in and I turned it on, I was up seven flights of stairs before they stopped me.

GUPTA: And now Connick is working on his feet all day long, whether at his job, around his house, or simply keeping up with his grandsons.

(END VIDEOTAPE)

GUPTA: All right, so good for him. An expert tells the key to chronic pain is to get to the root of the problem and see a specialist. And remember, there is help out there.

Now from chronic pain to a more common complaint -- aching back, weak muscles, shoulder pains. And we're not talking about weekend warriors or even middle-aged aches and pains. These complaints are coming from kids. Yes, children. Some of them even being sent to the emergency room. Why? Because of overloaded backpacks. This is a big issue. There are things you can do to prevent these increasingly common injuries. And Dr. Laurel Blakemore is here to try and help us guide us through that. She's chief of orthopedic surgery and sports medicine at Children's National Medical Center in Washington. Welcome, Dr. Blakemore.

LAUREL BLAKEMORE, DR., CHILDREN'S NATOINAL MEDICAL CTR.: Hi, Sanjay.

GUPTA: Good to see you.

BLAKEMORE: Good to see you.

GUPTA: Is this a pretty big deal? I mean, you're an orthopedic surgeon takes care of children. Do you hear a lot about these sorts of complaints?

BLAKEMORE: We get a lot of parents that are very concerned that the backpacks are causing children's back pain. And certainly, the incidents of back pain's on the rise.

GUPTA: So what symptoms should parents be looking for if they're concerned about this?

BLAKEMORE: Well, backpacks that are overloaded or don't fit properly or aren't used properly can cause problems like back pain in the shoulders, poor posture, or even numbness in the arms or loss of circulation in the arms.

GUPTA: Now I imagine some of this is -- you know, if they'd stop overloading their backpack or wearing a backpack at all. And it will just go away. I mean, how do they know when they should see someone like you?

BLAKEMORE: Generally, the problems seem to be self limited. There's no studies that prove that backpacks cause long term damage. So the first thing to do is to eliminate the weight in the backpack to 10 percent to 15 percent of the body weight and to try and make sure they wear it on both shoulders.

GUPTA: Yes, because it was pretty cool to just wear it on the one shoulder, right?

BLAKEMORE: Very hip.

GUPTA: For a long time. I think in our generation, maybe not so much anymore. So they come see you now because they have some real problems. What are you going to do for them?

BLAKEMORE: So generally, the first thing we do is try to make sure that we can limit the things we can. And usually, that takes care of these kind of temporary pains if they're caused by the backpack. If that doesn't make it go away, then they need more of a thorough work-up with x-rays and other studies.

GUPTA: I mean, can it be so bad that someone might need surgery or something more aggressive as a result of a backpack injury?

BLAKEMORE: No, that doesn't seem to be the case. It seems like when you adjust the backpack properly, the symptoms go away.

GUPTA: What about these roller backpacks? A lot of people talking about those. And I've seen them. Does that really help the problem?

BLAKEMORE: Well, they're a great idea in terms of decreasing the load, but in some schools they're not allowed either because of a tripping hazard, or because they can't carry them up and down the stairs.

GUPTA: What are some of the other issues related to sort of back to school? I mean, I'm sure athletic injuries, things like that. What are other things that parents should be looking out for as kids are getting back to school?

BLAKEMORE: Well, when kids get into the fall sports, especially if they haven't been practicing those things during the summer, they'll sometimes have overuse injuries or chronic pain injuries that we can treat in a sports medicine clinic.

GUPTA: And are there specific check-ups that they need or anything? I mean, I remember when I was, you know, going to school and playing sports, we get a physical exam every year. And a lot of times they check you for things like scoliosis or other things. I mean, does that still happen? I mean, should they be seeing someone like you ahead of time?

BLAKEMORE: Absolutely. And most schools require a school physical. And that does pick up a lot of problems like scoliosis. But sometimes the injury doesn't show up until the child's been involved in the sport for a couple of weeks.

GUPTA: OK. So don't load those backpacks more than 10 to 15 percent?

BLAKEMORE: That's exactly right.

GUPTA: Good rule of thumb. There's so many books nowadays, Dr. Blakemore, even more than so than when we went to school, I think.

BLAKEMORE: Yes, they're getting heavier. The kids are smarter.

GUPTA: The kids are smarter. Dr. Blakemore, thanks so much for being with us. Really good important advice as well.

And the start of a new school year can be filled with anxiety for all sorts of children and their parents as well, as I'm finding out. But as Judy Fortin reports, there are some strategies to ease the transition.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): It's the first day of kindergarten for 5-year-old Sebastian Grau. And his mother admits she's a wreck.

HEIDI GRAU, MOTHER: I was up about half of the night worried about Sebastian and what our transition would be like today. We've had some rough transitions in previous years.

FORTIN: Experts say separation anxiety is fairly common among young children. And they don't always know what causes it.

MARK CRAWFORD, CLINICAL PSYCHOLOGIST: When a child is anxious, they can look really scared, and sometimes act quite irrationally.

FORTIN: That's what happened to Sebastian during his preschool years.

JOERG GRAU, FATHER: When he leaves me, he holds on to my leg and he won't let go. And the teachers oftentimes have to kind of tackle him.

FORTIN: Meeting the new teacher ahead of time can help ease the transition. So can positive words from a parent.

MARK CRAWFORD, CLINICAL PSYCHOLOGIST: Be clear, matter of fact, completely confident, even if you have to fake it, and sort of go about it as though it's no big deal.

FORTIN: For the Graus, that was easier said than done.

J. GRAU: He started giving me a big hug, and he didn't want to let go. But he did great. I mean, it was much better than anticipated.

FORTIN: Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Judy. Thanks. And you can find more tips for helping kids transition back into the school year by going to CNN.com/health. You're going to find Judy's full article there as well on separation anxiety with links for even more information. Make sure to check that out. Plus, check out the American Academy of Pediatrics site at aap.org. Click on "health topics" and find more on back to school health.

Coming up on HOUSECALL, skipping medicine to be thin.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I don't take my medication because I want to lose an extra pound. It's always what isn't good for your body, but what do you want?

(END VIDEO CLIP)

GUPTA: Risking their lives to lose weight, you'll hear from a woman still living on the edge.

Plus, eating for two. Are pregnant women gaining too much weight? Be careful here. Some experts say yes.

Then, are you prepared for a disaster, floods, fires, hurricanes? What should you have in your house to help keep you and your family safe? Stay with us.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSECALL. I get to give some good news this morning. You know, there's been some concern about a link between a compound found in many popular foods and breast cancer. The links originally came from animal studies of a compound called acrylimide. Now this compound is released from foods, especially starchy ones are cooked. We're talking about things like French fries, some cereal products. But now there's a large study in women, shows no link between eating normal amounts acrylimide and breast cancer, specifically in women. Some good news there.

And coming up this fall, the Institute of Medicine is expected to begin gathering scientific evidence, examining an important question. How much weight should women gain during pregnancy? Now this is on the heels of research suggesting many women are gaining too much weight. Current guidelines say a normal weight woman should put on 25 to 35 pounds during pregnancy, but some experts say even that amount can lead to overweight toddlers. We'll keep you posted on that one.

And now to a fixation on losing weight that could cost women their lives. CNN's Dan Lothian reports on the dangerous and potentially deadly practice by some diabetes of skipping their insulin shots.

(BEGIN VIDEOTAPE)

DAN LOTHIAN, CNN CORRESPONDENT (voice-over): Jackie Lyons knew her daughter J.J., who suffered from Type 1 diabetes, was very ill, but the real truth about what took her life only came to light after her death in these disturbing diaries.

JACKIE LYONS: Why won't someone explain to me why I do not take my insulin? I often think it's because I want to eat and stay thin. It has just become an awful habit for me.

LOTHIAN: Jacqueline Walsh or J.J., had a dark secret, often called diabulimia, staying thin by skipping insulin shots to purge calories. Risky behavior because the life-saving injections are needed to regulate blood sugar levels.

LYONS: I've lived through five years of comatose death from not taking my insulin properly.

LOTHIAN: Do you think J.J. understood what was really happening and what was causing this, what was driving this?

LYONS: Now that I'm reading her journals, I see that she consciously was taking her insulin improperly to lose weight.

LOTHIAN: J.J., an attractive young woman engaged to be married, began to fade away.

LYONS: Her hair fell out. Her skin was very dry. Her face was sallow. She didn't look like the same person.

LOTHIAN: After several emergency room visits, J.J. died just one week shy of her 28th birthday.

ANN GOEBEL-FABBRI, DR., JOSLIN DIABETES CENTER: The research we've done here at Joslin shows that 30 percent of women with Type 1 diabetes engage in this behavior at some point in their lifetime for weight management.

LOTHIAN: 36-year-old Christel Marshand say she skipped shots and gambled with her life for three years before therapy set her straight. CHRISTEL MARCHAND, TYPE 1 DIABETIC: I thought about the fact that I was doing damage to my body. But at the time, it was more important for me to be a certain weight and to look a certain way.

LOTHIAN (on camera): As in J.J.'s case, eventually diabulimia can become fatal when toxic acids build up in the body and can't be flushed out.

(voice-over): But all the warnings don't seem to rattle 30 year old Christa, a wife and mother of a 3-year-old who compares her self- destructive habits to an alcoholic.

CHRISTA PIOSZAK, TYPE 1 DIABETIC: I'm not going to take my medication because I want to lose an extra pound. It's always what isn't good for your body, but what you do want. So...

LOTHIAN: Pioszak's husband tried to get her help. She refused. Why wouldn't you do something for your husband, who wants you to be healthy and be around for your child to grow up?

PIOSZAK: I don't really have a good reason except for the fact that I just didn't feel that maybe I was sick enough to do that.

GOEBBELL-FABBRI: People can rationalize and say, hey, you know, my body's used to this. I'm doing OK. And it's just not the case.

LOTHIAN: In fact, Pioszak has already suffered the side effects of skipping insulin shots, damaged blood vessels in her eyes and numbness in her feet.

GUPTA: So just part of the foot is numb.

PIOSZAK: Yes, my toes for the most part.

GUPTA: Pioszak says her decision to go public is part therapy, part cautionary tale.

PIOSZAK: I would like just to let other people know that there are others going through this.

GUPTA: Still, she's not willing to do the right thing. Her body image for now more important than her health, and frankly, her life.

Dan Lothian, CNN, Redford, Michigan.

(END VIDEOTAPE)

GUPTA: Wow, Dan, thank you so much for that. A dangerous game she's playing for sure. Hopefully, Christa will get some help. Millions of Americans are living with diabetes, about 20 million of them. And if you're one of them, click on my blog at CNN.com/health. Find some strategies there for managing this disease.

Also, stay where you are. Coming up, why what you say or don't say, as it turns out, during an argument with your spouse could impact your health. Then, we're checking up on schools, keeping them honest. Have those lunches become any healthier? Are there more Phys Ed classes? Find out if we're moving as a country in the right direction when HOUSECALL continues.

(COMMERCIAL BREAK)

GUPTA: This week's floods have given us a stark reminder of how quickly lives can change and how we all need to be prepared for such emergencies. You know, there's some simple things you can pick up and set aside that can make all the difference to your health when disaster strikes.

First off, here's an important one. Keep up with your tetanus immunizations just in case you have a wound that might become contaminated. Lots of rusty nails around there. Then have enough bottled water for all your family members. Obviously, formula for babies and diapers as well. Make sure to have prescription medicines handy or just keep a list of medical personnel and have a first aid kit. And lastly, in flood conditions where there's standing water, you're going to want insect repellant containing Deet.

Now I've been reporting extensively on food safety, especially following the deadly spinach outbreak last year. I want to give you two quick updates. The Agriculture Department is earmarking $5.5 million to study ways to prevent E.Coli. And earlier this month, the government canceled its plans to close more than half of the existing FDA field laboratories. That's both good news.

Those labs incidentally are used to test our food for contaminants. Now let's check in with Judy Fortin. She's here with this week's medical headlines. Judy?

FORTIN: Hey, Sanjay. Some interesting stories that we're following for you this week. A new study is linking weight loss and Alzheimer's disease. Researchers suggest women who have dementia start losing weight at least a decade before symptoms of the disease turn up. The connection may be tied to the loss of smell and appetite.

And according to another study out this week, women who force themselves to stay quiet during marital arguments are four times more likely to die than women who speak up. And men whose wives came home from work upset about their jobs were 2.7 times as likely to develop heart disease as men with less work-stressed wives. The study also confirmed that marriage is good for men's health. Compared with unmarried men, husbands were nearly half as likely to die.

And here's some food for thought. 2 out of 3 parents find school lunches very nutritious. That's according to a recent USA Today/Gallup poll. Now the same amount of parents also agree more fruits and vegetables and whole grains need to be incorporated in the menu. One option for concerned parents, packing fruits and veggies as snacks for kids to encourage healthy eating. It sounds simple, Sanjay, but now you got to get kids to eat it, right? GUPTA: You know, you're absolutely right. Actual fruits instead of those fruit juices and actual vegetables instead of French fries, you know.

FORTIN: Good for them.

GUPTA: It's amazing. Thank you so much, Judy, for that. And make sure to stay tuned because next up, we're going to actually check in on those very same school lunches. It's been a year since wellness programs were government mandated. Has your child's school become any healthier? We're keeping them honest when HOUSECALL continues.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSECALL. You know, we've been reporting on the battle against childhood obesity for two years now. Since then, people have become more aware of the problem. Government agencies, civic groups, parents and doctors are all taking notice. We've seen it, but with schools as one of the battlegrounds of this epidemic, will kids heading back this year see any changes?

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It's been a year since Congress required school districts to commit to wellness programs to combat childhood obesity, but has anything changed in three of the biggest problem areas? In cities like Oakland, California, and New York City, junk- filled school vending machines are a thing of the past. Policies vary across states and districts, but in schools where machines remain, healthy alternatives like granola bars, sugar free drinks, and baked snacks are now sold.

UNIDENTIFIED MALE: Now it's still not exactly what your mother would prefer you eat.

GUPTA: Loaded with calories and fat, most school cafeterias aren't much better than fast food restaurants. In fact, a recent study by the Physicians Committee for Responsible Medicine finds school lunches are falling short of providing students with healthy alternatives. That's because the government spends more money on high fat foods for school programs.

DULCIE WARD, PHYSICIANS CMTE. FOR RESP. MED.: In 2005, they spent $750 million on meat and dairy products and a mere $10 million on fresh fruits and vegetables.

GUPTA: But the report says progress is being made. States like California, Florida, Hawaii, and New York are allocating more money to add fruits, vegetables, and grains to their lunch programs this year. As for physical education, well, educators are realizing that PE may be the only time a child gets exercise, but many schools will have to cut funds somewhere else to bring physical education back.

KEN STANTON, UNIVERSITY OF BALTIMORE: That's been a bit more of a tough battle, even though we are very convinced that it's one of the important pieces of what we need to do. GUPTA: And that's why the face of physical education is changing. For example, West Virginia schools are incorporating active video games into their curriculum. The videos are relatively inexpensive and get the kids moving without having to hire special Phys Ed teachers.

(END VIDEOTAPE)

GUPTA: So there's some solutions there as well. And overall, the experts we've spoken with say schools have made some significant strides since last year, but they need to keep the momentum going by looking for ways to fund these obesity programs and work with parents and other groups to ensure the kids are living healthy at home as well.

Now just ahead on HOUSECALL, some new recommendations out there for sunscreens. You're going to want to see this. Stay tuned.

(COMMERCIAL BREAK)

GUPTA: You know, if you find all the numbers and initials confusing on sunscreen, you're not the only one. The FDA is proposing new regulations for sunscreens that may clear things up. What they want specifically is a ratings system for UVA protection. It's going to be one to four stars and it would actually be printed on the bottle. They also want a warning statement on the label that would talk about skin cancer and reminding you to reapply sunscreen every two hours. Proposed rules also will require mandatory testing of sunscreen products in the laboratory and on people before being approved.

Well, unfortunately, we're out of time for this morning. Thanks for watching. Make sure to watch next weekend as well for another edition of HOUSECALL. Also, e-mail us your questions at housecall@CNN.com.

Remember, this is the place for the answers to all your medical questions. I'm Dr. Sanjay Gupta. Have a good day.

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