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HOUSE CALL WITH DR. SANJAY GUPTA
Hospital Calls 911; A Woman's Brain on Menopause; Life-Altering Problem Americans Face; Should Parents Give Children Anti-Psychotic Drugs to Lose Weight?
Aired September 15, 2007 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA: Thanks, guys. This is HOUSECALL. We're making your rounds this morning.
First up, a shocking story. It's a hospital actually calling 911 for help with one of its own patients.
Then, some women say it makes them a different person, and not in a good way. Menopause and what can be done to help.
Plus, help for an often life-altering problem millions of Americans face every single day.
And later, parents giving their children anti-psychotic drugs to help them lose weight. Now is this going too far? We're going to be bringing all of that to you in just a moment.
But first, most people believe hospitals have doctors in-house at all times in case of an emergency, right? But some specialized hospitals are cutting costs by cutting staff. In fact, one counted on 911 to save the day when things went wrong.
CNN's Gary Tuchman reports.
GARY TUCHMAN: This is Steve Spivey's father, his mother, and wife. What they went through when Steve was in the hospital was harrowing.
TRACY SPIVEY, WIFE: He was panicking, very scared. I had never seen that kind of fear in his eyes ever.
TUCHMAN: Steve Spivey, a father of three, was in this Abilene, Texas hospital for neck surgery after a truck accident. The operation seemed to go well, but the 44-year-old started to choke that night. His wife was at his side.
SPIVEY: Nurses felt like he was just having a panic attack. And the last words he said were "No, I'm in trouble."
TUCHMAN: The hospital Spivey was in is one of about 140 in the country owned by the physicians who work there. But all the doctors had gone home for the day when Steve lost the ability to breathe.
SPIVEY: His eyes were bright green. And they turned very dark. His face turned dark. And he grasped my hands and shook like this, looked me in the eyes, and then closed his eyes, and went out. That was his last breath.
TUCHMAN: Tracy Spivey kept yelling to call a doctor. But in the meantime, incredibly, she says she performed CPR by herself for 15 minutes.
SPIVEY: There was no pulse. I checked, you know, three different places for a pulse and could find none. And I told them, we have no pulse. And one of the nurses said, "what's wrong, what's happening?" And I said, "He's dying."
TUCHMAN: About two hours after Steve started gagging, the surgeon arrived.
SPIVEY: All I heard was the surgeon yell very loudly to call 911.
TUCHMAN: And were you stunned that here you are at a hospital and they're calling 911?
SPIVEY: All I can remember saying is looking at him and saying, "you've got to be kidding me."
TUCHMAN: Steve Spivey was pronounced dead at a different hospital. This week, Tracy went back to the hospital with her attorney as they met with the hospital lawyer in preparation for a likely lawsuit.
DARRELL KEITH, SPIVEY FAMILY ATTORNEY: I look forward to being their champion.
TUCHMAN: Darrell Keith is her lawyer.
KEITH: Well, I think that the physician-owned hospitals as a general rule tend to be more, you know, profit-driven than patient safety-driven.
TUCHMAN (on camera): After the death of Steve Spivey, the federal government decided to no longer allow the use of Medicare at this hospital. And now the facility is shut down.
(voice-over): The hospital's CEO did not want to go on camera, but did tell us "911 is a last resort to Mr. Spivey's case. We were trying to get the patient to a higher level of care." He also said the facility may reopen some day in a different form. At another physician-owned hospital in Arlington, Texas...
GREG WEISS, USMD HOSPITAL AT ARLINGTON: If we treat every patient like a family member, the patients will want to come here, the referring doctors will want to refer here.
TUCHMAN: Doctors are in the facility around the clock. The physicians here at USMD reject the broad-brushed criticism they hear about doctors owning hospitals and have immense pride in their facility. JOHN HOUSE, DR., PHYSICIAN/OWNER, USMD HOSPITAL: We want a place where we can take care of our patients the way that we want to take care of our family members. And we have the ability to do that by owning and controlling our own facility.
TUCHMAN: But some members of Congress want to take a closer look at how these types of hospitals are regulated.
REP. PETE STARK (D), CALIFORNIA: The hospitals are often second rate, sometimes illegal. And it takes profitable business away from community hospitals.
TUCHMAN: Tracy Spivey still has nightmares about when she told her 10-year-old daughter the horrifying news.
SPIVEY: I just pulled her in my lap and held her. I told her I needed her to be real strong. And I said, "Baby girl, our daddy got very sick." And I told her daddy's not coming home.
TUCHMAN: Tracy still can't believe a hospital had to dial 911.
Gary Tuchman, CNN, Abilene, Texas.
GUPTA: Wow, Gary, yes, thanks. What a horrifying story. And to be clear, different hospitals offer varying levels of care. For instance, I work at a level one trauma center. And what that means is that we have emergency rooms, surgeons, anesthesiologists, and blood available 24-7.
Now smaller hospitals, whether they're private or not, are probably a lower level, meaning they're not required to have the same amount of readiness. There are things you should look for to make sure a hospital is prepared for any complications you might experience.
For example, a doctor should be present at all times. It should have a full lab to run tests, if necessary, and basic emergency equipment and personnel trained to use those as well. An extensive pharmacy should be available on site so you can be treated with medications immediately. And if you require an operation, the hospital, obviously, needs to have an anesthesiologist.
Perhaps most importantly, the hospital needs to have a pre- existing transfer arrangement with a larger, more well-equipped facility so patients can be quickly and more efficiently moved, if necessary. So make sure to ask for those things of doctors before scheduling any sort of operation, any procedure at all.
Now just ahead, a woman's brain on menopause.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: I was scared, and I was very irritable. It was like being a different person. (END VIDEO CLIP)
GUPTA: What's going on in the brain to make women feel that way? Plus, what works to help?
And kids prescribed amphetamines for weight loss. Are the results worth the risk?
And then later, the nation's largest food program facing cuts that could keep kids from getting their fruits and vegetables. Stay tuned.
GUPTA: Welcome back. Search for menopause in medical study databases, and you'll find more than 37,000 mentions. Many of them, it may seem like, talking about what doesn't work.
Here now,then a look at the latest science on what does work, and why it can be such a difficult time.
GUPTA (voice-over): Most see Pat Dodson living a charmed life. Her 60th birthday last year at her home, an old San Francisco speakeasy. Her life, a whirlwind of political campaigns and parties. A stark contrast to 14 years ago, when her mood crashed.
PAT DODSON, SYMPTOMS OF MENOPAUSE AT 41: I was scared and I was very irritable. I was like being a different person.
GUPTA: Throughout her 30s and 40s, Dotson juggled family life with career. At 47, she began having problems sleeping. Her tipping point, the day she confronted her husband with a list of his flaws.
DODSON: I was feeling alone. I was feeling angry. I was feeling sad. I was feeling as though I should get a divorce.
GUPTA: While there is no research suggesting a solid link between divorce and menopause, after the age of 50, 65 percent of all divorce papers are filed by women. But luckily for Dodson, before it went that far, she found neuropsychiatrist Dr. Louanne Brizendine, who told her like 30 percent of all women, her trouble sleeping was an often missed sign of menopause.
LOUANN BRIZENDINE, DR., NEUROPSYCHIATRIST: The biggest complaint in my offices often, intense irritability, decreased libido, and lots of times, mood fluctuations.
GUPTA: Brizendine says when women reach about 51 years old, the experience a seismic shift in hormones.
BRIZENDINE: Our estrogen and progesterone starts to have our brain fluctuating on a wave up and down estrogen, progesterone through our menstrual cycle. So that changes our reality as we go through our cycles. GUPTA: How do you manage menopause? Citing a recent breast cancer study, the FDA's revised guidelines state "Hormone therapy should be used for short-term relief of menopausal symptoms." Brizendine says she prescribes hormones just to get over the transitional bump of menopause, but she also prescribes antidepressants.
BRIZENDINE: Small doses that just take the irritability off and rebalance in the brain things that things that estrogen usually does most of our lives, but is now becoming erratic.
GUPTA: Dodson now exercises daily and briefly took hormones and antidepressants. Now at 61, she's experiencing menopausal zest.
DODSON: It's not something to look at, you know, with any kind of fear. It's something for women just to make sure, I think, that they get the right kind of care.
GUPTA: And with the right information, women can have a new mindset toward menopause.
GUPTA: She does look really good there. And according to the American College of Obstetricians and Gynecologists, certain women should not take hormones, period. Women with a history of breast cancer or women who smoke.
As for taking a short course of hormones, we spoke to the doctor who co-wrote that group's guidelines on hormone therapy. And she said this, basically, if it ain't broke, don't fix it, meaning unless a woman really feels she needs help, she shouldn't take medicines. However, that same doctor, I should point out, says it's also wrong to stigmatize the women who feel that they need some kind of relief.
Now there's also new hope for another life-altering condition. Growing evidence suggests stuttering is neurological, not emotional, as so many have thought. And help may soon be on the way.
GUPTA (voice-over): For Ken Steinhardt, making a simple phone call can be nerve-racking.
KEN STEINHARDT, STUTTERER: Would you tell her that Ken S -- Ken, Ken, ah, Ken Steinhardt called?
GUPTA: Ken has stuttered since he was a little boy. For years, he tried to hide it.
STEINHARDT: I wouldn't talk unless I absolutely had to.
GUPTA: Some 3 million Americans stutter. Most people start stuttering when they first learn to speak. And boys tend to stutter more than girls. For years, the conventional treatment has been speech therapy. Often, children come up with creative ways to cope. GERALD MAGUIRE, DR., UNIV. OF CALIFORNIA, IRVINE: I remember in kindergarten, first, second grade, I would imitate cartoon voices in class when I would be called upon. Hello, my name is Donald Duck or whatever. I haven't done them for a while, but...
GUPTA: Jerry Maguire grew up to be Dr. Maguire.
MAGUIRE: I likely stuttered the rest of my life.
GUPTA: A psychiatrist and researcher at UC Irvine, Dr. Maguire is one of the world's leading experts on stuttering. He's one of a growing number who believes stuttering is not caused by a psychological weakness, but by an anatomical problem in the brain.
MAGUIRE: We're learning that stuttering is actually a miscommunication of the brain speech centers with the mouth, throat, and tongue in getting the words out.
GUPTA: To better understand, let's take a tour through the brain. First off, this is the basil ganglea (ph), which controls speech. In people who stutter, it is believed the striatum is bombarded with too much dopamine.
Maguire and other researchers believe this anti-anxiety medication called pagaclone, can control stuttering by controlling dopamine, with no side effects.
MAGUIRE: We found that the medication was effective in reducing stuttering in over half, in over half the patients.
GUPTA: Pagaclone doesn't cure stuttering, but it does curb it.
MAGUIRE: I believe that the future of stuttering treatment will combine therapy and medications both.
GUPTA: Ken Steinhardt has been participating in the clinical trial for over a year.
STEINHARDT: Move, move...
GUPTA: And while Ken still stutters, pagaclone has helped dramatically.
STEINHARDT: Well, now, I have a free flow of thought that I've never experienced before. It's kind of weird. It's like a, kind of a revelation.
GUPTA: A revelation that doctors hope other people who stutter will soon experience.
GUPTA: Now let's check in with Judy Fortin with this week's medical headlines. Judy?
JUDY FORTIN, CNN CORRESPONDENT: Thanks, Sanjay. More concern over the popular diabetes drug Avandia, a drug used by about a million Americans to control blood sugar. Patients taking Avandia for long periods of time doubled their risk of heart failure and were 42 percent more likely to suffer a heart attack. That's according to a new Wake Forest University School of Medicine study, which also showed no increased risk of death from the drug.
A New England Journal of Medicine report in May found similar risks, prompting the FDA to issue a black box warning on the drug. Avandia manufacturer GlaxoSmithKline continues to support the drug as safe and says the recent study was selected and limited. Concerned patients should speak with their doctor to determine what treatments are appropriate.
Well, here's a good reason to stay in school. Education may be linked to a lower risk of dying from cancer. According to researchers at the American Cancer Society, black and white men and white women who completed more than 12 years of schooling significantly reduced their likelihood of dying from lung, colon, prostate and breast cancers. Researchers say a possible explanation is that educated people are more likely to utilize screenings, have access to healthcare, and are more informed of risk factors.
Death and serious injuries from a drug treatment nearly tripled between 1998 and 2005, according to a new study analyzing the adverse drug event and medication errors reported to the FDA. The Department of Health and Human Services estimates these errors may cost individual hospitals up to $5.6 million each year. Study authors highlight the need to improve means of administering prescription drugs.
Sanjay, back to you.
GUPTA: All right, Judy, thanks. And stay where you are at home. Just ahead, anti-psychotic drugs being used for weight loss in kids. Some say it's morally questionable. Others say it's worth the risk.
And women and children who get government food vouchers, they may not be getting their five a day after all. Find out why later in the show.
GUPTA: We're back with HOUSECALL. Overweight kids are at risk for some very adult-like diseases, such as Type II diabetes, high cholesterol and high blood pressure. To help children get slim, some parents are willing to do what one doctor calls horrifying.
Elizabeth Cohen has this report.
ELIZABETH COHEN, MEDICAL CORRESPONDENT (voice-over): This is how Alex Veith keeps his weight down now. But from ages 11 to 16, this little pill is how he lost weight, Adderall and amphetamine, a prescription drug intended only for people with Attention Deficit Disorder. Alex never had ADD, but in a controversial move, his doctor prescribed it to him to lose weight.
LISA VEITH, ALEX VEITH'S MOTHER: Within a year, he -- pictures can show that he definitely drastically changed.
COHEN: Here's Alex in fifth grade, Alex in sixth. On Adderall, he went from being 30 pounds overweight to being a normal weight. His parents were relieved. They tried everything to help him lose weight. They feared other kids would start teasing him. And his doctors said Alex was headed for serious health problems. But Adderall, a well known appetite suppressant, cut his appetite in half.
ALEX VEITH, USED ADDERALL FOR WEIGHT LOSS: You should saw everyone else when I went back to school that next year. I mean, everyone didn't believe it was me.
COHEN: Dr. Fuad Ziai, Alex's pediatric endocrinologist, says he's put hundreds of children who don't have ADD on Adderall, specifically to help them lose weight. And he's almost never disappointed.
JOHN LANTOS, DR., UNIVERSITY OF CHICAGO: Stick your tongue way, way out there.
COHEN: But this pediatrician and every other one we talked to is horrified.
LANTOS: Doctors who prescribe this could end up killing kids. Amphetamines can be habit-forming. And they have serious side effects.
COHEN: The Food and Drug Administration recently warned about sudden death when some people take ADD drugs and have underlying heart problems. The agency also warned that some people on drugs like Adderall develop psychiatric problems, hearing voices, becoming manic. But Dr. Ziai says he's seen few side effects, and they're far outweighed by the advantages. There's an obesity epidemic among kids. And he says he's getting results.
COHEN (on camera): I've got to tell you, other doctors we talked to, they think this is crazy to give a kid an ADHD drug when they don't have ADHD.
FUAD ZIAI, DR., PEDIATRIC ENDOCRINOLOGIST: I respect their opinions, but I'm sure that I would be very happy to have them review the cases that we have had.
COHEN: According to Dr. Ziai, Alex was headed towards severe obesity and Type II diabetes. Now he's not. Dr. John Lantos says he's quite clear other pediatricians are prescribing Adderall for weight loss. They're just not out in the open about it.
LANTOS: it's morally questionable and medically questionable, so I don't think anybody's proud of doing this.
COHEN: Elizabeth Cohen, CNN, Chicago.
GUPTA: Now it's worth pointing out that Dr. Ziai disagrees and he says he's treated about 700 kids, about 90 percent of them successfully.
Now coming up, the government's largest food program facing cuts that could mean kids won't get fruits and vegetables. That story's just ahead.
GUPTA: We're back with HOUSECALL. The Women, Infant and Child Program is the largest government food program in America. It provides vouchers and nutrition information for millions of low-income women and children. It's already been lacking fruits and vegetables. And now the program is facing possible budget cuts.
GUPTA (voice-over): Although her husband works, Corina Alvarez still needs help when it comes to feeding and taking care of her year- old baby.
CORINA ALVAREZ, WIC RECIPIENT: I like for them to give me ideas, since I'm a new mom.
GUPTA: So every month, Alvarez receives checks for food from WIC. Now this is a federal grant program. And it's designed to improve the health of low-income women and their children by providing food and counseling on good eating and healthcare.
DOUGLAS GREENAWAY, REV., NATIONAL WIC ASSOC.: The foods that WIC provides are really the tools that reinforce that nutrition education message that's delivered in 10,000 WIC clinics across the country.
GUPTA: Since WIC was founded over 30 years ago, thoughts on nutrition have changed. You see, the problem then was malnutrition, not obesity. So most WIC vouchers are for cereal, breads, crackers, milk products. Checks for fresh fruits and vegetables don't exist.
So last August, the U.S. Department of Agriculture decided to add produce to the voucher system to give clients a more balanced diet. They are expected to be available next year. But some say that might not happen because WIC is on the chopping block, slated for a $145 million cut in President Bush's 2008 budget.
GREENAWAY: It really threatens the availability of fresh, frozen, canned foods and vegetables, the culturally-diverse foods, the changes that are needed to reduce the incidence of obesity and overweight that we're finding most with most mothers and children.
GUPTA: Nutritionists say that's not good because the WIC produce vouchers could help control obesity.
KATHERINE TALLMADGE, AMERICAN DIETETIC ASSOCIATION: Studies have shown that women and children and infants who participate in the program have improved nutrition. Mothers give birth to fewer low birth weight babies, which saves medical costs.
GUPTA: Congress is now debating the finances for WIC. The final decision will likely come in the fall. Until then, mothers like Corina Alvarez will have to continue waiting for produce checks to become available.
GUPTA: Now if there are no budget cuts in WIC, and if the fruit- vegetable vouchers go through, they should become available in the fall of 2008. So good news there. More HOUSECALL after the break.
GUPTA: Get your health information 24/7 by going to CNN.com/health. While you're there, click on my blog. Tell me your thoughts about today's health news.
Well, unfortunately, we're out of time for this morning. Make sure to watch HOUSECALL every weekend for the latest news about your health and the answers to all of your medical questions.
Thanks for watching. I'm Dr. Sanjay Gupta. Stay where you are for the latest headlines in the "NEWSROOM," which starts right now.
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