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Sanjay Gupta MD

Big League Breakdown; Pot Study Hits a Major Snag

Aired July 12, 2014 - 16:30   ET


MIGUEL MARQUEZ, CNN ANCHOR: Well, you'll see much more of Gary Tuchman's reporting at the top of the hour when we air a special one- hour report the crisis at the border.

But, first, SANJAY GUPTA, M.D. begins right now.

DR. SANJAY GUPTA, CNN HOST: We got some big news today on one of the bigger stories we've been covering, medical marijuana. I'll tell you why a first its kind pot study that was approved by the federal government has now hit a major snag.

But first up, a lot of people are celebrating baseball. The all-star game is coming up on Tuesday. But there's a new shadow over the game, something that we've talked about before, the staggering number of pitchers, you're not going to believe the numbers, even young star players, have been knocked out with significant arm injuries.

And it's not just the big guys. These days, some doctors don't even blink when they see teenagers coming in to have their elbows rebuilt.


GUPTA (voice-over): Stephen Strasburg and Matt Harvey, this year, Jose Fernandez and Kris Medlen with surgery number two. Young stars on the shelf.

Now, these guys throw hard. Strasburg throws an average 95 miles an hour. The Cincinnati Reds Chapman has closed at 106 miles an hour.

And not only are the balls coming faster they're coming with more stuff.

BRONSON ARROYO, ARIZONA DIAMONDBACKS: Throwing the ball 95 to 100 miles an hour is a ridiculous amount of torque on your arm.

GUPTA: After 15 durable years as a pro, Bronson Arroyo of the Arizona Diamondbacks recently announced he'll undergo Tommy John surgery to replace a torn elbow ligament.

ARROYO: So, I just thought I would take time off and a lot of swelling but I was totally surprised when he said the ligament was totally ripped off the bone.

GUPTA: Despite intense monitoring and cautious pitch limits, a third of big league pitchers have now had this operation. The American sports medicine institute calls it an epidemic. But they say the damage doesn't start at the professional level.

MIKE HARVEY, PITCHING COACH: What pitchers are doing in their teen years, you know, how much baseball they're playing, how much throwing they're doing, I think it has a direct correlation to what we're seeing later on in their careers.

GUPTA: Marc Silverman has coached his son's little league team for four years.

MARC SILVERMAN, LITTLE LEAGUE COACH: Kids are playing three, four, five games a day, pitching six, seven, eight innings a day. And you're looking at kids going up well into the 100s of pitches, one afternoon, one game. So, yes.


GUPTA: And joining me from New York is David Epstein, he's the author most recently of "The Sports Gene: Inside the Science of Extraordinary Athletic Performance."

You know, what strikes me, David, when I hear about these things, you know, we seem to baby, if you will, pitchers more than ever in the big leagues and yet these arm injuries are at an all-time high. So, how do you reconcile those two things?

DAVID EPSTEIN, AUTHOR, "THE SPORTS GENE": That's right. There's no question that major league pitchers are pitching less than they ever have before. Pitch counts are kind of at historic lows. But these injuries are set in motion in the developing elbow, right?

So, this is something where the groundwork is set by micro tears in the ligament when that elbow is developing, you know, during puberty when the arm's growing and so, what we're seeing at the major league level is something that can't be prevented at the major league level. It has to be prevented in the developing pitcher.

GUPTA: So, before -- you're saying all this happens before they even get to the big leagues. They sort of show up -- as good as they may be, they show up perhaps with these micro tears or micro injuries.

EPSTEIN: That's right. They're pitching less than ever at the major league. There's only so much less they could even possibly pitch at the major league level, but their lifetime pitch counts are higher than ever before. Youth pitchers are playing for multiple teams now, the teams that aren't coordinating between one another. So instead of having maybe 80 pitches on five days rest, you're having 80 pitches on one or two days' rest for youth pitchers.

There are these showcases where youth pitchers are sort of made to show up if they want to be scouted by other teams, so they're pitching like crazy. And radar guns have become ubiquitous, not just coaches but parents are using them now. So, kids are throwing harder than they ever were before at a younger age.

GUPTA: So, one of the things we've been thinking, the number of operations are increasing and it's reflective of the fact that there's all these problems with elbows in particular. Could it be that -- it's not so much you have more injuries, it's that we're diagnosing them more, that players are more likely to get the surgery as opposed to before? So, it may not have changed that much, it's just our approach toward intervention has changed.

EPSTEIN: I think there's an aspect of that certainly more getting diagnosed and sort of continuing to want to pitch rather than sort of dropping out of the sport altogether. At the same time, the surgeries are going up among, you know, high school and youth pitchers as well. So, I think some of is actually a higher prevalence of the injury itself as well as some increased diagnosis.

GUPTA: Yes, I remember doing a story and some of the orthopedic surgeons are saying the young people are coming in because they believe, look, I get this operation, the Tommy John, for example, where I have two ligaments in that area of the elbow, instead of one, makes my arm stronger and makes it more resilient long term so they're more likely to get the surgery. We don't know obviously and I don't think that orthopedic surgeons would saying they are doing unnecessary surge ril, but no question the numbers have gone up.

Is it just pitch count? You know, I remember they used to be concerned about kids throwing curveballs, for example. Is it the type of throw they're doing or just the number of throws?

EPSTEIN: I think some of the emphasis on the curveball because it can be this weird arm motion. That's actually sort of receded a little bit and the studies are pointing to number of throws and strength of throws. So, the kids are trying to throw harder, again, partially because of radar guns. They're not having the off-season they used to have that you can use to strengthen your rotator cuff the muscles and ligaments to stabilize your shoulder, and build the flexibility in your shoulder and elbow.

So, they are missing that time when they have sort of been building up the support to resist throwing harder, to resist the damage from throwing harder and instead they're spending more time throwing harder. The issue of throwing junk balls and curveballs seems to have receded a little bit and not quite as important as we once thought.

GUPTA: Always enjoy having you on the program, David. Thank you.

EPSTEIN: Thanks for having me.

GUPTA: Anytime.

And coming up: why a federally funded, supported study of medical marijuana just ran into some big trouble. We'll explain.


GUPTA: When it comes to medical marijuana, there haven't been nearly enough studies actually testing its effectiveness. We talk about this all the time. That was also a pretty big deal when the FDA-approved a study at the University of Arizona, looking at marijuana as a possible treatment for veterans with post-traumatic stress. But, you know, this week the professor who was launching that trial was let go by the university.

Suzanne Sisley had been an associate professor in the college of medicine more than seven years and she thinks the move came down to politics.

Thanks for joining us.

DR. SUZANNE SISLEY: Thank you for having me.

GUPTA: Are you doing all right?

SISLEY: Yes, we sure are. We're going to persevere, believe me.

GUPTA: It's a jarring time for you.

SISLEY: Oh, it's so demoralizing because this is work we've been fighting for, for over four years now and the veterans have actually been standing shoulder to shoulder with us pushing to get this work implemented and to have it cut off at the knees like this is so disheartening.

GUPTA: I want to talk specifically about the study because as you know it's something we report on a lot. But let me ask what's going on right now with you and the university. They say, look, this is not out of the ordinary. We make these decisions all the time and not renew people's contracts. They wouldn't comment specifically on your case.

What do you -- I mean, they don't seem to be thinking this is some big deal, though.

SISLEY: Well, the university took away my work without giving me any reason, not even a fair hearing. It wasn't an issue of job performance, that's clear from my evals. It was an issue I was at the forefront of some of the most controversial research at the University of Arizona, and it appears that the U of A may have buckled under the pressure of some very right-wing lawmakers in Arizona who have gone on record to say that they oppose marijuana research.

GUPTA: I want to point out, again, we did talk to the university. They wouldn't comment specifically on you, but they did say, "In 2013 specifically, the university championed state legislation to ensure that universities could perform medical marijuana research on campus." They say they have not received political pressure to terminate any employee as has been suggested.

SISLEY: Well, it's clear that marijuana research was -- that is FDA- approved -- was always legal to do on campus. When you're doing federally regulated marijuana research, it supersedes state laws. So, that's what we were urging the university to simply find us a home, but they refused, suggesting it was illegal and that they needed to run this bill through the legislature.

So, that served to delay the implementation of this research another eight, nine months because they had to, you know, navigate a bill through the legislature and that succeeded in doing what they'd hoped was to impede the progress of this research. They could never seem to embrace the optics of conducting marijuana research on their campus.

GUPTA: And just quickly, to button that up, were you political at all in any way? Did you try and influence an election or any part of the career of any of these elected officials?

SISLEY: No. I was simply trying to educate the public about the need to eliminate all these unnecessary barriers to marijuana research. I was an outspoken advocate for conducting this work and trying to hem our veterans, so that's been my sole focus over the last four years how do we help our vets who are coming back in droves with PTSD that is treatment resistant, how do we help these folks? And it seemed that we had a mountain of anecdotal evidence that many vets are using this plant successfully to manage their symptoms. Nobody is saying it's a cure.

GUPTA: Right.

SISLEY: But it does seem to be effective for symptom control, and the notion that there's a potential that a plant could reduce the human suffering of these vets and yet it's being forced to sit on the shelf not being allowed to be tested rigorously is an abomination and I think we have a duty as physicians, you know, as the general citizenry to demand that this plant be put through the proper drug development processed of the FDA and that's all we've ever wanted.

GUPTA: Look, throughout history, right, there have been these constant conflicts between science and politics and there's been times when it just hasn't been easy at all. Hopefully I come down on the side of science and facts and data, let people be educated. I hope we get to that point.

SISLEY: Yes. I agree. I think we will. I have hope. I still love the University of Arizona. I will always be devoted to them, and I think this was just the decision of a few shortsighted, negligent administrators who don't see the value of this work.

GUPTA: There's a lot of fear out there still.

SISLEY: Yes, there really is.

GUPTA: Appreciate you coming on the program. It's a challenging time for you, but hopefully this will help shine some light on it. Thank you so much.

SISLEY: Thank you so much. Appreciate it.

GUPTA: You got it.

And up next an experimental treatment that doctors say just might be able to reverse the damage from a heart attack.


GUPTA: Consider this: this year alone, more than a million Americans are going to suffer a heart attack and the thinking has always been that the damage is permanent. That even if you survive a major heart attack, that the scarring will eventually lead to heart failure. Possibly even death. But a new experimental treatment out there using stem cells may be changing the picture.


GERALD KARPMAN, HEART ATTACK SURVIVOR: This is called the widow- maker.

GUPTA (voice-over): Gerald Karpman, a dermatologist near Los Angeles, suffered a heart attack in March.

KARPMAN: All of a sudden, the pain started. I mean, I couldn't sit still. I mean, even in the car, you know, driving over there, I couldn't put a seat belt on. I'm just moving around, just trying to -- you know, think of something else, but the pain overtakes every thought.

GUPTA: Doctors in the emergency room saved his life. But 20 percent of Karpman's heart muscle was already dead.

DR. EDUARDO MARBAN, DIRECTOR, CEDARS-SINAI HEART INSTITUTE: You can lose one-quarter or even 40 percent of your functioning heart muscle overnight.

GUPTA: During a heart attack, heart muscle is starved of oxygen and it dies. If the patient survives, a scar forms over that dead tissue. The remaining muscle can't pump as much blood. When the damage is extensive enough over time, months or years, the body tries to compensate by making the heart larger, but that only makes the pumping even less efficient. It's a vicious cycle, which leads in the end to heart failure.

In April, Karpman checked into Cedars-Sinai hospital to take part in a new clinical trial, testing stem cells to actually reverse the damage from a heart attack.

Here's how the treatment works: doctors infuse 25 million stem cells into the damaged coronary artery. From there, cells embed themselves in the heart tissue where they trigger the growth of new blood vessels.

MARBAN: So, the end result is new heart muscle.

GUPTA: Dr. Eduardo Marban developed the stem cell procedure.

MARBAN: The cells will be there. They'll be there for weeks. And during that time, they do their magic and their magic stays behind long after the cells are gone.

GUPTA: Other small studies have also gotten good results using a patient's own cardiac stem cells. This approach uses cells grown from the hearts of organ donors. It's simpler. And Marban says it seems to work just as well.

The study aims to test the treatment at more than two dozen hospitals around the United States on more than 300 patients. We caught up with Gerald Karpman nine weeks after his procedure. He's back to walking four miles a day. What he doesn't know, though, is whether he actually got stem cells or just a dummy treatment, a placebo.

That won't be revealed until the end of the trial, probably late next year. Along with answers that could spell hope or disappointment for millions of patients.

KARPMAN: If you have the placebo effect, it may be the stem cells, I don't know. I haven't thought too much about it. I'm just happy I'm feeling better.


GUPTA: Now, that might be the future of medicine but, you know, there is another way to reverse heart damage that's decidedly low tech. I talk about this a lot. You heard me say this before.

But the evidence just got even stronger for food as medicine.


GUPTA (voice-over): Cleveland clinic researchers have now confirmed that food can heal your heart. Their study published in "The Journal of Family Practice" found a plant-based diet not only prevents heart attacks but can actually reverse the damage.

First of all, out of the patients who tried the vegan diet, almost 9 out of 10 stuck with it, 81 percent had fewer symptoms and experienced fewer complications from heart disease. A whopping 22 percent reversed signs of heart disease. And the participants lost almost 20 pounds each on average.

(on camera): You have some easy-to-remember adages about how people can decide what they should or should not eat.

DR. CALWELL B. ESSELSTYN, JR., AUTHOR, "PREVENT AND REVERSE HEART DISORDER:": We know what they shouldn't eat, that is oil, dairy, meat, fish, and chicken. What do we want them to eat? We want them to eat all those whole grains for their cereal, bread, and pasta, beans, vegetables, yellow, red, green, and fruit. Now, what particular vegetables do we want them to have? Bok choy, Swiss chard, kale, collards, collard greens, beet greens, mustard greens, turnip greens, Napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley, spinach and arugula and asparagus, and I'm out of breath.


GUPTA: Now, the mantra is: eat nothing that has a mother or a face. Dr. Esselstyn and other researchers insist if you stick to that advice, you won't have a heart attack in the first place. Who doesn't want that?

Still ahead, the kids are all right. I'll tell you who's got the happiest, healthiest kids and what you can learn from this one particular kind of parent. (COMMERCIAL BREAK)

GUPTA: Well, here's the headline children of same-sex parents are happier and healthier than their peers. Kids raised by a mother and a father. No doubt this largest of its kind new study is going to get a lot of people fired up, asking a lot of questions one way or another.

So, to help me break this all down is one of the fiery moms that I know, CNN commentator and human behavior expert, Mel Robbins, joining us via Skype from Michigan.

Thanks for being here, Mel.

MEL ROBBINS, CNN COMMENTATOR: Of course, thanks for having me.

GUPTA: In some ways when I looked at the study it seems to confirm what we'd already started to see with smaller, more anecdotal studies. I don't think it comes as a big surprise. But what were the main takeaways for you?

ROBBINS: Well, basically, there were three. This was a study from the University of Melbourne where they looked at 500 kids and 315 same-sex parents, Sanjay, and they said three things that were really important.

First of all, in the category of general health, well-being and family cohesion, these kids that are being raised by gay parents are actually faring better than their peers. The second thing that the study concluded was that in most of the other categories, they're doing just the same as their peers. And then finally, they took a look at stigma, and the stigma that kids being raised by gay parents face, and that is the huge issue that I think is really important to dive into because it really impacts the way that these kids feel, of course.

GUPTA: I mean, how big of an impact was the stigma on overall well- being?

ROBBINS: It was enormous, because, you know, you're looking at -- and they do overlap. Let me explain the overlap first between why kids with gay parents might have better well-being and more family cohesion.

Number one, the study kind of suggested that because when you have gay parents, they don't typically divide down gender roles and the last time I was on talking with you, it was Mother's Day. And we were talking about how in most modern relationships when it is heterosexual even though most of the, you know -- most people are both working and the majority of households, there's still an unbelievable draconian split in terms of who's doing what in the household. In families where you have two same-sex parents, they tend to divide and conquer in the things that make them better parents.

And so, the focus is on the kids, which means better cohesion. It also means because their focus is on the kids, the kids feel like they're a tighter unit and their well-being is better. Now, the stigma plays out in two really interesting ways. I mean, first of all, the stigma completely blows for the kids. There are still 30 states out there where gay marriage isn't even legal.

And so, having kids live in parts of the United States, Sanjay, where their parents' relationship isn't even legally recognized opens the door to bullying. It opens the door to standing on the soccer lines and having other parents kind of do one of these at your parents, the subtle forms and the overt forms. And, of course, that has a huge impact on kids.

GUPTA: But just overall, in terms of attitudes in this country, leaving aside where we've been, what does a study like this mean in terms of where we're going?

ROBBINS: Well, it's really important, because basically it pops the huge balloon that folks that oppose gay marriage and folks that oppose gay men and women adopting kids have been blowing up. They've basically been saying as an argument against people being able to be married legally or adopt kids in a loving relationship that it's bad for the kids.

Ironically, do you know what this study proves? That the kids are just fine. In fact, kids of gay parents are doing great. They're doing at least as well as their peers and they're doing better in other categories.

And the worst thing that is out there for kids of gay parents isn't gay parents. It's the people that oppose them! It's these laws that rip away their due process rights.

The kids are fine. Gay parents are fine. In fact, most people in communities that have gay parents and fam -- and kids with gay parents don't care. They're part of the community. It's no big deal.

GUPTA: Mel, thanks for joining us from my home state of Michigan. I don't know if you knew that or not.

ROBBINS: I'm actually at my parents' house right now.

GUPTA: Well, say hi to them. They did a good job. Tell them that for me.

ROBBINS: I disagree but --


GUPTA: Thanks, Mel Robbins. Really appreciate it.

ROBBINS: You got it. Great to see you.

That's all the time we have for SGMD today, but let's keep the conversation going on Twitter @DrSanjayGupta.

Time now, though, to get you back into the "CNN NEWSROOM" with Miguel Marquez.