Transcript: Your Health Season 3 Episode 13 | Dec 18, 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…

Anita Hall is in her early forties with long curly dark brown hair. She wears a sleeveless orange sweater.

Anita says CLEAR FROM THE X RAYS

Maureen says TUBERCULOSIS
AT HOME

Jay Keystone is in his early fifties, clean-shaven with brown hair. He wears glasses, black suit, blue shirt and patterned blue and black tie.

Jay says WE LOSE THEM
IN THE PUBLIC SYSTEM
AS SOON AS THEY
ARRIVE IN THE COUNTRY.

Maureen says … AND ABROAD.

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

Paul says BUT PERHAPS THE
MOST COMMON IS
DAMAGE
TO THE CARTILAGE WITHIN YOUR
KNEE.

Maureen says AND FALLING ON YOUR KNEES
WITH DR. PAUL WALED WELL.

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 gray blazer and orange, blue and light brown diamond scarf.

Maureen says HELLO I'M MAUREEN TAYLOR.
MANY CANADIANS ARE OLD
ENOUGH TO REMEMBER
SANITORIUMS WHERE THOUSANDS
WERE QUARANTINED WITH WITH
TUBERCULOSIS.
ABOUT TWO BILLION PEOPLE ARE
STILL INFECTED WORLDWIDE.
AND AS MANY AS 3 MILLION
PEOPLE DIED FROM TB EVERY
YEAR.
LATER WE'LL TALK TO AN
EXPERT ABOUT WHY CANADIANS
NEED TO BE CONCERNED ABOUT
TB AND OTHER DISEASES.
BUT FIRST WE MEET ANITA
HALL.

The screen shows a picture of Anita.

Maureen continues BORN IN CANADA, SHE NEVER
DREAMED SHE WAS AT RISK.
AND SHE LIVED WITH ACTIVE TB
FOR MONTHS BEFORE SHE WAS
DIAGNOSED AND TREATED.

[monitor beeps]
A blue slate reads "A Critical Cough. Produced by Janet Aronoff."

A clip plays.

(guitar music plays)

Anita lies in a hospital bed. She has an arm in plaster.

Anita says I KNEW THAT I WAS
EXHAUSTED.
YOU COULD STAY IN BED FOR
HOURS ON END REGARDLESS
WHETHER YOU'D SLEPT EIGHT
HOURS.
YOU WOULD STILL BE THERE.
A LACK OF INTEREST IN
ANYTHING.
HEADING FOR DEPRESSION.
I WOULD FEEL LIKE I WAS
GETTING A COLD BUT THE COUGH
WAS HUGE.
AND THE CONGESTION IN MY
CHEST WAS SO SEVERE THAT I
WOULD WAKE UP IN THE MORNING
AND I OBVIOUSLY COUGHED SO
VIOLENTLY DURING THE NIGHT
THAT, I ACTUALLY COUGHED
PHLEGM FROM MY CHEST SO HARD
THAT IT SHOT ACROSS THE ROOM
AND HIT THE WALL.
WHAT BEGAN WHICH WAS NIGHT
SWEATS, IT'S LIKE FREEZING
TO DEATH IN YOUR OWN BED IN
A PUDDLE OF WATER THAT YOU
DON'T KNOW WHERE IT CAME
FROM.
YOU WAKE UP CURLED IN A BALL
WITH EVERY AVAILABLE BIT OF
BLANKET WRAPPED AROUND YOU.
AND YOU'RE SOAKING WET.
BUT IT'S LIKE ICE.
LIKE ICE WATER.
AND YOU'RE SORT OF YOU KNOW
WHAT'S GOING ON?
YOU KNOW, WHAT IS THIS,
WHERE IS THIS COMING FROM?
WHAT'S WRONG?
AT THAT POINT IN TIME I
COULDN'T SORT OF TAKE A LOOK
AT THE BIG PICTURE OF WHAT I
WAS DOING TO MYSELF, AND THE
FACT THAT YEAH, I WAS
PROBABLY SICK AND WHAT COULD
IT BE, I DIDN'T THINK ABOUT
IT.

A caption appears on screen. It reads "Anita."

Anita continues ALL I KNEW IS YEAH, THERE IS
SOMETHING WRONG AND WHEN I
ACTUALLY REALIZED HOW
DESPERATELY I NEEDED TO DO
SOMETHING, TOY CUSSED IT ALL
ON WHAT IS THE BIGGEST
PROBLEM THAT I HAVE.
AND FOR ME, IT WAS THE
ALCOHOL.
SO, I DECIDED I WAS GOING TO
GO INTO A REHABILITATION
PROGRAMME TO DO THAT, I HAD
TO HAVE A PHYSICAL BECAUSE
IF YOU'RE GOING TO GO INTO
RESIDENTIAL, YOU YOU KNOW
HAVE TO BE CHEQUED OUT
BEFORE YOU GO IN.
WHEN I DID THAT, THEY AMONG
OTHER THINGS DO A
TUBERCULOSIS TEST AND IT WAS
VERY CLEAR FROM THE X-RAYS,
THAT I HAD A VERY BAD CASE
OF TUBERCULOSIS.
AND WHAT THEY DISCOVERED WAS
THAT I PROBABLY HAD IT FOR
ABOUT A YEAR.

A female doctor uses a stethoscope on Anita’s back.

Doctor Jae Yang is in his late thirties, clean-shaven with short black hair. He wears round glasses, dark brown suit, white shirt and patterned black tie.

Talking to Anita, Jae says CAN YOU OPEN YOUR MOUTH
AND TAKE DEEP BREATHS FOR ME
PLEASE.

Jae says TUBERCULOSIS IS AN
INFECTION WHICH CAN BE
TRANSMITED FROM PEOPLE TO
PEOPLE.
AND MOST TUBERCULOSIS WE SEE
IS IN THE LUNGS.
THEY CAN COUGH OUT THE
BACTERIA AND THEN OTHER
PEOPLE CAN INHALE IT AND
THEN DEVELOP AN INFECTION.

The caption changes to "Doctor Jae Yang. Saint Michael’s Hospital."

Jae continues MOST PEOPLE ONCE THEY'RE
INFECTED DON'T GO RIGHT AWAY
TO HAVING ACTIVE
TUBERCULOSIS.
HOWEVER, LATER IN LIFE
THERE'S PROBABLY ABOUT A 10 percent
CHANCE THAT THEY MAY DEVELOP
ACTIVE TUBERCULOSIS AND
ACTUALLY GET SICK.

Anita says I REMEMBER WHEN THEY TOLD
ME THAT I HAD TUBERCULOSIS,
AND I REMEMBER LOOKING AT MY
DOCTOR, AND I JUST WAS
SHOCKED AND I WAS STUNNED
AND I JUST KIND OF LOOKED AT
HIM VERY WIDE EYED, I
SUPPOSE AS WIDE EYED AS I
COULD HAVE BEEN AT THE TIME
AND JUST SAID, WHAT?
HOW?
FROM WHERE?
AND HE SAID YOUR BODY, THE
WAY OR THE SHAPE THAT YOUR
BODY IS IN, YOU KNOW IT'S
NOT A SURPRISE.

Jae says ACTIVE TUBERCULOSIS MEANS
THAT THE PERSON HAS A LARGE
BURDEN OF BACTERIA IN THEIR
SYSTEM USUALLY IN THEIR
LUNGS.
AND THEY'RE SICK FROM IT AND
THEY'RES WILL INFECTIOUS.
WHEN YOU HAVE LATEENT WHICH
THE MAJORITY OF PEOPLE DO,
IT MEANS THE BACTERIA ZBOOT
THE PERSON'S SYSTEM, AND THE
BODY FOUGHT IT OFF.
BUT THE TB HIBERNATES OR
HIDES IN THE SYSTEM, USUALLY
IN THE LUNGS OR OTHER ORGANS
AND AT SOME LATER POINT, IF
THERE IS A BREAKDOWN IN THE
IMMUNITY OF THE PERSON AS WE
ALL AGE, OUR IMMUNITY WANES.
IF WE GOT SICK BECAUSE OF
SOME SORT OF A SUPPRESSIVE
CONDITION THEN THE TB WILL
MULTIPLY AND DEVELOP INTO
ACTIVE TUBERCULOSIS.

Jae checks Anita’s throat.

Anita says WHEN THE BOYD IS IN A
WEAKENED STATE, AND THAT
CAME FROM THE ALCOHOLISM,
FROM ME JUST DESTROYING MY
BODY WITH ALCOHOL, MY BODY
COULDN'T HANDLE ANYMORE AND
WHERE A REGULAR PERSON WHO
IS FIT, WHO HAS BEEN EATING
PROPERLY, BODY IS
FUNCTIONING WELL, YOU KNOW
IF THEY'RE EXPOSED TO THE TB
GERM THEY CAN ACTUALLY, IT
ENTERS THE BODY, IT CAN
ENCAPSULATE IN THE BODY AND
WON'T YOU KNOW SORT OF
MANIFEST IN ACTUAL ACTIVE
TB.
WHEREAS WITH MY BODY,
EVERYTHING WAS SO COMPLETELY
RUNDOWN THAT EVEN MY IMMUNE
SYSTEM WASN'T FUNCTIONING
WELL, SO I WASN'T ABLE TO
FIGHT IT OFF.

Jae looks at X-rays.

Jae says THE GOOD NEWS IS MOST
TUBERCULOSIS CASES ALMOST
ALL TUBERCULOSIS CASES CAN
BEEN TREATED.
WITH MEDICATIONS.

The caption changes to "Medical Director TB Program."

Jae continues HOWEVER, I THINK WE HAVE TO
BE VIGILANT ESPECIALLY AS
PHYSICIANINGS TO BE THINKING
THAT SOME PEOPLE WHO PRESENT
TO US WITH ABNORMAL SYMPTOMS
SUCH AS PROLONGED COUGH,
FEVERS, NIGHT SWEATS, WEIGHT
LOSS, WE HAVE TO THINK THAT
TUBERCULOSIS MIGHT CERTAINLY
BE A CAUSE OF THEIR
SYMPTOMS.
AND NOT JUST THE COMMON
THINGS LIKE PNEUMONIA OR
BRONCHITIS OR OTHER TYPES OF
INFECTIONS.

During an examination, the female doctor says YOU'RE GOING TO HAVE TO
HOLD ON TO THIS.
PUT THIS IN YOUR MOUTH.

Jae says DOING THE TEST IS VERY
SIMPLE AND CAN BE HIGHLY
EFFECTIVE IN FINDING A
DIAGNOSIS.

Anita says WHAT WAS REALLY ODD ABOUT
WAS THAT YOU DIDN'T GO DAY
OF DAY AFTER DAY FEELING ILL,
OF AT LEAST I DIDN'T.
I WENT THROUGH PERIODS WHERE
IT WOULD BE TWO MONTHS OR
2.5 MONTHS, 3 MONTHS WHERE I
WOULD BE FINE THEN IT WOULD
HIT LIKE A COLD, I THOUGHT.
I ALWAYS HAD A COUGH BUT I
THOUGHT BECAUSE I SMOKE TOO
MUCH.
IT'S BECAUSE I DRINK TOO
MUCH.
IT'S, YOU KNOW.
AND THERE'S AN ATTITUDE THAT
YOU GET WHICH YOU REACH THAT
POINT OF DESTROYING YOUR OWN
FWHED YOU BECOME USED TO THE
FEELINGS OF FEELING BAD.
SO, IF IT DOESN'T FEEL, IF
IT FEELS AS BAD AS IT
USUALLY DOES, IT'S NORMAL.

A male doctor X-rays a patient.

The male doctor says AND BREATHE.

Jae says THE COURSE OF THE
TREATMENT WE USUALLY USE IS
A STANDARD REGIMEN OF MANY
ANTITB MEDICATIONS.
IT IS HIGHLY EFFECTIVE IF
THE PERSON TAKES THE
MEDICATIONS APPROPRIATELY.
SOMETIMES THOUGH, WE DO RUN
INTO DRUG RESISTANT
TUBERCULOSIS AND THAT CAN
COMPLICATE THINGS BECAUSE
ONE, WE MAY NOT BE ABLE TO
USE OUR STANDARD MEDICATIONS,
SO THE PATIENT MAY HAVE TO
BE ON MORE TOXIC DRUGS.
THEY MAY HAVE TO BE ON
LONGER THERAPY.
AND IN SOME RARE INSTANCES
EVEN WITH MEDICATIONS WE'RE
NOT ABLE TO COMPLETELY
ERADICATE THE TUBERCULOSIS.

Jennifer Sedgwick walks into Anita’s house. She is in her forties with short curly brown hair. She wears glasses and a red and black long dress.

Jennifer says I'M JENNIFER SEDGWICK.
ONE OF THE NURSES THAT WORKS
WITHIN THE TB PROGRAMME FOR
TORONTO PUBLIC HEALTH, AND
MY JOB IS TO FOLLOW UP WITH
PATIENTS WHO HAVE BEENEN
DIAGNOSED WITH TB.
MAKE SURE THE PATIENT
UNDERSTANDS ABOUT THEIR
MEDICATION, AND WE WORK
COOPERATIVELY WITH THE
DOCTOR AND WITH THE PATIENT
SO ENSURE THEY COMPLETE
TREATMENT.

Talking to Anita, Jennifer says I'LL KEEP TRACK OF IT AND
BRING SOME MORE.
YOU KNOW.

Anita says DO YOU KNOW HOW MUCH
LONGER THIS IS GOING TO
HAPPEN?
IN TERMS OF THE MEDICATION
TIME?

Jennifer says YEAH.
FOR YOU, IT COULD BE LET ME
SEE YOU'VE BEEN ON
MEDICATION NOW FOR FIVE
MONTH.

Anita says YEAH.

Jennifer says YEAH.
IT'S GOING TO BE ANYWHERE
BETWEEN SIX AND NINE I
THINK.

Jae says NONCOMPLIANCE TO TB
THERAPY OCCURS TOO OFTEN.
BACK IN THE 19 EARLY 1990S,
THERE WAS A STUDY WHICH
SHOWED THAT IN TORONTO ONLY
58 percent OF PEOPLE WHO STARTED TB
MEDICATIONS SEEMED TO
FINISH.
SINCE OUR PROGRAMME HAS
OPENED WE'VE HAD IN OUR
FIRST YEAR 91 percent OF OUR
PATIENTS FINISHING THEIR
THERAPY AND A LOT HAS TO DO
WITH THE CONNECTIONS WE'VE
MADE THROUGH TORONTO PUBLIC
HEALTH WHO WORK WITH US TO
MAKE CERTAIN THAT THE PEOPLE
TAKE THEIR MEDICATIONS
THROUGH DIRECTLY OBSERVED
THERAPY, ANDS WILL THEY
FOLLOW UP WITH US TO MAKE
CERTAIN THAT THEY'RE HAVING
THOSE SIDE EFFECTS AND NO
PROBLEMS.

Jennifer says YOU TAKE CARE.

Anita says ALL RIGHT.

The caption changes to "Jennifer Sedgewick. Public Health Nurse. TB Program."

Jennifer says PEOPLE FEEL GREAT A LONG
TIME BEFORE THEY'RE FINISHED
THEIR TREATMENT AND IF THEY
HAVE TO BE ON MEDICATION FOR
SIX MONTHS OR A YEAR AND
THEY'LL GREAT AT TWO MONTHS
THEY'RE THINKING THIS IS
SILLY.
WHY AM I STILL ON THE
MEDICATION.
BUT THIS GERM, IT'S A
FIGHTER.
YOU KNOW, THE BACTERIA IS A
FEISTY ONE AND WE HAVE TO DO
WHAT WE CAN TO KILL IT OFF.

Jae says A QUESTION THAT I WOULD
ASK SOMETIMES IS IF TIME IN
AN ELEVATOR GOING UP TO THE
50th FLOOR IN THE BUILDING
WITH SOMEONE WHO HAS ACTIVE
TB AM I LIKELY TO CATCH IT.
PROBABLY THE ANSWER I WOULD
GIVE QUICKLY SUN LIKELY.
THE REASON I SAY THAT IS
THAT IN SOME PEOPLE WHAT
CANS WILL OCCUR IS THAT THEY
MAY ACTUALLY BREATHE IN SOME
TB BACTERIA INTO THEIR
SYSTEM.
BUT REMEMBER, WE ALL HAVE
IMMUNITY.
AND IF YOUR IMMUNITY KILLS
IT BEFORE IT SEED INTO YOUR
LUNGS YOU'RE NOT GOING TO
HAVE ANY REACTION.

Jennifer says IF PEOPLE ARE CONCERNED
ABOUT OH I CAN BE PICKING UP
TB ON THE SUBWAY.
THE AMOUNT OF TIME YOU'RE
NEAR SOMEBODYEN THAT HAS
ACTIVE TB IT'S UNLIKELY YOU
WOULD GET IT FROM A LIMITED
CONTACT LIKE THAT.

Jae says AIRPLANES HAVE BEEN
ANOTHER ISSUE IF SOMEONE HAS
ACTIVE TUBERCULOSIS ON AN
AIRPLANE DO, WE HAVE TO GET
CONCERNED?
WELL, I WOULD CERTAINLY SAY
FOR THE PEOPLE SITTING
DIRECTLY AROUND THAT PERSON,
YES.
IT'S MORE DEBATABLE AS TO IF
PEOPLE IN THE BACK OF THE
PLANE HAVE TO BE CONCERNED
BECAUSE THE PERSON IN THE
FRONT OF THE PLANE HAD TB.
THAT'S A BIT MORE DEBATABLE.

Jennifer says CHILDREN WHO LIVE WITH A
PERSON WHO HAS ACTIVE TB AND
ARE UNDER THE AGE OF SIX, WE
STRONGLY RECOMMEND TO THE
PARENTS THAT THEY BE PUT ON
MEDICATION.
BECAUSE THEY ARE SO
SUSCEPTIBLE.
THEY PICK IT UP SO EASILY
THAT THEY SHOULD BE ON
MEDICATION REGARDLESS OF
WHETHER THEIR SKIN TEST IS
POSITIVE OR NEGATIVE.
IF YOU ARE CONCERNED THAT
YOU HAVE BEEN EXPOSED THEN
YOU GET YOURSELF CHEQUED
OUT.
CERTAINLY GET A SKIN TEST IF
YOU BELIEVE YOU'VE BEEN
EXPOSED AND TALK TO THE
DOCTOR.
IF IT IS POSITIVE UNDERSTAND
THAT DOESN'T MEAN YOU HAVE
ACTIVE TB.
THE CHEST X-RAY AND THEN
DETERMINE WITH YOUR DOCTOR
IF YOU'RE GOING TO GO ON
MEDICATION OR NO.

Jennifer gives a shot to a woman.

Anita feeds her cats.

Anita says I WAS TRYING TO GET INTO
A REHAB PROGRAMME WHEN
THROUGH THE TESTING THAT WAS
REQUIRED THEY DISCOVERED
THAT I HAD TUBERCULOSIS.
NOW, IF I HADN'T RECOGNIZED
I NEEDED HELP THEY WOULDN'T
HAVE FOUND OUT ABOUT THE TB.
AND GIVEN THE FACT THAT I
WAS IN THE SHAPE THAT I WAS
IN, AND THEY GAVE ME THE
PROGNOSIS WHICH THEY DID, IF
I HADN'T CHOSEN THAT
PERSONALLY, I HAD TO MAKE
THAT DECISION, THEN I WOULD
BE DEAD.
I WOULD BE DEAD.

The clip ends.

(music plays)

Maureen says MORE ON
TUBERCULOSIS IN A MOMENT.
BUT FIRST, WHICH OF THE
FOLLOWING FAMOUS POETS DID
NOT HAVE TB?

A gray slate "Quiz. 1. John Keats. 2. Percy Shelley. 3. Robert Browning."

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

Maureen and Jay sit at a table.

Maureen says WE DON'T KNOW
HOW ANITA HALL CONTRACTED TB
BUT WE KNOW IN TORONTO
IMMIGRANTS AND REFUGEES MAKE
UP 90 percent OF NEW CASES OF
ACTIVE TUBERCULOSIS.
AND THAT'S DESPITE THE FACT
THAT IMMIGRANTS ARE
SCREENED.
HOWEVER THEY'RE NOT SCREENED
FOR OTHER THINGS LIKE
HEPATITIS B AND HIV, WHICH
ARES WILL DEADLY AND COSTLY
TO TREAT.
DR. JAY KEYSTONE IS AN
INFECTIOUS DISEASES EXPERT
AT THE UNIVERSITY HEALTH
NETWORK.
WELCOME BACK.

Jay says THANK YOU.

Maureen says HOW IS IT WE
STILL GET THESE CASES OF
ACTIVE TB IN IMMIGRANTS IF
WE SCREEN THEM FOR IT?

The caption changes to "Doctor Jay Keystone. Infectious Diseases Expert."

Jay says YOU HAVE TO REMEMBER THAT
THE SYSTEM THAT WE USE FOR
SCREEN SCREENING IMMIGRANTS
IS A CHEST X-RAY.
THE X-RAY ONLY SHOWS ACTIVE
DISEASE AT THE TIME.
WHEN YOU THINK OF TB AS
MOSTLY A DORMANT INFECTION
IN WHICH APPROXIMATELY
ONE-THIRD OF THE POPULATION
OF THE WORLD IS INFECTED,
THEN WHAT HAPPENS YOU COME
IN, YOU HAVE YOUR NORMAL
CHEST X-RAY, YOU'VE GOT THE
TUBERCULOSIS BUG IN THE LUNG
WHICH IS QUIET AND DORMANT,
AND THEN SOMETHING SUDDENLY
MAKES IT REACTIVATE.
WE THINK STRESSERS MAY BE
ONE OF THE PROBLEMS, BECAUSE
ABOUT 50 percent OF THE
TUBERCULOSIS IN NEW
CANADIANS OCCURS WITHIN THE
FIRST FEW YEARS AFTER
ARRIVAL.
WHICH MEANS THERE MUST BE
SOME TYPE OF TRIGGER THAT
CAUSES THE DISEASE TO
SUDDENLY ACTIVATE AND THEN
BECOME INFECTIOUS.
SO YOU COME IN, YOU'RE NOT
INFECTIOUS, YOUR CHEST X-RAY
IS NORMAL AND THEN YOU
REACTIVATE YOUR TB.
5 TO 10 percent OF PEOPLE WHO GET
TB SILENTLY AS MOST DO WILL
DEVELOP ACTIVE TB.
THAT'S WHY.

Maureen says WHAT WOULD
HAPPEN IF WE SCREENED FOR
INFECTION RATHER THAN ACTIVE
DISEASE?

Jay says WELL, WE COULD DO THAT,
BUT THAT WOULD MEAN DOING A
TUBERCULOSIS SKIN TEST, A TB
SKIN TEST MAKING SURE THAT
THE PERSON WHO DID IT DID IT
PROPERLY AND THEN WE WOULD
HAVE TO GIVE EACH PERSON A
MEDICATION FOR ABOUT SIX TO
NINE MONTHS.
DEPENDING ON THE AIDS GROUP
THE OLDER AGE YOU ARE, THE
GREATER THE RISK OF THE
MEDICATION.
SUCH AS SEVERE HEPATITIS
EVEN LEADING TO DEATH.
SO YOU GET TO A POINT WHERE
THE RISK OF TB IS LOWER THAN
THE RISK OF THE SIDE EFFECTS
FROM THE DRUG AND THAT
BECOMES A PROBLEM.
SO, IT'S NOT AN EASY
SITUATION TO WORK OUT.

Maureen says I GUESS THOUGH MY OTHER
QUESTION THOUGH IS IF WE
SCREENED FOR THE INFECTION
AND THEN DIDN'T ALLOW PEOPLE
INTO THE COUNTRY WHO WERE
INFECTED WHAT WOULD BE THE
RESULT?

Jay says WE WOULD SCREEN OUT A
THIRD OF THE POPULATION
COMING FROM DEVELOPING
COUNTRIES.
I THINK THAT WOULD NOT BE A
REASONABLE APPROACH.

Maureen says OVERKILL YOU'RE SAYING.

Jay says I THINK THAT WOULD BE WAY
OVERKILL AND I THINK THE
ISSUE IS ESPECIALLY IN
YOUNGER PEOPLE WHERE THE
RISK OF THE DRUG IS LOWER,
THOSE ARE THE PEOPLE THAT WE
SHOULD BE SCREEN STOG THAT
THEY'RE OLDER AGE, THEY
DON'T DEVELOP ACTIVE
TUBERCULOSIS.

Maureen says SO I GUESS WHAT
WE WANT TO DO IS FIND THE
NEW CANADIANS WHEN THE, THE
SBSHTION REACTIVATED AND
MAKE SURE THEY GET
TREATMENT.

Jay says ONE YOU WANT TO FIND IT
EARLY, NUMBER TWO, WE WANT
TO KEEP SOME OF THESE PEOPLE
UNDER SURVEILLANCE FOR TB.
AND MANY OF THOSE WHO WE
KNOW HAVE BEEN INFECTED FROM
AN ABNORMAL BUT NOT ACTIVE
CHEST X-RAY.
WE LOSE THEM IN THE PUBLIC
HEALTH SYSTEM AS SOON AS
THEY ARRIVE IN THE COUNTRY.
AND IN FACT, DATA SHOWS
PROBABLY A THIRD OR LESS OF
THOSE WHO SHOULD BE FOLLOWED
BY PUBLIC HEALTH ACTUALLY
GET FOLLOWED FOR ONCE
THEY'VE BEEN SCREENED FOR
TB.

Maureen says IS THAT A MONEY ISSUE OR
IS THAT THAT YOU DON'T WANT
TO BE SEEN AS A BIG BROTHER
WATCHING OVER.

Jay says PARTLY IT'S A MONEY
PROBLEM.
THERE ISN'T ENOUGH MONEY IN
THE HEALTH CARE SYSTEM
PARTICULARLY IN PUBLIC
HEALTH.
AND THE MEDICAL OFFICER OF
HEALTH OF TORONTO HAS BEEN
ASKING FOR INCREASED
RESOURCES, TO BE ABLE TO
FOLLOW AND SCREEN
INDIVIDUALS FOR TUBERCULOSIS
AND THEY NOT ABLE TO GET IT.

Maureen says ASIDE FROM TUBERCULOSIS,
WHAT ELSE ARE NEW IMMIGRANTS
AND REFUGEES SCREENED FOR
WHEN THEY COME TO CANADA?

Jay says THEY HAVE A URINE AL SIS
DONE.
THEY HAVE IS A HISTORY IN
PHYSICAL EXAM.
THEY HAVE A TEST FOR
SYPHILIS AND THAT'S ABOUT
IT.

Maureen asks WHY SYPHILIS?

Jay replies WELL, WELL SYPHILIS IS
TREATABLE.
SO IF WE MISS IT AT LEAST
AND THAT IS IF THEY HAVEN'T
BEEN TREATED IN THEIR OWN
COUNTRY, IT'S A VERY EASILY
TREATABLE DISEASE, AND CAN
HAVE DEVASTATING
CONSEQUENCES LATER IN LIFE.
BUT PART OF THE REASON TO
SCREEN FOR SYPHILIS IS TO BE
ABLE TO BE ABLE TO DO A
BLOOD TEST.
IT'S THE ONLY BLOOD TEST
THAT'S DONE ON A NEW
CANADIAN, AND THEREFORE, IT
ALLOWS THE IMMIGRATION
DEPARTMENT AT SOME POINT
SHOULD THEY WANT TO BROADEN
THEIR BLOOD TESTING, AT
LEAST HISTORICALLY WE'VE
DONE THAT BLOOD TEST.
FOR SYPHILIS.

Maureen says WHAT ARE THEY
NOT BEING SCREENED FOR?

Jay says THEY'RE NOT SCREENED FOR
HEPATITIS B.
THEY'RE NOT SCREENED FOR
HEPATITIS C.
THEY'RE NOT SCREENED FOR HIV,
OR FOR INTESTINAL PARASITES.

Maureen says ARE ANY OF THOSE
THINGS YOU THINK WE OUGHT TO
BE SCREENING FOR?

Jay says YES, I DO, ACTUALLY.
I THINK WE SHOULD BE
SCREENING FOR HIV AND I
THINK WE SHOULD BE
ESPECIALLY SCREENING FOR
HEPATITIS C, NOT TO PROTECT
CANADIANS.
MAKE THAT VERY CLEAR.
WE HAVE 80 MILLION VISITORS
EVERY YEAR.

Maureen says WHO ARE SCREENED FOR
NOTHING.

Jay says SO IF WE IGNORE THE 80
MILLION VISITORS WE'RE
LOOKING AT 250,000
IMMIGRANTS MAYBE A YEAR.
WE REALLY NEED TO BE
SCREENING THEM BECAUSE OF
THE EXCESSIVE COST TO THE
HEALTH CARE SYSTEM.
NOT PROTECT THE HEALTH OF
CANADIANS BECAUSE THEIRRIES
SOUTH CAROLINA VERY LOW, AT
LEAST UNLESS ONE DECIDES TO
TAKE ON A HIGH RISK ACTIVITY
LIKE UNPROTECTED SEX WITH
SOMEONE WHO YOU DON'T KNOW
THEY'RE HIV STATUS.
SO THE ISSUE HERE THOUGH IS
THE COST TO THE HEALTH CARE
SYSTEM.
AND THAT'S WHERE I THINK
THESE INDIVIDUALS CAN BECOME
VERY COSTLY.

Maureen says AND SO, HOW DO
WE AMBULANCE OUR DESIRE TO
ACCEPT IMMIGRANTS AND
REFUGEES TO BE SEEN AS A
COUNTRY THAT WELCOMES THEM,
BUT AT THE SAME TIME
UNDERSTAND THAT WE HAVE
LIMITED RESOURCES FOR HEALTH
CARE.

Jay says WELL, WE HAVE TO PUT
REFUGEES SEPARATELY OF
COURSE BECAUSE THEY COME
UNDER A SEPARATE CATEGORY
WHETHER IT'S POLITICAL OR
OTHER COERCION OR PROBLEMS.
IF WE LOOK STRICTLY AT
IMMIGRANTS, I THINK IT IS A
DIFFICULT PROBLEM.
BECAUSE WE TAKE SOMEONE WHO
CAN CONTRIBUTE TREMENDOUSLY
TO CANADIAN LIFE, AND I AM
VERY PRO IMMIGRATION.
I THINK WE'RE WAY WE HAVE
WAY TOO FEW IMMIGRANTS IN
THIS COUNTRY AND I THINK WE
SHOULD HAVE FAR MORE.
HAVING SAID THAT, I THINK WE
HAVE TO LOOK AT THAT BALANCE,
BETWEEN WHAT THE HEALTH CARE
SYSTEM CAN AFFORD, AND THE
QUESTION OF WHAT THE NEW
IMMIGRANTS WILL BRING TO
THIS COUNTRY.
IT'S NOT AN EASY DECISION
SO.
IF WE LOOK AT WHAT IT'S
COSTING, FOR LIVER
TRANSPLANTS FOR PATIENTS
WITH HEPATITIS C.
THE 15 TO 20,000 DOLLARS A
YEAR IT COSTS FOR SOMEONE
WITH WHO IS WITH HIV
POSITIVETY.
THEY WILL CONTRIBUTE BECAUSE
THEY WILL CONTINUE TO WORK
BUT IT'S STILL DOLLARS
COMING OUT OF THE HEALTH
CARE SYSTEM.
AND THAT BALANCE IS NOT AN
EASY ONE, BUT I DON'T THINK
THAT WE CAN JUST SAY WELL,
FORGET ABOUT IT, ANYBODY WHO
WANTS TO COME IN, NO MATTER
WHAT THEIR ILL SEASONS NOT A
PROBLEM.
I THINK WE HAVE TO HAVE THAT
AMBULANCE.

Maureen says LOTS TO THINK
ABOUT THERE, THANK YOU FOR
THIS.

Jay says YOU'RE VERY WELCOME.

Maureen says COMING UP.

(music plays)

In a clip, Paul says THE EDGE OF THE JOINT AND
CLEAN UP THE DAMAGED
CARTILAGE.

Maureen says FIXING UP YOUR KNEE ON
MEDICINE 101.

The opening sequence rolls again.

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

Maureen says HERE ARE SOME
STORYS FROM THE HEALTH
FILES.
U.S. WOMEN NOW HAVE THE
OPTION OF USING A PATCH FORM
OF BIRTH CONTROL.

The screen reads "Birth Control." A picture shows a patch on a woman’s back.

She continues THE FDA HAS APPROVED A PATCH
CONTAINING HORMONES WHICH
ARE DELIVERED THROUGH SKIN.
THE PATCH MUST BE REPLACED
WEEKLY.
ON THE SAME DAY FOR THREE
WEEKS.
ON THE FOURTH WEEK IT CAN BE
REMOVED SO THE WOMAN CAN
HAVE HER PER.
THE COMPANY THAT MAKES THE
PATCH SAYS IT'S AS EFFECTIVE
AS THE PILL WHEN USED AS
DIRECTED AND IT HAS SIMILAR
RISKS.
THE MANUFACTURER HAS APPLIED
TO HEALTH CANADA FOR
PERMISSION TO SELL THE
PRODUCT HERE.
YOUNG WHIM HAVE LONG OR
IRREGULAR MENSTRUAL CYCLES
MAY HAVE AT HIGH RISK OF
TYPE II DIABETES BY MIDDLE
AGE.

The caption on the screen changes to "Diabetes." A picture shows the female symbol and a calendar.

She continues WOMEN'S WHOSE CYCLES LAST 40
TRACE TWICE AS LIKELY TO BE
DIAGNOSED WITH DIABETES
KPAIRED TO WOMEN WHO ARE
BETWEEN 26 AND 31 DAYS
REGARDLESS OF WEIGHT.
IT'S NOT CLEAR WHY IRREGULAR
CYCLES RAISE THE RISK BUT
RESEARCHERS SUSPECT MANY OF
THESE WOMEN MAY HAVE
UNDIAGNOSEED POLYCYSTIC
OVERRY SYSTEM WHICH MAKE
WOMEN RESISTANT TO INSULIN.

The caption on the screen changes to "Prostate Cancer." A picture shows the male symbol and a laboratory samples.

She continues YOU MAY BE ABLE TO TAKE
AN EARLIER TO DETECT
PROSTATE CANCER.
TO MEASURE A CHEMICAL CHANGE
LINKED TO A GENETIC MARKER
FOR PROSTATE CANCER.
THE GENE IS KNOWN AS GSTP 1
AND MUTATIONS ON IT CAN
CAUSE PROSTATE CANCER.
THE MUTATION PRODUCES A
BIOCHEMICAL REACTION AND
IT'S THAT REACTION THAT HAS
PICKED UP BY THE NEW TEST.
THE TEST IS STILL IN THE
RESEARCH STAGE AND IT'S TOO
SOON TO TELL WHETHER IT WILL
BE A USEFUL DYING GNOSTIC
TOOL.

The Quiz slate appears.

She continues HERE'S THE ANSWER TO OUR
QUIZ.

The answer "2. Robert Browning" appears highlighted in yellow.

She continues HIS WIFE ELIZABETH BARRETT
WAS A VICTIM OF TB.
IF OFF BUM KNEE,
YOU'RE NOT ALONE.
KNEE PAIN IS THE MOST COMMON
REASON PEOPLE SEE AN
ORTHOPEDIC SPECIALIST.
YOU DON'T HAVE TO GO DOWN ON
BENDED KNEE, JUST LISTEN UP
TO DR. PAUL CALDWELL.

Paul sits at a table. Behind him, a human anatomy model and a TV monitor sit on a piece of furniture.

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

Putting his index finger against his thumb, Paul says EVER
HEAR THE EXPRESSION, WELL
ISN'T THAT JUST BEE'S KNEES?
IT MEANS SOMETHING IS
OUTLANDISHLY GOOD.
WELL, HERE IS A BEE'S KNEE.
BUT NO MATTER HOW LONG I
STUDY IT IT DOESN'T IMPRESS
ME NEARLY AS MUCH AS ONE OF
OUR OWN KNEES.
THE HUMAN.

He grabs a leg skeleton model.

He continues A HINGED JOINT WHERE THIS
BONE, THE THIGH BONE JOINS
WITH THE TWO BONES OF THE
SHIN.
THE TIBIA AND THE SMALLER
FIBULA.
THERE'S ANOTHER BONE IN THE
KNEE THE KNEECAP OR PATELLA.
IT'S A SMALL BONE, IT SITS
IN THE MIDDLE OF A TENDON.
A TEN BON DON IS A PIECE OF
BRIS THAT ATTACHS A MUSCLE
TO A BONE AND THE KNEECAP
SITS IN THE MIDDLE OF THE
THYMUSAL UP HERE.
IT PREVENTS WEARING OR
RUBBING OF THE TENDON LIKE
THIS.
AS THE LARGE MUSCLES OF THE
THIGH FLEX AND EXTENT THE
KNEE.
USUALLY IT'S THE LEGMENTS
AND CARTILAGE THAT ARE
INJURED.
LEGMENTS ARE TOUGH BAND HAS
THE JOIN BONE TO BONE SUCH
AS THESE.
THESE ARE COLLATERAL
LEGMENTS AND THEY STOP
MOVEMENT LIKE THIS.
IF YOU GET HIT FROM THE SIDE
YOU CAN STRETCH OR TEAR
THESE LEGMENTS.
INSIDE THE KNEE ITSELF THERE
ARE TWO OTHER LEGMENTS RIGHT
HERE.
THEY'RE CALLED BECAUSE
THEY'RE SHAPED LIKE A CROSS.
THEY STOP THE THIGH FROM
MOVING BACKWARDS ON THE
SHIN.
OR A DIRECT BLOW HERE TEARS
ONE OF THESE AND IS QUITE
LIKELY TO MAKE THE KNEE
QUITE UNSTABLE.
BUT PERHAPS THE MOST COMMON
KNEE INJURY IS DAMAGE TO THE
CARTILAGE WITHIN THE KNEE.
CARTILAGE IS THAT SMOOTH
SHINY SURFACE THAT LINES
JOINTS.
HERE IT IS IN THE CHICKEN
WING.
IN THE KNEE, THERE ARE TWO
CARTILAGES.
AND EACH OF THEM IS ROUGHLY
C-SHAPED.
THEY'RE THICKER AT THE
OUTSIDE AND THINNER IN THE
MIDDLE.
AND THEY STABILIZE THE IF
MEASURE WHEN IT ROTATES LIKE
THIS.
INJURIES TO THE CARTILAGES
ARE VERY COMMON.
SMALL PIECES OF THE INSIDE
INNER PART OF THE CARTILAGE
FRAY OFF.
AND MAY GET CAUGHT WHERE A
LARGER PIECE OF CARTILAGE
MAY TEAR OFF.
THE SO-CALLED BUCKET HANDLE
TEAR LOOKS LIKE THIS WITH A
LARGE PIECE OF CARTILAGE
PUSH INTO THE CENTRE OF THE
KNEE.

He shows a small blue rubber piece with a hole in the middle.

He continues IT'S A PAINFUL CONDITION
THAT LOCKS YOUR KNEE IN
PLACE.
TO REPAIR DAMAGE IN THE KNEE,
SURGEONS OFTEN USE A SCOPE,
A SURGICAL INSTRUMENT WITH A
SMALL LIGHT AND CAMERA
ATTACHED.
THE EDGE OF THE JOINT AND
CAREFULLY CLEAN UP THE
DAMAGED CARTILAGE.
PRETTY FASCINATING.

A clip shows a knee surgery.

Paul continues I WONDER, WHEN BEES DISCOVER
SOMETHING OUTLANDISHLY GOOD,
DO THEY EVER SAY WELL, ISN'T
THAT JUST THE HUMAN'S KNEES?

Maureen says GET YOUR
TRANSCRIPT OF DR. CALDWELL'S
ANATOMY LESSON ON OUR WEB
SITE.

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

Maureen continues NEXT WEEK ON
YOUR HEALTH.

A clip plays.

A male doctor says THIS IS A DIFFERENT FORM
OF CANCER THERAPY.
AND HAS A IMPORTANT ROLE THE
SAME AS SURGERY, THE SAME AS
RADIATION AND CHEMOTHERAPY.

Maureen says THE PROMISE OF
PHOTO DYNAMIC THERAPY IN
TREATING CANCER.

The clip ends.

Maureen concludes THAT'S ON THE NEXT EDITION
OF YOUR HEALTH.
JOIN US THEN AND 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."

(music plays)

The end credits roll.

Executive Producer, Patricia Ellingson.

Host and Producer, Maureen Taylor.

Producer, Cathy Perry.

Director, Michael Smith.

Logo: CEP Local 72m.

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

Watch: Your Health Season 3 Episode 13