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SANJAY GUPTA MD
World's 1st Full Face Transplant; Jake Glaser: A Personal Story; Hands-Only CPR
Aired July 31, 2010 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN HOST: Good morning. I'm Dr. Sanjay Gupta. Welcome to the show. I'm on assignment in Los Angeles.
First up, imagine having a horrific accident and losing your face, you're identity, your very sense of being.
You're going to meet Oscar. He's the world's first full face transplant recipient.
And take a look at this animation. It's fascinating stuff. You got to see it.
Plus, Jake Glaser may look like any ordinary 20-something. But he has one incredible story. His mother transmitted the AIDS virus to him, and his sister.
His mother and his sister both died from the virus. And you're going to hear his personal story now of triumph and tragedy.
And if you thought you knew everything you were supposed to know about CPR, you're going to want to stick around. These tips might help you save a life.
Let's get started.
GUPTA: We start today with a groundbreaking surgery, the world's first full face transplant. His name is Oscar. He suffered a horrific accident -- and in split second, his entire life and his entire face changed.
This week, he made his first public appearance. How did he get here and how did his doctors do it?
We have a picture of the patient. It's a medical miracle, of sorts. But just to give you fair warning, some of these pictures might be disturbing.
GUPTA (voice-over): It's a disarming idea, living without a face. Imagine it, your identity, your portal to the outside world -- gone. And imagine that doctors could intervene, give you another face, one not your own but a face, nonetheless. It happened to Oscar, a 31- year-old farmer from Spain.
OSCAR, FULL FACE TRANSPLANT RECIPIENT (through translator): I wanted to thank the hospital coordinators, the entire medical team, the family of the donor, and most of all my family who are supporting me these days.
GUPTA: Four months after his operation, the world's first full face transplant. Oscar still struggles to form words with his new mouth, and yet mustering any words is a feat, especially considering the events that led him to this day.
Five years ago, Oscar accidentally shot himself in the face. And the split second it took to fire that blast, and everything changed for Oscar. But a transplant, a new face would not even be an option for it not for those who came before him.
Before Oscar, there was Isabelle. Isabelle Dinoire was the first to get a new face. She had a partial transplant in 2005 after being mauled by a dog. Her case widely considered a triumph.
Then, tragedy -- Li Guoxing died two years after his transplant in 2006.
CONNIE CULP, FACE TRANSPLANT RECIPIENT: I guess I'm the one you came to see today.
GUPTA: In 2008, there was Connie.
CULP: I got me my nose.
GUPTA: Connie Culp was shot in the face by her husband.
DR. FRANCIS PAPAY, CLEVELAND CLINIC: Little children would shy away from her and actually be scared of her.
GUPTA: Dr. Frank Papay was one of Culp's surgeons.
PAPAY: We had to find a Caucasian female in her mid-40s to match Connie. Then once we were able to have a donor, we had to make sure that the texture of the skin, the structure of the bones, even the teeth were healthy enough to transplant that.
GUPTA: Unlike patients before him, Oscar needed an entirely new face, skin, underlying muscles, teeth, lips, a new jaw.
It is a long, tedious process. First, graft skin from the face of a donor. Doctors are careful to preserve arteries, veins and nerves. Then, using a powerful microscope, doctors marry tiny veins and arteries from the donor to the recipient. They have to be similar diameters, they have to nearly match. Then, they wait.
PAPAY: You have to hold your breath -- because you have to wait and see if it clots. If you see the tissue, it looks very pale. There's no blood flow in it. All of a sudden, it flushes with red.
GUPTA: And the end result -- well, it resembles science fiction. One human face transposed on to another.
PAPAY: People see that movie "Face-Off" and they think, we're going to look exactly like the donor, but that's absolutely not true. It ends up being a composite. So, you know, it doesn't look like the donor. It doesn't look like the recipient. It looks like something in between, something new.
GUPTA: Something new, a new face, a chance for peace, for normalcy.
UNIDENTIFIED FEMALE (through translator): He's looking forward to walking down the street without having people looking at him five times. We want to have a family meal together.
GUPTA: The operation you just saw there, it's cutting-edge stuff, first of its find.
Remember this, though, it's an elective procedure still, last resort, and not without serious risks. For the rest of Oscar's life, his body may try and reject his new face. So, there is a lifetime of taking immune system suppressant drugs. That, of course, carries its own set of risks.
Next now: someone is not breathing or they're choking. What are you going to do? Use CPR safety tips. It turns out there may be a different way to save a life.
And later in the show, Jake Glaser, he was born with the AIDS virus. His mother was America's most famous AIDS activist. Now, he's finding his own voice.
GUPTA: Imagine you see the person next to you collapse. No heartbeat. What do you do? Well, the answer is CPR.
And now, there is a great debate going on. Can you save someone by only using chest compressions?
Two large studies published this week in the "New England Journal of Medicine" say yes.
Now, we investigated this very issue in my special called "Cheating Death."
(BEGIN VIDEO CLIP) GUPTA: Some would say, "Look, you know, don't bother with the mouth-to-mouth at all. You've got oxygen in your bloodstream. The key is to move it around the body."
UNIDENTIFIED MALE: The trick is to get as many compressions in as you can.
GUPTA: A hundred times a minute?
UNIDENTIFIED MALE: A hundred times a minute with pretty much enough force that if you do it right, there will be sweat dripping off your nose after two or three minutes.
GUPTA: Your arms are straight over the guy's chest and you are ...
UNIDENTIFIED MALE: Straight over ...
GUPTA: Push, push, push, push.
UNIDENTIFIED MALE: Push, push, push.
GUPTA: What you're describing could save lives.
(END VIDEO CLIP)
GUPTA: The CPR studies do agree: the reason a person's bloodstream contains enough oxygen to live for several minutes. But the oxygen can't nourish brain cells unless it is circulated by chest compressions. If you want to see more on this, logon to CNNHealth.com.
GUPTA: All right. Let's shift topics now.
You know, it's been almost two weeks since I competed in the Nautica New York City Triathlon, alongside six of our CNN viewers. It was the first triathlon for all of us, but I don't think it's going to be the last one for any of us.
Let's check in with a few of the six-pack and see how they're feeling after the race.
(BEGIN VIDEO CLIPS)
ANGIE BROUHARD, CAME IN FIRST AMONG SIX-PACK: I feel really good about the race and how everything kind of fell together. I do feel like I could have done better on the run. I'm signed up to do the Great Buckeye Challenge here in Springfield, Ohio, in August.
LINDA FISHER-LEWIS, GOT SICK ON BIKE: I got back on Monday, started training on Wednesday. And have a triathlon on this Saturday, July 31st. I hope to get my confidence back a little bit because I have a big triathlon in Washington, D.C. in September. DEAN HANAN, QUIT SMOKING: I couldn't feel more proud, more confident, the point where I was in November of '09 to now. It's really changed my life. I did a five-mile race this past Saturday, which was almost a week after the triathlon. And I'm going to continue to do races.
MEREDITH CLARK, MET LIFETIME GOAL OF COMPETING: I'm looking forward to just continuing making triathlon and raising and the endurance training a part of my life.
(END VIDEO CLIPS)
GUPTA: All right. Guys, congratulations again. Maybe we'll all do it again next year. We'll see.
Well, next, we got a survivor coming of age. His dad is a famous actor who played Starsky on TV's "Starsky and Hutch." His mom is a famous AIDS activist who died early on in the epidemic. He lost his sister as well to the same disease at the age of 3. His amazing story is next.
GUPTA: Welcome back. I'm Sanjay Gupta.
Since the first stories about HIV and AIDS surfaced nearly 30 years ago, more than 60 million people have been infected, 25 million people have died worldwide, and today, there are more than 33 million people around the globe living with HIV.
It's become more of a chronic disease if you have access to powerful drug cocktails. HIV is preventable, but people continue to be infected. It's estimated that one American is infected every 9 1/2 minutes. Although there's still no cure, recent discoveries published in mid-July have revived the search for a vaccine.
You know, one person living with HIV is Jake Glaser. He was born with it. His mother unknowingly passed it on to him when he was still in the womb.
Jake's father is actor/director, Paul Michael Glaser, that's known as Starsky from the hit '70s TV series "Starsky and Hutch."
You might also remember his mother, Elizabeth Glaser, who moved the nation when she talked about AIDS at the 1992 Democratic National Convention.
I recently sat down with Jake.
GUPTA: You were born with HIV, as you mentioned. Have you -- this may sound like a silly question -- but have you ever wondered what it would be like not to have it?
JAKE GLASER, BORN WITH HIV: Yes. I don't think it's a silly question.
GUPTA: I mean, do you ...
GLASER: It's -- the phrase that I hear most is: what would it be like to be normal, to live a normal life? I give weight to both sides of that message. For me, being born with HIV, this is my normal life. This is what I do day to day.
GUPTA: This is all you've known.
GLASER: This is all I've known.
GUPTA: People who don't know your story. When you tell them, you're a 25-year-old man, you have HIV. Does that stigma still exist? Do you feel that?
GLASER: It does.
GUPTA: Sort of things happen.
GLASER: Well, you know, I'm very happy to say that it's not around nearly as much as it was. But that's not to say that it's completely done. Recently for myself, I do a lot of photography and I film in the skateboard -- action sports world. And one of the people that I was filming with, one of the kids found out just through talking to one of my friends that I was HIV positive, and he expressed that he was afraid to touch me.
And, at first, I was -- I guess you could say I had some anger, frustration with it. It was something that I hadn't dealt with since my childhood. It was interesting because I approached it in a way that I maybe wouldn't have expected myself to.
I kind of told everyone, stop what you're doing. Pick up your skateboards. You know, put down your cameras. Let's talk.
And it was honestly as simple as he just didn't have the information.
GUPTA: That's quite a moment. I mean, stop the shoot. You said, all right, this is an opportunity to educate them.
GLASER: Oh, without a doubt.
GUPTA: I feel like -- like so many others, got to know your mom in many ways. I heard her speak. I read a lot about her and all that she did and stood for.
I want to play a little clip from a speech that your mom gave and just get you to react to it. Take a look.
(BEGIN VIDEO CLIP)
ELIZABETH GLASER, AIDS ACTIVIST: My daughter lived seven years. And in her last year when she couldn't walk or talk, her wisdom shone through. She taught me to love when all I wanted to do was hate. She taught me to help others when all I wanted to do was help myself. She taught me to be brave when all I felt was fear.
(END VIDEO CLIP)
GUPTA: You see her speak and you see people react to her speaking. What's that like?
GLASER: It never gets old for me. My mom, for me, was a very amazing individual, and what she said about my sister Ariel -- I mean, the logo for the foundation, that was painted by my sister, you know, soon before she passed. And that showed my mom, like she said, that in that time of discomfort and fear, sadness, all these emotions that were going on, that that passion for life and that love for life and that understanding shone through.
And very much -- I mean, that logo, that painting has driven this foundation to where it is. I mean, 10 years ago -- 10 years ago we were reaching 15 percent of the women that needed medication in order to help stop the transmission of the virus to their child. Now, we're reaching 45 percent. Isn't that amazing?
It shows us and it shows my mom, she is still here with us, that it is possible.
GUPTA: We'll have much more from Jake Glaser next, talking about his dad and how he helped him face his fears.
Plus, most people struggle with diet and exercise. No surprise there. But there's new evidence that suggests keeping a journal might help. Does it really work? I've got that story right after the break.
GUPTA: Almost 20 years ago, Elizabeth Glaser emerged as one of the most famous activists in the battle against AIDS. Her daughter died of AIDS at age 7.
Her son Jake has the virus as well. But he just turned 25. He's healthy. He's also a spokesman for the Pediatric AIDS Foundation which his mother started. And now, he's headed for cooking school with a passion for his day job: making gelato.
GUPTA: I eat gelato. I don't know much more about it than that. So, what can you teach me about gelato?
GLASER: Do you know the difference between gelato and ice cream?
GUPTA: If I should know something that easy, maybe I'm trying to answer. So, let's hear that. Why don't you tell me?
GLASER: OK. Well, it's simple. Ice cream is made with cream. Gelato is made with a majority of organic milk. So, it's much lighter, there's more air, and in the product, it's much smoother.
GUPTA: It sounds like you're quite diligent about it. I mean, waking up early, getting there. You've really gotten into this.
GLASER: Oh, yes. I've been there about a year and a month now, and it is a lot of fun. It is a lot of fun. I get to make four different sorbets every day and I make 12 different milk-based gelatos and, you know, I get to watch a lot of people really enjoy it.
GUPTA: I can imagine. I mean, you lost your sister when I don't think you were quite 4, your mother when you were around 10 years old.
GUPTA: Both of HIV/AIDS. Do you -- how does that -- how do you approach that? I mean, do you feel like you're the lucky one?
GLASER: That's a question that I definitely ask myself a lot, because I've been fortunate to have really good health through the 25 years I've been alive. It's something that I dealt with a lot I'd say more in my teenage years. A lot of questions of, you know, why me?
I didn't really understand that, like I'll say it until now, until 25 years old, where I'm sitting here going -- all of my experiences in my life and all of my interactions and the people that have help me and the people that I've helped have 100 percent landed me where I am today.
GUPTA: Have you -- have you been sick? I mean, have you gotten to the point where you had some sort of infection and they thought because of HIV, this could turn into something more serious and ...
GLASER: I have not. I've had a lot of friends that have dealt with a lot of that. I have a lot of friends that have passed from HIV. And it is something that I've experienced in my relationships.
GUPTA: Do you remember the first time that happened, where you had someone that you knew that had HIV that passed?
GLASER: I mean, my family. That was -- that was really when I -- you know, when my sister passed, I was 3, turning 4 years old. It was something that was relatively difficult for me to grasp.
But, you know, when my mom got sick and, you know, the last year of her life when she was really dealing with this -- the virus affecting her health, was when I really faced the actuality of I am HIV positive and this is something that can affect you and it scared me a lot.
GUPTA: Your dad -- as I mentioned -- you're very close.
GUPTA: I mean, what were those conversations like? I'm sure he helped you navigate that time. GLASER: You know, a lot of it was -- at the time, was him talking and me fighting. But now, I do see everything that he's ever told me. You know, every night he would sit down by my bed and he would talk to me about the importance of facing my fears and accepting that it's OK because it is -- for me, it is in those times of un- comfort in my life that I've learned the most about myself.
And he's -- he's the guru. He's my Buddha. You know? He's my teacher. I mean ...
GUPTA: He'd be happy to hear that, I'm sure.
GLASER: Not to say -- not to say we don't butt heads, but ...
GUPTA: I wanted to talk to you for a long time. So, I really appreciate the fact that we could do this. Jake, thanks.
GLASER: Yes. Thank you very much.
GUPTA: And we all know that losing weight, keeping it off -- that can be a struggle. There's some new evidence that suggests that keeping an online journal of what you eat and when you exercise can help keep the weight off.
Researchers at the Kaiser Permanente developed an Internet-based weight management program. For two years, they followed over 300 people. Dieters were encouraged to log in at least once a week, they recorded their weight, minutes of exercise, and the number of days they kept food diaries.
Here's what researchers discovered: after two years, those who logged down the most and recorded their weight at least once a month had kept the most weight off. Pretty helpful, tool. For more information on that, you can logon to CNNHealth.com.
Now, you had a lot of questions after my special "Toxic America." Many of you wrote to us about saving your own environment and your own health. One question we got was about the amalgam in dental fillings. Is it toxic to your health? We'll tell you right after the break.
GUPTA: Welcome back.
Every week, I'm answering your questions. Think of this as your own appointment. No waiting, no insurance necessary.
Got a question from Rhonda in Illinois, writes this: "My husband's dental fillings are amalgam, mercury. How toxic is that the mercury in fillings?"
Great question, Rhonda, one that we got quite a bit actually.
The amount of mercury in amalgam fillings has raised a lot of safety questions over the years. But there have been many studies of cavities filled with amalgam, and they have found little evidence of harmful health effects.
Now, amalgam can release small amounts of mercury vapor over time. Patients can absorb small amounts of the vapor by inhaling or ingesting them. But exposure to mercury can be more harmful in other ways. For example, through certain foods like fish, medications, toxic air, working directly with mercury.
But a year ago, the FDA did recommend that amalgam have warning labels that include information to warn patients with mercury allergies, that dental professionals have adequate ventilation when handling dental amalgam, and statement discussing the scientific evidence on the benefits and the risk of dental amalgam so patients and dentists alike can make better choices of its use.
The use of amalgam has been declining. The good news is the cavity rates among school children and young adults are dropping. There's also a trend of fluoride use, changes in eating habits, and many improvements in oral hygiene products and practices. If you have any questions or concerns, of course, consult with your doctor.
And if you missed any part of today's show, be sure to check out my podcast at CNN.com/Podcasting.
Remember, this is the place for answers to all of your medical questions.
Thanks for watching. I'm Dr. Sanjay Gupta.
More news on CNN starts right now.