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Sanjay Gupta MD

Psychological Effects of War; Sleep and Its Health Effects

Aired March 10, 2007 - 08:30   ET

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

REYNOLDS: Could springing forward cause problems for your waistline?
UNIDENTIFIED MALE: Dr. Sanjay Gupta has the answers along with this week's top medical stories right now on HOUSECALL.

SANJAY GUPTA: Thanks, guys. Welcome to HOUSECALL. We're here in the CNN Newsroom and we are making the rounds this morning of some of the most intriguing medical stories of the week, amazing stories.

First up, the war at home. This week brought to light a breakdown in U.S. veterans healthcare. We're going to look at some solutions to help wounded warriors.

Then, Type A equals anxiety attack. We've all suffered from this. We're going to show you one man's struggle to keep his life together.

And time trials. We turn the clocks forward this weekend for Daylights Savings Time. Does how much you sleep affect how much you weigh? You're going to be surprised.

Finally, meet a wounded Marine who's going from the battlefield to the baseball diamond.

Let's get the show rolling, though, with a hard look at the healthcare of our veterans are receiving. It was a hot topic on Capitol Hill this week, but beyond the headlines are the people, their real stories.

Many of us have a friend, a son, a sister, a father who has fought for our country. Alina Cho takes a look at two young veterans and their struggle to be treated for their wounds of war.

(BEGIN VIDEOTAPE)

ALINA CHO, CNN CORRESPONDENT (voice-over): Army Major Chuck Ziegenfuss might be on a second tour of duty in Iraq were it not for the injuries he suffered in an IED attack in 2005.

CHUCK ZIEGENFUSS, IRAQ WAR VETERAN: Both of my hands and forearms, up to my bicep were injured. My right leg was the skin and the facie underneath it were completely blown off from the inseam. And right above my knee here, all the way to my hip.

CHO: He woke up four days later at Walter Reed Army Medical Center, where he says the care he received was first rate. The problem, he says Walter Reed was dirty. ZIEGENFUSS: After we had complained several times to get somebody to just come in and run a mop on the floor, my mom took a towel from the bathroom and got it wet and drug it back and forth across the floor.

CHO: Ziegenfuss was so fed up, he says he filed two formal complaints. Walter Reed was not available for comment. Today, the 34-year old is still recovering. When he's not with his wife and two children, he works at the ROTC.

Steve Kraft also served in Iraq. His problems are not physical, but mental.

STEVE KRAFT, IRAQ WAR VETERAN: I have a hair trigger temper, you know, I can't be around people. I don't want to be around people.

CHO: The 34-year old was diagnosed with post traumatic stress disorder a year ago, but says the care he needed was not readily available at New York area veterans hospitals. Kraft says he had to wait months for an appointment with a psychiatrist.

KRAFT: You start to self medicate. You find yourself in a bar. And you find something on drugs. You lash out.

CHO: One hospital where Kraft sought treatment told CNN it could not comment on his case, citing privacy laws. At this Manhattan veterans hospital, Director John Donellan promises no one will be turned away.

JOHN DONELLAN, DIR., NEW YORK VETERANS HOSPITAL: The veterans cannot get the care here, we will make it available to them. And even if we have to go outside, we have to go to one of the other hospitals in our network, we'll make the care available.

CHO: Kraft says he finally found a therapist at a veterans hospital two hours away, a sacrifice he says returning vets should not have to make.

KRAFT: Don't appoint a committee to do a review and figure out what happened, and you know, three years down the line fix it. No, fix it now.

CHO: Alina Cho, CNN, New York.

(END VIDEOTAPE)

GUPTA: Fixing the problem, that's what we're talking about, Alina. Thank you.

It is all about the people. We're going to look at some ways to help veterans today help themselves when it comes to navigating the system. And that can be difficult.

We're joined from Washington by Peter Gaytan of the American Legion. Now the Legion is the largest veterans group in the country. Peter is an Air Force Gulf War veteran and has worked other -- helped work other veterans navigate the military medical system for more than a decade now. First of all, thanks for joining us. PETER GAYTAN, AMERICAN LEGION: Well, thank you for having me.

GUPTA: First of all, I understand that there is an agreement that's been reached between the Legion and Walter Reed Hospital. Tell me about that.

GAYTAN: Yes, that's true. This is a ground-breaking agreement, which will open the doors to the transition office at Walter Reed to the American Legion. While the American Legion staff has on occasion gone up and helped brief these wounded service members who are out processing, we were going a step forward with this agreement. And the American Legion will have two paid staff members in the transition office at Walter Reed.

One staff member will help with the PEBs, the physical evaluation boards, that often the delay in these physical evaluation boards cause a delay in their out processing.

GUPTA: Right.

GAYTAN: And they're housed in sub par facilities for even longer. So we will have somebody on the ground assisting with these PEBs to speed along the out processing.

GUPTA: I think the navigation is a large part of this. And Peter, you know, we solicited emails about this. And we got hundreds quite literally. Some people just have a lot of questions about how to navigate the system. I want to read one.

This is from Tom in Washington state. He says, "I have been trying to get help for back pain. It took over a month to get results from my x-ray. I had an MRI on February 10, but still have not received any results. I have received nothing for pain, or any treatment. What should I do?"

Tom is a real person, Peter. What does he do? Because it's a large bureaucracy. It's hard to actually get people who are going to take care of you.

GAYTAN: That is true. And for his specific case, the American Legion recommends to begin with in the VA, talk to your care provider at the VA. Let them know you're not receiving timely healthcare.

If that's a dead end, then you can turn to a patient support service member at the VA facility. You can go with your problems, a patient advocate in the office there.

And in fact, the VA secretary just announced this week that the VA's going to hire 100 more patient advocates to be housed at the VA facility.

GUPTA: Are they easy to get to? I mean, for Tom right now, I mean literally he's watching, can you pick up the phone and reach one of these people?

GAYTAN: He should be able to reach -- yes. They are putting more emphasis on accessibility to these patient advocates.

GUPTA: And are those people in power to actually help Tom then?

GAYTAN: Yes, they are. That's why they're in place. And the secretary identified the need to improve that. And he's hired 100 more patient advocates.

Now if that becomes a dead end as well, the American Legion is here to help. We have service officers in almost every VA hospital who this - who Tom can turn to. And the American Legion can step in and ask what's going on here, why aren't these patients receiving the care they deserve?

GUPTA: OK. Let me get to another one -- something that hits sort of close to home. We at CNN have done a lot of stories on post-traumatic stress disorder. This questions comes from Ken in Tennessee. First of all, about 18 percent of returning Iraq War veterans have PTSD, as you probably know, Peter. Put it in some context.

Ken writes this, "I spent 2005 in Iraq. I have dealt with the VA for PTSD and a number of issues. I feel like they ignore your conditions and will not give you a diagnosis. How can I get the help I need for my PTSD?"

Peter, you know, when it comes to psychological issues, where do they rank? And how does someone line Ken actually get his PTSD addressed?

GAYTAN: It often becomes a problem because the PTSD and mental healthcare needs are not visible injuries, but they're serious injuries nonetheless. And these veterans who are returning back, who are seeking care for mental health, need to be treated in a timely manner from the VA. And it's sad to hear that he's being neglected.

Now one thing that a lot of the returning service members don't realize exist are the vet centers. Vet centers are outpatient mental healthcare clinics that exist and that are run by the VA.

So if he's running into some problems receiving the mental healthcare he needs from the VA healthcare system, I'm not saying turn away from the hospital, but consider the vet center as an option. A lot of them aren't aware of it.

GUPTA: Peter, you've been on both sides of this. You've been in the - you are a soldier and you also are someone who's helping people navigate now. How much confidence do you have? Like if you were injured or sick or something today, going to the VA system, how much confidence do you have in the system to take care of you?

GAYTAN: I have full confidence in the VA healthcare system. However, we as citizens and members of this country who are being protected by the current members of the military, we as citizens need to call Congress and the VA to action and say you need to hold strong your obligation to America's service members who are returning. You need to make sure that these obstacles don't exist.

GUPTA: Yes. GAYTAN: We as citizens need to make sure Congress, the VA, and the president are doing what they need to do to ensure that the service members that you've mentioned today are well taken care of. It's not the obligation of VA or Congress. It's the obligation of every American.

GUPTA: That's a good point. And I want to say to a specific question here because the specifics are really helpful to our viewers out there. Charles in New York writes this, "How does a soldier injured in a battlefield scenario obtain medical records years later to support a chronic injury?"

Let me just say something, these people get injured, and then years later they're trying to get a disability, they're trying to get further treatment. They can't get their medical records if they can't make their case. They really can't do anything about that. What do you say to him?

GAYTAN: They can turn to the American Legion. We have service officers nationwide under my direction and under the direction of the American Legion who assist veterans who come to them who are developing their disability claims.

We can go back years and help them develop their claims based on the paperwork that they need to obtain. We go to DOD. We obtain the paperwork. We go to VA and obtain the paperwork.

If it doesn't - the paperwork is hard to reach or it's been destroyed, we can turn to service members who served with this individual and ask for their testimonials that'll help support their case.

So it's never over. The American Legion is always there to help these service members, regardless of the amount of time that's elapsed.

GUPTA: Well, I applaud what you're doing. And I want to leave you with something as well. We've received many positive emails as well, Peter. I don't want to make it seem like they're all negative. About a quarter of them were actually positive.

This one -- Dan in Tennessee wrote this. "The VA people really care about the vet. It's not just a job. The cutting edge of technology and compassion I receive cannot be matched by any civilian hospital."

Peter, it's good for you to hear that. I just wanted to make sure I read that, because I think the doctors, the nurses, the healthcare professionals are top notch, but it is a large bureaucracy that's sometimes difficult to navigate.

GAYTAN: That is true. The American Legion agrees fully with that statement about the quality of healthcare within VA.

And over the past 30 years, VA healthcare has improved considerably. No longer are you seeing those images that were perpetuated by Hollywood like in "Born on the Fourth of July"...

GUPTA: Right. GAYTAN: ...where veterans were just warehoused in sub par facilities. The quality of VA healthcare has improved considerably. And it is based on the dedication and devotion of the employees of VA. They understand they're not just treating patients. They're treating heroes of this country.

GUPTA: Right.

GAYTAN: And they're dedicated to what they're doing.

GUPTA: Well, Peter, good luck to you. I'm glad the American Legion reached this agreement. I hope it works. I hope it can provide better care for our veterans. Thank you for all that you're doing.

GAYTAN: Thank you. And the American Legion is here to help all veterans.

GUPTA: Thank you.

And as I mentioned earlier, we just talked to Peter Gaytan - as I mentioned earlier, we received a huge amount of emails about the veterans healthcare system. It really impacted us here at CNN. In fact, we were so touched by all your stories, but there were so many that we could not answer all of them here on the show today.

So what we've done is -- I've given you my pledge. I'm going to get your concerns to the Veterans Administration. We're going to make sure all the emails you sent to us get to the people who need to hear that. You do deserve the best of care.

Now for more about how to help navigate the veterans health system, there are a number of websites, including the American Legion website at legion.org. And one that our friends in the Marine corps recommended as well, called woundedwarrior.org.

America's veterans come home from war mentally and physically challenged. But coming up, one injured Marine who's still living his dream to play professional sports, a good story.

And this man's problem could be yours as well. Do you have an anxiety disorder? A few questions to ask yourselves to figure it out.

Plus, make sure you get your zz's this weekend. Yes, it's time to spring forward a little early this year. I'm going to give you a look at the top 10 foods to help you sleep better.

(COMMERCIAL BREAK)

TIME STAMP: 0844:06

GUPTA: We are back with HOUSECALL. Pressure, stress, and the quest to be perfect. Anxiety disorders are the most common mental illness in this country, affecting about 40 million adults a year. It's remarkable. They can strike anyone any time.

Get this. Kevin Penwell was a type A Mr. Control guy. We all know somebody like this until two years ago. He suffered a meltdown.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): At 29, Kevin Penwell knew what he wanted, and he got it. He was an all-American ballplayer, ran a marathon, he had an MBA and a prestigious sales job. But two years ago sitting in a meeting, he thought he was dying.

KEVIN PENWELL, SUFFERED ANXIETY: I sweated profusely. I began shaking. I thought I was having a heart attack.

GUPTA: Penwell had a panic attack, one of many symptoms of anxiety disorders. Others include excessive worrying, shortness of breath, and racing heart for apparently no reason. When a therapist finally diagnosed him, Penwell was shocked.

PENWELL: I never knew that that healthy anxiety could turn on me one day and become negative. It was just - it was a negative force that, you know, really pushed me to the lowest point of my life.

GUPTA: Anxiety disorders affect 18 percent of adult Americans. Often that's accompanied by depression and substance abuse.

ALAN MANEVITZ, DR., PSYCHIATRIST: When people have an anxiety disorder, they could be paralyzed to the point where they're not functioning.

GUPTA: Experts look to biology, proper exercise, sleep when looking for causes of anxiety disorders. Also external factors like a bad relationship or job can also have an impact.

The problem may lie here in the amygdala, a portion of the brain that's a sensory information processor, and here in the hippocampus, which processes threats where a chemical imbalance may exaggerate a sense of doom.

MANEVITZ: You're taking in all the sensory information and you're coming up with the conclusion that I'm having a heart attack, that we're going to get killed, we're going to have a blowout. It's a catastrophic conclusion.

GUPTA: According to the American Psychological Association, most patients respond to psychotherapy and medications. Penwell used both. He has a cheat sheet in his wallet with phrases like "things will not be perfect," also reminds him he can't carry his anxiety, but can control it.

PENWELL: I hoped the whole time I was going through anxiety, I'd get back to normal. And that never happened. You know, I actually found a better place, became a better person, became a stronger person. And I'm happy I went through this. And I never thought I'd say that.

(END VIDEOTAPE)

GUPTA: Kevin, things don't always have to be perfect, as it turns out. Only one in five people with anxiety disorders get assistance. And more people need to get actually seen.

How do you know? You're asking yourself, how do you know if you need help? Well, the Anxiety Disorders Association of America says ask yourself some simple questions.

Here they are. Do you have excessive worry most every day for at least six months? Do you have unreasonable worry about a number of different events or activities and the inability to control the worry? If you have any of these issues, you can talk to your doctor. There is help out there. There's also more information. You could check out www.adaa.org.

All right, got to talk about time. Everybody wants more time. After all, it can make or break us. And this weekend, we tackle some of the hot topics of sleep. Can lack of sleep make you fat, huh? Plus, some ways to help you sleep better and longer.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSECALL. We want to check in with Judy Fortin. She has a look at this week's medical headlines.

Judy, what's going on?

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT: Hi, Sanjay. We're starting with some news that may concern brand new parents. Baby girls weighing less than 5.5 pounds may be more likely to experience depression as teenagers. A recent study found almost 25 percent of girls born with low birth weights developed depression compared to less than 4 percent of babies born at normal weight.

We're also following a couple of other stories involving weighty issues. Researchers found low-carb diets like Atkins get the best results. When comparing four diets, women who cut out breads, pastas, and other foods high in carbohydrates for a year experienced greater weight loss, lower blood pressure, and better blood sugar levels.

And a different study says reducing calories might help people live longer. Experts say eating less reduces the amount of damage that normally occurs in our body's cells, DNA, and proteins as we age.

And Sanjay, it's worth mentioning, more research needs to be done on the effects of low-calorie and low-carb diets. Back to you.

GUPTA: All right, Judy. Eating better is always a good idea.

And Judy, you know this. Well, we're losing an hour of sleep this weekend, changing the time and changing your sleeping habits. Could it make you gain weight?

And a Marine who's trading in one uniform for another. Get this. It's a home run of a story. Stay tuned.

(COMMERCIAL BREAK) GUPTA: We're back with HOUSECALL. Here in the CNN Newsroom, time is always critical. And this weekend, everybody's going to be watching the clock as most of the nation changes to Daylight Savings Time, actually loses an hour of sleep early this year.

In this week's "Fit Nation," we look at how sleep could affect your weight.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Bill Ten Eyck has always battled the bulge. He says since his 40s. He suffered three heart attacks and watched the numbers on the scale go up and down like a yo-yo. His cardiologist couldn't figure out why his weight was fluctuating. So he suggested that Ten Eyck see a sleep specialist.

BILL TEN EYCK, SLEEP APNEA PATIENT: I made the assumption that my fatigue, and my inability to do things was because my heart was just failing.

GUPTA: Ten Eyck was diagnosed with sleep apnea. His tests found that some evenings he stopped breathing 33 times in one hour. He wasn't getting rest. And that wasn't helping his weight.

Not only does a lack of sleep zap your energy, but studies have found that sleep-deprived people just seem to eat more. Doctors say chaotic sleeping patterns tend to develop chaotic eating habits, and that can mess up your metabolism and cause you to burn fewer calories.

Researchers have also found that people who got four hours of sleep or less a night saw a rise in the hormone grelin that stimulates the appetite and causes people to eat.

THOMAS LORUSSO, DR., N. VIRGINIA SLEEP DIAGNOSTIC CTR.: They got these patients to sleep better using various sleep hygiene techniques. And when they repeated the levels of these hormones, they found that the level diminished significantly.

GUPTA: Today, Ten Eyck is working on keeping the pounds off. He uses a C-pap device to help regulate his breathing. It blows air through his nose and keeps his airways open. He says it's been a lifesaver, because for once in his life, he's getting a good night's sleep.

(END VIDEOTAPE)

GUPTA: All right, so if lack of sleep can make you fat, let's look at some foods that can actually help you sleep

First of all, bananas. They're practically a sleeping pill in a peel, with melatonin, serotonin and magnesium, a muscle-relaxant. Chamomile tea, warm milk. It's not a myth, milk actually has some tryptophan. That's an amino acid that has a sedative-like effect. Honey, a little glucose tells your brain to turn off. Potatoes. A small baked spud can actually clear away some of those upsetting acids. There's oatmeal, there's almonds, there's flaxseed. Try spreading all of that on your bedtime oatmeal. Whole wheat bread, a slice of toast with your tea and honey will release insulin, which helps tryptophan get to your brain. Turkey - it's the most famous piece of tryptophan. Put a lean slice on some whole wheat bread, you've got one of the best sleep-inducers in your entire kitchen.

There's more to come on HOUSECALL, including the story of a young Marine who's not letting a battlefield injury keep him from his baseball dreams.

(COMMERCIAL BREAK)

GUPTA: We've talked a lot about war veterans on the show today. And we have a story now about a Marine who was injured at war, but still following his dream to play professional sports.

Katherine Garcia of our affiliate KMXV has more.

(BEGIN VIDEOTAPE)

COOPER BRENNAN, IRAQ WAR VETERAN: Well, the medial part and the pinkie, little finger, were blown off and had to be amputated to the bottom of the bone. The thumb was sewn back on. You can see the scars. And also the ring finger was sewed back on.

KATHERINE GARCIA, KMXV NEWS CORRESPONDENT (voice-over): His pinkie gone, blown away after a grenade exploded.

BRENNAN: It just malfunctioned. It went off in my hand.

GARCIA: Cooper Brennan is lucky to be alive. And it turns out, luck is still on his side, because this Marine is now a minor league baseball player under contract with the San Diego Padres.

BRENNAN: It's been a dream of mine that I've been wanting to fulfill since a little kid.

UNIDENTIFIED MALE: Cooper just happens to have a good right strong pitching arm.

GARCIA: And Brennan says being one finger short hasn't been an issue.

BRENNAN: I just kind of put it over. I put the ring finger into the pinkie slot and just adjusted other two fingers over. You know, and then this one, where the pointer finger would be, is empty. And I can squeeze the ball pretty good.

GARCIA: The Padres think so, too, with an array of pitches and a 93 mile-per-hour fastball, but Brennan's still a soldier first.

SANDY ALDERSON, SAN DIEGO PADRES: He's still got a couple of months left. So you know, hopefully, he'll keep that military hair cut.

GARCIA: And after that, this war hero will give up the combat zone to focus more on the strike zone.

GUPTA: All right, Katherine. What a great story and good luck to you with the Padres as well.

That's the news today from the world of medicine. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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