Wednesday, January 31, 2007
The perfect meal

There are so many diets out there - how do you know which is the right one? Check out Dr. Sanjay Gupta's podcast "Paging Dr. Gupta" (iTunes or CNN.com) for tips on the most balanced breakfast, lunch and dinner options.

Have you tried our perfect food tips? Have they worked for you? Tell us about your perfect breakfast, lunch and dinner meals!

Women's heart disease still poorly understood
As wives and girlfriends and sisters and friends worry that the men in their lives who smoke, eat big steaks and covet the couch will have a heart attack, I'm going to let you in on something the American Heart Association says fewer than one in five doctors know:

Heart disease kills more women than men.

The statistics are a study in superlatives.

Women are six times as likely to die of heart disease than breast cancer.

Heart disease kills more women older than 65 than all cancers combined.

And that has Dr. Sharonne Hayes, director of the Mayo Clinic's Women Heart Clinic frustrated.

"We need to be able to tell women whether the diagnostic tests we order are accurate and how treatments will affect them, but today we don't have enough data specific to women," says Hayes. She's just published research showing sex differences continue to be poorly understood.

She attributes it to the fact that far fewer women are included in clinical trials, and even when they are included, study results are not sex-specific.

Other facts:

-Men and women respond differently to certain heart medications.

-Even aspirin affects men and women differently: In women, aspirin therapy seems to reduce the risk of stroke more than in men, while in men it reduces the risk of heart attack.

-A woman may experience different heart attack symptoms. Men and women are both likely to feel chest pain, but women may also feel it in their neck, back or abdomen.

-Depression affects women's hearts more than men's.

-Smoking is much worse for women than men.

Why?

Doctors don't fully understand it yet but suggest hormones, particularly estrogen receptors in the heart, may play a role.

For both sexes, heart disease is often avoidable. Don't smoke. Maintain your weight. Get regular blood pressure and cholesterol screenings.

And knowledge helps.

Everyone from the Dr. Hayes to the first lady of the United States to our own Paula Zahn will be wearing red this Friday ... it's the American Heart Association's "National Wear Red" day to raise awareness.

So when you see people in red, remember: More women than men die of heart disease.

Pass it on.

Will you be wearing red to support heart disease awareness? Send us an i-Report by clicking here.
Tuesday, January 30, 2007
Doctor Salisu's Hospital
My interview with Dr. Salisu
As Americans, we can take for granted our access to safe health care. Even people without health insurance can still see a doctor when they are sick.

In Nigeria, Africa's most populous nation, having a doctor or any kind of health care nearby is still very much a luxury. But that's changing in the northern part of the country.

Recently, I visited a hospital in Katsina State near the border of the Niger Republic. I spoke with Dr. Salisu Barau Banye, who was born and raised in Katsina and has practiced medicine in the area for more than 25 years. When many of his generation were leaving Nigeria for opportunities abroad, Dr. Salisu chose to stay and serve his community.

Dr. Salisu works at Katsina General Hospital, which is considered a shining star for health care in northern Nigeria. People travel there from neighboring Nigerian states and even the Niger Republic. The tiny hospital treats 1,500 people a day and is open nearly around the clock. Just eight years ago, the hospital did not have a clean water supply, consistent electric power or adequate staff. But the government of Katsina State has invested millions of dollars into health care, and Dr. Salisu's patients are beginning to thrive. Like many places in Africa, the plague of poverty is the doctor's biggest foe. Infections, malaria, food-borne illnesses and malnutrition are some of the major maladies in Katsina.

Dr. Salisu and his colleagues say they are continuing to provide the three A's of health care: availability, accessibility and affordability. Thanks to funding from the Katsina State Government the hospital provides:

Free prenatal care and delivery
Free kidney dialysis
Free treatment of malaria
Free emergency treatment of accident victims
Discounted prescription medicines

New equipment, facilities, ambulances, better-trained doctors, nurses and midwives, improved immunizations and even a state-of-the-art intensive care unit have created an oasis of high-quality health care in a very rural area.

It's now Dr. Salisu's goal to bring more primary-care facilities to villages so people will not have to travel as far to be treated for more common illnesses. Easy access to health care is improving in this part of the world. Can you get medical care when you need it where you live?
Monday, January 29, 2007
Injecting your way to a younger face
Watching Dr. Lisa Airan, cosmetic dermatologist to New York's glamourotti transform a 40-something single mom into a 30ish-looking woman with a few pricks of a needle, I'm thinking, injectable facial fillers look as easy as hitting a "refresh button" on your face.

For the uninitiated, facelifts lift, lasers sand, Botox relaxes, and injectible facial fillers plump up wrinkles and folds.

Face work no longer requires extended periods behind dark glasses. Minimally invasive cosmetic procedures are skyrocketing: 8.4 million people in the United States had this type of work done in 2005.

While Botox remains the most popular minimally invasive procedure, facial fillers are elbowing their way in: Restylane remains the dominant player, but enter a crop of recently FDA- approved fillers: among them, Juvederm, Radiesse, and Artefill.

Users find the immediate gratification and few side effects (bruising and swelling) attractive. But fillers can be expensive: hundreds of dollars per syringe - several times a year. As Dr. Alan Matarasso, spokesman for the American Society of Plastic Surgeons points out, annually, a face-full of fillers may be comparable to facelift in terms of cost.

Artefill is billed as the first permanent filler, and may alleviate wallet and needle fatigue. Experts warn, Artefill is not a great choice as a first-time filler, and it's not approved for lips.

Also be careful about who's plumping your face. There's an aesthetic involved - and more isn't necessarily better. Fillers aren't insurance reimburseable, and even dentists are getting into the act. Dr. Matarasso says lips are the biggest offender in terms of looking "overdone."

Are fillers really safe? It's "buyer beware" according to Dr. Matarasso, who notes that no long-term studies support safety claims.

Finally, less into needles, more into natural? Key factors for face preservers: avoid weight fluctuations and the sun. Not as dramatic as hitting the "refresh button" - but it works for me.

Do you have facial fillers, or are you considering them? Tell us your stories.
Friday, January 26, 2007
Overcoming Asperger's Syndrome
Daniel Tammet sees the world differently from the rest of us. For the 27-year-old Brit, numbers possess distinct sizes and colors and personalities. For example, sixes are tiny black dots, like holes, while ones are bright white. Nines are immense, and threes are round. Fives are loud, and fours are shy and quiet. Tammet's intimate association with numbers also allows him to calculate huge sums in his head without thinking, much like Dustin Hoffman's character Raymond Babbitt in the movie Rainman. The answer simply appears in his head. For example, when he divides two numbers, he sees in his mind's eye a spiral rotating down until it reveals the quotient - to almost 100 decimal places. These mathematical abilities make Tammet what is known as a prodigious savant, one of perhaps 100 in the world.

Tammet also has Asperger's Syndrome, a form of high-functioning autism. In his new memoir "Born on a Blue Day," Tammet describes his mathematical genius in fascinating detail. More interesting still is Tammet's description of his childhood and adolescence with Asperger's, a condition that makes it difficult to read others' emotions or decipher expressions that are not literal. Even though children with Asperger's often possess higher-than-average intelligence, they have difficulty making friends and functioning in social situations. As a result, they often experience profound isolation and loneliness. Tammet describes these feelings in detail, without self-pity. His book lets you see the world through his eyes, as a loner who stayed on the fringe of the playground during recess, an outsider looking in who was often subjected to the teasing and ridicule of his classmates.

Tammet's book joins a growing bibliography of excellent writing that gets inside the mind of those with Asperger's. Others include the novel "The Curious Incident of the Dog in the Night-Time," by Mark Hadden, a former teacher, and the memoirs of Temple Grandin, "Thinking in Pictures: And Other Reports From My Life With Autism" and "Animals in Translation: Using the Mystery of Autism to Decode Animal Behavior."

Tammet, the subject of a documentary titled 'Brainman/The Boy with the Incredible Brain," first came to worldwide attention when he memorized pi to 22,514 decimal places. Simply saying that many digits took five hours. In addition to his extraordinary facility with numbers, Tammet is able to pick up languages with ease. He has learned Lithuanian, Spanish, Romanian, Welsh, French, German, Esperanto and Icelandic. He learned to speak Icelandic in a week and then appeared on a talk show there, conversing easily with the two interviewers on the current affairs program Kastljos (Spotlight). He now runs a web-based business for language tutorials.

From his awkward and isolated childhood, Tammet has emerged as a successful adult, comfortable in his own skin. You may know people like Tammet. What are their stories?
Thursday, January 25, 2007
There's more to hot sauce than just heat
A little restaurant I know in Silver City, New Mexico, serves the best enchiladas ever: stacked blue tortillas, smothered in fresh green chilies and cheese. They're so hot they make my husband's bald spot sweat! I literally cry when I eat them, but my tears are tears of joy. For me, the hotter the better! So when I read about a diet that helped a doctor lose 70 pounds by just sipping on hot sauce, it got my attention.

Dr. Spiro Antoniades, an orthopedic surgeon from Mercy Hospital in Baltimore, Maryland, came up with the idea to down a shot of hot sauce every time he got a craving for something unhealthy, like doughnuts or cookies. After a while, he had punished himself to the point that those goodies just didn't seem very appetizing anymore. And guess what? His plan worked. Antoniades slimmed down in less than a year. Today he's a health nut, runs every day and watches his food intake, all because of a little bottle of heat. So many of his colleagues asked about the diet that he's actually published a book. There's no science to it. It's really simple behavior modification.

But that doesn't mean that scientists aren't interested in hot sauce. It's really the chilies, which are the main ingredient in the sauce. Researchers are finding that capsaicin, the compound that gives chili and cayenne their zing, has a lot of health benefits. For centuries, folk medicine practitioners used capsaicin to aid digestion, fight infection and stimulate the kidneys, lungs and heart. Capsaicin has even been put into topical creams that soothe sore muscles and joints. Now researchers from Massachusetts General Hospital and Harvard Public Health are looking at capsaicin's ability to mimic the type of pain you experience when you have arthritis. Researchers theorize that if doctors treat the pain that capsaicin causes in your mouth, they can treat the pain that arthritis causes. And, theoretically, the painkillers would be natural, with few side effects. And they would actually go directly to the pain, and alleviate the discomfort longer.

But be careful. Capsaicin can also be harmful. Take a lot of it, and you can actually send your body into shock. Research on capsaicin's bad side is still in the early stages, but scientists have found that it can cause some tough side effects: abnormal blood clotting, blistering of the skin and severe diarrhea. Long-term use can lead to kidney and liver damage, so go easy.

Has hot sauce ever helped or hurt your health? Let me know.
Wednesday, January 24, 2007
Bush health plan: will it help you?
The news media usually get the text of the State of the Union address about an hour before the president begins the speech. When it hit my inbox last night, I sat up straight. My pulse quickened. I clicked and scanned for any mention of health or medicine. I found them. There were six paragraphs on health care.

President Bush is proposing a new tax deduction for everyone who has health insurance. The goal is to get more people insured who otherwise couldn't afford it. It's a standard tax deduction - $15,000 for families and $7,500 for individuals. My first reaction? Great! I get a tax deduction courtesy of George W. Bush.

But, of course, it's a tax code initiative, so it's complicated. Right now, the money you and your employer pay into your health plan is exempt from income and payroll taxes. The president's plan would turn all employer-provided health insurance into taxable income. Whatever you and your employer pay for your insurance would show up on your W-2 form. Suddenly, health care seems almost as tedious as doing taxes.

So does this plan help or hurt people? For the 160 million Americans with employer-based coverage, there would be slight differences. The White House says 80% of employer plans fall below the $15,000 and $7,500 caps. They estimate an average tax decrease of .3%. So, people like me with a decent employer-based insurance plan would see negligible tax relief. One out of five people with employer plans have insurance coverage costing more than $15,000 and $7,500. For them, taxes would increase an average of .1%, according to the White House. All in all, the Bush plan gives people incentive to get lower-priced plans.

So far, the American Medical Association, the American College of Emergency Physicians and insurance groups have applauded Bush's plan to get more people insured. According to the White House, 3 million people will pick up insurance under this plan. But there are 47 million uninsured Americans, and critics say the president's plan doesn't help enough of them. After all, a tax deduction won't help the 43 percent of the uninsured who are so poor they aren't required to pay income taxes.

Democrats and labor unions say this proposal will encourage employers to stop providing health insurance. One nursing group points out that it provides tax incentives for purchasing cut-rate plans that traditionally have high deductibles and other out-of-pocket expenses.

According to some analysts, the time when your annual health care spending exceeds the $15,000/$7,500 tax deduction may happen sooner than you think. The standard deduction amounts are tied to inflation, not to health care costs, which have increased by double digits in recent years. Also, you may be harder hit if you live in an area where health care costs more, such as the Northeast, or if you work for a company with an older and sicker work force with higher premiums.

It's been almost 60 years since a commander in chief first mentioned health care in a State of the Union address. It was President Harry Truman in 1948. "Our ultimate aim must be a comprehensive insurance system to protect all our people equally against insecurity and ill health." Six decades later we're still struggling with that goal.

What do you think about health care in America? Will the president's plan help you? Is it a step in the right direction? Or will it cause more problems than it solves?
Tuesday, January 23, 2007
Buying cells & buying hope?
Every year thousands of sick and disabled Americans make medical pilgrimages to China, Russia and Mexico looking for cures. Most are fragile and disabled.

Meeting one of them, Jim Dunn, left a lasting impression on me. Jim is an ex-Marine, a vibrant, fun guy who had skydived for more than 40 years. But when we met, Jim was in a wheelchair. He was violently attacked six years ago, his spinal cord severed. He's a quadriplegic. After years of lying in bed and hearing, 'You'll never walk again," Jim decided to take action. The wheelchair wasn't his destiny, he believed, and he was willing to pay whatever it took to walk.

He found neurosurgeon Dr. Huang Hongyun in China, who said he could help. Jim traveled from California to China for the experimental operation Dr. Huang offered, which would cost more than $40,000.

Dr. Huang injected fetal nose and brain cells (called olfactory ensheathing cells) into Jim's spinal cord, saying it would help regenerate his nerve fibers. Jim's heart stopped after the surgery. He almost died.

Six months later, Jim still is not walking. He's had a little improvement with movement and sensations in his hands and arms, but some doctors say that could be the result of intense rehabilitation.

I interviewed Dr. Huang after Jim's surgery and when I asked him whether Jim would ever walk again, his answer startled me: "I don't think our method right now can cure his spinal cord injury. I don't think Jim Dunn can walk again." I couldn't believe that Jim would have made the trip had he known that. Later, I asked Jim: "Did Dr. Huang tell you that you wouldn't walk again?" His face said it all. Jim looked stunned. "No," he said, "He never told me that." It still gnaws at me, thinking I may have taken some of Jim's hope away.

Jim never saw Dr. Huang after his surgery and there has been no follow-up. Was it all worth it? Would he do it again? Jim says yes even though he still doesn't know the outcome of his surgery decision. It was like "rolling the dice," he says, and he still hopes he will walk and skydive again.

I want to know what you think. Is it worth risking your life for an experimental surgery? Does experimental research deserve more funding?
Monday, January 22, 2007
The state of health care
Tomorrow night, President Bush will deliver his seventh State of the Union address. Call me a nerd, but I have watched every State of the Union since I was 5. I'm proud to say that I have never missed my annual checkup with the president. After all, the State of the Union is a unique public opportunity for the president to lay out his agenda for the upcoming year and to point to accomplishments of the last. To oversimplify, it's a summary of the year in the White House.

In that spirit, here's a very brief look at some of what Bush has said about health care in the State of the Union since he entered office:

2001: Medicare is a top priority: "No senior in America should have to choose between buying food and buying prescriptions."

2002: Tax credits and Medicare float to the top: "I ask Congress to join me this year to enact a patients' bill of rights - to give uninsured workers credits to help buy health coverage - to approve an historic increase in the spending for veterans' health - and to give seniors a sound and modern Medicare system that includes coverage for prescription drugs."

2003: Bush surprises many in AIDS community with a $15 billion commitment over 5 years to fight global HIV/AIDS with special mention of Africa and the Caribbean.

2004: Of all of his state of the union addresses, the president spends the most time this year on health care. He proposes tax-free health savings accounts and 100 percent deductible catastrophic health care premiums.
"A government-run health care system is the wrong prescription. By keeping costs under control, expanding access, and helping more Americans afford coverage, we will preserve the system of private medicine that makes America's health care the best in the world."

2005: Tax credits and health savings accounts headline again. The president also addresses the ethical issues of embryonic stem cell research.
"I ask Congress to move forward on a comprehensive health care agenda with tax credits to help low-income workers buy insurance, a community health center in every poor county, improved information technology to prevent medical error and needless costs, association health plans for small businesses and their employees - expanded health savings accounts - and medical liability reform that will reduce health care costs and make sure patients have the doctors and care they need."

2006: Familiar themes: insurance coverage expansion, medical liability law reform: "We will make wider use of electronic records and other health information technology, to help control costs and reduce dangerous medical errors. We will strengthen health savings accounts - making sure individuals and small business employees can buy insurance with the same advantages that people working for big businesses now get. We will do more to make this coverage portable, so workers can switch jobs without having to worry about losing their health insurance. And because lawsuits are driving many good doctors out of practice - leaving women in nearly 1,500 American counties without a single OB/GYN - I ask the Congress to pass medical liability reform this year."

As we prepare to cover tomorrow night's speech, we already know the president will propose tax reform designed to make basic private health insurance more affordable. It's no surprise, considering he's mentioned insurance coverage in every one of his yearly check-ups with American citizens. To be fair, health care coverage is a huge issue and there is no quick or easy fix. But with only two years left in office and a Democratic Congress, one question this year is whether he'll be saying the same things next year.

What do you hope to hear from the president tomorrow night? Do you think he and Congress have achieved any of their previous health care goals?
Friday, January 19, 2007
A former journalist battles heart disease
Click the photo to see Charlie's story


Editor's note: Retired CNN journalist Charlie Hoff, 61, knows too well the toll of heart disease. Three heart attacks left him in congestive heart failure. After open-heart surgery and other treatments, his doctors said he might need a transplant. Then he read about a clinical trial in which a patient's own cells are used to rejuvenate heart tissue. He joined the trial a year ago and has seen great results. We asked him to blog today about his experience.

Heart disease is a killer but we don't start worrying about it until our hair begins to gray. When I look at the risk factors for heart disease: family history, diet, smoking and a lack of exercise, it can be scary. Few of us eschewed cheeseburgers for fruits and vegetables when we had a choice and many in my generation were heavy smokers.

The pain associated with the onset of a heart attack is angina. Angina is non-discriminating and may attack your body in places other than your chest. My first episode was signaled by a pain in the neck - I was alone, confused and in denial. I did not get help for several hours and I have paid the price.

The blockage in my coronary arteries prevented blood from getting to part of my heart muscle and that part of my heart died. I had suffered a myocardial infarction, an MI. That marvelous organ that sustains life beats in your chest more than 100,000 times a day. When the heart muscle is compromised, it's less efficient.

I had two more heart attacks and although I got help much faster, complications caused additional damage. My heart's ability to pump blood was significantly reduced and I was told I had congestive heart failure or CHF.

In congestive heart failure your organs don't get enough blood because the heart is not pushing the blood out to the body with enough force. Many organs are undermined, especially the kidneys. The domino effect of weak organs and prescribed medications combine with an accumulation of fluids in the lungs to sap your strength and make many routine tasks impossible.

A year ago, climbing stairs or walking up even the slightest incline left me breathless. When I learned about a new experimental treatment that might restore part of my damaged heart muscle I knew it was my best shot at getting well, or at least getting stronger.

I am very fortunate that one of the trial sites for this treatment is Atlanta's St. Joseph's Hospital, only about seven miles from my home. On January 30 of last year Dr. Nicholas Chronos and his team used a catheter in my left ventricle and injected millions of muscle cells harvested from my own body into the dead muscle tissue in my heart.

In the past year I learned how to manage my condition. I don't know yet whether my heart muscle is in fact stronger. Tests at the end of the treatment in a few weeks will tell more. I do know I feel stronger. Life is good. I am very lucky, and I intend to remain lucky and strong for many years. I believe my improvement is just beginning.

Since my first heart attack countless friends and associates come to me with worries about chest pains. We discuss their symptoms, I ask a few questions and tell them: "see a doctor."
Thursday, January 18, 2007
My childhood memories of cancer
Every time I hear the word "cancer," I think of the Jerry Lewis Labor Day Telethon. The weekend before I started the fourth grade, my sister and I were conducting a used-toy sale in our driveway to benefit "Jerry's kids." We were broiling in the late summer sun, so we went inside to get something to drink. The telethon was on TV. My mom was on the phone, her back to us. The only words I remember hearing were "leukemia" and "Joe." I knew she was talking about her baby brother, my beloved Uncle Joe. And although I had never heard the word "leukemia" before, I knew something was terribly wrong.

My mom sat us down and told us my uncle had cancer and that he was heading to Maryland for treatment. I asked if he was going to die. My mom started to cry.

By Columbus Day, cancer had killed my Uncle Joe. He was only 22.

I don't remember much from the funeral except that my parents wanted us to know that good could come from my uncle's death. My uncle's illness, they said, would help doctors learn more about how to beat cancer in the future.

Wednesday morning, I was happy to read that U.S. cancer rates have dropped for the second year in a row. (Full Story) Science is making amazing breakthroughs. But I think it has something to do with the fact that many people are taking a stand and refuse to think of cancer as an automatic death sentence.

As part of Dr. Sanjay Gupta's special about cancer (Saving Your Life) I recently visited southwest Georgia, which has one of the highest mortality rates for cancer in the nation. There, I met up with Grace Miller and Jane Stoutenborough. They are "foot soldiers" in the war against cancer. Many afternoons they drive the back roads of rural Georgia visiting people in their homes and offering free cancer screenings. Their efforts are paying off. Recently, one of the women they visited learned she was in the early stages of cervical cancer. She got treatment and is doing great. It's just one more example of the little victories we are winning on the war against cancer.

I still can't watch the Jerry Lewis Telethon without crying. I still get sad when I think about losing my Uncle Joe so young. He would have been a great dad. But more than 20 years later, I still believe my parent's words are true. No cancer death is in vain. Each one helps doctors come one step closer to saving someone else's Uncle Joe. Do you have an "uncle Joe" whose battle with cancer inspired you?
Wednesday, January 17, 2007
Paying the price for preventive care


Last week I had my heart checked out and this morning I talked about the exam on CNN.

Truth is, I feel pretty good, I try and stay healthy and I eat well. I don't take any medications, but I do worry about heart disease because of family history.


If you talk to a dozen different cardiologists, you will probably get a dozen different responses about what a healthy person should do about preventing heart disease. My cardiologist wanted to examine my heart through a series of blood tests and a very sophisticated test called a CT angiogram or CTA.

My blood is being tested for the usual suspects, cholesterol and fats, but also things like genetic profile and inflammatory markers. I will get those results in a couple of weeks. The CT angiogram, which was completely non-invasive except for an IV, took incredibly high quality pictures of my heart, as you can see. The test will detect any calcifications as well as narrowing in the blood vessels and abnormalities in the blood vessel wall.

My test was completely normal. Reassuring.

It is one of the best tests for identifying heart disease, but it's not cheap - a little more than $1,000. Unless you are having some problem like chest pain, insurance probably won't cover it.

Many doctors feel that sort of thinking by the insurance companies is preventing us from becoming a culture of prevention. What do you think? Is an ounce of prevention really worth a pound of cure?
Tuesday, January 16, 2007
Hunting for clues to Castro's health
All through the night, we at CNN have been trying to learn more about the health of Fidel Castro.

Out of all the stories we do, getting details about the health of a public leader such as Castro can be the most difficult. It seems now that he is less likely to have cancer and more likely to have terrible diverticulitis. He is believed to have had three operations since July and continues to have a severe abdominal infection.

In fact, a Spanish newspaper reported said that Castro was continuing to "leak half a liter of fluid into his abdominal cavity every day." This can cause an infection known as peritonitis, which can be among the most difficult to control. There is no question that he is a very sick 80-year-old.

I always find the news gathering at CNN to be remarkable. In Spain, we have reporter Al Goodman, who chased down leads all day, eventually contacting a doctor who has examined Castro, and who denied the Spanish newspaper's report. We also have Morgan Neill, one of the few international reporters allowed in Havana. Finally, our international desk is always humming and was able to immediately translate the reported details of Castro's operations for me so that I could talk about them on television this morning.

Our few minutes of TV news were the result of lots of incredibly hard work by many people in several countries. As a result, there is a very good chance that CNN viewers actually know more about the health of Fidel Castro than the residents of Cuba.

Many think this is the very best of the journalistic process and the most comprehensive newsgathering. Others think that the personal health of someone, no matter how public a figure, should remain private. What do you think? Does it make a difference that we can bring you such specific details about the health of Fidel Castro?
Monday, January 15, 2007
Stop a killer, but promote sex? That is the question...
Forty-three years after Martin Luther King Jr. delivered his "I Have A Dream" speech, this country is still divided, particularly when it comes to disparities in health care. January is National Cervical Cancer Awareness Month. The numbers couldn't be more telling: Each year cervical cancer kills thousands of women, and, according to the American Cancer Society, the number of new cases of cervical cancer is more than 50 percent higher in black women than in whites. And African American women are more than twice as likely to die from the disease.

Family history, smoking and being overweight all increase your risk for this cancer. However, it has a high cure rate if caught early, and regular pap smears, which detect abnormal or cancer cells are critical.

But the single most important risk comes from a sexually transmitted disease called human papilloma virus or HPV. There is no cure or treatment, but since last year, there is a vaccine - Gardasil - the first, and only, vaccine to prevent HPV and cervical cancer. It's approved for use in girls and women ages 9 to 26, and it protects against 70 percent of cervical cancers.

Here in the nation's capital, a controversy over the vaccine is brewing. Last week, the city council introduced a bill that could make the District of Columbia one of the first jurisdictions, to require vaccinating sixth-grade girls - under 13 years old - mandatory.

Proponents of Gardasil hope that vaccinating children before they're sexually active will reduce the risk of HPV infection and cervical cancer. Opponents fear that by hearing about sex, and a sexually transmitted disease, so early, young girls might be less likely to abstain and more likely to become sexually active.

I don't live in D.C., but I am a black woman and the mother of a 10-year-old daughter. If history is a judge, she has a greater risk of getting cervical cancer than her white girlfriends. I haven't had a conversation yet with her pediatrician about the HPV vaccine, and I would like to think that I still have a few years before I need to talk to my daughter about STDs. The questions remain for many - what age is appropriate to talk about HPV and the vaccine? Should it be mandatory? Or is this much ado about nothing?
Saturday, January 13, 2007
Livestrong: A life changing moment
On November 21, 1996, I became a warrior in the fight against cancer. I was 14, and my grandfather had just died of liver and stomach cancer. A decade later, I've found myself in a similar place, not because of a personal loss, but rather a personal gain.

After we taped the "Saving Your Life" cancer special, a colleague and I attended the first Livestrong Summit in Austin, Texas. We spent two days among the most amazing and inspiring people I've ever encountered, those who had survived the fight of their lives, those who had taken care of loved ones ultimately lost to the disease, and those who simply wanted to make a difference.

Among those who truly touched me was Julia. She's an 81-year-old breast cancer survivor with the energy of a 30-year-old athlete, and when she speaks about her experience, it's as if you're hearing Maya Angelou read a poem. "You have to believe that there is a future, and you can be a part of it, but you must believe that you can make it through the night, for the joy comes in the morning...and the joy...is being alive."

And Rob Sartin, whose 6-year-old son, Spencer, continues to battle cancer. Rob told us how Spencer loads his arms up with yellow Livestrong bracelets and makes his way around social gatherings selling them, and donating the profit to the Lance Armstrong Foundation. So far, he's donated more than $30,000.

Then, Rob proudly pulled out a copy of Sports Illustrated which had a picture of Spencer sitting on Lance Armstrong's lap.

Speaking of Lance, we had an opportunity to interview him as well. I had seen him in action the night before at the "Saving Your Life" taping, but it wasn't until I sat next to him that I truly understood how deep this man's passion for beating cancer goes.

The ceremony closed shortly after our interview. WideAwake, an Austin band, took the stage and performed their song "Maybe Tonight, Maybe Tomorrow." The song was written as a tribute to a friend with cancer, and all proceeds from the sale of the song on iTunes go to the Lance Armstrong Foundation.

Every so often in this business, an event happens that really changes your life. For me, Hurricane Katrina was the first one. Watching WideAwake playing their song about triumph over cancer in a room filled with 900 cancer survivors is the latest.

To hear more inspiring stories from cancer survivors, go to cnn.com/savingyourlife and make sure to tune into CNN tonight and tomorrow at 8pm and 11pm ET to see our in-depth report on the war on cancer.
Friday, January 12, 2007
"War on cancer" continues
Over the past several days, I have been consumed by stories on cancer, your stories. So many of you shared them on this blog. One of our very first posts was from Julianne, in Virginia Beach, Virginia. It is so emblematic of how far we have come. Many years ago, while she was pregnant, she learned she had cervical cancer and had to undergo a radical hysterectomy. She lost her baby. Wrenching. But recently, her own 9-year-old daughter was able to receive the cervical cancer vaccine and be protected. I am sure Julianne wanted to make sure her own daughter would never suffer the same heartbreak and tragedy. Brava, Julianne. Other posters Javier Diaz and Vicki Childers reminded us that simply getting screened is not as easy as it sounds. They want to do the right thing, but simply cannot afford it. Vicki instead keeps her fingers crossed.

There were so many posts suggesting that our money would be better spent on fighting cancer than a war in Iraq. Lee in Atlanta, Georgia, didn't agree, admonishing us to take a course in economics. Nick from Telluride, Colorado, took issue with the use of military metaphors. Of course Nick, it was a former president who first declared "war" on cancer: Richard Nixon, in 1971. And, surely the head of many major cancer institutions, including the National Cancer Institute, have followed suit. Peg, in Saratoga Springs, New York, reminded us that cancer can "put up a helluva fight" as she described her own "battle." Geri, in Milwaukee, Wisconsin, told us to light a torch for pediatric cancer and Andy from North Ireland pleaded for us to point out that cancer is truly a global struggle. Of course, he is right: Cancer does not respect any boundaries, and no one is immune.

Lance Armstrong and I spoke on the phone last night. Judging from the flood of calls and e-mails to his foundation and to CNN, we know something has happened here. Cancer, something people don't typically speak about in polite conversation, came flooding out. People are so eager to share their stories. Eager to soak up as much knowledge as possible about this disease they call the beast. The stories and the courage are so inspiring. Now it's time to plan the next step. This is where you come in. How do we keep the focus and interest on cancer? Many of you talked about wanting to help. What do you have in mind and how can organizations like CNN and the Livestrong Foundation better do their job? We want to hear from you.

Don't forget to watch Saving Your Life, Saturday and Sunday at 8 p.m. and 11 p.m. E.T.
Thursday, January 11, 2007
Lance's fire burns bright
When we asked Lance Armstrong to write a column about cancer , most people here at CNN had no idea how it would explode. But, I did. You see, I know Lance Armstrong. I have sat down with him and seen firsthand his passion for this war on cancer. It burns. He and the president of his foundation, Doug Ulman, a three-time cancer survivor himself, will never accept defeat in this battle. Never.

All day long, it was among the most viewed pages on CNN.com. It showed just how much our viewers care about this issue. In a day filled with stories about Iraq and a presidential address, Lance and his vengeance toward cancer captured attention. More than 1 million people read his column, and hundreds sent responses. They shared stories of support and stories of victory over what cancer survivors call "the beast." They also shared stories of defeat that make you want to cry.

Lance has already heard many of your stories. Because of them, he doesn't sleep much. As he admits, he is not a patient man. Instead, he is busying himself directly calling political leaders and reminding them that 1,500 people will die of cancer today, and tomorrow, and the next day. He is reminding them that the National Cancer Institute cut spending $40 million dollars between 2005 and 2006, and may cut funding again this year. He is reminding them that we can save unimaginable amounts of money if we just spend a little more now. Case in point: colon cancer. Caught early, the cost is around $2,000. Caught late, and the costs balloon to $250,000, not to mention the aggressive and debilitating treatment. It makes sense, medically and financially to offer these screenings to everyone, regardless of cost.

Lance is undoubtedly the most famous cancer survivor in the world. His story of how he was given a coin flip's chance of survival from cancer that had spread to his lung and to his brain is legendary. He didn't accept defeat and he went on to beat cancer and then beat the world's best athletes seven years in a row. Now, he has everyone's cancer squarely in his crosshairs. You should feel better because he does.

Join our discussion here, or go to CNN.com/Savingyourlife, where you can get much more information on cancer and hear from cancer survivors or send us an I-Report with your own story. And be sure to watch Lance and me on CNN's "Saving Your Life" special, Saturday and Sunday at 8 p.m. E.T.
Wednesday, January 10, 2007
Menopause
This morning, we profiled a delightful 60-year-old woman named Pat Dodson. By all accounts, she has a charmed life. She lives in a beautiful old San Francisco speakeasy and throws lavish parties. But 14 years ago, things were much different. To look at her, you may have thought she was ill. She suddenly couldn't sleep well, she was angry almost all the time and was undergoing a significant personality change.

If she were my patient, I probably would've started searching for a medical problem to explain all her symptoms. As she came to find out, it was actually all pretty natural. She was heading toward menopause.

Now, surprising to most people, menopause, strictly defined, lasts just one day! It is the one day that is 12 months after a woman's last menstrual period. Ha! That is the longest day of a lot of women's lives. Seriously, though, perimenopause can last a long time and be difficult to treat.

And, the way an individual woman might act can vary wildly. It is not just about hot flashes anymore. A woman's oxytocin levels may go down. Oxytocin is sometimes referred to as the "cuddle hormone." A woman may somewhat suddenly appear less affectionate and less likely to want to care for her family. Truth is, I learned a lot reporting this story and better understand some of the women in my life. I am curious, though, as to what other symptoms you've experienced or seen during perimenopause.
Tuesday, January 09, 2007
Alzheimer's and Folate
Many people I know say they have occasional "senior moments." They may forget a name or spend several minutes searching for their eyeglasses, which are, in fact, precariously perched on top of their head. They often cautiously joke that they are developing Alzheimer's disease. Truth is, it can be hard to distinguish sometimes but here is a little pearl: some forgetfulness is part of normal aging. If you are forgetting things that you didn't spend a lot of attention trying to remember, such as where you left your checkbook or keys, you probably have less to worry about. On the other hand, if you are forgetting the directions to your home or how to balance a checkbook, there should be more concern.

The number of Alzheimer's cases is getting ready to explode. Over the next few decades, we will most likely see a quadrupling of Alzheimer's cases! So, no surprise then that researchers are scrambling to figure out a way to prevent the disease. There will be billions of dollars spent trying to figure out treatments, but an article today caught my eye. It involves something already found in most medical cabinets and refrigerators. It is folic acid or folate. Researchers at Columbia University followed nearly 1,000 participants with an average age of 75 for six years. They found that those with the lowest levels of folate in their diet had the highest risk of Alzheimer's disease. They also found that those who had adequate amounts (200 micrograms a day) through diet and supplements had the lowest risk.

Certainly, there are plenty of good reasons already to take enough folate, and even extra amounts (to a total 400 micrograms) if you are pregnant. It can ward off heart disease, depression and protect your unborn baby. Now, there may be another reason as well. Incidentally, spinach, turnips, peas and beans have the highest levels. I am curious, though, about other methods you may be trying in hopes of keeping Alzheimer's at bay. It may be simpler than we think. Is there something you believe increases or decreases your risk?
Monday, January 08, 2007
The Potential of Stem Cells
Stem cells - which have the potential to turn into different cells in the body and could theoretically provide treatment for a number of debilitating diseases - have touched off passionate debate in recent years. Last fall, ads by actor Michael J. Fox became a factor in campaigns by stem cell friendly political candidates and a state referendum on funding of stem cell research.

Today there's more stem cell news. In a study published in Nature Biotechnology, researchers at Wake Forest University and Harvard University found cells in amniotic fluid that appear to have the same qualities as other stem cells. This discovery would seem to allow researchers to sidestep the controversial "embryonic stem cells," which can be harvested only by destroying an embryo.

When researchers injected these cells, called human AFS cells, into mice, they saw bones, muscles, and nerves grow. This has also been accomplished to varying degrees with human embryonic cells and so-called adult stem cells, such as bone marrow cells.

The goal for all of this research is to find a way to convert these stem cells into therapies that may someday treat illnesses including diabetes, Parkinson's disease and spinal cord injuries.

The new research is promising especially because these AFS cells seem to reproduce as quickly as human embryonic stem cells. Also, the supply would seem nearly limitless, because they're found in the womb of every pregnant woman. Amniotic fluid is routinely extracted from expectant mothers over 35 to check for fetal chromosome abnormalities. The cells also are present in the placenta.

This isn't the first study to show promise in stem cells taken from amniotic or placental cells. Researchers are still working to develop actual therapies - in humans - with any of these various stem cells.

In the case of these AFS cells in particular, any therapies are still many years away, according to the study's lead author, Dr Anthony Atala.

The new finding is exciting, but research on all the types of stem cells will continue. As most stem cell researchers have told us in the past, and as Dr. Atala agrees, different types of stem cells may work better for different illnesses. AFS cells may turn out to be the best for one disease, but for another, human embryonic stem cells may work best. And for yet another, adult stem cells may provide the best remedy.
Friday, January 05, 2007
Stunting growth - in whose best interest?
The first time I saw a picture of Ashley, I could understand why her parents call her their "pillow angel." Her beautiful smile is engaging; her sparkling eyes, unforgettable. In many ways, she reminded me of my four little girls. But Ashley can't walk or talk. She can't keep her head up, sit by herself, roll or change her sleeping position, or even hold a toy. Basically, she is a baby inside a 9-year-old's body. Doctors say she suffers from something called "static encephalopathy of unknown etiology," which means she had an insult to the brain of unknown origin or cause. She will never get better. And now she's become the focus of an international controversy.

Ashley has the needs of a baby and always will. At 65 pounds, her parents can still carry her around and involve her in family activities, giving her "needed comfort, closeness, security, and love," as they've written in their blog. But what would happen if she got bigger? That's what her parents worried about, and so after long discussions, Ashley's parents, in consultation with her doctors and ethicists at Seattle's Children's Hospital, decided to stunt her growth by giving her estrogen therapy. "As a result, Ashley can continue to delight in being held in our arms and will be moved and taken on trips more frequently," they write. In addition, a surgeon removed her breast buds and uterus so she won't develop breasts or menstruate. "Ashley will be a lot more physically comfortable free of menstrual cramps, free of the discomfort associated with large and fully-developed breasts, and with a small, lighter body that is better suited to constant lying down and is easier to be moved around," her parents wrote, adding that since she looked like a girl, she'd be less of a target for sexual predators.

As you can imagine, this treatment has been very controversial. Art Caplan, an ethicist at the University of Pennsylvania, thinks what Ashley's parents have done is "morally wrong...permanently freezing a person into childhood as a solution is not the right answer." Caplan told me that Ashley has the right to grow up and not to be seen an "oddity" or a "freak." Although many comments on web sites are supportive of Ashley's parents, many have also been quite critical, some even saying the parents are practicing "eugenics." What do you think? What would you do if Ashley were your daughter?
Jump-Start Your Health
This time every year, many people suggest that we do a show on making and keeping resolutions. I wondered how to make such a familiar topic interesting for our viewers. But in talking with my co-workers I discovered that we shared many concerns - dealing with the stress of coming back to work, getting back to healthy eating after splurging over the holidays and getting organized.

This isn't cutting-edge medical news, but it's what many of us need -- a little help getting our lives back on track. So whether you've resolved to make changes or you're just trying to get back to normal, I hope this weekend's show will help you jump-start your new year. Our guest, Dr. Howard Shapiro, has some great advice on that front: "It is a journey, it is a process" but he says, as long as you stay focused on your target, you will succeed.
Do you have a health goal this week, month or year? If so, how are you planning to stay focused?

House Call airs weekend mornings at 8:30 ET.
Thursday, January 04, 2007
Veterans Fight Fat
As you probably know, I am on a kick about obesity in this country. One of the reasons I entered television journalism was that I thought it was too easy to sit on the sideline and complain. It was too easy to resign myself to watching a nation that used to be one of the most fit, robust and vibrant in the world gradually become one of the most obese. I wanted to do more than simply talk: I wanted to try and educate as many people as I could. Truth be told, I am optimistic that we can reverse this trend.

So, here's another good opportunity to raise awareness, and possibly your ire, about something related to obesity. Get this: If you are a U.S. military vet, you've got a better chance of being diabetic than just about any other part of the population. The reason is that most veterans are overweight. In fact, almost 75 percent of male veterans are considered overweight or obese. That percentage is higher than among the general public. In fact, when I searched a little harder, I discovered that it is higher than overweight and obese rates in Native Americans (73.9 percent), Hispanics (72.7 percent) and whites (72.5 percent). It appears, according to a study of nearly 2 million patients who were treated at 136 Veteran Affairs medical centers, our U.S. veterans are the most overweight and obese of any group in the country. Our veterans.

I was surprised by that. I always imagined that a rigorous military training and associated boot camps would create lifelong habits that would fend off obesity and the countless chronic diseases associated with it. It appears that is not the case. It is true that the VA hospitals are trying to do their part. Any overweight veteran who visits a VA doctor gets referred to MOVE. It is a program to get veterans to start eating healthier, become more physically active and start focusing on those behaviors that led them to obesity in the first place.

It is hard to say whether it will be enough. As much money as we spend on body armor, gas masks and firepower, the biggest enemy of all may have been the fatty food we have served our military men and women and the sedentary lifestyle they live once they retire. So, if we are optimistic we can reverse this trend. What would you recommend to better care for our veterans? And, whose responsibility is it?
Wednesday, January 03, 2007
Botox: Poison or Panacea
"Can you steal some for me?" asked my 81-year-old grandmother when she heard I was reporting on Botox. It's a hot commodity even to my old-fashioned granny who has never driven a car nor touched a computer in her life. "It's like magic," she said.

Apparently, she's not alone in her lust and awe. Using the substance for facial lines is this country's most popular cosmetic procedure, according to the latest numbers from the American Society of Plastic Surgeons. In just five years, the number of aesthetic procedures has quintupled.

As more people use Botox as the ultimate wrinkle remover, doctors are realizing that its benefits delve far deeper than the skin.

Here's a brief science lesson: Botox is a brand name for botulinum toxin type a. It's produced by the bacterium Clostridium botulinum. In its purest form, botulinum is one of the deadliest poisons known to humans. It can cause death by paralysis.

In 1989, long before physicians injected Botox into faces, the FDA approved it for patients with debilitating neurological diseases such as dystonia. In these conditions, faulty connections between brain and muscle cause parts of the body to spasm. Muscles are locked into uncomfortable, often excruciating, positions.

Amazingly, Botox liberated many of these patients by temporarily cutting the connection between overactive neurons and muscle, allowing the body to relax a bit. On a basic level, that is what's happening with Botox for wrinkles -- the muscle is loosening its grip on facial skin.

This ability to block the muscle trigger led researchers to use Botox for a whole host of other conditions. It's FDA-approved for excessive sweating due to overactive sweat glands. It is used off-label to treat multiple sclerosis, spinal cord injury, anal fissures, tension headaches and migraines.

In our report airing today and tomorrow, Dr. Gupta will show you Botox's benefits to stroke patients. Up to four in 10 stroke survivors suffer from spastic disability. You may recognize it as stiffness on one side of the body, often seen in a club-like hand or foot. These people lose their independence--the ability to wash themselves, to eat, and even walk.

We'll show you how Botox has been used for years in these stroke patients in combination with physical therapy. It allows some to regain mobility and muscle function.


It's not a cure-all. It does have minor side effects, and more studies need to be done on long-term use. But it's huge news for people like my uncle who just suffered from a stroke. It can give them motivation to get better and their families hope.

So, what did my granny say after I finished my spiel about the possible wonders of Botox? "See. I told you...it's magic. Now, try to steal two bottles. One for me. One for your uncle."

Now, what do you think? Whether it's for cosmetic or other purposes, it's still a poison. Would you want to use Botox?

Botox is a trademark of Allergan.
Tuesday, January 02, 2007
Testing for Down syndrome - Do you want to know?
If you've recently visited the doctor's office, you may have walked out more confused than before you entered. It is true that with the number of detailed tests offered, you may get answers to questions you didn't even know you had. Often times, you are suddenly required to make decisions, big decisions, without a lot of time to think. Nowhere is that more true than when it comes to prenatal screening. And, now new guidelines issued by the American College of Obstetricians and Gynecologists will lead to even more tests, and possibly more questions.

The new recommendation is that all women, regardless of age, be offered screening for Down syndrome. As you may know, Down syndrome is a common birth defect, caused by three copies of the 21 chromosome, instead of the usual two. These children may be mentally delayed in addition to having heart defects. It is well known that older women are more likely to have a child with this defect. For example, a 25-year-old woman has roughly a 1/1,250 chance as compared with a 40-year-old woman, who has a 1/100 chance. The conventional wisdom was that a woman over 35 should be offered an amniocentesis - placement of a needle into the amniotic sac and removal of amniotic fluid for testing. Unfortunately, that test carries a slight risk of miscarriage. Nowadays, non-invasive screening is available that involves testing the woman's blood and performing an ultrasound. In the first trimester of pregnancy, it can tell with more than 90 percent accuracy whether a child has Down syndrome. There is no additional risk of miscarriage, and the costs are fairly reasonable.

The question, though, for many young parents is, "Do we really want to know?" A certain percentage of parents may choose to terminate the pregnancy. Others may choose to immediately establish tax-free health savings accounts to help pay for the health costs of the child. Others may choose to have the child delivered in a hospital that specializes in high risk pregnancies. Many parents are just curious. But, is it worthwhile to know? Do you agree with the new recommendations put forth? Do you think this will reinvigorate the abortion debate?
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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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