Friday, April 27, 2007
Planning for a bird-flu outbreak in real time
"I don't have good news," the director of the Centers for Disease Control and Prevention said gravely, as reporters leaned forward in the CDC briefing room. "Until recently, H5N1 was a bird virus, contained to birds. Now there's strong evidence that in at least some cases, it has adapted and is capable of transmitting from one person to another and then another."

Sounds alarming. But we're not alarmed, because it's only part of a drill, an exercise involving more than 1,000 people, simulating a cross-globe outbreak of deadly bird flu. It started Wednesday morning in the CDC's very real Emergency Operations Center, in its Atlanta, Georgia, headquarters.

At 8:37 a.m., we got the scenario: a dozen people sick in the United States, all with connections to an Indonesian student at Georgetown University. The young man and two others are dead. Other suspected cases are on a plane being held at an airport in Honolulu, Hawaii. There are recommendations to funnel international flights to just 20 U.S. cities for screening, to send an investigative team to Jakarta, to move vaccines and antiviral medications closer to the hot zone.

"It's hard to define the worst-case scenario," CDC Director Julie Gerberding told "reporters" (in reality, CDC staffers), as well as real reporters observing the mock press briefing. The 25 percent fatality rate in this week's scenario "is beyond our planning imagination," she said.

It's easy to make light of role-playing scenarios, to say they don't approximate the real thing. But a drill like this helps inspire that imagination. It can turn up fixable problems - it took more than an hour to get everyone logged into computer stations in the Emergency Ops Center - but mostly, it gets everyone thinking about the questions they'll be asking in a real crisis.

How worried are you about bird flu? Let us know.
Fit Buddies update
As Dr. Sanjay Gupta's 2007 Fit Nation Tour heads to New Orleans, Louisiana, for weekend events, the CNN Fit Buddies are working to improve their eating and workout habits. Here's an update from the second week of the weight-loss challenge. Read about their successes and pitfalls every Friday here on the Paging Dr. Gupta blog. (More Info)

CNN correspondent Ed Lavandera
The staggered drumbeat of basketballs bouncing off the court echoes through the gym. I'm standing at the three-point line. The leather ball in my hands feels just as it did when I played pick-up basketball games regularly. The voice in my head says "I've still got the touch. I can feel it." The ball leaves my fingertips, floats through the air and miserably graces the bottom of the net. AIRBALL!

Is this how far I've fallen? So out of shape that tossing a basketball is a chore. Well, not exactly, but close enough. (The next shot hit the rim.)

This moment inspired me to really focus on the weight training. I always thought lifting weights right now would do more harm than good. Not the case. You just have to do it the right way.

And I'm already seeing the positive effects. At the end of the week, I went back to the basketball court and made three three-pointers in a row. The touch is coming back!

CNN Domestic director of coverage Stacia Deshishku
This week we decided to put our food diaries to the ultimate test - we e-mailed them to each other and to Robert.

Having to keep track of every item that goes in your mouth is a powerful tool. It certainly made me a lot more aware of my choices. One night I struggled with myself over eating a fudgesicle. I quickly e-mailed my buddies. The response was to "back away from the freezer!" Ed reminded me of the wasted calories and the fact that I would be giving them up for a temporary high. It worked! I was proud of myself and thankful for the support.

The food diary also got me into the habit of checking the calories, proteins, fats, sugars and carbs in each of my meals. I can't believe how many are hidden in seemingly innocent foods. Robert woke me up to the fact that each glass of wine has the same sugar count as a donut! So biggest lesson of the week: Wine=donut. Bad!

CNN Medical News producer Matt Sloane
I've found myself eating things I never would have eaten before. Oatmeal is a good example.

I'm not much for gooey, mushy foods, but my girlfriend convinced me to try her oatmeal concoction - oats, milk, fresh fruit and honey. It looked more like brick mortar with strawberries, but I gave it a shot...

Was it good? No, but I ate it because it's good for me. Do I like working out? No, but I do it because it's good for me.

I never quite understood that whole "no pain, no gain" saying. I always said "no pain, no pain - it's that simple."

My arms hurt, my legs hurt, I ate oatmeal and even salmon (the one fish I don't like) - but it's working. I don't know if I've lost weight yet, but I can feel my body changing for the better.

I'm learning that to really make a change in my health, my appearance and my lifestyle, there is going to be a little pain along the way, but it'll be worth it in the long run.

Fitness trainer Robert Dothard
Training clients for the last 20 years has been my labor of love for many reasons, and many of them have surfaced over the last couple of weeks.

First, being part of a team. It was great to see firsthand how the CNN Fit Nation team puts on a production, as they did in Atlanta, Georgia, last weekend. From the visual aids - a plastic yellow lump of a pound of fake fat and a mirror that shows people what they would look like 10 pounds lighter - to one of the best visual and speaking aids - CNN's own Dr. Sanjay Gupta, the event was a great awareness-builder.

Second, getting information you can actually use. I was a fan of the CNN show "House Call," long before joining the Fit Nation team, because the show takes complicated topics and gives me the resources to do my favorite thing, TAKE ACTION! So if you are following along, logging your nutritional habits and making "modest" changes like portion control, or simply making better food choices, it is indeed easier if SOMEONE ELSE is looking at it1 You may want to pick someone you will actually listen to, and who has solid nutritional habits of his or her own.

Exercise is the other bookend to positive results, but as we have seen through the new food pyramid, walking a few times a week for even as little as 10 or 15 minutes can improve your health. (I suggest 30 minutes at a "brisk" walking pace.)

Lastly, go with your strength. Ed is an ACTION guy, I think his goal is to out-work everyone else. Stacia is the "alpha" and she has me doing my homework, because whether it is the latest nutritional software, or shaking up her workouts, her attitude is "bring it!" And Matt has the Apollo 13 attitude - failure is not an option. Although he may not excel in any one area of his workout or nutrition, his program is balanced, and one I feel he can continue in one form or another for the rest of his life.

I don't know your motivation (your health, the way you look or feel), and I don't know why you have not been able to reach your fitness goals (time or money restrictions, or lack of motivation). What I DO KNOW is if you will join the Fit Nation TEAM, and start taking ACTION... we WILL over the next several weeks, inspire you and give you information on nutrition and exercise you can use NOW, TODAY, and as the old saying goes... what do you have to lose, but the weight!
Thursday, April 26, 2007
Ready for the end of the period?
When I realized I was having terrible mood swings at the same time every month, I started to take action to protect the people most important to me.

Me: Hey hon, so I'm pretty hormonal this week. Just a friendly warning...

Hubby: *Blink.* So, I've got to work late tonight. And tomorrow night. And the night after.

Me: [unintelligible because of my uncontrollable sobbing]

I can't fault the poor guy for wanting to avoid me. He's got the patience of Job but even he'd get run down after a few takes of me flipping out about the simplest things. "What do you mean your phone isn't charged? I really needed to talk to you! What if I was seriously injured and needed to reach you from the ambulance?" You know, the everyday stuff.

So in 2003 when the makers of Seasonale started to market their birth control pill as a chance to cut down to just four menstrual periods a year, I seriously sat up and listened. How great would it be to side-step the inevitable back pains, bloating, and bad attitude that much longer? It would probably make for a happier married life, I thought. But it seemed, I don't know... unnatural. And too new. So I sat back and waited for some scary study to come out saying that missing your period is actually bad for your health.

Instead, I just learned that the FDA is now about a month away from approving Lybrel, a contraceptive that allows you to get evade your period for even longer than three months. Like, forever. Or at least as long as you want.

So this whole period-skipping must not be so bad for us then, right? I mean, studies so far show that there are no added risks to your health if you do it. My doctor told me that I could do the same thing with regular birth control pills, just keep taking the white ones, and that some women do it for various health reasons. But other docs will point out that there are still no long-term studies out there to prove that the health risks won't surface later on down the line.

I know I'm not alone in still wondering whether this is a good idea. Wyeth, Lybrel's makers, said that almost two-thirds of women they surveyed said they were interested in giving up their periods, the New York Times reported.

But what about that comforting monthly sign that you're not pregnant when you don't want to be? And that feeling you first had when you started to menstruate back in junior high - that feeling of hey, I'm a "real" woman now, complete with menses and bra straps? Is having a period a biological phenomenon that we should just accept and respect as the way God made us? Or do you think if we have the technology to make our lives a little easier and less painful, then we should take advantage of it?
Wednesday, April 25, 2007
WIC on the chopping block
Not too long ago, one of our producers suggested a story on the most utilized food program in the United States. The news: The Women, Infants and Children program was finally getting vouchers for fresh fruit and vegetables. It may not sound too enticing at first - it didn't to me -- but then I considered that we're battling an overweight and obesity epidemic in our children. So the government is just now offering low-income mothers and children assistance in purchasing fruit and vegetables? I asked the producer to check her facts.

WIC has been providing nutrition services for low-income women and children for over 30 years. For most of that time, malnutrition was a key problem - so the vouchers focused on milk, bread, cereal - foods that can sustain you. Now, the concern is overweight and obesity in children, so the Department of Agriculture decided to add vouchers for produce - a healthy diet addition -- that can be redeemed at local grocery stores.

This was great - a success story on battling overweight and obesity. But then the producer came back to me with more information. It turns out WIC is on the chopping block, facing a $145 million cut in President Bush's 2008 budget.

If this happens, some fear that the produce voucher proposal will disappear. For now, Congress is debating, one hopes keeping in mind what those dollar signs on the page mean in real life.

For more, watch American Morning on Thursday, 6-9 a.m. ET, and tune in to House Call with Dr. Sanjay Gupta weekend mornings at 8:30 a.m. ET?
Tuesday, April 24, 2007
Out of Touch After Surgery
I'm back at work after an unexpected surgery. Waiting for my body to heal wasn't easy. But what made my surgery all the more difficult was the surprising lack of access I had to my doctor afterwards. Complications had me in the emergency room twice. I talked to ER doctors more than my own. I felt neglected.

Feeling neglected doesn't mean you're being neglected. But feelings are powerful nevertheless. When I got back to work I called Regina Sara Ryan. She's the author of "After Surgery, Illness, or Trauma." Ryan had some great advice on how to handle a doctor you think is out of touch. "It's a tricky path to walk," she says. "We are afraid of damaging this relationship." Still, she says the relationship we foster with our doctor is one of the most important bonds we have with someone. So... how to make things work:

1) Speak up. Don't let your physical weakness silence your concerns. Ryan says too many of us try to take on the burden of our recovery alone -- a saint-like approach that internalizes our worries and makes us passive healers. Sometimes our doctors intimidate us by their stature, their expertise. Try not to be overpowered by that fear, and if you still find yourself struggling ask a friend or relative to speak to your doctor on your behalf.

2) Keep a list. You're less likely to monopolize time and more likely to get the answers you need if you have a list of questions ready to ask your doctor. "A list gives the idea that you are not being casual," Ryan says. Remember, you're dealing with a physician you think is inattentive. A list of questions makes it harder to dismiss them.

3) Don't make your doctor the enemy. Your approach should be to salvage trust. Not an easy task when you're angry or in pain but try, regardless. Speak to your doctor about working together, even getting along. But be realistic. "Don't expect a best friend or the ultimate healer," Ryan says. What you want is a committed partnership.

4) Don't be blindly obedient to your doctor either. Express displeasure when your care seems below standard or your treatment disagrees with you. If your doctor isn't responding, Ryan says most hospitals have patient-advocacy programs that you can turn to for a new ally.

5) Last resort, make the switch. "A gruff manner is one thing," Ryan says. "But if your doctor isn't listening to you, if you have a real sense that something is wrong then it might be time to look for a new doctor." Red flags that should make you question: 1, a sense of incompetence, and 2, a lack of clear, available information.

Easing back into my routine feels so good, especially after the pain of surgery.

Have you ever felt neglected by a doctor? What did you do to get more attentive care?
Monday, April 23, 2007
Thumbing your way to arthritis
13-year-old Morgan Pozgar wins the texting championship
A 13-year-old girl won the National Texting Championship over the weekend. Morgan Pozgar from Claysburg, Pennsylvania, beat hundreds of other competitors of all ages by texting this phrase in 42 seconds:

"Supercalifragilisticexpialidocios! Even though the sound of it is something quite atrocious. If you say it loud enough you'll always sound precocious."

Even though my fingers ached just thinking about it, I did try texting the phrase on my alphanumeric keypad. I gave up after two minutes. I would have easily lost to Morgan who thumbed her way to victory and $25,000. (Full Story)

As Morgan rejoices in her keypad domination, I realize I'm beginning to pay a higher price for all those years of clicking away - first on Atari, then Nintendo, Sega, remote controls, and most recently my best friend, the Blackberry.

It's unofficially called Blackberry thumb. It's an ache and pain, sometimes throbbing in your thumbs. Officially, the diagnosis is tendonitis or inflammation of the tendons. The thumb, with one fewer joint than the rest of the fingers, is more sensitive to stress than the four other jointed fingers. Just as carpal tunnel syndrome sidelined keyboard users and forced some of them into braces, thousands of Blackberry and PDA users are showing up in orthopedists' offices around the country.

So why is it that Morgan isn't feeling the pressure, and my weary digits are feeling the pinch? Young people are at lower risk because their joints are still filled with fluid. Dr. Keith Raskin of New York University says that the elderly or people with a history of arthritis or tendonitis are at higher risk for Blackberry thumb.

Although I'm far from qualifying as elderly, I asked for a few tips on avoiding the ailment. Raskin suggests typing with the wrists in a neutral position with the thumbs resting freely without stress. He also says there is good news: "If patients reduce the workload, the symptoms will resolve."

So between videogames, texting and "Blackberrying," is this next generation facing a lifetime of Blackberry thumb? Do you text as a regular way to communicate? Why text over calling? Have you had any texting-related ailments? Is it changing the way we interact--for better or worse?
Get a behind-the-scenes look at the latest stories from CNN's chief medical correspondent, Dr. Sanjay Gupta, and the CNN Medical Unit producers. They'll share news and views on health and medical trends -- info that will help you take better care of yourself and the people you love.
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