Friday, July 13, 2007
TB testing
As someone who grew up in Germany and probably was vaccinated against TB as a child, I've been following the Andrew Speaker case on a personal level - not just as a journalist.

Thursday's revelation that one of the passengers on Speaker's flight back to North America tested positive brought back memories for me. That's because it reminds me that people can test positive for TB without having it. I'm one of those people.

I remember quite vividly being in 3rd or 4th grade and having one of my classmates shout "ew, she has the disease, she has the disease" because I had what looked like a round rash 2 days after getting 5 pricks from a TB tine test (nowadays a single injection is used). I didn't think I was sick and a follow-up x-ray showed my lungs were fine. But the impact was lasting.

I had a couple more TB tests administered while I was in school. But at least I was prepared now. I knew to expect the round redness on my forearm and another set of chest x-rays. Each time I was negative. Why was I testing positive? I may have been given a TB vaccine (I haven't checked my vaccine records in decades). TB vaccine was not commonly used in the U.S., but Europeans did use TB vaccine and it can cause a positive TB test. Or I may have come in contact with someone who had TB. In the end I was always told that I didn't have TB. But to this day, it's with me. When I go to the doctor and go over my medical history, I'll tell the doc I always test positive for TB.

So now, Andrew Speaker is being sued by 8 fellow passengers. Speaker, a 31-year-old Atlanta, Georgia, lawyer, caused an international uproar when he disregarded doctors' advice and traveled abroad to get married, potentially exposing his fellow passengers to the disease.

According to the attorney filing the lawsuit, one of these passengers, who was on the same flight from Prague to Montreal - a 72-year-old man- had tested positive for TB on a skin test. Follow-up x-rays have come back normal, but he's still waiting for further test results.

Could Speaker have infected him on the plane? His own physician, TB expert Dr. Charles Daley tells CNN this positive skin test result is "absolutely not related to Andrew Speaker." And Canadian health officials say so far "no active TB cases have been identified among the 29 passengers."

Why not? This passenger tested positive just 6 days after being on the same plane as Speaker. Not enough time has passed. Several TB experts tell us that a minimum of 2 weeks have to pass before a test would come back positive, if this man had been infected by the attorney from Atlanta.

If any of the other passengers stay TB negative for 2 months (which is just 11 days away), they can be sure they were not infected by Speaker, experts tell us.

The 8 passengers are suing Speaker because they feel he intentionally disregarded their safety. Do you think he did?
Wednesday, July 11, 2007
My conversation with Michael Moore
Last night on Larry King, I had a chance to sit and discuss health care with a man I admire. It is true. Michael Moore has been able to get people talking about health care policy in a way that I haven't seen in a long time. It is important, because we both agree on the need to fix the health care system. It is shameful and heartbreaking that so many people don't have access to what most consider a basic human right. An uninsured person in this country is forced to make impossible decisions every day, such as choosing between food and medications. They live with the constant fear of getting sick or injured and then suddenly finding themselves in financial ruin. Even for the insured, the system seems broken and antiquated. Most everyone who reads this, whether you are a doctor or a patient, agrees that the time has come for a change.

Michael Moore and I agree on these points. In fact, after the segment ended on Larry King last night, we chatted for a couple of moments off the air. It was friendly and he seemed appreciative that we had a chance to discuss some of these issues. He reminded me that we are both from Michigan, although he favors the Spartans and I am a die hard Wolverine fan. He also reminded me that he has been working on Sicko for a long time and wanted to be recognized for his efforts. And, I do recognize that. Sincerely.

I also think, though, that it is important to get the facts absolutely right and to be transparent about the sources of those facts. Michael knows that I took issue with the "cherry picking" of some numbers to try and bolster his argument. He cited an unsourced BBC report when talking about per capita Cuban spending. That same report also talked about US per capita health spending, but he apparently didn't like that number, so instead he used a projected number from a different study. I worry that comparing apples and oranges purposely, and perhaps needlessly, muddy the argument. To be clear, I got a number wrong in my original report, substituting the number 25, instead of 251. It was not deliberate, but an error of transcription. I felt awful it happened. I did correct it and apologize.

I also worry that Michael, who is an accomplished film maker, tried to leave people with the impression that health care is free in many other nations and there is a state of utopia. True, Michael did talk about increased taxes in his film, but he also kept calling it "free," which made it nebulous. No question, there are many valuable things to learn from other health care systems, but we should know all things before wholeheartedly endorsing one system over another. We should know that taxes will be much higher, as is the case in France where they are crippled by their health care system. We should also know that a significant number of people in these countries still buy supplemental insurance, apparently unhappy with what the government alone can provide. We should also remember that Medicare, an example of a limited national health care plan in the United States, is expected to go bankrupt by the year 2020. If there is a new national health care plan, we want it to be around for a very long time and to provide the sort of health care that we deserve. Personally, I believe that adopting a much more prevalent prevention model is an important first step. Keeping people from getting sick in the first place may cost more in the short run, but it is medically and morally the right thing to do.

Judging by the response over the past few days, people are very passionate about these health care issues. I think I can safely speak for Michael, when I say, that is the best news of all. I was a bit baffled, though, that Michael took such issue with my reporting in Iraq. I reported on a group of Navy doctors who worked hard to address the consequences of those booms and explosions we watched on television. They risked their lives everyday to save and improve the lives of others. I think about them everyday. I wish Michael would've watched some of that reporting before being so critical.

Although Michael accused me of it, I have never shilled for a corporate sponsor and I never will. What I will do is try and present solid reporting on the complexities of a health care system in disrepair, no matter who it makes uncomfortable - be they powerful vested interests or filmmakers.

On a final note, Michael has told people at CNN that he regularly receives nasty email and even death threats. As I have been thrust into this world over the past couple of days, I understand what he is talking about. If you want to contribute to the discussion, please try and keep your comments constructive.
Monday, July 09, 2007
A workout for your mind... and body!
Dr. James Levine works at his treadmill desk
Like any good journalist, I try to go into a story with an unbiased view. "Just the facts, ma'am" is my motto. But before I even arrived at the Mayo Clinic, in Rochester Minnesota, to produce a story on a treadmill built into a desk, I was rather skeptical. The story was simple. A doctor named James Levine, had designed a piece of office equipment for the Mayo Clinic that not only housed a computer and a phone, but a full-sized treadmill. The idea was to keep moving while doing your desk job.

Now I don't know about you, but the idea of walking at the same time you're writing a report or taking an important phone call was a little iffy for me. How was that possible? How could you concentrate? Yet when I arrived at Dr. Levine's office (equipped with two desks and two treadmills), he was already typing a manuscript while putting in his daily walk on the machine. He was doing it -- why couldn't the rest of us?

"Why not do the interview from the other treadmill?" he said. Ok! I was up for it! I had worn flats. I was ready.

First off, I found that the machine's tread moves slowly, about one mile an hour. And it's more of a natural movement; your feet just kind of get into it. After about 10 minutes you don't even feel like you're walking at all. It's very peaceful...very "Zen" like. I loved it. Not only was I doing the interview on the treadmill, (the photographer was on the treadmill with me!!!) but my heart rate seemed to go down. My mind was clearer. I was relaxed!!!!

The treadmill desk is a just part of a master plan of Levine's called the "Office of the Future.” He envisions a workplace equipped with exercise machines, including walking paths employees could use while working in an office setting. He's even patterned the "Suit of the Future," made out of lightweight material that you can wear to exercise in and then walk right into a boardroom meeting and not even kick up a sweat. It's all designed to help sedentary workers get active without losing precious time.

Levine says that on the average, an employee can burn about 150 calories an hour using the treadmill desk. Some doctors will tell you, you can get just as much exercise and burn just as many calories by taking a 20-minute walk for lunch. But Levine says in today's workplace, many employees never get to leave their cubicles. His thought: If they can't get to exercise, bring the exercise to them. Levine has already found a major corporation that will be providing the machines to its workers on a trial basis.

As for my treadmill experience? After about 20 minutes on the machine, I had gotten my interview and a pretty nice workout. I felt refreshed and ready to take on more work. It was invigorating and fun, and all it took was a little bit of energy to get on the machine and keep going. No longer a skeptic, I'll be calling my boss to see if we can have a few treadmill desks in our office!

Would you want a treadmill at your desk? Do you know of other ways for office workers to keep fit at work?
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