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Your Health

Study Offers More Reasons to Be Aware of Cholesterol; Insurers Question Necessity of Viagra; Blaine McCallister Keeps Medical Story Under His Hat

Aired June 24, 2000 - 2:30 p.m. ET


DR. STEVE SALVATORE, HOST: Today on YOUR HEALTH, cholesterol awareness can help in the fight against heart disease. But there's something else that may be just as important to keep in check.

Plus, Viagra is a billion dollar a year industry. But some insurers question is it really essential for living?

And you may know PGA veteran Blaine McCallister by his Panama hat. You may not know his wife's disabling eye disease is behind the reason he wears it. Now, their work to find a cure is starting to pay off.

Hello and welcome to YOUR HEALTH. I'm Dr. Steve Salvatore.

You probably know about the risks of high cholesterol and how it can contribute to heart disease, even heart attacks and strokes. But a new study shows that elevated triglycerides may sharply increase a person's risk of dying from a heart attack, even if that person has normal cholesterol levels. Researchers say these findings offer more evidence of the importance of both cholesterol and triglycerides.


SALVATORE (voice-over): When 33-year-old Paul Duncsak became a father nine weeks ago, he decided to make his health a priority.

PAUL DUNCSAK: I think I'm going to start a diet and an exercise regimen and hopefully keep it up, since I've only been married a year.

SALVATORE: Paul is concerned about what doctors call his lipid profile, what most people think of as their cholesterol levels. Part of that profile that doesn't get much attention but probably should is the level of triglycerides. According to a new study published in "Circulation," journal of the American Heart Association, a family history of high triglycerides alone increases the risk of heart disease.

MELISSA AUSTIN, PH.D., UNIVERSITY OF WASHINGTON: In the families in which we find only high triglycerides and not high cholesterol, we found that increased triglyceride levels predicted a two to threefold increase in cardiovascular disease death.

SALVATORE: And it may mean others with high triglycerides without a family history may also be at risk.

DR. DAVID VORCHHEIMER, MT. SINAI HOSPITAL: This study suggests that we need to be very aggressive with those patients, as well, even if the other lipid parameters appear to be normal.

SALVATORE: With a new plan of diet and exercise, Paul may not need medication to bring his triglycerides into the normal range.

VORCHHEIMER: Of all the cholesterol parameters that we measure in the blood, triglycerides are the one that are most exquisitely sensitive to even the most modest reduction in weight.


SALVATORE: Doctors recommend healthy people over the age of 40 have their cholesterol and triglyceride levels checked at least once a year. And be sure to have that sample drawn on an empty stomach after fasting because food can falsely elevate triglyceride levels.

Now on to Down's Syndrome. It's one of the leading causes of mental retardation and serious birth defects. Any woman can have a baby with Down's Syndrome regardless of age, health or family history. For that reason, pregnant women are offered screening tests in their second trimester. But those tests are not always accurate. Now, there's a new test being evaluated that may be better, as we learn from CNN Medical Correspondent Rhonda Rowland.


RHONDA ROWLAND, CNN CORRESPONDENT (voice-over): Susan Loeffler is pregnant with her second child. When she reached her second trimester, doctors offered her a routine blood screening test known as the AFP or triple screen that can detect Down's Syndrome but is not always accurate.

SUSAN LOEFFLER: I knew a little bit about it going into it and that there might be a chance that I'd get a false positive. But I was confident that it would be negative so I went ahead with it.

ROWLAND: But it came back positive.

LOEFFLER: I remember going oh brother, here we go, because again, I had done some reading in preparation and I knew that I had a lot of choices ahead or I could do nothing.

ROWLAND: At this point she was four months pregnant.

DR. FERGAL MALONE, PERINATOLOGIST, COLUMBIA UNIVERSITY: One of the most common complaints I have heard from patients over the years from offering second trimester screening is they would much prefer to have this information much earlier in pregnancy.

ROWLAND: Now researchers are evaluating a new screening test for Down's Syndrome that's done in the first trimester, between 10 and 14 weeks of pregnancy.

MALONE: So the area that we focus on here is the skin thickness at the back of the baby's neck, which is in this area.

ROWLAND: It involves two steps. One, an ultrasound exam that measures the skin thickness at the back of the fetus's neck. The thicker it is, the higher the chance of Down's Syndrome. And two, a blood test.

MALONE: And initial reports, while they're still very preliminary, would suggest that that package will detect 85 to 90 percent of cases of Down's Syndrome during the first trimester of pregnancy.

ROWLAND (on camera): In the study, to be completed in three years, researchers will determine if they can successfully screen for Down's Syndrome earlier in pregnancy and if there's a higher detection rate and were false positive results than current tests.

(voice-over): Susan Loeffler had a follow-up test called amniocentesis. It can cause miscarriage, but is 100 percent accurate in detecting Down's. The results were reassuring. There was no evidence of Down's Syndrome. The baby is due in June.

Rhonda Rowland, CNN, YOUR HEALTH.


SALVATORE: Ahead on YOUR HEALTH, the annual Women's Solutions tour is underway. We'll tell you what this interactive program is doing to improve women's health. And we'll look at a rare eye disease. It's the reason behind the trademark hat of a PGA champ. Plus, we'll give you a cheat sheet on what to look for to spot melanoma. But coming up next, Viagra, is it really a medical necessity and who should pay for the popular pill?


SALVATORE: Over the last few weeks, we've talked about the impotence drug Viagra and its continued popularity. In the U.S. alone, more than six million prescriptions of Viagra have been written since its approval two years ago. That adds up to more than a billion dollars in sales each year.

Well, CNN Medical Correspondent Holly Firfer reports, it's fueling a debate on who should cover the cost.


HOLLY FIRFER, CNN CORRESPONDENT (voice-over): Before you can answer who should pay for Viagra, you have to ask is it a lifestyle choice or essential for living? Some insurance companies like Kaiser Permanente say it's an unnecessary expense.

BEVERLY HAYON, KAISER PERMANENTE: You know, if you're weighing the total cost of immunizations for children, heart bypass and other chronic diseases, then we made a decision that those take precedence over erectile dysfunction.

FIRFER: But patient rights groups fear that insurance companies, not doctors, are making decisions based on cost, not care.

DENA MOTTOLA, CAMPAIGN FOR BETTER HEALTH CARE: And the fear is that they'll also look at other drugs that are popular, such as drugs for depression, which a lot of people use, and that that will go the same way, that insurance companies will make decisions about those drugs along the same lines as Viagra.

FIRFER: In this week's "Annals of Internal Medicine," researchers found using Viagra to treat erectile dysfunction is cost- effective in terms of quality of life. They compared the use of Viagra with other types of covered interventions for medical conditions such as renal dialysis, cholesterol lowering medications and coronary bypass grafting.

But Dr. Michael McGarvey with Blue Cross Blue Shield says although the numbers add up, in his opinion...

DR. MICHAEL MCGARVEY, HORIZON BLUE CROSS BLUE SHIELD: I think the difference between a patient with renal failure who will die without the treatment and a patient with erectile dysfunction who, all things being equal, probably will not die without the treatment puts us into two very different categories.

FIRFER: Some health insurance companies say they don't want doctors to stop prescribing the medication, but fell the patient should pay the $10 per pill.

HAYON: Within the monthly fee that you pay for your insurance, do you also want to pay for men who are impotent for a treatment which probably most people can afford to pay for?

MOTTOLA: There's money there in the system to cover what people need. There's a lot more than the insurance industry might let you think there is.

FIRFER: Both sides agree that this debate over drug cost and effectiveness may be less important than the overall issue of skyrocketing health insurance costs, leaving nearly 45 million people without any kind of coverage in the U.S.

Holly Firfer, CNN, YOUR HEALTH.


SALVATORE: When we return, Tiger Woods has stolen the golf spotlight. Later, we'll spotlight PGA legend Blaine McCallister and find out how his wife's rare eye disease made its way onto the golf course.



SALVATORE (voice-over): "Health" magazine is on the move, traveling throughout the U.S. to over 30 cities, educating women on ways to live healthier. Organizers of the "Health" magazine Women's Solution tour say 70 percent of women report they're actively looking for help in sorting out important health issues. The magazine, in conjunction with Chrysler, Kraft 2 Pecent Milk Singles and Wyath Aearst (ph) have all teamed up to offer women interactive tour opportunities that include ways to evaluate their diet, measure their fitness level, easy to follow workouts and techniques to deal with stress.

Sponsors of this event say they hope it encourages women to make more informed and healthier lifestyle choices.


SALVATORE: When YOUR HEALTH returns, do you know the signs of the potentially deadly cancer melanoma? Well, we'll show you how a simple skin check can make a big difference. But first, this week's health quiz.



ANNOUNCER: New research shows apples can stop the growth of certain cancer cells in the lab. While these findings are very preliminary, the American Cancer Society says it's well known people who have an overall healthy eating pattern have much lower rates of some cancers.

DR. MICHAEL THUN, AMERICAN CANCER SOCIETY: And that pattern is a diet that's predominantly plant foods, that's high in fruits, vegetables and grains, low in fat, particularly animal fat.


SALVATORE: Also, quitting smoking and recommended cancer screenings can greatly reduce the risks of many cancers. While your diet is not likely to play much of a role in the development of skin cancer but awareness can. Melanoma is a completely curable form of skin cancer when caught early.


SALVATORE (voice-over): Summertime means fun in the sun with many people searching for that perfect tan. But Lisa Nemroff's tanning days are over since she was diagnosed with melanoma eight years ago.

LISA NEMROFF: I used to go in sun all the time. I never wore sunscreen.

SALVATORE: According to the American Cancer Society, there are nearly 50,000 new cases of melanoma diagnosed each year in the United States and the disease is on the rise.

DR. BRUCE KATZ, DERMATOLOGIST: Melanoma is really increasing in incidence at an alarming rate. Just 10 years ago, you had a one in 250 chance of developing malignant melanoma. Now your chance is one in 70.

SALVATORE: Lisa's diagnosis caught her by surprise. After her father was diagnosed with the disease, she decided to go for a routine skin check.

KATZ: She had just a mole on her back and she didn't know that it had been changing and we found that this was a early melanoma.

SALVATORE: Lisa was lucky. Because it was caught early, she was completely cured. Dr. Deborah Jaliman is a practicing dermatologist in New York City. She says melanoma can be difficult to detect and is best done by a dermatologist once a year.

DEBORAH JALIMAN, DERMATOLOGIST, MT. SINAI SCHOOL OF MEDICINE: You have to have somebody look between your toes, definitely the scalp, behind the ears. Those are all places that people miss. But oftentimes people will have moles that change subtlety and they don't notice it.

SALVATORE: A changing mole is one of the early signs of melanoma. Look for things like bleeding, itching or changes in the size, shape, color or feel of an existing mole. Melanomas can also start on their own. They're usually asymmetrical with irregular borders, have multiple colors and are generally larger than a pencil eraser.

JALIMAN: They're usually larger than six millimeters. But actually even small spots that appear suddenly you have to have checked.


SALVATORE: Doctors recommend frequent self-examinations to check for melanoma before it spreads. Early surgical removal offers an excellent chance for a cure. If you have a doubt about any mole on your body, you should consult your doctor or dermatologist.

Next on YOUR HEALTH, there's progress to report in PXE research. Most people aren't even aware of the rare genetic eye disease, but it hits home with a legendary golfer and his wife. We'll have their personal story.



ANNOUNCER: PXE is a rare genetic disorder that weakness elastic fibers in the skin and blood vessels. It often goes unrecognized until adulthood and can result in disabling vision loss, gastrointestinal bleeding, heart disease and a shortened life.



Doctors say they've located the gene that causes the rare genetic eye disease PXE. Well, that's a big step forward in finding a cure. It's also good news to golfer Blaine McCallister and his wife Claudia. Both are long time fundraisers for PXE research and have their own reasons to support this cause.

Their story now from CNN's Jim Huber.


JIM HUBER, CNN CORRESPONDENT (voice-over): She stands midst the gallery and cocks her head to see the love of her life, cocks her head because it's the only way she can find him. Straight on, her husband disappears in a dark void. For Claudia McCallister has PXE.

CLAUDIA MCCALLISTER: It's pseudoxyanthoma elasticum (ph).

HUBER: A rare genetic disease that finally caused a retinal hemorrhage in 1990, forcing long time PGA veteran Blaine McCallister's wife to live on the periphery of her eyesight.

CLAUDIA MCCALLISTER: It's fun being out there even though I can't see exactly what he's doing.

HUBER: One reason Blaine has worn the trademark Panama hat for so many seasons.

BLAINE MCCALLISTER: It's made it easier for her.

CLAUDIA MCCALLISTER: Well, for instance, when Thursday and Friday last week of Dallas, I never knew it was Blaine. Blaine was walking around and he had a baseball cap on because it was too windy.

BLAINE MCCALLISTER: I had a baseball hat on because the wind was blowing so hard.

HUBER: She uses binoculars at the course and specially mounted binoculars to watch television.

CLAUDIA MCCALLISTER: But you just adjust them just like you would your own binoculars and then you just sit and everything is very clear. You have to try them. But it's perfect. See, now I can see the plant on the table.

HUBER: And she has a special computer that enlarges reading material. If she misses anything the most, it is the reading.

CLAUDIA MCCALLISTER: If I have to read something, then I'll use this.

HUBER (on camera): Now, how big must it be before you can read it?

CLAUDIA MCCALLISTER: Well, if it's that big and I'm real close I can, you know, I can see that.

HUBER (voice-over): She cannot drive or shouldn't, and that has taken away much of her independence over the years. But they have solved part of that problem, at least for a few feet. At one o'clock in the morning on recycling days she will drive this tiny car to the end of their driveway and back. And they can go to the movies and plays, but it requires sacrifice on Blaine's part.

BLAINE MCCALLISTER: You know, I have to change my seating arrangements for these plays and the movies because we have to get up close and I mean I can sit in a movie theater on the first, you know, first two or three rows on the left side there. I mean I've got to give it one of these. And she's seeing perfect and I'm giving her one of these. So I mean that, we...

CLAUDIA MCCALLISTER: And I appreciate that.

HUBER: They have worked for years and years to raise money to find a cure for PXE and the very day we visited, that paid off. A doctor from Switzerland called to tell the McCallisters that the gene had just been found which causes the disease.

CLAUDIA MCCALLISTER: Wonderful. Well, I'm so happy for all of us, really, but it is so exciting for all the work, the hard work that you've put into this. Amazing.

BLAINE MCCALLISTER: It gives me goose bumps. It is so exciting for me and not only for me but for, you know, for this lady here because she's, she's been kind of their, I don't know, I guess their spokesperson, their guinea pig, as you want to call it, since she was 23, 24, 25 years old. Life is too short to go out there and get worried about golf or to go out and worry about anything, really. I mean there's a lot of people that are a lot worse off in the world and we're very blessed.



SALVATORE: That's our show for today. If you would like more information about melanoma and how to protect yourself from the dangerous rays of the sun this summer, just click on our Web site at It's produced in conjunction with WebMD.

Well, from the entire CNN health team, I'm Dr. Steve Salvatore. Thanks for watching.



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