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Dr. Drew

Warning Signs Ignored?; Living With Crohn`s

Aired August 02, 2012 - 21:00   ET

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

DR. DREW PINSKY, HOST: Here we go.

News out of Colorado, reports that university staff may have known the accused Aurora gunman was, in fact, a threat. If so, why did they not tell police?

Plus, do bigger breasts mean a better life? Well, this woman literally begged for them. But this woman has a warning for her. She is here. A surgeon is here. Her surgeon is here.

And we are live. Call us, 855-DRDREW5.

Let`s get started.

(MUSIC)

PINSKY: The psychiatrist who is treating Colorado movie massacre suspect apparently had warned a University of Colorado threat assessment team that he could have been a danger to others but no action apparently was taken. And people are asking why not.

I`m saying it is not that psychiatrist`s fault, in all probability, in my opinion. Her credentials, I have looked at them carefully, they are exceptional. She is not only a highly well-trained and public psychiatrist. She was a physical medicine specialist before that.

This is no -- this is the real deal this woman. She is a highly train proceed federal governmental. And she did, based on what we`ve seen and heard so far, what I would say would be probably the only action she could have taken, given confidentiality laws the way they are, which is to notify the university assessment team -- the potential to evaluate this kid for trouble.

She, I suspect we are going to find out, was functioning at the highest professional level and probably did no wrongdoing. That`s my opinion.

But joining me to discuss this, Brian Claypool, he`s criminal defense attorney.

And Brett Sokolow, a specialist in campus safety and security. He`s the founder of the National Center for Higher Education Risk Management.

I want to go out first to Brett.

Now, Brett, you were part of the organizations that set into motion the really increasing awareness about assessment and potential for violence on the heels of the Virginia tech tragedy.

So, in reality, these organizations were supposed to stop or at least reduce the risk of precisely what happened at Virginia Tech and now here we have almost the same thing playing out. What went wrong? Was it the psychiatrist or was it the assessment team? What do you think?

BRETT SOKOLOW, SAFETY AND SECURITY EXPERT: Well, Dr. Drew, at this point, I don`t think that anything went wrong, or at least we don`t have anything that it did. As a matter of fact, I think the information that went to the team at C.U. Denver indicates a team that was functioning well. There was a transmission of information and what we don`t know at this point is whether they found him to be a significant threat and somehow didn`t act on that, or whether at the time they had information that he was concerning, maybe even had some mental health issues, but those didn`t necessarily correlate to violence. They often don`t.

And so, maybe it took reasonable action, under the circumstances. We just don`t know yet what those circumstances are.

PINSKY: And, Brett, how about -- what do we tell people who say, well, did this assessment team drop the ball because this kid dropped out from school?

Let me phrase the question a little differently. I would think that the assessment team would still have an ethical obligation from that kid even if he withdrew from C.U.

SOKOLOW: Yes, one of the things, and I helped to run NBITA, which is the National Behavioral Intervention Team Association. One of the things that we train on and we train 700 or 800 of these teams across the country, is that when a student either withdraws from college or the institution asks to separate the student for safety reasons, that`s not an opportunity to wash your hands of the situation, that actually may be a time for increased monitoring. It may be that the separation precipitates violence, agitates the individual, activates a desire for revenge.

And so, rather than saying he is outside our control at that point, there are a number of tools in the tool box that colleges and universities can enact, even with someone who is no longer a student.

PINSKY: When, Brian, I hear Brett say that, it sounds like they did drop the ball that assessment team. Again, I have real trouble people of pointing fingers at this psychiatrist. I think we`re going to find she did everything right. I`m worried about that assessment team.

BRIAN CLAYPOOL, CRIMINAL DEFENSE ATTORNEY: First of all, I`m not sure I agree with you 100 percent this psychiatrist did everything correctly.

At some point in time in our society, we have got to put responsibilities legally on people like psychiatrists, educators who have access to students who have access to patients who are coming to them and saying, hey, I`m a threat, I might harm somebody. Let me ask you, you have got a patient who comes to you, like this guy Holmes, and you`re sensing that this guy is a ticking time bomb.

PINSKY: OK.

CLAYPOOL: What do you do?

PINSKY: So, Brian, let`s say he says I`m feeling aggressive, screw you, Dr. Pinsky, I`m not going to listen to anything you say. What do I do? Call police? What are they going to do?

CLAYPOOL: OK. Not at that point. But what if he comes to you, OK, I`m James Holmes --

PINSKY: What are they going when I call police, unless he says I have guns? Police are on the same constraints as a psychiatrist is, unless he says, "I`m going to kill people," they`re going to say, hey, let`s see your gun registration, we`ve got an eye on you, that`s it. They`re going to leave him at his home.

CLAYPOOL: I bet you anything, we ever get access to that file, you`re going to see something in that file that is a trigger, something in there where Holmes is saying to Dr. Fenton, hey, I think I want to harm somebody, think I`m going to go out and buy a gun. I don`t see purpose in life anymore. I want to go shoot up somebody.

If you have something in there like that, then you have an obligation to call.

PINSKY: I agree.

CLAYPOOL: You got to pick the phone up and call law enforcement.

PINSKY: Of course.

CLAYPOOL: You can`t call a bunch of bureaucrats in a university and expect them to go do something. People in the mailroom couldn`t open a mail.

PINSKLY: Brett, what is the different between a psychiatrist`s obligations -- help people understand this -- between calling law enforcement, putting somebody on a hold, hold somebody against their will call law enforcement or the assessment team, what`s the difference?

SOKOLOW: I thank you a lot of possibilities open to a mental health professional in a situation like this. She or he could deal directly with the client and leave the relationship confine to that. That individual could go to parents and involve them in the situation which can often be a very effective type of intervention.

The psychiatrist or mental health professional could contact the campus team who is a team of trained, proficient administrators, not bureaucrats, looking to protect the campus and hopefully see the individual succeed as a student. There`s the possibility of the mental health resources of the surrounding community, which could include a 72-hour hold, involuntary hospitalizations after that hold and there`s also the possibility of going to police.

Going to police though, do we go to the police where he lives? Do we go to the police on campus? Do we go to the police where he may enact violence? What if we don`t know where he may enact violence?

So, I agree this statement. Yes, I agree with the statement that a psychiatrist or a mental health professional Colorado has a duty to warn. But that`s not something we need to enact into law t already exists into law.

If Fenton, in this case, did not call police or did not notify anyone who was at risk, it was because she didn`t sense the threshold was present.

CLAYPOOL: I disagree with that.

SOKOLOW: If you blow that away -- wait, we don`t know. But if you blow away the confidentiality you what happens is the patients don`t communicate with their mental health providers. If you want to shutdown that communication, people won`t get help.

PINSKY: If you say I`m going to notify law enforcement, if you tell me something worse or I have an inkling of trouble, those people withhold some of their information to their psychiatrist.

Let`s take a call. Nicki in New Hampshire -- Nicki.

NICKI, CALLER FROM NEW HAMPSHIRE: Yes, hi.

I have personal knowledge how this can work, if you communicate something that seems untoward during a session.

PINSKY: Were you yourself -- you yourself in a session where you said something that triggered action?

NICKI: Yes. Yes.

PINSKY: What happened?

NICKI: Well, the first thing I can tell you is from a university setting that when I was at a prominent school here in the Boston area, I became anorexic and went one semester from 130 pounds to 88 pounds and they asked me to leave for a semester, or longer, until I could get my act together and be functioning because of the safety issues.

So I think if you`ve got a good team on the university campus that pays attention, you are going to be noticed to anything that`s going to happen.

PINSKY: OK. So, your point is, based on Nicki`s experience, that the assessment teams, whether it`s to keep somebody safe or prevent violence, there are professionals ready to help, ready to separate institution from the student or reach out in that moment.

I got to tell you, Brian, it`s very difficult. I have been working at a psychiatric hospital for a couple of decades and there is -- what bothers me is that a physician`s intuition doesn`t carry much weight, it doesn`t, because let`s say my intuition is, somebody is going to be a problem, I call law enforcement what are they going to do?

They can`t do much of anything. I can`t put somebody on a hold based on intuition. I can call the assessment team but they can`t do much either.

CLAYPOOL: I disagree.

PINSKY: That`s the law. That`s the way it is.

CLAYPOOL: The law needs to change. What happens here, if Fenton calls law enforcement, or the lazy folks at the university who did nothing, nobody opened the mail, nobody cared about the report to the crisis intervention team, any one of those folks called law enforcement, I guarantee you, they go take one look at this dude, they are going to get search warrants, they are going to get -- fill out probable cause affidavit, they`re going to get over to that clown`s apartment and they are going to preempt this entire massacre.

At some point, there has -- some point, people have to go on instinct. What`s in your gut, probably sharper than that. It`s no different than law. We go on a gut, an instinct.

I bet you know, looking back at your career, looking back at some of your patients, who might have been more of a risk than others.

PINSKY: Brian, my patients die regularly, drug addicts, because my intuition can`t be supported by the law. I can`t -- I can`t intervene and take somebody`s rights away from them based on my intuition.

I wish I could. I could save a lot of lives of drug addicts. But I can`t.

Your point is well taken. I got to go to break. I agree with what you`re saying. I wish we could change that law.

Brett, I think you would agree with us, too a little more flexibility with intuition.

But, Brett, I want to thank you for stepping in here this is a very complex area. We didn`t even get into the whole issue of HIPPA versus FERPA versus whose records of who we can look at.

Let me just ask one thing before we go to break, Brett, when do you think we are going to get to see records and get information we can really start to look at what`s going on here?

SOKOLOW: Gut instincts are one thing that doesn`t substitute for a good threat assessment, in terms of the information it is dribbling out now. I think it will continue to dribble out, despite the gag order, over the next couple of weeks. And I think probably within two weeks, we will have a very good sense of what the team knew and whether its actions were appropriate.

Until then, I continue to be hopeful that they were a well-trained team doing what they need to do and that they did act appropriately.

PINSKY: I hope you`re right. I am 100 percent behind the psychiatrist at this time. I think people pointing fingers at her are making a grave mistake and really causing another human to suffer, another victim unnecessarily. But Brian feels otherwise.

I will get you both here to talk about this. Thank you, Brett. Thank you, Brian.

Next, I`m switching gears, entirely, we are going to take a turn, stay with me. I don`t know how to quite make this turn it goes from something very -- there she is. OK, she is going to help me make this turn.

We have somebody who literally begged for larger breasts. She says it was going to mean a better life for her. That guest you are looking at is going to help other woman with that decision. Don`t go away.

(COMMERCIAL BREAK)

PINSKY: Thirty-seven-year-old Chrissy Lance made headlines by panhandling on the side of the road, begging for money for -- get this -- breast implants. There she is, dressed in -- there she is, bikini, holding a sign saying "not homeless, need boobs."

Chrissy joins me now with her plastic surgeon, Dr. Michael Salzhauer.

Chrissy, I understand you have that sign with you. Let me see that. Is that right?

CHRISSY LANCE, HELD UP SIGN, "NEED BOOBS": I do.

PINSKY: Let`s see. There it is. That`s the sign that has prompted all this action, including Dr. Salzhauer.

Dr. Salzhauer, how did she become your patient? Did she raise the money and fly to Miami or what happened here?

DR. MICHAEL SALZHAUER, PLASTIC SURGEON DOING CHRISSY`S BREAST: She raise some of the money, actually, after a few days of the story hitting the Internet, somebody posted it on my Facebook page, actually my anesthesiologist did. We do a fair amount of pro bono cosmetic work, a little unusual, but we do that a few cases a month.

Her story touch our hearts when we heard she was out there, she`s a single mom, working as a bar maid, trying to put herself through school.

And it was -- you know, it was a case of the squeaky wheel getting the oil. It got our attention.

PINSKY: All right. All right. I get it.

But, Chrissy, how is this going to enhance -- it is going to enhance your body. How is it going to enhance your life?

LANCE: First off, self-esteem issues, because I am AA, just make me feel better about myself.

PINSKY: And you have a daughter -- off daughter is that right? Are you concerned that the focus on call it sexualizing your body is going to have -- the message you want to be giving your daughter?

LANCE: There is no message that I`m giving my daughter. My daughter, I`m raising her to be open minded.

SALZHAUER: You know, I should step in here a little bit. Chrissy, to be fair, she is a AA bra size right now. She is fairly flat. She is not talking about getting implants to be DDD. She is talking about being normal, to be a B or a C cup, and especially in her line of work.

In my experience, a lot of the waitress and bar maids see increases in their tips after they get plastic surgery. That is just a fact of life. And so, she is doing it not just for her self-esteem she told me, but also as an investment. You know, there`s something to be said for that.

PINSKY: All right. Let me bring in a guest who has been with us in the past. She is somewhat of an expert in this area.

Lacey has, I guess, L sized cup breasts she and says she wants to get even bigger. We have been concerned about that.

Lacey, we have raised our concern about the health consequences for you. You are a fan of the procedure obviously, but not sure what is going on with Chrissy. Tell me why.

LACEY WILDD, HAS L COUPS, WANTS TO BE BIGGER: Well, I`m concerned about her support system there at home. I`m hoping that she has some type of support at home to help her in this -- I see that a doctor has stepped forward to help her, which is amazing. And I believe helping your self- esteem issues is a great thing because I did the same thing. I was in her shoes.

My concern is free is not always good. So, has she done her background checks on the doctor? Just something like that? I mean, jumping on an operating table would concern me without doing her homework.

PINSKY: All right. Well, let me do some of the homework with her. Dr. Salzhauer, are you certified?

SALZHAUER: Correct. I`m a board certified practice surgeon. I`ve been in private practice in Bal Harbour for the last nine years. I do about 350 breast augmentations, I had 10,000 patients, no one has ever died and I have never been sued for malpractice.

So, that`s an important information every person who`s looking up a plastic surgeon should find out about their plastic surgeon. I`ve got a Web site with literally hundreds of before and after pictures and 1,200 handwritten testimonials you can look up at balbody.com.

So, I`m not just a fly by night guy operating in a garage in Hialeah somewhere. So --

PINSKY: All right. Fair enough. You passed muster.

Let me read a Twitter -- a little Twitter comment from Yancey Faith (ph). She says, "Yes, I can tell you firsthand, big boobs do give you a great life, no question whatsoever, friend," she says.

I`m a little concerned about all this. Let me talk to a caller real quick before we go to break.

Allison in Florida -- Allison.

Allison, are you with us?

ALLISON, CALLER FROM FLORIDA: How are you?

PINSKY: Good. Go right ahead.

ALLISON: I have had at least 14 boob operations or breast operations, one about four months ago. I would say about 1200 CCs and I`m already looking to go bigger. It`s definitely an addiction. I don`t leave my house much because I don`t feel like I`m big enough.

PINSKY: Wow.

ALLISON: It controls my life.

PINSKY: All right. I thank you for that comment.

I also understand, I know, you are somewhat like Lacey a little bit, she definitely leaves home.

But also concerns about the possibility that this is not just the first surgery that someone might need when they have a breast augmentation, there maybe future surgeries. And I`ve got a surgeon that`s coming on who wants to talk about those aspects of this procedure.

Give us some calls, 855-373-7395. I`m not going away. You don`t go away.

Be right back.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

PINSKY: I`ve got 10-pound fruit down here, I`m going to pick this up. And -- I mean, not to be funny about this but first of all, I got backache just picking them up. If I put this on my chest and tried to lie down, I couldn`t sleep. Really just leaning back like this I have trouble taking a deep breath.

(END VIDEO CLIP)

PINSKY: That`s -- no kidding. I really worried about the pulmonary consequences of having 20 pounds on your chest. It was an enlightening experience for me.

Lacey Wildd who says her breasts weigh 20 pounds each is back, along with Chrissy Lance, a single mom who says she needs these breasts to make her life better.

Also joining us is plastic surgeon Linda Li.

And, Linda, you, during the break, said something very revealing, I wanted to pick up there what did you want to say to me? You whispered?

LINDA LI, PLASTIC SURGEON: I said there are some days I`m embarrassed by what I do.

PINSKY: OK. Now, go.

LI: As a plastic surgeon, our job is to try to meet the needs of our patients, we need to be realistic. We need to give them normal augmented breasts but this becomes ridiculous.

PINSKY: Now, we heard from someone that was addicted to getting larger breasts. Lacey, obviously, show a picture of Lacey, she is into this, made a whole career out of it.

But what about Chrissy, she wants to get more tips. She feels it`s not that big a deal. The surgeon has stepped in to try to help her. Should we be concerned about that?

LI: I`m concerned because there are always risks involved with surgery, even in the best intentions. Complications can occur.

PINSKY: Don`t they have to be repaired at some point?

LI: Given how old she is, some time between now and before she passes away, she will need to change out her implants. There`s --

PINSKY: So, Dr. Salzhauer, are you going to give her the follow up procedures, too?

SALZHAUER: Sure, absolutely. I stand behind my work. But beyond that, just to explain to your viewers like, when you talk about 1200 CCs or 3,000 CCs, the implants that Chrissy is going to get are about 375 CCs.

PINSKY: Dr. Salzhauer, I got to take a break. Hold those implants. We are going to be back with that.

More calls after the break.

(COMMERCIAL BREAK)

PINSKY: We are back. And we are talking about whether bigger breasts means a better life and why so many women feel they need to have these larger breasts.

And what I want to bring out at this point is how -- because on one hand, fine, you help enhance people`s self-esteem. Chrissy gets more money in tips.

But let`s remind people, this is a surgery, potential complication. You said you had a case where things didn`t go so well.

LI: I have a parent I recently saw. She came from another plastic surgeon and had a complication which we do see. It is not the surgeon`s fault.

PINSKY: Encapsulation.

LI: Encapsulation, the breast implant, where the breasts get hard. She has now had four surgeries with this other surgeon and it`s $26,000 in debt and moved back in with her father.

PINSKY: So, Chrissy, you think about that the potential complications as you sort of head on into this procedure?

LANCE: There`s always going to be complications with any kind of surgery that --

SALZHAUER: There`s always risks.

PINSKY: There`s always risks. But I`m wondering whether Chrissy thinks about those risks so anxious to have her breasts enhanced, I`m just wondering.

LANCE: I don`t think about it too much, no.

PINSKY: And, Lacey, I know you have thought about it a great deal because your risks are like out of control. I mean, you know you are taking life-threatening risks every you do this.

WILDD: I`ve had a lot of complication and it wasn`t when I was just this big. I was as small as she was at one time. My concern is does she know -- is she going over the muscle, under the muscle? Does she have someone down here with her in Miami when she comes?

I mean, what kind of support system does she have? I mean, I would reach out to her and meet her while she`s here if she would like to talk to me about pros and cons.

PINSKY: But Lacey, I got to stop and hang a little lantern on something. You were the same size as Chrissy at one time?

WILDD: Yes, I absolutely was, and I went into for it for the same reasons that she did. I was supporting my children. I was AA breast size, and I needed to make more money.

PINSKY: Are you worried that Chrissy is going to get -- go down your path? Just saying.

WILDD: I absolutely -- well, I mean, it could happen, but I don`t see that happening. She`s -- I think, that right now she`s more concerned about her self-esteem and making a little bit of money. I don`t think she`s trying to be one of the biggest breasted girls in the world like me. That`s a whole different story.

PINSKY: Let`s take a call. Patricia in California -- Patricia.

PATRICIA, CALIFORNIA: Hi, Dr. Drew. Thanks for taking my call.

PINSKY: Pleasure.

PATRICIA: I wanted to know. I support Chrissy 100 percent. I was flat-chested until I was about 30 years old. I had my two children, decided no more. And so, I went in and had the silicone implants, which several years later, I -- it scared me. I thought maybe they might break and leak, so I went back and had the saline done.

PINSKY: OK.

PATRICIA: And not to be a Lucy -- I don`t know where she`s going with that, but anyway, your self-esteem is so important. And It does help. You don`t have to wander around with things cut down to your belly button, but just a nice bust line is great. Don`t overdo it.

PINSKY: Thanks, Patricia. Linda, what approach is best in your opinion?

DR. LINDA LI, PLASTIC SURGEON: I would stay in this day and age, most women want a very natural look. So, most of us plastic surgeons are putting the implants underneath the muscle. Saline feels like a water bag --

PINSKY: What approach?

LI: Here in California, we tend to use an areolar approach.

PINSKY: So, they`re going just under the nipple. They`re going under the muscle, and they`re using silicone?

LI: Yes.

PINSKY: Is that what you`re doing?

DR. MICHAEL SALZHAUER, PLASTIC SURGEON DOING CHRISSY`S BREASTS: Exactly. And believe it or not, through an incision about two inches wide, we can get this implant through and under the muscle. And again, Dr. Drew, I want to reiterate, I mean, the size that Lacey is, about 3,500 CCs, this is one-tenth of the size of Lacey.

So, she`s -- you know, Chrissy is going for normal looking --just normal-looking breasts, fill out a bra, feel out a dress, and feel good about herself.

PINSKY: Robin in Florida -- Robin

SALZHAUER: -- go down the path of Lacey.

PINSKY: Go ahead.

ROBIN, FLORIDA: Hi, Dr. Drew. How are you?

PINSKY: Good.

ROBIN: I have been large breasted most of my life, and it`s not something I would have chosen. It`s more of an inconvenience than anything. I find it interesting that so many women pay thousands of dollars for implants when I would give my left arm for a reduction.

PINSKY: Yes. It`s interesting to me that all women are unhappy with some part of their body.

LI: Absolutely.

PINSKY: They really are. But Robin is -- in fact, my understanding is, Linda, that the most common -- the most happy population of plastic surgery patients are the breast reduction patients.

LI: Absolutely. The breast reduction patients are incredibly happy because they no longer have the back pain, the neck pain, the sweaty under breast issue. They can wear a normal bra. They don`t have to go out and buy a $100 custom bra. They can go to Victoria Secrets and feel sexy.

PINSKY: So, Robin, let`s ask Chrissy. What`s going on, Chrissy? Why don`t you feel more like Robin?

CHRISSY LANCE, PANHANDLED TO RAISE MONEY FOR IMPLANTS: Why? I kind of do feel as same as her except I`m opposite. I have got none. I can`t go in to Victoria Secrets and feel pretty because they don`t make bras to fit me.

SALZHAUER: Most people just want to be normal. If they`re flat- chested, they want to have a normal cup size. And if their breasts are too big and they`re interfering with their daily life, they want them smaller. I mean, it makes sense.

PINSKY: All right. Let`s go to another caller. I believe this is Zach coming up here? Is that right, Zach?

ZACH, PENNSYLVANIA: Yes. Hi, Dr. Drew.

PINSKY: Zach, go ahead.

ZACH: I just wanted to touch on all different -- the self-esteem part of the conversation.

PINSKY: Excellent. Go ahead.

ZACH: I mean, I have absolutely no problem with Chrissy wanting to feel normal and fit in and fit into clothes well. I`m worried when self- esteem is connected directly with one part of your body or one part of your life instead of being too beat up (ph) into multiple aspects.

PINSKY: Zach --

ZACH: Because in one part -- yes.

PINSKY: That`s a great point, or really, I mean, although we can fix the outside and enhance self-esteem is that really going after what`s going on in the inside that often is the issue in self-esteem. So, let`s talk about that, Chrissy. Are you doing anything to enhance your mental health?

LANCE: I don`t believe I have mental issues. I`m a very outgoing person.

PINSKY: Well, you said you have self-esteem issues.

LANCE: I do have self-esteem. I don`t like being stared at, because I will feel like it`s because I am very small chested.

SALZHAUER: People have self-esteem issues about the way they look. I had a big nose and I had a rhinoplasty. I got over -- I had plastic surgery. Now, I have a normal nose, and I feel great about it and I move on with the rest of my life. It`s not like you get fixated, not everybody gets fixated on one body part and continues.

When that happens, that`s called body dysmorphic disorder. And you know, some of the people, some of the callers, maybe even Lacey may have that where they`re fixated on just one body part.

PINSKY: Lacey, are you worried about that, about having body dysmorphia?

WILDD: No, I don`t have that. I mean, one of these days, I`m going to take my breasts out. This is to make money. And that`s why I support what Chrissy`s doing. This is to make money. I`ve had a lot of other surgeries, though.

LI: I think breast surgery --

WILDD: I totally support her.

PINSKY: OK, Lacey.

LI: I think that breast surgery can really enhance somebody`s self- esteem, but it is not the beyond and all. It`s not a magic pill that`s going to make you happy.

PINSKY: All right. Thank you, guys. Interesting. Thank you, Lacey. Thank you, Chrissy. Good luck, Dr. Salzhauer, with your patient, and whatever re-repairs needed to be done. And Linda, I appreciate you coming and talking about this.

LI: Thank you.

PINSKY: It`s just -- I think the important thing here, above all else is, two big things came out in this conversation. One, have self-esteem issues, OK, fix the outside, but let`s really focus on the inside as well, and most of those solutions come interpersonally, in your relationships. That`s where people develop self-esteem and quality, attached, secure relationships, number one.

And then, number two, to really understand that these surgeries are not simple, they`re -- they may be a series of surgeries that follow.

LI: This is a lifetime commitment to a set of implants.

PINSKY: OK. There you go.

Next up, a star of the secret life of the American teenager talks about his illness. We`re changing gears yet again and talking about something you may not have heard of before. Certainly, I`ve dwelt with a lot as an internist. It is called Crohn`s disease. You`ll hear about that after this.

(COMMERCIAL BREAK)

PINSKY: OK. I`m getting whipsawed around myself from the dramatic changes in topics we`re having today. We`ve gone from the tragedy in Aurora to -- and that was kind of interesting -- to breast implants, and now, we`re going from breast to bowels. That`s right. And there`s a lot of things the physicians see and hear that people don`t talk about.

But one actor is opening up about a serious illness that many have tried to keep secret for hundreds of years. Joining me, actor, Ken Baumann of the ABC family hit show "The Secret Life of the American Teenager," airs Monday night, 9:00 p.m. Here now is a clip.

(BEGIN VIDEO CLIP)

KEN BAUMANN, "SECRET LIFE OF THE AMERICAN TEENAGER": Hear ye, hear ye. All ye freshmen, gather round. Come on. Come on. That`s OK. You don`t need a mentor. You don`t need anyone to guide you through your first year here. No. Just listen to my words and heed my warning. No good thing can come of this, of high school.

(END VIDEO CLIP)

PINSKY: But in real life, Ken is battling a very serious condition. It`s known as Crohn`s disease. And Crohn`s disease is what`s called an inflammatory bowel disease. It`s related ulcerative colitis. People may even heard that.

It`s diarrhea, cramping, vomiting, weight loss, appetite, and eluded back in the old days, before we had treatment for this, the bowel would get so inflamed that would literally come to the surface and break open to the external world. It`s called (Inaudible) all over the abdomen.

And you made a very interesting comment before we saw that little clip, which was 100 years ago, you wouldn`t be here.

BAUMANN: Yes, exactly.

PINSKY: Now, we have things to completely control this.

BAUMANN: Yes. I`m so glad that abdominal surgeries have evolved.

(LAUGHTER)

PINSKY: You had part of your ileum and colon taken out?

BAUMANN: I did. I had my entire terminal ileum removed.

PINSKY: Which is the end of the small bowel.

BAUMANN: And a foot of my colon.

PINSKY: And you -- you have nine feet.

BAUMANN: Yes. You know, they can just keep taking it out, taking it out. You know, I have a little left.

PINSKY: And the -- before that so people understand this, inside, the inflammation, again it leaks contents of the bowel into your abdomen. You developed an abscess in the muscle in your back called psoas muscle. And they had to clean that out surgically.

BAUMANN: Correct. I had (INAUDIBLE) hole in my small intestine that was just leaking by, (INAUDIBLE) all over. so, I had two surgeries. You know, I had a CT guided abscess drainage, which was, you know, a blast --

PINSKY: This must be a picture of your abdominal --

BAUMANN: Oh, yes. That`s it. There you go. That`s about a week after my resection was performed, which is the second surgery.

PINSKY: And now, you`re on what they call tumor necrosis factor inhibitors, which are by logics that modulate the immune system and suppress all that what you call autoimmune attack. What do you want people to know about this condition?

BAUMANN: Well, you know, primarily, the first time I was in the hospital and sort of the in the big unknown of what is this and, you know, why am in so much pain.

PINSKY: You never heard of it before?

BAUMANN: Never.

PINSKY: Yes.

BAUMANN: I had a friend. I did theater with back in Texas that had it, but then, after that, it was gone out of my head. And then, I just kept thinking about a fan of the show who had potentially, you know be 14, 15 and dealing with this and not have, you know wonderful fiance at the time, now wife and mother to support them so beautifully.

So, I thought if I can use sort of whatever public light I have to talk about it and make it less uncomfortable for them, that`s the goal.

PINSKY: I think that not only is it uncomfortable, it`s knowing that you have this kind of a scary illness, it`s really painful.

BAUMANN: Oh, yes.

PINSKY: Yes. it`s really a painful thing.

BAUMANN: Yes.

PINSKY: Cheryl in Texas. You wanted to ask something?

CHERYL, TEXAS: Well, yes, I wanted to discuss -- I was diagnosed with Crohn`s when I was 13 and had my first resection for the same reasons at 13. And I think the saddest part about it is the shame associated with diarrhea and going to the bathroom. It took me to my adult years to get over that.

PINSKY: You know, Cheryl, that`s a really important point, as a non- sufferer, I think -- as a doctor, I think more about the fistulas and the weight loss and the nutritional issues, but as a kid, as a teenager, the diarrhea was more scary or disturbing than anything else.

BAUMANN: That`s it, you know? It sort of reorganizes your social life. So, I feel like that is sort of -- you have to get rid of the anxiety and the embarrassment about it, because you know, nothing will keep you ill more so than being terrified of discussing this with people or, you know, of, you know, having to run to the bathroom and feeling ashamed about it which is just totally ridiculous.

It`s a need, you know? It`s a biological need. So, do what you have to.

PINSKY: And you have kids now?

BAUMANN: No. No children.

PINSKY: No children?

BAUMANN: No. Just married.

PINSKY: Just married. So, I assume you will have kids, and when you do, this is something you`ll discuss openly and --

BAUMANN: Yes, I would think so. I mean, I have incredible parents who --

PINSKY: There`s a picture of your lovely wife.

BAUMANN: There you go. That wasn`t too long ago, June 16th. But I have --

PINSKY: And she`s an actress, too, right?

BAUMANN: She is.

PINSKY: How would we know her?

BAUMANN: "Superbad" is sort of the biggest.

PINSKY: Right. And your incredible parents, tell us again?

BAUMANN: They`re amazing. And you know, anything in the world is open on the table of discussion. So, I feel like, you know, if parents sort of around the world to be quite grand about it would be, you know, as open with their kids and hopefully, I`ll be the same way, it will make it easier, you know?

PINSKY: Yes. I mean, here`s my sort of note and I appreciate you coming on, talking about this, and we forget in America that we`re biological. We just lose track of it. And people are shocked when they have a medical problem, and they`re common. This is a common one. Great news is we live in a time where there are treatments, these things go completely into remission.

BAUMANN: Exactly.

PINSKY: Well done, my friend. Thank you for coming out and talking about it. Appreciate it.

All right. Thank you. More of your calls next on any topics you guys would like to address. Give me more vertigo. Let`s go to something completely different than what we`ve been talking about. That after this.

(COMMERCIAL BREAK)

PINSKY: M_Muzza says, "Thanks for bringing attention to Crohn`s." And if you want to hash tag that, it`s Crohns. "It`s an embarrassing and painful disease. We`re recovering from surgery right now. I hope you get well soon." Again, this is a completely treatable condition these days.

Alex in North Carolina -- Alex.

ALEX, NORTH CAROLINA: Hey, Dr. Drew.

PINSKY: Alex.

ALEX: We actually met on "Dawson`s Creek," on the set --

PINSKY: Oh, for goodness sakes.

(LAUGHTER)

ALEX: I know. I`ve got a question. Serious -- this is really serious topic.

PINSKY: OK.

ALEX: My wife, she had a child in 2011. We had a child. In 2012, we also had another child this past May.

PINSKY: OK.

ALEX: Now, postpartum depression, nothing on the first child. Second one, severe.

PINSKY: OK.

ALEX: And my question is, when does the hormonal and sensualness actually creep back into that, in the relationship and in the future --

PINSKY: Alex, well, I`m not sure I understand that question. What do you mean?

ALEX: Well, um, she`s really detached away from the actual being intimate and being, having -- her self-esteem is really low, and she`s getting treatment.

PINSKY: OK.

ALEX: And I`m really wanting to raise awareness about this because I was not aware of how severe postpartum is for women.

PINSKY: Yes, Alex, and let me just stop you. I mean, when you`re around postpartum, like severe postpartum, it really is striking, isn`t it? How you can almost feel how biological it is. They just sinking -- they`re uncharacteristic, profound depressions, and then, they feel guilt and shame because they`re not able to mother the way they want to because they`re so impaired from the depression.

But I`m so glad you brought it up, because it is something that people need to be aware of. It`s dangerous and it is highly treatable. How is your wife doing now?

ALEX: She`s doing a lot better.

PINSKY: Good.

ALEX: She is getting treatment. But, she actually is the one that pushed me to actually talk to you. She was going to see if you were ever going to have a show basically around that because it`s important for women and I think that I`m a pro-support on this now. And it`s just something --

PINSKY: Listen, Alex, I will take that to the producers, see what we can do. It`s an important topic. We have dealt with it here and there certainly, certainly calls like yours are important, but I cannot tell you enough. I mean, when you hear stories of women doing awful things to children and stuff, you got think about postpartum depression.

They actually become psychotic and do things they would never do in another time and another state. So, absolutely it is treatable. And one thing I think, Alex, you were talking about your physical intimacy with your wife there, right?

ALEX: Yes. Yes. She`s seeing if there was any kind of alternative medicine --

PINSKY: Be careful. Alex, Alex, Alex, Alex, here`s the deal. It is dangerous. You got to get that depression treated. In many times, -- and the unfortunate reality is that the depression treatment will sometimes shutdown libido and shutdown, you know, the desire to be physically intimate.

But listen, that`s going to be shutdown anyway in that first year of pregnancy. Let her get her treatment, let her get stabilized, talk openly with the psychiatrist or doctor about that particular issue, because the last thing you want do is have relationship stress at a time when you need to be intimate with your partner. When they`re depressed, they need you, and they need you a lot.

So, just keep open about it, and hopefully, the psychiatrist can get to the point where he or she can transition her to other medication or get her off the medicines so things can be re-established, but everything in its time. Alex, thank you for that call.

Brad in West Virginia. Real quick, Brad.

BRAD, WEST VIRGINIA: Yes, sir. I had a work accident back in 1986. And my left side of my face was reconstructed. And I`m now -- when I look in the mirror, I can just see myself exactly like the night that the accident happened. You know what I mean?

PINSKY: Yes.

BRAD: I don`t know if that`s something normal or --

PINSKY: No --

(CROSSTALK)

PINSKY: Yes, you should. You mean you see all the trauma of that night, yes?

BRAD: Yes.

PINSKY: OK. Listen, that`s a flashback. That`s posttraumatic stress disorder. You definitely talk to your doctor about that. More calls after the break.

(COMMERCIAL BREAK)

PINSKY: And we`re going back to the phones. Cindy in Ohio -- Cindy.

CINDY, OHIO: Yes. I have a question about birth control.

PINSKY: OK.

CINDY: I never really did the research before I chose one to go on, and I`m currently on the Implanon. And I down (ph) after about two and half years almost.

PINSKY: OK, which is the implantable, right, OK.

CINDY: Yes. And if you ask my husband, I have a sex drive on one to ten of negative ten.

PINSKY: OK.

CINDY: But I really have one of like negative 50.

PINSKY: Cindy --

CINDY: And I rest (ph).

PINSKY: Listen, this is something that we, as doctors, do not spend enough time counseling our patients about, which is that birth control, whatever pill, whatever type, if it`s a hormonal birth control, can have that side affect. And it`s different for different women. In other words, I can`t predict that one product is going to affect one woman that way and not another.

Most of my experience, the progesterone predominant pills, sort of mini-pills, the ones that are really more popular these days have a very powerful progesterone are the ones that really shutdown libido and sex drive.

In this case, the implant is the one that`s affecting you, and you ought to talk to a doctor about switching or maybe adding something, you know, that they can try to kick start things, because it is so biological, and when that biology is shutdown, it can really mess with your relationship.

CINDY: Yeah. It has. He`s asking me if I`m talking to somebody else. There`s no -- you can put "Magic Mike" in front of me, and that`s not going to do anything.

PINSKY: I get it. I think that says it all for everybody, Cindy. "Magic Mike" is there, it`s not going to turn you on. So, -- but listen, you talk to your doctor about changing or adding or getting something going. And anyone out there that`s suffering from this, don`t stop until things are normalize.

Jodie in Florida, very quickly -- Jodie.

JODIE, FLORIDA: Hi, Dr. Drew. Thanks for taking my call.

PINSKY: My pleasure.

JODIE: I`m a single mom with a 16-year-old daughter who`s anorexic and has exercise-induced bulimia.

PINSKY: Right.

JODIE: She is seeing an eating disorder specialist.

PINSKY: OK.

JODIE: He only wants to see her two to three more times, maybe four.

PINSKY: OK.

JODIE: She`s still losing weight. She`s down to 105. She only takes in about eight to 900 calories a day.

PINSKY: OK. So, Jodie, Jodie, Jodie -- so, Jodie, OK. This is very serious stuff, right?

JODIE: I know.

PINSKY: I mean, anorexia can be life threatening. One of the difficult parts of her condition is her exercise bulimia, which is very difficult to treat, because people don`t identify as exercise bulimics. They get so many positive strokes for exercising. Their trainers tell them they`re doing a great job. Their peers think they`re so great for exercising so much, but it`s a very challenging problem and can be very difficult to treat.

With anorexia, it becomes quite dangerous. My question is, is that individual seeing her only three or four more times because that`s all the resources there are or does she have options to go into a treatment program?

JODIE: No. He just said she`s doing a lot better, because she`s finally going out with other people.

PINSKY: Jodie, I`ll tell you what, it`s a chronic condition like alcoholism or depression, you know, other mental health issues, and she needs to be in ongoing care. And I would look very hard into a program, you know, a comprehensive program or somebody with really extensive experience treating that age group with that particular constellation of problems. It is treacherous. And listen, you stay on top of this, Jodie. Your instincts are very, very good.

Thank you all for watching. And of course, those of you called tonight, thank you. And thank you for hanging with my vertiginous show tonight, which we went from one another extreme to the other. Again, thanks all for watching. Nancy Grace starts right now.

END