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Sanjay Gupta MD

The Latest News on Health Care Reform; The Largest Environmental Disaster in the U.S.: Have You Even Heard of It?; The Truth About Organics

Aired June 13, 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. Welcome to HOUSE CALL: The show that helps you live longer and stronger. I'm Dr. Sanjay Gupta. Thanks for watching.

First up: Health care reform in the spot light. And we're the place for the latest news. This week, President Obama looks to sway doctors.

And it's the largest environmental disaster in the United States. Here's the thing -- you probably never heard of it. Is the government doing enough to protect people?

Plus: The truth about organics. Not all of them are created the same. We've got the facts about what you're really paying for.

You're watching HOUSE CALL.

(MUSIC)

GUPTA: It is full-court press time on health care, no question about it. President Obama is holding a town hall meeting while Democrats in Congress are pitching their own versions of health care reform. So, we're going inside the offices where these decisions are getting made.

White House correspondent Suzanne Malveaux is joining us from the White House.

Thanks so much, Suzanne. I really appreciate it.

SUZANNE MALVEAUX, CNN WHITE HOUSE CORRESPONDENT: Sure.

GUPTA: You and I have been talking about this for some time. First of all, is the president getting the support that he thought he'd be getting at this point in the game?

MALVEAUX: Well, Sanjay, so far, he is not getting the kind of support that he needs. And that is why we've heard from him saying it's a make or break period. He wants legislation on his desk in two months. That's why we saw him in Green Bay, Wisconsin, going directly to the American people to put pressure on members of Congress to do something about this huge problem.

There are three options, Sanjay, that have emerged. One of them -- some Democrats are saying, take a look at tax-free health care benefits. Let's limit the amount of tax-free health care benefits for the wealthiest measure of Americans.

When Obama was a candidate he said no to that. As president, he may actually say yes. There's something that the president is pushing and that is to create this kind of government-run, if you will, insurance plan to rival privately-run insurance plans. Republicans will have nothing to do with that. They say butt out of the insurance business. They're not up for that.

And there seems to be, Sanjay, a compromise that has emerged over the week or so. We'll see how it plays out. That is the idea of a co-op, where you have a privately-run insurance system or a plan for folks that could sign up for this that would be federally-funded. It's something that at least some sort of bipartisan support, Sanjay.

GUPTA: You know, as you walk around the hallways there at the White House, Suzanne, what are the confidence levels as far as getting this done? I mean, I know there's been a lot of talk. But how -- what's the mood?

MALVEAUX: You know, the mood is they know they have a lot of work to do. This is going to be a very tough fight. That's why we've heard really strong language from the president and it's one of the reasons why we are going to see him really in the belly of the beast, if you will.

That's Chicago, the headquarters of the American Medical Association, largest doctors group as you know. He's got to go before those physicians and essentially ...

GUPTA: Right.

MALVEAUX: ... convince them, like Hillary Clinton tried to do some 16 years ago, that this change, this plan is going to work. And they're saying, "Look, we are not going to stand for anything that is government-run insurance plan. We're not having that. We're having no part of anything that would mandate physicians to participate."

So, he has a very tough sell here.

GUPTA: Interesting.

MALVEAUX: And people here at the White House -- they absolutely know that.

GUPTA: Thanks so much for joining us.

MALVEAUX: Sure. Thanks, Sanjay.

GUPTA: Now, on to an environmental disaster that dwarfs the famous Exxon Valdez spill in Alaska. You remember that. People living near the Tennessee Valley Authority plant in Kingston, Tennessee, say they are choking on toxic air while the government is saying that everything is safe.

Best way to find out about stories like this? Get up from behind my desk and go and see it for myself. (BEGIN VIDEOTAPE)

GUPTA (voice-over): Desperation is mounting here -- ever since the disaster six months ago. Families are terrified about their health and they fear no one is listening.

PAMELA HAMPTON, LIVES NEAR COAL ASH SPILL: Death? Cancer? Everyone here deserves a future, you know?

GUPTA: Three days before Christmas, a barrier broke and a torrent of toxic sludge spilled across 300 acres in eastern Tennessee. I went to see it for myself -- but before even arriving to the spill site, a hitch.

ERIN BROCKOVICH, ENVIRONMENTAL ACTIVIST: We're a little stuck at the moment.

GUPTA (on camera): What has happened with all this coal ash, it's taken this body of water which used to be about 25 feet deep and turned into just inches deep. So, as we're crossing along in the boat, the motor gets stuck and we're trying to get a tow.

(voice-over): Here's what we do know. For the United States, this is the largest environmental disaster ever.

(on camera): Just to give a scale of reference, Valdez was about 11 million gallons.

BROCKOVICH: That's right.

GUPTA (voice-over): Eleven million gallons of oil spilled at the Exxon Valdez.

UNIDENTIFIED MALE: All toxic.

GUPTA: Here in Tennessee -- 1.1 billion gallons spilled, almost 100 times larger. And yet families here believe no one responsible for protecting them takes their fears seriously.

SARAH MCCOIN, LIVES NEAR COAL ASH SPILL: I know darn well that's hazardous. And you know what? They know it, too. And I guarantee you, if any of those people lived here, they would be totally freaking out just like the rest of us.

GUPTA: Community members blame the Tennessee Valley Authority, the TVA. And they brought in environmental activist Erin Brockovich to help. She's successfully sued a big utility in California in the 1990s.

BROCKOVICH: The thing that just blew my mind was there was a lake there. It's gone. I kept saying, where's the lake? It's gone. It is mud. It looks like a moonscape. It looks like Mars.

GUPTA: To produce power, the Tennessee Valley Authority, the TVA, burns tons of coal every day. That produces ash. There's no safe way to dispose of it, so the TVA mixes it with water and stores it in vast retention ponds -- that are not supposed to break.

ANDA RAY, TENNESSEE VALLEY AUTHORITY: TVA maintains that we did daily inspections and quarterly inspections and did constant monitoring. This was not expected at all.

GUPTA: But, keeping them honest, we found TVA inspection reports that detailed, quote, "visible evidence" of water seeping out of TVA's coal dam, and small blow outs for years before this spill.

Engineering and geology experts we spoke with say all the signs for imminent danger were there. TVA disagrees, saying leaks were repaired. They're waiting for an independent report to be issued about the cause of the spill later this month.

(on camera): So, we finally made our way here by boat. And what I'm about to show you is the largest industrial spill in U.S. history. Take a look over here. That is all coal ash.

What is then remarkable to us, if you talk to the Tennessee Valley Authority and the EPA, they say they've tested the water. They've tested the air. They say it is safe.

But as we investigated and talked to the citizens of community, we're hearing a different story. We're hearing stories of bloody noises, asthma, headaches. People here say they are choking on ash.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Before the break, we told you about a small town in Tennessee struggling with the largest industrial spill in United States history. Now, people living near the spill say they are scared for their children's health.

Here's part two of my investigation.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): The Hamptons live less than a mile away from the spill. Here's what they see.

HAMPTON: A daughter who's constantly complaining of headaches that she didn't use to have before. Joshua, he was having the upper respiratory situation. Noah, now, drainage out of the eyes, the nose, the chronic cough. He was having ear infections and they were so bad the doctor says they look like grapes in his ears. He's never had this before -- never.

GUPTA: After the spill, a Duke University study found high levels of toxic elements and radioactivity, toxins in the atmosphere and contamination of surface water.

Anna George is a scientist with the Tennessee Aquarium Research Institute, which works to protect the environment. ANNA GEORGE, TENNESSEE AQUARIUM RESEARCH INSTITUTE: We've seen some fish where the gills were completely coated in sediment. It makes it difficult to breathe. So, it's like suffocating. So, you can imagine a similar thing might be happening to humans this area and making it difficult to absorb oxygen across their lungs as well.

GUPTA: Coal ash, which contains potential cancer-causing agents like arsenic, lead and selenium, but is not considered by the EPA to be hazardous.

(on camera): Why wouldn't that be considered hazardous?

LISA JACKSON, EPA ADMINISTRATOR: Over time, EPA's regulations have treated as a solid waste, equivalent to garbage waste, household garbage, but not as a hazardous waste. By the end of the year, we'll make that regulatory determination as to whether or not it's hazardous.

GUPTA (voice-over): At issue, what amount of chemicals in coal ash is safe?

BROCKOVICH: We have to convince someone that inhaling cancer- causing chemicals is bad for you. It just doesn't make any sense to me at all.

GUPTA: The TVA advises families to see their doctors about health problems and says that soon clinics will be set up to test blood for potential toxins. Like many families here, the Hamptons can't afford to move.

HAMPTON: I have no confidence in what they're saying -- that they're doing this and they're doing it right. Absolutely none. And I can't believe anything they say -- because, to me, it's a lie.

GUPTA: Erin Brockovich echoes the fears of people here.

BROCKOVICH: Somebody has to protect these people because they're going to find out 10 years too late. It will be the "oops" moment -- I do have cancer, I am sick. And then there will be no recourse for them. That's not fair and that's not right.

(END VIDEOTAPE)

GUPTA: So, there are six other lawsuits concerning this spill pending against the Tennessee Valley Authority.

Now, as the EPA's Lisa Jackson told us, the government should make this decision about whether or not coal ash is hazardous by the end of this year. What we know about coal ash is it contains substantial amounts of toxin chemicals all at which at high levels can impact your lungs and your nervous system.

Now, straight ahead: From health insurance coverage to pregnancy care -- some women are continuing to fall through the cracks. We've got details. And, fighting cancer with a robot. This little metal contraption here goes inside your body. It's a fascinating story. It's just ahead.

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GUPTA: Welcome back to HOUSE CALL.

The World Health Organization has raised the flu alert to its highest level, declaring that a global pandemic of H1N1, the swine flu virus, is now underway. Now, increasing the alert to phase six does not mean that the disease has become deadlier or even more dangerous, just that it's spread to more countries. In the United States and elsewhere around the world, where the virus and the response to it are already widespread, it's not likely to mean really any significant changes.

But the WHO urges countries that have not yet seen cases or seen only limited cases to get ready. The U.S. Department of Health and Human Services and the Department of Homeland Security tell CNN the agencies have already been acting for weeks as if phase six were in effect. They say no additional measures are going to be put into effect.

And a report out this week by the Kaiser Family Foundation found startling health disparities between white women and women of color. They say it's more widespread, existing in every state. The largest disparity seems to be in the rate of new AIDS cases. The average rate for women of color is 11 times that of white women.

In addition, there are significant disparities in the rates of late prenatal care and having health insurance. Among all minority women, those rates are about double what the study found in white women.

Now, imagine having a robot that could possibly save your life. It sounds like science fiction. But Israeli researchers are developing what they call a cancer-fighting robot, a miniature device that could potentially fight cancer.

It's amazing stuff here. It is ViRob. And take a look at this. This is it right here. It's about a millimeter in diameter, about 14 millimeters in length. It is made of silicone and metal. It is completely remotely-controlled and it can go just about anywhere in your body.

It's just really interesting. We want to give you a real clue as to how this possibly could work. Take a look here, if you could. Here is this little ViRob making its way through a simulated blood vessel. It's got little whiskers on it. You can see there. And it goes through, again, remote controlled. You can see it making its way from one end to the other. You can see it smaller there with all the whiskers.

So, how might this work? Well, specifically, you could imagine a scenario like this. You have the ViRob, you see it over here, and you take those green particles, which are chemotherapeutic agents and attach it to the end of the little robot.

Take that robot now; put it in someone's trachea. This is a patient who might have lung cancer. Make your way through the bronchials -- again, by remote control -- and get to this tumor over here, attach the robot to the specific tumor and start to release that chemotherapy. That is targeted therapy like you've never heard before.

Now, to be fair, there are some caveats here, some important caveats for sure. First of all, this has not been done in humans yet. There's been no human testing whatsoever. It is expensive, probably tens of thousands of dollars and it still five to 10 years before they finish any development.

Another interesting point they told me about -- they haven't quite figured out how to get the robot back out once it's done its job. They're working on that. For now, this prototype would just stay in the body. It sounds like they need a reverse switch or something.

Now, a lot of people have been tweeting on this, a very popular topic. Quick sample of what people are saying. First one, "This is another disruption in innovation in health care." A fair point, we do spend a lot of money on technology.

Another Twitter user says, "We got to get it out of the body afterwards." Another good point, it is very expensive. You'd like to be able to reuse that.

And probably the most common, "This is an amazing piece of technology."

Now, if you want to become part of the conversation, follow me, Twitter.com/SanjayGuptaCNN.

There's also some new numbers, colon cancer on the rise and it's taking on a whole, new younger generation.

Plus, organic foods -- the truth about what you're buying -- may not be as organic as you think.

You're watching HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

There's an alarming report out this week, colorectal cancer in younger people, ages 20 to 29 is on the rise -- 5 percent men, almost 6 percent in women. Now, the report lists some possible culprits, including obesity, changes over all in dietary patterns like eating more processed foods, eating more red meat, consuming too much fast food.

Now, if you're concerned, you have a family history or something, you think you might be at risk, talk with your doctor, of course -- because keep in mind colonoscopies are not regularly done for those under age 50.

And the best heart diet -- a question we get all the time -- the best heart diet for vegetarians. Well, a new small study out this week, overweight vegetarians who ate a low-carb, low-calorie diet consisting of foods like soy, fruits, vegetables -- they not only lost weight, but after four weeks, they also improved their cholesterol -- those numbers. And they improve their blood pressure as well.

Now, another group who also ate low-calorie vegetarian but eat high carbs -- they did lose weight but they had no improvement in their cholesterol or their blood pressure.

Bottom line: we need to do a lot more research on this. But this is some promising news, especially for those who are watching their numbers.

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GUPTA: When it comes to terms like "100 percent organic," "all natural" or "made with organic ingredients," can leave you a little confused. It leaves me confused as to what you're really getting. So, we decided to go shopping with nutritionist Cheryl Williams and get some answers.

(BEGIN VIDEOTAPE)

CHERYL WILLIAMS, NUTRITIONIST: The term "natural," you might be seeing it on a lot of products in the supermarket. But what exactly does it mean? Technically, the FDA has not defined what "natural" means, but it has defined use of the term. And it basically refers to any foods that are going to be minimally processed, free of any type of synthetic preservatives or artificial additives and colors.

In addition to that, it's really important for consumers to know that if a food label uses the term "natural," it has to define use of the term on the label. So, for example, for this Turkey Jerky, it's all natural, and it specifies on the label that there's no artificial ingredient and that it's minimally processed.

So, this would be an example of a product that's made with about 70 percent organic ingredients and the label usually says made with organic ingredients. In addition, the food label is going to usually specify which ingredients or ingredient is organic. And on this case, it's the pasta. So, all the ingredients in this particular processed food are not organic.

There are some other types of organic food labels, for example, when we take a look at this pasta, this basically says the pasta says is organic. And what that means for this particular type of label is that about 95 percent of the ingredients are organically derived, with the exception of salt and water.

The other 5 percent of ingredients are basically non-organic ingredients that aren't found in organic form. And they also have to be ingredients that are on an approved list for non-organic ingredients that are allowed to be put in organic food products. When it comes to produce -- produce is generally going to be, when it comes to fresh produce, 100 percent organic. And that just means all organic ingredients.

(END VIDEOTAPE)

GUPTA: All right. Thanks, Cheryl.

And keep in mind, just because it says organic, not always going to be healthy. So, read the nutrition labels as well. Those products, they can be high in sodium, high in fat as well.

Now, a young empowered patient, she diagnoses her own condition. See how she trumped her own pathologist. We got it next on HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

An interesting story now, a teenager diagnoses her own disease in science class. For years, doctors misdiagnosed Jessica Terry's abdominal discomfort. That didn't stop the Advanced Placement student from doing some digging on her own.

So, CNN medical correspondent Elizabeth Cohen joins us with some details on pretty interesting story.

I don't know what this says about either her doctors or her science class, but what happened here?

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Well, I think it says a lot about her. Jessica Terry is the epitome of an empowered patient. What happened to Jessica is that for eight years, she had terrible stomach problems, vomiting and diarrhea and fevers and anemia.

And what happened was that she went to the doctor and she never got a definitive diagnosis. So, at age 18, senior in high school, she asked her pathologist for some of her own slides of her intestinal tissue. She looked at it under microscope for many hours and said, "Holy smoke, I see a granuloma, which means that I have Crohn's disease." And then her doctor confirmed that it was actually true. And now, she is being treated for Crohn's disease.

GUPTA: Good for her. That's a remarkable story.

If you sort of find yourself in a position where you think you might have a misdiagnosis, are there some red flags or if you don't have a diagnosis at all?

COHEN: Yes. There are some red flags that you should look for, that will tell you whether or not -- or help tell you whether or not you've been misdiagnosed.

So, let's go over what some of those are. First of all, if you don't get better with treatment, that is a sign that your doctor perhaps has gotten it wrong. And so, you need to ask some questions.

Secondly, if your symptoms don't match your diagnosis, that could be a problem. I know that sounds obvious, but you can always go online and say, "Hey, gee, do my symptoms match my diagnosis?" Sometimes they don't.

Also, if your diagnosis is based purely on one lab test, that could be a problem. It is a possibility that lab got it wrong.

GUPTA: All right. Elizabeth, thanks. Good advice, as always. We really appreciate it.

And you can read more of Jessica's story -- it's a good one -- online at CNN.com/EmpoweredPatient.

Next: an insurance policy for cancer only? Is this a good idea or maybe a waste of money? We got that -- "Ask the Doctor" is next.

(COMMERCIAL BREAK)

GUPTA: It is time for my favorite segment of the show: "Ask the Doctor." Let's get right to it.

Evelyn has this question: "I started having vertigo a few months ago, and I'd like to know what causes this to come on suddenly."

Well, Evelyn, vertigo creates the illusion of movement, as you know. A type that's common in people 60 and older is called positional vertigo. It's brought on when you lie down or sit up or you move your head to look up or down.

Let me show what's happening. When you go inside the inner ear here, you have an area called the otoconia, which see over here. If you blow that up, you see these little crystals. They're really important. We zoom in even further, you get a sense of what these crystals look like and the relationship overall to the inner ear.

Here's where things are probably going wrong. This structure monitors the rotation of the head. When you experience vertigo, the displaced otoconia essentially confuses things in the canals and kind of makes you feel dizzy. Your doctor might have you try some subtle head tilt exercises that are intended to clear those crystals out of those canals.

We got another question now from Penny in Roanoke, Virginia. "Do I need to continue my cancer insurance now that I've had -- I've had all my life now that I'm retired and on Medicare? I'm just afraid to drop it."

Well, understandable question, Penny. Let me give you a breakdown. Medicare is going to pay for hospital stays and physician services if you get cancer. And since you're on Medicare, with your cancer policy, you might be paying for insurance you don't really need.

Take a look at your cancer policy to see if you have a coordination of benefits clause. Now, many plans out there won't pay if another plan is already paying.

Also, if you're thinking about dropping your cancer insurance, find out if your policy has a non-forfeiture clause, that's a protection for the consumer. You might be able to recoup some of your money if you don't use the policy. Good luck.

Unfortunately, that's all the time we have for today. If you missed any part of today's show, be sure to check out my podcast, CNN.com/podcasting.

And always remember, this is a place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta.

More news on CNN starts right now.