Horizon, Host: Ted Simons

August 21, 2007


Host: Cary Pfeffer

Health Special


  • On Tuesdays, HORIZON brings you stories on a variety of health topics. Tonight, we look at smoking, nutrition, diabetes and allergies.
Guests:
  • Will Humble - Deputy Assistant Director, Arizona Health Services
Category: Medical/Health

View Transcript
Cary Pfeffer:
Tonight on "Horizon," added taxes on cigarettes, a statewide public smoking ban. For those who want to quit, now may be a good time to kick the habit and take up a healthy one instead, walking. And keeping healthy with safe eating means being sure to cook ground beef thoroughly. Eating healthy, as well as exercise such as walking, can play a role in managing diabetes. And helpful information for allergy sufferers this season. Those stories next on this "Horizon" health special.

Announcer:
Horizon is made possible by contributions from the friends of 8, members of your Arizona PBS Station. Thank you.

Cary Pfeffer:
Good evening, I'm Carey Pfeffer. On Tuesdays we bring you stories on a variety of health topics. On this special we look at some issues that we've covered over the last few weeks. First up, a major motivation to quit smoking is, of course, for your health. But there are some additional incentives. Cigarettes cost more due to voter approved tax hikes, a ban on smoking inside of places can make lighting up inconvenient, and those who want to quit can take advantage of some state and county tobacco prevention programs. Merry Lucero introduces us to a former smoker who went through one of those programs and is now happy to be smoke free.

Merry Lucero:
Natasha Grupo had enough. With the support of her employer the University of Phoenix and Maricopa county, she has quit smoking that is. Grupo has many reasons to snuff out her last cigarette.

Natasha Grupo:
For health reasons, for my children, for everything, for a whole change of life. I was tired of it, tired of my clothes smelling like it, tired of it running my life. You know, basically, there is no reason not to quit, every reason, every aspect of my life threw at me, I need to quit smoking.

Merry Lucero:
Grupo smoked a pack a day for 11 years. She developed asthma and other health issues, and was spending a lot of time away from her desk.

Natasha Grupo:
Now I'm able to sit, complete a task, and if I need to, I can take a walk around the building or find other ways to distress, other than going out and having a cigarette. It's made a big impact on my work, as well.

Merry Lucero:
But the biggest thing smoking took away from her, time with her family.

Natasha Grupo:
Any time I have to step out to smoke, anytime I do that that's time away from my family and my children. That was a big issue for me. And I've seen the change since I've stopped, big time. More time with my kids, with my husband, finding other things to do.

Merry Lucero:
Grupo credits a big part of her success to the Maricopa county tobacco use prevention program, offered through her work.

Natasha Grupo:
Once I seen that course I knew I wanted to do it. I knew it was something I probably wouldn't have taken the time out to do any other time but because it was offered through my job, and I could take it on a lunch break, that was a big deal to me, a big deal, and very convenient.

Deborah Catz:
It's six weeks for about an hour each time, once a week. And it's an education program. So what it teaches people is that smoking is more than just a physical addiction. It involves a whole lifestyle, all the social things people do, and the emotions people have, the psychological piece, also. It teaches people how they have to change their lives, how they live their lives. Almost everything people do, smokers do, are somehow associated with smoking.

Merry Lucero:
She is getting help from a nicotine patch.

Deborah Catz:
People going through the program get 15\% off the nicotine replacement products, including the gum and the patch, the lozenges and antidepressants. They get 50\% off at the pharmacy.

Merry Lucero:
Attendees also develop a quit plan, learn the dangers of smoking, and grieve the lost of the habit and more.

Deborah Catz:
How to avoid weight gain, start an exercise program as part of their healthier life change. They learn about relapse prevention.

Merry Lucero:
They also learn how to handle stress without smoking. Natasha found a positive way to spend the $50 a week she used to burn on cigarettes.

Natasha Grupo:
Instead of spending the money smoking, I buy fresh fruits and vegetables for my family. It benefits me because I'm able to eat healthy. Now that I stopped smoking, I don't have to worry about the weight gain, and another use is I'm able to provide my family with some things -- the money I was taking for smoking, I'm able to put that back into my home in a positive way.

Merry Lucero:
Walking is becoming increasingly valued as one of the best forms of exercise for people of all ages. It promotes good health in many ways, increasing oxygen intake and circulation throughout the body. For weight loss, walking helps to burn stored fat. For a pound of body weight, you must burn 3500 calories. Walking one mile burns up about 100 calories. Most people naturally walk an average of just under three miles or between 3 and 4,000 steps every day. So if you add just one mile and walk four miles four times a week, you could burn 1600 calories. Some things to remember when getting started: warm up. Lightly walk the first few minutes to get your circulation flowing and your calorie burning started. Stretch your major muscle groups, gently holding for at least 30 seconds. Go for distance over quickness. Think about a comfortable pace rather than being a speed walker. Head for the hills, stairs, bleachers as hills can give you some incline to alternate your routine. You don't have to take long strenuous walks. Just start a steady routine. And walking strengthens your muscles. If you want, you can gradually speed up as your fitness level improves.

Cary Pfeffer:
Public health officials are warning the public about the expansion of a u.s.d.a. ground beef recall because of concerns that repackaged meat by grocery stores may contain e. Coli. In a moment we'll talk more about the recall. First, Merry Lucero has a look at how samples of the ground beef is tested at the state health lab.

Merry Lucero:
The process at the Arizona state health lab, to accurately test ground beef for the e. Coli bacteria is complex. This public health scientist Roman begins with the basic preparation of a sample.

Roman:
We don't know, is there something in this meat or not. And we will try first to make the bacteria grow. After this, we will try to isolate it. I will weigh 25 grams of this sample, I will try to take it from the middle.

Merry Lucero:
He will reduce the growth of other bacteria, to grow the e. Coli bacteria if it is present. This biochemical analysis will identify the outbreak organism. The process can take several days.

Roman:
Only one suspicious bacteria grows, not all of them.

Bill Slanta:
It's an extensive process, because the food products themselves are not sterile. We have to separate the pathogenic from the nonpathogenic organisms. Sometimes it can be very difficult to do that. That's why we have the original process, and then the plating process where we're putting it onto different selective media. We're using multiple different types of media, and taking multiple picks from each media, to try to separate and clean up and get a pure isolate of what is quite possibly a pathogenic organism.

Merry Lucero:
The state health lab received a sample of ground beef bought at a local store in Yavapai county. The consumers had become ill. The sample did turn out to contain the pathogen e. Coli.

Bill Slanta:
We received frozen ground beef patties. The sample, when it arrived, we processed the sample according to the standard bacterial analytical methods as prescribed by the FDA and we confirmed that the isolates from the food sample was the same e. Coli that was identified in the patient's clinical sample. Afterwards, we transmitted the DNA. fingerprint pattern to the centers for disease control, who posted that on their pulse-net site. They determined that this was the outbreak strain of e. Coli.

Merry Lucero:
Pulse-net is coordinated by the CDC. it was instrumental in the ground beef recall by a Los Angeles-based foot processor, expanded to 5.7 million pounds of ground beef products. They are from April 6 to may 7. It included several brand names and was repackaged under several store names. Consumers should only eat meat that has been cooked to a safe 160 degrees.

Cary Pfeffer:
Joining me now is Will Humble, deputy assistant director at the Arizona health services. We heard probably the most important information there at the end. People need to make sure and cook their ground beef thoroughly, completely.

Will Humble:
There's a level of expectation that you think your ground beef is clean, so oh, medium rare, it's okay. It's not okay to cook ground beef medium rare. Cook it until it's 160 in the center. If you're making thick patties, you really need to use a thermometer to make sure you're getting it to 160. You can't really go by the color. The thinner hamburgers and patties, it's easier to get it to 160 in the center.

Merry Lucero:
The American diabetes association estimates that about one third of the roughly 20 million people with diabetes in the nation are unaware that they even have the disease. That's more than 6 million in the u.s. who have diabetes and don't know it. There is a simple seven-question test that you can take online to find out if you're at risk for type 2 diabetes. First, select your age category. Enter your height and weight. Then a series of true-false questions: are you under 65 and get little or no exercise? Do you have a sibling or a parent with diabetes? Are you a woman who has had a baby weighing more than nine pounds at birth? After you answer the questions click the calculate button to reveal your type 2 diabetes risk score. You can take the test on line at the American diabetic association website, diabetes.org. Click the prevention tab on the left. You need to pay special attention to this test if you are a member of one of the ethnic groups that have a higher risk for developing type 2 diabetes. The disease is more common in African Americans, Latinos, native Americans, Asian- Americans, pacific islanders, as well as the aged population.

Cary Pfeffer:
Well, are you suffering from watery, itchy eyes and a runny nose? Have you been coughing and perhaps congested? If so, you may be among the thousands of allergy sufferers in the valley feeling the pain this season. The strong breezes and cooler temperatures don't help matters much. Aside from the over-the-counter drugs available, there is some relief for serious allergy sufferers out there. Being properly diagnosed is a start. We'll talk more about that in just a moment. First, merry Lucero tells us why allergy symptoms may be worse this season.

Merry Lucero:
Flowers are blooming from mesquite to olive, blossoms are everywhere. For allergy sufferers, that means one thing: pollen. For chronic allergy patients like Richard Vezzosi, it means more time at the doctor's office.

Richard Vezzosi:
This is a little worse this year for me, why, I don't know, but it's just worse this year as far as my breathing.

Merry Lucero:
Doctor Bart Leyko thinks this year is somewhat worse than last year in the valley. A series of sharp climate changes is bringing allergens.

Bart Leyko:
I think the weather also was such that plants held off for the pollen release because of the cold weather. And when the heat came in, along with the rain, rain which tends to stimulate the plants to release the pollen, we had a large amount of pollen being released around the same time.

Merry Lucero:
Multiple plants, grasses, weeds, and trees are pollinating. Many people are coughing, sneezing, and feel more tired and achy than they ever have.

Bart Leyko:
And many patients that have allergies may have some reactive disease, and maybe before it wasn't so apparent, or was slowly developing, and this allergy season finally it can be diagnosed because the symptoms became so severe.

Merry Lucero:
Allergies cause inflammation of the airways, as in Vezzosi's case. This can lead to asthma, bronchitis, and sinusitis.

Richard Vezzosi:
I guess a sinus infection in my lungs real bad. I have a little problem breathing at night, really bad.

Merry Lucero:
People with allergies tend to get more viral and bacterial infections. Why?

Bart Leyko:
Probably because their immune system is busy fighting the allergies. You get that baseline inflammation and a swelling of airways, and that makes it a little harder to resist the viral infection. In fact, that may provide a ground for a bacterial infection. It tends to provide more food in terms of the mucus and swollen airways; it makes them a little more exposed to the viral bacterial infections.

Merry Lucero:
Pollutants or other irritants can also cause those ailments. As for allergies, medication can counteract the inflammatory reaction.

Richard Vezzosi:
I've taken the allergy shots, taking inhalers and stuff like that, flonase, advair and they do help to a point. This time nothing's helping me. So he'll give me something special that I'll get a prescription for. And that'll usually clear me up and I'll be all right for a while, and then come back, just for the change of season. There's not much you can do about it.

Merry Lucero:
Desensitization is another prescription.

Bart Leyko:
We sensitize that person to the allergen through a repeated injection of increasing quantity of the allergen over time. It's a long process, but it's probably the closest thing to a cure that we have for allergies.

Merry Lucero:
Indoor allergy triggers can be reduced. But outdoors, controlling pollen is difficult because it travels for miles, making allergy patients sick.

Richard Vezzosi:
I can't breathe at night hardly at all. I use the products they tell me to use. I just get so congested I can't. Hopefully he'll help me today.

Merry Lucero:
In the meantime, allergy sufferers hope some day to be able to stop and smell the flowers.

Cary Pfeffer:
And recently I spoke in detail with dr. Mark Schubert of the allergy asthma clinic about causes, treatment, and continuing care of allergies.

Cary Pfeffer:
Thanks for being here. Let's start with the undeniable fact that this has been a very difficult year for people who suffer with allergies. I'm sure Kleenex sales are through the roof. we're in a situation where this year, as compared to maybe some recently, really is a difficult one.

Mark Schubert:
I think every year seems to be getting somewhat worse. The existing trees are getting bigger, so more pollen per tree. We have done a few things to try to limit growth of some of the major pollen producers. But nonetheless, I think each spring seems to be getting somewhat worse.

Cary Pfeffer:
Sometimes there are factors that happen as far as temperature and that sort of thing that can have some impacts on what it's like year to year?

Mark Schubert:
Sure. We do see pollen counts sometimes higher, then lower, higher. There seems to be a cycle. The overall pollen counts are rising a bit, with the exception of olive and mulberry tree.

Cary Pfeffer:
You were part of an effort in the early 90's to try to limit the kind of specifically mulberry and olive trees that were out there, that were so much the source of a problem for folks like me who suffer from these things.

Mark Schubert:
Paul Johnson, the mayor at the time, asked some of us to review the literature and take a look at what we had in the way of pollen counts here locally, to make a decision as to whether or not there should be anything done about limiting any sort of tree or plant. We did decide that olive and mulberry trees were the best to limit. We did pass a law through the city of phoenix as an ordinance, and then through Maricopa county association of governments, m.a.g., and surrounding cities picked up that ordinance. We have banned olive and mulberry tree plantings since about 1992. The existing trees are grandfathered in. But with the growth in the valley, certainly I think this is having an impact by not adding additional trees.

Cary Pfeffer:
Now we're more than ten years into that process. Do you have a sense that while the population has grown and we have planted a lot of other things, if we were to just have continued with the mulberry and olive plants out there we would probably be in worse shape than we are right now.

Mark Schubert:
I think it would have been a disaster. It takes about 20 pollen grains per cubic meter of air to cause allergy during allergy season. Olive trees make about 300, and mulberry trees make about 3,000.

Cary Pfeffer:
Now there's some talk about sort of expanding some of that, trying to search out the other culprits. Is there some thought of considering some other plants that are difficult for us?

Mark Schubert:
There isn't right now. That would require a further initiative. But when you really look at the pollen count data, as I have, that we really had during those years, it was olive and mullberry that really stood out. Some folks would like to ban, for example, bermuda grass. I think it's now indigenous, it grows wild everywhere. I think it's going to be really difficult to try to really ban that grass.

Cary Pfeffer:
Let's move on to some of the things that can be done for somebody who is suffering. Certainly there are people watching this program right now who are saying, that's me, I can identify with the sniffles and the sneezing and just feeling zapped of energy. Talk about some of the treatments out there, as well as the skin test that's now available.

Mark Schubert:
Well, treatment does follow directly on diagnosis. A lot of folks think they may have allergy. When you ask 100 people to raise your hands, how many of you have allergies, about 50 or 80 will, depending on the study. But actually we know that about 35 have allergy. The rest of them have other forms of non-allergic nasal sinus disease. But skin testing will give us the answer. If a patient is symptomatic, it'll tell us exactly what the problem is and then based on those results we can follow right into treatment.

Cary Pfeffer:
When people think of a skin test, they think of the old fashioned skin test, which was pretty elaborate and which took a pretty long period of time. The good news is that that test has been updated and it's not nearly as sort of feared as it once was.

Mark Schubert:
Well, thank you for pointing that out, I appreciate that. it's true. Allergy skin testing has been streamlined. We use a little plastic device where we place little water droplets on the forearms, and make a little teeny prick. It's just a touch, you can feel it, but it's not painful. It takes just a few moments to put these little drops on. Each drop has a different pollen. Within 20 minutes you'll see an itchy little red welt come up if you're allergic to something specific. we make a little list, and then just wipe these off.

Cary Pfeffer:
That's not anything compared to the old-fashioned way. Let's lastly talk about some of those specific treatments that people should consider. There really are -- they fall into three categories.

Mark Schubert:
We have three categories. We've got avoidance, and that's based upon what you're allergic to. And allergy skin testing will give us that information. But of course avoidance can't be a full treatment, unless it's something direct like, say, cat allergy only or dog allergy only, then you've got avoidance strategies you could use. But then you've got pharmacotherapy, medications. The third category is immunotherapy or allergy shots.

Cary Pfeffer:
When someone comes into the office, you sort of lay out those possibilities and it's a matter of having that discussion with the patient?

Mark Schubert:
That's right, most patients are on some combination of those three categories. Some, as I say, may do fine just with an avoidance strategy. By the time they come to an allergist, they're severe enough they require some combination of treatment.

Cary Pfeffer:
Thank you so much for coming in.

Mark Schubert:
It's my pleasure, thank you.

Cary Pfeffer:
For internet links on these health topics and other issues you've seen on "Horizon" please visit our website, the address www.azpbs.org. You can also see video and transcripts of our program. Thank you very much for joining us on this special edition of "Horizon." I'm Cary Pfeffer.

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