Transcript: Show #2 | Oct 03, 2000

The title of the show appears: "Your Health." Clips of the episode are displayed behind the title sequence.

Maureen says THIS WEEK:

A woman in her thirties says NO MY FIRST DOCTOR
UMM DID NOT UNDERSTAND.
AS A MATTER OF FACT
HE HAD WRITTEN IN MY FILE
THAT I WAS AN ADDICT.

Maureen says ADDICTED TO
PAINKILLERS OR DEPENDENT,
WHAT IS THE DIFFERENCE.

A doctor in his forties says YOU KNOW, PEOPLE COME IN AND
ARE FEARFUL, THEY SAID MY
DAD HAD DIABETES AND MY MOM
DID, DOES THAT MEAN FOR SURE
I WILL GET IT.
NO, IT DOESN'T.

Maureen says DIABETES, CAN WE STOP THE
EPIDEMIC.
AND, A SCIENTIFIC LOOK AT
NATURAL REMEDIES.

(music plays)
The opening sequence begins.

Clips of different people flash against a grey background. A 30-year-old woman with shoulder length black hair looks through a microscope, a 30-year-old with very short black hair holds up her 1-year-old son, a pharmacist counts and organizes red-and-yellow pills, a surgeon cuts into the abdomen of a patient and, finally, a man wearing a ted tank-top lifts weights. An animated microscope, pill bottle, syringe, and small dumbbell fly around the screen.

The title appears: "Your Health."

Maureen stands in a wood-paneled studio with T.V. screens embedded in the walls. She is in her forties, with short wavy red hair. She wears a cream blazer over an orange blouse and a pair of earrings.

Maureen says HELLO, I'M
MAUREEN TAYLOR.
NOTHING IS BETTER FOR
MANAGING SEVERE AND CHRONIC
PAIN THAN NARCOTICS OR
OPIOIDS.
BUT EXPERTS ESTIMATE THAT AS
MANY AS 70 percent OF CANADIANS WHO
SUFFER PAIN DON'T RECEIVE
ADEQUATE PAIN TREATMENT, IN
LARGE PART BECAUSE DOCTORS
ARE AFRAID TO PRESCRIBE
STRONG DRUGS LIKE MORPHINE
OR METHADONE AFRAID THEIR
PATIENT ALSO END UP ADDICTED
TO THEM.
BUT PAIN EXPERTS SAY THE
MEDICAL COMMUNITY IS STILL
CONFUSING ADDICTION WITH
DEPENDENCY.

A clip shows Laura sitting on a sofa with a toddler. Laura is in her thirties, with mid-length slightly wavy red hair. She wears a red sweater and a patterned vest.

She says I WAS... I WAS CRYING AN
AWFUL LOT BECAUSE TO JUST
SIT DOWN AND SUFFER FROM
THAT MUCH PAIN, IT WAS... IT
WAS UNBEARABLE.
AND AS SOON AS I STARTED
THIS MEDICATION IT WAS LIKE
A GOD SEND IT WAS LIKE
FINALLY I HAD SOME SEMBLANCE
OF MY LIFE BACK.

A caption reads "Name: Laura de Costa; Pain source: Crushed discs in spine; Drug: Oxycodyne."

Laura says I'M TAKING SOMETHING, A PILL
CALLED OXYCODONE, A TYPE OF
MORPHINE.
AND IT REGULATES THE PAIN
VERY WELL.
IT IS ALMOST NOT THERE NOW.
I HAVE A BIT OF BREAKTHROUGH
PAIN THROUGH THE DAY BUT
VIRTUALLY NO PAIN ALL DAY
LONG COMPARED TO BEING IN
CONSTANT PAIN WHEN THIS ALL
STARTED.

The caption changes to "Name: Gayle Gibson; Pain Source: Osteoarthirtis and injured shoulder; Drug: Methadone."

Gayle is in her thirties, with long straight brown hair with bangs. She wears jeans and a black T-shirt.

She says THAT IS MY MAIN SOURCE OF
PAIN RELIEF IS THE OPIOIDS.
I TAKE THE OPIOIDS EVERY DAY
LIKE REGULAR MEDICATION.
I TAKE METHADONE, I TAKE
APPROXIMATELY 330 MILLI
LITRES A DAY.

Maureen says HOW DO YOU TAKE
METHADONE.

Gayle says WHAT WE DO IS WE HAVE TO
PICK IT UP FROM THE PHARMACY
IN THE SYRUP AND POUR IT
INTO SOMETHING THAT YOU
ENJOY THE DRINK AND DRINK IT
BECAUSE IT TASTES VERY
BITTER.

Maureen says GAIL AND LAURA
ARE TWO OF THOUSANDS OF
CANADIANS WHO LIVE WITH
CHRONIC PAIN.
BUT THEY DON'T SUFFER
BECAUSE THEIR DOCTOR
PRESCRIBES POWERFUL
NARCOTICS OR OPIOIDS AND THEY
TAKE THEM EVERY DAY.
DOCTOR ROMAN JOVEY IS ONE OF
CANADA'S LEADING EXPERTS ON
THE USE OF OPIOIDS TO TREAT
PAIN.

Roman is in his fifties, with short wavy white hair and a moustache. He wears a blue shirt and a blue tie.

He says INITIALLY WE LEARN FROM
THE CANCER POPULATION THAT
WE COULD USE OPIOIDS OVER A
LONG PERIOD OF TIME IN HIGH
DOSE WITHOUT CAUSING A LOT
OF ADDICTION OR IN FACT, IF
THE DOSE WAS CAREFULLY
TITRATED AND THAT MEANS
ADJUSTING THE DOSE TO GET THE
PROPER AFFECT, THAT PEOPLE
COULD FUNCTION QUITE
NORMALLY ON OPIOID THERAPY.
NOW THAT EXPERIENCE HAS BEEN
TRANSLATED TO THOSE PEOPLE
WITHOUT CANCER PAIN, PEOPLE
WITH SO-CALLED CHRONIC
NON-CANCER PAIN.

Maureen says BUT NOT ALL
DOCTORS ARE COMFORTABLE
PRESCRIBING SUCH STRONG
DRUGS FOR PEOPLE WHO AREN'T
TERMINALLY ILL.

Roman says IF YOU LOOKED AT THE
OLDER CLINICAL STUDIES FROM
15 YEARS AGO, THE THOUGHT
WAS THAT ANYBODY WHO WAS
EXPOSED TO AN OPIOID LONG
ENOUGH WILL BECOME ADDICTED.
AND THIS SCARED A LOT OF
PHYSICIANS OFF FROM USING
THEM.
BUT IN THIS AREA CHANGES ARE
VERY SLOW.
THAT IT IS TAKING SOME
PHYSICIANS A LONG TIME TO
ACCEPT THAT THERE IS A ROLE
FOR OPIOIDS IN CHRONIC PAIN.

Gayle says MY FIRST DOCTOR DID NOT
UNDERSTAND.
AS A MATTER OF FACT, HE HAD
WRITTEN IN MY FILE THAT I
WAS AN A DICK.
HE WAS NOT ASKING THE RIGHT
QUESTIONS AS FAR AS I'M
CONCERNED.
HE DID NOT INVESTIGATE MY
PROBLEM AS DEEPLY AS HE
SHOULD HAVE.
HE DIDN'T TAKE THE TIME
TO... HE WASN'T FAMILIAR
ENOUGH WITH PAIN, AND I
DON'T THINK A LOT OF DOCTORS
ARE FAMILIAR WITH PAIN, YOU
KNOW.
WHEN I... UNLESS YOU GO
THROUGH IT, YOU DON'T KNOW.
NO ONE KNOWS WHAT IT IS LIKE
TO WAKE UP EVERY DAY AND
KNOW THAT YOU ARE GOING TO
FEEL PAIN UNTIL YOU GO TO
BED THAT NIGHT.
AND YOU PROBABLY WON'T SLEEP
BECAUSE YOU CAN'T GET
COMFORTABLE.

Maureen says PEOPLE WHO TAKE
OPIOIDS FOR CHRONIC PAIN SAY
THE DRUGS DON'T GIVE THEM
THE SAME HIGH THAT THEY GIVE
AN ADDICT IT IS AS IF ALL
THE MEDICATION IS USED UP IN
TREATING THE PAIN.

The caption change to "Laura de Costa."

Laura says I, MYSELF, PERSONALLY
DON'T FEEL ADDICTED.
I DO FEEL DEPENDENT BECAUSE
IT ALLOWS ME TO LIVE
NORMALLY DAY-TO-DAY.
I CAN DO ALL THE NECESSARY
THINGS, TAKE MY CHILDREN TO
SCHOOL, TAKE THEM TO
EXTRACURRICULAR THINGS, BE
ABLE TO WORK, BE ABLE TO RUN
MY OWN BUSINESS.
WHEREAS AN ADDICT I BELIEVE
IS TOTALLY JUST COMPLETELY
OUT OF IT.
THEY CRAVE IT.
THEY HAVE TO HAVE IT, MAYBE
MORE THAN TWICE A DAY.
AND THEY WILL GO TO ANY
LENGTHS TO DO THAT.

The caption changes to "Gayle Gibson."

Gayle says ADDICTED?
I LOOKED UP THE WORD THE
OTHER NIGHT AND NO, I'M NOT
ADDICTED.
I'M DEPENDENT, DEPENDENT ON
IT.
JUST LIKE A DIABETIC WOULD
BE DEPENDENT ON INSULIN.
I AM THE SAME WAY.
IF I DIDN'T TAKE IT, I SURE
WOULD FEEL SOME SIDE EFFECTS
OF WITHDRAWAL, BUT I'M
SUPPOSED TO TAKE IT SO THAT
IS WHAT I DO.

The caption changes to "Doctor Roman Jovey. General Practitioner."

Roman says IT IS CONFUSING TO MANY
HEALTH CARE WORKERS, THIS
DIFFERENCE BETWEEN PHYSICAL
DEPENDENCE AND ADDICTION.
SO PHYSICAL DEPENDENCE
SIMPLY MEANS THAT YOU ARE
TAKING A... IN THIS CASE, A
MEDICATION ON A DAILY BASIS
AND IF YOU WERE TO SUDDENLY
STOP THAT MEDICATION YOU
WOULD HAVE A CHARACTERISTIC
SET OF WITHDRAWAL...
WITHDRAWAL SYMPTOMS.
IN THE CASE OF OPIOIDS THAT
WOULD BE ANXIETY, SWEATS,
BONE CHILLS, DIARRHEA,
ABDOMINAL AND MUSCLE CRAMPS.
AND THIS CHARACTERISTIC
WITHDRAWAL REACTION WOULD GO
ON FOR SOME DAYS, ONE DAY,
TWO DAYS, THREE DAYS AND
GRADUALLY PETER OUT.
NOW THAT IS DIFFERENT FROM
ADDICTION.
ADDICTION IS CHARACTERIZED
BY REPEATEDLY USING A
PARTICULAR SUBSTANCE, IN
THIS CASE, FOR EXAMPLE,
OPIOIDS OR EVEN A BEHAVIOUR
SUCH AS EATING OR GAMBLING.
USING IT REPEATEDLY TO THE
POINT IT STARTS TO DISRUPT
YOUR LIFE.

The caption changes to "Name: Frasier; Pain source: Leg injury; Drug: Oxycontin."

Fraser has long brown hair. He does not show his face. HE wears jeans, a blue shirt and a blue vest.

He says I WENT THROUGH A NUMBER
OF GENERAL PRACTITIONERS...
WELL, NOT A NUMBER.
I WENT THROUGH THREE OR FOUR
GENERAL PRACTITIONERS.

Maureen says FRASER IS ALSO ON OPIOIDS
FOR CHRONIC PAIN IN HIS LEG.
HE SAYS HE'S QUALIFIED TO
TELL THE DIFFERENCE BETWEEN
DEPENDENCE AND ADDICTION TO
A DRUG.

Fraser says I HAVE BEEN ADDICTED TO
COCAINE AND HEROIN FOR YEARS
PRIOR TO MY ACCIDENT.
I WAS VERY INVOLVED IN THE
DRUG CULTURE, IF YOU WILL.
AND I KNOW WHAT IT IS ALL
ABOUT TO BE A DRUG ADDICT.
AND HOW A DRUG ADDICT THINKS,
AT LEAST FOR ME HOW I
THOUGHT AS A DRUG ADDICT AND
WHAT MOTIVATED ME AS A DRUG
ADDICT.
AND IT IS VERY DIFFERENT
THAN WHAT I EXPERIENCE NOW.
IT IS ALMOST LIKE A
DIFFERENT PERSON.

Maureen says CAN YOU GO INTO THAT A
BIT.
WHAT ARE THE DIFFERENCES.

Fraser says AS A DRUG ADDICT, AS A
DRUG ADDICT YOU ARE
MOTIVATED BY THE DRUG.
THE DRUG PRETTY MUCH
CONTROLS YOUR LIFE, CONTROLS
WHAT YOU DO, WHO YOU
SOCIALIZE WITH, THE WAY YOU
BEHAVE, CONTROLS YOUR VALUES,
YOUR MORALES.
BASICALLY IT TAKES OVER YOUR
ENTIRE LIFE AND YOU LIVE TO
SATISFY THE NEED TO GET THAT
DRUG.
WITH THE NARCOTIC THAT I'M
ON NOW THERE IS NONE OF
THAT.
THE NARCOTIC THAT I'M TAKING
NOW DOESN'T HAVE ANY...
DOESN'T... THERE ARE NO
HIGHS.
YOU DON'T GET STONED FROM
THIS NARCOTIC.

Maureen says BUT PUTTING SOMEONE WITH
FRASER'S HISTORY ON OPIOIDS
DOES CARRY RISKS.
ALTHOUGH THE OXYCONTIN HE IS
ON HASN'T REKINDLED HIS
ADDICTION, DOCTOR JOVEY SAYS IN
RARE CASES IT HAPPENS.

Roman says WHAT I HAVE ARE PEOPLE
THAT HAD HIGH-RISK PAST
HISTORIES WHO WERE PUT ON
OPIOIDS FOR PAIN AND IT
REKINDLED, IT SORT OF WOKE
UP THEIR ADDICTION, IF YOU
WANT TO THINK OF IT I HAVE
YET TO MEET A SINGLE PATIENT,
NOR IN SPEAKING WITH MY
COLLEAGUES ACROSS THE
COUNTRY HAVE YET TO HEAR OF
A GENUINE CASE OF SOMEBODY
WHO HAD NO RISK FACTORS FOR
ADDICTIONS, WAS PUT ON AN
OPIOID FOR PAIN AND THEN
BECAME ADDICTED.
I'M SURE SOMEWHERE IN THE
COUNTRY THERE MAY BE ONE OR
TWO PATIENTS IN WHOM THAT
HAS HAPPENED BUT I THINK
THAT IS HOW RARE IT IS.

Maureen says THERE ARE MANY
EXAMPLES OF DOCTORS,
ESPECIALLY IN THE U.S. WHO
HAVE BEEN PROSECUTED FOR
PRESCRIBING TOO MUCH
MEDICATION, SPECIFICALLY
NARCOTICS.
BUT LAST YEAR A DOCTOR IN
OREGON WAS DISCIPLINED FOR
UNDERTREATING A CANCER
PATIENT.
HE GAVE THE MAN TYLENOL WHEN
WHAT HE REALLY NEEDED FOR
THE PAIN WAS MORPHINE.
SO HAVE WE COME FULL CIRCLE
IN THE DEBATE OVER PAIN
MANAGEMENT?

Roman says AS THE PUBLIC BECOMES
AWARE THAT THERE IS NO
REASON, FOR EXAMPLE, WHEN
THEY BREAK THEIR LEG THAT
THEY SHOULD SUFFER
EXCRUCIATING PAIN FOR HOURS
AND HOURS, WE HAVE THE
TECHNOLOGY TO IMPROVE THAT.
SIMILARLY, POSTOPERATIVELY
THERE IS NO REASON THIS DAY
AND AGE SOMEBODY SHOULD HAVE
UNCONTROLLED PAIN AFTER A
PHYSICAL PROCEDURE.
AND I THINK SIMILARLY, NOW
THE POPULATION WILL BECOME
AWARE THAT IF THEY HAVE
CHRONIC NONCANCER PAIN IT IS
NOT THAT WE CAN TAKE AWAY
AND CURE ALL OF THESE PAINS
BUT I THINK THEY CAN BE MUCH
BETTER MANAGED THAN THEY
HAVE BEEN IN THE PAST.
AND SO THERE WILL BE A
PUBLIC PRESSURE NOW ON THE
HEALTH-CARE SYSTEM, ON
PHYSICIANS TO PROVIDE BETTER
PAIN MANAGEMENT.
AND I THINK THAT THAT CASE
IN OREGON IS PROBABLY JUST
THE BEGINNING.

Maureen says BUT NO ONE
RELISHES THE THOUGHT OF
STAYING ON NARCOTICS FOR THE
REST OF THEIR LIFE.
AND WHETHER IT IS BECAUSE OF
THE SIDE EFFECTS OR THE
STIGMA OF BEING ON STRONG
PAINKILLERS, THESE PEOPLE
LOOK FORWARD TO THE DAY WHEN
THEY CAN GIVE THEM UP.

Laura says THEY ARE MAKING GREAT
STRIDES IN BACK MEDICINE
THESE DAYS AND SAYS PERHAPS
IN FIVE YEARS THEY WILL HAVE
SOMETHING OUT THERE TO SOLVE
MY PROBLEM AND I HANG ON TO
THAT EACH AND EVERY DAY.
AND I DO HOPE FOR TO BE OFF
THIS MEDICATION ONE DAY BUT
FOR THE TIME BEING IT IS A
REAL LIFESAVER FOR ME.

Gayle says I THINK THE WORST PART IS
THOUGHT OF BEING ON IT AND
WHAT PEOPLE THINK OF ME.
I THINK IT IS SOMETHING THAT
I USED TO DISCUSS WITH
PEOPLE, SOMETHING NOW THAT
MAYBE I DON'T BRING UP QUITE
AS QUICK.

Roman says IF THERE WAS SOMETHING
BETTER RIGHT NOW TO TREAT
PAIN THAN OPIOIDS WITHOUT
THAT SMALL RISK OF ADDICTION,
I WOULD GO FOR IT.
BUT THE FACT IS RIGHT NOW
THERE ISN'T.

Maureen says FOR MORE
INFORMATION ON CHRONIC PAIN OR
TO FIND A PAIN SPECIALIST IN
YOUR AREA, CONTACT THE NORTH
AMERICAN CHRONIC PAIN
ASSOCIATION OF CANADA AT
1-800-616-PAIN, THAT IS
1-800-616-7246.
OR VISIT THEIR WEB SITE AT
WWW.CHRONICPAINCANADA.ORG.

Maureen says READY FOR OUR
HEALTH QUIZ.
HYPERGLYCEMIA IS A SYNONYM
FOR WHAT COMMON CONDITION,
HIGH BLOOD PRESSURE, HIGH
BLOOD SUGAR OR HIGH
CHOLESTEROL.
STAY TUNED FOR THE ANSWER
LATER ON "YOUR HEALTH."

A slate with the quiz appears.

Maureen now sits in the studio with a guest.

Maureen says MORE THAN TWO
MILLION CANADIANS ARE
DIABETIC, AND THAT MEANS
MONITORING BLOOD SUGAR
LEVELS AND DALEY INSULIN
INJECTIONS.
PROPERLY MANAGED DIABETICS
CAN LIVE A LONG AND HEALTHY
LIFE BUT DIABETES IS ALSO
A DEBILITATING AND
POTENTIALLY DEADLY DISEASE
IF LEFT UNTREATED.
SO WHEN EDMONTON RESEARCHERS
ANNOUNCED THEY COULD REVERSE
DIABETES BY
TRANSPLANTING PANCREATIC
CELLS IT RAISED THE HOPES OF
THOUSANDS OF PEOPLE WHO
THOUGHT THEY COULD THROW
THEIR NEEDLES AWAY.
WHAT DOES THIS RESEARCH MEAN
AND WHAT IS ITS POTENTIAL
AND WHAT ARE THE LATEST
DRUGS AND NATURAL PRODUCTS
TO HELP PEOPLE MANAGE THEIR
DIABETES.
DOCTOR IAN BLUMER KEEPS TRACK
OF THE LATEST RESEARCH.
HE IS AN INTERNAL MEDICINE
SPECIALIST AND DIRECTOR OF
ROUGE VALLEY HEALTH CENTRE
AND DIE BEAT EASE EDUCATION
CENTRE.
WELCOME TO THE PROGRAMME.

Ian is in his forties, clean-shaven and balding. He wears a beige shirt and a gray blazer.

Ian says THANK YOU.

Maureen says WELL, CAN DIE
BEAT... DIABETICS THROW
THOSE NEEDLES AWAY BECAUSE
OF THIS RESEARCH.

Ian says NOT TOO MANY BUT I FIND
IT ENCOURAGING.
THIS STUDY WHICH A LOT OF
PEOPLE HAVE READ ABOUT WHICH
COMES FROM EDMONTON, THEY
LOOK AT A GROUP OF PEOPLE,
ONLY SEVEN PEOPLE SO IT IS
LIMITED NUMBERS, REALLY, BUT
THEY FOUND TERRIFIC SUCCESS
WITH A TRANSPLANTED THE
ACTIVE INSULIN PRODUCING
CELL, NOT THE WHOLE PANCREAS
BECAUSE THAT HAS BEEN DONE
BEFORE, BUT THE INSURANCE
INSULIN PRODUCING CELLS
TRANSPLANTED INTO SEVEN
INDIVIDUALS AND THEY ALL DID
COME OFF INSULIN.
AND TO THIS POINT THE
AVERAGE LENGTH OF TIME... IT
HAS BEEN VERY SUCCESSFUL,
VERY ENCOURAGING BUT I HAVE
RESERVATIONS ABOUT IT WHICH
WE CAN TALK ABOUT.
BUT I THINK THERE IS
DEFINITELY ROOM FOR
OPTIMISM.

Maureen says BEFORE WE GET TO
YOUR IDEAS IT IS MY
UNDERSTANDING ALL SEVEN WERE
TYPE I DIABETICS.

Ian says THAT'S RIGHT.
THESE ARE PEOPLE WHO IF THEY
WEREN'T GIVEN INSULIN WOULD
DIE WITHIN DAYS OR WEEKS AT
THE MOST.

Maureen says DOES THAT MEAN
IT DOESN'T HAVE ANY
POTENTIAL FOR PEOPLE WITH
TYPE II... TYPE II DIABETES.

Ian says NOT TO THE SAME DEGREE.
BECAUSE IN TYPE II PEOPLE
ARE PRODUCING INSULIN.
THEY ARE TRANSPLANTING
EYELET CELLS TO GIVE THEM
MORE INSULIN WILL BE HELPFUL
BUT NOT REALLY A CURE.
IN TYPE II DIABETES WHICH IS
THE TYPE THAT AFFECTS 90 percent OF
PEOPLE WHO HAVE DIABETES IT
IS MORE THE RESISTANCE OF
THE ACTION OF THE INSULIN,
NOT THAT THEY DON'T HAVE ANY
INSULIN.
PATIENTS ASK ME ALL THE TIME
ABOUT THIS.
AND I THINK IT IS
ENCOURAGING BUT IT IS A VERY
LIMITED NUMBER OF PEOPLE,
ONLY SELF SEN, MOST PRODUCTS
WE USE TO TREAT DIABETES
HAVE BEEN TESTED ON TENS OF
THOUSANDS OF PEOPLE THIS IS
JUST SEVEN PEOPLE, VERY
SHORT TERM STUDY.
BUT UNFORTUNATELY A LOT OF
PRESS DOESN'T MENTION THIS,
THESE PEOPLE ARE TAKING
MULTIPLE DIFFERENT DRUGS TO
PREVENT REJECTION.
SO THEY ARE TRADING INSULIN
FOR TAKING MULTIPLE DRUGS TO
PREVENT REJECTING THESE
TRANSPLANTED CELLS.
AND THESE DRUGS CAN BE
POTENTIALLY TOXIC.
AND A LOT OF PEOPLE DON'T
KNOW THAT.
SO I'M AFRAID THAT A LOT OF
THESE PEOPLE THAT GET EYELET
CELL TRANSPLANTS MAY TRADE
ONE DISEASE FOR ANOTHER,
DIABETES FOR SOME
COMPLICATION OF THE
TREATMENT.
I DON'T WANT TO SOUND
NEGATIVE, I THINK IT IS
ENCOURAGING BUT IT NOT A
CURE, NOT JUST YET.

Maureen says LET'S GO TO SOME
THINGS THAT ARE DEVELOPING
THAT MIGHT BE MORE READILY
AVAILABLE.
DIFFERENT METHODS OF TAKING
INSULIN, WHAT CAN YOU TELL
US ABOUT SAY ORAL INSULIN.

Ian says SURE, WELL INSULIN AS
MOST PEOPLE PROBABLY KNOW
HAS BEEN GIVEN BY INJECTION
WITH A NEEDLE AND SIR
INGVAR.
BUT NOWADAYS THEY ARE
LOOKING AT OTHER WAYS LIKE
ORAL INSULIN WHICH HAS BEEN
STUDIED FOR A WHILE, TO BE
TAKEN LIKE A PILL.
AND PEOPLE WHO GO ON INSULIN
ARE USUALLY VERY RETICENT.

Maureen says OF GIVING A
THEMSELVES A NEEDLE EVERYDAY

Ian says NOT VERY PLEASANT.
IT HAS BEEN TRIED BUT IT
GETS CHEWED UP INSIDE THE
STOMACH AND BOWELS SO YOU
DON'T GET MUCH ABSORPTION OF
THE ACTUAL INGREDIENT.
ANYBODY WITH ASTHMA IS
FAMILIAR WITH PUFFERS.
THEY ARE LOOKING AT WAYS OF
GIVING INSULIN THAT WAY OR
AS A NOSE SPRAY.
AND I THINK PEOPLE WOULD BE
A LOT MORE LIKELY TO AGREE
TO BE ON INSULIN IF THEY
COULD GET IT THAT WAY.
IT WOULDN'T BE PAINFUL.
AND THEY ARE DOING TRIALS OF
THAT, THEY ARE DOING HUMAN
TRIALS AND WHO KNOWS, MAYBE
IN THE NEXT YEAR OR TWO.
I THINK THERE IS ROOM FOR
OPTIMISM THERE AND AN
INSULIN PUMP?

Ian says YES, THAT IS A DIFFERENT
WAY OF GIVING INSULIN.
RATHER THAN GIVING A SYRINGE,
IT LOOKS LIKE A PAGER, ABOUT
THE SIZE OF A PAGER.
AND IT HAS GOT A LITTLE
PLASTIC TUBE AND A RESERVOIR
INSIDE THE PAGER LOOKING
DEVICE AND YOU PUT A LITTLE
NEEDLE UNDER YOUR SKIN AND
IT GIVES A CONTINUOUS
INFUSION, A CONTINUOUS
SUPPLY OF INSULIN AROUND THE
CLOCK.
STILL HAVE TO KEEP GIVING
YOURSELF INSULIN INJECTIONS,
IT IS CONTINUOUS LOW AMOUNT
AND IT WORKS VERY WELL.
PEOPLE WHO USE IT ARE
USUALLY VERY HAPPY.
EXCEPT THAT IT COSTS ABOUT
5,000 DOLLARS.

Maureen says NO!

Ian says AND COMPANIES, INSURANCE
COMPANIES ALMOST NEVER PAY
FOR IT.
SO AGAIN, THERE IS A
LIMITING FACTOR THERE.

Maureen says WOULD THERE ALSO
BE A FACTOR THAT YOU ARE
NEVER REALLY GETTING AWAY
FROM YOUR DIABETES THAT WAY,
YOU.

Ian says NO, YOU SHOW AMAZING
INSIGHT, THAT IS EXACTLY
RIGHT THAT SOME PEOPLE LOVE
IT BECAUSE THEY FEEL THEY
HAVE MOMENT TO MOMENT
CONTROL, CAN ADJUST THE RATE
OF INFUSION.
AND OTHER PEOPLE SAY EXACTLY
THAT, THEY SAY WELL NOW I
FEEL LIKE I'M TRAPPED.
LIKE I'VE ALWAYS GOT THIS
THING CONNECTED TO ME.
IF I DISCONNECT IT MY SUGARS
WILL FALL APART AND I CAN
GET SICK QUICKLY.
SAY HEY, I'M NOT INTERESTED
IN THAT.
BUT SO IT IS A GREAT POINT
AND SOME PEOPLE GET TOTALLY
TURNED OFF BECAUSE OF THAT.
HOWEVER, OF AIL THE PEOPLE,
ALL MY PATIENTS THAT HAVE
TRIED THE PUMP, THEY HAVE
DECIDED TO STAKE WITH IT,
EVEN THOUGH THEY COULD GET
MAYOR MONEY BACK IN SIX
MONTHS IF THEY DIDN'T LIKE
IT.

Maureen says WHAT ABOUT OTHER
DRUGS... DRUG AS SIDE FROM
INSULIN TO HELP CONTROL
DIABETES.
WHAT DO WE KNOW.

Ian says THERE ARE MORE AND MORE
DRUGS COMING OUT ALL THE
TIME.
AND I ALWAYS FELT JEALOUS OF
THE CARDIOLOGIST, HE ALWAYS
HAD A THOUSAND DRUGS TO
CHOOSE FROM AND THE DIABETES
SPECIALISTS HAD ABOUT THREE.
THIS ISN'T FAIR, I WANT TO
OFFER MORE.
BUT NOW WE HAVE MANY
DIFFERENT DRUGS AND NOT JUST
COPY DRUGS BUT DRUGS THAT
USE TOTALLY DIFFERENT
MECHANISMS.
THE ONE THAT HAS RECEIVED A
FAIR BIT OF PRESS AND I USED
A LOT RECENTLY, THE GENERIC
NAME IS ROSIGLITAZONE, OR
THE ADVERTISED NAME IS
AVANDIA, IT BREAKS DOWN THE
RESISTANCE TO INSULIN.
IF YOU ARE TYPE II DIABETIC
ON THAT DRUG, FOR EXAMPLE,
ROSIGLITAZONE, AND I HAVE
HAD VERY GOOD SUCCESS WITH
THAT.

Maureen says AND YOU WERE
TELLING ME THAT PATIENTS ARE
BOTH ON INSULIN AND THESE
DRUGS AS WELL.

Ian says WELL, THAT'S RIGHT.
IT USED TO BE WE HAD A
FAIRLY LAISSEZ-FAIRE
ATTITUDE TOWARDS MANAGING
TYPE II DIABETES WHICH IS
90 percent OF PEOPLE THAT HAVE IT.
IF YOU HAVE SUGAR CONTROL OR
BLOOD LEVELS AROUND 10,
PEOPLE WOULDN'T HAVE
SYMPTOMS, SAYING THAT IS
GOOD ENOUGH.
BUT BASED ON RECENT
LITERATURE WE KNOW IT IS NOT
GOOD ENOUGH.
THE LOWER THE BLOOD SUGAR,
THE HEALTHIER YOU ARE.
THE LOWER THE BLOOD SUGAR IT
LESSER RISK OF EYE DAMAGE,
KIDNEY DAMAGE, NERVE DAMAGE
AND THEREFORE SPECIALS LIKE
ME AND FAMILY DOCTORS AS
WELL ARE INCREASINGLY
AGGRESSIVE.
SO IF WE HAVE SOMEONE ON
PILLS FOR DIABETES AND IT IS
NOT ACHIEVING WHAT WE WANT,
WE ADD INSULIN OR CONVERSELY
WE ADD PILLS TO INSULIN.
WE NEVER USED TO DO THAT.
USUALLY IF YOU WERE ON
INSULIN YOU SAID THAT IS THE
LAST RESORT BUT NOW OFTEN IT
IS NOT.

Maureen says IT IS MORE
AGGRESSIVE NOW.

ABSOLUTELY INTO KIDNEY
FAILURE, EYE PROBLEMS,
AMPUTATION OF THE FEET WAS
ALWAYS A COMPLICATE...
COMPLICATION OF DIABETES, IS
THAT INEVITABLE.

The caption changes to "Doctor Ian Blumer. Internal Medicine."

Ian says NO, AND THAT IS WHAT I
MUST ADMIT GIVES ME
SATISFACTION IN WHAT I DO.
BECAUSE I DON'T HAVE TO HAVE
THE FATALISTIC APPROACH.
I KNOW I CAN MAKE
INTERVENTIONS THAT ARE GOING
TO HELP.
I DON'T WANT TO SOUND LIKE A
BIG SHOT.
IT IS THE PATIENT THAT HAS
TO DO MOST OF THE CHANGING
BECAUSE DIABETES IS
LIFESTYLE RELATED BUT WITH
AGGRESSIVE TREATMENT, IF THE
PATIENTS ARE ABLE TO FOLLOW
LIFESTYLE MEASURES WHICH IS
THE TOUGHEST TREATMENT OF
ALL, IN CONJUNCTION WITH
PILLS OR INSULIN MONITORING
APPROPRIATE STUDIES BEING
TAKEN, THEN THEY ARE LIKELY
OF COMPLICATIONS IS LARGELY
AVOIDABLE.
WE COULD REDUCE THE
LIKELIHOOD OF BLINDNESS BY
ABOUT 70 percent.
AND HUGE REDUCTION, WE
COULDN'T DO THAT BEFORE.
BUT WE CAN NOW.

Maureen says WHAT ABOUT NATURAL
PRODUCTS.
I'M READING THAT GINSENG HAS
BEEN PROVEN TO BE HELPFUL
FOR DIABETICS.

Ian says THERE IS NOTHING TO SAY
THAT A DRUG ON PRESCRIPTION
HAS TO BE BETTER THAN A
NATURAL PRODUCT.
A LOT OF DRUGS ON
PRESCRIPTION ARE NATURAL
PRODUCTS, EXTRACTED FROM
TREE BARK OR PLANTS OR
WHATEVER.
BUT GINSENG HAS BEEN STUDIED
AND IT DOES REDUCE BLOOD
SUGAR SIGNIFICANTLY.
HOWEVER, THE DEGREE TO WHICH
IT REDUCES BLOOD SUGARS IS
ABOUT HALF OF WHAT TYPICAL
PRESCRIPTION DRUGS DO.
THAT IS NOT INCONSEQUENCE.
WE KNOW ANY BLOOD SUGAR
REDUCTION IS HELPFUL AND
GINSENG IS QUITE INNOCUOUS
SO TAKING IT PERFECTLY FIN
AND IT DOES HELP TO A
DEGREE.

Maureen says SO YOU TELL YOUR
PATIENTS DON'T GIVE UP WHAT
YOU ARE ALREADY TAKING BUT
COMPLEMENT IT WITH THIS.

Ian says I THINK IT IS
INAPPROPRIATE FOR DOCTORS TO
SAY NATURALS FORGET IT,
FORGET IT, HOCUS, POCUS, IT
HAS BEEN STUDIED AND IT DOES
WORK.

Maureen says WE USED TO CALL
TYPE II DIABETES ADULT-ONSET
DIABETES BUT I UNDERSTAND
THAT IT CAN BE DETECTED IN
CHILDREN.

Ian says WELL, THAT'S RIGHT.
AND AN MAZING THING, WHICH
IS REALLY NEW, AND TYPE II
DIABETES WHICH IS TYPICALLY
ADULTS, TYPICAL MIDDLE AGE,
TYPICALLY OVERWEIGHT, IT WAS
UNHEARD OF IN KIDS.
BUT NOWADAYS UP TO 25 percent, ONE
IN FOUR KIDS IN THE STATES
IS DIAGNOSED AS HAVING
DIABETES, OF THE SO-CALLED
ADULT TYPE.
I MEAN THAT IS SO SAD
BECAUSE TYPE I DIABETES WHEN
YOU GET IT, IT IS NOT YOUR
FAULT T HAPPENS.
BUT TYPE II, THEY ARE TIP
THREE OBESE KIDS THAT SIT
AROUND SEDENTARY TOO OFTEN.

Maureen says WATCHING
TV AND PLAYING VIDEO
GAMES.
SO THE INCREASE IN OBESITY
IN CHILDREN MAY BE AT THE
ROOT OF THE INCREASE IN TYPE
II DIABETES.

Ian says IT IS A LIFESTYLE ISSUE.
THAT IS WHY IT IS SO SAD.
IT DOESN'T HAVE TO HAPPEN.
THESE KIDS IF THEY WERE OUT
PLAYING SOCCER MORE AND
PLAYING NINTENDO LESS IF I
WANTED TO MENTION TRADE
NAMES, THEN IT WOULDN'T BE
NEARLY SO LIKELY TO HAPPEN.

Maureen says BUT WE ARE STILL
PREDICTING AN EPIDEMIC OF
DIABETES IN THE FUTURE WHAT
DO WE HAVE TO DO TO MAKE
SURE THAT DOESN'T HAPPEN.

Ian says WELL, AGAIN, I HATE TO
SOUND LIKE A BROKEN RECORD
OR A BROKEN CD IF THEY SKIP,
WHICH THEY DON'T.
BUT THE POINT IS LIFESTYLE
MEASURES REMAIN PARAMOUNT.
THE LIKELIHOOD OF DIABETES
IS DIRECTLY RELATED TO WHAT
YOU DO, THE EXERCISE YOU DO,
WHETHER YOU ARE EATING THE
RIGHT FOODS OR NOT.
AND IT IS AVOIDABLE.
YOU KNOW, PEOPLE COME IN AND
ARE FEARFUL, THEY SAID MY
DAD HAD DIABETES AND MY MOM
DID, DOES THAT MEAN FOR SURE
I WILL GET IT.
NO, IT DOESN'T.
IF YOU ARE CAREFUL, IF YOU
EXERCISE REGULARLY, DON'T
GET YOURSELF O BOSE YOU YOUR
LIKELIHOOD OF GETTING
DIABETES IS DRAMATICALLY
REDUCED.
IT STILL MIGHT HAPPEN.
SOMETIMES THE WRONG THINGS
HAPPEN TO PEOPLE DOING ALL
THE RIGHT THINGS BUT THE
LIKELIHOOD IS MUCH, MUCH
LESS SO THE REASON THERE IS
AN EPIDEMIC, THE CURVE IS
GOING UP AND UP IS PURELY
RELATED TO LIFESTYLE ISSUES.
THAT IS THE TOUGHEST THERAPY
OF ALL, THOUGH.

Maureen says IT SURE IS,
THANKS FOR BRINGING US UP TO
SPEED DOCTOR BLUMER.

Ian says PLEASURE.

Maureen says COMING UP.

Joe Schwarcz THE STUDIES HAVE SHOWN
THAT CATARACTS DO NOT FORM
IN PEOPLE WHO PARTICULAR
BILBERRY.

Maureen says DOES BILBERRY A
DAY KEEP THE EYE DOCTOR
AWAY.
THAT IS LATER ON YOUR
HEALTH.

A slate appears with the logo of the show.

Now Maureen stands next to a screen with a slate that reads "Health Digest."

The caption changes to "Dementia."

Maureen says AND NOW A LOOK
AT SOME STORIES FROM THE
HEALTH FILES.
A NEW STUDY SAYS THAT
DEMENTIA IN ITS LATE STAGES
IS A TERMINAL CAN AND MAY
REQUIRE NONSTANDARD
TREATMENT FOR OTHERWISE
COMMON MEDICAL CONDITIONS.
THE STUDY FOUND THAT
PATIENTS WITH SEVERE
DEMENTIA WHO WERE
HOSPITALIZED FOR PNEUMONIA
OR HIP FRACTURES WERE FOUR
TIMES MORE LIKELY TO DIE
WITHIN SIX MONTHS OF
HOSPITALIZATION THAN
PATIENTS WITHOUT DEMENTIA
EVEN THOUGH THEY RECEIVED
SIMILAR TREATMENTS.
RESEARCHERS SAY THE FINDINGS
SUGGEST THAT ENHANCING THE
PATIENTS COMFORT MAY BE MORE
IMPORTANT THAN INVASIVE
PROCEDURES AND TESTS.

The caption on the screen now reads "15 percent birth weight."

Maureen says ADD DROPPING OUT OF HIGH
SCHOOL TO THE LIST OF
PROBLEMS EXPERIENCED IN
LATER LIFE BY LOW BIRTH
WEIGHT BABIES, A NEW STUDY
FOLLOWED A GROUP OF CHILDREN
TO AGE 19.
AND FOUND THAT WHILE MORE
THAN HALF OF THE NORMAL
BIRTH WEIGHT BABIES
GRADUATED FROM HIGH SCHOOL,
ONLY 15 percent OF LOW BIRTH WEIGHT
BABIED MADE IT TO
GRADUATION.
PREVIOUS RESEARCH SHOWED
THAT LOW BIRTH WEIGHT
CHILDREN HAVE ACADEMIC
DIFFICULTIES BUT IT WAS
THOUGHT THESE PROBLEMS FADED
OUT IN THE PRESCHOOL YEARS.
A BABY'S BIRTH WEIGHT IS
CONSIDERED LOW IF IT IS LESS
THAN FIVE AND A HALF POUNDS.

The caption on the screen now changes to "Heart disease."

Maureen says A LARGE CANADIAN STUDY
HAS KNOWN SHOWN THAT PEOPLE
FROM SOUTH ASIA ARE MORE
LIKELY TO SUFFER
CARDIOVASCULAR DISEASE THAN
PEOPLE OF EUROPEAN OR
CHINESE ORIGIN.
THAT IS A SURPRISING FINDING
GIVEN THAT EUROPEANS TEND TO
HAVE THICKER ATHEROSCLEROSIS,
A MAJOR DETERMINANT OF HEART
DISEASE.
OF THOSE STUDIED 11 percent OF
SOUTH ASIANS HAD IT COMPARED
TO FIVE percent OF EUROPEANS AND
TWO percent OF CHINESE PEOPLE.

The diabetes quiz appears on screen again.

Maureen says SO DID OUR DIABETES
DISCUSSION HELP YOU FIGURE
OUT THE ANSWER TO OUR QUIZ?
HYPERGLYCEMIA IS ANOTHER
WORD FOR HIGH BLOOD SUGAR.
OR DIABETES.
THEY DON'T GROW WILD
ALONG THE ROADSIDE BUT
BILBERRY MIGHT BE JUST WHAT
YOUR
OPHTHALMOLOGIST RECOMMENDS.
ACCORDING TO OUR HERB
ALCHEMIST JOE SCHWARCZ THE
HERB CAN PREVENT A VARIETY
OF EYE DISEASES.

Joe appears in a lab.

A caption reads "Doctor Joe Schwarcz, Ph.D. Chemist."

Joe is in his mid-forties, clean-shaven and with short wavy gray hair. He wears a black suit, a blue shirt and a polka dotted red tie.

He says DURING THE SECOND WORLD
WAR ROYAL AIR FORCE PILOTS
HAD SUCCESS SHOOTING DOWN
GERMAN AIRPLANES.
WHY?
THEY SAID THEY WERE USING
BILBERRY.
THEY WEREN'T ACTUALLY FIRING
THE BILBERRIES FROM THEIR
GUNS THEY WERE EATING
THEM.
THE PILOTS SAID THAT BEFORE
DOGFIGHTS THEY WOULD STOCK
UP ON BILBERRY JAM.
BILBERRY IS VERY MUCH LIKE A
BLUEBERRY, IT GROWS ON
LITTLE SHRUBS, MOSTLY IN
EUROPE.
AND THE SUGGESTION WAS THAT
THIS MADE THEM SEE BETTER
IN THE DARKNESS.
WELL, CAN IT REALLY DO THIS.
I SUSPECT THAT THEIR SUCCESS
WAS MORE DUE TO RADAR THAN
BILBERRIES BUT BELIEVE IT OR
NOT THERE ACTUALLY ARE
COMPOUNDS IN BILBERRIES
THAT HAVE BEEN LINKED TO THE
EYE HEALTH.
THESE ARE CALLED ANTHOCYANINS
AND THEY ARE INSTRUMENTAL IN
THE FORMATION OF A CHEMICAL IN THE EYE
CALLED RHODOPSIN ESSENTIAL FOR
SEEING WELL IN THE DARK
CONTINUES... DARKNESS BUT
MORE INTERESTING ASK THE
POSSIBILITY THAT THESE
INGREDIENTS IN BILBERRY CAN
HELP WITH CERTAIN EYE
PROBLEMS.
SOME STUDIES SHOW THAT
CATARACTS DO NOT FORM AS
EXTENSIVELY IN PEOPLE WHO
TAKE BILBERRY.
AND A TERRIBLE DISEASE
MACULAR DEGENERATION MAY
PROGRESS MORE SLOWLY WITH
BILBERRY IN THE BLOOD.
AND THE BLOOD VESSELS IN OUR
EYE AND BODY CALLED
CAPILLARIES ARE LESS PRONE
TO HEMORRHAGE OR BREAKING IF
THERE IS A HIGH LEVEL OF
ANTHOCYANINS.

He holds a pill container and says THERE IS NO RISK WITH TAKING
ANY OF THESE OF BUT YOU WANT
TO LOOK FOR SOME... YOU WANT
TO MAKE SURE YOU ARE LOOKING
AT PILLS THAT WILL ALLOW TO
TAKE ABOUT 500 TO 1000
MILLIGRAMS OF EXTRACT
EVERYDAY AND WHICH ARE
STANDARDIZED TO 25 percent
ANTHOCYANINS TO MAKE YOU SEE
BETTER.

Maureen says THANKS, JOE.
JOE WILL BE BACK NEXT WEEK
WITH ANOTHER FEATURED HERB.
AND YOU CAN GET A TRANSCRIPT
OF HIS HERBAL ADVICE ON OUR
WEB SITE VISIT
WWW.TVO.ORG/YOURHEALTH.
WE WELCOME YOUR COMMENTS
ABOUT OUR PROGRAMME.
OUR E-MAIL ADDRESS IS YOUR
YOURHEALTH@TVO.ORG.
THE FAX NUMBER IS
416-484-4519.
OR WRITE TO US AT YOUR
HEALTH PO BOX 200 STATION Q
TORONTO M4T 2T1.
THAT'S ALL THE TIME WE HAVE
FOR THIS WEEK,
I'M MAUREEN TAYLOR, THANKS
FOR WATCHING.

A slate appears with the caption "The advice given in the preceding programmes is of a general nature only viewers should consult their own medical professional for medical advice specific to their circumstances."

Music plays as the end credits roll.

Executive producer: Patricia Ellingson.

Producer: Cathy Perry.

Director: Michael Smith.

CEP Local 72m.

A production of TVOntario.

Copyright 2000. The Ontario Educational Communications Authority.

Watch: Show #2