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Sharon Undergoes Third Surgery; Update On Sago Mine Survivor; Make More Money At Work Tips

Aired January 06, 2006 - 10:00   ET

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

MILES O'BRIEN, CNN ANCHOR: And it is Friday and we hope you have a good weekend.
SOLEDAD O'BRIEN, CNN ANCHOR: Yes, we'll see you back here on Monday.

Let's get right to Daryn Kagan. She's going to take you through the next couple of hours.

Hey, Daryn. Good morning, again.

DARYN KAGAN, CNN ANCHOR: Hi. You guys have a great day -- a great weekend, actually, in New York City.

We are following a couple of really big stories this hour, including Israeli Prime Minister Ariel Sharon undergoing more emergency surgery. We'll take you live to Jerusalem in just a moment for the very latest on his condition.

Also, a briefing could soon get underway at a hospital in Pittsburgh. Doctors there will give us an update on Randy McCloy, the sole survivor of the West Virginia coal mine tragedy.

First, though, let's take a look at what's happening "Now in the News."

Jose Padilla will be back in federal court this afternoon. Heavily-armed marshals handed the terror suspect over to the Justice Department yesterday. Padilla has been held as an enemy combatant for the past three years in a military brig. In November, he was indicted by the U.S. government on several terror-related charges.

In Yemen, new videos show five Italian citizens who were freed after nearly a week in captivity. They were kidnaped Sunday by Yemeni tribesmen in the north. Their release came after government troops converged on the mountain hideout where they were being held.

The death today of an 11-year-old Turkish girl from bird flu has been confirmed. Turkish officials say she is the third family member to die from the virus this week. The girl and two teenage siblings are the first fatal cases of bird flu reported outside of China and the Southeast Asian area.

And about 2,600 employees of Independence Air are without jobs today. Last night's flights from Tampa to Washington were the airline's last one. Independence began flying less than two years ago. Its parent company declared bankruptcy in November.

And now we're showing you video. This was taken just a few seconds ago, in fact, and just in here to CNN. President Bush getting off of Marine One and he is heading to Chicago today. He is going there to talk about economic numbers and to tout encouraging economic news for the United States. More on his visit a little bit later with our Suzanne Malveaux.

Good morning to everyone. I'm Daryn Kagan at CNN Center in Atlanta.

This hour in Israel, a nation's eyes are focused on a hospital in Jerusalem. That is where Israeli Prime Minister Ariel Sharon has undergone a third round of surgery to stop more bleeding in his brain. It ended just minutes ago. And while we wait official updates, it's become increasingly clear that Mr. Sharon's progress is bleak. CNN's Fionnuala Sweeney is outside the hospital and she joins us now live from Jerusalem.

Fionnuala.

FIONNUALA SWEENEY, CNN CORRESPONDENT: Daryn, indeed, as dusk falls here at the start of the Jewish Sabbath, it has to be said that Ariel Sharon's condition is such that doctors say he has now undergone his third procedure in at least 48 hours. He's been taken from the operating theater and we were understood a few moments ago that he is now undergoing a brain scan.

(BEGIN VIDEO CLIP)

RON KRUMER, HADASSAH HOSPITAL SPOKESMAN: The operation of Prime Minister Sharon was completed a few minutes ago and he was taken to the city's scan unit. Thank you.

(END VIDEO CLIP)

SWEENEY: That was all we heard from the hospital spokesman, Ron Krumer, a few moments ago. But he did say afterwards that there would be a further statement issued once the results of that brain scan were known. So there is feverish activity here among the reporters, the journalists outside this hospital here. We are on the forecourt of the Hadassah Hospital and any time we see any movement at all coming from behind us, there is feverish activity to get to the front of the cue, so to speak, to hear what might be said.

But it is obvious now that Ariel Sharon is in the twilight of his political career. It is not thought by many independent experts that he will be able to resume his post as prime minister. Indeed, if he survives this operation at all, I think that we can understand he will be a fraction of the commanding personality he once was.

I'm just going to take a quick look behind me, Daryn, because it does indeed seem as though a news conference will begin imminently because we're seeing the first indications of what's become rather routine here over the last couple of days. A sign for the Hadassah Medical Center being put up and that is usually followed shortly thereafter by Shlomo Mor-Yosef, who is the hospital director, coming out and giving a short statement. But we don't have a time frame for that. So we could be seeing it in a minute or two or we could be seeing it in 10 minutes.

But as I say, everybody here, Daryn, gathered around the hospital forecourt for news of Ariel Sharon's condition following the third major procedure he's undergone in the last 48 hours.

Daryn, back to you.

KAGAN: Fionnuala Sweeney live in Jerusalem. As soon as that briefing beginning, we will go back to you live. Thank you very much.

And this is an interesting political note of what's taking place in Israel right now. Even before this latest grim turn, Israelis knew that for the first time in decades they were looking at a political landscape without Ariel Sharon. Now two newspapers say that polls show strong support for this new Kadima party that he recently founded. Polls predict it will pick up between 36 and 42 seats in Israel's parliament, depending on which Sharon ally would assume leadership.

And he has been involved in Israeli politics for many years, but a lot of people are not so familiar with the man who has been named acting prime minister of Israel. Here now, a little background on Ehud Olmert.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE, (voice over): Acting prime minister, Ehud Olmert, is no strange to Israeli politics. Olmert was first elected to Israel's parliament in 1973 when he was only 28-years old.

(END VIDEOTAPE)

KAGAN: And we'll have more on Mr. Olmert later. Now we want to go to Pittsburgh, to the hospital, for the latest on miner Randy McCloy.

DR. RICHARD SHANNON, ALLEGHENY GENERAL HOSPITAL: That had been caring for Mr. McCloy throughout the night. They've each had a chance to assess him and will specifically address the nature and extent of injuries that we are now involved in treating. Let me begin by introducing each of the members and then I will turn this over to Dr. Zikos.

On my far right is Dr. Stephen Sandrone (ph), who is the director of the division of renal diseases at Allegheny General Hospital. On my immediate right is Dr. Tony Zikos, who is a member of the pulmonary critical care division and is coordinating the critical care efforts and the hyperbaric oxygen treatments for Mr. McCloy. To my immediate left is Dr. James Valeriano, who is a member of the department of neurology here and has been conducting the clinical neurological assessments. And to my far left is Dr. Brad Blot (ph) from the department of neurosurgery here at AGH and has been working together with Dr. Valeriano on the assessment of the neurological status. So with that, I'd like to turn this over to Dr. Zikos, who has directed the critical care efforts and the HBO therapy today.

DR. ANTONIOS ZIKOS, PULMONARY MEDICINE: Good morning. Thank you all for coming.

First of all, let me give you a brief update on what's been happening over the past 24 hours. First of all, as you all know, this young man is greatly ill and I want to commend the Morgantown team. They've done a great job in caring for him.

Let's start from assistance point of view. From a pulmonary point of view, he has a lot of inflammation. We have done a bronoscopy so far because he had a left lung collapse. That has been fixed and has been doing quite well. So thus far, the pulmonary status appears to be improving. We did discover a left upper lobe clot which appears to be small to modest and does not appear to be serious at this point.

The kidneys have stabilized. He has not required any hemodialysis thus far. Therefore, we're hopeful that they will turn around in due time. However, that is unknown.

From a GI point of view, the gastroneurology, he had a minor bleed. That has been fixed with medications and it is currently stable.

The hematologic part. He had a problem that occurs as a result of the rapomilisis (ph). That's the licis of the muscle that occurs as a result of the injury and being down in the mine for 40 hours. This problem called disseminated intravascular coagulopathy is a minor issue at present. Appears to be stabilizing. It is very mild in its early stages.

From a cardiac point of view, his cardiac function is progressing nicely and has improved during the time that he has been here.

His brain, I will defer to my colleagues to the left, Dr. Valeriano and Blot. But briefly to tell you, we're uncertain at this point. He is in a coma, a medical coma, for many reasons. One, to rest his brain. A second reason is, he has been biting on his tube and he has been critically ill. So therefore he needed to be stabilized and he is on a lot of medications at this point in an attempt, in an effort to stabilize him.

From the hyperbaric point of view. He had two hyperbaric treatments so far. These went very well. I just want to make mention of just a minor point on hyperbaric oxygen. In this particular case, hyperbaric oxygen is an adjunct to his treatment. It will probably help. There is some evidence that it's helpful long term. However, this is not an acute treatment. It's merely an adjunctive treatment to all the other treatments that he's receiving.

I'm going stop there and entertain questions.

QUESTION: (INAUDIBLE). ZIKOS: Carbon monoxide treatment is treated acutely early on within the first 24 hours. This gentleman was not able to receive carbon monoxide treatment early on because he was clinically unstable. He could not be transferred. So, therefore, he was transferred when he became stable.

Now, we give him the benefit of the doubt due to the fact that there is evidence in the literature that delayed use of hyperbaric oxygen can be helpful. It may delay or prevent neuropsychiatric problems in the future. So, therefore, we gave him the benefit of the doubt. And the Morgantown team felt that was important.

QUESTION: What took so long to get him here to AGH? I know you said you wanted him to be stabilized. But what took so long to get him here to this hospital? And do you think not getting him here immediately caused more damage to his body?

ZIKOS: The Morgantown team worked very hard to stabilize him. He had multiple complex issues. He had a collapsed lung. He had a high potassium level, which was very dangerous to transfer. His potassium level required emergent hemodialysis. And he was fluid overloaded initially and, at one point, he was massively dehydrated and then was mildly fluid overloaded.

However, the potassium itself was very risky. He probably would have had a cardiac arrhythmia in route. So therefore they deemed it appropriate to stabilize him. And I do agree with their decision.

QUESTION: Do you think it caused further (ph) damage not getting here?

ZIKOS: No, no, I agree with the decision to stabilize him first and then transfer him.

QUESTION: All right. Thank you, sir.

QUESTION: Mr. Zikos, do you have any idea how long he may remain in this medical coma?

ZIKOS: Well, that's a good question. At this point, we take it day by day or perhaps hour by hour. He requires the sedation. It's a brain rest protocol. But in addition to that, he's developed mild cerebral edema. And my colleagues, I think, are probably more qualified to speaking to that. And I will be throwing that to Dr. Valeriano and Dr. Blot.

DR. JAMES VALERIANO, VICE CHAIRMAN, NEUROLOGY: Yes.

Just, maybe to give you an overview of the neurologic issues. When we evaluate people neurologically, there's a couple of ways you can do it. One way we like -- I mean, there's a clinical way. In other words, you examine someone and there's x-rays you can do, MRI scans and CT scans.

Right now, because of the medications he's on, which is basically, as Dr. Shannon and Dr. Zikos said, he really is in essentially a drug-induced coma from -- he's almost under anesthesia at this point. So it doesn't allow us to get a very good picture neurologically, clinically. In other words, when we examine him, he looks like anybody would look who is under the degree of medications that he has.

When we do see his scans, his MRI scans and his CT scans of the brain, there is evidence that he has some anatomic injury to the brain. In other words, brain injury from the carbon monoxide. He does have what's called white matter injury, where some of the tracks of the brain, the white matter tracks of the brain, appear to have been injured or have lost possibly mylan (ph), which is sort of a coating material that goes on the tracks of the brain.

And some of these areas have actually become somewhat hemorrhagic. In other words, he's had small brain hemorrhages. The brain hemorrhages, I don't think, are going to be a big problem. They're very small and, given his age, I don't think they'll be a problem.

I think the white mater injury, the track injury to the white matter, is a little bit more problematic or worrisome as we go along, but it's too early to tell yet. This could be a sign as of an early injury that we'll resolve. It could be that this is as bad as it gets and then we'll just have to see how he does with it. Or it could be that this is a sign of an evolving injury that could increase as time goes on. It's just to early to know.

I think neurologically by far the best thing for him is that he's this young. Given his age, 26, his ability to recover is much greater than anybody at a later age. So I think really given the benefit of the doubt, it's much too early to say neurologically what his ultimate prognosis is. We had Dr. Blot's going to address the -- we have the neurosurgery team onboard to see if there was anything that we thought need to be done sort of more dramatically interventionally, which we don't think at that time, and I'll let Dr. Blot address that.

But I think neurologically now, we're at the point where we can't say a lot clinically because of the medication. We can say that the scans are abnormal. They're not terribly abnormal. But again, we're going to have to do sequential scans and see what happens as time goes by.

QUESTION: There were AP reports this morning that there was some response. That he was giving some response. Is that true?

SHANNON: Let me comment on that. During periods in which the medications are being adjusted, it is not uncommon for patients in this condition to begin to move spontaneously, to bite on the endotracheal tube, as Dr. Zikos eluded to. And these are the movements that were reported by the AP this morning. But it is our goal to keep him in this state of a medically-induced coma as both Dr. Valeriano and Dr. Zikos have said, largely as an attempt to rest the brain and allow us to control and treat the other underlying organ system dysfunction, all of which are designed to try and give the brain the best chance of recovery. So I don't want to -- we really need to be specific about two very important issues. The coma at the moment is medically induced. When the medications are weaned or reduced, Mr. McCloy does move. Mr. McCloy does bite down on his tube. Mr. McCloy does appear, you know, to flicker his eyelids. All those things are true.

I don't want to let anyone think that that is some clear indication whatsoever of the nature and extent of his recovery or injury. Those are simply things that occur as we wean the medications. It will be our intent to continue to keep him heavily sedated in the state of a medical coma for as long as possible.

I'd like to make one other clarification, just so we don't confuse this. For the first time this morning you heard Dr. Valeriano and Dr. Zikos introduce this term small brain hemorrhages. These are tiny, punctuate, pinpoint like hemorrhages, small hemorrhages, in areas of the brain that have suffered anoxic (ph) injury. These are not the type of hemorrhages about which you are reporting in the Israeli prime minister. This is an entirely different set of circumstances. And as you will hear from Dr. Blot, at the present time there is no need or intent to intervene.

Brad, I don't know if you want to . . .

: I would just echo . . .

QUESTION: (INAUDIBLE) that the coma wasn't medically induced. You wanted to (INAUDIBLE) the medication. So, I mean, I just want to clarify that point. Is it true that he has any improvement at all or are we (INAUDIBLE)?

VALERIANO: Again, it's hard to say because now what we do have is a medically-induced coma. So we really have never seen him -- I mean, I've examined him a couple of times and each time I've seen him he's been on enough medication that you would basically consider him under general anesthesia. When it gets lightened a little bit, when we -- sometimes we do try to back off on the medicine a little bit, he does become somewhat -- he will do a little bit more activity, like Dr. Shannon said. He'll bite down on the tube. We can get him somewhat to, you know, with painful stimulation, we can get him to move a little bit, that type of thing. But we've never -- I've never at least seen him when he's on no medication.

QUESTION: The family has said that he has -- they feel that he has responded to them when they talk to him and to specific things they say. Are they misreading, you know, the other responses or is it possible that's what they're seeing?

VALERIANO: Again, if they saw him off medication, that's not impossible. We've never seen him -- or I've never seen him in that situation. I've never seen him do that. But again, I've never seen him where he hasn't really been on high dose of sedating medication.

QUESTION: So, Doctor, are the movements, in your mind, purposeful or is it reflex?

VALERIANO: The movements I've seen so far are reflexive.

QUESTION: When you talk about this white matter injury, can you kind of put it in layman's terms, what are some of the things that you typically see after effects (ph) on somebody usually who suffers this kind of (INAUDIBLE)?

VALERIANO: The white matter, essentially, is the brain -- is sort of a cable system of the brain. So the brain cells are usually what you think of as the gray matter. Then there's tracks from them, cables, that go out from the gray matter that we call basically the white matter. So they're fiber tracks. So depending on the degree of where they're -- of which tracks are injured, it can affect your strength, it can affect your vision, it can affect anything. It depends where they're injured.

The question right now I think, though, is, are we seeing just some swelling of the white matter. In other words, that there's some relative degree of anoxia, of lack of oxygen to the brain that was caused by carbon monoxide. So what we're seeing is just a relatively small degree of injury and just seeing brain swelling that the MRI is picking up or is this evidence of more significant injury. And right now there's just no way to know that. Normally how we know it is because we can examine someone so we have a better idea to correlate their clinical picture with their anatomical picture, with their MRI scan. But right now, because of the situation, the degree of the illness and the requirement for the high dose of medication, it's hard to make that correlation.

QUESTION: When you look at the scan, can you pinpoint specifically where these injuries are on the brain? What part of the brain?

VALERIANO Yes.

QUESTION: So what parts are they? I mean . . .

VALERIANO: So far what we see are mostly posterior injuries. So the part of the brain that would have to do more with sensation and possibly even with vision would be a possibility. The more interior parts of the brain, which you would think of more as your thinking abilities, those type of things, really right now look pretty well intact. As Dr. Shannon pointed out, there are probably three small hemorrhages. But these are not what you think of as large, massive brain hemorrhages. These are very small bleeds that I don't think are really going to be any long-term problem.

KAGAN: We've been listening to doctors in Pittsburgh who are currently now treating Randy McCloy. He has been transferred there to get even more treatment than he was getting in Morgantown, West Virginia. They say that the one surviving minor is still critically ill. His lungs are inflamed but improving and he is in a medical induced coma.

As for his brain function, they say it is very hard to tell because of this medically-induced coma, which they intend to keep him in for as long as possible. It is because of the carbon monoxide that they do say that there's some brain injury with Randy McCloy but they're not exactly sure how much.

If you're interested in continuing to watch this news conference, please go to our new technology. It's Pipeline. CNN Pipeline. Just go to cnn.com/pipeline and you will see it as it continues to stream into your computer.

Also, we're standing by for another hospital briefing. This one out of Jerusalem. The latest on Israeli Prime Minister Ariel Sharon undergoing his third brain surgery as he has suffered a major stroke. The latest on the prime minister's status in just a minute.

Meanwhile, let's go back to this hospital in Pittsburgh. Our Jonathan Freed is standing by. We've heard the medical update, but also earlier today we heard from the family and Jonathan has that part of the story.

Hello.

JONATHAN FREED, CNN CORRESPONDENT: That's right, Daryn. Hello.

Earlier today, Anna McCloy, that would be Randal's wife, was here at the hospital. A very emotional scene. She as recently as yesterday, Daryn, had asked for privacy. Saying that she really just needed to be alone with the thoughts and with her family and standing by her husband. But she came out today and quite bravely faced the cameras and expressed her hope and her feeling that everything is going to turn out all right. Let's listen to that.

(BEGIN VIDEO CLIP)

ANNA MCCLOY, RANDY MCCLOY'S WIFE: It's a blessing that I even get to see him. And, yes, there have been some responses to me when I'm with him.

MILES O'BRIEN, CNN ANCHOR: Do you think he knows you're there?

MCCLOY: I know he knows I'm there.

(END VIDEO CLIP)

FREED: And, Daryn, Anna McCloy, that's the wife of Randal McCloy who's been here at this hospital since yesterday late afternoon, early evening, doctors saying that he is in that medically-induced coma at this point to try to rest his brain. That's what doctors were saying at a news conference that is still ongoing right here at the hospital. That his brain function, of course, a high area of concern right now. Not clear exactly the extent to which what brain damage there may be. He's still unconscious, unable to really relate to them. And they're keeping him unconscious, again, trying to give him as much rest as possible and the best shot of recovering.

Daryn.

KAGAN: Jonathan Freed, live from Pittsburgh, Pennsylvania, thank you for that. Once again, we're standing by for this other hospital presser coming out of Jerusalem, the latest on Israeli Prime Minister Ariel Sharon. He went into surgery for the third time as doctors still are trying to stop the bleeding inside his brain following a stroke. When that begins, we'll go live to Jerusalem once again. Right now, a quick break.

(COMMERCIAL BREAK)

KAGAN: Once again we are watching two important medical situations. At the top of your screen you see a presser going on right now. That's from Pittsburgh, Pennsylvania, where Randy McCloy, the one surviving miner, is currently being treated. If you're interested on still listening to that, you can go to cnn.com/pipeline.

At the bottom of your screen, stay with us for this. This is the hospital in Jerusalem where Israeli Prime Minister Ariel Sharon is being treated. We are standing by for the latest on his status and condition.

Meanwhile, we move on.

Well, talk about incredible timing. Have you heard about this story? Three sisters, all pregnant, due about the same time. And wait until you hear how their deliveries timed out. And we will get to that in a minute. A pretty incredible story. Gerri (INAUDIBLE) interested in that story.

Meanwhile, people also interested in how you can get more money out of your paycheck this year. That's a good way to start the year.

GERRI WILLIS, CNN CORRESPONDENT: That's right. You know some people have a resolution that they want to save more money. Maybe they want to lose weight. We're going to show you how to make money.

First, you have to determine your value in the marketplace. You don't know what kind of raise to ask for until you know what people typically get for what you do. So go to a couple of Web sites, bls.gov, that's the Bureau of Labor Statistics Web site. They have great information, including how much you should make in your occupation by where you live, which is a huge thing. People make different money for the same kind of work in different parts of the world, as you know. Salary.com can tell you what kind of bonus information people typically get for what you do.

KAGAN: All right, forget about modesty, right, you've got to be your own PR person.

WILLIS: You know, this is particularly tough, I think, for women in the workplace. They're not good at tooting their own horn and bragging about what they're great at. The trick to this is being really specific about what you're good at. Talk about the number of people you've been manage if you've got a big department. Talk about how much you've advanced sales. How much sales have gone up while you've been working in your department. And remember, this year, according to the surveys we're seeing, you're more likely to get a bonus than a raise. So if you're not making any progress asking for more money every week, well maybe you will by making a little bit more money at the end of year. That's money in your pocket too.

KAGAN: Yes, whatever you want to call it, I don't care. Just send it along.

Be nice. How about that for some advice?

WILLIS: You've got to hear it. Daryn, this is unbelievable. "Harvard Business Review" does a survey. It shows that likability is more important than competency when it comes to advancing in the workplace. That's right, you've got to be nice. That means you don't criticize people, you criticize outcomes. That means no e-mails to people when you're really mad. And for God's sakes, do not hit reply all when you're sending one of those scorching e-mails. Don't forget to smile. That's important too.

KAGAN: We'll try to work on that.

What about finding the hot jobs out there?

WILLIS: Well, you want to go to companies that are working in fields that are on fire. So that's healthcare. That's international. That's even technology. Those are the areas where businesses are really growing and expanding. Remember, this is the beginning of the year. This is when companies are actually adding on to their employee roster. So it's a good time to be looking. If you're not getting the raise you want at work, it's time to, you know, go knocking on some doors. KAGAN: Meanwhile, you've got people out there daydreaming. Oh, if I could only be doing this or doing that. How do you get a chance to try out a dream job without giving up your current job?

WILLIS: Well, here's a great idea. It's called vocationvacations.com. Go to that Web fsite, vocationvacations.com. Take some time off. Go do something you've always dreamed about doing. Being, say, a brewmaster or a chef or say even a TV producer. They put people in the field on their vacation to sort of test drive a new job, see if they like it. Now you'll have to pay for the privilege. It can be a little expensive. But if there's something that you really dreamed of doing, it's a great way to tests it out.

KAGAN: So we'd have a CNN producer but they would have to pay for the privilege of being it.

WILLIS: That's right, Daryn.

KAGAN: No, my producers are not replaceable.

WILLIS: Ah, there's some love right there.

KAGAN: No openings here.

WILLIS: You're being nice.

KAGAN: See that.

WILLIS: That's tip number two. You've got it.

KAGAN: And I'm still here. All these years later.

Gerri, thank you.

WILLIS: You're welcome.

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