Transcript: Your Health Season 3 Episode 4 | Oct 09, 2001

A slate reads "The advice given in the following program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

(music plays)

Against a gray background, an animated blue, green and gray grid shows clips of doctors and patients as the white letters of the title of the show fly forward: "Your Health."

Maureen says THIS WEEK...

Gerry is in his late fifties, with receding white hair and clean-shaven. He wears a plaid blue shirt.

Gerry says I SHOULD HAVE, UM, SEEN A
DOCTOR WHEN THAT FIRST
MANIFESTED ITSELF.
BECAUSE THE LATER I FOUND IT,
OF COURSE, THE BURNING WAS, IN
FACT, EATING AWAY AT THE ESOPHO
G US.

Maureen says WHY YOU SHOULD
TAKING YOUR-- TAKE YOUR HEART
BURN SERIOUSLY.

Randy is in his late forties, clean-shaven with receding combed blond hair. He sits in a wheelchair. He wears glasses and a black shirt.

Randy says MY GREATEST FEAR IS WE'RE
NOT READY FOR THAT NEXT BABY.

Maureen says THE MOST KNOW
TEROUS DRUG MAKES A COMEBACK.

Paul Caldwell is in his late fifties, with a beard and receding white hair. He wears a blue shirt and dotted yellow tie.

Paul says YOUR HEARTBEATS AND YOU'RE
AFRAID AND YOU'RE OVERWHELMED
BY THE CONVICTION THAT
SOMETHING TERRIBLE IS ABOUT TO
HAPPEN.

Maureen says DR. CALDWELL DESCRIBES A TRUE
PANIC ATTACK.

(music plays)

The animated grid appears showing clips of a woman holding a baby, pills, a surgery, a needle and a man doing exercise.

The title of the program reads "Your Health." The "R" in "Your" ends with an "X."

Maureen Taylor stands next to a screen in a studio. She is in her late thirties with shoulder-length light brown hair. She wears a light green blazer and green and blue scarf.

Maureen says HELLO.
I'M MAUREEN TAYLOR.
ACID INDIGESTION.
HOW MANY TIMES DO YOU FIND
YOURSELF REACHING FOR AN
ANTACID TO GET RID OF THAT
BURNING SENSATION IN THE THROAT
AND CHEST.
10 O MILLION DOLLARS A YEAR IS SPENT
ON THOSE MEDICATION INSIDE
CANADA.
THAT'S A LOT OF PEOPLE SELF
MEDICINE INDICATION.
PEOPLE LIKE GERRY.

The picture of Gerry appears on the screen.

Maureen continues HE WISHES HE HAD HEADED TO THE
DOCTOR INSTEAD OF THE
DRUGSTORE.

(pop music plays)

A clip plays.

A young man says I ALWAYS GET HEART BURN.

An old man says NO HEART BURN.

A man with glasses says SOMETIMES IT ALMOST MAKES ME
CRY.

A man wearing a cap says BIG TIME.

The man with glasses says SO THAT IT REALLY BURN.
SERIOUSLY.

Maureen says HEART BURN.
IT'S TO-- IT'S SO COMMON THAT
MILLIONS OF CANADIANS SUFFER
FROM IT DAILY.
YET ONLY HALF EVEN MENTION IT
TO THEIR DRRS BECAUSE THEY
DON'T THINK IT'S A MEDICAL
PROBLEM.
THAT'S EXACTLY HOW GERRY
BIERNBAUM FELT.

Doctor LawrenceCohen examines Gerry.

Gerry says I, IN FACT, IGNORED THE
SYMPTOMS BECAUSE I THOUGHT THAT
IT WASN'T SUCH A TERRIBLE
THING.
IT WASN'T MAYBE AT THE
BEGINNING.
BUT THEN IT BECAME WORSE AND
WORSE AND MORE FREQUENT.
AND-- AND, UM, AND I SHOULD
HAVE ACTED MUCH SOONER.

At a hospital, Lawrence says TAKE A DEEP BREATH FOR ME.

Maureen says GERRY BIERNBAUM FIRST
EXPERIENCED HEART BURN IN HIS
MID-40'S.

Gerry says WHEN I FIRST EXPERIENCED
HEART BURN, IT WAS IN THE UPPER
PART OF MY STOMACH AND JUST
BELOW THE THROAT.
GENERALLY AFTER I HAD EATEN AND
I RETIRED FOR THE EVENING.

Lawrence gently hits Gerry’s belly.

Maureen says BUT IT WAS FIVE
YEARS OF PERSISTENT BOUTS
BEFORE HE EVEN MENTIONED IT TO
HIS DOCTOR.

Gerry says I JUST SORT OF DIDN'T
CONSIDER IT TO BE VERY
IMPORTANT.
I TOOK AN ANTACISM D
OCCASIONALLY AND IN RETROSPECT,
THAT WAS A HUGE MISTAKE.
I SHOULD HAVE, UM, SEEN A
DOCTOR WHEN THAT FIRST
MANIFESTED ITSELF BECAUSE THE...
THE LATER I FOUND IT, OF
COURSE, THE BURNING WAS, IN
FACT, EATING AWAY AT THE ESP...
ESOPHOGUS.

Lawrence Cohen is in his mid-forties, with a short moustache and receding black hair. He wears glasses and a white doctor apron.

Lawrence says THIS IS THE HEART BURN WHERE
IT'S CONCERN.
WHERE IT'S PROLONGED THROUGHOUT
THE DAY AND DISTURBING THEIR
LIFESTYLE AND RESISTANT TO
SIMPLE ANTACIDS.

Maureen says THIS IS GASTRO ENTEMOLOGIST
IN WOMEN'S COLLEGE AND TORONTO
GENERAL.

Lawrence says THE HEART BURN IS 7-10 percent OF
THE POPULATION AND THIS GROUP
WILL EXPERIENCE HEART BURN IN A
DAILY BASIS AND GIVES MORE OF A
PROLONGED RISK OF HURTING THE
LINING OF THE ESOPHOGUS.

Maureen says THE STOMACH HAS A LINING OF
MUCOUS AND CELLS TO PROTECT IT
FROM THE ENZYMES NEED TODAY
BREAK DOWN THE FOOD.
BUT THE ESOPHOGUS DOESN'T HAVE
THIS PROTECTION.
HEART BURN PAIN IS WHEN STOMACH
ACIDS BUBBLE BACK UP INTO THE
ESOPHOGUS.

An animation shows the process explained.

Lawrence says ACID SHOULD STAY IN THE
STOMACH.
WHEN THE ACID GOES UP
INAPPROPRIATELY AND FOR LONG
PERIOD OF TIMES INTO THE ES
ESOPHOGUS, A DAMAGE IN THE
LINING OCCURS.

A camera inside the esophagus shows a red channel that leads to a cavity with a white substance attached to it.

Maureen says THIS IS A MUSCLE AT THE BASE
OF THE ESOPHOGUS.
SUPPOSED TO CLOSE BACK THE
ENTRANCE TO THE STOMACH AND
HOLD BACK THE CONTENTS.

A caption appears on screen. It reads "Doctor LawrenceCohen. Gastroenterologist."

Lawrence says WHEN IT RELAXED
INAPPROPRIATELY, THERE WILL BE
INAPPROPRIATE REFLUX OF STOMACH
CONTENTS AND THE STOMACH
CONTENTS COULD BE ACID OR BILE
IT COULD BE FOOD ITSELF SO THE
MECHANISM REF L UX IS DUE TO A
WEAKNESS OR AN INAPPROPRIATE
RELAX ACE OF THIS SPINCHTER.

Maureen says THAT'S CALLED GUR DID.

Lawrence says THE SPECTRUM OF-- UM, OF
GASTRO REFLUX CAN LEAD TO THE
INFLAMMATION OF THE ESOPHOGUS,
SHOWING REDNESS ONE LOOKS AT IT
AND TO ALCERATION.
THAT MEANS THE LINING HAS BEEN
DAMAGEED AND THERE'S SOME DEPTH
OF INJURY.
THE ULCER IS AT RISK FOR
DEVELOPING BLEEDING AND
PERHAPS, STRICTURE AND ALSO
HAVE TO BE CONCERNED THAT AN
ULCER MAY REPRESENT A CANCER.
ANYONE OVER 50 WHO HAS HEART
BURN FOR A RELATIVELY SHORT
PERIOD OF TIME AND-- AND THOSE
WHO HAVE, UM, HAVE, UM, HAVE
SYMPTOMS OF WORRISOME DISEASE,
SUCH AS WEIGHT LOSS, SWALLOWING
DIFFICULTIES, BLEEDING, UM, AND
SO ON, SHOULD BE STUDIED
PROPERLY.

Talking to Gerry, Lawrence says WHAT WE'RE GOING TO DO IS...
TO DO TODAY IS HAVE A LOOK
INSIDE YOUR...

Maureen says AN ENDOSCOPE IS
USED TO ASSESS THE DAMAGE TO
THE ESOPHOGUS.

Gerry lies on a hospital bed. Lawrence puts a plastic piece with an opening on Gerry’s mouth.

Lawrence says BREATHE AND RELAX.

Maureen says THE DOCTOR THREADS A LONG
TUBE WITH A CAMERA AT THE END
OF IT, DOWN INTO THE ESOPHOGUS
TO LOOK LINING.

Lawrence says THE DIAGNOSIS IS VIRTUALLY
INSTANTANEOUS.
WHEN THEY PUT IT IN, THEY CAN
SEE THE PROBLEM IMMEDIATELY.
AND, UM, AND IT WAS EASILY
DETERMINED THAT-- THAT THE
ULCER EXISTED.

Maureen says BUT THERE CAN BE
EVEN MORE
SERIOUS COMPLICATIONS OF
HEART BURN, INCLUDING THE RISK
OF CANCER.

Lawrence says THERE SEEMS TO BE A DEFINITE
ASSOCIATION BETWEEN THE
DURATION OF ACID REFLUX AND THE
EVOLUTION OF THE ESOPHOGUS
PROBLEM.
THIS IS THE NEW LINING THAT
REPLACES THE TRADITIONAL LINING
OF THE ESOPHOGUS WHICH IS THE
LINE THAT PUTS THE PATIENT AT
RISK OF DEVELOPING CANCER.

(music plays)

A person applies sauce to a pasta dish.

The man with glasses says I CAN'T HAVE ANY HOT SAUCE
AT ALL.

A middle-aged man says ORANGE JUICE.
TOMATO JUICE.
ACITY.

A man with short hair says GREASY, REALLY GREASY FOODS.

The man wearing a cap says PEPPER.
PEPPER'S A BIG THING.

Maureen says LIFESTYLE HABITS,
LIKE ADDING ACIDIC AND SPICY
FOODS AND EATING A LOT AT NIGHT
AND BEING OVERWEIGHT AND
SMOKING AND DRINKING ALCOHOL
DON'T CAUSE REFLUX DISEASE BUT
INCREASE THE RISK OF DEVELOPING
IT.
SO PEOPLE ARE FIRST TOLD TO
CHANGE THEIR HABITS.

Gerry walks on a treadmill.

Gerry says I HAVE TRIED TO CUT DOWN ON
THE QUANTITY OF THE FOOD THAT
EAT IN GENERAL.
I ALSO TRY NOT TO EAT LATE.
IN TERMS OF EATING WHAT I CALL
ACIDY TYPES OF FOODS LIKE THE
TOMATO SAUCE, I CUT THAT DOWN
DRAMATICALLY.
IF I EAT A SMALL AMOUNT AND EAT
IT AT THE PROPER TIME, I DON'T
HAVE ANY EFFECT EAFTER LIFESTYLE
MODIFICATION, UM, WE THEN GO TO
TO-- HAVE ANY EFFECT.

Lawrence says AFTER LIFESTYLE
MODIFICATION, UM, WE THEN GO TO
MEDICATION.
MAYBE ANTACIDS.
GAVISCON OR ALGIC OH.
N AND THEN MOVE TO A CLASS OF
DRUG CALLED THE H-2... LIKE
ACIDODINE OR PEPCID OR THOSE.

Fast clips show various types of medicines.

Gerry says THE MEDICATIONS WERE
SOMEWHAT EFFECTIVE BUT NOT
COMPLETELY EFFECTIVE.
THE ULCER WAS GETTING A LITTLE
BETTER BUT REALLY WASN'T TOO
GREAT.

Lawrence says WE FIND A LOT OF PATIENTS
DON'T DO WELL ON THIS CLASS OF
DRUG AND THEY'RE THEN ADVANCED
TO A NEWER CLASS , A MORE
EFFECTIVE CLASS CALLED PROTON
PUMP INHIBITORS.
TRADE NAMES KNOWN AS LOSEC AND
PREVACID.
WE FIND THAT THESE DRUGS ARE
VERY EFFECTIVE.
AND-- AND AS TIME HAS SHOWN,
VERY SAFE.

Gerry says THE PILL HAD-- HAD VERY,
VERY QUICK RESULTS.
I FELT RELIEF WITHIN 24 HOURS
OF TAKING THE FIRST PILL.
WHEN THE PILL EVENTUALLY PUT
THE ULCER WELL UNDER CONTROL.
SO THAT AFTER, UM, AFTER A FEW
YEARS, IN FACT, THEY WERE TIMES
WHEN IT COMPLETELY HAD
DISAPPEARED.
BUT I FOUND IF I STOPPED TAKING
THAT PILL FOR AS MUCH AS TWO OR
THREE DAYS, THEN THE PAIN WILL
START AGAIN.

Gerry drinks a glass of water to take a pill.

Lawrence says THE INFLAMMATION GENERATED
BY ACID IS NOW TREATED.
THE INJURY OF THE-- OF THE
ESOPHOGUS HEALS AND IF THE
PATIENT GOES OFF THEIR DRUGS,
THAT INJURY'S GOING TO COME
BACK.
THE RELAPSE RATE IS VERY, VERY
HIGH.
SO PATIENTS ON THIS DRUG
THERAPY HAVE TO MAINTAIN THEIR
DRUG THERAPY BECAUSE YOU
HAVEN'T TREATED THE UNDERLINED
CAUSE.

Gerry says IF I HAD KNOWN WHEN I WAS 45
YEARS OLD THAT I KNOW NOW,
THINGS WOULD HAVE BEEN
DIFFERENT.
I WOULD HAVE SOUGHT MEDICAL
IMMEDIATELY.
I WOULD HAVE TAKEN APPROPRIATE
STEPS BY WAY OF MEDICATION, BY
WAY OF POSSIBLY RAISING THE
HEAD OF MY BED, BY WAY OF
CHANGING MY EATING HABITS.
EATING A LITTLE LESS, EATING A
LITTLE EARLIER AND I MIGHT HAVE
AVOIDED SOME OF THE PROBLEMS.
I THINK I PROBABLY WOULD HAVE
AVOIDED, UM, THE ULCER HITTING
HITTING-- GETTING TO THE STAGE
THAT IT, IN FACT, DID.

Gerry works out in his house.

Maureen says OKAY.
HERE'S OUR HEALTH QUIZ FOR THIS
WEEK:

A slate appears on screen. It reads "Quiz. When doctors use the adjective ‘pulmonary’, does it refer to: 1. The lungs. 2.The heart. 3. The liver."

Maureen continues STAY TUNED FOR THE ANSWER LATER
ON "YOUR HEALTH."

Maureen and two guests sit at a table.

Maureen says EVEN THE
PRESIDENT OF THE PHARMACEUTICAL
COMPANY THAT MANUFACTURERS
PHALAMIDE ADMITS IT CAUSED MORE
HUMAN SUFFERING THAN ANY OTHER
SINGLE DRUG.
BUT THALIDIMIDE COULD HELP IN
OTHER THING MUCH IT'S INVOLVED
IN NO FEWER THAN 100 CLINICAL
TRIALS TO TREAT EVERYTHING FROM
MULTIPLE ME L ONA TO KRON'S
DISEASE.
BUT BECAUSE SOME EARLY TEST
RESULTS HAVE SO-- ARE
PROMISING, DOCTORS ARE ALREADY
USING IT.
TODAY, THE TRAGIC SIDE EFFECTS
OF THALIDIMIDE ARE WELL KNOWN.
SO BEFORE PATIENTS IN THE US
TAKE THIS NOTORIOUS DRUG,
HERE'S JUST A PORTION OF THE
KIND OF EDUCATION MATERIAL THEY
MUST WATCH.

A clip plays.

A brunette woman with short arms sits on a sofa. A caption reads "Educational video."

The woman says PLEASE, PLEASE FOLLOW YOUR
DOCTOR'S INSTRUCTIONS
CAREFULLY.
IF YOU ARE A WOMAN WHO IS ABLE
TO GET PREGNANT, YOU MUST USE
THE REQUIRED METHODS OF BIRTH
CONTROL.
AND IF YOU ARE A MAN, YOU MUST
NEVER HAVE SEXUAL ENTER COURSE
WITH A WOMAN WHO-- WITHOUT
USING A LATEX CONDOM.
AND BOTH MEN AND WOMEN SHOULD
NEVER SHARE THEIR THALIDIMIDE
CAPSULES WITH ANYONE.
I ASK YOU WITH ALL OF MY HEART
TO DO EVERYTHING POSSIBLE TO
MAKE SURE THAT NOT EVEN ONE
WOMAN IS FORCED TO DEAL WITH
THE TRAGEDY OF DEFORMITY OR
DEATH OF HER BABY DUE TO
THALIDIMIDE.

The clip ends.

Maureen says WHEN THALIDIMIDERS
LIKE THAT REALIZED THAT THE
DRUG WAS BACK, THEY WERE
DEVASTATED.
RANDY WARREN IS THE COMPEKTIVE
DIRECTOR OF THE THALIDIME
DIRECTOR'S ASSOCIATION.
THIS IS IS A SCIENTIST AND
DIRECTOR OF THE PSYCHIATRY AT
THE UNIVERSITY OF TORONTO.
GENTLEMEN, THANK YOU.
RANDY IF YOUR ASSOCIATION IS TO
AGAINST A THALIDI M IDE
COMFORT, WHY ARE MEMBERS
PARTICIPATING IN THE EDUCATIONAL
PROGRAM?

The caption changes to "Randy Warren. Thalidomide Victims Association."

Randy says IT-- IN ORDER TO PREVENT
MORE BABIES BEING BORN, UM,
THAN NECESSARILY IN-- AND WAS
WARRANTED AND WITHOUT WARNINGS,
ET CETERA, UM, WE DECIDED TO
PARTICIPATE-OF-PARTICIPANT.
HOPEFULLY OUR PARTICIPATION
WOULD BE, UM,-- WE DECIDED TO
PARTICIPANT.
HOPEFULLY OUR PARTICIPATION IS,
UM, ROOG A NUMBER OF THE RISKS.

Maureen says PETER, MANY PEOPLE
THOUGHT THIS DRUG WAS GONE FOR
GOOD.
NOBODY WAS MAKING IT.
OFF THE SHELVES.
NOBODY WAS EVEN LOOKING AT IT.
WHAT HAPPENED?

The caption changes to "Peter Wells. Professor of Pharmacy." Peter is in his fifties, with a white beard and balding. He wears a denim shirt.

Peter says IT'S NEVER BEEN OFF THE
SHEFL TOTALLY.
ONLY OFF THE SHELF IN EUROPE
AND NORTH AMERICA.
BUT USED IN AFRICA AND SOUTH
AMERICA SINCE IT WAS FIRST
MARKETED.

Maureen says FOR WHAT?

Peter says WELL, FOR LEPERCY AND AS YOU
WILL GET IN TO HERE, A LOT OF
THINGS HAVE EVOFED UNOFFICIALLY
AS WELL.
SO, WELL WHILE IT'S BEEN
REINTRODUCED FOR THINGS LIKE
LEPERCY, IT CONTINUES TO HAVE
MORE EFFECTS BEING DISCOVERED
THAT HAVE APPLICATIONS IN NEW
AREAS.
THAT'S-- THAT'S TRUE OF A LOT
OF DRUGS.
THEY HAVE SECOND-ROUND USE WHEN
IS-- WHEN THEY DISCOVER OTHER
EFFECTS.
AND, UM, AND IF THE BENEFITS
OUTWEIGH THE RISKS, THEN THEY
OFTEN WILL BE REMARKETED.

Maureen says RANDY, WHEN DID YOU
REALIZE THAT THALIDOMIDE WAS
BACK?

Randy says UM, IT WAS AROUND 1993, '94,
UM, I THINK WATCHING A TV SHOW,
WE SAW A WOMAN INGESTING, UM,
THE DRUG FOR, FOR SOME FORM OF
CANCER.
AND THEN WE REALIZED THAT...
THAT THEY'RE JUST GOING TO
BRING IT BACK BECAUSE WE DON'T
TRUST ANYBODY ANYMORE SO WE
FIGURED WOULD COME BACK INTO
LICENSED AIRNSIAS AND OUR GROUP
SAT DOWN AND DECIDED TO MAKE A
POSITION.
WE'RE RIGHT.
AMERICANS HAVE LICENSEED IT AND
LIKELY TO BE LICENSED HERE.

Maureen says YOU'RE CALM TALKING
ABOUT THIS NOW.
BUT WHEN WHAT WAS YOUR REACTION
WHEN YOU SAW THAT WOMAN INGEST
THALIDOMIDE ON TV?

Randy says I WAS HORRIFIED.
ESPECIALLY IT WAS A WOMAN THAT
WAS TAKING THE DRUG AND
AVAILABLE.
AND WITHOUT WARNINGS, UM, THERE
WAS NO REFERENCE ON THAT-- ON
THAT SHOW TO-- TO ANY OF THE
SIDE EFFECTS.
AND, UM, MY MOM TOOK IT TWICE,
AND SHE WAS DISRESPECTED BY
THAT PROGRAM I THINK EVERYONE...
EVERY-- WHAT PEOPLE DON'T REALZ
IS THAT WE'RE THE CONSEQUENCE
OF THAL THAT WILL.
YOU CAN SEE THAT.
PHYSICALLY.
OUR MOTHERS WERE THE VICTIMS OF
THE DRUG THALIDOMIDE AND OUR
FAMILIES, UM, I MEAN, IT TOOK
SUCH A TOLL.
UM, TO BE QUITE HONEST, I WAS
WATCHING IT IN A THALIDOMIDE-ER
MEETING AND THE OTHER THREE
BROKE DOWN IN TEARS.
UM, I ONLY HOLD IT TOGETHER
BECAUSE YOU HAVE TO HOLD IT
TOGETHER.
BUT EVEN NOW, UM, THIS IS NOT A
SUBJECT I SHOULD BE TALKING
ABOUT.
AND THEY SHOULD BE REPLACING
THIS DRUG.
IN THREE TO FIVE YEARS.

Maureen says LET ME GET THIS
STRAIGHT.
THALIDOMIDE HAS FDA APPROVAL
ONLY FOR LEPERCY RIGHT NOW AND
YET SALES ARE HIGHER FOR THESE
CANCER, LIKE THE-- LIKE, UM,
WHAT DID I CALL IT?
She looks at a paper and says THE MELENOMA THAT I TALK ABOUT.
HOW IS THAT POSSIBLE?

Peter says WELL, I'M NOT A PHYSICIAN.
BUT AS I UNDERSTAND IT, THE
PHYSICIAN CAN USE THE DRUG
FOR-- FOR PERSONAL PATIENTS'
USE WHEN THEY WANT TO.

Maureen says THAT'S CALLED
OFF-LABEL USE?

Peter says THAT'S RIGHT.
AND IF THERE'S SOME EVIDENCE
THAT THE PATIENTS CAN BE HEPED
BY IT AND THE CURRENT THERAPY
ISN'T GOOD ENOUGH, PHYSICIANS
ARE-- OFTEN WILL-- THERE'S SOME
PUBLISHED EVIDENCE THAT IT MAY
BE EFFECTIVE AND SOMETIMES IT
HELPS THE PATIENT AND SOMETIMES
IT DONE.
BUT THAT'S PART OF MEDICAL
EXPERIMENTATION IF YOU LIKE.
IT'S HOW WE GET SOME OF OUR
ADVANCES.

Maureen says WHAT'S THE
SITUATION HERE IN CANADA?

Peter says WELL, AS FAR AS I KNOW,
IT'S-- IT'S NOT LICENSED FOR
ANYTHING IN CANADA YET.

Maureen says BUT IN-- IT'S IN
CLINICAL TRIAL.
SOME PEOPLE ARE GETTING IT,
RIGHT, RANDY?

Randy says IT'S AVAILABLE THROUGH THE
SPECIAL ACCESS PROGRAM, WHICH
IS LIKE A COMPASSIONATE DRUGS
PROGRAM.
DRUGS NOT LICENSED YET IN THE
COUNTRY, BUT HAVE PROVEN
EFFECTIVE TO MAKE THEM
AVAILABLE UNTIL A DRUG COMPANY
ACTUALLY GOES WITH AN
APPLICATION FOR LICENSING.
THE GOVERNMENT CAN, UM, CAN
GIVE PRESCRIPTION PERMISSION IF
YOU WILL.
SCARY THING IN CANADA IS
THERE'S NO MANDATORY PROGRAM.
DOCTORS, UM, ARE NOT REQUIRED
TO-- TO GIVE CERTAIN
INFORMATION.
HOPEFULLY THEY DO.
TO PROVIDE IT WITH THAT
INFORMATION.
BUT THEY'RE NOT REQUIRED TO DO
THAT.

Maureen says WHAT DO YOU MEAN BY
CERTAIN INFORMATION?
LIKE THE VIDEO WE WERE
WATCHING?

Randy says LIKE SHOWING THE VIDEO OR
PROVIDING EDUCATIONAL TEERMS
THAT WOULD BE HANDED TO THE
PATIENT AND ENSURING THAT THEY
ACTUALLY READ IT AT THE
DOCTOR'S OFFICE.
THIS IS ALL PART OF THE
MANDATORY COMPLIANCE IN THE
U.S.
NOW THE MOST RESTRICTED...
RESTRICTED DRUG IN U.S. HISTORY
N CANADA, IT'S AVAILABLE
THROUGH CLOAK AND DAGGER,
CONTROLLED BY A GOVERNMENT THAT
ALLOWED IT TO BE LICENSEED IN
THIS COUNTRY WHEN IT WAS NEVER
LICENSED IN THE U.S. IN THE
FIRST PLACE.
WE TRUST THAT SYSTEM.
WHY?
WE DON'T.

Maureen says AND...

Peter says I THINK RANDY HAS A REALLY
GOOD POINT, ACTUALLY.
THE SYSTEM THAT-- THAT HIS
ORGANIZATION WORKED OUT WITH
THE DRUG COMPANY IS-- HAS
RESULTED IN, AS FAR AS I KNOW,
AN UNPRECEDENTED, UM, PROGRAM
FOR PROTECTING PARBTS
UM,
AND-- AND MAKING SURE THAT
PHYSICIANS DO WHAT-- PROTECTING
PATIENTS AND, UM, AND MAKING
SURE THAT THE PHYSICIANS DO
WHAT THEY SHOULD DO AND MAKE
SURE THE PATIENT ARE WELL
INFORMED.
IN ANY WAY POSSIBLE, TRYING TO
MAKE SURE THE INFORMATION GETS
OUT.
INCLUDING WEEKLY PREGNANCY
TESTING.
VERY WELL THOUGHT OUT CAREFULLY
PLANNED REGULATION THAT IS
RANDY WAS INSTRUMENTAL IN
HELPING THEM PULL TOGETHER.
AND I CAN'T IMAGINE THAT-- THAT
THE DRUG COMPANY WOULD BE ABLE
TO-- EVEN ON COMPASSIONATE USE
TO, USE IT IN CANADA WITHOUT
THE SAME SORT OF PROGRAM.
IT'S-- IT'S, UM, IT'S ALMOST
THE MINIMUM STANDARD FROM A
TOXICOLOGIST POINT OF VIEW,
WHICH IS MY SIDE OF THE WHOLE
ANGLE.
SO-- SO I-- I AM REALLY HOPING
THAT THE CANADIAN, UM, THE...
THE CANADIAN COMPANY WILL ALSO,
UM, ALSO USE THE SAME APPROACH,
EVEN THOUGH THEY'RE NOT
REQUIRED TO.

Maureen says HAVE YOU TALKED...
IT'S A DIFFERENT COMPANY IN
CANADA THAT'S DISTRIBUTING THE
DRUG?
OR...

Randy says CURRENTLY, THERE IS NO
COMPANY, UM, THAT HAS APPLIED
FOR AING OF-- LICENSING OF
THALIDOMIDE.
BUT CERTAINLY IF A COMPANY DOES
COME FORWARD, WE SBEND TO BE
INVOLVED AS THALIDOMIDE-ERS TO
MAKE SURE THERE'S A SAME
COMPLIANCE PROGRAM.
RIGHT NOW, SUPPLIED BY THE
AMERICAN COMPANY TO-- TO THE
CANADIAN GOVERNMENT.
AND-- AND PHYSICIANS APPLY TO
THE GOVERNMENT, UM, TO...
BASICALLY, BASICALLY FOR PERM
MISSION TO RELEASE THIS SPREE
DESCRIPTION OF THALIDOMIDE.
THERE'S JUST NO MANDATORY COME
LINE.
THERE'S JUST-- JUST NOT
AVAILABLE.

Maureen says THERE ARE OTHER
DRUGS THAT CAN CAUSE BIRTH
DEFECT.
ACUTAN E ONE OF MORE WELL KNOWN
ONES.
HAVE EDUCATION CAMPAIGNS WORKED
TO PREVENT BIRTH DEFECT?

Randy says IN, THEY-- NO, THEY FAILED.
ACUTANE RESULTS IN EIGHT TO TEN
LIVE BIRTHS OF PEOPLE EVERY
YEAR.
AND JUST LIKE THALIDOMIDE-- THE
PROBLEM WITH ACUTANE, AGAIN, A
VOLUNTARY COMPLIANCE PROGRAM
WHERE INFORMATION CAN BE
PROVIDED BUT DOCTORS AREN'T
REQUIRED TO-- TO DO IT.
AND DOCTORS-- DOCTORS ARE-- ARE
WONDERFUL PEOPLE.
THEY'VE SAVED MY LIFE ON MANY
TIME ON SEVERAL OCCASIONS BUT
EVERYONE GRUNLTS AT A DIFFERENT
TIME AND AT A DIFFERENT LEVEL
OF COMPREHENSION, IN MY
OPINION.
AND BIRTH DEFECT DRUGS SEEM TO
BE, UM, SEEM TO BE NOT
NECESSARILY WELL MANAGED.
AND...

Maureen says PETER, HOW
CONFIDENT ARE YOU THAT THE
PRE-INDICATIONS AT LEAST IN THE
U.S. WILL PREVENT THE BIRTH OF
A SINGLE BABY THALIDOMIDE-ER?

Peter says I DON'T THINK YOU CAN EVER
BE TOTALLY SURE.
BUT I THINK THAT-- THAT THEY
HAVE, UM, INSTITUTED EVERY
POSSIBLE THING.
AND EVERY POSSIBLE PROGRAM
THAT-- THAT, THAT WILL MINIMIZE
THAT.
AND I THINK THAT-- THAT NOTHING
EVEN REMOTELY LIKE IT.
EVEN ACUTANE WHICH IS
VOLUNTARY.
THAT'S A MAJOR DISADVANTAGE
BECAUSE IF IT'S VOLUNTARY AND
SOME PHYSICIANS AND SOME
PATIENTS WILL NOT BE AS
RIGOROUS AS THEY SHOULD BE.
UM, AND-- AND I THINK THAT...
THAT AS RANDY SAYS, THAT'S WHY
ACUTANE, THE PROGRAM HASN'T
BEEN AS EFFECTIVE AS IT COULD
BE.
ALTHOUGH IT'S STILL PROBABLY
SAVED A LOT OF KIDS.

Maureen says QUICK QUESTION...

Randy says BUT IN THREE YEARS, THERE'S
BEEN NO FETAL EXPOSURE WITH
THALIDOMIDE.
AND IT KEEPS DOUBLING EVERY
YEAR FOR THE PILL.
HOWEVER, DON'T MAKE ANY
MISTAKE, THERE WILL BE A BABY.

Maureen says WHAT ABOUT THE
EFFECTS ON THE PERSON WHO TAKES
IT?
WE KNOW THE EFFECTS ON THE
BABY, OBVIOUSLY.
BUT WHAT ABOUT YOUR MOM?
SHE ONLY TOOK IT TWICE.
DID ANY LONG-TERM EFFECTS OF
THALIDOMIDE ON THE PEOPLE WHO
ACTUALLY INGEST THE PILLS?

Randy says FUNNY, EH?
BRING BACK A DRUG THAT WAS
AROUND 40 YEARS AGO AND THEY
DECIDED NEVER TO CHECK THAT
POPULATION THAT COULD HAVE BEEN
PROVEN TO HAVE TAKEN IT FOR THE
LONG-TERM EFFECTS.
HOWEVER, THERE ARE OTHER SIDE
EFFECTS.
AND-- AND OUR ASSOCIATION
REALLY FIGHTS FOR PEOPLE TO
MAKE A RISK AWARE CHOICE.
OBVIOUSLY IF YOU'RE DYING OF
MULTIPLE MELENOMA, MANY SIDE
EFFECTS ARE REALLY GOING TO BE,
WHO CARES, WE'RE GOING TO TAKE
IT.
BUT THERE'S NUMBNESS AND
TINGLING HANDS AND FEET.
THE FIRST VICTIMS OF
THALIDOMIDE WERE THOSE PEOPLE
WHO SUFFERED FROM THAT.
CONSTIPATION AND YOU CAN'T
OPERATE ANY MACHINERY WHEN
YOU'VE TAKEN IT.
AND, UM, MANY SIDE EFFECTS.

Maureen says RANDY , WHAT IS
YOUR GREATEST FEAR NOW THAT
THIS IS BACK?
MAYBE BACK IN FORCE SOON?

Randy says MY GREATEST FEAR IS THE BABY
THAT WILL BE BORN.
BECAUSE THE MORE THAT THE TAB
LETS ARE OUT THERE ON THE
MARKET THE MORE THAN LIKELY
THERE WILL BE A BABY BORN OR A
FETAL EXPOSURE AND, UM, AND I
KNOW VERY WELL WHAT WILL
HAPPEN.
THAT BABY WILL BE THE
RESPONSIBILITY OF THE
THALIDOMIDEERS THAT CAME
BEFORE.
BECAUSE GOVERNMENTS TURNED
THEIR BACK ON US BEFORE.
AND THEY'LL TURN THE BACK
AGAIN.
DRUG COMPANIES ARE NOTORIOUS
FOR SHUTTING DOWN IN A CRISIS
AND THEY'LL SHUT DOWN AGAIN SO
MY GREATEST FEAR IS THAT NEXT
CHILD WHEN SOCIETY'S NOT READY
FOR THAT BABY.
THAT'S MY GREATEST FEAR.

Maureen says I HOPE THAT DOESN'T
HAPPEN.
THANK YOU BOTH FOR TALKING TO
US TODAY.

Randy and Peter say THANK YOU.

Maureen says COMING UP...

In a clip, Paul says FOR 5 percent OF THE POPULATION,
EPISODES OF PANIC CAN OCCUR
WITHOUT ANY CAUSE WHATSOEVER.

Maureen says DR. PAUL CALDWELL ON PANIC
ATTACKS.

The opening sequence rolls again.

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

Maureen says NOW SOME STORIES MAKING HEALTH
NEWS.
ENDOCRONOLOGISTS IN THE U.S.
WANT TO SCREEN PEOPLE FOR
DIABETES AT AGE 30 IF THEY'RE
IN A HIGH-RISK GROUP.

The screen reads "Diabetes." A picture of a hand holding a blood glucose monitor appears.

She continues PREVIOUSLY, U.S. GUIDELINES
RECOMMENDED SCREENING START AT
AGE 45.
BUT DOCTORS ARE FINDING THAT...
THAT HALF OF PEOPLE DIAGNOSED
WITH DIABETES ARE ALREADY
SUFFERING COMPLICATIONS OF THE
DISEASE.
IN CANADA, EVERYONE IS URGED TO
BE TESTED FOR DIABETES AT AGE
40, EARLIER IF YOU'RE AT HIGH
RISK.
THOSE AT HIGH RISK INCLUDE
PEOPLE WITH A FAMILY HISTORY OF
DIABETES, PEOPLE WHO ARE
OVERWEIGHT, PEOPLE IN CERTAIN
ETHNIC GROUPS, SUCH AS
ABORIGINALS AND AFRICAN
CANADIANS AND WOMEN WHO HAVE
DELIVERED A BABY WEIGHING MORE
THAN 9 POUNDS.

The caption changes to "Alcohol." A picture of glass bottles appears.

She continues A RECENT STUDY NOW SAYS THAT
ALCOHOL MAY NOT BE ALL THAT
HEALTHY.
RESEARCHERS LOOKED AT MORE THAN
70,000 MIDDLE-AGED FRENCH
WOMEN.
AND FOUND THAT THOSE WHO DRANK
THE MOST ALCOHOL ALSO HAD
POORER DIETS.
AND THEY CONSUMED ABOUT 30 percent MORE
CALORIES AND 32 percent MORE CHOLE
CHOLESTEROL THAN TEA TOTALERS.
INTAKE OF FAT AND CALORIES ROSE
IN TANDEM WITH THE AMOUNT OF
ALCOHOL USED.
HEAVY TRIFRPGSERS-- DRINKERS
TEND TODAY EAT MORE PROCESSED
MEATS AND CHEESE AND BREADS AND
FEWER FRUITS AND VEGETABLES.
RESULTS CONTRADICT-- CONTRADICT
PREVIOUS STUDIES THAT MODERATE
DRINKERS HAVE HEALTHIER DIETS
THAN NONDRINKERS.

The caption changes to "Sleep Apnea." A picture shows a woman sleeping.

She continues IT DOESN'T SOUND COMFORTABLE
BUT A NEW TWICE WORN IN THE
MOUTH WHILE YOU SLEEP CAN
PREVENT NORG AND SLEEP APNEA.
THEY TRIED THE SPLINT IN 24
PATIENT WAS SLEEP APNEA.
THAT'S A CONDITION OF SNORING,
ACCOMPANIED BY INTERRUPTED
PERIODS OF BREATHING DURING
SLEEP.
THEY FOUND THAT EPISODES OF
SLEEP APNEA FELL FROM 30 PER
HOUR WITHOUT THE SPLINT TO ONLY
14 AN HOUR WITH IT.
SNORING DECREASED BY 65 percent AND IT
WAS LESS NOISY.
BUT IT TOOK AN AVERAGE OF 20
WEEKS FOR PATIENT TODAY REALIZE
THE FULL BENEFITS OF THE
SPLINT.
HERE'S THE ANSWER TO THIS WEEK'S
WEEK'S...

The Quiz slate appears. The answer "1. Lungs" appears highlighted in yellow.

Maureen says THOSE WHO SUFFER
FROM PANIC DISORDERS SAY THAT
PANIC DONE BEGIN TO DESCRIBE
HOW THEY FEEL IN THE THROES OF
AN ATTACK.
IT'S MORE TERRIFYING THAN
ANYTHING THEY'VE EVER
EXPERIENCED.
HERE'S DR. PAUL CALDWELL ON
PANIC ATTACKS.

Paul sits at a table with a heart model on it. Behind him, a human anatomy model sits on a piece of furniture.

Paul says YOU WANT TO KNOW WHAT I
SEE A LOT OF IN MY OFFICE AND
THE EMERGENCY ROOM: PANIC
ATTACKS.
WE ALL KNOW WHAT PANIC FEELS
LIKE.
BUT USUALLY WE HAVE A REASON TO
PANIC.
A BUMP IN THE NIGHT, OUR
TEENAGER IS LATE COMING HOME.
REALLY LATE.
BUT FOR 5 percent OF THE POPULATION,
EPISODES OF PANIC CAN OCCUR
WITHOUT ANY CAUSE WHATSOEVER.
AND THESE SO-CALLED PANIC
ATTACKS COME ON ANY TIME.
AND WE-- YOU COULD BE READING A
NEWSPAPER OR EATING LUNCH.
OR WATCHING TV OR CHATTING WITH
A FRIEND.
THERE'S NO APPARENT EXTERNAL
STRESS OR CAUSE.

The caption changes to "Doctor Paul Caldwell. Family Physician."

He continues AND AN ATTACK USUALLY STARTS
WITH AN INTENSE FEELING OF
DREAD AND FOLLOWED BY A
SHORTNESS OF BREATH AND NAUSEA.
AND THE HEART RACES AND
SOMETIMES YOU FEEL INTENSELY
AFRAID AND SWEATY.
YOU'RE
OVERWHELMED BY THE CONVICTION
THAT SOMETHING AWFUL IS ABOUT TO
HAPPEN.
SOMETIMES YOUR FACE OR HANDS
BEGIN TO TINGLE.
AND YOU MAY FEEL AS IF YOU'LL
PASS OUT.
OFTEN YOU SEE YOURSELF OUTSIDE
OF YOUR BODY, LOOKING DOWN ON
YOURSELF AS IF FROM AFAR.
PANIC ATTACKS USUALLY LAST
BETWEEN 15 TO 20 MINUTES.
ALTHOUGH THEY MAY BE LONGER.
THEY MAY BE RECURRING.
A CONDITION KNOWN AS PANIC
DISORDER.
PANIC ATTACKS ARE OFTEN
ASSOCIATED WITH ANOTHER ANXIETY
DISORDER: AGRO-PHOBIA.
THE INTENSE AND IRRATIONAL FEAR
OF BEING IN A CROWDED OR CLOSED
SPACE.
AGRO IS THE FRWEEK WORD FOR
MARKETPLACE AND BEING IN THE
SITUATION LIKE A MARKET WITH
ITS HUSTLE AND BUS DISPL...
HUSTLE AND BUSTLE AND CROWDED
WITH VENDORS AND BUYERS, THAT
PRODUCERS PANIC-LIKE STATE.
SOMETIMES PANIC DISORDER AND
AGROPHOBIA THAT THE PERSON
AVOIDS SOCIAL CONTACT.
EVEN HIDING INSIDE THE HOME TO
TRY TO PREVENT THE INTENSE
UNPLEASANT FEELING.
ANXIETY, THE STATE OF BEING
WORRIED OR TROUBLED, AS YOU
CONSIDER WHAT MIGHT HAPPEN IN
THE FUTURE, IT'S NOT A BAD
THING.
IN FACT, IT CAN BE A GOOD
THING.
IF-- IT ALLOWS US TO PREPARE
OURSELVES FOR WHAT MIGHT OCCUR
IN THE FUTURE.
BUT IN CASES OF PANIC DISORDER,
THE ANXIETY IS NO LONGER
HELPFUL.
IT'S A DESTRUCTIVE FORCE,
LIMITING OUR PERFORM AND
ENJOYMENT OF LIFE.
AND THE GOOD THING IS THAT
ANXIETY DISORDERS ARE VERY
TREATABLE.
USUALLY BY A COMBINING OF
MEDICINES AND PSYCHOLOGICAL
THERAPY SO WHY NOT TALK TO YOUR
DOCTOR SO I DON'T SEE YOU IN
THE EMERGENCY ROOM?

Maureen says THANKS, DR.
CALDWELL.
YOU'LL FIND:

The caption changes to "www.tvo.org/yourhealth."

Maureen concludes THAT'S ALL THE TIME WE HAVE
FOR THIS EDITION OF "YOUR
HEALTH."
I'M MAUREEN TAYLOR.
THANKS FOR WATCHING.

A final slate reads "Your Health. Email: yourhealth@tvo.org. Fax: 416-484-4519. Mail: Box 200, Station Q, Toronto, ON, M4T 2T1."

Logo: CEP Local 72m.

A production of TVOntario. Copyright 2001, The Ontario Educational Communications Authority.

Watch: Your Health Season 3 Episode 4