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Sanjay Gupta MD

Special Edition Coming to You From Delhi, India: Country is Becoming a Hot Spot for Medical Tourism; Twittering During Surgery: Social Networking Could Have Some Real Educational Benefits; Are We Overly Concerned About Germs?; Spicing Up Your Health: What Spices May Provide the Most Health Benefits

Aired February 28, 2009 - 07:30   ET

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

DR. SANJAY GUPTA, CNN HOST: Good morning. And welcome to a very special edition of HOUSE CALL -- the show that helps you live longer and stronger. This is a special edition coming to you from Delhi, India.

You know, this country is becoming a hot spot for something known as medical tourism. Thousands of people are flocking here for specialized medical care. The question is why?

And also, Twittering during surgery. How using social networking could have some real education benefits.

And then: spicing up your health. We're going to go to a local market and figure out what spices may provide the most health benefit. It may surprise you.

But first, we are talking about medical tourism. It's a phrase I'm sure you've heard me use before. To do a simple Google search, it will turn up more than 5 million results. It is a booming industry. A lot of it is taking place here in India. And it's really piqued my interests.

Some of the numbers are pretty staggering. More than 750,000 Americans leave the United States every year to go to foreign countries to have their operations -- big operations such as orthopedic operations and heart surgery. Patients do come from all over the world, from United Kingdom, from Afghanistan, from Nigeria, and a lot of them end up here -- for good reason. Oftentimes if you go to India, Singapore, Thailand, the cost is a fraction of what it is in the United States, about 10 percent.

But the real question is: does it make a difference? We decided to follow this one woman, a 61-year-old Las Vegas native. She came to India when she was told that she needed life-saving heart surgery. She's going to see private suites; she's going to see personal chefs; she's even going to have a personnel concierge.

But does all of that seem to make a difference? That's a question we had, that's a question we're going to answer in the weeks ahead.

But first, let me ask you: when you think of countries with state-of-the-art leading medical technology, what comes to mind? India? Maybe not.

But I have to tell you, being here now for some time, this country is making a lot of great strides. So I decided to go inside one of the hospitals and spend some time talking to a leading neurosurgeon.

(BEGIN VIDEOTAPE)

GUPTA: I'm here with Dr. Ajaya Nand Jha, who's the director of neuroscience at the Max Hospital here. Thank you so much for joining us. Appreciate it.

DR. AJAYA NAND JHA, NEUROSURGEON, MAX HOSPITAL: Thank you, Sanjay.

GUPTA: Medical tourism, patients coming from foreign countries to India is becoming quite common, quite popular. Why is that?

JHA: Well, there are two things. I think one -- there is a lack of availability of health care in many of the surrounding countries of India. And, two, as far as developed countries are concerned, like the United States, there is a huge cost issue. There is huge number of uninsured patients who can't afford to get the treatment done in their countries and they can get it done at a fraction of the cost in this country.

And slowly, we are developing a reputation of having the best technology in the world and some of the best people in the world to do this. So, naturally, patients will gravitate towards something where they can afford the treatment and yet be reasonably sure that they are going to get a good outcome at the end of it.

GUPTA: How good is the care here? When the average person hears (ph) in the United States, if someone is going to go to India to get their operation, they may be a little bit suspicious.

JHA: Absolutely. It's a different culture, it's a different environment. Many Americans have not even traveled outside their state. So, there is a mental block to people coming here.

But I think a lot of that goes away because we communicate a lot with them through our -- through our -- through the e-mail, through Internet and telephone calls. So they have a fair idea. They can look on the Net today and actually, physically see the facilities, do virtual tours, and get a comfort level.

As far as the technology is concerned, we use the same machines that they use in the United States. And the people, our doctors, staff and people, many of them are well-trained, most of them are trained outside of this country or have gone to courses and training and keep regularly updating themselves. But certainly, there is a gap at the lower levels where the nurses, the best nurses have gone to the United States. So, we have to keep on retraining our people.

GUPTA: Right. JHA: It wouldn't be exactly as people expect, but then when you travel to a foreign land, always you will find things different. Sometimes better, sometimes not so good. So ...

GUPTA: This is an amazing operating room. You know, you have an intraoperative MRI scan over here, which is something you hardly see in many hospitals in the United States, certainly, places around the world. You're looking right now at an operation team taking place on a brain tumor. There's microscope, operating microscope. There's a navigation system.

As you say, it's some of the most technologically-sophisticated equipment anywhere in the world. How can you do it so much cheaper? I mean, 10 percent of the cost of the United States?

JHA: Well, we don't look at recovering money from each of our machines that you buy. What we wanted to do when we set up this organization was to provide a high-quality of care, then we got to do whatever it takes. And this room, for instance, cost us a huge amount of money. The floor is reinforced. There's a seven-ton magnet out here; there's an image guidance system, endoscopes.

So, our philosophy is not to get money just from this, because we charge only 25,000 rupees extra when we do a case in this room, which is about $500,000. So, we can never recover the cost of this machine. But we wanted to create an environment where the (INAUDIBLE) of neurosciences, we could do the treatment and this is the price we have to pay.

So, our people cost as much lower than the United States and we negotiate very hard with our vendors.

GUPTA: Indians are good negotiators.

JHA: Good negotiators.

GUPTA: Yes.

JHA: So, we -- and we are very careful about what we are using in the operating rooms. We look very carefully at even $10 items, we would think if do we need to use this or do we not need to use this. So, we're very cautious.

GUPTA: Keep up the good work, Dr. Jha. Thank you so much. Thanks for having us here.

JHA: Thank you.

(END VIDEOTAPE)

GUPTA: And back in the United States, doctors are networking from the operating rooms. We're going to join Elizabeth Cohen. She tells us about Twittering during surgery.

(BEGIN VIDEOTAPE) ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT (voice-over): It's just after 7:00 a.m. at Henry Ford Hospital, and the surgical team is about to embark on a complicated cancer surgery.

UNIDENTIFIED MALE: Let's do this!

COHEN: They are ready to go. Doctors, check. Nurses, check. Twitter, check. Twitter?

UNIDENTIFIED MALE: So, we are Twittering? Oh, good.

COHEN: That's right. Surgery meets social networking. The surgeons are Twittering the entire procedure for all the world to read.

(on camera): So why are you Twittering a surgery?

DR. CRAIG ROGERS, HENRY FORD HOSPITALS: We're trying to use this as a way to get the word out.

COHEN (voice-over): Teaching via Twitter. Dr. Craig Rogers and his team want people to know about a relatively new technique to remove a cancerous tumor on the kidney without having to remove the entire kidney. "Wow! Live tweeting of surgery from Michigan," tweets one follower. While Dr. Rogers performs the robotic surgery, chief resident, Dr. Roge Langani (ph), documents what's going on in real time.

UNIDENTIFIED MALE: There is the tumor. See it? Right there.

COHEN: They finally reach the tumor, but then the Dr. Langani has to tweet some bad news.

UNIDENTIFIED MALE: My gosh, this is big.

COHEN: Dr. Langani immediately let's the Twitter-verse know, "The tumor has been isolated and it is penetrating very deep into the kidney."

UNIDENTIFIED MALE: OK. Spencer, let's talk this through.

COHEN: They may have to remove the entire kidney. And that's exactly what they didn't want to do. Dr. Rogers knows the Twitter universe is watching.

UNIDENTIFIED MALE: Could I have picked a harder case for this?

COHEN: Adding to the tension, they have only 30 minutes to get the tumor out before a lack of blood flow damages the kidney. Then there's another problem -- they're having trouble controlling the bleeding.

UNIDENTIFIED MALE: I'm going to need you to suck like there's no tomorrow.

COHEN: Just in the nick of time, crisis diverted. In the end, Dr. Rogers saves the whole kidney and shares the good news with the Twitter-verse.

UNIDENTIFIED MALE: Nice Twittering.

COHEN: Elizabeth Cohen, CNN, Detroit.

(END VIDEOTAPE)

GUPTA: HOUSE CALL is back in 60 seconds with the medical headlines. Plus, debunking the germ house. Is living in a germy house, a good thing? Stay with HOUSE CALL.

(COMMERCIAL BREAK)

JUDY FORTIN, CNN MEDICAL CORRESPONDENT: Welcome back to HOUSE CALL. I'm Judy Fortin with this week's medical headlines.

It's being called a major breakthrough by the ALS Association. Researchers are finding a new gene that causes Lou Gehrig's disease or ALS. Scientists say the gene is responsible for about 5 percent of inherited cases and plays a similar role to another ALS gene they discovered last year. This new discovery gives them genetic clues as to how the disease works. And more importantly, clues for its new treatment -- important because at this time, there is no known cure for Lou Gehrig's disease.

Can vitamins help you see? In a new study, researchers found that women taking a combination of B-6, B-12 and folic acid reduce their risk of age-related vision loss. Macular degeneration is the leading cause of blindness in older people. Nearly 9 million Americans have some form of it. Researchers say B vitamins lower levels of homocysteine, an amino acid which could damage the small blood vessels in the eyes.

And there's been a lot of debate whether alcohol is good for our bodies. Now, a report in the "Journal of National Cancer Institute" says alcohol may increase a woman's cancer risk. Researchers found that drinking alcohol may account for nearly 13 percent of the breast, liver, rectum, and upper digestive cancers in women. This was a very large study in the United Kingdom. Most of the women had at least one drink a day.

Researchers found the risk of cancer went up when alcohol was consumed -0 whether it be wine, beer, or hard liquor. Now, according to the NIH, if you look at this study, there is no level of alcohol consumption that can be considered safe when it comes to cancer.

HOUSE CALL is back in just 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Welcome back to a very special edition of HOUSE CALL. We're here in the streets of Old Delhi, an open market place often teeming with people and lots of vendors as well, selling food in the open market. Lots of questions about the food, how it's prepared, are there concerns about selling it in the open air like this? But are we overly concerned about germs? We decided to have an American microbiologist go to a typical home to try and find out just how germy we really are. More importantly, should we be more concerned?

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Most parents worry about the germs in their house.

LAURA AUSTIN, MOTHER: The thing that concerns me the most is the baby crawling around on the floor, maybe licks the floor. So, there's just no telling what he's picking up.

GUPTA: The Austins allowed us to put their home to the test. Microbiologist, Dr. Zehava Eichenbaum, stopped in for a visit and inspected the place.

Let's take a closer look. What about the bathroom?

DR. ZEHAVA EICHENBAUM, MICROBIOLOGIST: The bathroom seems like the grossest place, but maybe it's not.

You would find more bacteria in the kitchen sink than you would find in the toilet seat.

UNIDENTIFIED MALE: I'd be very curious in there what kind of stuff ...

EICHENBAUM: Yes, I think it's going to be a jungle.

GUPTA: A jungle of bacteria that can make you sick. And now that you're concerned about your kitchen, let's dig in a little deeper.

(on camera): The kitchen sink has to be one of the dirtiest places in the house. And the sponge -- even worse. Wipe that sponge across the kitchen sink, never know what you're going to get.

EICHENBAUM: MRSAs, staphylococcus, you find salmonella, you found e. coli, you found, you find pathogenic and un-pathogenic bacteria. Everything that we bring to the kitchen, you know, we will find in the sponge.

GUPTA (voice-over): And wait, how about this? Door knobs and handles.

EICHENBAUM: Many people touch them. It's not, you know, it's just another single person. So we transmit bacteria. Those places are going to be not clean.

GUPTA: And there's even more nasty stuff around the house. Did you ever wonder about your bed sheets?

AUSTIN: I change the baby's and Hank's at least once a week. Ours probably get washed about once every couple of weeks.

GUPTA: A couple of weeks? Well, here's the surprise.

EICHENBAUM: We do shed bacteria from basically through the skin or through secretions, where the bacteria that we have will be on that bed sheet.

GUPTA: And bedroom bacteria is one of the biggest causes for allergic rhinitis.

So, we took the swab samples to grow in the lab and here's what we found. The results -- typical.

EICHENBAUM: Everywhere that we swabbed beside the counter (ph), we found bacteria. And these are typical bacteria that you find in a normal environment. I think it's important to keep in mind that most of the bacteria in the environment are not pathogenic to people. And then, most of the encounters that we have with bacteria, even if they are pathogenic do not resolve in infection or disease.

GUPTA: Bottom line, while most of these microorganisms are found on our body, some can produce disease if they're inhaled or digested or come into contact with broken skin.

UNIDENTIFIED MALE: It's good to hear that the house is pretty clean.

GUPTA: You can put your mind at ease. While there's no way to germ-proof your home, good old-fashioned hygiene practice helps reduce the risk of getting sick and keep those serious infections away.

(END VIDEOTAPE)

GUPTA: The good news is that simply washing your hands can keep a lot of colds and viruses at bay. But you've got to remember to wash your hands for at least 15 to 20 seconds.

And remember, they say variety is the spice of life. But could a variety of spices actually lead to a longer life? We're going to take you to a special market. That's later in the show.

(COMMERCIAL BREAK)

GUPTA: And we are back with a very special edition of HOUSE CALL, reporting to you from the streets of Old Delhi. We're here doing a bunch of stories about the surge in medical tourism, and a lot of those patients ending up right here in Delhi. We'll be bringing you those reports over the next few weeks.

But for now, let's toss it back to the CNN Center and Elizabeth Cohen for the "Empowered Patient."

COHEN: Sanjay, we've all heard so much about the problem of people not having health insurance in this country -- 47 million Americans and counting. There's sure to be many more as more and more people get laid off. We talked to one woman who's in this position to find out what she's going to do.

(BEGIN VIDEOTAPE)

COHEN (voice-over): In early 2008, life was going great for Pamela Rinchich. She had a good job and was about to get married. Then, in March, the plant where she had worked for more than 20 years in Sarasota, Florida, shut down and she lost her job. And with it, her employer paid health insurance.

PAMELA RINCHICH, UNEMPLOYED CANCER PATIENT: I was upset but I thought it would be all right.

COHEN: But two months later, an even bigger bombshell.

RINCHICH: I found out I had breast cancer.

COHEN: Rinchich does have insurance, but she's paying through the nose for it. Her unemployment check is $900 a month, and she pays $368 of that just for insurance. And the insurance has high co-pays and deductibles. So now, she's $20,000 in debt because of her medical expenses. One doctor has even refused to see her until she pays her bills.

RINCHICH: I offered to go and do all I could, even to work in their office to cover it.

COHEN: According to the Department of Labor, more than 1.7 million jobs were slashed in the past three months. Analysts believe about half of the people who lost jobs also lost their employer-paid insurance.

(on camera): When people don't have health insurance, they often end up here in the emergency room and that costs all of us. It's one of major reasons why insurance premiums have skyrocketed.

DR. KATE HEILPERIN, EMORY UNIVERSITY HOSPITAL: In many respects, we all are paying for the uninsured. Those who don't have health insurance are actually impacting those who do have health insurance.

COHEN (voice-over): And despite efforts from the president, Congress and others ...

RON POLLACK, EXECUTIVE DIR., FAMILIES USA: I think there's no question that it is likely to get worse before it gets better.

COHEN: As for Pamela Rinchich, she's done with her chemotherapy. And for now, she's cancer-free, but more surgeries lie ahead.

RINCHICH: I just try to keep a positive attitude.

(END VIDEOTAPE)

COHEN: If you or someone you love needs medical care, but don't have insurance, you can go to CNN.com/empoweredpatient -- I have some tips for what to do.

Also, you'll see this week's "Empowered Patient" column. It's about a woman named Dr. Doreen Kossove. She passed away this month. And in her final years, she dedicated herself to helping other people with rare cancers. Again, CNN.com/empoweredpatient.

From "Empowered Patient," I'm Elizabeth Cohen.

GUPTA: Now, chronic back pain affects millions of people. Ahead -- one man, facing an operation, is looking for answers. Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: And we're back with HOUSE CALL, coming to you from a hospital in New Delhi. We may be out of the country, but we're not forgetting to check our inbox. We'd get lots of e-mails and lots of different topics.

Let's get to one now. This is from Dan in Florida, writes this, "I have severe spinal stenosis. How do I select a neurosurgeon who is proficient in this type of surgery? And what is the approximate recovery time?"

Well, Dan, thanks for writing in. First of all, spinal stenosis is a narrowing of a lot nerve roots in your back. What sometimes happens is people get pain not only in the back but also shooting down the legs. It's main characteristic when it happens when someone walks and it gets better when they stop walking or sit down or lie down.

Oftentimes, you see people sort of hunched over like this because it makes their back feel better. If you're going to see a surgeon, they probably would tell you that you have a couple of different options. One is to try and remove some of the bone around those nerves. So, it's not as much pressure. That's one option. That's called laminectomy.

The second option is to actually do that (ph) connection across the spinal fuse and to put some instruments in the back to try and prevent that back from slipping or having problems later on down the road.

Those are the two options. And I'm not sure what doctors have told you, you might just need physical therapy. Sometimes, that can work as well.

Since we are here in India, I want to point out something that I think is really interesting and that's to do with the cost of this procedures. The average cost of an operation like this back in the United States is anywhere between $50,000 to $85,000. When it comes to India, and Dr. Jha (ph) and you may go to a hospital like this, around $5,500. So, that's -- I hope that helps you, Dan.

We are coming to you from New Delhi. Up next: We're going to investigate some spices that we're told have some remarkable health benefits. We're going straight to the streets of Old Delhi. Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with a very special edition of HOUSE CALL. We're in one of my favorite places in the world. This is the spice market of Old Delhi, it's one of the largest spice markets anywhere in Asia. And you can see a little like cartfulls and stoolfulls full of the spices.

I got to tell you -- just being here very much reminds me of being with my mom. Our house was always filled with the stink of smell that you smell here, full of spicy Indian dishes. She'll always serve these tasty foods with the healthy dose of "It's good for you."

Well, it turns out that science may be right. Maybe finally catching up with my mother, knowing what she knew all along. For example, take a look at some of these spices. Cumin, for example, is a spice that's often used in many Asian dishes. It is thought to ward off prostate cancer, to help with asthma and help with indigestion as well.

Turmeric, which is over here, it has its golden yellow color, maybe the star of the spice world. This is something that's thought to boost brain power. It's full of antioxidants. It may reduce the plagues that caused Alzheimer's disease.

Chilly pepper is something you got to talk about whenever you talk about spices. These are very hot, as you may know. But the good news is, you don't have to eat them to necessarily get the beneficial affects of them. If you actually take the active ingredient known as capsaicin and put them in a body cream, you could actually ward off arthritis.

And, finally, ginger. Ginger is a staple of just about any Asian diet. And it actually can help with motion sickness as well. So, you get a sense that there are a lot of health benefits to be had when it comes to a lot of these spices.

Turmeric, 70. Seventy? I'd like to get some.

If you miss any part of today's show, of course, you can check out my podcast CNN.com/podcasting. Unfortunately, that's all the time we have for today. Greetings to you from India. I hope you have a healthy weekend, hope you have a spicy weekend.

Stay tuned now for news on CNN.