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Sunday, December 31, 2006
Happy New Year
Have you made your new year's resolutions yet? Tell us what they are!
Make sure to check out the Paging Dr. Gupta podcast this Wednesday to get some tips on making good resolutions and sticking to them. Happy new year from all of us at CNN Medical News to you and yours! Friday, December 29, 2006
Toning up with Technology
In the two years that I've been producing the Bod Squad fitness segments, we've covered everything from celebrity-driven workouts such as Budokon, which combines martial arts, yoga and meditation, to cardio-tennis, to training like an NFL player at Competitive Edge Sports boot camp to observing firsthand the flexibility and discipline of the Cirque Du Soleil athletes. So what's the next hot thing? Virtual fitness. Americans spend billions on the fitness industry annually but only about 15 percent of the population goes to a gym. If you're not wild about working out in public or you don't have a lot of time, Demand Fitness lets you work out anywhere, anytime. If you feel like yoga at 3 a.m. in your pajamas, you can log on to the company's Web site and a yoga instructor will coach you along. They're not Live but they are always available. Thursday, December 28, 2006
The impact of autism
All this week, we have been talking about autism. We have touched on some remarkable research where doctors are able to peer into the brain of an autistic child, using advanced MRI scanning techniques. While they still don't know what precisely causes autism, they are able to compare the brains of autistic children with those who don't have autism.
We have also seen the burden autism takes on an entire family. I was stunned to learn the divorce rate among parents of autistic children is 80 percent. We have also touched on the impact early intervention could have on a child. Start treating autism before age 5, even better before 2. It can help alleviate some of the biggest barriers of autism. I was heartbroken as I heard tearful parents worry about who would take care of their autistic children when they were gone. One of our viewers, Jerry, wrote in to tell of his 27-year-old-son. "It took 22 years to get a solid diagnosis," he wrote, and "what we need now is help in managing an adult child with this condition." Jerry went on to remind us that like most children, his son is very intelligent, even graduating from college. It is the lack of social skills though, along with the lack of resources for adults, that has left his son jobless. Jerry raises an important issue and something we don't touch on enough. It is something that will become more important as a generation of autistic children grow up. How should society take care of autistic adults? We are so used to thinking of autism as associated with children, but eventually those children grow up. Employers may be hesitant to hire an adult with diminished social skills, and society may be unwilling to incur the additional costs of paying for them if they don't work. The other issue that we have to touch on is the cause of autism in the first place. There have been no definitive links between autism and mercury preservatives in vaccines, but still many parents remain unconvinced. What are your thoughts? Wednesday, December 27, 2006
Remembering President Ford
Gerald Ford was the first president I ever saw in real life. I was 5 years old in 1975, when my dad read in the newspaper that the presidential motorcade would be passing close to our small hometown of 4,000 people. He decided to take me and hoisted me up on his shoulders as the motorcade passed. Truth is, I really couldn't see anything. I do remember a lot of people cheering, though, and my dad getting really excited. My dad, who had emigrated from India just a few years before, had always dreamed of meeting a U.S. president, and he believed this was the closest he would get.
In the spring of 2006, I had a chance to visit the Gerald R. Ford Presidential Library in Ann Arbor, Michigan. It is on the campus of the University of Michigan, where Ford went to school and was a football standout. I went there with my dad, and we talked to some of the staffers about President Ford and his health. They said he was doing pretty well, aside from some "minor" problems with his heart and his lungs. He had a pacemaker put in this year and had been hospitalized for pneumonia. Still, he was fairly active and spry for being in his 90s. "But he is old," my dad said to me as we walked out. It is true that Ford was 93 years old, the longest living president. Doctors, though, don't focus as much on age as they do on physiology. That means a 60-year-old could really have the medical conditions of a 90-year-old and vice versa. Most people would like to live like an incandescent bulb - shine brightly their entire life and then suddenly go dim. They would like to live long and die short, as Ford did. When asked what caused his death, the answer is not "old age." That hasn't been an official cause of death in this country since 1951. Most likely, it was a combination of heart and lung problems. I called my dad early this morning to tell him Gerald Ford had died and he immediately recounted the story from 31 years ago. He also thanked me for introducing him to President Clinton a few years ago. His dream of meeting a U.S. president finally came true. Tuesday, December 26, 2006
How do I get people to care about obesity?
One of my professors in medical school once told me that being overweight or obese is linked to just about every chronic disease there is out there. It seemed to make sense, because heart disease and strokes are pretty well linked, as is diabetes. Those are the most common chronic diseases. In addition, diseases such as degenerative arthritis as well as cholelithiasis (gall bladder disease) and gout are also associated with obesity. Today, the American Cancer Society definitively added another one to the list - prostate cancer.
After studying 70,000 men for more than a decade, researchers concluded that not only does carrying around extra weight increase your risk of prostate cancer, it increases the likelihood of developing the most aggressive or high-grade forms of prostate cancer. In case you are wondering what a little extra weight means - generally, a 5-foot-10-inch man who weighs 180 pounds is considered overweight, and if he weighs 220 pounds, he is obese. A quick point of clarification though: Those numbers are based on the body mass index scale, which is by no means a perfect scale. And I am not just saying that because I have added a few pounds over the years... Still, the message is clear: My professor was right and obesity is linked to just about everything. The struggle I have when reporting these stories is giving our viewers a take-away message. My guess is that most people already know that they should lose some weight. And, if they are like nearly 80 percent of Americans, losing weight will be a part of their New Year's resolutions. Still, I am not sure a story about prostate cancer and obesity will even make an impression on a typical viewer, because so many have seemingly accepted that America has become an overweight nation. What do you think it will take to start sending a message that actually provokes action when it comes to our waistline and our health? Monday, December 25, 2006
"The Godfather of Soul" was at risk for pneumonia
![]() It was 3:20 this morning when i heard a noise... I thought maybe it was Santa, but it was actually the newsroom calling me... James Brown had died (Full Story). I was on call for breaking news this weekend, so when I got the call, I quickly threw on some clothes and headed into work to get the details. At about 5 AM, my correspondent Rusty Dornin and I were off to the hospital where the self-proclaimed "Godfather of Soul" had passed away. Watch: James Brown Dies at 73 As it turns out, the 73-year-old music legend was spotted last Friday near his hometown in Augusta, Georgia handing out Christmas gifts to underprivileged children. After he finished there, he headed into Atlanta for a routine dentist appointment, and at some point over the weekend, he was taken to Emory's Crawford Long Hospital with severe pneumonia. At 1:45 AM on Christmas day, he passed away from what his manager says was a heart attack related to pneumonia. While it all seems pretty sudden - one day handing out presents, the next day in the hospital - pneumonia is notorious for striking suddenly. So should you be concerned that your chest cold may be pneumonia? First, if you have a pretty sudden onset of symptoms like shortness of breath, chest pain or coughing - particularly a cough that produces greenish mucous - there may be cause for concern. Often times, pneumonia also come along with flu-like symptoms - a fever, shaking chills and muscle pains - so if you're experiencing any of these symptoms, go see your doctor, and let him or her sort out what's causing your discomfort. Finally, know your risk factors - Young children and the elderly, those with chronic diseases and smokers have a much greater risk for developing serious lung infections like pneumonia, so if you fall into any of these categories and you have a cold you just can't seem to shake, it might be a good time to go see your doctor. Alzheimer's advances
My uncle, Rudy, died of complications from Alzheimer's when he was 83. Although he was diagnosed with the illness in his early seventies, we think he was suffering from it long before that. What his family thought back then were just quirks - like brushing his teeth four times in one hour or wearing someone else's shoes - were probably signs of a man already losing his cognitive skills. Back then, no one knew very much about Alzheimer's. There weren't any treatments, no tests to really prove he had it... just a long waiting period of watching a vibrant man waste away.
But today there's hope. Drugs are in development to arrest the disease and new technology is helping doctors catch the illness in its earlier stages before it becomes debilitating. Recently, researchers at UCLA announced they are using a new brain imaging technique that allows doctors to see Alzheimer's before the disease hits, meaning physicians can begin treating the illness earlier. When the next generation of Alzheimer's drugs reach the market, doctors using this brain imaging technology may be able to treat Alzheimer's the way they now treat high cholesterol or high blood pressure. The scan can detect abnormalities in the brain such as plaque buildup and nerve tangles which are the signature of the onset of Alzheimer's disease. Up until now, the only way to detect these problems was through an autopsy. Scientists say the scan could help doctors slow the progression of the disease or even stop it. The key of course is to find the cause. And as of now, no one knows exactly why Alzheimer's happens. Some doctors say it's genetic, some say it's lifestyle... others say it's both. But more and more evidence points to lifestyle choices as playing a key role. Physicians are finding that many patients who suffer form heart disease and diabetes have a greater chance of developing Alzheimer's. It's well known that African Americans and Hispanics are more likely to develop cardiovascular diseases, so doctors worry that this may be putting these groups at higher risk for developing cognitive problems. In fact, the Alzheimer's Association expects the rate of the disease to explode among minorities... and that by the year 2050 the number of Hispanics with Alzheimer's will grow by more than 600 percent. It also predicts that in twenty more years, the number of African Americans with Alzheimer's is expected to double. Health experts say, educating minority groups on healthy living is crucial if we are going to fight the war on Alzheimer's and win. If someone you love is showing signs that they may be suffering from Alzheimer's... act now... don't wait. Call a neurologist, make an appointment. Early diagnosis is essential. As one doctor I spoke to said... "It's easier to protect a healthy brain then to repair one that's already damaged." Treating Alzheimer's earlier can help a patient live a longer, fuller life. .. A life I wish my uncle could have had so many years ago. Friday, December 22, 2006
Would you buy immortality?
Do you want to live forever? My gut reaction to this question has always been a resounding, "No way!" I have no desire to outlive my loved ones and to endure the aches and pains of old age on my own.
But what if you could die, then come back hundreds of years later with a new body? What if you weren't alone? What if your children, your spouse, even the family pet could come back with you? Well then...maybe I'd reconsider. Recently, I met a group of people who believe that scenario will one day become reality. It's called cryonics. In short, it's the deep-freezing of human bodies immediately after death for preservation and possible revival in the future. Believers call themselves cryonicists and they pay big money. It costs $150,000 for the whole body and about half that for just the brain and head. There are discounts for entire families and pets. I'm sure you've heard of cryonics. It's been spoofed in countless movies. Many people think Walt Disney (false) and baseball great Ted Williams (true) are resting in liquid nitrogen indefinitely. The hope is that one day, technology will advance to the point where cryonicists will be revived from their frozen state. Sound unlikely? Yes, it does to me too, but spending time listening to some of the cryonicists' arguments have made me just a little less skeptical. They point to the exponential rate of technological advances. As for me, it does make me consider all the medical procedures that were simply mind-boggling just decades ago. Dialysis allows people with kidney disease to live longer, healthier lives. Operating on fetuses still in the womb is commonplace. Brain surgery can be done without incision. Cryonicists see the transport of chilled organs and tissue for transplants as a step in the right direction. Doctors at Harvard Medical School are working on a process similar to suspended animation. They can take severely injured pigs, the size of humans, and slow down their body's functions, just long enough to mend their traumatic injuries. When the pigs are revived they show no sign of cognitive loss. To be clear, most doctors we spoke to said it's unthinkable that cryonics will ever become a reality. After all, we're still talking about bringing someone back from death. Dr. Sanjay Gupta will examine the medical possibilities of cryonics in a report airing on CNN tonight on Paula Zahn Now at 8pm Eastern and this weekend. You'll also meet some of the people who are planning for their future...their very distant future...that is. Let us know what you think? How much would you pay to buy immortality? Thursday, December 21, 2006
Solving your medical mysteries
When I met Dinh Thai, he had endured a near-constant facial twitch for three years and was excited about the brain surgery that would eliminate the spasms. The twitch had disrupted his sleep, his social life and his professional world for long enough. It went on for three years because no one could diagnose the rare condition (a hemi-facial spasm) properly. He had seen a neurologist, an ophthalmologist, an acupuncturist and a dermatologist, as well has his own family doctors. Finally a friend of a friend referred him to a neurosurgeon, who diagnosed the disorder within seconds.
Thai's long road made me wonder what resources are available for people like him, who have a condition that turns out to be something rare and difficult to diagnose, but that does have a treatment. There are some online resources that people can turn to. You can search the National Library of Medicine database for key words related to the condition. For example, the first four results from a search for the words "facial spasm"contained the words, "hemi-facial spasm." Another place to look is the National Institutes of Health Genetic and Rare Diseases Information Center. These sites can help patients be proactive about finding answers and can serve as starting points to discuss with a doctor in hopes of pinpointing the actual condition. A couple of other pointers: It's always OK to ask for a second opinion. Another doctor in the same area of specialty might have a completely different diagnosis based on his or her experience and realm of knowledge, so don't be afraid to ask. Also, a patient should examine his or her own family health history with a doctor to identify any possible clues that could lead to a cure. I hope you find this information helpful. I'm also curious: What other online medical and health resources do you use? Wednesday, December 20, 2006
Coming in sick is not something to be proud of...
Do you go to work even when you are sick? That's dedication your boss may not like.
"Presenteeism" - the term used to refer to sick employees who show up at work - is a growing concern for companies worried about the bottom line. A recent Unscheduled Absence Survey from CCH Incorporated, a publisher of human resources information, found that presenteeism affected more than half of the companies it polled. Other studies show that the loss of productivity from presenteeism, which can cost U.S. companies upward of $180 billion annually, is far worse than the reduced productivity that results when employees fail to show up to work. If an employee is sick, not only is he or she less likely to be productive but also risks contaminating the entire office. Why don't sick workers just stay home? The CCH survey cited a number of reasons including wanting to preserve precious vacation time, saving sick days for later in the year, and even company loyalty. But the No. 1 reason for presenteeism in the office is the fear of missing deadlines. Let's face it, we all have hefty work loads and it's not likely that someone else will pick up the slack while we are home recovering. But perhaps the following information from the Centers for Disease Control & Prevention can help you decide when you really are too sick for work. Generally if you experience any of the following symptoms, you should probably just stay home: high fever, headache, extreme tiredness, cough, sore throat, runny or stuffy nose, muscle aches, nausea, vomiting or diarrhea. In some cases, it's possible to work from home. But, if you absolutely must be at work, remember healthy habits such as covering your mouth and nose and frequently washing your hands can help prevent spreading germs to the entire office - a courtesy your coworkers will appreciate! Tuesday, December 19, 2006
Scared into checking for skin cancer
A few years ago, I was walking with friends in downtown Chicago. Fleming, who was 8, came up behind me, grabbed the back of my upper arm, yelled "boo," laughed and ran ahead. A few seconds later, I felt a faint trickle of something warm. Blood was coming out of a mole. Not good. I immediately made an appointment with my dermatologist.
I thought about my experience when I heard that first lady Laura Bush had skin cancer (Full Story). In November, doctors removed a nickel-sized tumor from her leg. A biopsy determined it was a squamous cell carcinoma, a malignant tumor. It's the second most common form of skin cancer. The exact numbers of cases of this type of cancer are hard to know because doctors are not required to report them, but the American Cancer Society estimates that between 200,000 and 300,000 cases are diagnosed every year. It kills up to 2,000 people annually, mostly the elderly in whom the cancer is detected far too late or those who are immune compromised. Men are three times more likely than women to get squamous cell carcinoma, probably as a result of more sun exposure. Cancer experts also say that people with fair skin and who have had prolonged sun exposure are more likely to develop squamous cell carcinoma. It's more common in the southern latitudes of the Northern Hemisphere. Mrs. Bush is from Texas. Fortunately, her cancer was caught early and she's expected to make a complete recovery. So what about you? Are you at risk? The American Cancer Society says these are the warning signs for skin cancer: 1) Changes in existing moles, blemishes or freckles. 2) New growths, spots or bumps getting larger. 3) Sores that don't heal within three months. Also - another thing to keep in mind, there may be suspicious moles in places you can't see every day, as in my case, the back of the arm. Make an effort to check those places as well. When I saw my dermatologist, he took a punch biopsy of my suspicious mole. A short time later, he told me I had pre-cancerous melanoma or as he put it, "pre-John McCain cancer." (That's the bad kind - the American Cancer Society estimates close to 8,000 people die from that yearly.) Had I waited another month to get it checked out, he said, it most likely would have been cancer. After my scare, I became more diligent about checking for skin cancer. I hope the first lady's news will prompt others to do the same. A supercentenarian looks back over 112 years
But to me, what makes Mrs. Baines so special is not her age, but how she has maintained her independence spanning three centuries, even when women and especially black women were considered second-class. Mrs. Baines was born in a small town south of Atlanta, Georgia, and lived a pretty simple life. But there was nothing simple about her. She says her first real memory was of a car ride to Canada. In those days very few people ever left their hometowns. She left her country. She later married and had a daughter, who died at an early age. She moved to Ohio where she worked as a "house mom" at a state university. She eventually divorced and traveled to Los Angeles, where she retired and lives to this day. A few months ago, Mrs. Baines was honored as the oldest citizen in California. President Bush sent her a letter, and Gov. Arnold Schwarzenegger came to visit with a plaque. She is a member of an exclusive group of people older than 110, the supercentenarians. And researchers believe that by studying these super senior citizens, they may find the secret to the fountain of youth. They're so confident, a new research center is being set up to observe people like Mrs. Baines. When I interviewed Mrs. Baines for our story on the Supercentenarian Research Center, I expected to meet a fragile, feeble woman. Instead she greeted me in her wheelchair, wearing a fancy leopard print hat and a big smile. She didn't want to discuss airplanes, shuttle launches, civil rights, iPods or politics. Instead, she preferred to talk about her family, her loves, her heartbreaks, her faith. It didn't matter what historic events she had witnessed over the last 112 years. It was more important to her to talk about how she lived. When I asked why she thought she had lived this long, her answer was... "God. Ask him... I took good care of myself, the way he wanted me to." So simple, but so complex. How do you extract that kind of attitude and put it in a bottle? How do you take that zest for life and make a vaccine? That's really up to the scientists who are studying Mrs. Baines and people like her. But here's a thought. Maybe long life is more than just good genes, exercising and eating well. Maybe healthy longevity depends on your faith, the way you treat people, the way you love, the way you handle bumps in the road and the way you face the day every morning. What are your ideas for living a long, healthy life? Monday, December 18, 2006
Recognizing symptoms of hypothermia
Hearing the news yesterday about Kelly James, who died on Mount Hood (Full Story), I was reminded of my days in EMT training. I was also reminded of how little experience I've had treating cold related injuries because I worked in Atlanta. It's a rare year when we see more than a quarter-inch of snow.
I thought it might be a good time to refresh my memory, and yours, on how to spot hypothermia. First of all, it's important to remember that you don't have to be stranded on a mountainside to get hypothermia, which strictly speaking is defined as a core body temperature of 95 degrees Fahrenheit or below. The condition is considered life-threatening at temperatures of 90 or below. But if you're very young or very old, you could have problems just being out in the cold weather. The biggest indicator of hypothermia is confusion. The first thing to go as your body loses heat is your brain function. In fact, I read yesterday that once your body temperature drops below 95 degrees, for each additional degree of temperature loss, you also lose about 4 percent of your brain's processing power. Other symptoms... If you start to slur your speech, feel very fatigued or lethargic or start breathing very slowly, you should try to get medical attention immediately. If you're concerned that a loved one may be affected, the best thing to do is get him or her inside, out of the cold, and take off any wet clothes. Once you're inside, you can start the re-warming process, but be very careful to do it slowly... Blankets and hot tea will get you started, but it's a good idea to call for medical help. There's a saying in the medical field: "You're not dead until you're warm and dead." Exposure to extreme cold can actually slow your heart and metabolic rates so much that they're virtually undetectable. With all your processes practically standing still, it's also possible to survive a longer time without breathing. If you come upon someone in this condition, you should begin CPR and rescue breathing immediately, and call 911 for help. Are we really prepared for the flu?
"The nation is nowhere near as prepared as we should be for bioterrorism, bird flu and other health disasters," says the Trust for America's Health, a prominent group that promotes public health and emergency preparedness.
Just one example: During even a moderate flu pandemic, half the states would run out of hospital beds within two weeks, the group says. The news isn't all bad. For example, every state has at least started planning for a flu disaster. In 2003, just 13 states had even considered the possibility. On a related note, health officials from around the country gathered recently to discuss what they might do to slow a pandemic. There's a lot of talk about 1918, which saw the worst influenza pandemic ever recorded - though not as bad, we're cautioned, as the next one could be. In 1918, a new flu strain - which, by the way, mutated from a version found in chickens - killed at least 100 million people around the world in a matter of months. 600,000 people died in the United States. New research, led by University of Michigan historian Howard Markel, examines how 45 major cities handled the outbreak. St. Louis closed schools and banned public gatherings when the city still had relatively few influenza cases. Philadelphia did the same things, but not until the disease was burning through its population like a brush fire. Everywhere, the pattern was the same. The scope of the catastrophe could be explained almost solely by how quickly health officials moved to prevent large gatherings. Most people think our best hope against killer flu is finding a vaccine, or the right medicine. But even today, it may be more important to keep from being exposed in the first place. Would your boss let you stay home, or telecommute, if an outbreak lasted months? How long would your child's school stay open? Better to think about these questions now, than when a crisis is in full swing. You can see whether the Trust For America's Health thinks your state is ready, at healthyamericans.org Friday, December 15, 2006
"Eragon" author reveals the secret to his genius
When I met Sanjay Gupta this summer, we spent a long time talking about creativity: how to define it, the importance of encouraging it in childhood and early adulthood, its importance in nearly every aspect of modern life, and what people can do to develop creativity in themselves and in others. The conversation reminded me of certain methods my parents used when home schooling my sister and me, techniques that helped us express ourselves freely and find unique solutions to problems. For example, whenever we became curious about a particular subject, my mother would surround us with information on that topic: books from our local library, pictures, music, sticker books... anything relevant to the subject. She would encourage us to draw pictures and write a few paragraphs on the subject, and then she would take these pages and bind them into booklets. The rich environment my parents provided taught us to embrace new knowledge and to enjoy educating ourselves. These are habits that anyone can learn on their own. Whenever you come across an unfamiliar fact or skill, grab hold of it and learn everything possible about it. By doing so, you can acquire a vast pool of facts, figures, and abilities: the primordial soup from which creativity can arise. For creativity, at its simplest, is the art of putting together seemingly unrelated things and combining them in new ways. By doing that- by looking at the world from a different perspective - it's possible to achieve greater success in work, play and in artistic endeavors. Less HRT may be the key to less breast cancer
It is nice to blog about some good news every once in a while. A new study shows that breast cancer rates plunged 7 percent overall and in some cases as much as 14 percent in 2003. That is especially good news considering there had been a steady increase in breast cancer from 1975 to 2000, with almost a 30 percent increase over that time. (Full Story)
Most interesting perhaps, is that many researchers believe they know exactly why the rate is going down. They point to the swirling negative problems surrounding hormone replacement therapy or HRT. In July 2002, the Women's Health Initiative warned that HRT could actually lead to an increase in breast cancer and heart disease. It seems patients and their doctors started to pay attention. By the end of 2003, the number of prescriptions written for HRT went from around 22 million to 12 million. Shortly thereafter, we started to see the first declines in breast cancer. At first, it was just small changes but now for women with estrogen-fueled tumors, the most common breast cancer rates have dropped up to 14 percent. For all age groups, the rate dropped 7 percent. Not surprisingly, representatives from the American Cancer Society are being cautious. After all, it is just one year's worth of data and that hardly makes a trend. Still, that hasn't dampened the enthusiasm of breast cancer researchers who have been working their entire lives for a win. What is most difficult, though, are the conversations I have had with many women around the country about HRT. So many of these women are simply debilitated and unable to function because of the frustrating symptoms of menopause. They will read today's news and still refuse to give up their HRT, even though they know it could dramatically reduce their risk of breast cancer. To them, the risk is worth it. So, what should doctors tell these women and is there anything else out there that works? Thursday, December 14, 2006
Senator's speech signals bleeding brain
Yesterday, Sen. Tim Johnson, a South Dakota Democrat, was in a meeting when he suddenly started having difficulty speaking. At first, he couldn't find the right word, then he started stammering and finally stopped speaking altogether. After he walked back to his office, it seemed that his right arm or leg had become numb. His staffers didn't know what was wrong at first, but then sent him to the hospital. It was the right thing to do. Johnson was having symptoms that sounded like a stroke.
As we now know, the senator actually had a congenital arterial venous malformation in his brain, known as an AVM. This is a cluster of arteries and veins in the brain that grow together. Sometimes, for unclear reasons, this tangle of blood vessels will bleed - and that blood puts pressure on the brain. The pressure causes the stroke-like symptoms. He underwent an operation to remove the blood and stabilize the tangle. The doctors say it was successful, and the senator is now recovering. Judging from the location of his bleeding, his recovery will most likely take quite a while. It was on the left side of his brain, in an area responsible for the ability to speak and understand. Most surprising to many is that this AVM was probably with the senator his entire life and never before caused any problems. The senator probably never even knew he had a problem until he could no longer speak. Most people reading this and watching the news coverage are immediately wondering whether this could happen to them. The answer is: It's very unlikely. You have about a 1/1000 chance of having such a problem. Still, many people may want to get screened to tell them for sure. They never want to be in the position in which the senator now finds himself. The problem is that the screening can get very expensive. The best test to look for this sort of problem can cost $2,000. If everyone in the nation were screened, the cost could be in the hundreds of billions of dollars. Is it worth it? Let's hear your thoughts. Wednesday, December 13, 2006
Anti-Depressants and Suicide Risk
One story that has fascinated me the most over the last couple of years is the one about anti-depressants and suicide risk. You may remember that in October 2004, a black box warning label was created for antidepressants used to treat children. This warning, which is located prominently on the package insert, warns specifically of an increase in suicidal thoughts if someone is taking the medication. It was fascinating to me, because it seemed so counterintuitive - I mean, weren't anti-depressants supposed to make someone feel better? And, didn't it make more sense that the depression itself was leading to the suicidal thoughts or behaviors?
Well, that is at the heart of what promises to be a very contentious FDA hearing today. Studies have shown that using antidepressants elevates the risk of suicidal thoughts and behaviors in young adults. So a similar black box warning for antidepressants being used by adults is being considered. There will be testimony from individuals whose loved ones committed suicide while on the medications. And, there will be testimony from the American Psychiatric Association telling the FDA that the risk of increased suicidal thoughts is small and greatly outweighed by the risk of untreated depression. It is unclear as to why the use of antidepressants and suicide would be linked. It could be that an alteration in the brain chemistry affects some people differently, actually causing a downward spiral, instead of a mood enhancement. Or, it could be that antidepressants elevate someone's energy levels before their mood. So, they have just enough energy to start acting out suicidal thoughts, while they are still depressed. It might just be the natural and sometimes tragic natural history of depression. It is clear that depression remains a widely stigmatized disease and that too many people don't get the treatment they need. After the black box warnings were implemented in 2004, prescriptions for anti-depressants went down 20% for young adults, potentially leading to even more untreated depression in that group of people. There is a possibility that could happen again, if those warning are extended to adults. So, if you had a chance to weigh in on these FDA hearings, what would you say? Tuesday, December 12, 2006
Resident Work Hour Limitations a Bad Thing??
Over the past few months, we have been working on a documentary about the impact of resident work hours. There have been many studies about this topic, primarily relying on questionnaires, but we decided to spend several weeks with resident doctors from different specialties to see for ourselves what their work hours and their lives were really like. Several things started to become apparent.
First off, it is true that resident doctors do routinely work shifts lasting longer than 24 hours. In fact, despite regulations put in place by the Accreditation Council for Graduate Medical Education, many surgical residents work 30-hour shifts twice a week on top of their regular daily hours, for a total of 80 to 88 hours a week. While the limit is 80 hours, an extra eight hours may be added, if used specifically for learning purposes. It also became clear that anybody who is awake for 24 hours in a row has trouble staying awake and may nod off from time to time, usually in lectures or when in front of the computer finishing paperwork. Finally, as we interviewed people from various facets of medical education, such as deans, chairmen of training programs, residents themselves and nurses, we realized that the regulation of work hours is a very contentious issue. At heart is the obvious, which is the possibility that sleepy doctors might make more mistakes. And, according to a study released yesterday from the division of sleep medicine at Brigham and Women's Hospital, doctors in training reported that they were four times more likely to make a fatigue-related medical error after working five or more long shifts. Others will argue that resident doctors need to work the longer shifts so they can have continuity of care with sick patients. After all, if they leave the hospital in the middle of caring for a patient, couldn't that jeopardize care? And, what about the concern that doctors who have curtailed the number of hours in a residency program might not be trained as well for real-life practice as doctors who worked the longer shifts? It is by no means an easy question. For now, the work hours will be regulated. I am eager, though, to hear what you think. Look for CNN Presents: Grady's Anatomy coming to CNN in March. Monday, December 11, 2006
The Menopause Catch-22
Menopause isn't a disease.
But for the 150,000 American women entering menopause each month, the mood swings, hot flashes and libido changes that often accompany a drop in estrogen can leave them feeling, "I need help." Consider: 50 percent of all women go to their doctor for menopausal symptoms. But many women have mixed feelings about taking medications for this natural change of life. Do benefits outweigh risks? The FDA has revised its guidelines, stating that hormone therapy should be used only for the short-term relief of symptoms - and only for low-risk patients (no smokers, no history of breast cancer) because of the risk of breast cancer, heart attacks and stroke. Yet, the American College of Obstetricians and Gynecologists maintains hormone therapy is effective at relieving menopausal symptoms, and may even ward off osteoporosis and memory loss. Dr. Louann Brizendine runs the Women's Mood and Hormone Clinic at the University of California, San Francisco, and is author of the book, "The Female Brain." A neuropsychiatrist, she frequently prescribes not only hormone therapy, but anti-depressants such as Paxil, Prozac and Celexa in small doses to ease irritability and restore libido during a patient's seismic shift in her hormonal self. "There are all sorts of things we doctors can use nowadays that can get you back to feeling your best," says Brizendine, stressing women may not need medication forever but rather just during the transitional period when they feel most on edge. But what of this notion, 'this is what nature intended' and if we're out of control, we're bad? Dr. Brizendine, the daughter of protestant missionaries, has a ready anecdote. While treating Sisters of Charity nuns for their menopausal symptoms a decade ago, she asked them whether their Lord would think it's a sin to take medication. "Oh no," the nuns assured her. "He'd be upset if we didn't use everything provided by Him to help us be our best selves." The decision to medicate menopause remains a highly personal one, and each woman must be the arbiter of her own risk. But it's important to know there's an arsenal of drugs out there that target menopausal symptoms and if you're feeling bad, your doctor can help. As Dr. Brizendine is fond of saying: "The change will set you free." We'll have more from Dr. Brizendine and the "The Brain on Menopause" this week on American Morning. Friday, December 08, 2006
Finding Your Genius
If you asked me where to find big thinkers, I might point you toward Silicon Valley, where some of the Internet's biggest companies have their headquarters. Or, I might tell you to begin your search in Cambridge, Massachusetts, home to MIT and Harvard.
Francestown, New Hampshire, is not known for producing beautiful minds, but that's where we caught up with Matt Savage, a 14-year-old piano playing savant. We profiled Matt for an hour-long special report on genius. Matt lives on a small farm along a picturesque country road, with his parents, a sister, seven cats and a few head of Belted Galway cattle. The farm is about an hour's drive from Manchester, New Hampshire, the nearest city. Not only does Matt possess prodigious piano playing skills, he composes beautiful jazz melodies that have won national awards. What's more, the home-schooled teenager has an encyclopedic knowledge of geography and, of all things, roller coasters. With the encouragement of his parents, Diane and Larry, Matt is thriving some distance from any intellectual mecca. By the same token, creativity can be found in unlikely places. Eureka moments tend to come not at work but when we're relaxing. People who study creativity calls this phenomenon the three B's: bed, bath and bus. Shift the mind into idle while riding the bus, lying in bed or relaxing in the bath, and big ideas will come. The ideas don't come from nowhere, though. You're much more likely have a creative burst if you've been working hard, according to the experts. Have you had creative ideas in unusual places? Tell us about them, and don't forget to watch House Call this weekend to hear more about Matt and other geniuses. That's Saturday and Sunday at 830 AM Eastern. Thursday, December 07, 2006
Leaving Maternity Leave?
This is my first week back from maternity leave, and even though it's the fourth time I've done this, it's always a challenge. There are the emotions of leaving a little baby; the logistics of finding care; the struggle to locate, for the first time in three months, socks that match. Here's some advice from Linda Mason, author of "The Working Mother's Guide to Life"; the Mayo Clinic; and a few thoughts from myself and my mommy friends: 1. Go back to work midweek. As Mason says, "going back to work can be overwhelming. If you know you only have to do two or three days, you can make it through." 2. Work out child care way in advance. The last thing you want to be doing in your final days of maternity leave is interviewing nannies or visiting day-care centers. 3. Mason suggests taking a picture of your baby on your cell phone every morning so you have a very current photo every day. 4. Accept that you'll feel sad or guilty sometimes. There's really no way around it. 5. Here's one from me: You'll be a better worker and mommy if you spend a little time on yourself. Develop a 15-minute exercise routine you can do at home (15 minutes of yoga, 15 minutes on the treadmill, or lifting weights). Let's face it: For a few weeks at least, you'll never have more than 15 minutes each day to exercise, so why set yourself up for failure? And if you do find more than 15 minutes, I don't want to hear about it =) Wednesday, December 06, 2006
Maneuvering the Menu
New York City's ban on artificial trans fats in restaurants underscores the difficulty of eating heart healthy when eating out. It means not only looking for low-fat and low-calorie choices, but also cutting the artery-clogging trans fats. Nutrition coach Kendra Coppey offered these pointers on how to navigate a restaurant menu, with healthful eating in mind.
Her main tip: Ask whether the food is prepared with trans fats. The server may not know, and you may have to ask the manager or owner, but increasingly, restaurants are serving concerned customers. So they may not be surprised to be asked whether the food is prepared with the "bad stuff:" hydrogenated or partially hydrogenated oil, which includes most vegetable oils, shortening, and margarines or similar spreads. Course by course, Coppey says, there are red flags to look for: When ordering a salad, cut out the croutons, which are made from bread and probably a lot of shortening. If they're a must, order them on the side. Choose olive oil with vinegar for dressing, or balsamic vinaigrette, which is more likely to be made with olive oil, a healthy fat. In choosing a veggie, ask for it to be cooked in olive or canola oil, or even sauteed in a little butter. Rule of thumb: The more a food looks like its original form, the more likely it is to be lower in trans fats. For example, mashed potatoes are probably going to be higher in trans fats than a baked potato with butter, and with the latter you can control the amount of added fat. Most meat courses are probably OK because they're eaten right away and don't require stabilizers; trans fats are often used for that purpose to prolong shelf life. But avoid fried meats (e.g., chicken-fried steak), and breaded meats; those bread crumbs are probably high in trans fats. When the dessert cart rolls around, skip the pastries, cookies and cakes, which are probably made with shortening. Safer choices are fruit with fresh whipped cream, ice cream, and maybe even chocolate pudding or mousse. As always, portion control is a must. I'm sure there are a lot of other good strategies out there for eating healthy in restaurants. What are yours? Tuesday, December 05, 2006
Surgeon General's Warning: Exercise... I Do!
The U.S. surgeon general recommends that everyone get at least 30 minutes of activity a day... but do the surgeons general really follow their own advice?Former Surgeon General Dr. David Satcher does. During a recent interview for a "Fit Nation" segment for House Call, I learned that Dr. Satcher gets up before 5:30 a.m. every day and exercises. His morning ritual in Atlanta includes rowing on the lake behind his home. "It doesn't matter what the temperature is and it doesn't matter if it's dark or light," Dr. Satcher says. "I'm out there. To be out there when the sun comes up... that's one of my favorite times of the day." The 65-year-old travels frequently as director of the Center of Excellence on Health Disparities at the Morehouse School of Medicine. Dr. Satcher takes a brisk morning walk - in China, Kenya or Washington. "When you live the kind of life I live and you are working all day with people, answering the phone and making speeches... I like having a part of the day that's quiet," he says. "I even make meditation part of my physical activity." Dr. Satcher says he plans to work out every day, so that not exercising becomes the exception. A knee injury forced him to stop jogging so he rows. He also does strengthening exercises using his body weight, push-ups, sit-ups and straight leg raises. He will do these exercises at home or in a hotel. He has a saying: "If you have enough time to eat and enough time to sleep, you have enough time to exercise." So, are you following the surgeon general's advice? Dr. Satcher sure is. Monday, December 04, 2006
Polonium and You
On Friday morning I was shown into a radiation lab, and, wearing no goggles, gloves or other special protection, held a vial containing a tiny sample of polonium 210, the chemical believed to have killed former Russian spy Alexander Litvinenko. It's Monday morning, and I'm still OK.
The intrigue of espionage has brought public awareness to a substance that has been around for over 100 years, but had yet to be cause for public panic. If you are one of the many out there worried about polonium 210 showing up somewhere near you, perhaps the following info will help calm your nerves. The most important thing to remember about polonium 210 and other alpha emitters is that basic hygiene can save your life! An alpha emitter can do damage only if it gets into your system. The same is true for the flu, salmonella and numerous viruses. Washing your hands remains your first line of defense. And about those traces found on commercial airlines - Dr. Cham E. Dallas, director of the University of Georgia's Center for Mass Destruction Defense, says not to worry. In fact, there are very small amounts of it all around us - in the in the soil, in the atmosphere... and even in the human body. In extremely low levels, natural traces of polonium 210 can be found just about everywhere. With that said, it is also important to know that there are very tight government protections on the extraction of polonium. The substance is produced in large quantities generally for the production of nuclear weapons. As a result, in the United States this is not a substance that just anybody can get his or her hands on. After a full week of researching the topic, I feel confident in saying that, of the many potentially deadly things we civilians have to worry about, polonium 210 should not be one of them. To learn more on how polonium 210 was used on Alexander Litvinenko, be sure to watch Anderson Cooper 360 tonight at 10 p.m. ET Friday, December 01, 2006
Imperfection Can Be Bliss
This weekend marks three weeks until Christmas, and many Americans will be shopping, planning, decorating, traveling and trying to get everything just right. That's just the problem according to psychologist Jeffrey Gardere. He says you should be aiming to enjoy the season, not for perfection. Gardere warns that all the stress we put on ourselves can make us act in a way we may regret. Add that to excessive alcohol and food and we may be setting ourselves up for a very un-jolly holiday.
We teamed up Gardere with former Surgeon General David Satcher and Dr. Caroline Richardson to give you the best plan for enjoying the peace of the season - including dealing with difficult family members and finding healthy gifts. That's coming up this Saturday and Sunday on House Call at 8:30 am Eastern. In Satcher's words: "We are more likely to get stressed out because we get caught up in things other than what our body and minds need." What are you doing to keep your body and mind healthy during this busy season? |
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The U.S. surgeon general recommends that everyone get at least 30 minutes of activity a day... but do the surgeons general really follow their own advice?