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HOUSE CALL WITH DR. SANJAY GUPTA
Shocking Numbers for AIDS in the U.S.; Your Cell Phone and Your Health; Awake Brain Surgery
Aired September 20, 2008 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, CNN HOST: Welcome to HOUSE CALL. Let me take you on the rounds this morning of the most amazing medical stories. So much to tell you.
First up, shocking numbers for a deadly disease. In fact, the one segment of the United States population is actually worse off than developing countries. I'm going it to tell you what I mean.
And what you need to know about your cell phone and your health. Is there a link? I'm so fascinated by this story. We're also going to include some tips on how to use your phone to minimize any risks.
Plus, take a look at this. What you're looking at is awake brain surgery. As you know, I'm a neurosurgeon. And I'm going to take you there. It's an exclusive look at a tumor being removed while the patient is awake. You've got to see this.
First, though, a possible breakthrough. The FDA says it found the smoking gun in the nationwide salmonella outbreak. Health investigators say they've traced the salmonella strain to irrigation water and Serrano peppers at a Mexican farm. So what they're warning is people not to eat Mexican grown Serrano or jalapeno peppers.
And President Bush, this week, signed a bill ensuring that $48 billion will be spent over the next five years to fight deadly diseases around the world. The focus of the plan is AIDS, but there is something we should all know.
A new report says that, while the United States spends billions fighting HIV abroad, the epidemic is spiraling out of control at home, especially for black Americans. In fact, of all of the people living in America with HIV, nearly half of them are black. That's compared to 34 percent for whites and 19 percent for Latinos and other groups.
Now, a total of 15 countries received funding through PEPFAR. That's the President's Emergency Plan for AIDS Relief. But according to this report, if black Americans made up their own country, they would rank higher than several nations that receive emergency dollars. Some of those nations, Botswana, Vietnam, Namibia, Rwanda, and Haiti, all of that in terms of HIV infections.
Now, while awareness groups urge the government to do more at home, one CNN hero is taking matters into her own hands.
UNIDENTIFIED MALE: This is "CNN Heroes."
BAMBI GADDIST, MEDICAL MARVEL: Here in South Carolina, HIV is a problem, particularly among African-Americans. After 27 years of AIDS, we are still combating a mentality of fear and shame. I'm Bambi Gaddist, and I'm fighting to stop the spread of HIV/AIDS in South Carolina. Our organization has the only HIV testing mobile unit in the state. So our goal is to be in the community, testing at a nightclub, we're there when young folks are out.
UNIDENTIFIED FEMALE: It was my first time, very first time. I'm glad I did it. Takes time to explain things, actually break it down.
UNIDENTIFIED MALE: When people that are scared see a place like this, it might make them want to go in and get tested.
GADDIST: We had a very good night. We had quite a few people decide to find out their status. We also had positives.
We got some business to handle. When we get a positive, it validates why we need to keep doing the work.
Did you get tested yet?
UNIDENTIFIED FEMALE: I did.
GADDIST: You already got it? OK. I sure appreciate you coming out.
I joke about being a 70-year-old woman giving out condoms to the children. When it's my time, I want my obituary to think that I made a difference for someone and that I saved somebody's life.
UNIDENTIFIED MALE: Get involved, CNN.com/heroes.
GUPTA: Surgeons performing an operation while the patient is awake, it may sound like a mistake, right? Nope. The reality is when it comes to brain surgery, being awake can protect some of our most precious functions. Different areas help us read, walk, talk, even cry and smile.
So, if a tumor is located in a crucial part of the brain, doctors now perform surgery on the patient while they're awake, in order to see what functions they may be affecting while removing the tumor. This is a rare procedure. And we have exclusive video of this operation being performed at Methodist Hospital in Indianapolis on a young patient who was diagnosed just a few months ago.
Now, we thought long and hard about whether or not to show you this piece. And we decided to go ahead. The video you're about to see is graphic. It's pretty amazing, as well.
(BEGIN VIDEOTAPE) GUPTA (voice-over): His name is Conor Mather-Licht, he's 19- years-old, and he has a brain tumor. Although Conner has been suffering many seizures for nearly three years, he didn't realize he had a problem until last spring. He was out to dinner one night with friends, when he couldn't read the menu.
CONOR MATHER-LICHT, BRAIN TUMOR PATIENT: I felt it was different. I couldn't -- I could sort of read it, but I didn't just quite understand everything.
GUPTA: Located above his left ear, the growth was interfering with Conor's ability to read. Because his tumor was located in such a delicate area of the brain, his doctors recommended he undergo brain surgery known as awake craniotomy with mapping.
AARON COHEN, DR., METHODIST HOSPITAL: Conor has a tumor that's located close to the area of his brain that controls reading, naming, and comprehension. To be able to reset the tumor in the best fashion, we should be able to find out where those critical functional areas are. And that's why awake mapping makes sense.
GUPTA: The patient is heavily sedated, but remains conscious. So the doctors can start to actually create a map on his brain. Once the skull cap is removed, that brain is exposed. Take a look at it. That's a functioning human brain, pumping to the beat of the heart. And keep in mind, the patient is wide awake.
COHEN: Doing OK, Conor?
GUPTA: By stimulating certain areas of the brain and talking to the patient...
COHEN: Conor, did you hear anything? Feel anything?
GUPTA: ...the surgeon can tell which of those areas are sensitive and need to be avoided during the operation. Here they are creating a map of the brain. In Conor's case, he remained awake through during the entire procedure reading Kurt Vonnegut out loud while a section of his brain was completely exposed. If the doctors pressed on a sensitive area, Conor's reading would be affected, telling his surgeon that's an area to avoid.
COHEN: So you see how I stopped stimulating, he can say the name. But before that, he can't.
GUPTA: Once the brain is mapped, the surgeon starts to remove the tumor, again while the patient is still awake.
COHEN: Your voice is shaking.
MATHER-LICHT: It's shaking?
GUPTA: The procedure, which lasted about five hours, usually requires only a few days of recovery.
COHEN: He was cooperative. He was very patient. And although we had some difficulty with reading, which I think will be temporary, his speech and all of his movements remain intact.
GUPTA: Although Conor remains awake after his operation, he is exhausted. Because his tumor was large, covering a wide area, he still sometimes having troubles reading and speaking, but his doctors expect a full recovery.
GUPTA: Now, wasn't that something? And we have some continued good news. Conor's doctors believe he'll be able to go back to college in August with no problems. Good luck, Conor.
Now, 911 operators are always waiting to handle emergencies. But for Judy McCook, a new dispatcher, this was her day.
JUDY MCCOOK, 911 DISPATCHER: 911, what is your emergency?
TAELISA THOMAS, MOTHER: Yes, I have a 3-month-old baby stopped breathing, but she's not blue yet.
MCCOOK: Start doing CPR ma'am.
THOMAS: Yes, yes, I know CPR.
MCCOOK: OK, I'm going to talk you through it. She flat on her back?
MCCOOK: OK. Tilt her head.
MCCOOK: OK, just tilt it back slightly, not too far, OK.
MCCOOK: I want you to put your mouth over her mouth and her nose, over her nose, start giving her two puffs of breath, OK? One, two.
THOMAS: One, two, three, one, two, three.
MCCOOK: Keep going.
THOMAS: One, two three, one, two, three, one, two, three. Oh, my God! MCCOOK: Is she breathing?
THOMAS: Yes, thank you!
MCCOOK: OK, OK, stay there. The ambulance is on the way. She's breathing?
MCCOOK: OK, good, good, good.
It was very tense, but when I heard her take her breath, that was -- that was when I started breathing again.
THOMAS: Thanks to Miss Judy, she did a wonderful job.
GUPTA: It gives me chills. So good for that little girl. It's terrifying for a parent to have to perform CPR on their own child. I've seen it happen before, but it's critical that if a child becomes unresponsive, not to panic. Call 911 immediately and be very specific with the operator.
And here's how you might know when to begin CPR. If your child stops breathing and there's no visible signs of circulation, can't feel a pulse, can't feel the heart beating, there's also loss of muscle tone.
All parents should learn how to do CPR. It could save your child's life. So go to redcross.org. Do it today if you can. You can buy kits that teach you basic lifesaving skills, as well as CPR that you can do at home.
Now onto cell phones and your health. Is there a cancer connection? That's the question. How concerned should we be? Experts are going to weigh in on this. Plus, we have tips on using them safely. That's just ahead.
We also have a doctor who has these crazy hours and he has a busy mom as a wife. What's their secret to losing over 190 pounds? We're going to tell you later. That's on HOUSE CALL.
GUPTA: And we are back with HOUSE CALL. Making a lot of news recently, cell phones and your health. One prominent doctor's warning his staff to be careful about using them. In fact, recommending children only use cell phones in the case of an emergency. But what do we really know whether it's adults or children? Well, take a look at these images. These are computer-generated models of the absorption of electromagnetic radiation into the brain.
Now, this image over is of a 5-year-old child. You get a sense of how much they predict of the radiation would actually be absorbed into brain. Compare that to a 10-year-old over here, a little bit less. And then finally an adult. You can see how much less that is comparatively speaking.
Now, it's hard to know what to really make of this. And it could be one of these things where people say, look, this is non-ionizing radiation, which is very different than ionizing radiation. So it might not be that bad for them. But what should we do with all this information?
Well, Larry King had a great group of experts taking this on. Listen to their conclusions.
LARRY KING, CNN HOST: What about 8, 9, 10-year-olds all over elementary school, running around with them right now?
OEVRA DAVIS, PITTSBURGH CANCER INSTITUTE: Well, right now, unfortunately, of the 28 million children in this country between the ages of eight and 12, about half of them are using a cell phone. Sometimes it's their mom and dad's, but using it frequently. And we're all very concerned about that, because we know that the cell signal gets deeply into the brain of the child.
KING: Are you concerned, Dr. Black, about the child?
KEITH BLACK, DR., CEDARS-SINAI MEDICAL CENTER: Yes, I am. We know that young brains may be more susceptible. And they have a longer exposure. And some of the studies have also suggested that the longer exposure, the higher the risk.
I think that the key thing here, Larry, is that we would assume, as a society, that cell phones are safe, that the government wouldn't allow us to use this device unless it was safe. The reality is it's a source of microwave radiation. There have been studies to suggest that they may be an associated risk of brain cancer and also a benign tumor of the ear. And there have been some studies to suggest eye tremors as well. The important thing, I think, for your listeners to hear is that they need to be cautious, because we may not have the answer to this for another 10 years.
KING: But where do you stand on this issue, Ted?
TED SCHWARTZ, DR., NY-PRESBYTERIAN HOSPITAL: I think there are few things that we all agree upon here. The first is that the majority of brain tumors are not caused by cell phones. Brain tumors have been around long before cell phones were in existence. There's not an increased incidence of brain tumors that's significant. And it's probably an increased incidence of our ability to pick them up and our ability to publicize them.
The other thing I think we all agree upon is that the currently available literature is at best inconclusive about whether there's a link between cell phone use and brain tumors.
And one of the problems with these long-term studies, these 10- year studies, is that they're based on the use of analog cell phones. Nobody uses analog cell phones anymore. They have a higher power. They emit more power. We use digital phones now. And there's absolutely no data on digital phones, their long-term use, and the incidence of cancer.
So the question is is it reasonable to base a public health warning on a lack of evidence? Because basically we have no good evidence one way or the other. And my answer is no.
GUPTA: Now, the number of people using cell phones in the United States has increased dramatically from only 340,000 in 1985 to more than 156 million today. And a new survey says men spend more than nine hours a month on the phone, whereas women spend almost eight hours. So women actually talk less than men. Frankly, I'm not sure that I'm actually buying that, that men spend more time. We'll discuss that.
Obviously, people aren't going to stop talking, but there are things you can do to reduce your risk of exposure to this radiation that we're talking about. Elizabeth Cohen, of course, joining us with some tips in this week's empowered patient. We've been talking about this for quite a bit.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Yes.
GUPTA: I mean, first of all, do you think men talk more than women on the phone?
COHEN: I have to say, I see you in the hallway talking on your cell phone all the time, Sanjay.
GUPTA: All right, fair enough.
COHEN: I think that might be true.
GUPTA: All right. I'll talk to my wife about that as well. But what can you do now? What have you done as you've been looking into this?
COHEN: Well, first of all, what I think you have to keep in mind, and you know this, you talked about this on "Larry King," is that we don't know if there's a connection between cell phones and cancer. I mean, some experts who say you can do this all day and you're going to be fine, there's no link to cancer. Other people would say I'm radiating my brain cells right now.
But if you are worried just at the thought of this, if you think there's enough evidence to be scared, there are things you can do besides just freaking out. So I have some examples here, Sanjay, of what some people recommend, some experts.
First of all, this is just a plain old wired head piece that came with my phone. You put something on it called a fairite (ph) bead. And I got this for $5 around the corner. And it's supposed to break any radiation that might be along the wire.
Second of all, this is a Bluetooth. This is very familiar to many people. It has at least 100 times less radiation than if you put the cell phone to your head like I was doing before. Now this contraption is very strange. What this is, is a wire, just a regular wire, like any other wired head piece. But then the part that goes up near your head is a hallow tube. It's like a stethoscope. It's just a hallow tube. So there's no wire coming up near your head. And some people recommend that.
GUPTA: You know, it's funny, even as you were talking, I could hear the microphones going up.
GUPTA: It's always sort of slightly disturbing thing that obviously something is happening there.
GUPTA: So you have the headset. What about the rest of your body? How do you carry the phone then? Where do you place it?
COHEN: Right, this is the mistake that people make. People, for example, take an ear piece like this, and they hold it in their ear. And then they take the cell phone and they put it in their pocket.
COHEN: Or they strap it to their belt. Well, you're just sort of -- some people would say radiating your bone marrow at that point. So if you're going to be doing that, what you want to do is put your ear piece in, and hold your phone at something of a distance.
Now Sanjay, this might not look like a lot of space, but every millimeter counts. This actually will some radiation, a good deal of radiation away from your body, even just...
GUPTA: That's good advice.
GUPTA: Quickly, what does a cell phone industry say about all this?
COHEN: Well, here's the statement they sent us, Sanjay. They say "The overwhelming majority of studies that have been published in scientific journals around the globe show that wireless phones do not pose a health risk." And I'll tell you, Sanjay, other experts outside the industry told me the same thing. It's so hard to know if there is a link between cell phones and cancer.
GUPTA: All right, Elizabeth, thanks.
GUPTA: As always, great tips. Be sure to check out her column as well, Elizabeth's column, tipsonline@CNN.com/empoweredpatient.
Now, I'm heading to Minneapolis when HOUSE CALL returns, showing you how a patient taught this doctor how to change his life. You got it after the break. Stay with us on HOUSE CALL.
GUPTA: Today, I'm reporting to you from Minneapolis, Minnesota. You know, about 62 percent of the adults here are either overweight or obese, which makes the story of Chris and Mia Balgobin more impressive. He's a doctor with crazy hours. She is a mother of two adorable little girls.
Yet together, they were able to do something incredible. They beat the odds. Take a look.
GUPTA (voice-over): Chris Balgobin was a fairly active kid. But he quickly realized that he liked books better than sports.
CHRIS BALGOBIN, DR.: Growing up as a kid, I was an eager kid determined to be a doctor since I was 6 years old. So studying was more important to me than activity.
GUPTA: And over time, a healthy appetite led to husky clothes and an unhealthy self-esteem.
C. BALGOBIN: Life was difficult. You just didn't feel good. Used to shop in the big and tall. Even though I'm not tall, I was big.
GUPTA: Despite the hardships, Chris reached his goal of becoming a doctor, married his high school sweetheart Mia, and had two beautiful children. He had everything, except for a slim physique. And even that was about to change.
C. BALGOBIN: My big turning point is being a physician, seeing diabetes, seeing high blood pressure all of the time. A patient of mine said I'm going to change my life. And when I saw him back for follow-up, he lost 30 pounds. I'm like wow, if this guy can do this, why can't I do this?
GUPTA: Chris and Mia started their weight loss journeys together. Less than two years later and 190 pounds lighter, I met up with them at our Fit Nation event in Minneapolis.
(on camera): I think the biggest question people are going to ask is, how did you do it? 190 pounds between the two of you. What's the secret?
C. BALGOBIN: The secret is counting calories and activity, you know, watching what you're eating, keeping accountable to yourself and your spouse. And for me, it was my patients and activity.
MIA BALGOBIN: He was like, OK, I did number -- resistance six on the treadmill today, but I tried to do a little bit higher.
GUPTA (voice-over): You could call it a healthy dose of husband and wife competition and a much healthier future for this young family.
C. BALGOBIN AND M. BALGOBIN: We're the Balgobins and we lost 190 pounds together.
GUPTA: Congratulations to them for sure. And there was another unintended benefit of all of this. The couple, they say, they've become much closer through this whole experience of losing over 190 pounds together.
This is our Fit Nation Tour. We're traveling around the country. Got many more stops still. Go to CNN.com/fitnation. You can check out our tour schedule there. Also, many tips. And they can help yourself at home.
Stay tuned to HOUSE CALL. We got much more after the break.
GUPTA: It's time for our "Ask the Doctor" segment, where we answer the medical questions that are on your minds. And here's a question from one of our i-reporters. Diane in Illinois asks this, "I sit in front of a computer all day and by the end of the day, my neck is tired and I can barely hold up my head. Are there any exercises I can do to strengthen my neck?"
Good question, Diane. Sitting at a desk for too long can strain the neck muscles. So here's what you can do. There's some obvious things, first of all. Stretch frequently and watch your posture while at your desk. Plus, try doing these things as well. Keep your computer screen at eye level. Make sure you really look for that. And use the arm rests on your chair as well.
Also, if you can afford this, get a head set inside of tucking that phone between your neck and your ear. And finally, take a break from time to time. Get up, move around, try and get the blood circulating. Hope that helps. Don't work too hard. It's another piece of advice.
Now, here's a question from a roving camera.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: Well, I'm in my early 30's and I was wondering how early should I worried about bone health?
(END VIDEO CLIP)
GUPTA: Well, taking care of your bones is crucial at every age. There are really two things to remember. Calcium and weight bearing exercise. Now a good source of calcium include dairy products, dark, green leafy vegetables, and nuts. And keep in mind, we need different amounts of calcium as we age. The CDC recommends roughly 1300 milligrams a day for teens, 1000 milligrams a day for the 20s and 40s. You can take it easy a little bit there. And back up to about 1200 milligrams a day starting in your 50s. Hope that helps as well.
Well, unfortunately, that's all the time we have for today. If you missed any part of today's show, download the podcast at cnn.com/podcast. Remember, this is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.