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Sanjay Gupta MD

Drastic Surgery: A Successful Face Transplant; Your Doctor's Office Might Be Closed When You Need It Most; What Your Shopping Habits Might Say About Your Personality

Aired December 20, 2008 - 08:30   ET

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

SANJAY GUPTA, CNN HOST: Good morning, welcome to HOUSE CALL, the show that helps you live longer, live stronger as well.
This morning, a drastic surgery. Doctors revealed the details of a groundbreaking, life threatening transplant. A woman is now walking around with a face of a cadaver.

Plus, some troubling numbers out there can mean your doctor's office might be closed when you need it the most. We'll explain.

And this weekend before Christmas, discover what your shopping habits might say about your personality.

First, though, we start with groundbreaking surgery. Doctors at the Cleveland clinic announcing for the first time a successful near total face transplant in the United States. A woman getting 80 percent of her face replaced with skin from a cadaver. It's remarkable.

CNN's senior medical correspondent Elizabeth Cohen has her incredible story.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT (voice-over): Her doctors call it the first surgery of its kind, a near total face transplant was performed at the Cleveland clinic.

MARIA SIEMIONOW, DR., CLEVELAND CLINIC: I must tell you how happy she was when with both her hands, she could go over her face and feel that she has a nose, that she has a jaw, and she has a full face in front of her.

COHEN: In a breakthrough 22-hour surgery, surgeons transplanted 80 percent of her face. From a cadaver came skin, facial muscles and nerves, lower eyelids, cheekbones, upper jaw, blood vessels, arteries.

SIEMIONOW: The patient will never look like him or herself. And the patient will never look like a donor or recipient.

COHEN: The identity of the patient is being kept a secret, but we do know she suffered severe trauma several years ago, and as a result is blind in her right eye. She couldn't smell or taste and had trouble speaking. Her sibling says in a statement, "We never thought for a moment that our sister would ever have a chance at a normal life again after the trauma she endured."

This woman is now the fourth to have a face transplant. The first was French woman Isabel Dinoire. She once looked like this and now she looks like this.

ISABEL DINOIRE, FRENCH FACE TRANSPLANT PATIENT (through translator): Now, I can open my mouth and I can eat. And I can feel my lips, and my nose.

COHEN: But it hasn't been an easy road. Dinoire at one point went into kidney failure when her body tried to reject the transplant. That hasn't a problem for the Cleveland Clinic patient.

UNIDENTIFIED MALE: So far she has done well and we haven't seen any sign of rejection.

COHEN: In the coming weeks, she'll have intense physical therapy. Doctors estimate it will take 3 to 6 months before her nerve endings regenerate. And her face will begin to feel and work like her own.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: Remarkable story, remarkable pictures. Elizabeth, thank you so much.

Now refusing care according to your conscious. It's a medical dilemma. Physicians and other health care workers refusing to refer or take part in certain procedures like abortions as a matter of conscience. Now a new rule issued by federal health officials say that's okay. As you might imagine, there are strong views on both sides of this debate.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE: How are you guys doing?

GUPTA (voice-over): Twenty years ago when Dr. Sandy Christiansen went to medical school, she never thought she'd face discrimination. Yet because of her anti-abortion views, she said she was repeatedly denied the opportunity to perform medical procedures that another intern was allowed to do. When she pressed her superiors, she didn't like the response.

SANDY CHRISTIANSEN, DR., OB/GYN: She's doing that because she's working hard at the abortions and you haven't. And so she gets that perk.

GUPTA: Even after she got her license, Christiansen said she felt unaccepted by some of her peers because of her views. Now a medical consultant for a pregnancy resource center in Frederick, Maryland, she has never performed an abortion and refuses to refer patients to abortion clinics. CHRISTIANSEN: Just in the same way my conscience would not allow me to perform an abortion, I wouldn't ask another colleague to do that.

GUPTA: But many health care organizations, including the American Medical Association, believe health care providers like Christiansen have an obligation to their patients to advise them of the options despite their own beliefs. Now, a new regulation introduced by the Department of Health and Human Services would support Christiansen's right to refuse referrals and withhold information that goes against her own beliefs.

Critics argue there are already laws on the books protecting health care professionals when it comes to refusing care for personal reasons. The new proposal goes further by making it so that all health care workers from doctors to janitors who work in the hospitals may refuse to provide services, information, or advice to patients if they are morally against it. Critics fear that could mean anything from fertility treatments to abortion to stem cell research.

ADAM SONFIELD, GUTTMACHER INSTITUTE: This regulation explicitly allows that doctor or that nurse or any other health care provider to withhold information that would be relevant from a patient trying to make a medical decision.

GUPTA: Organizations like the American Nurses Association already have a code of ethics for their members. They believe nurses and other health care professionals are there for the patient. And it's the patient's prerogative to make decisions on care based on their own beliefs, not the health care providers'.

MARY JEAN SCHUMANN, AMERICAN NURSES ASSOCIATION: We don't go to school to learn how to make God-like decisions. That's not what it's about for us. It's about trying to get where the patient is and helping the patient make their own decision. You know, nobody appointed us the ultimate person to pass judgment.

GUPTA: But Christiansen says she's not playing God, just exercising her code of ethics along with the Hippocratic oath.

CHRISTIANSEN: Why would you want to eliminate people, you know, who have, you know, these certain held beliefs in conscience from a particular field of practice? Frankly, all the more reason to hold them there.

(END VIDEOTAPE)

GUPTA: Well, now we have a lesson in charity. An elementary schoolteacher diagnosed with stage four cancer. Find out what her generous young students did for her. It's really touching.

Plus, rescuing Youssif. The ongoing recovery of an Iraqi boy who was savagely burned. You've been e-mailing us. We have an update. Stay with HOUSE CALL.

(COMMERCIAL BREAK) GUPTA: You're watching HOUSE CALL. New research out there raising questions about the effectiveness of one of the gold standards in cancer detection. What you need to know about color cancer testing, that's straight ahead. And solutions for treating altitude sickness. I tell you what, I had my own grueling experience with this high in the mountains of Peru. I'll tell you about it in our "Ask the Doctor" segment.

And later, do you like to shop until you drop? You've heard that phrase. How you spend your money says a lot more than you think about your mental state. So what kind of shopper are you? Find out. HOUSE CALL's back in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. Students in a Colorado elementary school teaching lessons in charity. They took their love for their cancer-stricken teacher to the next level. The 35-year-old teacher is fighting stage 4 colon cancer and could not get her insurance company to cover an expensive treatment. So that's when two of her fourth grade students started the True Gift Fund. They convinced other students to give up a gift this Christmas and donate that money to the fund.

We tried to find this teacher and we tracked her down.

(BEGIN VIDEO CLIP)

JEWELY DEL DUCA, FOURTH GRADE TEACHER: I think about what it was like for me to be a kid and Christmas and to give up something that I've wanted, maybe all year long I've wanted it. And to give it up for another human being is such a mark of empathy.

(END VIDEO CLIP)

GUPTA: In case you're curious, so far the fund is up to $6,000. The goal, $25,000.

Now, it has been hailed as one of the most effective cancer detection tools available. But there are some questions this morning about just how effective colonoscopies are as a screening tool. Overall, colonoscopies reduce colon cancer deaths by about 90 percent. But new studies show results can vary depending on where in the colon the cancer is specifically located.

Take a look at this animation here. If you go ahead and look at the intestine specifically. And it start to take away everything but the large intestine. This is where the endoscope goes in. This is the left side of the colon. That's part of the reason it's easier to find cancers on this side.

Also, look at the types of tumors, types of polyps. Over here, they're sort of more mushroom shaped. Over on the right side of the colon, they're a little bit flatter. It's easier to see those polyps over there, and to remove them as well. It's important to point out that colonoscopies are still the gold standard of care and still do prevent deaths.

It is time for my favorite segment of the show, "Ask the Doctor." Let's dive right in. Georgia gets the first question this morning. She writes this, "What causes altitude sickness and what's the best way to treat it?"

Well, Georgia, altitude sickness occurs when your body is not getting enough oxygen. It's common when driving through the mountains, hiking, basically any time you can increase altitude over a short period of time. In fact, in full disclosure, a few months ago, I was in Peru shooting "Planet in Peril," and we drove up a 14,000 foot mountain. And our whole crew got altitude sickness. That's me looking absolutely awful. I felt very dizzy, had a bad headache, was experiencing shortness of breath. Those are the common symptoms of altitude sickness.

Now to treat it, the locals there found me pure oxygen. As you can see here, I'm wearing it. That really helps. Another remedy is taking a diuretic, which can help get rid of some of the excess fluid that's building up in your brain. And in Peru, another local remedy is chewing on cocoa leaves, which really helped me as well.

Now prior to leaving for a trip, you can also take a drug known as Diamox to help curb the symptoms. Loading up on carbs, drinking lots of water can help as well.

All right, another question now coming from Geri in Woodstock. She asks this. "Is it advisable and safe for adults over the age of 60 who have had childhood chickenpox to get the shingles vaccine?" Great question.

You're asking specifically about the Zastavax (ph) vaccine. Yes, I would advise getting it if you're over 60. And if you're older than that as well and if you've had chickenpox in the past.

Now, this vaccine's not going to make you immune from shingles, but if you do get the virus, it's going to reduce your symptoms pretty dramatically.

Now, if you've never had chickenpox, there's a different vaccine you should look into. It's called the Verivax (ph) vaccine. Most kids get this when they're about a year old, but it's generally safe for adults as well. Of course, talk to your doctor about whether these vaccines are appropriate for you. People are sometimes allergic to them and they can be problematic for people who have had with weakened immune systems either now or in the past.

Now CNN viewers helped to rescue him. Burned, he was left to die. He was just a little boy. Nearly two years after Youssif's savage attack, his recovery continues. Find out how he's doing today.

Also ahead, how the way you spend your money could speak volumes about the kind of person you are. The distinctive personalities of shoppers. Find out which one you are.

And later, eating right, exercising, seems to be a huge task for many of us. We'll tell you how this busy dad is managing to stay fit by giving people Internet access to his life. Stay with us.

(COMMERCIAL BREAK)

GUPTA: Let's check some of this week's most viewed stories on the health page now. A severely disfigured woman gets a new face in a groundbreaking operation. Read the details, hear what the doctors have to say.

And before you fly home for the holidays, check out CNNhealth.com. Find out which are the nation's healthiest airports. They rate everything from healthy food to the cleanest bathrooms. In case you're curious, Phoenix came in at number one.

And an Olympic medalist three times over, fencer Sada Jackobson inspiring kids to take up fencing for a great mental and physical workout. Catch all of those stories on CNNhealth.com.

You know, through our Web site, you have made your voices known and your impact felt. By donating money through our Impact Your World Day, you helped a severely burned Iraqi boy and his family come to the United States for badly needed surgery. Thousands of you have followed Youssif's story.

Our own Arwa Damon is still in touch with the family.

(BEGIN VIDEOTAPE)

ARWA DAMON, CNN INTERNATIONAL CORRESPONDENT (voice-over): Youssif loves going to school and for good reason. The little guy already has a very serious goal in mind.

Do you remember when we were talking and I asked you what you want to be when you grow up? What did you say you want to be?

YOUSSIF: A doctor.

DAMON: A doctor. Why do you want to be a doctor?

YOUSSIF: So I can help.

DAMON: So you can help?

Nearly two years ago, masked men in Baghdad doused Youssif with gasoline and set him on fire. He was just 4 years old at the time. Slowly, he's putting that behind him and inspiring everyone in the process.

MARIO DALEY, YOUSSIF'S TEACHER: I worked with children of all levels of ability. And for Youssif with what he's gone through, his motivation, his -- what he produces is fantastic.

DAMON: He's loving the first grade, making friends like Brandon. Youssif has gone through more than a dozen surgeries.

PETER GROSSMAN, DR.: A lot of things that we've moved forward and done. DAMON: And there's still a lot more to be done. The bulge in Youssif's cheek is a tissue expander, meant to stretch out the healthy skin so Dr. Peter Grossman can use it to replace the scar tissue.

GROSSMAN: The problem that we have with Youssif is at every operation we do tends to heal well after surgery. But then a month after he starts forming these really thick scars. And it's probably best at this time to let him -- his body relax, let these scars mature over a period of a year or two years.

DAMON: It hasn't just been a physical transformation.

UNIDENTIFIED MALE: He talks to people. He plays, he does everything. Before...

DAMON: Yes, it was very different.

UNIDENTIFIED MALE: He wouldn't talk to anybody.

DAMON: Now Youssif is definitely doing most of the talking.

Yeah, what do you want me to do for you?

And I'll do anything for this kid, who's touched all of us. Keely Quinn of the Children's Burn Foundation stops by for some extra reading lessons.

What's the biggest change that you see in him in the last year?

KEELY QUINN: Aside from reading and learning English, I think the change in confidence and his ability to handle himself in special situations.

DAMON: And from the looks of it, that ability is only going to be getting better.

Arwa Damon, CNN, Los Angeles.

(END VIDEOTAPE)

GUPTA: And, of course, we'll bring you more updates on Youssif in the days and weeks to come.

Well, we are just days away from Christmas. Maybe you still have last-minute shopping to do? Sound familiar? What does how you spend say about who you are? Elizabeth Cohen with some unique insight into the personalities of shoppers.

Plus, how does this competitive cyclist with two kids and a demanding job still find time to exercise? Can't we all do that? He's part of our fit nation. His surprising workout solution is ahead. Stay with us.

(COMMERCIAL BREAK)

GUPTA: That's some nice music to get you back with HOUSE CALL. Only one weekend of holiday shopping left. So we were curious, does how you spend your money say anything about the kind of person you are?

CNN's senior medical correspondent Elizabeth Cohen joins us. We're just a few days away from Christmas and other holidays as well. What about it? First of all, congratulations on your promotion.

COHEN: Thank you very much.

GUPTA: That's a little holiday...

COHEN: That's right, exactly, from CNN to me, right.

GUPTA: But what does your shopping habit say about your personality?

COHEN: Well, there's an economist who likes to study consumer psychology. And he says that if you look at your shopping habits, it can actually become sort of diagnostic tool. You don't need to spend money on a shrink. You can just look at how you shop. And it tells a lot about yourself.

First of all, what he did is he devised three categories of shoppers. He says there are normal shoppers, who spend less than they earn. They save for the future, and they do prudent planning.

All right, then from there, you go to the neurotic shopper. The neurotic shopper spends an excessive amount of time shopping hours looking for that one little thing. They're perfectionists, but they don't overspend. So they're safe shoppers, although they're a little neurotic.

The third category, compulsive shoppers. This is where you start to get into trouble. You spend money you don't have. You go on buying binges to make yourself sort of feel good like an alcoholic goes on drinking binges. And you're so embarrassed afterwards, you hide those purchases from your spouse because you can't afford them.

So, Sanjay, I'll reveal first. I'll share first.

GUPTA: OK.

COHEN: Which is that I think I'm pretty normal, but I do have flashes of neurotic shopping.

GUPTA: Right.

COHEN: Sometimes I'll spend hours looking for that one perfect thing. It was really kind of unnecessary. That's where I am. How about you?

GUPTA: You're a sweet person, that's why you're doing it. I -- because I'm here I think a lot, or so much of the time, I'm probably a compulsive neurotic. I go out the day before, buy the exact same gift for everybody, and give it to them the next day.

COHEN: Well, that sounds smart. That sounds smart, right. Efficient, it's very efficient. So that actually sounds good.

GUPTA: You know, you do watch some of these people who are kind of crazed shoppers out there. If someone is out of control with regard to their shopping, is there -- I mean, is there shopping intervention?

COHEN: Well, there is such a thing as a category four shopper.

GUPTA: Oh, OK.

COHEN: And these Cat four shoppers, they go really crazy. They spend so much money that they end up in legal trouble. Sometimes they develop drug habits to make them feel better about their shopping habits. It can really become a mess. And there's a group called Spender Mender. You can look them up online. Spender Menders, a group of people who get together to talk about their shopping habits. You can kind of think of it as an AA for shoppers.

GUPTA: Good advice as always, Elizabeth. And happy holidays for you.

COHEN: And thank you. Good to see you.

GUPTA: Spend some time with your beautiful family and your daughter.

COHEN: Thank you, thank you. You, too.

GUPTA: Good luck. Thanks.

Busy people often say they have a hard time fitting exercise into their schedule. Could Googling a solution help? Ahead, how an online calendar is helping this competitive cyclist stay fit.

(COMMERCIAL BREAK)

GUPTA: You want to exercise more, but you can't find the time. Sound familiar? Several online tools like the Google calendar can help you schedule fitness into your already very busy routine.

Take a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Life here at Google headquarters in Mountain View, California is a bit different from most jobs. Free food, free time, and a free forum working environment.

KEN NORTON, GOOGLE PRODUCT MANAGER: The food is amazing because it's great. But it's, you know, it is everywhere, so you kind of have to be careful.

GUPTA: But still, people like Ken Norton, a product manager here face the same work life balance issues as the rest of us.

NORTON: I'm a competitive cyclist. And I am always trying to balance the training time on the bike with two little kids and a family at home and a full-time job.

GUPTA: So in an effort to simplify things, Ken has turned to a product he helped develop, the Google calendar. To manage his busy lifestyle, putting his training schedule at his coach's fingertips.

NORTON: And you can see that today I -- my coach has me riding for two hours in the morning. The purple calendar is my son's school calendar. So we have a book fair family night.

GUPTA: The biggest benefit of Google calendar, Ken said, is that it's portable and it's shareable.

NORTON: I spend a lot of time, you know, at different computers and with my mobile device. And it just doesn't make sense to have a kind of a particular document living in one place. I share it with people in my team, I click share and then those people will be added as collaborator.

GUPTA: And he says even for those of us who aren't competitive cyclists, the extra help in organizing our exercise time can be a positive experience.

NORTON: It may just be as simple as, you know, blocking out an hour in your calendar to go to the gym at lunch.

(END VIDEOTAPE)

GUPTA: You know what the key is here? Accountability. Sticking to those scheduled workouts, a useful tool from the folks at Google. But there are some other online resources that you might want to try as well. Weightwatchers.com has a program you can use without ever having to go to the meeting.

Another Web site that we liked a lot, sparkpeople.com. You can go there to manage your fitness plan. And of course, you can always go to our new Web site CNNhealth.com. We updated it for you with some terrific new diet and fitness tools.

Well, unfortunately, that's all the time we have for today. If you missed any part of today's show, be check out my podcast on CNN.com/podcast. Remember, this is the place for the answers to all of your medical questions. Thanks for watching and happy holidays, everybody. We'll be back next week. I'm Dr. Sanjay Gupta. More news on CNN starts right now.