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06/28/06
Announcer>> This Life and Times health care special is made possible by a grant from QueensCare, a public charity providing health care to the low income and uninsured residents of Los Angeles County.
Val Zavala>> Tonight on Life and Times --
Who is the one doctor your doctor turns to in case of epidemic, food poisoning or bioterrorism?
Dr. Laurene Mascola>> Like strep throat. We don't want to hear about strep throat cases. There are four bazillion cases of strep throat and visually nothing. You know, it's just that it happens.
Val Zavala>> And then, it's a device that helps athletes reach peak performance, but what could it do for victims of stroke or heart attack?
It's all straight ahead on a Life and Times health care special.
Announcer>> Life and Times is made possible through the generous support of the L.K. Whittier Foundation dedicated to improving the quality of life by supporting innovative endeavors in the fields of medicine, health, science and education.
And by a generous grant from Jim and Anne Rothenberg.
Val Zavala>> Is it possible for family ties to get in the way of proper care for an elderly parent? Well, that's especially true in the case of Alzheimer's where home care is not necessarily the best care. And as Hena Cuevas tells us, for certain cultures and certain families, that decision is a tough one.
Hena Cuevas>> Seventy-three year old Reiko Hayashi moved to Los Angeles three years ago with the intention of helping her daughter, Gayle, take care of her three children. But earlier this year, Gayle began to notice a change in her elderly mother.
Gayle Hayashi>> Instead of noticing something wrong, we've been expecting it to happen because it runs in her family.
Hena Cuevas>> She's talking about Alzheimer's Disease, a neurological disorder that affects peoples' memory and behavior.
Gayle Hayashi>> She actually is not diagnosed with Alzheimer's. Her brain scan does not show that yet, but her symptoms are there.
Hena Cuevas>> Symptoms such as not being able to keep track of dates or balance a checkbook.
Gayle Hayashi>> What she keeps saying is you don't know what it's like to -- it's like a blackboard that just is erased in front of your eyes. You know, it's there and then it's gone, and she says that all the time. It's like you have no idea what that's like.
Hena Cuevas>> The odds of Reiko developing full-fledged Alzheimer's are high. It runs in the family. Reiko's grandfather suffered from it and so did her mother.
Reiko Hayashi>> She was really angry at herself because she couldn't remember. She was the most talented woman and the smartest woman. She was smarter than my father. She used to be a school teacher.
Hena Cuevas>> Reiko was also a teacher until she retired five years ago. Even then, she says, she had problems with her memory.
Reiko Hayashi>> I was teaching and I couldn't remember a lot. I would forget the students' names and that wasn't good for a teacher.
Hena Cuevas>> Nearly four and a half million people suffer from Alzheimer's in the United States and the cost of taking care of them is upwards to a hundred billion dollars a year. But what are some of the challenges of taking care of a loved one who's been recently diagnosed with Alzheimer's? According to experts, how you handle that has a lot to do with your cultural background, but more importantly, your cultural expectations. In Asian American and Latino communities, family ties can be especially strong and the thought of putting a loved one in a home is often rejected.
Gayle Hayashi>> I hope that she can be like this for as long as we can get her to, but, you know, eventually I think we're just kind of taking one day at a time.
Hena Cuevas>> Stella Henry runs the Vista del Sol Care Center in Culver City.
Stella Henry>> We have forty residents in the nursing home and thirty-four in the assisted living care.
Hena Cuevas>> She's seen many families grapple with this difficult choice.
Stella Henry>> Everyone wants to keep their parent, their spouse, their grandmother, their uncle, at home and that's Plan A. But the question we have to ask ourselves is can we truly take care of them at home? Can we really meet their needs?
Debra Cherry>> Alzheimer's Disease is a twenty-four hour a day job for caregivers.
Hena Cuevas>> Debra Cherry is the Associate Director of the Alzheimer's Association in Los Angeles. She says forty percent of those who live past the age of eighty-five will get Alzheimer's, and one cultural variation? What's considered a burden in one family is an accepted responsibility in others.
Debra Cherry>> I've heard Latino families say, "You talk to me about caregiver burdens. I don't see this as a burden. I'm caring for my mother because that's what I want to do."
Hena Cuevas>> What kind of a connection is there between culture and guilt?
Debra Cherry>> I think that guilt is available universally and people never feel like they're doing enough for a parent with Alzheimer's Disease or a spouse with Alzheimer's Disease.
[Film Clip]
Hena Cuevas>> Henry says that, even when a family decides to put an Alzheimer's patient in a home, the extended family can interfere, especially within Latino families.
Stella Henry>> I had one family say to me, "You know what? We are now all pretty comfortable, but I have an aunt who was saying, 'How can you do that?'" So now you're being judged by the second outer circle.
Hena Cuevas>> Even Gayle, who is a fourth generation Japanese American, admits she's held on to certain values common to Asian cultures.
Gayle Hayashi>> I do realize that there are cultural things that I've retained through whatever, socialization, I'm not sure, but I do retain some things and some of it has to do with how you care for your parents.
Hena Cuevas>> That's why keeping her mother at home is so important to her.
Gayle Hayashi>> I think the longer she stays with family, the longer her quality of life will be, you know, good. So I'm hoping that she'll be able to stay with us forever, but I don't know what the future is going to bring that way.
Hena Cuevas>> But Henry says that may change as the disease progresses.
Stella Henry>> It's the stage of behaviors. That's when you're going to see the wandering, maybe the aggression, the paranoia, sometimes the removing of clothing, inappropriate symptoms, and that is when people start deciding, "Can I take care of my parents at home?"
Reiko Hayashi>> Like I can't memorize anymore and I forget. It's very hard now psychologically to accept that and that's when I get angry and that's when I get impossible to live with, I think, and my poor daughter is going to suffer. I don't look forward to going to a home because I know what it's like.
Hena Cuevas>> That's because Reiko has dealt with the issue from the other side. She had to put her own mother into a home when she became too difficult to handle.
Reiko Hayashi>> And it was a horrible experience. I used to go visit and it's not good. No matter how nice, you know, they are, but it's not final what's in for me when I get unruly and become, you know, a danger to myself.
Hena Cuevas>> Because you know that that is a choice that Gayle will have to make at some point?
Reiko Hayashi>> Oh, yeah, I know. But it has to be done because if you just take off and run off into the street . . .
Hena Cuevas>> To help others facing those difficult decisions, Henry has written a book called "The Eldercare Handbook", a guide for caring for aging parents published in English and Spanish.
Stella Henry>> I feel like I needed to be a Paul Revere to wake everybody up to the realization that, you know, of our parents aging and the needed planning that goes along with it.
Hena Cuevas>> Gayle says they don't really have a plan.
Gayle Hayashi>> Aside from, you know, trying to keep abreast of what's happening in the medical world and all that, we're not really doing too much. You know, I don't think we're planning that well.
Hena Cuevas>> Reiko gets brain scans and is tested every three months to see if the disease is progressing. Still, it's early enough for her to be aware of the sacrifices her daughter and her family will have to make.
Reiko Hayashi>> I really appreciate all she's done for me because I know what it's like. Can you imagine my running after my mother and she'll have her bedding all wrapped and she runs out of the house and I have to chase after her? So I know how far it can go.
Hena Cuevas>> I'm Hena Cuevas for Life and Times.
Announcer>> Kcet.org is the place to look for the very latest on Life and Times. You'll find previews of upcoming stories, plus transcripts and audio of past episodes and links to some of our most interesting features. Just go to kcet.org, scroll down the page and click on "Life and Times".
Val Zavala>> Experts say that it's just a matter of time before an epidemic, pandemic or plague sweeps across the country and here in southern California, being such a global village, we're likely to see something catch on. So who's the doctor in charge of keeping all of us healthy? Anne McDermott met her. She's Los Angeles County's Chief of Communicable Diseases and she's got one big job.
Anne McDermott>> Firefighters protect us. The police protect us. And Laurene Mascola protects us. If you haven't heard of her, you're not alone. But Dr. Mascola, Chief of the Acute Communicable Disease Control program of the Los Angeles County Department of Health Services, has been watching over us for fifteen years, monitoring some eighty-plus communicable diseases in this county, the dangerous ones.
Dr. Laurene Mascola>> We don't want to hear about strep throat cases. There's four bazillion cases of strep throat and visually nothing. You know, it's just that it happens. But if it is a disease that we can do a vaccine against, it's a disease that we can change a behavior in a human being like putting on DEET so you don't get bit by a mosquito, so you don't get West Nile, then we make those diseases reportable to the Health Department so we can look at them and then say, hey, this is a pocket over here of infection that maybe we could do some extra education on or target physicians to work with their patient populations to prevent this disease from happening.
Anne McDermott>> Not an easy task in a county of ten million people in an area of four thousand square miles, a territory that Dr. Mascola likes to call a state within a state. And it's not just disease that keeps her busy here. She's also responsible for food poisoning, outbreaks of infection at hospitals, airborne diseases and disasters.
[Film Clip]
Anne McDermott>> Anything from earthquakes to terrorism, especially bioterrorism like an anthrax attack.
Dr. Laurene Mascola>> We have plans in place to set up what we call PODS. They're not science fiction pod people, but they're Points of Distribution where we would set up mass either vaccine distribution centers or, you know, microbial prophylaxis distribution centers. So if there was an anthrax attack, everyone would go and get Ciprofloxacin or, if there was a smallpox event, everyone would go and get smallpox vaccines.
Anne McDermott>> Dr. Mascola says we'd get help in a bioterrorism situation. Officials in other parts of the country could be expected to send supplies our way since a bioterrorism attack would likely be a localized event.
Dr. Laurene Mascola>> If a disaster is going to happen, it's going to happen here, so we're more than open to working with everybody (laughter).
Anne McDermott>> But what about other widespread disasters or diseases for which there are no vaccines and there are no quick solutions, a disaster that hits here as well as the rest of the country? Avian flu, for example, or any flu pandemic.
Dr. Laurene Mascola>> It's like the earthquake. You know, we always keep saying there's going to be another big earthquake. Well, we keep saying there's going to be another pandemic. That just means there's going to be a strain of an influenza virus that none of us have ever seen before, that we have no immunity against, so there's not going to be a vaccine to prevent it like the vaccines we have every fall for influenza and it could take six to nine months in our current technology to get this vaccine, so people would have really no protection against it. But again, it did happen in 1968. It happened in 1957. You know, life went on.
Anne McDermott>> Well, not for everyone and some experts say a bad flu pandemic today could kill as many as one hundred thousand people in Los Angeles County. But even now, Dr. Mascola has her health detectives on the case going through hospital and pharmacy records so they'll be able to spot the first signs of any pandemic or any other unusual health problems and then quickly begin treating the problems.
In a recent speech to other health care professionals, Dr. Mascola said that doctors can be the first line of defense against bird flu, for example, as they learn to grill their patients.
Dr. Laurene Mascola>> "Where did you travel? What were you exposed to? Were you drinking duck blood? I mean, you know, we have to get doctors to ask these questions. They're not used to that."
Anne McDermott>> Will Avian Flu hit here or any flu pandemic? Dr. Mascola says who knows? But if it does, she advises everyone to remain calm.
Dr. Laurene Mascola>> Yes, there might be some people that die, but there are thirty-six thousand people that die every year from influenza. We sort of nonchalantly say that every year, and some of that is completely preventable.
Anne McDermott>> Preventable by getting a flu shot if a vaccine exists. And in a pandemic, one way to prevent illness or at least ease the symptoms is simply to be healthy in general by exercising, eating right and kicking bad habits. And Dr. Mascola says that maybe the fear of a pandemic isn't such a bad thing if it forces people to prepare.
Dr. Laurene Mascola>> Preparing for it is a good thing and, if preparing for it means that everyone gets a flu vaccination, if preparing for it means that everyone washes their hands, people don't go to work when they're sick, people cover their mouths with a tissue or their sleeve, or if you see someone sneeze and then they go to shake your hand, you demure. You know, maybe we should all bow instead of shake hands. Maybe we should do, you know, the elbow shake. I mean, if people just try to practice good health now because they're worried about a flue epidemic, then that's a good thing.
Anne McDermott>> So are people getting the message? Well, educating people isn't easy.
Dr. Laurene Mascola>> If education worked, we still wouldn't be having STDs because we've been telling people to have safe sex for how many centuries? You know, STDs still occur.
Anne McDermott>> No, education doesn't always work.
Dr. Laurene Mascola>> Which is why I love vaccines because then you don't have to worry about education at all. You just shoot people with these vaccines. They're not going to get the disease. You don't have to say to them to wear a condom, wash your hands, don't eat food that might be contaminated with tapeworms.
Anne McDermott>> And another thing, Dr. Mascola says keep these critters at arm's length. We'll all be healthier if we leave the wildlife alone.
Dr. Laurene Mascola>> We are getting closer and closer to where animals roam. In fact, if you look at the last couple of new diseases that have hit our, you know, radar like SARS, the pandemic flu, it's been West Nile disease. There was an episode with monkey pox which came from those cute little prairie dogs. What's happening is that we're moving into their territory.
Anne McDermott>> Dr. Mascola knows you can't win every single battle to save everyone from everything, especially new strains of disease or even some of the old like the plague that turns up in the county now and again. But that doesn't stop her from battling and winning much of the time. So we'll leave her now. After all, she's got a lot to do what with watching out for you and me and the ten million others in Los Angeles County, the people she works so hard to protect. I'm Anne McDermott for Life and Times.
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Val Zavala>> This next story will make some of you, especially athletes, want to go out and plunk twenty-five hundred dollars down for a new device. It not only enhances athletic performance, but it can improve the quality of life for people with serious diseases like multiple sclerosis. Sam Louie explains.
Sam Louie>> When you work out or spend time under the hot sun, it's not just your skin temperature that rises. If you get hot enough, there's a change in what scientists call our core body temperature.
Dr. Craig Heller>> The heat builds up in the core. Now our critical organs are the heart, the brain, the lungs, the kidneys, the liver.
Sam Louie>> In most cases, your body is able to release the heat by sweating. But there are instances, especially among athletes or soldiers, when the body temperature cannot be brought down quick enough and that can lead to life-threatening situations.
Dr. Craig Heller>> Increase in temperature of these organs can be disastrous. This is what happens in heat illness, heat stroke and can lead to death.
Sam Louie>> Dr. Craig Heller is a biology professor at Stanford University. How the body's core temperature is regulated has long been a mystery, but after fifteen years of research, Heller and a colleague found a key to understanding. In 2005, their findings were applied in this device.
Dr. Craig Heller>> And then they simply turn it on and that draws a vacuum in the chamber and there is cool -- not cold -- but cool water circulating through the cone and the heat is then extracted from the hand into the perfusing water.
Sam Louie>> The device is called CoreControl. You simply put your hands in a small vacuum chamber and grasp the cool rod inside for a few minutes.
Dr. Craig Heller>> This makes it possible to extract a large amount of heat very quickly from the body core.
Sam Louie>> Sandi Coffer of Newport Beach can't believe how the small machine has changed her life.
Sandi Coffer>> I am absolutely astounded, just astounded. It's one of those things that you dream of because of the benefits that it could give not only me, but other people with maybe other diseases that this would have an application for.
Sam Louie>> Sandi is sixty years old and has been living with multiple sclerosis for the past twenty.
Sandi Coffer>> You have loss of balance. You can have tremors. You can have memory problems. You can have vision problems. Pretty much anything that has to do with your central nervous system.
Sam Louie>> The debilitating disease attacks the central nervous system. The damage can block or slow the nerve signals that control muscle coordination, strength and sensation.
Sandi Coffer>> You get kind of fuzzy in your head. I mean, it's just that everything kind of shuts down.
Sam Louie>> The severity in effects vary from person to person. For Sandi, a once healthy and competitive amateur golfer, it meant saying goodbye to what she loved most.
Sandi Coffer>> You get angry sometimes because you have this sense of loss when something like that happens to you.
Sam Louie>> Sandi could still play recreational golf, but could no longer walk the course.
Dr. Craig Heller>> And for reasons we don't really know, once the covering or the insulation on the nerves have been damaged, they're much more temperature-sensitive. So frequently, MS patients that are still mobile, that they can still walk, they can even go out and play golf, for example, as soon as the ambient temperature goes up a little bit or the body temperature goes up a little bit, they're incapacitated. They can't function.
Sam Louie>> She had to resort to using a golf cart. Sandi often had to quit early because of her body's reaction to the heat.
Sandi Coffer>> My leg flops around like this when I'm tired or too hot, and stress brings on the symptoms for me.
Sam Louie>> The symptoms also brought fears of a major relapse.
Sandi Coffer>> It's just a terrible feeling because you're scared. You don't know what's going to happen.
Sam Louie>> Then last year, doctors recommended that she try the CoreControl system.
Dr. Craig Heller>> If you can extract the heat from them, you can restore their mobility. You can restore their ability to be functional in a warm environment or at a high activity level.
Sandi Coffer>> So what I do is I stick my hand in here and you turn it like this.
Sam Louie>> The company that manufactures CoreControl allowed Sandi to test their new gadget for free. She wasn't expecting much.
Sandi Coffer>> I didn't think it would work. I really didn't. I was very skeptical. I'm going, "Yeah, right."
Sam Louie>> Eighteen holes later, she had an entirely different opinion.
Sandi Coffer>> I finished eighteen holes of golf in hundred degree weather. That's unbelievable. This was like magic for me.
Sam Louie>> MS patients are not the only ones that researchers say can benefit from CoreControl.
Dr. Craig Heller>> Anyone who has suffered a stroke or suffered a heart attack, any of the ischemic diseases, they stand in danger of tissue damage that's permanent, whether it's the heart, whether it's the brain. If you lower the temperature of the tissue within the first couple of hours after the event, you can dramatically decrease the eventual damage.
Sam Louie>> And there are major implications for athletes whose performance can improve dramatically without drugs if the body's core temperature is kept cooler.
Dr. Craig Heller>> People doing pull-ups were able to triple their capacity in a matter of five or six weeks. I mean, this is capacity at hundreds of pull-ups.
Sam Louie>> Dr. Heller says the vast improvement is rooted in the way muscles respond to heat.
Dr. Craig Heller>> The performance of muscle is limited by temperature, so as the muscle is active, it generates heat, temperature goes up and then it fatigues. So if extract heat from the muscle, the muscle can do much more work. The endurance is extended.
Sam Louie>> Wes Idol considers himself a healthy sixty-nine year old man. He works out six days a week to stay in shape, but age was taking a toll on his body.
Wes Idol>> And at the end of the week, you're too tired. You really can't put a workout together and then you work out, but you wonder am I helping myself or am I just tearing myself down? Here I am tired and trying to work hard.
Sam Louie>> As a Stanford alumni, Wes heard about the CoreControl system in the University's newsletter and wanted to try it. His wife bought him one for twenty-five hundred dollars and gave it to him for Christmas.
Wes Idol>> The water is being pumped from the ice and water here. It's being pumped through the machine or the cone that I'm holding and then circulating back into the machine.
Sam Louie>> After using it for six months, Wes feels like he's found the Fountain of Youth.
Wes Idol>> This is much better than taking steroids. That's what steroids do. They allow you to train and you come back and you can train just as hard the next day.
Sam Louie>> The benefits are clear and the core cooler received approval from the FDA. But are there any risks? Any negative consequences that people should be aware of? Dr. Heller says not really.
Dr. Craig Heller>> What it's doing is, it's returning the body to normal, so this application is not pushing you out of normal. It's returning you to normal.
Sam Louie>> The CoreControl system is being put to the ultimate test on American soldiers in Iraq where summer temperatures average well into the triple digits, but its potential doesn't stop there. Heller sees a brighter future for everyone from construction workers to firefighters. In the meantime, MS patient, Sandi Coffer, is making the CoreControl a part of her regular golf gear, but she says there is one thing it can't do.
Sandi Coffer>> Unfortunately, it doesn't help your golf swing (laughter).
Sam Louie>> I'm Sam Louie for Life and Times.
Val Zavala>> For past health care stories, you can go to the KCET website. Just go to kcet.org, scroll down to "Life and Times" and click on the Health and Science page. And that's our program. I'm Val Zavala. For everyone at Life and Times, thanks for watching. We'll see you next time.
Announcer>> This Life and Times health care special is made possible by a grant from QueensCare, a public charity providing health care to the low income and uninsured residents of Los Angeles County.
By the L.K. Whittier Foundation dedicated to improving the quality of life by supporting innovative endeavors in the fields of medicine, health, science and education.
And by a generous grant from Jim and Anne Rothenberg.
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