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SANJAY GUPTA MD
Morning-After Pill for Teens Under 16?; Gluten: Friend or Foe?; Interview with Author Mary Roach; NBA Player Wants To Be a Face for M.S.
Aired April 6, 2013 - 16:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Hello, and thanks for joining us.
Could everyone benefit from going gluten-free? We've got some answers ahead.
Also, the Final Four. You know, we all cringed when Louisville's Kevin Ware went down on the court. I'm going to show you exactly what surgeons did to fix his leg.
Plus, one thing you can start today that will lower your kids' risk of future heart disease.
But, first, on Friday, a federal judge ruled the so-called "morning- after" pill, that Plan B, can be sold over the counter to anyone at any age. Previously, it was description only, if you were under 17.
Now, Plan B is called emergency contraception and the CDC says that one in nine women age 15 to 44 have used it.
So, joining me to talk more about this is my friend and colleague Elizabeth Cohen.
You've been following this story for some time. And the news is sort of interesting because the judge said there was no real reason that it shouldn't be sold over the counter.
What are you hearing from your doctor sources?
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right. The judge called it capricious, and I think other doctors, I think doctors would agree.
What he basically said was, look, the FDA is charged with deciding whether a drug is safe and effective. And if it's safe and effective for 17 and older, it's also safe and effective for 17 and younger. He said the medical data is clear, 15, 25, 35, it works the same in a woman's body. It's safe and effective no matter what age.
Therefore, his reasoning was, it should be available over the counter to anyone at any age.
GUPTA: But there are things that are safe and effective that still require a prescription.
COHEN: Right. That's true. But he's saying if you're not going to require a prescription for 17 and older, right, why are you requiring a prescription for younger than that? And the Obama administration said because they were worried the younger girls wouldn't really understand how to take it.
GUPTA: We'll talk more about the impact on this. But, Elizabeth, I want to introduce you to a woman named Brooke Macke. She's joining us from New York.
Brooke, thanks for joining us.
You've obviously been following this story, I'm sure, because this is so personally relevant to you. You told us when you were a young teenager you needed Plan B, but couldn't get it. Can you explain what was going on?
BROOKE ELIAZAR-MACKE, COULDN'T ACCESS PLAN B AS A TEENAGER: Sure. Although I would like to say that I've been following the events in this case because I'm part of a group called National Women's Liberation, that's been fighting for 10 years to get the morning-after pill over the counter.
I am personally impacted because as a teenager, I did need the morning-after pill. I was someone who had unprotected sex. I wasn't able to ask my mom because I personally couldn't go to my parent and say that I need to get the morning-after pill.
For most teenagers, I would think for all teenagers, that the only way to get access to a doctor, to get access to a prescription, is to go with your parent and access their health insurance. And so, rather than take -- rather than go to my mom and ask to go to the doctor, because I had just had sex, I took all of her birth control pills and used them as a morning-after pill.
Although as an adult, I also need the morning-after pill and still faced the requirement of having to show an ID, find a pharmacy that's open, and a pharmacist who will give it to me.
GUPTA: Yes, these are tough conversations. And I -- Elizabeth and I are going to talk about it in a second. I have three daughters and she has four daughters. We think about this a lot.
And I know you advocate, Brooke, for the plan b to be available with no limitations. But what do you think now that a little bit of time has passed, the parents' point of view is in all of this?
ELIAZAR-MACKE: Restricting people who can be pregnant, that that line of a woman or a young girl who doesn't have control over her body, who can't make a very basic decision on whether or not she will have a child, that that is something that each woman, each girl should be able to decide on her own.
GUPTA: Elizabeth, what are the health concerns? So we're talking about any woman of childbearing age. We're talking potentially pretty young girls here. You know, are there any particular health concerns?
COHEN: There are no particular health concerns for young girls versus older girls. There aren't very many side effects to these pills. It's usually something like a headache or dizziness or nausea. Not major side effects. You're taking this usually within 24 hours of having sex.
So, it's not like when you think about an abortion many months later. It's very different.
GUPTA: And what -- I mean, obviously the critics say this is an abortion pill. You've heard that terminology thrown around. How does it work in the body?
COHEN: It works mainly by telling the ovary, hey, don't release an egg, which is sort of how a birth control pill work, because this is basically a high powered birth control pill. So, that's mainly how it works. It can also keep egg and sperm away from each other.
It can also in some instances keep a fertilized egg from implanting into a woman's uterine wall. And that's the one that people get upset about. Some people consider that abortion. You've got this fertilized egg, and the drug says, hey, don't implant. So, people consider that an abortion.
GUPTA: Because the egg has already been fertilized at that point.
COHEN: Correct, right.
GUPTA: An impossible question -- and I know you're probably think about his, because you're a thoughtful person and you're a parent and I have three daughters myself. What do you think about -- I was talking to Brooke about the parental notification. Jus the psychological impact of having the child be talking to the parents about this. It's an uncomfortable conversation. I don't want to have it with my daughters.
GUPTA: But what do you think?
COHEN: I mean, I talk to my teenage girls -- two of my girls are teenagers -- about sex. You know, I told them I want you to come to me and your father and talk to us. I think that's the conversation you need to have.
Even if my daughter, God forbid, were to have to go out and take this drug at the age of 15, the drug itself wouldn't really bother me. I don't think it's going to hurt her. But the fact that she needed it, that's what would bother me.
I mean, I think the conversation we should be having is how do we keep 15-year-olds from having sex in the first place.
GUPTA: Yes, I mean, having the conversation ahead of time. We tend to these things in the throes of something. COHEN: Right.
GUPTA: Elizabeth, thanks.
COHEN: OK, thank you. Thank you.
GUPTA: I think about this quite a bit. So, thank you.
GUPTA: You might have heard this. A type of food that's getting a bad rap from a lot of people is gluten. But is a gluten-free diet really a cure-all for many of your ailments or is this just a fad?
GUPTA (voice-over): Gwyneth Paltrow, Miley Cyrus, they've gone gluten-free. Even Oprah tried giving up gluten for a cleansing diet. Gluten is a protein that's found in wheat and other grains, in foods like pasta and bread.
NARRATOR: If you are gluten intolerant, you end up spending half of your dinner looking for gluten-free items on the menu.
GUPTA: Gluten-free foods and diet books, they are now part of a $6 billion industry. But is the fuss worth it? Dr. Larry Sperling wanted to know.
DR. LARRY SPERLING, DIR., EMORY HEALTHCARE CTR. FOR HEART DISEASE PREVENTION: To my knowledge, unless you have true gluten sensitivity, there's nothing magical about a gluten-free diet.
GUPTA: One point to make clear, gluten-free is essential for people with celiac disease. Their body simply can't digest gluten. And even a microscopic amount like eating food that was prepared with the same utensils that touched a food with gluten can cause real problems.
SPERLING: Celiac disease is a disease of inflammation of the intestines. And so, it can produce intestine-like symptoms, upset stomach, diarrhea.
GUPTA: Long-term, it can also lead to osteoporosis and cancer. It can be identified through a blood test, but not so with gluten sensitivity.
And here's where it gets complicated. Some doctors say in people who are just sensitive, gluten can trigger headaches, auto immune symptoms like eczema and a host of other chronic problems.
A handful of study show about 6 percent of the population may have this sensitivity. But some doctors, like Dr. Agatston, suspect it may be much more common.
GUPTA: Joining me now, Dr. Arthur Agatston. He's a renowned cardiologist. He's inventor of the South Beach diet. He got a new book out, called "The South Beach Diet Gluten Solution."
Thanks for joining us.
You're one of my favorite guests. You've helped me so much just with my own health and I really, really appreciate that.
This particular book, you say gluten -- the thing about gluten-free diets may be a trend, but there's something to it as well for most people.
DR. ARTHUR AGATSTON, AUTHOR, "THE SOUTH BEACH DIET GLUTEN SOLUTION": Yes, number one, it's real. And people wonder, can it be affecting me? We think it's affecting the majority of women in this country and a lot, a lot of men. So it is the real deal.
GUPTA: You say just try it, basically, I think is what I took away. Try it for a period of time and see how you feel.
AGATSTON: Yes. First, you have to make sure you don't have celiac disease. That's like a nut allergy. If you get a little gluten, you're in trouble. And usually, a bad G.I. symptom is associated with that.
But the majority of people will test negative for celiac disease. They are simple blood test for screening. For gluten sensitivity, there's no test. So, you just have to get off gluten for a while.
GUPTA: So if you're having troubles and they're pretty significant, you probably should get tested and a blood test is pretty accurate?
AGATSTON: Yes. The screening blood test for celiac, because if you have celiac, you have to be very, very strict about gluten. If not, you have to be what we call gluten aware. Everybody will have a different threshold for how much gluten they can tolerate.
It's like lactose intolerance.
AGATSTON: People can tolerate a little milk in their coffee, but they have an ice cream sundae they're up all night. There's a similar spectrum of gluten problems. And so, our book and our program helps you find where you fall on the spectrum. And a lot of people fall someplace.
GUTPA: When you talk about this, is there a period of time when you know?
Because I imagine there's a lot of people out there who just have some symptoms and they thought, I don't think that's gluten. But now, though, become gluten aware, as you said. How long before they know it's actually problem?
AGATSTON: G.I. problems, things like reflux, energy focus, you'll often know in just a few days. Our program recommends being gluten- free for a month, and fairly strict the first month. It's easy to be gluten-free for a month. It's very hard to be gluten-free your whole life.
AGATSTON: And then once you know it's affecting you, then you can add back whole grains gradually and see what your threshold is.
GUPTA: Find your sweet spot.
Thanks for joining us. It's always interesting and I think it's so actionable, the things that you talk about as well, Dr. Arthur Agatston.
AGATSTON: Great to be back with you.
GUPTA: Good luck with the book.
GUPTA: And up next, we're exploring to what happens to your food after you gulp it down. That's the name of a new book by bestselling author Mary Roach and she joins us.
GUPTA: My next guest has been called America's funniest science writer. It's pretty good moniker, Mary Roach. She's written about the curious lives of human cadavers and (INAUDIBLE), about the science of sex, and about the curious science of life of the void, about space exploration.
Her latest book out this week is "Gulp: Adventures on the Elementary Canal".
Did I say -- you know, it's one of those words I always saw written but hard a time, is it elementary or elementary?
MARY ROACH, AUTHOR: Elementary.
GUPTA: We'll go with elementary, not elementary, which will be a totally different book.
ROACH: You can say it however you want?
GUPTA: How did you decide on this topic?
ROACH: OK, I'm going to tell you this. I was talking with a reader who happened to be a gastroenterologist. We were talking about the whole, you know, digestive tract, and it's pretty interesting thing.
And he says -- he goes, think of it. Nobody appreciates their digestive tract. It could be human anus, this is a rim of muscle, the nerve that can discriminate between solid, liquid, and gas and selectively decide what to let go. And it's like -- he goes -- anyway, he was like no one appreciates their parts, Ok? It's pretty miraculous.
GUPTA: So, you appreciate -- maybe no one talked about it.
ROACH: Lonely anus.
GUPTA: Lonely anus.
You said people like what they eat rather than eat what they like. What does that mean?
ROACH: That has to do with the fact that we talk about if someone's a picky eater and trying to change people's eating habits. One of the things you can do is just -- if you get somebody to just eat it a few times, they'll say they like it. There's a study about women in this -- women's college who, they ask them do you like evaporated milk? And only 15 percent said they liked it. They fed it to them 16 times and they asked them, do you like evaporated milk? Now 51 percent said, yes, I do.
So whatever is in front of you, if you eat it enough, you tend to like it. So, if you can get somebody to try something --
GUPTA: I mean, culturally foods are so different as well. So I guess that would explain in part why some foods are so palatable in certain cultures even at a young age versus other cultures.
ROACH: Sure. Whatever -- well, up until the age of about two, you can get kids to try almost anything. There was a psychologist Paul Rizen (ph) who did this wonderful study where he presented babies with a number of very off putting things like a cracker with ketchup, or fish eggs. And one was fake dog doo.
And up through the age of two years, you could get the kids to try pretty much everything. The dog doo, it was 55 percent, it wasn't real, it was made of peanut butter, the smell came from Lindenberger cheese and they made this whole concoction. But the kids were like yes, I'll try that.
GUPTA: You know, this comes up and people always ask me this. I'll get your take on it. But the stomach itself, you have all this digestive acid, hydrochloric acid, why doesn't it digest itself?
ROACH: My understanding is in fact it does, but it also is very good at rebuilding its own lining. So, you essentially have a new lining every three days or so because you're -- yes --
GUPTA: Sloughing off.
ROACH: Yes. Because the acid does do its job even on your own stomach, because you would think you can eat tripe and you eat other stomach and digest it, why don't you digest your own?
GUPTA: Did your diet change while writing this book or afterward?
ROACH: You have fewer -- I'm careful with hot dogs.
GUPTA: I really enjoy you and I enjoy your books very much. I'm honored that you would join us. ROACH: Oh, thank you so much. A pleasure to be here. Thank you.
GUPTA: "Gulp". Thank you.
And coming up, it is Final Four weekend, one of my favorite weekends. I'm going to show you exactly how surgeons repaired the pretty shocking broken leg of Louisville basketball guard Kevin Ware.
Stay with us.
GUPTA: We are back with SGMD.
As you probably know, Louisville guard Kevin Ware, he broke his lower right leg in two places this week. His shinbone, in fact, it actually broke through the skin. It was so gruesome -- too gruesome to really show again on television, but you get the idea of what happened. You can see the looks on his teammates' faces and really everyone else nearby.
It was a pretty unusual injury. It appears that he jumped quite significantly horizontally and vertically and he landed in an awkward position.
Let me show you specifically what we're talking about here. Look at the lower bones over here. This is the knee, the ankle.
This is the tibia bone, and the fibula. And both of these bones specifically were broken as a result of that jump.
I'll show you an X-ray now. This is sort of illustrated -- this isn't his X-ray specifically. But keep in mind the picture you just saw and you see the fracture here and another fracture down here. This is the skin and you can see the bone coming through the skin there.
When that happens, there's a big risk of infection as well and one of the keys is you've got to operate, but you've got to do it even more quickly because of that risk of infection.
Let me show you something here. To reset a break like the one you see there, they put in a metal rod. The inside of the bone is more hollow. It has some space in there, so they're able to thread this through the top of bone and reconnect the two pieces. Eventually the hope is that they heal back or fuse back together. This is a pretty rare thing and it's a gruesome injury really, but they do say that Kevin Ware -- this wasn't a career-ender for him, although a season- ender for sure.
Now, from college to the pros. You might think being a professional athlete and also having multiple sclerosis, that those two things would be mutually exclusive. But just last month, Chris Wright, he broke that barrier when he got a call from the Dallas Mavericks of the NBA and he stuck with the team for 10 days.
(BEGIN VIDEOTAPE) GUPTA (voice-over): With less than three minutes left in the game against the Atlanta Hawks, Dallas Mavericks point guard, Chris Wright, is in the game. Playing in the NBA has been his lifelong dream. But it almost didn't come true.
CHRIS WRIGHT, MAVERICKS POINT GUARD: While I was shooting, my whole right leg went numb, right foot went numb. Basically it went all the way up to the right side of my body.
GUPTA: Last year, Wright was diagnosed with multiple sclerosis, M.S., a disease that damages the protective covering of nerve cells in the brain and spinal cord. It's a disease he had never heard of.
WRIGHT: I didn't know what it was. I was just remaining positive about it. Once I found out, I still have to remain positive. I'm like, OK. You know, I just have to do what I have to do to maintain my life.
GUPTA: Doctors told Wright he would never play basketball again. But he responded well to treatment and less than three months after his diagnosis, Wright was back on the court. He made history when he signed a 10-day contract with the Dallas Mavericks becoming the first person with M.S. to play in the NBA.
While it may have only been a short stint, Wright believes this won't be the last time he'll play in the NBA.
WRIGHT: Everything happens for a reason. And everything you go through definitely it's not a coincidence. And it happened during M.S. Awareness Week. So, you know, everything kind of fall into place.
GUPTA: Monthly treatments are keeping his M.S. from progressing and he's not shying away from his diagnosis. Wright says he's proud to be the face of M.S.
GUPTA: And still ahead, how to not be duped by product packaging when you visit the grocery store.
Stay with us.
GUPTA: When it comes to sodium, we simply eat too much, on average about four grams per day as an adult, when we really need about half that, about two grams per day.
There's a study that came out that said if you get down to two grams a day, we could potentially save about 150,000 lives a year, simply from that one thing. Frozen foods, they're going to have a lot of sodium in there for lots of different reasons, but mainly because sodium is a good preservative. That's why it's in there. But also canned foods -- you know, a lot of parents, again like me, they go to canned foods. The problem is you get about 950 grams, almost a gram of sodium, just for something like this. Far too much for an adult and far too much for most kids as well.
Cereal is also an important food choice for many homes. Make sure you read those labels again.
One thing about reading labels as well, when you're reading labels, try and find foods like this that have less than five ingredients. That's really going to help.
When it comes to that sodium again, one thing that we do in our house, we never leave crackers or cookies just sitting out. We'll pour a little bit into a small table.
And it's important to find salt substitutes as well. We don't need salt shakers out there. But if you find a substitute like this, no salt, for example, or just some flavorings, you can both cut down on your sodium, increase your potassium and possibly solve a lot of those problems.
GUPTA: I'll tell you, now, all those shopping tips are especially important for your kids, because too much sodium can hurt them the most and it's not just the salt shaker on the table. It can be a lot of processed, frozen foods. In fact, a recent CDC study found that 75 percent of meals that are targeted to kids have way too much salt. There's no specific regulation on this. And blood pressure of the kids in the study who ate these diets that were high in salt, they were seven times higher than in kids who didn't. High blood pressure is a major risk factor, as you know, for heart disease and stroke, something to be mindful of.
That's going to wrap things up for SGMD, but, you know, I can't say a proper goodbye without a shout-out to my Michigan Wolverines in the Final Four this weekend. I am proud of Blue. You help me chase life.
As always, let me know what you think, CNN.com/Sanjay. And follow me on Twitter @DrSanjayGupta.
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