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HOUSE CALL WITH DR. SANJAY GUPTA
Pregnant Women and Seat Belts; What if Your Doctor is Addicted to Drugs or Alcohol?; Will Autism Become a Campaign Issue?; You Don't Have to Diet to Lose Weight
Aired April 5, 2008 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL. We're making the rounds this morning on some of the top medical stories affecting your health and your safety.
Pregnant women and seat belts, many worry their baby can be hurt. We have breaking news on this. And I'll show you the right way to buckle up.
Plus, what if your doctor is addicted to alcohol or drugs? What are your rights?
Then, our continuing investigation of autism. Do the presidential candidates have an agenda? Will autism become a campaign issue?
Finally, you don't have to diet to lose weight. See how one woman made big changes without dieting.
But we start with new information just out that can help you save someone's life. Really important. You heard the report here on CNN first. A new study showing that mouth-to-mouth breathing isn't necessary when doing CPR.
Now the American Heart Association is recommending chest compressions only for lay people who step in to help adults suffering cardiac arrest. Keep in mind, sudden cardiac arrest kills 900 people every day.
Now everyone at home should take a course at some point to learn CPR, but in the interim, here's what you can do to help. Actually kneel down, put your dominant hand down first, use your heels of your hand, and really put it in the middle of someone's chest. But you want to do is get your shoulders well over the elbows and start pushing down about 100 times a minute. You want to feel the chest contract and then come back up again.
Now keep in mind, only about 27 percent of people as things stand now actually jump in to help someone suffering a cardiac arrest. The hope is that doing chest compressions only will bring those numbers up if people don't have to do the mouth-to-mouth.
Now remember to call 911 first. These recommendations for CPR fall in line with the story we brought you just weeks ago about paramedics in Arizona using compression only CPR. Found amazing stuff, a three times greater survival rate. But the Heart Association is still not recommending health professionals adopt the no breathing technique.
Now, if you ever thought wearing your seat belt while you're pregnant could harm your baby, well, think again. New research out this week shows pregnant women who wore seat belts had an 84 percent reduction in bad outcomes like a miscarriage if they were in an accident. This is very strong evidence that it's better to buckle up than not to buckle up.
Now, I've heard women say it's uncomfortable to wear seat belts toward the end of pregnancy. So I wanted to show you how moms to be could buckle up the right way.
GUPTA: There are a couple things you want to keep in mind when buckling your seat belt if you're a pregnant woman. Pearl Simone here is 31 weeks pregnant, has agreed to help us.
Go ahead and put your seat belt on here so then we'll demonstrate. First thing, you have two straps. The abdominal strap, you want to make sure this is low and tight as possible. One common misconception, if there is an accident, it actually tightens up on the sides here as opposed to on the belly. So it shouldn't really be dangerous to the baby.
Also, if it doesn't fit, you can think about using a seat belt extender. As far as this upper strap, you want to start just as Simone did across the side of the stomach, coming up the middle of chest and then land sort of in the middle of the collarbone on the one side here. That's the best way to put the seat belt on. Again, low and tight and across the middle of the collarbone.
GUPTA: There are two more big headlines affecting your health this week. Doctors are being urged to return to tried and true treatments for high cholesterol. That's because a new study suggests that cholesterol lowering drug Vytorin is no better than generic drugs already on the market. Now while Vytorin does lower bad cholesterol, or LBL, researchers say it does not eliminate the buildup of artery damaging plaques, no more effective than generic statins.
Also in the news, experts warn insomnia may be a risk factor for developing depression later in life. A new study finds people with insomnia lasting more than two weeks are almost twice as likely to go on and develop depression. And at least 80 percent of depressed people experience difficulty falling or staying asleep.
Just ahead, we'll tell you the single most important thing you need to bring to your doctor's appointment.
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UNIDENTIFIED FEMALE: Dr. Brian West looks good on paper. A board certified Stanford educated plastic surgeon. Missing from his resume? Dr. West is an alcoholic.
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GUPTA: A confidential program helping doctors recover from addiction, but are patients hurt in the process? CNN investigates. Stay tuned.
GUPTA: And we're back with HOUSE CALL, the show that helps you live longer. That's one of our goals here. You know, an integral part of that is being your own health advocate. We're often telling you what you need from your own doctor, but this morning medical correspondent Elizabeth Cohen here is to tell us what your doctor needs from you.
What does the doctor need?
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: You know, you can really help your doctor help you. And people don't often think of that. So we have some tips for how to help your doctor do his or her job even better.
The first thing that you can do is realize that you've got a limited amount of time with the doctor, so make that time work for you. Use it wisely.
First of all, bring in a list of medications that you can just hand to the doctor saying, I take this, I take this dosage, and I take it this frequently. That's so important.
And secondly, bring in, write it out, a list of your top three concerns. What are the top three reasons that you are there to see the doctor? And that way, Sanjay, you're not there kind of hemming and hawing and trying to remember what you wanted to talk about. You have it right there in front of you.
GUPTA: It makes it a much more efficient visit for sure. So sometimes they'll refer you to a cardiologist, to a rheumatologist. And the doctors are all saying things, but not necessarily talking to each other. How do you get them to work together?
COHEN: It's a huge problem. It really is a big problem. And so one thing that you can do is when you finish with a specialist, say can you please get me a copy of the notes from this visit? And that way, you can have those notes in your hand when you go to see another doctor and hand it to that doctor. So you're not remembering oh, I think Dr. Smith told me this, but I'm not sure. You have it in black and white. Just get a copy of the notes.
GUPTA: So many people love your tips, Elizabeth. Really good stuff. I appreciate that very much. You can also check out more of her column at CNN.com/empoweredpatient.
What you should know about your doctor before going under the knife. It's amazing stuff and that's next. And later, are most important health issues at the top of the president candidates agendas? We're going to hear from McCain, Clinton, and Obama. All that's on HOUSE CALL. Stay with us.
GUPTA: Welcome back to HOUSE CALL. What rights do patients have if their doctor is an addict? And are doctors getting special treatment? Well, there's a controversial program in California that helps doctors deal with their addiction privately.
Here's CNN's Randi Kaye with our HOUSE CALL investigation. I'm warning some of the video you're about to see is extremely disturbing.
RANDI KAYE, CNN CORRESPONDENT (voice-over): Dr. Brian West looks good on people. A board certified, Stanford educated plastic surgeon. Missing from his resume, Dr. West is an alcoholic and a member of a special program in California called the Physician Division Program, which allows doctors to secretly get treatment for addiction while continuing to operate on patients.
Would you have liked to have known that your doctor had a substance abuse program before he treated you?
UNIDENTIFIED FEMALE: Absolutely.
UNIDENTIFIED FEMALE: Sure.
UNIDENTIFIED FEMALE: Absolutely.
KAYE: These are some of Dr. West's former patients. And this is what they say he did to them, the result of a common procedure where abdominal muscle is used for breast reconstruction or tummy tucks.
UNIDENTIFIED FEMALE: I had a hole in my abdomen that would not heal.
UNIDENTIFIED MALE: There was nothing but plastic mesh holding my wife's insides in.
UNIDENTIFIED FEMALE: He took a scapula and cut me back open so I would heal better.
KAYE: Former patients say Dr. West butchered them and that he frequently smelled of alcohol and looked flushed. Dr. West declined our request to interview him, but his lawyers said there's no evidence he ever treated a patient while under the influence of alcohol.
Becky Anderson had a mastectomy after learning she had breast cancer. Dr. West used stomach muscle to perform a breast reconstruction, leaving her with a volleyball-sized pouch.
BECKY ANDERSON: This is what I have now. And so, this is my intestines. Just covered by a skin graft right here. KAYE: That was last year. Becky had to forego cancer treatment while battling complications from the surgery. And today, she is dying of cancer, too sick to be interviewed.
If only she'd known about Dr. West's two convictions for driving under the influence. One of them, on the way to treat her. He later lied about the DUI, blaming the missed appointment on a car accident.
She sued Dr. West. He never admitted any fault, but settled for more than $250,000.
(on camera): Here in California, the state Medical Association says there are about 200 to 400 doctors in this program on any given day. And a nationwide study found about one percent of all physicians in the U.S. are in confidential treatment. That's about 8,000 doctors. 8,000 doctors whose patients have no idea they're addicts.
In California, five program audits since 1982 found a string of failures. Physicians appointed underlings as monitors. The medical board found Dr. West's office manager, who was also his program appointed monitor, forged Alcoholics Anonymous sign-in logs for him. And the board also found the random testing for drugs and alcohol was anything but.
JULIE D'ANGELO, PERFORMED 2004 AUDIT: The drug testing was, in a word, ridiculous. They were using untrained collectors who were not collecting samples on the random date generated by the computer. Instead, there were routinely doing it on days the physician could anticipate.
KAYE: California's medical board, which oversees the program, decided to abolish it come July, saying it failed to protect patients. Still, one powerful state agency is fighting to keep the program alive and keep the names of doctors enrolled confidential. Keeping them honest, we'll ask them why.
D'ANGELO: How many people do they have to hurt or mutilate before something gets done about it?
GUPTA: Do you know about one percent of all physicians practicing in the United States are in confidential treatment programs? That's right. The question is how does a patient know? And how do you protect yourself?
Here once again, CNN's Randi Kaye.
KAYE (voice-over): Sharon Mikulecky had a mastectomy after learning she had breast cancer. So she went to California plastic surgeon Dr. Brian West for breast reconstruction. Neither Sharon nor her husband were aware Dr. West was an alcoholic, had two DUI convictions, and would soon secretly enroll in a state rehab program that requires outside treatment and lets him continue operating on patients while keeping the addiction confidential.
KEN MIKULECKY, WIFE SAW DR. WEST: When that person's right to privacy hurts other people, harms other people, that should not be allowed to happen.
This is the second hospital that we were in.
KAYE: Ken Mikulecky says Dr. West operated using abdominal muscle to rebuild the breast. His wife's incision became infected, leaving a gaping hole in her abdomen.
MIKULECKY: She told me several times that she could smell alcohol on his breath. Until the day I die, I've got to live with that. And that hurts pretty good, because I didn't believe my wife.
KAYE: Dr. West refused to be interviewed for this story, but Ken Mikulecky's says his wife was so weak, she had to postpone cancer treatment for about a year. In 2003, cancer killed her.
Do you think that your wife would be alive today if she hadn't been treated by a doctor who was an addict?
MIKULECKY: I think she would have had a better shot at surviving.
KAYE: Have you forgiven him?
MIKULECKY: Yes, I have. That's between him and God. I've got my own soul to look after. I just want him to stop.
KAYE: Mikulecky and some of these former patients, along with California's attorney general are petitioning to have Dr. West's license revoked. The California Medical Board says Dr. West flunked out of the state diversion program, was placed on probation for five years, and could not operate for one year.
(on camera): Don't patients have a right to know if their doctor is abusing alcohol or drugs? Wouldn't you want to know? Keeping them honest, we asked the head of California's Medical Association why the program must remain a secret and why he's fighting to keep it alive.
JOE DUNN, PRES., CALIF. MEDICAL ASSOCIATION: We believe very strongly this is the absolute best way to ensure patient safety. We need to get physicians out of the shadows.
KAYE (voice-over): The Medical Association President Joe Dunn argues if this program shuts down in July, doctors will continue to feed their addiction privately and not get help. Why shouldn't a patient know if there were going in for surgery or just going in for a consultation that their doctor had a drinking or drug problem?
DUNN: Without a diversion program, no one knows. Patients don't know, health professionals who could help don't know. KAYE: Nearly every state has a similar program. And a recent nationwide study found they have an 80 percent success rate. His lawyer tells CNN Dr. West is back in the program and has been in recovery for years. But that's no comfort for his former patients and their loved ones.
MIKULECKY: I don't want to see any more people get hurt, any more innocent people go under the knife because people are hiding other people's addiction. I want to see that stopped.
KAYE: Despite the claims against him, Dr. Brian West is back in business operating on patients in Beverly Hills.
GUPTA: Well, that was CNN's Randi Kaye reporting.
A few more facts for you. These programs she was talking about last eight to ten weeks. And during treatment, doctors cannot practice in case you were curious about that. They're also required to go through a series of tests to prove they're sober and they have good cognitive function. Doctors must also have to read and participate in a monitoring program. If they don't do that, they can lose their license.
Now, we have some new information out this week on preemies and the links to autism. The smallest of survivors may have a bigger fight ahead. I'll have all the details and that story coming up.
And who you vote for could determine how your insurance deals with big health issues like autism. Where the candidates stand, we're going to have it in 90 seconds.
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UNIDENTIFIED FEMALE: Julius is amazing. He is resilient. He's changed my whole outlook on life. We live every moment to the fullest.
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GUPTA: New developments in the search for answers about autism. For the first time, researchers have linked premature birth to the disorder. A new study finds 25 percent of babies born extremely premature showed signs of autism. Experts we talked to stress babies born at this age, we're talking about 10 weeks early, are at risk for many complications and developmental problems, not just autism. Yet researchers suggest early screening might be warranted in this high- risk population.
And for all infants, there are some early warning signs. For example, has your baby developed a social smile by age three months? Does your baby make eye contact? Language is a key element of diagnosis. So if your baby doesn't say single words by 15 months, or two word phrases by 24 months, ask your health provider, but make sure to remember that all babies are a little bit different.
Regardless of development, the American Academy of Pediatrics recommends all children be screened by the age of two.
Now, every expert we've talked to agrees. More money, more support is needed to help with that diagnosis and those treatments. So we went to the people who may soon hold the key to that future funding, seeing where the presidential candidates stand on autism.
GUPTA (voice-over): John McCain caused quite a stir when he linked autism to childhood vaccines.
SEN. JOHN MCCAIN (R), PRESIDENTIAL CANDIDATE: There is strong evidence that indicates that it's got to do with the preservative in vaccines.
GUPTA: And that's a widely held view, but mainstream scientists say it's wrong, mainly because the preservative Senator McCain referred to is no longer used in childhood vaccines. And the autism rate is still going up. A few days later, McCain backed off.
MCCAIN: And we don't know what's causing the increase in autism.
GUPTA: But the episodes showed that autism can be an election issue.
SEN. BARACK OBAMA (D), PRESIDENTIAL CANDIDATE: It is reaching epidemic proportions.
GUPTA: All the candidates say they would fund more research into what might be making children sick, but Democrats say they would make sure insurance companies cover therapy for children with autism by not allowing it to be classified as a pre-existing condition.
SEN. HILLARY CLINTON (D), PRESIDENTIAL CANDIDATE: Something is causing this.
GUPTA: Senator Clinton also promises to create a special task force to identify which treatments work best and says she wants to provide care to families faster once a child's been diagnosed.
CLINTON: We've got to have services that are available so that families can know that there's some help there.
GUPTA: Like Clinton, Senator Obama says he'll give more money to schools for screening to make sure children with autism are diagnosed early and to improve special education classes.
OBAMA: And what I've said is, we're going to start fully funding special education.
GUPTA: In fact, when it comes to education for children with autism, the candidates basically agree. MCCAIN: I would do everything in my power to try to help find the cause and to help with the education, so that these young people can lead useful lives and contribute to our society.
GUPTA: McCain says he would promote early screening and research to find effective treatments for autism.
Of course, without a known cause or a cure, autism will be a daunting challenge for the next four years and beyond.
GUPTA: CNN is covering autism on a global scale. Beyond the sound bites, you'll find interviews, expert blogs, and stories of hope at CNN.com/autism. Also on CNN.com, our "Fit Nation" weight loss stories. This woman says don't diet. She thinks the answer to losing weight can be found on the Internet. And she shares her story with us. That's next.
GUPTA: We're back with HOUSE CALL. Sharon Twitchell is using her computer in her battle against weight gain and all the health problems that can come with it, but can it help her lose the 100 pounds necessary to return to a healthy weight? By all accounts, Sharon Twitchell lived a quiet suburban life, but she had a darker side.
SHARON TWITCHELL, WEIGHT LOSS SUCCESS: I would find any reason to eat. And I would do a load of laundry and reward myself for doing a load of laundry. I had stashes in the house hidden away. And I was doing basically the same thing that an alcoholic does.
GUPTA: Frightened by her actions, she decided to seek help.
TWITCHELL: I went to my doctor hoping, of course, for the little magic pill, which we all know it doesn't exist, but in our hearts we hope it does. And I saw the "W" start to form on his lips. And I said, don't go there. Don't say Weight Watchers. I won't go to the meetings.
GUPTA: Her doctor persisted, suggesting the online version of Weight Watchers instead, but could an online program be as effective as face-to-face interactions?
TWITCHELL: It's good because it keeps me in check. If something goes in the mouth, it goes in the computer.
GUPTA: She was diligent in recording everything she ate as part of the Weight Watchers regimen, and began exercising six times a week. She never set foot at a meeting. Now more than 100 pounds lighter, Sharon says her weight loss has completely changed her life and her marriage. TWITCHELL: My husband went out and bought a new diamond wedding band for me. And as he slipped it on my finger, he said this is a renewal of our vows. And it has. I mean, we had a partnership for about 15 years. Now we actually have a marriage again. My name is Sharon Twitchell and I've lost 110 pounds.
GUPTA: And you can read more about Sharon's story online at CNN.com/fitnation. We also want you to share your own weight loss success stories by submitting an i-Report on the "Fit Nation" Web site. You can tell your story right here on HOUSE CALL.
Remember, we're here every weekend with the answers to all of your medical questions. Also, download my podcast at CNN.com/podcast or on i-Tunes. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.
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