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Sanjay Gupta MD

The Legacy of Hurricane Katrina; Cancer Vote; How Do You Know When You Need a Second Opinion?; Ask the Doctor

Aired September 01, 2007 - 08:30   ET

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

SANJAY GUPTA, HOST: Thanks, guys. This is HOUSECALL. We're making the rounds this morning of some of the most intriguing medical stories of the week.
First up, Katrina. Two years later, I paid a visit to New Orleans and found the legacy of the storm still runs very deep. For many, it's still a question of life and death.

Then, the cancer vote. Funding, treatment, and a cure -- will it matter to your next president? Plus, how do you know when you need a second opinion? We'll have some tips on when and why you need to double-check your doctor's diagnosis.

Also, have the answers to some of your craziest medical questions you never asked until now. It's our new feature called. It's called "Ask the Doctor."

First up, though, our top story. It's been two years since Hurricane Katrina hit the Gulf Coast with these horrific consequences. As you know, New Orleans took the brunt of the storm. Now all eyes are on the city again. Some presidential candidates visited, talking about the necessity to continue rebuilding.

I was in New Orleans two years ago to the day. And the healthcare system was completely broken. Even hospitals became death traps. And now, well, I returned to find a disturbing problem.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It's been two years, and the images still haunt me. Patients desperate to be rescued.

UNIDENTIFIED MALE: Two of them have already died here on this ramp waiting to get out on this very spot.

GUPTA: Early casualties in the chaotic aftermath of Katrina. But surely, things must have improved by now, two years later.

KEVIN STEPHENS, DR., DEATH RATE STUDY AUTHOR: We would just stop. I mean, we counted the deaths in 2006 for the first six months. And that's when we saw a 47 percent increase in the number of deaths.

GUPTA: A 47 percent increase in deaths as compared to before Katrina, more people dying long after the floodwaters had cleared.

STEPHENS: Our studies showed excessive mortality, meaning these are people who would not have died had it not been for Katrina.

GUPTA: Physicians working in the emergency rooms day in and day out say in the wake of Katrina, fewer doctors and patchwork care mean more people die from treatable diseases like diabetes, heart disease, even mental illness.

JAMES MOISES, DR., TULANE UNIVERSITY HOSPITAL: I mean, we're seeing that the population that we see here in the emergency department, they're sicker. And that's where we're seeing large number of death rates increase 47 percent.

GUPTA: But the top health official in the state says the numbers are misleading and inflated.

FRED CERISE, DR., DEPT. OF HEALTH & HOSPITALS: What we're seeing is that we did not have a sustained increase in mortality. And we feel comfortable that the death rate itself is roughly where it was pre-Katrina.

GUPTA: Dr. Cerise Bases his numbers on official state death certificates, which he acknowledges are not real-time reporting. These paper records take months to update. In fact, when Dr. Stevens, who's the medical director of New Orleans, asked the state for actual death records, even he couldn't get them. They weren't ready. So he was forced to turn to a surprising source, the local paper.

STEPHENS: Tell the state to actually get on the death certificates and do their analysis. There's probably a quick and dirty way, if you will, to get an estimate of what's going on.

GUPTA: This particular day, we saw three full pages of obituaries. What's even more remarkable is the number of deaths is probably better recorded by the newspaper here in town than by the state itself. We decided to find out why.

CERISE: In the period immediately after Katrina, our vital records section was located in New Orleans. There was a period where that was not our primary focus.

GUPTA: Truth is many doctors and patients feel two years later, they are still not the primary focus. And shockingly, the city and the state are so disorganized, there are no realtime records on the continued impact of Katrina. No definitive up to date numbers on who was alive and who is dead.

(END VIDEOTAPE)

GUPTA: There are many doctors who have left New Orleans, we know that. Not just the ones that treat the body, but also the mind. In fact, according to a survey last fall, the number of psychiatrists had fallen from 220 before Katrina to just a mere handful now. Many people just aren't getting the help that they need.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: You don't want to be back on this medicine? OK.

GUPTA: Two days in this tiny room. Carlton Jackson is still waiting to be admitted as a psych patient.

JERRYARTIS BRUMFIELD, JACKSON'S AUNT: All of a sudden, just somebody was trying to hurt him, somebody was trying to kill him. And he got angry at home, upset.

GUPTA: Twenty-two years old and paranoid schizophrenic. He's bounced in and out of emergency rooms for weeks. His aunt hopes he can get help before he hurts her or himself.

JAMES MOISES, DR., TULANE UNIVERSITY HOSPITAL: Very difficult. You see a half dozen patients like Carlton every day.

GUPTA: Emergency room doctors say a good portion of their beds are filled with mentally ill patients, some violent, some not.

CECILE TEBO, NEW ORLEANS HEALTH DEPT.: In the past six to nine months, we have started to see a huge surge of those with chronic mental illness returning back into the city.

UNIDENTIFIED MALE: Slow down your breathing.

GUPTA: And their timing couldn't be worse. More survivors are also developing new problems. Mental illness is double the pre-storm levels, according to early findings from an ongoing Harvard Medical School study with the staggering jump in the number of residents seriously considering suicide and showing signs of post traumatic stress disorder.

PETER DEBLIEUX, DR., MEDICAL CENTER OF LOUISIANA: Mental health care services right now in the city is like an orphan, but you know, I kind of liken it to an ugly orphan. You know, nobody really wants it. Nobody really wants to look after it.

GUPTA: State and local officials say more beds and services will open in the next few months.

UNIDENTIFIED FEMALE: Oh, I love you. Love you, love you.

GUPTA: But for now, people like Carlton can only wait.

(END VIDEOTAPE)

GUPTA: You know, and we wish Carlton and all the others in New Orleans the very best as they try and get through this. If you watch this and want to help the Gulf Coast recover, you can make an impact. Just go to cnn.com/impact. There you can connect with organizations that definitely need your help as we found out.

Presidential candidates are hoping to make an impact by making health care an issue on the campaign trail. Now the Cancer Forum hosted by Lance Armstrong in Cedar Rapids, Iowa, Democrats and Republicans talked about the importance of cancer funding and the need for a clear plan. (BEGIN VIDEOTAPE)

SEN. HILLARY CLINTON (D), PRESIDENTIAL CANDIDATE: The big goal of the war against cancer has to be fit into the absolute essential big goal of quality affordable health care, universal health care for every single American. You cannot do one without the other. And we need to do both. And I intend to.

MIKE HUCKABEE (R), PRESIDENTIAL CANDIDATE: It costs a lot less money to provide screenings than it does to wait until people are diagnosed in stage four and then wonder how on earth we're going to find enough money to treat them for the long-term effects of a cancer.

SEN. JOHN EDWARDS (D), PRESIDENTIAL CANDIDATE: If you think about this just in basic logic, the hundreds of billions of dollars that we spend taking care of people with cancer, if we invest a billion or $2 billion or $5 billion or $10 billion in finding a cure, think about the extraordinary economic benefit from that. Just the economic benefit. That's not even thinking about stopping the spread of the disease and stopping people from getting sick. So I am committed as commander in chief to dramatically increasing our research in this area.

SEN. SAM BROWNBACK (R), PRESIDENTIAL CANDIDATE: What better way, what better way for the federal government to show that they are working for the American people than to take on the objective of ending deaths by cancer in 10 years?

GOV. BILL RICHARDSON (D), PRESIDENTIAL CANDIDATE: We are going to more than double cancer research. I mean, we went to the moon. John F. Kennedy, I remember, we're going to go to the moon in 10 years. Why don't we have a similar plan that we will conquer cancer?

(END VIDEOTAPE)

GUPTA: Republican candidate Mitt Romney is also talking cancer. At a Susan G. Komen event for the Cure conference, Romney said there needs to be more money for cancer research.

(BEGIN VIDEO CLIP)

MITT ROMNEY, (R) PRESIDENTIAL CANDIDATE: It's pretty clear that breast cancer and cancer generally are not getting their fair share. And so I believe that a scientifically based evaluation of where money goes suggests that you're going to see a great deal more funding for breast cancer and cancer generally.

(END VIDEO CLIP)

GUPTA: All the way to election day, we'll be watching how your vote can affect your health. That's right here, of course, on CNN.

When you can't get to your television, we can, from time to time, certainly go online. This week's candidates are speaking out. Click over to cnn.com/housecall to find out what they're saying. Discover, for example, why John Edwards is trying to take Hillary Clinton to task over health care. Plus, candidates' own health problems. That used to be taboo. Find out how that's now changing.

Then, we're going to do something new here at HOUSECALL. We're going to put the show into your hands. Go to cnn.com/health and vote for which topic you'd like to see on HOUSECALL next weekend. Cast your vote for one of the three topic. We got chronic pain, we got dealing with stress, and we have vision surgery. And of course, you'll see it right here next weekend.

Now news that for the sixth straight year, the number of Americans without health insurance has grown. The Census Bureau reports 47 million were not covered by health insurance last year. That's up from 44.8 million in 2006. This represents almost 16 percent of the population.

Now, what may surprise you is that the fastest growing group without insurance, households making $75,000 or more. Again, households making $75,000 or more, the fastest growing group of uninsured. The Census Bureau finds fewer workers are getting coverage from their employers.

Now still to come on HOUSECALL, making sure your doctor is right. It's not always easy. Why a second opinion is important and when you need to go for one. Elizabeth Cohen will be here for that.

Then from football to wrestling, when it's no longer just a game.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: By the time I hit the ground, I had a terrible headache. And I didn't know really where I was or what I was doing.

(END VIDEO CLIP)

GUPTA: But first, just 60 seconds away, a test about getting clean. It's a battle of the soaps. Do you know who wins? Stay with us.

(COMMERCIAL BREAK)

GUPTA: So how do you get the germs to hit the high road? Well, we asked before the break what kind of soap is the best, antibacterial or regular soap? New study says it's not the soap, really, but how you wash your hands that matters. So anti-bacterial soap is no better or any worse for that matter at killing germs.

We spoke with the doctors in the infectious disease unit of Washington Medical Center. They say the best way to fight common germs is to wash your hands 15 to 30 seconds with warm water and soap, any soap. Even the flu virus can be stopped if you wash your hands correctly. Important advice if you're spending a lot of money on those products.

Now in medicine, a second opinion can make all the difference. Medical correspondent Elizabeth Cohen is looking into second opinions while being an empowered patient. Really interesting. I think most doctors are OK with getting second opinions, but how does a patient know when they should get one?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Well, a patient should definitely ask their doctor. And you know, a second opinion is often a good idea when your doctor suggests a procedure.

But here's a good rule of thumb. If your doctor suggests an invasive procedure for which there are alternatives, those are two good reasons to go ahead and get a second opinion. So here are two procedures that our experts told us, very important, get a second opinion.

And the first one is heart bypass surgery. Heart bypass surgery means opening up the chest. And there are alternatives these days that weren't around decades and decades ago. For example, stents might work for you instead of bypass surgery.

And here's another one. Varicose veins. There are several different options for varicose veins, which are unsightly, not to mention painful. And if you get the wrong procedure, it's probably not going to help you. So worth it, doctors say, to get a second opinion.

GUPTA: Yes, and you know I mean, people worry about costs for these sorts of things. So if you have your doctor and you go to get a second opinion from another doctor, will your insurance cover that?

COHEN: No, insurance generally does pay for second opinions. When we talked to insurance industry folks, they said we want you to get the right procedure. They will pay for it, especially if it's a complicated medical problem.

GUPTA: I'm always hear for a second opinion for you.

COHEN: Well, thank you. I'll remember that. Thank you.

GUPTA: Good advice. A lot of people - really curious about that, especially when they're confronted with this sudden information about their own health.

COHEN: Right.

GUPTA: So good stuff. Thanks a lot, Elizabeth.

And you can, of course, read more of Elizabeth's column on the top five procedures for getting a second opinion at cnn.com/health.

Now some athletes take a beating on the field, and they keep on going. But sometimes playing the game means playing with your life.

And later in the show, a common problem caused by ice cream and slushies. We've all eaten that from time to time. Ask the doctor what to do. We have the answer. Stay tuned to HOUSECALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSECALL. Let's get straight to Judy Fortin with this week's medical headlines. Judy?

JUDY FORTIN, CNN CORRESPONDENT: Hi, Sanjay. Some interesting medical stories to tell you about this week.

A damp, moldy house is not only unpleasant to live in, but it may lead to depression, according to a study of almost 6,000 European adults. Researchers say dampness and mold may cause health problems, such as asthma, headaches, and nausea and a perceived lack of control over the home, which ultimately triggers depressive symptoms. The authors say more should be done to promote healthy housing.

Pre-menopausal women whose ovaries are removed to prevent cancer or disease face increased risk of dementia and cognitive impairment later on in life. A new Mayo Clinic study finds estrogen replacement therapy may be a good option for these women because of the protective effects on the brain. The Mayo researchers say for such women, the sooner estrogen therapy begins, the better.

A drug widely used to lower cholesterol may also help lower the risks of Alzheimer's disease, early findings from a small study suggest. Researchers compared the autopsy brains of people who took statins and those who did not. And it found people taking the drugs had fewer of the disease-related plaques and tangles found in the brains of those who have Alzheimer's.

The authors say more study is needed on the benefits of statins outside of cardiovascular diseases. Sanjay, back to you.

GUPTA: Thanks, Judy. And that was something I was really following this week as well about the statin drugs. Really interesting story there. You can read more about it on my blog at cnn.com/health. To find out why I'm urging caution about this news, also to tell me what you think. While you're there, you can also download this week's podcast containing all the highlights of HOUSECALL.

Now college football is back this weekend. Go, blue! And sometimes players play a high price in the grid iron battle. Approximately 1 million Americans are treated for head injuries every year, many of them are athletes. From the field to the ice, it's a dangerous game.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Brute force can lead to concussions, an injury most often caused by a blow to the head, where the brain violently rocks back and forth inside the skull. Symptoms include dizziness, severe headache, vomiting, confusion, memory loss. Multiple concussions can be devastating.

GERARD GIOIA, DR., CHILDREN'S NATL. MEDICAL CENTER: They're in short succession. And if they're poorly managed, the long-term consequences can be pretty significant. They can actually have structural damage to the brain.

GUPTA: Pro football players are especially susceptible. The University of North Carolina studied nearly 1,800 retired NFL players. The 200 who had five or more concussions were three times as likely to suffer from depression than players who had none. 44-year-old Andre Waters, a former player, suffered numerous concussions during his NFL career. Reportedly depressed, Waters committed suicide last November. Dr. Bennett Amalu examined Waters' brain tissue. He says Waters had the brain of an 85-year-old man. And that brain damage from his concussions contributed significantly to his suicide.

BENNET OMALU, DR., NEUROPATHOLOGIST: There was significant loss of brain cells. There were accumulation of abnormal -- large accumulations of abnormal proteins that kill off the brain cells.

GUPTA: Chris Nowinski played college football and was a professional wrestler. He's had at least six serious concussions that he can remember. His last was the most damaging.

CHRIS NOWINSKI, FMR. FOOTBALL PLAYER WRESTLER: I got kicked in the chin, and my head snapped back. And by the time I hit the ground, I had a terrible headache. And I didn't know really where I was or what I was doing.

GUPTA: He's written a book to educate other athletes about the dangers. It's been years since his last match. He still has severe migraines, problems with memory, sleeping, and says he'll probably be on medication for the rest of his life.

NOWINSKI: I lost a lot of my ability to think straight and accomplish anything or, you know, be productive. I lost that.

(END VIDEOTAPE)

GUPTA: A fate he hopes other young athletes can be spared. As you watch some of those games, just keep in mind the price that they pay sometimes being out there on the field.

Coming up, though, new rankings of the fattest states. How does your neighborhood weigh in?

And preventing childhood obesity before birth. New research may help doctors stop a growing problem. HOUSECALL's got it.

(COMMERCIAL BREAK)

GUPTA: Welcome back. Here at HOUSECALL, we're committed to the fight against obesity. Some startling new numbers to share with you that shed some light on just how widespread obesity is. According to a report by the Trust for America's Health, obesity rates are up in 31 states.

Now in case you're curious, Mississippi tops the list with more than 30 percent of its population considered obese. West Virginia, Alabama, Louisiana, South Carolina and Tennessee are all close behind. Colorado is the leanest state with 17.6 percent obesity.

The rate of combined overweight and obese adults now exceeds 60 percent in 32 states. And as staggering as these numbers are, there are government figures which are even higher.

Too much sugar can help you pack on the pounds. You know that. And many times, though, it comes in the form of high fructose corn syrup. It's in everything from snacks to soda. But this kind of sweetness can be dangerous.

According to a new study by the American Chemical Society, sodas sweetened with high fructose corn syrup may contribute to diabetes in kids. That's right. Researchers say that compounds in corn syrup aren't found in regular sugar and may actually damage some tissue.

And women who develop diabetes during pregnancy may be passing a higher risk of obesity on to their babies. New research finds the higher the mother's blood sugar, the greater the risk of a child being overweight or obese by age 5 to 7 years old. That risk disappeared. If the women with diabetes followed a special diet, they exercised, or they took insulin.

A couple questions for you. Can cracking your knuckles cause arthritis? You asked that question. We got some answers. Our new segment is called "Ask the Doctor" is up next.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSECALL. This week, we're trying something new. Hitting the streets to answer some of your medical questions, things that are on your minds. It's our new segment. We call it "Ask the Doctor." Here's what one viewer asked.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I'd like to know, if I eat my ice cream too fast, why would I get a headache?

(END VIDEO CLIP)

GUPTA: It's amazing how many questions we get like that. That's a great one. This phenomenon is known as the brain freeze effect. A lot of people know that.

Now here's what you maybe didn't know. It happens when the chill of something frozen hits the roof of the mouth and actually triggers a nerve that temporarily alters blood flow to the brain. That may sound complex, but if this has happened to you, don't worry you can still enjoy that delicious cone. Brain freeze usually lasts less than two minutes. It can be excruciating, though. Best thing is to avoid it. Eat those cold foods slowly. You can actually sometimes run your tongue across the roof of your mouth to warm it as well. Another question now.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Can cracking your knuckles cause arthritis?

(END VIDEO CLIP) GUPTA: This is an amazingly common concern. First of all, the cracking sound that a joint makes when it is stretched, pushed, or pulled are caused by changes in pressure within the joint capsule. Now we talked with the Arthritis Foundation specifically, who assures us knuckle cracking does not lead to any type of arthritis or joint degeneration. Cracking joints causes no known long-term health problems either. So your mother's warnings were probably meant to stop a bothersome habit instead of warning of dire health consequences.

We have much more of those in the weeks to come. Unfortunately, though, that's it for today's edition of HOUSECALL. Remember, this is the place for the answers to all of your medical questions. Thanks for watching. Stay tuned now for more news on CNN.

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