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SANJAY GUPTA MD
Danger at the Salad Bar; Beau Biden's Stroke
Aired May 15, 2010 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Good morning. I'm Dr. Sanjay Gupta. Welcome to a place we're going to learn how to live longer and stronger. I'm your doctor and I'm also your coach.
Contaminated lettuce is in the news again. You know, whether it's lettuce, spinach or cookie dough tainted with E. coli or salmonella -- is the government really doing enough to try and protect our food? We'll tell you.
Also, Beau Biden, he's the oldest son of the vice president. He had a mild stroke at the age of 41 years old. Every 40 seconds, someone in this country has a stroke. And how often does it happen at such a young age? We'll tell you.
And our "Medical Mystery of the Week": Barbara Walters -- she needs a heart valve replacement. A lot of people have been asking: what makes a heart valve go bad? We'll have that and more.
Let's get started.
GUPTA: We begin, though, with food safety. The Centers for Disease Control confirms now at least 23 people got sick in four states after eating romaine lettuce contaminated with E. coli. Now, lettuce distributed by Freshway Foods was found to be contaminated and the company voluntarily recalled their products in 23 states and the District of Columbia last week.
Now, we asked Freshway Foods about this and they told us, quote, "We've been cooperating fully with public health officials who are trying to track the source of the E. coli outbreak."
The lettuce was sold to wholesalers, food service outlets, and delis, and salad bars and supermarkets. The point is: E. coli has not been found in the bagged lettuce you can buy in the grocery store.
Now, still, food safety advocates say it's another example of why more needs to be done to make our food safer.
And that's where we'll drill down today.
Joining me now is Bill Marler. He handles more food safety -- food poisoning cases than any other lawyer in the country, and he's also representing a client in a new lawsuit against Freshway Foods.
Thanks so much for joining us.
BILL MARLER, FOOD SAFETY ATTORNEY: Thank you, Sanjay.
GUPTA: You and I have talked a lot about this issue over the years. What concerns you the most about this? You're representing a client.
MARLER: Well, I think one of the big concerns is that we're seeing a new form of pathogenic E. coli hitting the market. This particular outbreak is E. coli O145 -- just as deadly as the E. coli that we hear a lot about, the O15787. But I think one of the big concerns is that we are seeing a new bug coming after us in the marketplace.
GUPTA: A few years ago, we went to one of -- one of the hardest hit, if you will, outbreaks, the origin of that in recent years. The thing that you really impressed on me at that time, Mr. Marler, was this idea that, you know, you have animals, sometimes contaminating crops. You have a lot of natural occurrences that ultimately can lead to food being contaminated.
First of all, have things been improved -- improved since then? And can you really prevent that sort of thing from happening?
MARLER: Well, I think the industry or in many, many parts of the industry have done remarkable job. We certainly are not seeing the large-scale 200, 250 people sickened in outbreaks. We still see three our four, sometimes five spinach or lettuce-related outbreaks yearly. They're much smaller.
GUPTA: When you decide to take on a case like this as a lawyer, what -- who is at fault here? Is there someone wearing a black hat that you point to and say, "A mistake was made, you have to pay"?
MARLER: Well, in many respects, as -- the question you asked before, you know, this product is being grown outside. There's, you know, chances for animal feces, which is what causes these outbreaks to enter the food stream. It's really not an issue of who's a bad guy or who's at fault. It really is just, you know, the consumers should be compensated for what they went through.
But almost more important for me and as you know, I'm very interested in finding out why these things happen so we can try to continue to try to prevent the next one from occurring.
GUPTA: Is that FDA ...
MARLER: That's not -- that's not ...
GUPTA: ... the food maker -- I mean, when you say somebody has to compensate, who's going to compensate?
MARLER: Ultimately, it will be the grower, the shipper and the manufacturer of this particular lettuce. They have a responsibility to a consumer to do the absolute best they can to get animal feces out of their food products. And that obviously didn't happen here. Twenty-three states are recalling products. There are at least 23 people sick, probably a lot more because not very many labs test for E. coli O145.
GUPTA: And I know given the way that this contamination often occurs, it's hard to -- it's hard to anticipate that we're going to completely eliminate this problem. But at least, good to hear from you that things are getting better.
MARLER: Thank you very so much.
GUPTA: Thanks a lot for joining us. We'll talk to you soon, especially if something like this happens again. Thanks so much.
MARLER: Thanks a lot.
GUPTA: The older son of Vice President Joe Biden was hospitalized this week. Delaware Attorney General Beau Biden was diagnosed with a mild stroke early Tuesday. Now, later that day, doctors said he was recuperating well, fully alert, talking and had full motor skills -- obviously, very good news.
What's surprising, though, in this case, is that Biden is only 41 years old. Every 40 seconds, someone in this country has a stroke. But if you look at cross the statistics, fewer than 1 percent had a stroke at such a young age.
Now, there are two types of strokes Beau Biden might have suffered. One is called a hemorrhagic stroke, or a bleeding, is often the result of some sort of ruptured blood vessel or what's known as an ischemic stroke that's caused by a blood clot. And nearly 90 percent of strokes in this country are ischemic.
And I want to show what happens really quick -- a blood clot can fleck off, as you see there, from somewhere in the body, maybe from the heart. You see it break off. That's the clot there. Once it travels through the blood vessels, it eventually finds its way to the brain, blocking off a small vessel and depriving the brain of oxygen.
Now, it's worth pointing out, there's a known history in Beau Biden's family. His father had aneurysms back in 1988.
But nearly 1/3 of strokes, the cause ultimately is still unknown.
Now, if you're having a stroke or you see someone who's having a stroke, it's important to act fast. And this I want to give you an easy way to sort of know what to look for.
Remember this word, FAST.
F stands for face. Have someone smile, for example. Look for a droop on one side of the face or other.
A is for arms. Have them raise their arms and look to see if one arm is sort of drifting. If it is, that could be a sign of subtle weakness, early stroke.
S is for speech. Have someone say their name, speak a simple sentence. Look for a slur or any kind of a word substitution.
And, finally, T is for time. This matters more than anything else. Call 911. The window is often short. If you act quickly, you can make a huge difference.
Also, on a different note, I want to let you know about a special investigation I've been working on called "Toxic America." It's a two-night television event. On Wednesday, June 2nd, I'm going to take you to one of the most toxic towns in the United States. And the next night, we're going to reveal the toxic chemicals pregnant women and our children are being exposed to right now.
Got to tell you, as a reporter, as a doctor, as a dad, what I found was eye-opening. You're not going to want to miss it.
Still ahead, though, our Fit Nation triathlon team, they're getting in shape biking with my good friend, Lance Armstrong. We'll have his advice. That's next.
GUPTA: We're back with SGMD.
You know, every week at this time, I'm going to be answering your questions. Think of this as your appointment. No waiting. No insurance necessary.
Let's get right to a question from Ronald in Kentucky. He writes this: "I'm a 63-year-old male. I recently found out that I have a pituitary adenoma. What can I do? How long can I live with this condition?"
Well, first of all, Ronald, the short answer is you can definitely live with this condition. A pituitary adenoma or tumor is an abnormal growth that usually develops at the base of the skull, sometimes caused excessive production of hormones that regulate important functions in your body. Other times, they can actually lead to lower levels of hormones, as well.
Now, pituitary adenoma is going to occur at any age but they are more likely to appear in older adults. Ninety-nine percent of the time, these tumors are noncancerous and non-spreading.
Now, what doctors are going to do specifically is try and measure the size of this tumor and try to figure its location by performing a CT scan or an MRI. Oftentimes, your doctors may also talk to an endocrinologist who specializes in hormone production of the body to determine the best treatment.
What happens if these are untreated? Several things could happen. It can lead to all sorts of particular conditions, including hypertension, diabetes, mood disorders, sexual dysfunction, infertility, heart disease to name a few. So, this is something that certainly has to be evaluated.
Also, when you're talking specifically about the treatments, about half of these tumors, roughly, are going to need surgical removal. And the others can be treated with medication. Sometimes you get both. Radiation, surgical removal and medication, and certain times, you simply just watch these over time.
Ronald, I hope that helps.
GUPTA: All right. Let's shift topics now. We are about two months away, roughly, from the New York City triathlon. I'm training pretty hard. We're kicking the training into high gear now and the Fit Nation team and I decided to go to Austin, Texas, to get some cycling tips from a serious professional. Inspirational guy, as well, my friend, Lance Armstrong.
GUPTA: All of these athletes have never done a triathlon before.
LANCE ARMSTRONG, 7-TIME TOUR DE FRANCE CHAMPION: OK.
GUPTA: And, obviously, they're very interested in the cycling part and wanted to see if you had any specific ideas or tips for a first-time competitive cyclist.
ARMSTRONG: I guess the key is to really enjoy it. Obviously, nutrition, hydration, super important, especially if the weather is like today when it's hot and humid and steamy. Big mistakes can be made if you don't fuel up before the race, the days before, the hour before, and then also during.
GUPTA: What would have breakfast for today?
ARMSTRONG: What did I have today? Don't ask me what I have today.
ARMSTRONG: We don't want to talk about.
ANGIE BROUHARD, CNN FIT NATION PARTICIPANT: I have a question for you. I'm a cancer survivor. Breast cancer last April. I know you talked about how cancer survivors, it is a community. What advice do you have for those of us who are going through cancer or just getting, you know, beyond it?
ARMSTRONG: I have never forgotten those days, never turned your back on this thing, this enemy, this foe that we -- you and I know so well. The support group around you is really critical when you're diagnosed and being treated, but even afterwards. I mean, those people have to be -- have to be great teammates just as they were when you were sick.
DEAN HANA, CNN FIT NATION PARTICIPANT: When you get to points in the race and when you find yourself just getting mentally exhausted, what do you tell yourself at that point? ARMSTRONG: We all get to that point, like, I'm hurting so bad, I can't go any deeper. And you think, wait a minute, I'm doing this for Leukemia & Lymphoma Society or I'm doing this for the American Cancer Society or for LIVESTRONG. And think about the people that would love to be doing what I'm doing today are suffering. So, that helps.
UNIDENTIFIED MALE: That's awesome. You guys did great.
GUPTA: All right. Lance and the Fit Nation team, congratulations. Keep up the good work.
Men and women, they really are different, especially with respect to their minds -- at least according to our next guest. She wrote a book called "The Male Brain."
Stay with us.
GUPTA: If you ask just about anybody, they'll tell you, men and women, well, they'll different. Neuropsychiatrist, Dr. Louann Brizendine, has dedicated her life to trying to figure out why.
I recently sat down with the author of "The New York Times" best- seller, "The Female Brain" and her new book is called "The Male Brain."
GUPTA: How did you get interested in neuropsychiatry?
DR. LOUANN BRIZENDINE, AUTHOR, "THE MALE BRAIN": I'd always been a student of human behavior. And, of course, at 18, 19, 20, what are you interested in -- you're interested in how guys act, how females act, and a lot about what behavior is made of. And I found that the fact that hormones predispose our brains toward certain behaviors.
GUPTA: We have a brain on the table here. Not that anybody that was once living, a model of a brain. I've seen a lot of these, as you know, Dr. Brizendine, as a neurosurgeon -- to look at a brain, like this, you can't tell whether it's a male brain or a female brain.
BRIZENDINE: Well, but you can in some ways in that the male brain is larger ...
BRIZENDINE: ... by 9 percent or 10 percent.
The part that we know that are different because we all start off at conception with the female-type brain circuits until eight weeks of fetal life when the tiny testicles start to pump out huge amounts of testosterone marinating the brain circuits and changing them.
GUPTA: So, we start off all having female brains?
BRIZENDINE: Yes, with what called female-type brain circuits because until that testosterone tsunamis hit them, the circuits don't change into the male brain.
GUPTA: How much of this were just born with? Or sometimes in development, something happens to our brain that makes us boys versus girls?
BRIZENDINE: So, we know that from birth, we've got a lot of biological wiring in there. We've got a lot of hormones. And as we go into puberty, the female brain gets awash in much more estrogen, like 15-fold more and boys get awash, teen boys in 20-fold more testosterone. So, the fuels that are running those circuits are different.
GUPTA: Is my brain, as a father, as a dad, different because of my three girls?
BRIZENDINE: Interestingly enough, that's one of the things I found out in doing the research for the daddy brain chapter in the book. And the daddy brain starts to form very early, actually in ways that we believe are biological. The pheromones from the sweat glands of your pregnant spouse starts to let off certain pheromones that waft over to the male and start to stimulate his brain to make more prolactin and less testosterone. So, by the time the baby is born, dad's perceptual systems for hearing baby's cry has improved greatly from when he was a non-dad.
GUPTA: What is the take away?
BRIZENDINE: You know, there's two things that I would say that come to mind right away -- which is that, you know, one of the things that I discovered in doing some of the research is boys -- through wriggling and moving the muscles a lot and in learning to do math and explaining math problems -- boys need to move around a lot in the classroom.
The other part that I found fascinating in the daddy brain piece of things of how that's formed, but also but also how, interestingly enough, dads need to spend one-on-one alone time with their babies. They're able to get into father-child synchrony that way, and if mother is always around being the gatekeeper, dads always defer to them. It's very, very helpful -- research shows -- for the dads to spend one-on-one alone time with their babies.
GUPTA: Thanks so much for joining us. We enjoyed it.
BRIZENDINE: Thanks so much for having me, Sanjay.
GUPTA: Appreciate it.
GUPTA: Well, coming up -- from skid row to the operating room. I recently spent my day at my other job with a remarkable young man.
GUPTA: Kenneth Chancey, he's an honor student. He's a star athlete. And at one point in his life, he was homeless. But tough circumstances have not stopped him from dreaming about his future. One of those dreams is to become a neurosurgeon, a brain surgeon.
I decided to make that dream a reality for him, if only for a day.
GUPTA (voice-over): What you're looking at is Skid Row, Los Angeles. The streets here are overflowing with mental illness, addiction and desperation.
UNIDENTIFIED MALE: It's no place to grow up.
GUPTA: Just last year, 18-year-old Kenneth Chancey lived here in a homeless shelter.
KENNETH CHANCEY, FORMERLY HOMELESS: My mom used drugs. My stepdad used to hit me.
GUPTA: But as we'll learn, sometimes, resilience can overpower even the darkest of situations -- because it was on Skid Row that Kenneth dared to dream about going to Harvard and becoming a neurosurgeon. I decided to surprise him with a day in the life.
(on camera): See, the thing is, that Kenneth has really seen so much. Yet through all that, he still became the president of his class. He became this athletic star. I wanted to know how could that all happen. Let's go meet him.
GUPTA: How are you doing? Sanjay Gupta.
CHANCEY: Kenneth Chancey.
GUPTA: My understanding is you want to be a neurosurgeon one day.
GUPTA: I get you some scrubs.
GUPTA: All right. I'm really excited that you're here. Let's get you changed.
So, every day, do you know you're going to sleep that night? CHANCEY: No. I would get a call from my dad saying, "OK, the hotel room was due and I didn't have the money to pay it." I'd have to find somewhere to go that night.
GUPTA: Was it more of the images that you saw or was it -- was it things that happened to you personally?
CHANCEY: I think it was the images, because things that happened personally I can shake off. I just thought --
GUPTA: But would most people be able to shake them off?
CHANCEY: I doubt it. Either you can remember it and let it bring you down for the rest of your life, or you can forget it and move on with your life. The world is going to spin regardless.
GUPTA: Let the grafts underneath, right on top on those two ones.
CHANCEY: This is a good learning experiment.
GUPTA: A lot of carpentry here.
Are you OK?
CHANCEY: Yes, just hot.
GUPTA: You're not going to pass out, are you?
CHANCEY: I doubt it.
(voice-over): Sometimes, it's hard to remember he's just 18 years old.
(on camera): All right.
CHANCEY: That was interesting though.
GUPTA: I'm glad you liked it.
(voice-over): For Kenneth, putting his past behind him means fulfilling that dream to become a neurosurgeon.
(on camera): So, we're talking about four years of college, four years of medical school, seven years of training.
CHANCEY: Seven years -- five to seven years.
GUPTA: Possibly a fellowship after that. We're talking between 15 and 20 years to get to your dream. That's a long road.
CHANCEY: But I'm ready for it.
GUPTA: You're ready for it? CHANCEY: Yes. I have all this energy. I have to throw it somewhere.
GUPTA (voice-over): So, what is there to learn from Kenneth Chancey? That resilience is intangible, that dreams are not lost, even to children in the most desperate of circumstances.
GUPTA: A lot of fun spending the day with Kenneth Chancey. I certainly wish you well. Pretty good hands there, too. We'll keep an eye on you.
Next: a TV news superstar has heart surgery. What makes a heart valve go bad? Our "Medical Mystery" -- that's next.
GUPTA: When Barbara Walters announced this week on "The View" that she needed a heart valve replace. That leads us our "Medical Mystery" this week: What makes a heart valve go bad?
Now, there are four valves in the heart, and two of them, the mitral valve and aortic valve are the most common sites of valve disease. As you get older, the aortic valve can start to become stiff, become narrow. And according to ABC News, Walters needs her aortic valve replaced.
Now, take a look at this. We're sort of zooming in on the heart -- go specifically to this part of the heart over here which is the outside heart muscle. If you take that away, all of a sudden, you're looking at the aortic valve there. You can see how blood goes through there.
Typically -- now, what can happen sometimes is that it becomes difficult for blood to go through because some of those flaps start to become hard, that causes blood to back up into the heart and makes it more difficult for blood to get through the aorta as well -- which is one of the key blood vessels providing blood flow to just about every part of the body.
Now, what a person may experience: shortness of breath, dizziness, and chest pain as well. If doctors listen to a patient's heartbeat and hear a murmur, they may order an echocardiogram, which is sort of an ultrasound of the heart to confirm, in fact, there is a problem.
Now, valve disease is often hereditary as well. Sometimes, infection can cause this, especially an infection early in life. It usually has nothing to do with diet and exercise.
Walters will be looking at about a five to 10 -day stay in the hospital, about one to three months in terms of recovery period. That's average.
Barbara, we wish you a lot of luck. We wish you a lot of good wishes.
If you missed any part of to today's show, be sure to check out my podcast on CNN.com/podcasting.
And remember, this is the place for the answers to all of your medical questions. Thanks for watching.
I'm Dr. Sanjay Gupta.
More news on CNN starts right now.