July 2nd, 2008 by Dr. Val Jones in Celebrity Interviews, Expert Interviews
Tags: Cardiology, Health Tips, News, Parenting, Podcast, Research
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Would you know what to do if someone in your office collapsed in front of you and became unresponsive? Having a defibrillator handy could save their life – and it’s important for you to know how to use one. I interviewed Dr. Jon LaPook, Medical Correspondent for CBS Evening News with Katie Couric, to get his take. [Interesting factoid: Jon became passionate about cardiac defibrillators after a friend of his died while exercising at a gym in NYC. The health club did not have a defibrillator on site - which could have saved his friend's life.]
*Listen to the podcast*
Dr. Val: What is a defibrillator?
Dr. LaPook: It’s a machine that can convert a life threatening heart rhythm (like ventricular tachycardia or ventricular fibrillation) back into a normal beating pattern. It uses a pulse of electricity to do this. These machines are potentially life-saving.
Dr. Val: Why is it important for offices to have them on hand?
Dr. LaPook: About 1.2 million people in the United States have a heart attack every year and 300,000 of those have “sudden death.” The reason why these people die is not because of the heart attack, but because of the irregular heart rhythm that accompanies it. When the heart isn’t beating in a coordinated fashion, it can’t pump blood effectively and people pass out and ultimately die if there’s no intervention.
If a defibrillator is used to administer a shock to the chest during one of these life threatening heart rhythms, there’s a much higer chance that the person’s life will be saved. For every minute of delay (from the time a person collapses) to receiving a shock to the chest, their chance of survival decreases by 7-10%. So it’s very important for people to get defibrillation quickly.
Dr. Val: How do you use a defibrillator?
Dr. LaPook: When you first see someone collapse and become unresponsive, all you have to do is get the defibrillator and press the “on” switch. It will talk you through the next steps. Remember that the first step is always to have someone call 911 so that EMS will be on its way while you continue CPR. Then you expose the victim’s chest so that you can apply two sticky pads, and the defibrillator will tell you where to put the pads. Then it will analyze the victim’s heart rhythm and decide if it requires a shock to get it beating in a coordinated way. If a shock is recommended, the machine will announce that and ask you to step away from the person. Once the shock has been received, it will then give you instructions for CPR (which includes chest compressions and rescue breaths) until EMS arrives or a pulse is able to be felt. If a person doesn’t require a shock, the machine will not give one – so there’s no risk of harm to the victim.
It’s important for people not to be intimidated about defibrillation because it’s really very simple and can save a life.
Dr. Val: What are a person’s chances of surviving a cardiac arrest?
Dr. LaPook: Nationally, your chances of survival (without intervention) are about 4-6%. If you receive CPR, your chances increase to 15% but with a defibrillator – especially if it’s used quickly – the chances are 40% or higher.
Dr. Val: What do you think about the new research suggesting that rescue breaths may not be as important for CPR as initially thought?
Dr. LaPook: I spoke to Dr. Rose Marie Robertson, who is the Chief Science Officer at the American Heart Association, and she said that in a “witnessed arrest” (when you actually see someone collapse) it doesn’t seem to make a {big} difference if you do rescue breathing (i.e. mouth-to-mouth resuscitation) or not. The reason they studied this is because one of the main reasons why people don’t perform CPR is the “ick” factor of mouth-to-mouth resuscitation. As it turns out, chest compressions alone are about as successful at saving lives as traditional CPR. However, if you’ve been trained to do the rescue breathing technique, you should definitely use it. The key to CPR is “hard and fast” chest compressions, about 100 compressions per minute. Whatever form of CPR you use, the key to success is using the defibrillator as soon as possible, ideally within several minutes.
Dr. Val: What should people working in an office environment know about first aid?
Dr. LaPook: The most important thing is for people to be trained in CPR, the Heimlich maneuver, and defibrillator use.
Dr. Val: Are there enough defibrillators out there nowadays?
Dr. LaPook: Not at all. At the very least, defibrillators should be in every single health club in America. I also think they should be installed in every office building and be widely available at schools.
A cardiologist friend of mine told me about some parents who lobbied for their daughter’s school to purchase a defibrillator. (They were in tune to cardiac issues in children because their daughter had an arhythmia called Wolff-Parkinson-White syndrome.) Two years after the school purchased the device, the girl - only 13 years old at the time – collapsed while walking past the nurse’s office at the school. The nurse saved her life with the very defibrillator that her parents fought so hard for. So defibrillators are incredibly important, and although they’re not inexpensive (about $1200), you really can’t put a price on life.
*Listen to the podcast*
*Check out Dr. LaPook’s defibrillator training video with Katie Couric*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 12th, 2008 by Dr. Val Jones in Celebrity Interviews
Tags: Diabetes, Endocrinology, Hospitals, News, Parenting
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I had the chance to interview diabetes spokesperson and Hollywood A-lister, Maria Menounos, at a recent diabetes conference. Prior to the interview I was given her Entertainment Industry Foundation biography for my review. Most of the biographies that I see belong to physicians and health policy experts – so it was an interesting change to read an entertainer’s biography.
Of note, Maria is a featured reporter on The Today Show and Access Hollywood – she has directed and produced several films and was listed in People Magazine’s “50 Most Beautiful People.” She also landed in the top five of the askmen.com poll for “the girl men most want to marry” along with Angelina Jolie and Charlize Theron.
But don’t let her beauty fool you – Maria has struggled with poverty, a chronically ill father, and her own weight issues. I enjoyed getting to know her better, and to learn about why she is such a passionate advocate for diabetes awareness. Enjoy our chat!
Dr. Val: Tell me a little bit about your dad’s diabetes and how you’ve been helping him to manage it.
Maria: My dad has type 1 diabetes, and he’s quite unusual in that he is extremely compliant with medical advice and dietary restrictions. He NEVER cheats. Many years ago he was told to avoid carbohydrates and so even when he was having a low blood sugar attack he’d refuse to drink juice to bring up his levels. Unfortunately my dad’s English isn’t so good (his native language is Greek and he has quite a language barrier with doctors) and I think a lot was lost in translation when he was given advice about how to manage his disease.
As a result of growing up in a poor neighborhood and not having access to more advanced medical care (along with the language barrier), my dad’s doctors were not particularly effective at communicating what he should be doing. My mom did her very best to follow their instructions religiously – she became his personal chef and kept him from eating carbohydrates.
My dad was in and out of the hospital all the time for low blood sugar, and because of a lack of coordination of care my family never realized why this was happening or what we could do to prevent it. So we were trying harder and harder to be more strict with his diet, which was in fact making the problem worse. My dad did janitorial work and would nearly pass out on the job due to a low carbohydrate diet. But since the doctors told him not to eat sweets or bread or pasta, he believed that his sickness was due to his not being strict enough, so he’d just eat less and less until he ended up weighing 140 pounds at 6 feet tall. My family was living in constant fear of him passing out again and needing to go to the hospital. We knew every ambulance worker and every fireman in our neighborhood by name because they were always at our house.
Finally when I moved to Hollywood and had some career success I was able to get my dad to a world renowned endocrinologist, Dr. Anne Peters. Within three visits she straightened him out and explained how he did in fact need to eat some carbs. She got his blood sugars evened out and he never had to be hospitalized again.
What scares me the most is what’s happening to people who have diabetes and language barriers. They’re at incredible risk for misinformation, confusion, and poor care. Imagine how many people in this country are just like my dad – trying to follow advice they don’t fully understand? This is a real problem that we often overlook in diabetes education.
Dr. Val: As a Hollywood insider, how aware are your peers about diabetes and is there much talk amongst them about getting involved in campaigns to reduce type 2 diabetes?
Maria: I’m sure they are but I haven’t come across that many. It doesn’t come up that frequently. There haven’t been any breakthroughs in insulin therapy or any other huge scientific advances in diabetes care so the topic isn’t that newsworthy or “sexy.” It’s a real shame that it isn’t talked about more. Everyone seems to be aware that type 2 diabetes is preventable but no one seems to know how to do so. They don’t realize that you need to lose weight and exercise. But I learned about that when I had a weight problem.
Dr. Val: YOU had a weight problem?
Maria: As I said, I came from a diabetic home. We ate vegetables fresh from the garden every day and my mom was extremely careful about what we ate. We didn’t eat anything bad. My mom would buy ice cream and Doritos like, once a year when family was coming over. I didn’t even know what a bagel or a waffle was for most of my time growing up. Then I went to college and there was endless all-you-can-eat food. So over 3 or 4 years of eating pizza and I ended up gaining 40 pounds. One day I decided that I wanted to move to California and get into the business and I realized I needed to lose the weight.
I wrote down everything I ate in a week, and I realized that my problem was carbs. So I cut them back substantially and the weight just melted off. I lost about 20 pounds in several months, and then I added exercise to get the last 20 off. I’ve never looked back.
Dr. Val: How can we be more effective in getting Americans involved in their own health?
Maria: First of all, I think that we need to focus on educating children about healthy lifestyle choices. We have to get the message to them early. Kids enjoy knowing more than their parents and teaching them something new. So it’s really empowering for kids to learn about nutrition and then bring that knowledge home to their families and teach them a thing or two.
Obviously getting Americans to be more involved in their health is a very difficult challenge. Many people are struggling to get by and don’t have time to put their health first – they have to focus on work, paying their gas bill and putting food on the table. It will take a national, coordinated effort to really make a difference.
**Join Dr. Val’s Weight Loss Group**This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 9th, 2008 by Dr. Val Jones in Celebrity Interviews, Health Policy
Tags: Finance, Fitness, Food and Nutrition, Hospitals, News, Weight Loss
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This is a continuation of my interview with Mike Huckabee at the National Changing Diabetes Program conference in Washington, DC. In my previous post I asked Mike about his weight loss journey, and in this post I asked him some global questions about healthcare. My regular readers will appreciate that my digital voice recorder did not malfunction during this interview, though I did drop my Blackberry at one point out of sheer enthusiasm. Gov. Huckabee was the first to reach down and help me get it. What a gentleman!
Dr. Val: Your friend, Dr. Fay Boozman, said “We need to stop treating snake bites and start killing snakes.” Tell me what that means in practical terms.
Huckabee: Healthcare in America is reactive and is geared towards intervening in catastrophic situations, when what we should be doing is focusing on preventing them. The whole system is upside down. It’s like we’re focused on putting Humpty Dumpty back together again instead of keeping him from falling off the wall. Our healthcare system is based on a broken egg concept.
So the key thing that we have to change in healthcare is to focus our resources on prevention and a healthy lifestyle.
Dr. Val: You said that your hope was that “‘Healthy Arkansas’ will spread like a highly contagious but benevolent virus that could become the genesis of ‘Healthy America.’” Can you give me a virus update?
Huckabee: We did in fact launch “Healthy America” and it was the most successful Governors’ initiative in that we had more states participate in this than any other NGA (National Governors’ Association) initiative. Forty-three states launched state-based health initiatives for preventive health. Some were more aggressive than others.
We began the initiative because there was a new awareness of the need to change the healthcare model from intervention to prevention. The concept of Healthy America was to influence behaviors at work, at play, at home, and at school. These programs have been remarkably successful. For example, in the first year, the average productivity of state employees increased by $3400/year. And that’s not to mention the savings in healthcare costs. The average diabetic spends 8.3 days/year in the hospital. The cost of those days could pay for 7 years of diabetes counseling and medication. It’s as if the choice is between a new oil filter or a new engine – which do you think is going to be less expensive?
Dr. Val: Revolution Health is attempting to encourage behavior modification through social networking and online, physician-led programs. What do you think are the strengths and limitations of this approach?
Huckabee: First of all the strengths are more dramatic than you may realize. When we used the online approach in Arkansas, we did health risk assessments followed by online coaching for everything from smoking cessation to weight control. Online programs can be very successful because they’re instant and accessible 24 hours/day. The socialization becomes very important because peer pressure can be harnessed to challenge people to walk more steps or lose more pounds than the others in their group.
Online approaches aside, the key to improving health in America is to create an atmosphere of healthy behavior. This cultural change may take a generation to achieve, which is why most politicians don’t touch it. Politicians like to deal with issues that can be dealt with in an election cycle, not a generation.
However, America’s approach to littering, seatbelt laws, smoking, and drunk driving are four examples of real changes we’ve made in this country over time. The changes took place in three stages: attitude change, atmosphere change, then an action is changed.
Attitude change involves giving people information that changes the way they think about an issue. Atmosphere change means making unhealthy behaviors difficult to participate in (like taking away ash trays and putting up a no-smoking sign), and finally the government codifies into law the new behavioral norm.
The government is usually the last player, not the first, because people have to create the behavioral norm before the government can enact laws. If the government tries to mandate a personal habit, then the debate will not be over the merits of the approach, but over the personal liberties of people to do what they want to do. And in America, the government always loses that argument. So what you have to do is get enough Americans believing that taking care of themselves is the right thing to do, and then there will be the demand for government to put that into law.
We don’t have a healthcare crisis in America, we have a health crisis. And if we dealt with the health crisis we would resolve the healthcare crisis. The real reason we’re in trouble is because 80% of the money we spend on healthcare is a result of chronic disease. And that chronic disease is primarily the result of over-eating, under-exercising and smoking. It’s our lifestyle that’s killing us.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 8th, 2008 by Dr. Val Jones in Celebrity Interviews
Tags: Diabetes, Fitness, Food and Nutrition, News, Weight Loss
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I had the exciting opportunity to interview Governor Mike Huckabee at a recent conference for the National Changing Diabetes Program. As most of you know, Mike lost 110 pounds through lifestyle interventions and has kept the weight off for over 5 years.
Since I’m leading a weight loss group, I was inspired to read his new book, “Quit Digging Your Grave with a Knife and Fork.” I really enjoyed his witty and down-to-earth, positive approach to health. If you can imagine Dave Barry and Norman Vincent Peele getting together to talk about weight loss strategies, you’d pretty much have Gov. Huckabee’s book. I highly recommend it.
As for our interview, I’ll split the Q&As into two posts. This first post is about Mike’s personal journey, the second is about his view of healthcare. One thing’s for sure, after meeting Mike Huckabee in person, I can say that I’ve joined the team of folks who wear the “I heart Huckabee” t-shirts. He is a softspoken, kind-hearted, honest man with a quirky sense of humor and a gift for parables and analogies. Enjoy his thoughts below…
Dr. Val: It seems to me that your weight loss journey began the day when you sat in a chair at the State Capitol, and it broke under your weight (in front of a group of government officials). Do you think that successful weight loss usually begins with an “ah-ha moment” like yours?
Huckabee: I don’t think it’s always the case that people have that level of epiphany. Most people who are overweight know it – every time they bend over to tie their shoes and can’t, every time they need a seat belt extender on the airplane, etc. they realize that there’s a problem. Unfortunately, though, their response is often one of helplessness. They believe that they just have to live with their weight problem instead of believing they can do something about it.
Sometimes an epiphany can make people really angry, and cause them to say – “I don’t care what I have to do, I need to change.” Most people have made numerous attempts to lose weight and have tried many different diets, but they don’t understand the real problem. It’s a lifestyle issue, not a program issue. Diets fail because they have a beginning and an end. You’ve got to see this as change not so much of the menu but of your mind. Don’t focus on losing weight – that’s a big mistake. Focus on the things that make you healthy and then the weight takes care of itself. You may never be the skinniest person, but you’re better off healthy than you are skinny.
Sometimes I find that when people make weight loss their goal they lose weight but they’re not healthy because they haven’t done it in a healthy way. They haven’t combined activity with the weight loss. They’ve just starved themselves, and that’s not health.
Your health is like a dashboard. If the only thing you ever look at is your speedometer, and you don’t look at the oil gauge and the water gauge, you can get into serious trouble. You think, “hey, I’m going the speed limit” but that’s not the point. That’s how fast your car’s going, not how well it’s running. Health is the same way – you can’t just focus on weight, you’ve got to look at your cholesterol levels, hemoglobin A1C, blood sugar, and blood pressure as well.
After I broke the chair I went to see my doctor and he ran some tests that confirmed I was a diabetic.
Dr. Val: What did your doctor say to you at that point?
Huckabee: My doctor gave me a talk that changed my life. A lot of doctors simply say, “you’re a diabetic, here’s some medication, try to lose some weight and do some exercise.” But my doctor looked me in the eye and said, “you need to understand that if you don’t make a lifestyle change, you’re in the last decade of your life, and let me describe the decade…”
Quite frankly if he had just said that I was in my last decade I might have said, “Hmm, that’s not good, but you know what? I bet a drug company will solve this problem for me in the next few years. That way I can eat what I want and do what I want and just take a pill and everything will be fine.”
But that’s not what he told me. Instead he told me the truth, and he said “let me describe the decade…” And in great detail my doctor began to explain what diabetes would do to my body, organ by organ – my vision, my extremities, my heart. He made it sound like a slow, lingering death. And right then and there I vowed to come up with a different exit strategy for my life.
I gave up sweets and fried foods and began to exercise. You have to understand that this was a huge turning point for a southern boy. I used to say that exercise is for people who have nothing better to do with their lives than to get on a treadmill and play the role of a hamster. But I became one of those people that I used to make fun of – I’ve already completed four marathons. But most importantly, I haven’t needed any medications in 5 years and my doctor says that it’s as if I never had diabetes at all.
Dr. Val: You wrote, “If you really hate yourself when you’re fat, you’ll also hate yourself when you’re thin.” What did you mean by that?
Huckabee: Well, you have to be honest and tell people that their weight is a reflection of their personality. There is something inside of them that let them get completely out of control. It may have been a feeling of inadequacy, or some guilt – every person is different. But usually something is underlying the weight problem. It may be the fear of not having anything to eat next week. But something has to give a person that reckless abandon. Just because you change the physical aspects of your life, doesn’t mean that your emotional, mental, and spiritual aspects are going to change.
Dr. Val: How do you get to the bottom of what’s driving unhealthy behaviors?
Huckabee: I know that for me it was when I started to ask myself, “why is it that I’m triggered to overeat?” Some of it was childhood memories – it was the comfort that food brought. As a child, the few privileges I had were related to food. So food was always a reward. I received affirmation from dessert and would indulge myself to re-experience those childhood memories. I know that sounds awfully elementary but these things get imprinted on us. When we’re adults and someone is cruel to us or something bad happens, we affirm ourselves with food so that we can feel as if we’re a good person again. But once you come to terms with this, you regain control. You can tell yourself you’re alright and you don’t need food for comfort or affirmation.
**Up next, Mike speaks out about healthcare**This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 29th, 2008 by Dr. Val Jones in Celebrity Interviews, Opinion
Tags: Cancer, News
2 Comments »
I’ve been wrestling for some time about whether or not it’s appropriate to blog about celebrity news (particularly health issues). On the one hand it seems like an invasion of privacy – what gives me the right to speculate on their health? Shouldn’t I leave the poor celebs their privacy, hen pecked as they are by the media? Yet, on the other hand, when the country is abuzz about an important health issue, there is a “teachable moment” in which doctors can perhaps influence patient lifestyle choices for the better, or encourage some preventive screening if needed.
I did decide to blog about Heath Ledger’s sad passing, and thought it might be important for people to know about autopsies and how they work. Although I had mixed feelings about the post, it was one of my most popular in a long time. So that led me to conclude that I shouldn’t shy away from celebrity news. Nonetheless, I confessed my squeamishness to a friend of mine, and his answer was so insightful that I thought I’d share it with you:
The other way I think
of it is this: health is really personal. Almost everyone who writes about
health does it from the perspective of a personal story – the most common health
blogs are health blogs by patients / survivors about their own experience, the
next most common is by doctors talking about patients. You could have written
yesterday’s entry [Heath Ledger] about the death of a friend or a patient under unknown
circumstances. The problem is that a blog that begins every time with, “I had a
friend who had ALS…” is very concrete to you – you know the friend – but not
concrete to the reader – they don’t know your friend. The use of celebrities
creates a shared vocabulary – people we all “know” that we can converse about.
Put another way, in an
era before blogs, where health conversations were held around kitchen tables and
over the back fence, there was probably less discussion of celebrity health
because the discussants all shared a common stock of people about whom to chat:
Doris down the street has breast cancer; Trudy two doors down has a pregnant
teen; Francine on Maple Street has a mom with Alzheimer’s. The internet and
blogs are an attempt to create a similar conversation with people all over the
country – the planet – who don’t know any people in common. Celebrities are the
only folks we can all discuss, because they are the only folks we all
know.
What do you think? Is it ok to blog about celebrities? Should I do more of it? Less of it? Does my friend have a point? Please share your thoughts.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
