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Sanjay Gupta MD

Made in China; Heart-Tough Jobs

Aired November 03, 2007 - 08:30   ET


SANJAY GUPTA, HOST: Thanks, guys. This is HOUSECALL. We're making the rounds of some of the most intriguing medical stories of the week. First up, your medication may be made in China, but are there hidden dangers in your drugs? Then HMO or PPO or POS? What's the best health insurance for you? If you can't quit, we'll tell you some great ways to beat on-the-job stress.
Let's get started, though, with that made-in-China label. This time, it's on drugs. You may not know it, but the Communist state has been exporting huge amounts of pharmaceuticals into the United States. Kitty Pilgrim has details.


KITTY PILGRIM, CNN CORRESPONDENT (voice-over): Compliments of China, poisoned pet food, hazardous toys, toxic toothpaste, and now medications. Thousands of manufacturers in China supply about 50 percent of the ingredients for prescription and over-the-counter drugs made by pharmaceutical companies in the United States.

DARRELL ABERNATHY, U.S. PHARMACOPIA: They simply assemble it into the final drug product. And that's what goes to the market. The drug manufacturer oftentimes really doesn't know either where many of those materials have come from.

PILGRIM: U.S. lawmakers are worried there is virtually no oversight of drugs used by Americans every day.

REP. BART STUPAK (D), HOUSE OF ENERGY & COMMERCE CMTE.: Like our penicillin, real basic staple in the medical field, that's all produced in China. Where is the oversight with penicillin being produced? Is it the right potency? Is the active ingredients still good? There are really unanswered questions.

PILGRIM: The Chinese government admits its own oversight of the industry is full of loopholes. Last July, a former chief of China's state food and drug administration was executed for taking bribes to approve the applications of hundreds of untested drugs, some absolutely fake. FD inspections at U.S. factories are unannounced and happen every two years. In China, the FDA's power is limited.

LYNNE JONES BATSHON, BULT PHARMACEUTICAL TASK FORCE: If an FD inspector were to go inspect at a Chinese facility, they have to be invited by the Chinese government. The Chinese government, in turn, gives notice to the local manufacturer, who has anywhere between 30 and 60 days' notice. PILGRIM: Fake Chinese products have made it to U.S. store shelves. Last month, the FDA issued an alert to consumers about counterfeit Chinese diabetic test strips used by millions of Americans to measure blood sugar levels.

(on camera): Industry experts say there is virtually no U.S. government oversight of how these products are being manufactured in China. Supervision of the quality of the manufacturing process is mostly left up to the Chinese supplier.

Kitty Pilgrim, CNN, New York.


GUPTA: All right, thanks, Kitty. And this story is still developing. We talked with the FDA, who told us this. "Before we approve any new drug application, including for products (or active pharmaceutical ingredients) manufactured outside of the U.S., we inspect any associated manufacturing sites to make sure the product and its active ingredients are manufactured according FDA regulations. We believe that American consumers should have confidence that our regulatory system is very effective in ensuring the safety and quality of finished drug products without regard to where the active ingredients are produced.

And of course, we'll keep you informed as Chinese goods remain under critical review.

Now your job may be hard on your heart, especially if you've already had a heart attack. In fact, a new study in "The Journal of the American Medical Association" finds people who return to stressful jobs after having had a heart attack are twice as likely to have another one or experience another type of heart problem. You've got to work, so what do you do? Elizabeth Cohen joins us with some ways to fight workplace stress for your heart's sake.

ELIZABETH COHEN: That's right. Absolutely. I mean, when I was talking to the experts, Sanjay, they were very clear. They said all the evidence is in. You've got to reduce workplace stress if you don't want to have a heart attack. That's very clear.

Now what's interesting here is that they said it's not really the work load so much or what you do or even how many hours. It's how you perceive the stress. It's what you do about stressful situations.

So Sanjay, I'm going to give you a little bit of a quiz here...


COHEN: ...and see if you can help figure out what to do in certain job stress situations that all of us have been in at one time or another. Let's say, for example, that you have a backstabbing co- worker. Let's say I'm sweet to your face, but behind your back, I'm saying terrible things about you.

GUPTA: Right. COHEN: What should you do? Should you confront me, do you think?

GUPTA: I think I probably would if I talked to you directly about it, I think.

COHEN: Well, you know, what's interesting, these experts that I talked to, who wrote a book called "Working with You is Killing Me," like that's a great title, they say don't confront a backstabber.

GUPTA: Really?

COHEN: They said the backstabber isn't a very nice person. They're not going to own up to what they do. So you're not really going to get anywhere. They said what you have to do is you have to launch a PR campaign of your own. The backstabber is saying terrible things about you. You have to launch a campaign to correct that. And that'll make you feel less stressed out.

X : Well, I would have never guessed that.

COHEN: Right.

GUPTA: Learned something.

COHEN: Yes, wouldn't have guessed that either.

GUPTA: Now most people obviously need their jobs. They got to stay employed. So if it's getting really stressful, what else can they do?

COHEN: Well, they can also do is they think about their bosses, because the experts I talked to - now you and I have the same boss, we have the same boss.

GUPTA: Yes, we do.

COHEN: We have a great boss. We have a wonderful boss.

GUPTA: We're saying it on air.

COHEN: That's right, we're saying it on air. But a lot of people really apparently have bosses that are terrible. These consultants tell me that most of the time when people come to them stressed out about work, it's about their boss. So the explosive boss. Sanjay, what do you think you would do if you had a boss who was a screamer and a yeller? What would you do?

GUPTA: Start a PR campaign?

COHEN: No. That would be a wrong answer.

GUPTA: No, talk to them? I don't know.

COHEN: No. What they said to do, the authors of this book said to do, and I thought this was pretty brilliant, they said just be quiet, watch them scream., and look a little bored, maybe kind of go like this and look around. And they said eventually they'll just kind of burn themselves out possibly. You know, they said just look bored, don't react. Detach yourself. And then they said if you've got this kind of a boss, that means after work you need to go running, you need to do some yoga.

GUPTA: Right.

COHEN: You need to meditate. You need to physically detach yourself from this toxic boss.

GUPTA: Wait them out.

COHEN: Exactly. There you go.

GUPTA: I always learn something from these segments.

COHEN: Oh, I'm so glad.

GUPTA: Fascinating stuff. Thanks so much.

COHEN: Thanks.

GUPTA: And you can actually check out Elizabeth's column as well on this very topic at Every week, she writes about ways you can empower yourself to get the most out of your health care. Really good stuff, important stuff as well.

Many viewers seem to be concerned about stress. So coming up on HOUSECALL, we're going to have more about it in our "ask the doctor segment". Plus, do you know your HMO and your PPO or your POS?



UNIDENTIFIED FEMALE: I don't know the initials.


GUPTA: Kind of humorous, but knowing the difference can actually be good for your health and for your wallet. We'll sort it all out. Viewers voted. We listened. The lowdown on the no period pill. Birth control is the subject of our quick quiz. That's coming up in one minute.


TIME STAMP: 0839:50

GUPTA: Throughout history, there have been some interesting ways to prevent pregnancy. And that's the topic of our quick quiz. Which of the following has been used as a form of birth control? A, honey; B, crocodile dung; C, turning a spinning wheel backwards at midnight, and D, all of the above. The answer, a minute away.


TIME STAMP: 0840:00

GUPTA: Before the break, we asked, which of the following has been used as a form of birth control? Honey, crocodile dung, turning a spinning wheel backwards at midnight, or all of the above?

The answer is D, all of the above. That may sound far-fetched, but they are used at some point in history.

There are, of course, much more effective methods of contraceptions nowadays. On this week, we asked which topic you would like to see us tackle on HOUSECALL. And you voted for the latest generation of birth-control pills. The no period pill.

Thanks to all who voted as well. And here to answer some of our questions is Dr. Hilda Hutcherson in New York. She's director of the Centers for Women's Sexual Health at Columbia University Medical Center. She's also professor at Columbia University's Medical School. Thanks for joining us.

HILDA HUTCHERSON, DR., GYNECOLOGIST: My pleasure to be here.

GUPTA: Thank you. You know, we're talking about obviously oral contraception today. And people may not realize all the various options out there. So what are some of those?

HUTCHERSON: Well, we have a number of options today from the traditional birth-control pills in which you take one pill every day for 21 days and then seven days off. And you get your period once a month, to pills that give you your period four times a year, to the newest one that gives you no period at all. So we have options.

GUPTA: Let's talk a little bit about that. We've heard a lot about this no-period pill. I think called Lybrel.


GUPTA: How exactly does that work?

HUTCHERSON: Well, it has the same two hormones that the traditional birth control pill has, estrogen and progestin. And you take one pill every single day throughout the year. So theoretically, you should have no period when you're taking this pill.

GUPTA: And I have two questions about possible concerns or dangers. What are the dangers of these no or less-period pills? There's rumors about blood clots, one question. The other is, is there just a problem for a women in not having periods?

HUTCHERSON: Well, no, we don't think so. We think that the real risk of taking this pill are the same as taking the traditional pills. The blood clots that you mentioned. And if you're 35 or older, an increased risk in stroke or heart attack.

But we don't have any long-term data. So we don't know, for instance, if you take this pill every single day for the next ten years, whether there will be a new risk or problem down the road.

GUPTA: OK. Well, we sent our roving cameras out, Dr. Hutcherson to try and get some of the people's thoughts on this. Speaking of dangers, specifically our roving camera captured a question from one concerned woman.


UNIDENTIFIED FEMALE: I want to know what are the statistics of women becoming unfertile after taking birth control.


GUPTA: I don't know if you heard that, but the question about infertility.


GUPTA: With taking long-term birth control.

HUTCHERSON: That's a common fallacy about birth-control pills. There is no risk of infertility from taking birth-control pills. And it doesn't matter how long you take the pill. When you stop taking the pill, your fertility should be the same as it was before you started taking the birth-control pill.

GUPTA: What about another big concern for women, weight gain? More weight gain with this pill?

HUTCHERSON: Oh, yes. Very, very common. The truth is that most women do not gain weight on birth-control pills. Now some women will gain a little bit of weight because of water retention, or it increases their appetite. And of course if you eat more you're going to gain weight. But an equal number of women actually lose weight on birth-control pills.

GUPTA: So you really don't have any concerns about this particular new product, Lybrel?

HUTCHERSON: Well, my only concern is that the studies that have been done have only been done for one to two years. And we just don't know whether something else is going to come along down the pike. But as far as not having your period while you're on the pill, I don't see that as a risk, as a medical risk.

GUPTA: Dr. Hilda Hutcherson, we'll be checking back with you because this is really interesting stuff. Thanks for so much information today.

HUTCHERSON: Thank you.

GUPTA: All right, now let's check in with Judy Fortin. She's here with this week's medical headlines. Judy?

JUDY FORTIN, CNN CORRESPONDENT: Thanks, Sanjay. When it comes to fighting deadly cancers, what you eat really does matter. The American Institute for Cancer Research evaluated more than 7,000 studies on food, nutrition, and cancer prevention. The group concludes eating a healthier diet can prevent 30 to 40 percent of people from getting cancer in the first place.

Among the recommendations - eat mostly a plant based diet, maintain a healthy body weigh, and limit fat intake.

A groundbreaking report helps to hope in the early detection of autism. The American Academy of Pediatrics is calling on parents and doctors to have all children screened for autism as young as 18 to 24 months. Experts believe early intervention results in a better prognosis.

Now here's a comparison of a typical child versus a child with autism, which illustrates some red flags. The typical little boy is making eye contact, is engaged with those around him. The child with autism, he doesn't make eye contact and stays focused on specific items. Experts advise parents to look for other red flags such as no babbling or pointing by 12 months. No single words by 16 months. And loss of language or social skills at any age. If you see any of those signs, check with a pediatrician.

The extra hour of sleep we'll get this weekend by setting the clocks back will be a welcome gift, but it can really mess up a child's schedule. Some pediatricians claim that it can take weeks after a time change to get kids back on track. Doctors say it helps to establish a regular nighttime routine year round that doesn't involve any stimulating activities. So that means no TV, no video games, and no computers before bedtime. Sanjay, back to you.

GUPTA: Judy, thanks for all that other stuff as well. It's open enrollment time for many with company-sponsored health insurance. Probably got that packet in the mail. How do you choose the right plan for your family and for your budget as well? Gerri Willis is going to join us with some tips. And the best way to be to lose weight may be doggone easy. We'll explain.


TIME STAMP: 0849:29


UNIDENTIFIED MALE: It's preferred plan -- something?




UNIDENTIFIED MALE: Point of service or something like that? I don't know.

(END VIDEO CLIP) GUPTA: Well, it's that time again. And many companies are now holding open enrollment, allowing employees to change their health insurance. But the plans can be an alphabet soup of confusing options such as HMO, such as PPO, even more than that. CNN personal finance editor Gerri Willis joins us with some top tips for picking the right insurance for you and your family.

I'm a doctor and sometimes I get confused by all this as well.

GERRI WILLIS, PERSONAL FINANCE EDITOR: Well, there's a lot out there. I mean, the reality though is that the choices are consolidating. They're actually fewer and fewer out there. The two main choices you mentioned already - HMOs, health maintenance organizations and preferred provider organizations. Very different.

The HMO is like the Chevette plans. It's less expensive. You pay less out of pocket. Your choices are fewer.

Now if you really want to get the doctor of your dreams, you may have to go with a PPO. Because there, you have lots of choice with the physicians but you're going to pay more for it.

There's one other plan out there that merits consideration or certainly discussion. It's a high-deductible plan that's relatively new, that's being offered by some employers out there. It can be very, very expensive, as much as $1,100 to $10,000 in deductibles alone.


WILLIS: This is only for people who don't have other options or if you're really, really young and you don't expect that you're ever going to get sick.

GUPTA: I like that analogy. HMO, kind of like the Chevette. PPO, if you want Dr. Mcdreamy, you said. Is that right?

WILLIS: Absolutely. Right.

GUPTA: Now you're in good health. I try and stay in pretty good health as well. Is that a benefit in terms of our overall premiums and deductibles?

WILLIS: You bet. You know, some employers out there are actually offering financial incentives to people who do healthy things, that they are in a disease management program, for example.

But I have to tell you, there's a flip side to this, Sanjay. If you have unhealthy habits, let's say you smoke, you could get charged $50 to $100 a month in extra deductibles just to cover those costs.

GUPTA: That's interesting. So I mean, both sides get penalized for bad behaviors and possible rewards for good behaviors.

So this is a time, open enrollment. What's the biggest mistake you think people make? WILLIS: People just pick the plan they had last year. They don't even think about it. You just make the automatic check and you don't even look at what's going on. But here's what you need to know. Costs are going up as much as 10 percent. That means as much as $330 extra out of your pocket each and every year. You really want to look at these plans because they do change over time. And employers are trying to unload more costs onto you.

You know, I meant to mention a website that could be very helpful for you as you look at these plans. You can actually get a report card on your plan. There's a website called the National Committee for Quality Assurance. It's, Great reference source for people out there who are struggling. You can also call your HR department and say walk me through this, I don't understand the literature.

GUPTA: It's probably worth the extra time.

WILLIS: You bet.

GUPTA: All right, Gerri, this is good stuff. We're going to be talking about it a lot this season. Gerri Willis, thank you so much for joining us.

For more information, healthy consumer advice as well, be sure to tune in to Gerri's own show. It's called "Open House". It's right here on CNN every Saturday at 9:30 Eastern and both Saturday and Sunday on "Headline News" at 3:30 Eastern.

More of this week's medical news you need to know is coming up, including why taking your dog for a walk may bring you one step closer to a smaller size.

And our "ask the doctor" segment, stay tuned.


TIME STAMP: 0854:32

GUPTA: We're back with HOUSECALL. Everybody has a theory about the best way to stay fit, but this next story caught our eye. It's all about letting your exercise routine go to the dogs. Literally.


GUPTA (voice-over): Since January, Tom Gayeski has lost 14 pounds, not at the gym or using any fancy equipment or diets. He's done it just by walking his dog, Max.

TOM GAYESKI, STUDY VOLUNTEER: I was coming off of hip surgery. So I needed to exercise, needed motivation.

GUPTA: Both Gayeski and Max were part of a study conducted by Bassett Health Care in Cooperstown, New York, to see if people who walked their dogs had a better chance of losing weight than those who didn't have four-legged friends.

ALLAN GREEN, BASSETT RESEARCH INSTITUTE: People are overweight tend to have overweight dogs. Maybe people could partner with their dogs much as you partner with a gym buddy to lose weight.

GUPTA: And in Tom's case, it worked. Not only has he lost weight, Max, the dog, shed some pounds as well. Researchers found that anyone with or without a dog lost weight by walking, but they found that those participants with dogs have an edge. They're more likely to keep the weight off because they keep walking. Seems the pet, not weight loss, is the prime motive to exercise.

GREEN: And I think bottom line is that if you stick with the program, whether it's walking your dog, riding a bike, or going to the gym, it will work for you. And I think one of the secrets is that each individual needs to find out -- find something that they enjoy doing and stick with it.

GUPTA: Green also believes that people need reasons to get out and get moving. Animals require exercise. He says put the man and the beast together, and that's better than an underused treadmill sitting in the basement.


GUPTA: Good-looking dog as well. There's more to come on HOUSECALL. Our "ask the doctor segment." Really important stuff. Simple ways to beat stress right now. That story, straight ahead.


TIME STAMP: 0858:30

GUPTA: It's time for my favorite segment of the show. It's called "ask the doctor." And we hit the streets to find out the medical questions that are on your mind. So here's a question that a viewer had for me.


UNIDENTIFIED FEMALE: There's stress that is related to my job. I would like to know would that contribute to my migraines?


GUPTA: It's a great question. You know, our bodies react to stress in all sorts of different ways, some of them surprising, through our digestive system, our nervous system. And stress can absolutely be the culprit to your may migraine headaches.

Now experts say migraines not only occur during stress, but can be triggered by hard work, followed by relaxation. So it might hurt more when you start to relax. It's always good to try and alleviate your stress before it gets to that point. Take a walk. Do some deep breathing. Take a hot bath even.

Another question now.


UNIDENTIFIED MALE: Could stress make me more tired than I should be on a daily basis?


GUPTA: You know, stress and anxiety can make your body fatigued. That's a fact. We know that. During our ancestor's time, stress was an alarm system used to survive. You've heard fight or flight. But in today's society, you may feel stress for hours every day. And that's something that our bodies simply weren't designed for. When you're exhausted, that's just one symptom that your body stress response is in overdrive. You need to take a break. So pay attention to what your body is telling you and take action to manage that stress a little bit better earlier as well. Try and slow down a bit and get some rest.

Well, unfortunately, that's all the time we have for today. Remember, this is the place for the answers to all your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN starting right now.