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HOUSE CALL WITH DR. SANJAY GUPTA

Alternative Medical Methods, Including Chiropractic Care, Acupuncture, And Massage Therapy; Teen Bariatric Surgery

Aired April 8, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


(WEATHER REPORT)
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Hello and welcome to HOUSE CALL. I'm Elizabeth Cohen, filling in for Dr. Sanjay Gupta.

This week, we're looking at some alternatives to traditional medicine that have become almost mainstream. Studies find that about a third of all Americans prescribe to at least one form of alternative or complementary medicine. Three of the most popular, chiropractic care, acupuncture, and massage therapy.

Joining us from Albany, New York to help answer your questions is Dr. Mark Hyman. He's an M.D., who also believes in alternative care and calls himself an integrated medicine specialist. And he's co- author of the best-selling book "Ultra Metabolism", which is currently number five on "The New York Times" best-seller list.

Welcome, Dr. Hyman.

DR. MARK HYMAN, INTEGRATED MEDICINE SPECIALIST: Welcome to you, too. Thank you, Elizabeth.

COHEN: Thanks. Doctor, could you give me an example of when you might treat a patient with both traditional and alternative medicine?

HYMAN: One of the most common things I see is diabetes. And it affects over 20 million Americans. And often the treatment is simply medication.

And in my practice, and actually in my new book "Ultra Metabolism", I talk about a comprehensive, integrated approach that deals with all of the underlying causes of disease and diabetes in particular and obesity.

And diabetes I would use not only medications when needed, which often aren't if you use a comprehensive approach, but looking at dietary therapies, using fiber, and supplements, for example, using fish oil, using certain herbs, using exercise, all of which can be used in an integrated way, along with exercise and stress management.

By the way, which really shouldn't be considered alternative medicine. When is diet really considered alternative medicine? It really shouldn't be.

COHEN: Now before we launch into more in our three topics today about alternative medicine, we have an e-mail from Liz in Montgomery, Alabama. She wants to know. She says, "I know that medical doctors have rather strict licensing requirements. What type of licensing programs are there for chiropractic care, massage therapy, acupuncture and other alternative practices? Dr. Hyman?

HYMAN: Well, the good news is there are licensing boards in most states. Chiropractors are licensed in 50 states. Acupuncturists in over 40 states. Massage therapists in about 35 states.

And each of these organizations, the American Chiropractic Association, American Massage Therapy Association, there's Acupuncture Associations all provide licensing, credentialing, examinations that qualify their practitioners. So you can be assured that if you make sure that your practitioner has been qualified by an exam and by licensing from these organizations, that they're credentialed and probably very well trained and safe to use.

COHEN: Well, let's get started then with a look at chiropractic care. More than 30 million Americans pay a visit to a chiropractor each year.

(BEGIN VIDEOTAPE)

COHEN (voice-over): Pat Phillips had two herniated discs in her lower back. And despite numerous visits to doctors, and months of physical therapy, nothing worked.

PAT PHILLIPS, CHIROPRACTIC PATIENT: And it was excruciating pain. And I just couldn't get over it.

COHEN: Then, the 68-year-old grandmother paid a visit to a chiropractor.

PHILLIPS: When I came in, I was hardly able to walk.

UNIDENTIFIED MALE: So nice and gentle.

COHEN: After a couple months of treatment, she's nearly back to normal. Chiropractic care focuses on the spine, muscles, and nervous system. The most common procedure performed is known as spinal manipulation or an adjustment.

That adjustment is meant to restore mobility, alleviate pain, and allow the injured area to heal. Lower back pain like Pat's is the most common condition chiropractors treat.

ROBERT HAYDEN, CHIROPRACTOR: I can put my hand over the bone, directly above that herniation. And in flexing the table downward, I can open that joint just like that. I relieve the leg pain, I relieve the back pain.

COHEN: Chiropractors consider themselves healthcare providers who treat the whole person.

PHILLIPS: I am able to get up and walk and go and do whatever I want to do without just having to think will my back let me get back home? HAYDEN: Conservative care should be the first option before drugs or surgery.

(END VIDEOTAPE)

COHEN: Well, we have quite a few e-mail questions lined up for Dr. Hyman. Let's get started with this one about chiropractic care.

Jessica in Los Angeles asks, "How safe are chiropractic adjustments of the neck?" Dr. Hyman, sometimes you hear some questionable things about these kinds of adjustments.

HYMAN: That's actually very true. My wife's an orthopedic surgeon. And she's expressed concern. However, when you look at the data, only one in 400,000 people suffer complications such as a stroke from chiropractic adjustments, which is very low considering how much chiropractic care is going on out there.

So looking at the safety data, it's a very safe, overall manipulation therapy that can be used for treatment of chronic pain.

COHEN: And our next e-mail question is kind of similar. Lisa in St. Louis asks, "Can too many chiropractic adjustments be detrimental to your body?" Dr. Hyman?

HYMAN: Well, I've looked at the literature, Elizabeth. And I think that, particularly in the Annals of Internal Medicine Research Review, there was really no evidence of significant damage or harm from chiropractic adjustments. And I think there's no evidence that frequent adjustments are harmful.

COHEN: Now some chiropractors, you hear them, Dr. Hyman, making some pretty big claims about the effectiveness of their treatment. And Mike in Warm Springs, Georgia asks, "What about chiropractors who claim to be able to cure everything from fibromyalgia, to depression through spinal manipulation?" Should you be suspicious?

HYMAN: Well, if my chiropractor told me that, I would find another chiropractor because we have to realize that, you know, if everything -- if all we have is a hammer and everything looks like a nail, so in other words, we need to find the right treatment for the right problem.

And in dealing with, for example, any issue which is, let's say depression, you want to find the cause. It may be it's essential fatty acid deficiency from Omega 3s. It may be a folic acid deficiency. It may be stress. It may be hypothyroidism.

So you want to find the underlying issue. You can't just treat everything with the same modality, whether it's chiropractic or anything else.

COHEN: Well, we'll have more of your e-mails coming up. Plus...

UNIDENTIFIED FEMALE: It doesn't seem like it would be a comfortable way to treat pain or quit smoking, but acupuncture is an ancient remedy getting some very modern attention.

And the massage therapist is in.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I think it's a good way to relief the stress from a tough, long week.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Lie back, relax, and stay tuned to HOUSE CALL.

(COMMERCIAL BREAK)

COHEN: Welcome back to HOUSE CALL. We're talking about popular alternatives to traditional medicine today and answering your e-mail question. Let's move on to an ancient form of medical care that's very popular in Asian cultures: acupuncture.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: Can you feel it?

KRISTIN GORELL, ACUPUNCTURE PATIENT: Yes.

UNIDENTIFIED MALE: OK.

COHEN (voice-over): Kristin Gorell turned to acupuncture after being diagnosed with a thyroid condition and feeling stressed after her daughter's birth. She now comes here about once a month. Her insurance doesn't cover acupuncture, so she pays about $70 for each treatment out of her own pocket. She says it's worth it.

GORELL: Since I've been coming to see him, my allergies have disappeared. My thyroid has evened out. And I don't feel the effects of it any more at all. And we're working towards trying to see if I can each get off of the medication for it.

COHEN: Dr. Young Lee says the 5,000-year-old Chinese practice is really very simple. It's all about balancing the body's life force or chi. During a typical session, Dr. Lee checks the pulse to see how the heart is beating. He makes a tongue diagnosis and looks at the eyes, palms, and fingernails. He also listens.

Tiny needles are then inserted into points of the body to stimulate energy channels that are believed to run throughout the system.

YOUNG LEE, ACUPUNCTURIST: Can you feel a sensation here?

GORELL: Yes, a little bit warm.

LEE: Warm, OK.

COHEN: Lee says he treats infertility in women and a lot of chronic diseases, like joint pain, sleep disorders, and hypertension.

Sometimes just paying attention to the body seems to do the trick. Lee says often, after a session or two, a patient will make a healthy life change and no longer have any complaints.

(END VIDEOTAPE)

COHEN: Now to answer your questions about acupuncture, we're joined by integrated medicine specialist Dr. Mark Hyman.

Now Dr. Hyman, let's start with this e-mail from Nancy in New Hampshire. She asks, "Is acupuncture a viable treatment for asthma?"

Now we received many e-mails like this one that asked about the effectiveness of acupuncture for very specific conditions like asthma, arthritis, migraines. Dr. Hyman, what's your experience with acupuncture and some of these conditions?

HYMAN: Well, I think acupuncture has been around, as you said, for many, many years. And there's over 500 randomized trials since 1970 looking at acupuncture.

The National Academy of Science has said that acupuncture is an effective and safe therapy for nausea related to post operative nausea, to nausea of chemotherapy, and pregnancy, as well as dental pain.

And there are many other areas where it shows promise. And in particularly a new study by Dr. Brian Berman at the University of Maryland showed that acupuncture was very effective in treating osteoarthritis.

In asthma, I think the evidence is less clear. I think the Cochrane systematic database review looked at all the research on asthma and acupuncture and didn't find convincing evidence.

However, the basic science research is very exciting. We're looking at changes that happen in the brain chemistry, neuropeptides, brain chemicals that can affect pain sensation that control inflammation. And they have many other effects.

So I think we're looking at more and more research that's showing promise.

However, I'd like to see more clinical research before we come down surely on the side of effectiveness for a lot of common disorders.

COHEN: Well, here's another question that has to do with acupuncture. And we received a lot like this. Debbie in Morganton, North Carolina asks, "Can acupuncture help me quit smoking?" What do you think?

HYMAN: Great question. Again, there's been good literature on this as published by the Cochran databases. And it showed there were some studies that showed clear benefit, but there are also studies that didn't. And I think that the data in the consensus is still out there. We don't quite know, although it may be effective in early treatment of addictions.

COHEN: Well, stay tuned because more of your e-mail questions about medical alternatives are coming up.

UNIDENTIFIED FEMALE: Plus, the touch that makes a difference. More people are turning to massage therapy for relief of everything from pain to stress.

And when diets and exercise don't seem to work, why more kids are turning to surgery to get rid of the extra weight.

But first, this week's medical headlines in "The Pulse".

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): Expectant moms no longer have to worry about contracting a once-common disease that can cause birth defects. Researchers credit a vaccine introduced back in the '70s with nearly wiping out Rubella or German measles. Fewer than 10 cases were reported in the U.S. last year. Rubella was known to cause death, blindness, deafness and congenital heart disease in tens of thousands of infants.

When your mom tells you to drink your juice, she now has the government's backing. Researchers say they found that children who drink 100 percent fruit juice have healthier overall diets than non- juice drinkers. The kids studied had higher intake of key nutrients and lower amounts of saturated fat and sodium.

Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

COHEN: We've been talking about alternatives to traditional medicine today. And now, we're going move into one of the fastest growing, massage therapy.

(BEGIN VIDEOTAPE)

COHEN (voice-over): There are days when many of us could use a massage. For business traveler Tom Worth, massage therapy relieves the fatigue of being a frequent flier.

TOM WIRTH, BUSINESS TRAVELER: Definitely helps you relax, helps you recover a lot of the muscles you use for maybe sitting for extended periods of time. I think it's a good way to relieve the stress from a tough, long week.

COHEN: Tom is not alone. According to the American Massage Therapy Association, nearly 50 million Americans get a massage every year. And that number continues to rise. A few health insurance plans even pay for massages. LINDA TAYLOR, MASSAGE THERAPIST: A couple of my clients have gone to emergency rooms thinking they were having heart attacks. They were having chest pains, but it was just stress. So doctors in that instance would often send someone to a massage therapist.

COHEN: Massage therapists claim it's more than just relaxing.

TAYLOR: There's a lot of therapeutic benefits for it. It lowers your blood pressure. It helps your immune system. If you have pain in the neck and shoulders, it can alleviate that discomfort almost immediately. And the results are fairly long lasting.

COHEN: For Tom, it's all about taking care of himself.

WIRTH: I think it's a good time to take an hour's worth of your time and give it back to your body.

(END VIDEOTAPE)

COHEN: So for some people, massage seems to be the answer. We're joined again by Dr. Mark Hyman.

Now let's get to more e-mails. This one is from Linda in Kansas City. And she asks, "I have a bulging disc in between my shoulder blades for the past year. Would massage therapy help this?" Dr. Hyman, what do you think about massage therapy for bulging discs?

HYMAN: Well, I think massage therapy is great in a lot of cases, particularly since 95 percent of our illnesses are either caused or made worse by stress.

But in the case of a bulging disc, I would have concern that the underlying problem is not being dealt with. And I think this is really why people are seeking more alternative or complementary therapies. They're trying to deal with the underlying issues related to disease.

And that's really what we need in this society. We need an integrated, comprehensive approach that doesn't distinguish between complementary or alternative or conventional. It really finds the best medicine. What's the right medicine or good medicine for a particular problem?

COHEN: Well, let's move on now to another e-mail. David in Jonesboro, Tennessee, asks, how do you find a truly qualified massage therapist?

Dr. Hyman, can anyone just call themselves a massage therapist and hang out a shingle?

HYMAN: In some states, yes. In some states, no. Where there's licensing, there's restrictions. And I think you should go to the American Massage Therapy Association Web site and look in your area code for qualified massage therapists, who are licensed, and who have taken qualified number of hours, which is about 500 hours of training in order to be qualified as a massage therapist. And I'd also recommend getting referrals and references from someone you know, which obviously is often the best case to find someone who's good and who's therapeutic.

Now obviously, we've been talking today about people who get help from massage or help from acupuncture. Is it possible that some of these treatments can actually do harm on occasion?

HYMAN: Well, that's a very good question, Elizabeth. I think there has been the question brought up if these therapies are harmful, such as chiropractic, acupuncture, massage.

You know, personally, I had an adverse effect from acupuncture. I had acupuncture in China for my back. And it helped tremendously for my back pain, but the acupuncturist left needles in my head. And that was actually a common side effect of acupuncture, forgotten needles, but...

COHEN: Yikes.

HYMAN: ...you know, massage therapy, again, is very safe unless you have a blood clot, unless you have severe osteoporosis, unless you have a skin infection, or perhaps a concern over metastatic cancer.

You know, there's very few indications for stopping or not doing massage therapy.

As far as chiropractic, I think again if you have spinal stenosis, or severe neck arthritis, or perhaps carotid artery disease, which is blockage in the arteries, there's some risk.

But for most people, most of the time these are very effective and safe therapies that can be used without much concern, compared to the number of side effects you get from say medications or surgery.

COHEN: Well, we'll have more on medical alternatives when HOUSE CALL returns.

UNIDENTIFIED FEMALE: And in our fit nation series, weight loss surgery for kids. It's more common than ever, but is it safe?

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: It saved Jonathan's life. So if he would have kept getting bigger and bigger and bigger.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

SEN. TOM HARKIN (D), IOWA: We spend very little on wellness and prevention, lifestyle changes. But boy, we'll spend hundred of billions of dollars to patch you and fix you and mend you later on.

(END VIDEO CLIP)

(BEGIN VIDEO CLIP)

KALE SANDERSON, OLYMPIC GOLD MEDALLIST: In my eyes, I see that, you know, kids are growing up now not exercising, you know, not having fun, not getting, you know, pushed into those kids' programs.

(END VIDEO CLIP)

COHEN: That was Senator Tom Harkin and Olympic gold medallist Kale Sanderson speaking at Iowa State during the last stop -- latest stop of our Fit Nation Tour to fight obesity.

Next, we go to the University of North Carolina in Chapel Hill.

But first, we focus this week on a growing trend -- teen bariatric surgery. Dr. Sanjay Gupta has more.

(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT (voice-over): Jonathan Hernandez was a normal sized baby. His mother says he didn't start getting big until third grade. As he got bigger, he stopped going out and he stayed in his room.

JONATHAN HERNANDEZ, BARIATRIC SURGERY PATIENT: What would people think when they saw me like that? And then I was, like -- and then I didn't want them to, like, look at me looking at me like oh, my God, look at him like that.

GUPTA: At 16, he weighed 402 pounds. His sleep apnea was so bad that even breathing was difficult. He had to undergo a tracheotomy.

MARYDALE MASSEY, JONATHAN'S MOTHER: He was so big, that it was pressing on his heart and on his chest. And he couldn't breathe.

GUPTA: In two years, he's lost 90 pounds after having weight loss surgery at a new pediatric program offered in Atlanta.

MARK WULKAN, DR., EMORY PEDIATRIC SURGEON: It's a lifesaver and it's life altering for these children. I think you give them back a piece of their childhood.

GUPTA: Dr. Mark Wulkan performs bariatric or weight loss surgery that involves inserting a band that clamps down on the stomach, restricting access. The Food and Drug Administration has not approved the use of the so-called lap band for children 17 and under, but Wulkan believes it's safe in part because it's reversible.

(on camera): Hospital officials around the country say the increased demand for adolescent weight loss surgery has prompted them to create special programs for obese kids. In fact, one surgeon here in Atlanta told us he used to get requests for surgery once a year. Now he's getting them once a month.

(voice-over): Weight loss surgery can cost up to $25,000 with Medicaid sometimes picking up the tab. And the issue surrounding obese teens are complex and cultural. Nutrition and fitness expert Dr. Pamela Peek urges extreme caution when it comes to surgery.

DR. PAMELA PEEK: We don't have long-term data outside of three to five years. And at that time, we're seeing that it appears a large number, if not a majority, are actually regaining their weight.

HERNANDEZ: Bye, Kaitlin. See you tomorrow.

GUPTA: Jonathan's mother says for her son, having the operation was a life saver.

MASSEY: That saved my baby's life.

GUPTA: Despite the work, Jonathan says he'd do it all again. He now has good friends, has taken a great interest in drama class, and just went to his first prom. Jonathan's mother sums it up this way.

MASSEY: Now he's enjoying life to the fullest, believe me, I mean, to the fullest.

GUPTA: Dr. Sanjay Gupta, CNN, Atlanta.

(END VIDEOTAPE)

COHEN: If we didn't answer all of your questions about medical alternatives, stay tuned for more on HOUSE CALL.

(COMMERCIAL BREAK)

COHEN: We've been talking on our show today about alternative medicine, but it seems that not everyone has bought into alternatives to traditional medicine.

We received this e-mail from Katherine in Atlanta, Georgia. She writes, "I've had chronic thoracic back pain for over a year and have tried acupuncture, massage therapy, and a chiropractor but have yet to see any lasting results. When can you expect to see results before your wallet is empty?"

Dr. Hyman, we've been talking about all of these different therapies. They work for some people, but not for everyone.

HYMAN: That's right. And I think this underscores key point. I think Dr. Gupta brought it up in his last piece about dealing with surgery for a problem that really needs to be dealt with by dealing with the underlying causes, such as obesity, not simply a quick fix or dealing with the symptom.

You know, surgery can be helpful. And that's really what I talk about in my book "Ultra Metabolism." It's a comprehensive approach.

And just like this patient with back pain, they need to find the cause of the problem. You know, if it's something like an arthritis or a facet, which is a joint in the spine that can be inflamed, if it's the posture the person's in, if it's chronic use of the mouse on the computer that's causing chronic pain, the treatments of acupuncture, or massage or chiropractic may not be helpful.

So you really need a comprehensive, integrated approach to deal with any problem, whether it's obesity or back pain.

Well, Dr. Hyman, thank you for joining us today.

HYMAN: My pleasure.

COHEN: And that's all the time we have. Remember, this is the place for the answers to your medical questions. Thanks for watching. I'm Elizabeth Cohen. Stay tuned for more news on CNN.

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