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Sanjay Gupta MD

Treating Soldiers Wounded In Iraq War; Chris Bagge Discusses Prosthetics; Traumatic Brain Injury Becomes Signature Of Iraq War; How Medics Are Trained; Former President Clinton Discusses Need For Rehauling School Lunches And Vending Machines

Aired May 06, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

TONY HARRIS, CNN ANCHOR: And good morning, everyone. Now in the news, you're looking at video out of Basra, where a British helicopter crashed earlier today. British military officials confirm there are casualties. No word on how many. Officials say the chopper crashed in a residential neighborhood. CNN is working to confirm reports by local officials that the chopper was hit by a missile. We will keep you posted on this developing story.
CIA Chief Porter Goss is out at Air Force. General Michael Hayden may be named at his replacement. Senior Bush administration sources say Hayden is a leading candidate for the post. And official announcement is planned for Monday.

Chopper crash. The military says 10 U.S. soldiers were killed in a helicopter crash in Afghanistan. It happened during combat operations in southeastern Afghanistan last night. The helicopter was a CH-47 Chinook, like the one in this file video. The military says the crash was not the result of enemy fire.

I'm Tony Harris live from the CNN World Headquarters in Atlanta. We'll see you back here at the top of the hour. "HOUSE CALL" with Dr. Sanjay Gupta starts now.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta. Well, this morning, we're going behind the headlines of the fighting in Iraq. Behind the numbers you hear on the TV news, almost 18,000 American fighters wounded since the war began.

This morning, we're going to find out about the most common injuries and why more soldiers are surviving than ever before. Right now, Kelly Wallace gets us behind the treatments that a lot of these soldiers are receiving.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: Bring it up and hold it. Hold it. Hold it. Hold it! Hold it! Down.

KELLY WALLACE, CNN CORRESPONDENT (voice-over): There is a lot that 24-year-old Christian Bagge wants to do.

UNIDENTIFIED MALE: Attack that cone, attack that cone! Come on, push, push, push! Shuffle, shuffle, keep going, keep going, keep going.

STAFF SGT. CHRISTIAN BAGGE, U.S. ARMY: I want to run. I want to swim. I want to mountain bike. The biggest goal of all is just to do what I did before.

WALLACE: What he did before the attack in Iraq, before the humvee he was driving was blown apart by a roadside bomb...

UNIDENTIFIED MALE: Arms in. Hip steers, hip steers. There you go.

WALLACE: ...and his life forever changed.

BAGGE: I told one of the guys, tie my wedding ring around my wrist. And they did. And that was the last image I had in my mind was my wedding ring being tied around my wrist. And then I woke up in Germany with my amputated legs.

WALLACE: Before going off to war, Christian's passions included playing drums in a Christian rock band and a gal named Melissa. The two were good friends in high school, who fell in love about a week before he left for Iraq. They married while he was on leave, just three months before he became a double amputee.

MELISSA BAGGE, WIFE OF AMPUTEE: There have been times when I thought it was -- how am I going do it, but there's always someone there.

UNIDENTIFIED MALE: Dig in, last cone. Dig in, dig in.

WALLACE: And always someone who knows just what they are going through. The Brook Army Medical Center in San Antonio is home to one of only two U.S. Army amputee care centers in the country.

C. BAGGE: It's kind of like a brotherhood in there. We all -- we're rooting for each other and pushing each other to do the best that they can.

UNIDENTIFIED MALE: Push, pull.

WALLACE: The pushing comes not just from peers, but from a team of physical therapists.

CAPT. JUSTIN LAFERRIER, U.S. ARMY: Some people come in and they say, wow, I would have never thought that I would be able to do that again. And they need to be pushed to be shown that it is possible.

WALLACE: Also available to amputees like Christian, state-of- the-art technology to create custom-made legs for any activity they choose.

Christian's immediate goal, to run with President Bush. When the president visited the center on New Year's Day, Christian asked if they could jog together some time. He says Mr. Bush said yes.

C. BAGGE: He said that I would be an inspiration to other people. And I think he's right. You know, hopefully, then I can be an inspiration.

WALLACE: His positive outlook doesn't mean there haven't been really hard times. In the beginning, he was angry and depressed. And every day, there are reminders of what life used to be like.

C. BAGGE: It takes me longer to shower, it takes me longer to getting my legs on, getting dressed. Putting pants on is a 20-minute process and I hate it.

WALLACE: But Christian and Melissa are adjusting, even thriving.

C. BAGGE: You learn a lot about true love, being away from your family. You learn the important things in life.

WALLACE: Charting a new life with new limbs and new friends who know what it's like to walk in their shoes.

Kelly Wallace, CNN.

(END VIDEOTAPE)

GUPTA: Wow, Kelly, great story. Thank you so much.

And joining us now is Staff Sergeant Christian Bagge and the chief of prosthetics as well at Brook Army Medical Center, John Ferguson.

First of all, thank you both for being here.

C. BAGGE: Thanks, you're welcome.

JOHN FERGUSON, CHIEF OF PROSTHETICS, BAMC: Thank you.

GUPTA: Staff Sergeant, I want to start with you. I mean, it's just incredible. You look so good in Kelly's piece. Has your -- do people -- in terms of your mobility, has it gotten any better even since then?

C. BAGGE: You know, absolutely. Every day, I continue to -- to continue therapy. I've been involved in this running group over on main post here at Fort Sam Houston. And every day, we really plug away at pushing myself to perform better. And I think ultimately, that does improve my mobility.

GUPTA: You know, it's really remarkable because I think for the average person who's never met someone who's had a limb amputated. They didn't realize you could get around as well as you can. I mean, it was really remarkable to see you doing those exercises and everything. I mean, could you go running with the president today if he asked?

C. BAGGE: Absolutely. Yes, I could.

GUPTA: Well, good for you. Yes, John Ferguson, those prosthetics are amazing. And you know, we've come such a long way. What does the future hold? I mean, if someone is -- has an amputation today, what takes place? And what will happen to them?

FERGUSON: Well, you know, today we're really moving really quickly on all the technology that's available. What you saw Christian doing is really the tip of the iceberg, I think, to where we'll be in the next four or five years.

When you first meet Christian, if you don't see his prosthetic devices, you don't know that he uses them.

GUPTA: Yes.

FERGUSON: And that's a big success for us in the prosthetics department. But my goal really in terms of providing things that are absolutely useful and comfortable for him is to get him on the track again, to help provide him what he needs to get there. The legs don't make him run. He makes the prosthesis perform.

GUPTA: Right.

FERGUSON: But still, if I limit him in the technology, then he's going to be limited.

GUPTA: It is incredible, Christian, as I saw you walking down the hall with your wife there. I mean, I couldn't tell. I mean, your gait, everything seemed very normal just watching you.

Look, you know, we're recruiting some e-mail questions from our viewers. They did have some questions for you two.

Let's start with an e-mail from Charles in Connecticut, who wants to know this. "How do amputees deal with severe phantom limb pain? I'm a left AKA," which stands for above knee amputation, "and cannot control my phantom limb pain."

Christian, did you have to deal with that at all?

C. BAGGE: Yes, yes. In the beginning after the amputation, up 'till about a month ago, I dealt with severe phantom pain. And you know, I wish I could answer his question a little bit better, but the bottom line is I don't know.

There are several techniques that we use to control phantom pain. One of those, unfortunately, is narcotics. Another one may be a contrast path with hot and cold bath waters. Or as John and I have tried earlier using a compression through what we call a shrinker that wraps around the bottom of the residual limb.

And you know, a lot of these techniques may work for some people. And for others, they don't. And you know, up until about a month ago, I had severe phantom pain. And one day it stopped.

GUPTA: I mean, you actually -- did it feel like your leg was still there, but you just -- it would just hurt?

C. BAGGE: Right. It tingled a lot. It hurt. And basically, the way I understand it from what the doctors have told me is, you know, your nerves and feelings are no longer there. So any time your brain receives a signal, it doesn't know how to interpret that. So it now interprets that signal as pain.

GUPTA: Right. Really remarkable.

And John, you know, again, the technology is so remarkable. Any amputee who comes to you, are they all candidates for a prosthetic? I mean, how do you determine who's going to get what?

FERGUSON: Well, for us in the Department of Defense, I consider everyone that comes to me an absolute candidate for a prosthesis. And we start with looking at goals for running right off the bat, even if they don't think they'll even be able to walk again. We want them to be able to run and for them to understand that they can run.

So I don't really look at many of our injured soldiers that are not candidates for prosthetic devices. I consider them all candidates. And I want them to make the decision if they're not a candidate or not. Not me.

GUPTA: Really remarkable. And it's such a valuable service for our men and women coming back from overseas wars.

And Christian, just I applaud your efforts, everything that you're doing. And I wish you and your wife very good luck in your new life together.

C. BAGGE: Thank you.

GUPTA: Thanks to both of you for being here today.

C. BAGGE: Thank you very much.

FERGUSON: Thank you.

GUPTA: Stay with us. More HOUSE CALL coming up.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I had two teeth that were blown out. I basically didn't have an ear drum in my left ear.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: The lasting injury for this soldier is more subtle than his scars show. Find out what some are calling this silent injury of this war.

Plus, discover how soldiers are training to become combat medics. We'll go inside the Army's only U.S. medic training school later on HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. Ninety percent of the military wounded survive in today's war. And this is really an amazing number, when you consider past conflicts.

Now what doctors and experts are finding, though, is there is one injury that is leaving its mark. And sometimes it's not so noticeable.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Every war has a signature injury. For Sergeant David Emme, this was it. It came on November 19th when his truck set off an explosive device.

SGT. DAVID EMME, BRAIN INJURY PATIENT: I didn't see a blast or anything. Next thing I know is I wake up and my head hurts. I had two teeth that were blown out. I basically didn't have an eardrum in my left ear.

GUPTA: And a brain that had been rattled back and forth in his helmet, a traumatic brain injury. As things stand today, over two- thirds of the soldiers injured in a blast in Iraq suffer from a traumatic brain injury. Simply, it has become the signature of this war.

DR. DEBORAH WARDEN, DEFENSE AND VETERANS BRAIN INJURY CENTER: If I think about my head, if you think about even in a car accident, my head going forward, hitting the ground, or the windshield.

GUPTA: Dr. Deborah Warden has seen firsthand the impact. And she knows this war is different. The Vietnam War became known for spinal cord injuries, limb amputations, and Agent Orange poisonings.

The first Gulf War inflicted the controversial syndrome of the same name.

But this time, it is landmines, mortar attacks, and rocket- propelled grenades. They create blasts that literally rock the brain, similar to a high-impact car accident. The skull moves forward, impacts a hard surface, and then stops suddenly. The brain goes back and forth and then begins to swell.

EMME: It bruised my brain. And what ended up happening is my brain swelled up twice the side of a normal brain. And they took a big hunk of my skull out.

GUPTA: The operation saved his life. And he looks pretty normal today, but the signature of a traumatic brain injury may be subtle.

EMME: It was like somebody speaking a foreign language. You know, and they had to keep on repeatedly tell me the same stuff because, you know, due to the brain injury, I had a hard time comprehending, or talking, or verbalizing a lot of stuff.

GUPTA: In mild cases, a traumatic brain injury may be a mild headache or occasional dizziness. More severe cases can involve complete memory loss, personality changes, or even persistent vegetative state.

Unlike an obviously severed limb, traumatic brain injuries are difficult to diagnose. But make no mistake, they're increasingly common.

Doctors at Walter Reed say they have seen more than twice the number of brain injury patients as limb amputees returning from Iraq. And today, all patients returning with the war wound are automatically screened for a traumatized brain.

When Sergeant Emme was screened, his doctors saw clear changes in his personality, such as anger and hostility, leading to violence.

EMME: A lot of times what they call this is they call this the silent wound or the silent injury that I'm not Sergeant David Emme that I used to be.

GUPTA: A silent signature of war.

(END VIDEOTAPE)

GUPTA: And you know, something else that might go unnoticed at first is psychological stress. Our recent study, an interesting one, found about one-third of military personnel returning from Iraq seek mental healthcare when they return home.

Study author and Army Colonel Dr. Charles Hoge acknowledges there's a stigma in the military about seeking help, but points out they now require mental health screenings for returning service men and women.

(BEGIN VIDEO CLIP)

COL. CHARLES HOGE, U.S. ARMY DOCTOR, STUDY AUTHOR: We're really focused on trying to educate and learn as much as we can about the mental health impact, as the war is going on and get people to come in early before their problems become more severe.

(END VIDEO CLIP)

GUPTA: And Dr. Hoge also found service members returning from Iraq were most prone to post traumatic stress disorder than those returning from Afghanistan. Now he believes that that might be due to the frequency and intensity of combat experiences in Iraq.

Coming up on HOUSE CALL, the life saving docs in the field. We go inside their training after the break.

UNIDENTIFIED FEMALE: Behind the headlines of combat injuries in Iraq are the men and women treating soldiers on the front lines. Find out how medics training today are being helped by doctors in Iraq.

But first, this week's medical headlines.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): Motivation may be the key when people are trying to quit drinking. According to a new study, alcoholics were able to dramatically cut back their drinking, no matter what kind of treatment they tried as long as they badly wanted to quit and received medical counseling.

Middle-aged Americans may be a lot less healthy than their British counterparts. That's the finding of a study of Americans aged 55 to 64, excluding blacks and Hispanics in the Journal of the American Medical Association. The study found the Americans were nearly twice as likely to have diabetes or cancer. Researchers say it may be due to the higher rate of obesity in the U.S.

Judy Fortin, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. More than ever before, soldiers are surviving injuries sustained in combat. Some of the reasons, better body armor and faster medical evacuations. But Army commanders say the major difference is more combat medics on the front lines.

Kelly Wallace again now with a behind the scenes look at how those medics are trained.

(BEGIN VIDEOTAPE)

WALLACE (voice-over): An explosion at a Baghdad market. U.S. Army medics rush in.

UNIDENTIFIED FEMALE: Do they need help?

WALLACE: And within minutes must decide who needs to be treated first.

UNIDENTIFIED MALE: I got one more in here!

WALLACE: It's make believe, but designed to feel, sound and look like the real thing.

UNIDENTIFIED MALE: You got a head injury?

WALLACE: All to prepare these would-be medics for combat.

CLAY WALKER, SIMULATION TECHNICIAN: We want to ingrain in them when they see it, it's an automatic reaction. It's just a response. I have a limb removed. I need to stop that bleeding.

UNIDENTIFIED FEMALE: Who's the company commander?

WALLACE: Fort Sam Houston in San Antonio, the site of the Army's only medic training school. Any soldier turned medic heading to Iraq or Afghanistan is trained here.

UNIDENTIFIED FEMALE: I'm going to check your respiration again all of the way down your chest.

WALLACE: In essence, they're getting one year of medical school in a 16-week course...

UNIDENTIFIED FEMALE: I'm going to go ahead and administer.

WALLACE: ...learning primary care, emergency medical techniques, and combat medicine all at once.

It's tough. About 15 percent don't make it past the first few weeks.

UNIDENTIFIED MALE: It took you three and a half minutes to realize that he was missing his leg.

WALLACE: They could mean the difference between life and death. Nearly 90 percent of military men and women wounded in Iraq survive, which is higher than the 78 percent survival rate for the first Gulf War and 73 percent for Vietnam.

Leaders here say that's partly because there are more highly- trained combat medics, more soldiers on the front lines with basic, medical knowledge.

COL. PATRICIA HASTINGS, FORT SAM HOUSTON MEDICAL DIR.: The combat medic allows the patient to come in as a patient and not a victim so that the physicians and nurses at the upper echelons of care can take care of them and get them back to the states.

UNIDENTIFIED MALE: Can you hear me? Can you hear me? One, two, three.

WALLACE: The training is constantly updated, based on what soldiers are now seeing regularly on the battlefields of Iraq.

UNIDENTIFIED FEMALE: OK. How's his breathing?

WALLACE: For instance, new types of injuries from IEDs can be woven into the training here in less than 90 days.

UNIDENTIFIED MALE: We get feedback from our doctors and our VA's back from the war. And this -- the injuries they're seeing.

WALLACE: Eight of the 16 weeks are devoted entirely to combat medicine. Can they work in the darkness? What if they come under fire? Can they handle the seriously wounded?

UNIDENTIFIED MALE: He's doing good. He's doing good.

WALLACE: In this scenario, four soldiers come across an infantry man whose hand has been blown off.

UNIDENTIFIED MALE: Come on, doctor, hurry up. WALLACE: These soldiers have been here now for 12 weeks and say the highly-specialized training is invaluable.

PFC. RUBEN RYAN, U.S. ARMY: By the time we're released to go with the regular line units, it's going to be that much more advanced or be able to pick up the slack where we need to.

UNIDENTIFIED FEMALE: Come on, doctor, hurry up. We've got to get going.

UNIDENTIFIED FEMALE: All right.

WALLACE: Trying to give these soon-to-be medics a sense of what they'll see on the battlefield before they actually see it for themselves.

UNIDENTIFIED MALE: Hang in there, buddy. We'll take good care of you and get you out of here.

WALLACE: Kelly Wallace, CNN.

(END VIDEOTAPE)

GUPTA: And about 7,000 soldiers will be trained at the school this year. And a third of those training will go off to Iraq within six months of graduation. Good luck to all of you. More HOUSE CALL after the break.

UNIDENTIFIED FEMALE: Soft drink makers agree to a ground breaking deal, to help control childhood obesity. We'll bring you the highlights when HOUSE CALL returns.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. You know, we've talked with leaders from around the country in our efforts to combat childhood obesity. Last year, we spoke with former President Clinton, who talked about the need for rehauling school lunches and vending machines.

Christy Feig now with agreement, brokered by the former president. And they do just that.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): If the Clinton Foundation and the beverage industry have their way, this will be something you no longer see in schools. President Clinton is teaming up with the leaders of the soft drink industry to try and take sugar laden soft drinks out of school vending machines.

BILL CLINTON, FORMER PRESIDENT OF THE UNITED STATES: Cadbury- Schweppes, Coca-Cola, Pepsi Cola, and the American Beverage Association have agreed to new guidelines limiting the portion sizes and reducing the number of calories available to children through their products during the school day. FEIG: Under the voluntary program, elementary schools would only sell water, 8 ounce juices, and reduced fat milk. Middle schools would sell larger sizes of the same products. And high schools could add diet sodas and some sports drinks.

DAWN HUDSON, PRES. & CEO, PEPSI-COLA NORTH AMERICA: We're doing our part to offer healthier products in schools. No calorie or low calorie beverages and nutritious and functional beverages.

It's important to remember that this is about where we sell we products, not about the products themselves.

FEIG: Vending machine profits are an additional source of revenue for many schools. And soft drinks are an easy money maker with kids. But a government study found when schools got rid of sweet sodas, 12 of 17 school districts reported increased revenue. Four reported no change.

The industry hopes to have 75 percent of schools volunteering for the program by the 2008/2009 school year and 100 percent the following year.

I'm Christy Feig reporting from Washington.

(END VIDEOTAPE)

GUPTA: All right, Christy, thanks. And unfortunately, that's it for HOUSE CALL this morning. Tune in next weekend when we celebrate Mother's Day with a look at women's health. And let me just say Happy Mom's Day a week early to my mom.

E-mail your questions to Housecall@CNN.com. Tune in for the answers. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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