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.

The Fit Buddies enjoy their successes
Matt Sloane, Medical News Producer

"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
Chefs prepare their entries at the World Championship Steak Cook-Off
"It was the smell of steak heaven!"

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?
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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