Thursday, May 31, 2007
TB: bigger questions raised
As I have been covering the story of tuberculosis, specifically XDR - TB, several things have occurred to me. So, I thought I would just muse for a few lines and get a sense of what you are thinking as well.
I think, after looking at the science and talking to most people involved, the likelihood of anyone getting infected is incredibly small. Even the TB patient's wife, who was just on a honeymoon with him, has tested negative so far. That's the good news. The bad news is that a lot of people on those flights have been incredibly confused, and a little angry. I spoke to a few of them this morning.
First off, they were first contacted by CNN, not the Centers for Disease Control and Prevention - even though they had sat in the same exact row as the infected man. They were tested after seeing news reports on television. One man was immediately placed into a temporary quarantine and asked to wear a mask at his local hospital. The doctors had no idea how to deal with this problem. Many others who were not in the nearby two rows were told to get tested only if they were concerned. Well, what does that mean? Shouldn't everyone be concerned?
Now, the latest CDC advisory simply says everyone who flew on those planes should get tested. That's the confusing part. The anger part: the passengers seemed to think that this infected man was not malicious or out to hurt anyone in particular, but that he was selfish and unnecessarily put many people at risk and created anxiety and worry.
More than anything, I think this one case reflects deeper failings in our public health system. What if there were ten cases, instead of just the one? What if it were smallpox or a bioterrorism attack? Are we ready?
Wednesday, May 30, 2007
The story of the patient with XDR-TB - an "extensively drug-resistant tuberculosis" that's rarely seen - is unfolding much like a mystery novel in reverse. It seems we have the end. Patient has XDR-TB and is under a federal quarantine order.
But who is he? Why does he have an armed guard outside is hospital room? Why did he leave in the first place, when health officials told him not to travel? (According to the Atlanta Journal Constitution, he left because he was getting married and health officials knew his plans to leave and could not forbid his leaving.)
Public health officials aren't releasing his name because it would violate his personal privacy and because he's complying now. Some may argue that the information should be released to notify people who may have come in contact with him. Public health officials tell us this is a dilemma they face all the time. And in this case - because he is not very contagious - the risk of infection for anyone who came in contact with him is very low.
So there are lots of questions that many reporters including ours are trying to answer.
Do you think he should have left the country even though health officials told him not to? When do you think public health overrides personal privacy issues?
Tuesday, May 29, 2007
Heeding contact solution warnings
We covered a story this morning that provides an interesting look into the psychology of the average consumer. The story is about contact lens solution and the fact that a certain brand is linked to a devastating eye infection. The solution is called Complete MoisturePlus and is made by Advanced Medical Optics. The concern is that users of this solution have seven times the risk of getting the infection, caused by acanthamoeba, a parasite. Ick. This parasite is found in fresh water and salt water, and as it turns out, can even get into contact lens solution.
Admittedly, the numbers are very, very small. There were 39 cases of this infection (out of more than 30 million contact lens users in the United States) and 21 of those people used this solution. You literally have a 1 in a million chance of contracting the infection, which is slightly higher if you use this product. According to the CDC, improper storage, handling and disinfection of contact lenses, as well as swimming or showering while wearing contact lenses contribute to these kinds of infections.
If you do get the infection, you could go blind. In fact, nine of those 39 will require a corneal transplant with no guarantee of their vision returning.
So, what do you do? Obviously, the recommendation is to throw away the solution, the contact lenses and the carrying case. That costs money and aggravation. Do you think the average consumer goes through the steps to ensure that they aren't the one in a million or do they ignore the warnings - confident that it won't happen to them? What would you do?
Friday, May 25, 2007
MIA in plain sight
The other morning, I saw my father's face on the train. Dad died 11 years ago, but I came across a man who could have been my father had fate dealt Dad a different hand.
The first thing I noticed about the man on the train was that he was he appeared to be a Vietnam Veteran, and proud of his service. On the back of his dirty jean jacket was a huge Marine Corps patch and other military patches. One that particularly caught my eye said: "In Memory of the 58,000 brothers who never returned from Vietnam 1962-1975."
My dad was an Army Green Beret and returned from his three combat tours in Vietnam with a couple of bronze stars and dozens of memories he never talked about.
This thin little man on the train was about my dad's age, with long hair, a scraggly beard. He was carrying on a conversation with himself and swatting at an imaginary fly. When there was a lull in his conversation, I caught his eye and said hello. He mumbled back, but didn't look at me. He got off the train at the next stop.
It's not the first time I've run across a Vietnam vet on the street who looks as if he's down on his luck. But it's just a reminder this Memorial Day to remember not only those who have died serving our country, but also those who survived.
2.7 million Americans served in Vietnam. Many veterans were attacked personally by their fellow Americans who opposed the war. I remember my dad talking about being spat upon when he was in uniform. Combine that national rejection with horrific combat experiences, and many Vietnam Veterans still have mental health issues and they may never get the help they need.
An estimated 400,000 veterans are homeless at some time during the year. Most of those homeless veterans have some kind of mental health or substance abuse problem, according to the National Coalition for Homeless Veterans; one of every three homeless men who is sleeping in a doorway, alley or box in our cities and rural communities has at one time put on a uniform and served this country.
According to a Department of Veterans Affairs study released in March, nearly a third of U.S. soldiers returning from Iraq and Afghanistan are being found to have at least one mental health problem.
Will they too, become Missing in Action right in front of us?
Fit Buddies update
Editor's Note: When posting replies, please include your name, city and state.
The CNN Fit Buddies have made it through Week 5 of our weight-loss and fitness challenge. Here's an update on their efforts to eat better and exercise more. Read about their successes and frustrations every Friday here on the Paging Dr. Gupta blog.
"Look directly at a fixed point on the wall, and breathe deeply," said the hypnotist. What was I doing here, I thought? The answer: trying to lose weight! I think I was in middle school at the time - struggling with my weight of course - and my mom found this hypnotist who claimed he could help you lose weight.
He asked me to picture something in my mind that scared me about being overweight. The first image that came to mind: me in the operating room getting heart surgery! If anything was going to get me to lose weight, it would be that image, or so he told me.
Ten years later, I'm still struggling, but the thought of my own mortality has not escaped me. I was excited to find out about the study that is the basis for our Fit Nation Challenge. It showed that for each hour of exercise you do, you could add two hours to your life later on. I prefer to use this positive reinforcement to get motivated, and really, with Robert's guidance and constant reflection on everything I eat, I feel like I'm finally starting to make a dent in my weight problem.
The producer in me is excited to tell you that we surpassed our goal in the Fit Nation Challenge last weekend! 1 million hours added to the lives of Americans in just over a month!
We could never have expected such a huge commitment from you all, and I think it really shows that America, too, is ready to take on its weight problem. Keep pledging and let’s get to 2 million!
Ed Lavandera, CNN Correspondent
"You've got to shock the body every time you work out!"
That was one of the most important lessons I learned the first time I worked out with Robert back in April. I've always kept those words in the back of my mind as a reminder to always freshen up and intensify my workouts. But every once in a while you need a good system shock. That's what I experienced last week in my second workout with Robert.
We changed up all the weight exercises I was doing (still working the back, chest, shoulder, biceps and triceps muscle groups.) And instead of resting between each weight set, I added a minute of cardio exercise. I ran in place, jumped over a line on the ground and did mountain climbers. My body couldn't figure out what was going on. And my legs and upper body were burning.
Now I feel like I'm back at Stage One starting a brand new exercise routine for the first time.
That's just the way Robert says the weight will burn off. His version of "shock and awe."
Stacia Deshishku, Director of Coverage CNNUS
Yes! I'm doing it! I'm getting there! I had my mid-term assessment yesterday. Though I have only lost 7 pounds, I have lost tons of inches. 4.5 inches in my thigh. 4.5 inches in my hips. 3 inches in my waist.. it goes on and on! My body fat is also down 6 percent, and my resting heart rate dropped 24 beats per minute. My 10 push-ups jumped to 25. I'm actually running. OK, not long, but I AM running!
I'm stronger, leaner and have a LOT more energy than I ever thought possible. This is what I wanted -- to be fit enough to chase down my boys! And I'm getting there. Imagine where I will be in another 6 weeks? We are spending a week at the beach this summer and I can't wait to get active with the kids.
This "win" has me more energized than ever. I'm ready to step up my workouts. I have realized that the greatest weight resistance training I can do is using my own body weight! Whether it is push-ups, sit-ups, planks, walking, running -- none of them require a gym or a weight -- just me and my determination and tenacity. What a gift I can continue to give myself -- for free!
Robert Dothard, Fitness Trainer
I think the major areas of a training program are: client assessment, the exercise and lifestyle prescription, re-assessment, and the changing of the program to address areas of concern.
Now that we have passed the half-way mark, Ed, Stacia, and Matt's assessments came as both a celebration, and a "wake-up" call. To me, it is always an opportunity to help them and to help YOU build a healthy lifestyle for you and YOUR FAMILY!
When you join the "Fit Nation" or any program to improve your health, one of two things will happen: You will either have success, or you will have failure...either way YOU WIN!
Allow me to explain.
You have faced many challenges, from school to personal finance, but with ALL of the "issues" we've had in these categories, two things are constant: Some sort of "assessment" has to be done, and then a NEW ACTION needs to be taken. So, just as better study habits help the student, and proper money management helps produce a sound financial future, exercise and proper nutrition WILL improve your health! If you have taken action as part of Fit Nation, I celebrate with you today, and if you have only thought about it, I challenge you to start today! Move more and eat less, as the first step to a journey that will change YOUR life, and change (for the better) the health of your FAMILY.
Good Luck, and good health.
Thursday, May 24, 2007
Do doctors disclose mistakes?
Something that caught my eye this morning was a story about whether doctors report medical errors. It was a fascinating survey, published in the Journal of General Internal Medicine, of doctors regarding disclosure of mistakes. There were lots of different numbers, but allow me to summarize by saying that around 20 percent acknowledged that they had not disclosed a minor error and around 5 percent acknowledged not disclosing a major error. Keep in mind, this was just a survey of doctors, not a study of actual medical errors.
The article also prefaced the results by saying that physicians inherently think it's important to disclose medical errors, yet many do not do so when it comes to their own mistakes. As we sat and talked about this in the newsroom, it seemed everyone had an opinion. Many non-physicians think doctors are all part of an "exclusive club" where they take care of one another and block disclosure of mistakes. Others pointed out that we live in a very litigious society, where doctors are running scared and fearful of lawsuits. Many thought doctors would never disclose an error and believe they often withhold information from patients.
I was a little surprised at all the conjecture. Still, it taps into some important attitudes toward doctors and perhaps the trust of the medical establishment in general. What do you think? If your doctor made a mistake, do you think he or she would tell you?
Wednesday, May 23, 2007
Kids taking cues from You Tube?
This morning we watched a video on You Tube that boggled my mind, and it turns out the minds of many others as well. Startling video of kids donning lacrosse and hockey helmets who proceeded to beat on each other until somebody went down. We came to find out that the goal was unconsciousness and the prize was bragging rights on You Tube.
At first blush, it may seem like children just goofing around, but it is much more serious than that. The brain, which is like a fluid medium, literally moves around in the skull from side to side possibly causing injuries and swelling (Watch animation). In addition, you can have shearing of tiny blood vessels deep in the brain which can be catastrophic. It is true that kids are resilient, more so than adults but it is during these formative years that the brain is that much more susceptible to injuries.
We also know more about head injuries than ever before. For example, while a concussion is bad, a second concussion is exponentially worse. We also know that a helmet can be protective, but it is the rotational injuries, where the head actually moves around, that can cause someone to lose consciousness. Also, in the long term - headaches, memory problems, dizziness, concentration problems and equilibrium problems could be a problem.
As a parent, I am constantly worrying about my kids and these videos just add to my concern. I know there are lots of extreme sports out there. What else have you seen and how do we protect our kids?
Tuesday, May 22, 2007
Giving in to sin
Ever wonder what makes you more likely to give into temptation? What makes you eat sweets on your diet, or break that promise to yourself not to gossip? Researchers at Duke University, the University of Southern California and the University of Pennsylvania have been looking at the power of suggestion, and how having mixed feelings on a subject (i.e., wanting to do something but knowing you shouldn't) affects your ability to resist giving in. What they found is that simply being asked questions about something that tempts you can significantly increase the chances you will give in to it.
For example, the researchers looked at two groups of college students. The first group was asked how often the students intended to skip class the next week. The control group was asked how often they intended to floss. At the end of the week, students from the first group had an average of one more absence from class compared with the second group. Slackers.
The researchers theorize in next month's Journal of Consumer Research that seemingly harmless questions about intention can be more powerful than we imagine, and that these kinds of queries lower our guard and make us feel freer about giving into our desires. That could explain how some TV ads are more effective than others, and probably how some people are more likely to get you to do what you know you shouldn't.
Fortunately, the researchers also noticed that thinking about how to avoid temptation ahead of time, and deciding on a reward for sticking to your guns does help thwart the power of temptation.
What is your personal vice, and how do you avoid the temptation to indulge? Have you noticed that being asked about it makes you more likely to think about it and thus makes it harder to resist? Have you found that self-rewards and other pre-meditated plans help? If not, what does?
Monday, May 21, 2007
Red meat risks
That's how David Nelson described the scene at the 18th annual World Championship Steak Cook-Off last weekend.
I closed my eyes and tried to imagine the mouth-watering taste and smell of more than 4,000 steaks grilling in Magnolia, Arkansas. My stomach growled just thinking about it. The winning chef, Lance Woolridge, beat 52 other competitors for the top prize of $2,500 and the championship cup. Wooldridge's secret is keeping it simple: a little bit of salt and pepper and don't burn it.
I am an unabashed red meat lover. For the last ten years or so, I've been a pariah for it. Even at my liberal arts college years ago, the vegetarian and pescetarian majority would moan and groan about brisket or burger night. They scowled at me, I smiled and sang my meat song. I still eat my steaks loud and proud, but there may be good reason that I'm in the minority.
While beef can be a good source of protein, zinc, vitamin B-12, iron, magnesium, selenium and phosphorus, it is terribly high in saturated fat and cholesterol. Consider these numbers from the Harvard School of Public Health:
- A 6-ounce Porterhouse steak can give you 38 grams of complete protein, but also 44 grams of fat and 16 of them the bad, saturated kind
- 6 ounces of salmon gives you 34 grams of protein and 18 grams of fat, and only 4 of them bad, saturated fat.
- 1 cup of cooked lentils has 18 grams of protein, but less than 1 gram of fat.
Aside from high fat and cholesterol, eating a lot of red meat has also been associated with heart disease, type 2 diabetes, and higher risks of breast, stomach and colorectal cancers. According to USDA statistics, it seems as if the public has responded to all this bad press. The average per capita beef consumption was highest from 1970 to 1975 at 85 pounds annually. In 1980-85 it was 78 pounds per person. These days, the per capita average is less than 64 pounds annually.
There is a growing body of evidence that suggests how you cook your red meat can contribute to increased risks for cancer. A carcinogen called polycyclic aromatic hydrocarbons is found in grilled, barbecued and smoked meat (as well as many other foods). And another carcinogen called heterocyclic amines is produced by cooking meat at high temperatures - like pan frying and grilling. Interestingly, chicken and fish cooked in the same way do not have as high a level of carcinogens.
But the question remains is it actually red meat or grilling itself that is the cause of higher disease rates or is eating red meat just emblematic of poorer habits in general? Those same studies have found that people who eat red meat are more likely to smoke and eat fewer vegetables and fruits.
How much steak or red meat do you eat? Do you think eating red meat is unhealthy? Why or why not? Do you avoid red meat? Do you think grilling raises your cancer risk? Do you stick to the recommended portion of 3 ounces or roughly the size of a deck of cards? Do you think vegetarianism is healthier?
Friday, May 18, 2007
Fit Buddies update
Editors Note: When posting replies, please include your name, city and state.
The CNN Fit Buddies have made it through Week 5 of our weight-loss and fitness challenge. Here's an update on their efforts to eat better and exercise more. Read about their successes and frustrations every Friday here on the Paging Dr. Gupta blog.
If you're like me walking into a gym triggers a daunting, overwhelming feeling of confusion. Which machine do I use? Which weight exercise is the best? Am I using the right technique? Most personal trainers I talked to in the past didn't help untangle the confusion.
But I have developed a weight routine with our trainer, Robert Dothard, that is delivering inspiring results for me.
How you work out matters. Robert has taught me several interesting strategies to making my weight workout effective:
-- Work the biggest muscle groups and work down to smaller muscles. That means hit your back then chest, then shoulders, then triceps ad biceps and abdominal muscles.
-- Do your cardio routine AFTER you work with weights.
This routine is incredibly effective for those of you like me who have hectic, crazy lives and limited time to work out. I can do that weight routine and hit all those upper body muscle groups in 30 minutes.
I could not have imagined such a focused and effective routine when I walked into the gym with Robert a month ago.
The hard work is paying off I've lost 25 pounds so far.
Stacia Deshishku, CNN Domestic director of coverage:
What a week. I've been sick as a dog, but not able to really take a day off. I finally relented yesterday and visited the doctor. Ear infection! Oh was that what was causing that ringing?
My hellacious cold has sunk my energy to a subterranean level. Subsequently I made only one workout this week. I have felt so guilty and so I have been fighting that nagging negativism that lurks in the back of my mind sometimes. "What if I don't ever go back to the gym?"
The truth be told, Monday is going to be hard. I'm dreading it as much as I am looking forward to it because this is one of those things that has gotten me off track in the past. Stopping the workouts, if only for a week, more often than not turned into two weeks, then three, then...no more gym.
This time the challenge is mental. I need to stop feeling so anxious about Monday's struggle and start looking forward to the chance to get back on track. I got some help today during the lunch I had with Eddie, Matt and Robert. They pumped me up and reinvigorated my challenge.
It made me realize the best part of this experience hasn't been the weight loss - it's been the bonding and camaraderie of the challenge alongside friends.
Matt Sloane, Medical producer:
You've been keeping up with my progress all along, so you know there are a few times I've slipped up (most notably, New Orleans). Overall though, I thought I was doing ok -- better than I ever had in previous attempts at losing weight. So last week, I decided to go weigh in - the first time since we started the program. I had lost 25 pounds!! Could it be that even with all of that falling off the wagon that I had actually lost 25 pounds?
Unfortunately, it was too good to be true. After gloating in my success for about a week, a sneaking suspicion last night led me to try a few more scales, and much to my dismay, the number was MUCH smaller. As it turns out, I've lost about 6 pounds. Still a good start, but not even close to the great success I thought I'd had. For the record - I REALLY don't like scales!!
Regardless of the number, it's inspiration to keep going. I know now for sure that slip-ups do count and that missing workouts will have an effect on my success. Either way, I'm proud of my progress. Without a doubt, I've been making better food choices across the board, I know that I am capable of running and I'm finally of the mentality that a grueling workout is the best kind!
Robert Dothard, Fitness expert:
My job is like most: If you give your clients "positive" results, you are able to keep them as clients, in most cases.
Stacia, Matt, and Ed have all celebrated victories in the last few weeks, but ALL of their programs MUST change or the results could stop!
Many people who get great initial results with an exercise program will do a couple of things to kill their program. They will celebrate too much (bad eating, or start to skip workouts), or they continue to expect the same results.
The key is: take DIFFERENT action! I have encouraged all three of training "studs" to do the same thing once the positive results started - First CELEBRATE, then get back to work with a renewed focus, and a "Stacia" type of BRING IT ON attitude!
Ed's in Atlanta this week to get his program updated (I may have to up my liability insurance, because of what I have planned for him), and I have scheduled time to meet with Matt and Stacia's trainers as well.
The real news here is.. YOU can do it too! If you have been with us from the start, I hope this week finds you celebrating YOUR results; or if you are new to the "Fit Nation", don't worry. Just as Stacia, Matt and Ed have learned over the past few weeks, results are only going to start, when YOU do! Good luck and good health.
Washing off the E. Coli not so easy
As part of my investigation of food safety for this weekend's special, I really wanted to look into this whole idea of "triple washing" spinach. What does that really mean and is it effective? In order to best investigate this, we decided to do our own independent scientific testing. We actually took some E. coli 0157:h7 (the bad stuff) and placed it on a few spinach leaves.
Now, keep in mind, it takes only about 100 organisms to make you sick, even fewer if you're young, old or already ill. We took carefully measured samples of spinach leaves, "inoculated" them with E. coli 0157 and then tried to wash off the dangerous bacteria. Not washing the spinach at all left around 12,000 bacterial colonies, which could include as many as 24,000 microorganisms. (Watch: We test different washing techniques against E. Coli)
Now, with tap water, which is what most people probably use, the number of organisms was reduced to about 3,700. A vigorous wash with tap water left 2,900.
The commercial wash left around 6,000 organisms, even worse than tap water alone.
Chlorine plus the commercial wash left around 2,300.
But remember, any of these amounts will make you sick.
So, clearly washing the produce alone at home isn't enough, and the commercial washes during the packaging don't seem to be adequate either. In my CNN Special Investigations Unit Danger: Poisoned Food hour this weekend (8 p.m. and 11 p.m. ET Saturday and Sunday), you will see that we came up some other alternatives. But, I am eager to hear what you do to clean your fruits and vegetables. What do you think would work to make our produce safer?
Editor's Note: Please include your name, city and state when responding.
Thursday, May 17, 2007
A face behind the spinach scare
By Dr. Sanjay Gupta
Chief Medical Correspondent
Over the past several months, we have been working on a one-hour special about food safety. I have to say, it has been one of the most eye-opening stories on which I have worked. As a general rule, when we go to the grocery story, we have a simple expectation. We expect what we purchase will be safe to eat, especially when it comes to healthy foods like spinach. As most everyone knows, that is not always the case. Over the last decade, there have been 22 major outbreaks of E.coli 0157:h7 in produce, and the most recent one in spinach last October killed at least three people and made more than 200 very sick.
If you're like most people, these numbers may not mean a whole lot to you. As a journalist, though, I thought it was important to introduce you to just one of the faces behind those numbers. Ashley Armstrong is from Indiana. Just 2 years old, she was cute, spunky and in constant motion. Always running around the house, sometimes giggling at the top of her lungs, she reminded me of my own daughter. On a fall day, she, her adorable sister and two parents sat down to a healthy dinner, including a spinach salad. Within a week, three members of the family became sick. Soon, it became clear that Ashley had been hit the hardest. For a long time, her parents thought the illness would just pass. It didn't and Ashley was soon diagnosed with kidney failure and brain swelling. Doctors were trying everything possible to save their life. It took a while, but they figured out that she had been infected with E.coli 0157:h7 and its deadly toxin was systematically shutting down her body. I remember her father looking at me misty-eyed and saying, "Fathers are supposed to protect their daughters... in this case, there was nothing I could do." The culprit was a green, leafy piece of spinach.
I took Ashley's story with me when I was given unfettered access to the chiefs at the FDA. They sat down with me and told me that, for the most part, food is safe in this country. Fair enough, but what about Ashley? Was the food any safer this year as compared to last? They really couldn't say for sure and beyond that, they told me something even more alarming: They weren't even sure exactly how to make the produce any safer. One FDA chief just called it bad luck.
What do you think? Do you believe it is just bad luck and that we should accept a few deaths and illnesses every year from our food? Or, do we as a society say this is important-- I don't ever want to worry about the safety of my food and we should do whatever it takes to see to that?
For the rest of Ashley's story and an exclusive look at food safety from farm to fork, watch "Danger: Poisoned Food" this Saturday and Sunday at 8 p.m. and 11 p.m. ET.
Wednesday, May 16, 2007
Are women responsible for obesity among children?
Women have been blamed for many of the world's problems since Eve in the Garden of Eden. But when I heard women were being blamed for childhood obesity, I was more than skeptical. The theory is that when American women started to enter the workforce en masse in the 1970s and '80s, kids started getting fatter. (Watch video)
Lew Fuller of the Obesity Society, a scientific society that studies the topic, says it's not that women shouldn't go to work, it just means that when women did go to work there was no one home to make balanced meals and make sure the kids got out and exercised.
Some of the working mothers we talked to acknowledged that their haste can make make for bigger waists. They said they were often too tired after working all day to make a meal for their kids and ended up picking up fast food. According to the Robert Wood Johnson Foundation, when children and teens eat fast food, they consume more calories, fat, carbohydrates, sugars and sugary beverages.
Does that mean that Mom is to blame for the 16 percent of American children that are overweight? (That's three times the number of kids that were overweight in 1980.)
Not so fast, according to Kathryn Thomas of the Robert Wood Johnson Foundation. "At it's very simplest, our kids are taking in a lot more calories than they are burning off. There are a lot of reasons for that. It's not just because they aren't eating as many dinners at home," she says. Thomas recommends all members of American families take a close look at their eating and exercise habits. "We need to get physical education back into schools. We need to get the junk food out of schools. We need to make communities safer for kids to walk and bike and play," says Thomas.
So weight management begins in the home, with Mom and Dad. But it continues at school and in the community. And instead of pointing fingers at working Moms, maybe we should be looking in the mirror. What do you think?
For more on this and other diet and fitness information, check out Dr. Sanjay Gupta's Fit Nation segment every Friday on "American Morning." Also, sign up for the Fit Nation Challenge - click here for details.
Tuesday, May 15, 2007
Bono takes on the world's toughest issues
Most of his attention is now focused not so much on fronting U2, but rather fronting another organization he started called DATA -- Debt, Aids, Trade and Africa. In some ways, it is a watchdog organization to hold leaders of the G8, the world's leading industrialized nations, accountable for the promises regarding Africa.
As Bono told me, it really is a case of good news and bad news. Here are a couple of examples. In 2002, only 1 percent of the people in sub-Saharan Africa who needed lifesaving AIDS medications received them; today the number is closer 28 percent. Also, for the first time, debt relief and cancellation are starting to occur and as a result more money and resources can be dedicated to the very poor. Bono likes to focus on the good stories because they remind us that some of these problems are fixable and also in the vital interest of our nation.
To be fair, the United States is doing more than ever before. The President's Emergency Plan for AIDS Relief, which is supposed to be $15 billion over five years, is the largest commitment, if the dollars all come through. There have also been private endeavors including the Red campaign, which raises money through the sale of red merchandise and which Bono says has produced $25 million in the last quarter for the Global Fund. It is directly helping organizations buy more pills for the sick.
During the interview, Bono was very candid. He said it was hard to fly around on private jets to attend lavish parties and also watch someone die for lack of two pills. He reminded us that "we don't have to ask God for a blessing, but rather just go where the poor and misfortunate are, because God is already there."
I also asked him about Bono fatigue. "I am Bono," he replied "and I'm sick of Bono." Truth is, though, a lot of people aren't. They listen to him because he is passionate, because he has the ear of presidential candidates and prime ministers and well, because he is a rock star. Does Bono's message resonate with you and does he make a difference?
Editors Note: Download the "Paging Dr. Gupta" podcast each week at CNN.com/Health or on iTunes.
Please include your name, city and state when responding to blog postings.
Monday, May 14, 2007
Cultural barriers to mental health
About this time a month ago, I was rushing to catch a plane to Roanoke, Virginia. Just an hour before, sitting in the CNN newsroom and pecking away on the keyboard, I heard a collective gasp. 20 dead at Virginia Tech. Next thing I knew, my colleague Elizabeth Cohen and I were driving through the breathtaking Blue Ridge Mountains, toward one of the most heartbreaking stories we had ever covered.
That sadness came back during a visit to Houston last week. Elizabeth and I were working on a story about Asian-Americans and mental health. Plans were already in the works to investigate this topic when Virginia Tech happened. Elizabeth and I learned a lot about the cultural barriers surrounding simply talking about mental health. For example, in many Asian languages, there is no word for "depression." According to researchers, Doctors Albert Yeung and Raymond Kam, the term "mental disorder" is frequently translated in Chinese as jing shen bing which in the mind of most Chinese means "craziness." You can find out more about what we learned Wednesday night on "Paula Zahn Now."
But here's a little bit of what you won't hear. Consider it the "producer's cut." After the interviews were over, Stu, our photographer, and I went to shoot additional material at a Korean-American senior center. Sitting around long tables, about 60 seniors were watching a PowerPoint presentation. Even though the conversation was in Korean, the topic was obvious. Images of brains and sad looking people filled the screen. They were talking about depression.
As Stu took pictures, a very sweet woman offered us a handmade gift of jongie jupgi, Korean origami. She had folded paper in the shape of a swan. They were absolutely mesmerizing. Pictures shot and birds in hand, we started to leave. But before we could, the president of the group said he wanted to make a statement. Speaking on behalf of the senior center, he wanted to extend deepest condolences to the victims of the Virginia Tech massacre and announce that his group had raised money for the victims' families. This distinguished and proud man worried the actions of Seung-Hui Cho reflected badly on all Koreans. The real issue, he went on to say, was the lack of mental health services and gun control.
Walking out of the center, I was struck by what we had just witnessed, and as the days pass, I am still thinking about it. As a white woman, no one would ever expect me to defend my sex or race for the violent actions of someone like Jeffery Dahmer or Aileen Wuornos. But from terror to terrorists, minority communities are often expected to apologize when someone of the same race or group commits a heinous crime. Why do you think this is? Also, I know it's only been a month since the Virginia Tech tragedy, but do you think the country is any closer to investing more in mental health services and research?
Friday, May 11, 2007
Fit Buddies update
Editors Note: When posting replies, please include your name, city and state.
The CNN Fit Buddies have made it through Week 4 of our weight-loss and fitness challenge. Here's an update on their efforts to eat better and exercise more. Read about their successes and frustrations every Friday here on the Paging Dr. Gupta blog.
I keep the big-picture goal in the back of my mind but I've attached a prize to it. I've always dreamed of seeing U2 perform in Ireland. So when I reach my goal, I hope to celebrate with a special trip.
But what I think about most often are short-term goals. In a month, my sister is getting married and she's asked me to walk her down the aisle. So now when I don't want to lift weights or go on a bike ride or eat the right food, I remind myself that a tuxedo is waiting for me and I want to look the best I can for her special day. After the wedding, I'll be looking for my next short-term reward.
But now that I have become acutely aware of my food intake, I feel like I've had an epiphany. Stop the madness - reduce the portions. Now! In self-defense, I've begun ordering my food and a to-go box - simultaneously. I immediately pack up half of the meal. No more lingering dinners that end in a clean plate with very little memory of what all I ate. I am now going to make two or three meals out of one! I'll save money AND unnecessary calories.
Now comes another big test: my girlfriend's graduation. Family is coming into town, parties are planned, and then we're heading out on a family vacation, so these are certainly going to be challenges to my new-found glory. But after working as hard as I have this week at my own personal Fit Nation challenge, I see no reason to mess it up now.
One other thing has really helped me this week: The Nintendo Wii! What I love about this system is it's not your typical "sit on the couch and play" device. I was up, moving around, swinging the remote as if I were playing baseball - not as good for me as playing these sports in real life, but I definitely broke a sweat!
It did not take long for "life" to happen with missed workouts and food logs better suited for a Jay Leno monologue. Can you say "New Orleans?"
Now, we have hit our stride, and the workouts and the nutrition are in a "zone."
Matt is back in town and kicking some butt! Sure, he is using terms like "holy hell" to describe his workouts, but I can already see a change in his physique!
Ed continues to be the "absolute STUD" when it comes to consistency. He has been doing live shots in knee-deep water for CNN all week, but much to everyone's surprise, he found a way to get his workouts in, and to eat healthily on the road.
Last but certainly not least, Stacia AND her husband have become regulars at my training studio. Stacia has also done a computerized nutritional program to turn up the "heat" on Matt and Ed. If you want to give yourself winning odds in a fitness program, bring your family along!
But as all of us who are married know, even when things are going well in a relationship, it still requires work - so until next week, best of luck, and best of health.
Thursday, May 10, 2007
For Mother's Day, focus on the heart
The best gift you can give to your mother this Mother's Day is a heart-to-heart, about well... her heart. It's a fact. Heart disease is the biggest killer of men, and women. Heart disease kills far more women than breast cancer, and yet few people, even doctors, know that. This month, take time to make sure your mom is getting her heart checked out. Today is my mom's birthday and I called her first thing to remind her.
Here are some things to specifically look for: Besides an accurate blood pressure reading, which she should remember for future comparisons, she should get blood tests, including cholesterol and triglycerides. An EKG, or electrocardiogram, which checks the heart's electrical activity, is also a good start. If she has ever had any symptoms, she may need a stress test or another heart study to determine whether she has any calcifications or blockages.
Speaking of symptoms, women don't always have the classic Hollywood heart attack, where one hand comes up to the chest - think Fred Sanford in "Sanford and Son" (Yes, I am dating myself.) Instead, a heart problem may just first look like unusual tiredness, pain in the stomach, arms and neck or just shortness of breath. The biggest defense it to make sure you are thinking about it, along with Mom. I have heard countless stories where a woman, thinking it was indigestion or fatigue, ignored symptoms that turned into a devastating heart attack.
Next Monday, Laura Bush is giving me an exclusive interview about issues related to women's health. She has made this part of her wide platform as first lady, including the national "Red Dress" campaign, which serves as a visual reminder that this disease robs us of half a million sisters, daughters and yes, mothers - every single year.
After six years in my job, I am always surprised that we are still telling people about this relationship between heart disease and women. Is it not as sexy to talk about as other health care conditions? Does women's heart disease need stronger and louder advocates? There are doctors who believe we can eliminate heart disease in women with what we already know, but the first step is getting women checked out. How do we get there? Also, any questions you would like me to ask Laura Bush next week?
Wednesday, May 09, 2007
Clinton gets people to care about AIDS
Over the past several years, Bill Clinton has been crafting his post-presidency initiatives. I always thought that would be an amazing thing to think about. After retiring as "leader of the free world," you get to set your sights on just about anything, presumably things that fascinated you most as president, and areas where you feel you can make a difference. He chose two health-care related areas for much of his focus - AIDS and childhood obesity. He told me he chose obesity because of his own struggles with weight, especially as a child. Also, because the obesity epidemic threatens, for the first time ever, to turn back our steadily progressing life span. Stunning.
Yesterday, the former president gave me an exclusive interview to talk about AIDS and a sprinkle of current presidential politics. The success of the foundation has been pretty concrete, by just about anyone's standards. In a day where AIDS achievements are measured by advocacy groups with the loudest voice, the Clinton Foundation has been instead busy negotiating lower drug prices. Thanks in large part to its efforts, those prices are now less than a dollar a day, admittedly still expensive in an area of the world where the per capita income on averages around $800 a year, but still cheaper than ever. Also, the pills are a once daily, very effective medication that offers the real possibility of a normal length of life. President Clinton seemed genuinely pleased with the achievement and was already planning trips back to Africa this summer.
As far as presidential politics go though, the success of Hillary Clinton could truly be a case of good news/bad news for the Clinton foundation. Certainly, as "first gentleman," the former president would be in a position to do many of the things Mrs. Clinton worked on as first lady. Still, it would to some extent take him away from what he has called his life's work, AIDS.
One thing former President Clinton has done is he has kept AIDS squarely in the public eye. Even at a time when our attention has been focused on a million other things, his steady voice still reminds us that HIV/AIDS remains one of the biggest killers in the world. Still, even he has a hard time getting people in the United States to care.
If you had a few minutes with Bill Clinton, what strategies would you offer him to get and keep people engaged on the issue of AIDS?
Tuesday, May 08, 2007
TV time hurting your kids?
As a television news correspondent, I am always struck by how many stories I report about people watching too much television. No, I am not trying to put myself out of a job, but now that I have children, these stories do always catch my attention. The age old question, "How much is too much?" will probably not be answered anytime soon, but the American Academy of Pediatrics has just put out one of the largest and longest term studies on the subject.
I will just go ahead and put it out there - I am guilty. My 22-month-old has been known to sit down and watch an entire episode of "Dora the Explorer." I swear it doesn't happen often, but it is the only time I have seen the little girl sit still for more than a few minutes. It is a blissful reprieve for us, even for just a few minutes. The American Academy of Pediatrics says it's a mistake to let children under 2 watch any television. Uh oh. For children older than 2, the recommendation is no more than 1-2 hours a day.
Their recommendations come from a study that followed almost 700 children (and their mothers) for 20 years. On average, it was from age 13 to 33. They found that adolescents who watched more than an hour of television were at elevated risk for poor homework completion, negative attitudes toward school, poor grades and long-term academic failure. They added that those who watched three or more hours were at elevated risk for subsequent attention problems. The problem seems to lie in something known as the orienting reflex. In a nutshell, because TV offers so many different stimuli in a short period, individuals are more likely to maintain focus only for very short periods.
Of course, not everyone is buying all of this. We checked with the Attention Deficit Disorder Association. They reminded us that this study still does not show a conclusive link between television and ADHD, and that around 50 percent of ADHD cases are genetic.
So, what do you think? Do you limit the number of hours of television your child watches? What are those limits? I am off to do another television segment, but looking forward to your reponse.
Monday, May 07, 2007
"Hey,are you ready for your 42-mile bike ride?" asked my friend.
"Oh yeah sure. Bring it on. When is it again?" said my inner bravado.
"This weekend," replied my buddy.
"Oh really. I must have forgotten," is all I could say. My inner bravado quickly shut up and the wheels of excuses started to churn in my head. As my colleagues talked about their training rides, I began to scheme on how I could get out of riding. Maybe I started to feel a tickle in my throat. I could tell them that I was getting sick. Or perhaps I had to work on Sunday. Alas, I couldn't bring myself to outright lie. It was too late. I had to ride. I had to ready my inner bravado for being embarrassed and bruised.
On Sunday, I got up at 6 a.m. to join 30,000 other people for the Five Boro Bike Tour of New York. For 30 years, they've closed down streets and major highways for one day. Bicycles run the course through Manhattan, Bronx, Brooklyn, Queens and Staten Island. Of the thousands of people who ride, 13 percent have not trained and do not ride bikes regularly, race organizers say. I guess I was one of them.
As we lined up, I looked at my friend the marathon runner and my other friend who had done a 30-mile training ride last weekend. Would I hold them back? Would I be the weakest link?
As we rode through the city, I began to see it in a way I've never seen before. I grew up in New York, but riding my bicycle on the highway was an entirely new experience. It was amazing. I distracted myself with the scenery.
Every once in a while, we'd see a wiped out biker surrounded by EMTs on the side of the road. An ambulance would come racing by. It reminded me of the CDC statistics: 700 people die every year in cycling accidents, and half a million Americans are treated for bicycle injuries.
Before I knew it, the ride marshals told us we only had eight miles left. What?!? Really. My backside wasn't hurting. I wasn't out of breath. I was feeling good.
In the end, I made it without embarrassing myself. In fact, I did pretty well. It took us about five hours to finish, but the delays were mainly due to rider congestion.
As a reward, my friends and I treated ourselves to pizza, beer and ribs. I began to calculate as I stuffed my belly. I burned approximately 3,000 calories on the five-hour bike ride including breaks. According to calorielab.com, it ranged from 858 to 390 calories an hour, depending on intensity. I drank two beers, ate two slices of pizza and some baby back ribs for dinner. My reward cost me at least 2,500 calories. It turns out the bike ride was nothing to stress over, but maybe I should spend more time training... and thinking about my diet.
From half-marathons to long bike races, are big exercise events intimidating? What's your favorite form of exercise or training? Do you think group physical events inspire better health? Do you think biking is as good a workout as other forms of exercise? Do you have stories of overextending yourself physically?
Friday, May 04, 2007
Fit Buddies update
As Dr. Sanjay Gupta's 2007 Fit Nation Tour heads to Denver, Colorado, for the weekend, the CNN Fit Buddies are working to improve their eating and workout habits. Here's an update from the third week of the weight-loss and fitness challenge. Read about their successes and pitfalls every Friday here on the Paging Dr. Gupta blog.
CNN correspondent Ed Lavandera:
Bare with me a moment as I crunch some numbers. I've worked in four different cities the last nine days. Take those nine days and multiply by three meals per day and that equals 27 total meals. Eighteen of those 27 meals I've eaten on the road.
I suspect there are a lot of you who live out of a suitcase. This is the biggest challenge for me. I'm getting better at making smart choices when I read through a restaurant menu but it's tough. I don't like sitting in a restaurant on the road for several hours. Often I just want to order the quickest and easiest item on the menu so I can get out of there. This might sound crazy to some of you but ordering the right food requires a lot of "brain energy" for me. More than anything, it's a mental challenge for me. When you're tired, cranky and wrapping up a 15- hour work day taking the extra time to find the healthiest option is a chore.
CNN Domestic director of coverage Stacia Deshishku:
Long before I joined the Fit Buddies bandwagon, I planned a girl's trip to Jazzfest in New Orleans. Therefore, last weekend was a challenge for me to stay on track with my eating and exercise. There is simply no city like New Orleans - especially when it comes to eating and drinking! The weekend had high points as well as its share of low ones. On the one side, I really thought about my food choices. At the fest, instead of etouffee and fried bread, I opted for salad and sushi. Instead of sitting all afternoon, I walked around and around the fairgrounds. I racked up 30,000 steps on my pedometer! On the downside, I did partake in some of the Big Easy's most famous delicacies - hurricanes and beer! The "old" me would have fallen off the wagon and not gone back to the gym. But the "new" me privately looked forward to Monday's grueling workout with someone who could help me refocus on the task at hand.
This week's lesson: cheating doesn't have to spell the end! Just make the best choices possible at the moment, don't get discouraged and jump back on the bandwagon ASAP!
CNN Medical News producer Matt Sloane:
As I sit on a plane ready to takeoff to the next Fit Nation stop in Denver, I'm reflecting on last week's stop - New Orleans. I don't have to tell you that it's a city of excess, or about how many poor choices I made because Stacia already has covered the temptations.
The plan was to get back to town, get back on the wagon with my eating and working out, and just regard last weekend as a "speed bump" of sorts on the road to fitness.
You know what they say about plans. With only 2 1/2 days in Atlanta before leaving again, it seemed there were things that needed more immediate attention than my diet. My house was a mess, my dog was lonely, my chain link fence needed to be finished, and I had a ton of prep work to do for the Denver trip.
Guess what? No workouts this week. We're heading to a Cinco de Mayo festival in Denver, but I promised myself, Robert and my girlfriend that I would eat well and keep the drinking to one margarita with an old buddy of mine. Here's hoping my will power is stronger than the allure of authentic Mexican food!
Fitness trainer Robert Dothard:
We all knew this stuff was going to happen - that there would be bumps in the road to fitness for each of you. But I encourage you to keep the faith and workout and make good-for-you food choices. There will always be set backs and challenges. So what do you? First, refocus - remember why you started this fitness journey in the first place (odds are those reasons still exist). Second, educate yourself on healthy eating, fitness and exercise. Lastly, and you could see this coming, take different ACTION. For example, over the next week, I would love to see a lot fewer nutrition and exercise log entries start with: "I was bad"... "I caved and had XYZ"... and of course the final type of entry... a selection from the library of excuses we all have!
Next week let's re-start - not to dismiss all the work you have done so far - I mean you have inspired me to lose 10 lbs and 1 percent body fat since we started, but to keep us all from leaning on old habits like an athlete clings to his or her glory days.
Thursday, May 03, 2007
Paying for your life
Every year, around 6,000 people learn they have ALS or Lou Gehrig's disease. That may seem like a small number, unless of course you are one of those people, or love one of those people. It is an awful disease that robs people of strength in their extremities and then relentlessly marches toward the center of the body, eventually causing paralysis of the throat muscles and diaphragm. There is no cure, and once diagnosed, people are essentially handed a death sentence.
Unfortunately, there has been little progress made in the treatment of this disease. Many believe that is because there are few incentives to investigate and develop medications, because of the small number of potential beneficiaries. Unlike other neurodegenerative problems, such as MS, there are fewer clinical trials for ALS, and investigators have greater difficulty securing funding. That could be why so many more advances have been made with MS. To be fair, ALS is considered an "orphan disease," and because of that there are some federal incentives to reduce the cost of drug development. Many researchers, though, say it is not enough.
This morning, we told the story of an investigator who decided to get creative. He went to his own patients and suggested that they pay to be a part of a clinical trial. He didn't require payment, but he explained that the trial was in jeopardy without more money. We followed one patient who gave $4,500 and another patient who thought it was wrong to pay and gave nothing. Both say that ultimately, they were treated fairly and even had some benefit from the medications.
It does raise a larger issue. Should patients with a terminal diagnosis be asked to pay to participate in a clinical trial or is that ethically questionable? Should we as a society do more to support funding for rare diseases, such as ALS? What are your thoughts?
Wednesday, May 02, 2007
Is melamine changing your diet?
For the past two months, pet owners have been wondering whether they were feeding their cats and dogs food that might kill them. That's because the Food and Drug Administration found melamine and melamine-like products in various pet foods. The official death toll for animals is still at 17, and the Food and Drug Administration says it has received reports of thousands more.
Melamine is normally used to make plastics, building supplies and is also used in fertilizer - it was found in wheat gluten imported from China. Cyanuric acid, is a compound similar to melamine, normally used in swimming pool supplies, was found in rice protein, also imported from China. 153 different pet products have been recalled, and it was thought to be an animal problem. However, that changed in the past week, when we learned that the contaminated products had made their way into the human food supply.
Now we know that almost 3 million chickens and at least 350 hogs may have consumed animal feed mixed with this tainted pet food, and these chickens and pork products have made their way into the supermarkets and on to people's dinner tables.
But the FDA tells us they "believe the likelihood of illness after eating pork from hogs [and chickens] that were fed the contaminated product would be very low." You may be wondering, how they can be so sure? The FDA says it's all about "dilution."
I spoke with Dr. Michael Payne, a University of California-Davis toxicologist, who explained that the only studies that show how dangerous melamine can be to animals were done with pure melamine. Those studies found melamine to be 15-35 times LESS toxic than caffeine.
However, pets tend to eat the same pet food day after day, so if the food they eat is tainted, they're more likely build up a concentration and get sick from it. People are different. We eat a variety of foods. First of all, not every meal we eat includes chicken or pork. So here's how the FDA explains it:
Pet food with melamine is already considered diluted (not pure melamine). When the tainted pet food is mixed with the animal feed, it's diluted again. When the chickens or pigs eat the animal feed, and we consume the product, it's diluted another time. And when we digest the food, it's diluted again.
That's why they are comfortable telling us that the risk to humans is minimal.
Have you changed your eating habits based on this latest news? Are you concerned about the possibly having consumed tainted chicken or pork?
Tuesday, May 01, 2007
Doctors & drug companies
I'm back today after being away for a little while. I was out spreading the word about "Chasing Life," a CNN special and an accompanying book. Thanks to many of you, the book is a New York Times and national best seller. I hope all of you get a chance to chase life. I decided to write the book after the birth of my first daughter, and now I truly practice what I preach. While I never really thought about mortality, I do know that I want to be around as long as possible, and I believe this book could help us all.
On my first day back, I'm reporting about the cozy relationship between the pharmaceutical industry and doctors, based on a new survey published in the New England Journal of Medicine. I was surprised to learn that 94 percent of physicians have some sort of relationship with the pharmaceutical industry. That means just about every physician that cares for you has interacted with the industry in some way. Most of the time (83 percent), the relationship is based on food and beverages provided to doctors, such as a catered lunch. Another popular icebreaker (78 percent) is free drug samples, and about a third of the time the relationship involves money-- actual payments to doctors for consulting services or for lectures.
Breaking it down even further, the survey found that family practitioners are most likely to meet with representatives from the pharmaceutical industry, and cardiologists are most likely to accept payments. Doctors at hospitals and clinics were less likely to meet with the drug companies than physicians in solo practice.
So, what does this all mean for you? On one hand, an argument can be made that these drug representatives help educate doctors about new medications and therapies. That certainly could be in your best interest. Others argue that relationships, ANY relationships, between doctors and the pharmaceutical industry are unscrupulous and should be questioned. Where do you come down on this issue? Again, keep in mind- as it stands now, more than nine out of 10 doctors interact with the pharmaceutical industry in some way.
ABOUT THE BLOGGet 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.