Monday, December 31, 2007
Looking back at 2007
It's time to reflect and take stock of 2007. For me, it was an incredible year mainly because of the arrival of my second child, another girl! CNN was kind enough to give me a few days off this past week, and I spent all of it with my wife and two daughters. It reminded me just how important it is to always remember the ones we love and to really be with them physically and mentally as much as possible. Of course, with our busy lives, sometimes that is easier said than done...
So, where did 2007 take the CNN medical unit?
Well, for a while, there was some sort of recall every few weeks. As we learned, there was too much lead in our children's toys and too much melamine in our pet food. It forced us to take a real look at the globalization of our commodities and often times we didn't like what we saw. China was the culprit in both cases.
Of course, we didn't always have to look beyond our own borders when it came to questionable food safety. There was E.coli in California spinach and Midwest ground beef, leading to one of the biggest meat recalls in our history. Our medical unit decided to tackle these issues head on, not only reporting directly from China but also from the Salinas Valley in California --known as the salad bowl of America. Our goal was to follow every aspect of the food chain - from the farm to the fork.
There were medical stories that caught our collective attention. The story of Andrew Speaker, a man infected with drug resistant Tuberculosis traveled across the world on commercial planes. He was subsequently quarantined and then had a portion of his lung removed in Colorado. He invited me to watch it and tell the story to the world. I did. What I learned was that our public health system had great difficulty in deciding exactly how to handle Mr. Speaker and that did not bode well for a situation of many people coming down with an infectious disease. In some ways, Andrew was treated like Typhoid Mary, but more importantly, he may have served as a wake up call.
Chris Benoit, the wrestler who murdered his entire family, was subsequently found to have a brain that had the characteristic findings of dementia. While it is unclear exactly what caused Mr. Benoit's brain to degenerate, it did get people talking about steroids again.
Of course that is something former Senator Mitchell and all of baseball kept talking about most of the fall.
I hosted several documentaries this year, and a few really touched me. One was "Waging War on the VA." What I tried to do here was really analyze the care our veterans receive after returning from war. For many of them, the VA represents the very best of our medical system. For many others though, the system is inconsistent, filled with mind boggling bureaucracy and sometimes it's simply unfair. As a journalist, I could hear countless stories from across the nation and then take them directly to those who are responsible. The response was remarkable from our elected officials, veterans and citizens alike. We only hope we did our profiled veterans true justice.
Another special I helped host along with Anderson Cooper and Jeff Corwin was Planet in Peril. From Central Africa to the Cartarets Islands, I saw first hand the effects of global warming. I met the world's first environmental refugees and saw the incredible pillaging of the earth that goes on every day. I was reminded again of my daughters and how much this plight could affect their lives.
I also had a chance to introduce the world to Amanda Baggs. While I have spent most of my life as a neurosurgeon, I had to start by admitting that I knew very little about autism, which is why I spent months reading, talking to experts and simply trying to assimilate all that I had learned. It was a daunting task and I will always wish I could do more and report on all aspects of autism. Stay tuned for more in 2008.
Along with Arwa Damon, I hosted a report about five year old Youssif. Badly burned by masked men, Youssif may have been yet another tragic tale from Baghdad except that you the CNN viewers responded with a thrust to propel goodness over cruelty. And in December, we introduced you to the new Youssif, who had undergone three operations in Los Angeles thanks to your contributions.
As I sit and write this blog, we are already looking ahead to January.
I will be reporting all month long on our broken health care system and more importantly what can be done to fix it. I am also planning a trip to Afghanistan to bring you front line stories about how medics take care of people in some of the most treacherous and dangerous places on the planet.
We do count on you the viewers and users of CNN.com for your thoughts and ideas and I want to thank you personally for your contributions. If you have any areas you would like me to cover in 2008, please let me know here. Also, while we can't always post the tremendous number of responses we get, we will always try and post representative remarks for all to read.
Happy New Year, Sanjay.
Tuesday, December 25, 2007
My friend Jillian got to go home for Christmas. While most of us take spending the holiday's at home for granted, for Jillian this is a huge deal. You see, Jillian has cancer. For the better part of this year, she has been in and out of the hospital. Jillian and I became friends while I was working on a story about African Americans and bone marrow transplants. Jillian is one of my favorite people -- smart and sassy -- a real ball of fire - a girl with spunk. Literally a girl: Jillian just turned 10.
Jillian's mom, Jessica, writes a blog to let friends and family know what's going on. Sprinkled in with the triumphs and challenges, there is great wisdom. From time to time this year, I've shared some of Jillian's reflections. After reading a recent entry, I asked if I could share it. Here it is:
"I asked Jillian if she could have three Christmas wishes what would they be. She said:
1. All the hospitals empty - like no patients on Christmas Eve or Christmas at all, even the adults.
2. I'd like to know the meaning of my life - my purpose - so I can get through it.
3. I'd wish for everyone to have a good future. "
Wow. I told you Jillian is deep. I am curious, what would you add to the list?
Friday, December 21, 2007
Cruelty like that really does exist in the world. You will see it if you watch the CNN Impact Your World Special "Rescuing Youssif." But, you will see something else. Something that is wonderful. Something that offers hope and optimism. You will see goodness that fights that cruelty with a vengeance. And wins. You see, when correspondent Arwa Damon and her producer Mohammed first started reporting the story on CNN, people all over the world reacted. You reacted. You gave letters of support, and money to help. Hundreds of thousands of dollars. It was enough to bring Youssif and his family to the United States and to house them for the entire time of his treatment. It was enough to start Youssif on the path to care for those horribly disfiguring burns. It was enough to make Youssif safe. It was enough to impact the world.
Through Youssif's eyes, you will see what happened on that awful day. You will be taken on a journey from the bombs in Baghdad to the beaches of Los Angeles. You will watch state-of-the-art burn surgery at work and learn about Dr. Peter Grossman, who stepped up to take care of Youssif and donated all of his services. You will see a remarkable transformation. As you watch, though, look not just at the physical healing, but notice the emotional healing as well. If you are like me, it will give you chills and make you feel good inside.
Maybe it's because I am a doctor, or maybe because I have children of my own, but I could not stop thinking about Youssif. Maybe it's that I have spent time in Iraq seeing things that I wish I could erase from my mind. For all those reasons and many more, I am so proud to be able to report this story, along with Arwa Damon, a woman I admire. Watch, and you will see why it just may be the best story to come out of this war. It is goodness overcoming cruelty.
Programming note: CNN's Impact Your World Special "Rescuing Youssif" premieres Monday at 10 p ET. It airs again at 4p ET Tuesday and Friday at 8p ET.
Tuning in to watch a 'miracle?'
The question many people may ask themselves is "Why did Mr. Everett recover when so many others don't?" Some will say his spinal cord injury wasn't as bad as originally thought. Others will say it had to do with a controversial therapy, known as hypothermia, where the body and spinal cord are chilled. Some will say it is a miracle.
No one could argue that Everett's recovery is on track, and that's a good thing. But as a neurosurgeon, I feel a wholesale endorsement of a highly controversial - and in medical literature, largely unproven -- treatment (one that's potentially quite dangerous - it's linked to everything from infection and cardiac arrhythmias to pneumonia and organ failure) does warrant a little more discussion, which is why I am blogging about it.
First off, the rehabilitation doctors at Memorial Hermann TIRR stated in a press release that Kevin Everett actually suffered from a central cord syndrome, as opposed to a complete spinal cord injury. This is very important because we know the vast majority of patients (97 percent) with central cord syndrome do actually improve to the point of walking again (click here for more information). So, Kevin already had the odds in his favor.
And here's what is incredibly striking. Kevin's improvement and recovery began before the hypothermia was ever started. Dr. Gibbons - who was right there, treating Kevin alongside Dr. Cappuccino, and who had largely stayed out of the limelight during Kevin's treatment -- had this to say in a yet unpublished letter to the Editor of Sports Illustrated: "Kevin's dramatic recovery of movement began before the placement of the catheter and before effective cooling."
So, why is this so important? Well, because many people around the country who have suffered a tragic injury to the spinal cord may point to hypothermia as the key to recovery. That may offer false hope. As with most things, it is not that easy. Of course, none of this really matters to Kevin, and I will tune in to see him walk at the game. It will be a great moment.
Thursday, December 20, 2007
Pre-existing conditions preclude you from insurance
There is more evidence than ever that not having health care insurance can cost you your life. I was pretty struck by a report this morning showing that cancer patients were 1.6 times more likely to die in five years if they did not have insurance. (Watch Video)
And, here is something even more striking: A patient with grade 2 cancer has a 90 percent survival rate at five years if the patient is insured. A patient with grade 1 cancer (a better stage to have) has an 80 percent survival rate if the patient is not insured. Yes, you read that right. According to new data from the American Cancer Society, being uninsured makes you less likely to survive, even if you start with a lower-grade cancer.
There are more insurance issues raised in the study, and many of them have to do with lack of access to care. For instance, 86 percent of insured women get pap smears, compared to only 68 percent of uninsured women. And, to make matters worse, if you do develop cancer, it is often difficult to get insurance because you now have a pre-existing condition. In fact, health care proposals released by presidential candidates Rudy Giuliani, John McCain and Fred Thompson have few provisions for people to obtain insurance if they already have a medical condition. That is all the more ironic, given Mayor Giuliani's history of prostate cancer, Sen. McCain's history of melanoma and Sen. Thompson's history of lymphoma.
The insurance industry is taking steps to try to create plans for people with pre-existing conditions that are not prohibitively expensive, but for many people that relief may not come fast enough. Have you had a hard time getting insurance, even when you wanted to buy it? What did you do about it?
Monday, December 17, 2007
Rating your doctor
I hate going to see the doctor. I probably shouldn't admit this, but it's been almost three years since my last general checkup. In my case, it's not about the high cost of insurance (my co-pay is a reasonable $15) and not about being lectured on taking better care of myself (even though the doctor does harass me about exercising more). For me, avoiding the doctor's office is about not actually liking my doctor's personality. I don't particularly find her pleasant to be around.
You see, I've tried to find a doctor I like, but as many of you know, it's not easy. If you do manage to make an appointment with a doctor who actually accepts your insurance, you wait months to see him or her. Even after you get into the examination room, good luck spending more than five minutes with the doctor. I can't even remember the last doctor who actually remembered me from my last visit.
That's why I was so intrigued by a new service run by the restaurant review service Zagat's Survey and health insurance company WellPoint. I've been using Zagat's little burgundy books to choose my dining experiences for years. My wife and I never try a new restaurant without consulting Zagat's first. Before I sound too much like a commercial, let me tell you what I like about it. More than 300,000 people chime in on restaurants all around the world, and the establishments are rated on a 30-point scale on food, decor, service and cost. There is also a "straightforward" and "helpful" comment section that puts "well-meaning" reviewer comments in quotes (as I just did). Now, imagine the same idea of "quick and easy" reviews applied to your doctor's visit.
In the Zagat/WellPoint survey, the doctors will be rated online on trust, communication, availability and environment on a 30-point scale. There will also be a comment section after the numerical ratings. A doctor's review won't be published until he/she has 10 reviews by patients. The survey is free and for now is available only to WellPoint insurance members.
"It's not necessarily a bad idea," says Dr. James King, president of the American Academy of Family Physicians. "It's a little different choosing a doctor over the best restaurant in town. Whether you like the doctor is not indicative of whether you're not getting the best care. A patient needs to understand what's being measured and not being measured." King says communication and friendliness don't always come hand in hand with the best skill. Critics say that a potential pitfall may be any influence WellPoint may have in the survey. Other rating services by insurers may factor the cost of a patient's care into the ratings.
What do you think about rating your doctor? What would you say needs improvement at your doctor's office?
Friday, December 14, 2007
Fighting cancer with radio waves
Kanzius'story began eight years ago, when the successful businessman from Erie, Pennsylvania, retired to Sanibel Island, Florida. Kanzius thought he'd fish, relax and maybe dabble in some small radio stations. Instead he ended up fighting leukemia. Doctors didn't give him much hope at first... until he began treatment at M.D. Anderson Cancer Center in Houston, Texas. With state-of-the-art treatments, Kanzius improved. But the scars of cancer remained with him. He was haunted by the faces of others who were also stricken with the disease. He "saw way too many young people die before their time." He was determined to do something.
The effects of chemotherapy kept him up at night, so Kanzius did a lot of thinking.
He used his radio engineering background and equipment, and his wife, Marianne's, pots and pans, to design a machine that used radio waves to heat and possibly kill cells.
He had never gone to medical school and had no real background in science, but he gained a patent for the machine. He then showed it to his oncologist at M.D. Anderson. Dr. Michael Keating found the concept attractive, because the treatment would kill off cancer cells without invading a patient's body. "It was the power of a good idea," Keating said.
Keating showed it to surgical oncologist, Dr. Steven Curley, who thought of using microscopic metal bits, known as nanoparticles as heat conductors. The idea was to inject the particles into tumors, direct radio waves at the tumor and heat the particles to destroy the cancer cells.
Keating also was treating a Nobel Laureate, Dr. Richard Smalley, who specialized in nanotechnology. Smalley was skeptical about Kanzius' machine, but was willing to loan nanoparticles to the project - just to see what would happen.
After testing the machine, the results were promising. So promising that Curley continued his research with the device and found liver tumors in animal subjects did shrink. Curley knew he was on to something, "If we can target these nanoparticles to get into the cancer cells, and then do this treatment, there won't be a lot of side effects that people usually associate with chemotherapy."
Doctors hope the machine will eventually be used to fight all types of cancers - from breast cancer to liver tumors. But human trials are at least three to four years away. The ironic thing is Kanzius' machine is designed to target cancer cells and send the radio waves directly to the tumor area. That might not work in Kanzius' case, because he has a form of leukemia, which is a fluid cancer. That means the cancer cells flow through the body and would be more difficult to zero in on.
But Kanzius said he never invented the machine for himself, he just wanted to help people he saw who were suffering.
"The medical world is going to say we need to treat people's cancers in a more humane way if nothing else," Kanzius said. "I hope I have changed the prevailing thinking of the medical world."
John Kanzius: one man and his machine making a difference.
Do you think one person can make a difference in the medical community? Tell us about that person.
Writer's Note: One of the wonderful things about my job is I get to meet fascinating and inspirational people. When I interviewed John Kanzius at his home in Sanibel and met his wife Marianne, I found them to be two of the most positive, uplifting people I had ever met, even though John is fighting a life-threatening illness. They truly believe that John's machine can make a difference in the world of cancer treatment. Now in the hands of some of the best doctors in the country, it is possible that Kanzius' invention may eventually treat those diagnosed with cancer. I hope to report on the machine's progress as it goes forward towards human trials.
Tuesday, December 11, 2007
Drinking, Facebook and Out in the Open
I knew this would be one of those stories that would tick people off. Someone turned me on to the Facebook group "30 Reasons Girls Should Call it a Night." I am a Facebook addict and I laughed as I read the list (my favorite is number 17: Every conversation starts with a booming, "DON'T take this the WRONG WAY but.."). Then I got to the pictures. Girls throwing up, falling down and urinating in public places. Wow. I was intrigued that people made these personal and often embarrassing moments so public. We had to investigate. Contrary to what one of my Facebook brethren think, this "tight a**" (thanks, Josh!) knows what college is all about. I went to college and lived the experience to its fullest. In fact, I think I saw my old dorm room in one of those pictures. We turned our findings into a report for Out in the Open.
The first thing I did today was log on to Facebook and check out the comments on the group's "wall." We love it when our stories get people talking and thinking. The responses were fascinating. Many people said that CNN is encouraging people to join the Facebook group by doing this story. Point taken. Others think CNN was unfair to the young women. One young lady said, "They need to get OVER this 'girls drinking epidemic' because its NOT a problem... we are YOUNG, having fun..." But others thought CNN was right on. A woman named Jennifer said, "Actually CNN has a total right to post these photos. I know that sux but you put them out there for everyone to see so you made them public. They blurred out our faces so they covered their a**es."
That leads me to my last point. When journalists do a story on social networking sites, they always walk a fine line. Legally, we can show what's on the site since it is public. But there are other considerations and after long conversations, we decided not to show the faces of the women on the site.
We want to know what you think. Do you think it's fair that we brought this group "out in the open"?
Monday, December 10, 2007
Meet the 'Lance Armstrong mouse'
Imagine if you could live longer, be super fit, bear children at age 85 and had the ability to not only be able to run marathons, but to have an unquenchable desire for extreme exercise.
Well, all this is possible - if you're a mouse.
Researchers at Case Western Reserve University School of Medicine have created a new breed of mouse that some people are affectionately calling the "Lance Armstrong mouse."
Physiologically, these mice produce less lactic acid during exercise. That means their muscles can go longer and harder without major fatigue, a trait that was identified in Lance Armstrong by exercise physiology researchers at the University of Texas at Austin. But the wonders of the mighty mice don't stop there.
These mice can run for more than five hours straight, long after their normal rodent counterparts have given up and fallen off the treadmill. This endurance is due in part to their bodies' producing more mitochondria. For those of you who don't remember middle-school biology, mitochondria are a cell's powerhouse. The mice could run an incredible 5 km at 20 meters/minute. You can see the mice running alongside a normal mouse by clicking here http://www.cnn.com/video/#/video/health/2007/12/10/vo.mighty.mice.cnn. The lab subjects also ate 60 percent more food than the average mouse, but weighed only half as much. These mice burned just their fat when they exercised, resulting in being leaner and eating more to recover. All in all, they not only lived longer than other mice, but they could reproduce at older ages. The female mice were able to have a baby when they were nearly 3 years old -- that's 85 in mouse years.
How did scientists make such a mighty mouse? They came in the form of transgenic mice -- a mouse that was genetically manipulated to research a specific gene or enzyme. Case Western University researchers engineered lab mice to have an overabundance of an enzyme called phosphenolpyruvate carboxykinase or PEPCK (pronounced pepsi-K) in their muscles. The enzyme can be found in the livers and kidneys of all animals including humans.
Manipulating lab mice is a common practice in science. "In general, mice are the preferred choice because of their size, breeding efficiency and short gestation time," according to Dr. Karen Wu, a physiology researcher at Columbia University. Furthermore, mice and humans are 99 percent genetically similar according to a 2002 mapping of the mouse genome in Nature magazine. In fact, the same researchers said that 90 percent of genes associated with disease are the same in humans and mice.
But hold on. Don't expect PEPCK to show up in pills, shots or supplements anytime soon.
"I wouldn't dream of putting these genes in humans!" warns Dr. Richard Hanson of Case Western. "The process just wouldn't be possible in humans." Regardless of human applications, the news wasn't all good for the supermice. They are very hyperactive, aggressive and their intelligence has yet to be measured.
What do you think of the mighty mouse or supermouse? Do you think we'll ever see such traits in humans?
Friday, December 07, 2007
Losing my keys or losing my mind?
My car keys were nowhere to be found. I checked the usual places and I retraced my steps from the night before. Nothing. My pup, Buddy, has stolen socks and shoes, but he looked innocent. I asked my housemate, Tom, whether he had seen them. He said he hadn't. I got to work using a spare set, but I spent the day wondering whether losing my keys was the first step to losing my mind.
I consulted memory expert Dr. James Lah, an Emory University neurologist. I related the key incident, and he asked me if I usually put them in the same place (I do). He asked if I tend to park my car in the same spot (I do). He said that those habits are how we remember things, and he bet that Tom was the guilty party.
Dr. Lah says some memory lapses are a normal part of aging. If our attention is affected, memories won't be stored efficiently. Fatigue, hormone imbalances, stress, depression, certain prescriptions and distractions can all prevent us from remembering.
We can also have problems retrieving memories. If the storage areas of the brain are damaged by Alzheimer's disease, or a stroke, the brain won't be able to properly recall the information stored in the damaged area.
Lah says it's not unusual to forget names or misplace items occasionally. But forgetting something that you recently did, or forgetting a responsibility that affects your well being - such as not paying bills, may merit a doctor's scrutiny. As our population ages, screening for memory problems will be a critical.
While there are several drugs available for treating Alzheimer's disease memory and thinking problems, Dr. Lah says, excitement is building for neuroprotective treatments that are in the development pipeline, including a vaccine. The hope is that the drugs will prevent and eliminate the brain-clogging deposits that are part of Alzheimer's disease.
Turns out Dr. Lah was right about my keys. Tom had used them to take out the trash and left them in the box where the trash bags were, under the kitchen counter. It's good to know that my mind wasn't the issue... in this case.
Do you worry about your memory? What do you do to keep your memory sharp?
Wednesday, December 05, 2007
Breaking the silence
There was a time when my best friend, Sarah, was the "sex lady." Out of college, one of her first jobs was as a sex educator. Sarah was passionate about it. Often, she would bring work home and, like many of us, dump it by the front door. On more than one occasion, I walked into Sarah's apartment and was greeted by a poster sized picture of full-blown chlamydia. I guess when you talk about sex all day, you don't think twice about what you leave in the hallway.
I thought about Sarah and her days as the "sex lady" recently when I took my dog, Bella, to our local dog park. I ran into "Apoo's Mom." (At the dog park, humans don't go by their real names. It's kinda like being in the CIA.) Apoo's mom is a pathologist. She works in women's health. She spends most of her days looking at slides. We got to talking about, you guessed it, STDs. Apoo's mom went to medical school in Europe and then came to the United States to do her residency. She says she is shocked by the STD problem we have in the U.S. "Almost every slide I see has trichomoniasis," sighed my dog park friend as we watched our "children" chase squirrels. "It is really alarming."
Just a few weeks ago, the Centers for Disease Control put out its annual STD report. The CDC estimates that 19 million infections occur each year - that's more infections than the total number of people who live in New York. According to the CDC, the big three STDs are chlamydia, gonorrhea and syphilis. Left untreated, these STDs can lead to infertility and in the case of syphilis, kill you. Nearly half of all infections happen among people ages 15 to 24.
Intrigued, I called Dr. Claire Brindis, professor of pediatrics at the University of California at San Francisco. "It is a silent topic," says Dr. Brindis. She says a number of factors contribute to the high numbers. First, young people tend to have "serial relationships" and when the relationship becomes "serious," the rules change and condoms come off. "The condom becomes a symbol of trust," says Brindis. But over the course of time, if someone has a series of monogamous relationships (and has a fling here or there), their risk and their partner's risk increases.
Dr. Brindis also points out that some groups have higher rates than others. According to the CDC report, the rate of chlamydia among African Americans was more than eight times higher than the rate among whites. Dr. Brindis says scientists are still trying to figure out why. She says it could be that African American teens tend to have sex earlier and that they don't have the access to condoms other groups do. Another possibility is that the health care community is just doing a better job screening for STDs. "We have better and less invasive tests," says Brindis.
She says we need to get creative when it comes to educating young people about STDs. She mentioned a program in San Francisco that sends "safe sex" messages to teen's cell phones.
I am curious to hear what you think. Why do you think the STD rates are so high? What do you think needs to be done to lower it?
Monday, December 03, 2007
Awake: Waking up during surgery
"My toes wouldn't move. My whole body was completely paralyzed. I had no way to let them know I was awake...I felt the doctor take my hand and I thought oh dear god, they're getting ready to cut my hand."
That's Jodie Stanley describing being awake during surgery. It's a phenomenon called anesthesia awareness. Jodie, a registered nurse, says she had never heard of it until it happened to her. Victims have called it their worst nightmare. "They may remember sounds or conversations in the operating room or they may have excruciating pain or wake up feeling paralyzed, not being able to respond. It's like being alive, but inside a corpse," according to Dr. Peter Sebel of Emory University School of Medicine.
A new movie called "Awake" just came in at No. 4 in the weekend's box office tally. The thriller stars Hayden Christensen as a patient who is fully conscious but physically paralyzed during surgery. The movie's promoters have said, "It will do for anesthesia what 'Jaws' did for swimming in the ocean."
To be clear, anesthesia is very safe, and awareness incidents are rare. Out of the 30 million cases in which anesthesia is used, anesthetic awareness happens in about 1 or 2 cases out of every 1,000 according to the American Society of Anesthesiologists.
Researchers believe that anesthesia awareness is under-reported by 50 percent to 100 percent of the official numbers, says Carol Weihrer, president and founder of the advocacy group Anesthesia Awareness. She bases her numbers on her own experience as an advocate and information she has pulled together from other organizations.
She emphasizes that whenever it does occur, the impact can be traumatic. According to her organization, approximately 50 percent of awareness victims suffer from post-traumatic stress disorder.
It's definitely a scary risk however remote, but there are certain things that can help reduce your risk of experiencing anesthesia awareness. Brain monitors can help reduce the risk by more than 80 percent, but they are available in only half of operating rooms according to Sebel.
Here are some important points you should address with your doctor before going under:
Operating room brain monitors: Are they available in your facility?
Weight: Your body mass index (BMI) or amount of body fat is a factor. Anecdotally, women and slimmer patients report more awareness.
Age: The older you are, the less anesthesia you need.
Existing disease: Your risk can change, especially with diabetes or cancer.
Medications/herbal supplements: Any medications including herbal supplements can have a big effect on the anesthesia.
Type of surgery: Some surgeries are more susceptible to awareness including cardiac and obstetric operations and acute trauma surgery.
Have you or someone you know experienced anesthesia awareness?
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.