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HOUSE CALL WITH DR. SANJAY GUPTA

H1N1 Vaccine Red Tape; Washing Your Hands and H1N1; High Cost of Medical Malpractice; Dial-A-Doc Online; Hispanic Growth; What is H1N1?

Aired September 26, 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.

You know, we're focused on the health care debate, as you know, taking it on piece by piece. Medical malpractice, who wins and who loses, who pays? We're going to have one doctor's incredible story.

And this time of year you hear it all the time, wash your hands, it prevents you from getting sick. But does it really work for the flu? Some surprising stats.

Plus one simple can of soda. How much does it make a difference? How much can it put you over your daily limit?

I'm here to tell you and to help you. You're watching HOUSE CALL.

We start, though, with an update on H1N1 vaccine trials in children. The preliminary results are back and so far in children between the ages of 10 and 17 the vaccine reacts just like the one for the seasonal flu strain. Just one dose prompting a strong immune response, which is what they are looking for.

Now that response is not as great in children younger than 10. And a final recommendation for that age group will be made later in October. The way it works, about 600 children nationwide were enrolled in this vaccine trial and so far none of them showed any adverse effects.

Now as those trials continue and the nation waits for the H1N1 flu shot to become available, one company says it already has it and they have a vaccine that's ready to go. But for now it can only market that vaccine abroad and not in the United States. We're still waiting for final approval in this country.

Meanwhile, right down the road from this company, a university stock pile sanitizers and face masks and they're waiting for the vaccine.

CNN's chief national correspondent John King has the story.

(BEGIN VIDEOTAPE)

JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT (voice-over): An early flu season and fears of a possible H1N1 flu pandemic has college campuses across the country on alert. So far so good is the early assessment at the University of Connecticut. One confirmed and two probable cases two weeks into the school year. Yet director of Student Health Services, Mike Kurland, assumes his luck will eventually run out.

MIKE KURLAND, UNIVERSITY OF CONN. STUDENT HEALTH DIR.: We have approximately 20,000 students here in this course. The amount that we'll see is the unknown. So we're making preparations for whatever might happen.

KING: Constant calls with state and federal officials. Constant preparation.

KURLAND: We purchased large numbers of supplies, 15,000 surgical masks for patients who might be infected, 28,000 doses of Advil, 28,000 doses of Tylenol, 10,000 fever thermometers, thousands of hand sanitizer bottles.

KING: The seasonal flu shot is available for free, but like everyone else, UConn is in a long line waiting for the H1N1 vaccine.

In this lab, 45 miles from the UConn campus, tests on a seasonal flu vaccine awaiting federal government approval, and in this refrigerator, an H1N1 vaccine its makers hope is on the market soon.

CLIFTON MCPHERSON, PROTEIN SCIENCES QUALITY CONTROL DIRECTOR: This is a sample of what was actually sent to Australia for the clinical trial. It's just one of the -- the vials that was here for testing.

We're going to be starting production again next week of H1N1 so we can ramp up very fast.

KING: Protein Sciences Quality Control Director Clifton McPherson says the process here is different than most influenza vaccines. Traditional flu shots are made using eggs infected with the virus. Protein Sciences splices protein from the virus into caterpillar cells.

MCPHERSON: So we never have to handle live flu virus. We use the insect cells basically as protein factories and then we purify that protein from the insect cells, and that purified protein is then our vaccine.

KING: CEO Dan Adams says the Australian trials are going extremely well, that he's negotiating to sell H1N1 vaccines to Australia, China, South Korea, Mexico, and others.

DANIEL ADAMS, PROTEIN SCIENCES PRESIDENT: And so each one of those countries is free to approve our vaccine based on their own standards and...

KING: But in the United States...

ADAMS: We're not a licensed manufacturer yet. We definitely are plan B.

KING: Plan B, because unless the FDA granted Protein Sciences emergency authority to market here in the United States, it could be months or longer before Washington passes judgment on the safety and effectiveness of this particular H1N1 vaccine.

John King, CNN, Maryland, Connecticut.

(END VIDEOTAPE)

GUPTA: You know we hear it all the time. Wash your hands to prevent the spread of flu. But some experts say it may not be the best way to go. What?

Senior medical correspondent Elizabeth Cohen has the story. Elizabeth?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Sanjay, I want to start off by saying, washing your hands is always a good idea. It can help stop the spread of all sorts of diseases like the common cold, like stomach bugs, various diseases.

However, I have to say that the experts I've been talking to say that washing your hands won't necessarily do much to stop the spread of influenza, including H1N1 flu. Here's why. They say that a flu virus won't live very long on your hands any how. So it really doesn't necessarily help to wash them all the time to stop the spread of flu.

They say the way flu is spread is when someone coughs or sneezes pretty much within three feet of you and you breathe in those aerosolized particles. That's what can get you swine flu or any other kind of flu. But still the advice stands washing your hands is always a good idea.

Now, Sanjay, you'll notice them here at the White House. The reason why? Senior administration officials held a briefing this week for reporters about H1N1 flu. And in it they expressed concern that too many Americans might not be taking H1N1 seriously enough. They might think it's no big deal. And if they get sick it will pass in a few days and then we'll be OK.

Well, that is the case for most people, some people do get very sick from H1N1 and sadly some people do die. So they urge everyone to get the vaccine, especially those in high risk groups. The vaccine is scheduled to be available the week of October 5th. Sanjay?

GUPTA: All right, Elizabeth, thanks. I'm going to keep washing my hands as well. You be sure to read all the top tips on how to avoid spreading the flu. That column is up right now, CNN.com/empoweredpatient.

Now a lot of you do have questions about H1N1, the swine flu. So we got a special edition of "Ask the Doctor." That's coming up.

Also ahead, a doctor saves her patient's life. And the patient's baby as well. So why would that same patient sue her? We'll talk about it.

And the growth of Alzheimer's disease. There's some new numbers out there that are alarming. We'll talk about that next.

ANNOUNCER: "Empowered Patient," brought to you by....

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL. Let's get to some medical headlines now.

The number of people with dementia, including Alzheimer's disease is expected to double over the next 20 years. Think about that. The World Alzheimer's report says more than 35 million people have some form of dementia as things stand now. By 2030 that number is expected to nearly double to more than 65 million, and in 40 years, more than 115 million people around the world will be living with dementia.

Now according to the National Institute of Health, one out of every 7 Americans age 71 and older has dementia right now. The NIH says physical exercise and mental stimulation can help in terms of keeping the brain healthy.

Also in the news, a new tobacco ban from the Food and Drug Administration. In an effort to reduce the number of young smokers, the FDA has banned all clove, fruit and candy flavored cigarettes. It says health complications from smoking are preventable. They remain a leading cause of death in the United States.

Incidentally, the FDA is also asking for your help. If you continue to see the products in stores, you can submit an anonymous report at fda.gov/flavoredtobacco.

Now the obesity epidemic in America. We talk about this all the time. We're going to take you to one area that's actually getting some help. There's also some new guidelines out there for you to try and trim some of all that sugar that you add into your diet.

Plus, a doctor is sued after performing what she calls a successful life saving operation. Where are we with medical malpractice? We'll have that story next.

You're watching HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know the American College of Obstetrician and Gynecologists say 89 percent of OB-GYNs have been sued at least once. So what happens exactly when a patient sues even after a life-saving procedure?

Randi Kaye takes a look.

(BEGIN VIDEOTAPE) RANDI KAYE, CNN CORRESPONDENT (voice-over): Over nearly two decades, Dr. Wendy Fried has delivered more than 3,000 babies, so many babies and still this OB-GYN has never been found to be at fault. So why is she paying close to $170,000 a year in malpractice insurance?

DR. WENDY FRIED, OBSTETRICIAN-GYNECOLOGIST: For the year I will be paying $168,192 to be able to practice obstetrics.

KAYE (on camera): In case you're sued.

FRIED: In case I'm sued.

KAYE (voice-over): Everyone wants a perfectly healthy baby. So when something goes wrong, some families sue. Among all medical specialties, obstetrician are sued most.

In 1998, one of Dr. Fried's patients sued for malpractice. She says the pregnancy was fine but during labor the baby just didn't budge.

(On camera): What did that tell you?

FRIED: Immediately I suspected a uterine rupture which is our biggest fear. At this point I recognized that she was absolutely going to need an emergency life-saving hysterectomy.

KAYE: Dr. Fried had to act quickly. She says her patient would have been dead within half hour had she not performed that emergency hysterectomy. The woman had lost so much blood, Dr. Fried said, she had to give her 54 units. That's about seven times the average amount of blood in the entire human body.

(Voice-over): Both mom and baby survived, such a happy conclusion, the family invited Dr. Fried to Christmas dinner. Then six months later.

FRIED: I wound up getting a request for my records for this patient from a plaintiff's attorney.

KAYE: In fact, it was the beginning of a three-year legal battle. Dr. Fried was sued for unnecessary hysterectomy and failure to counsel her patient. Dr. Fried felt betrayed. She said she had saved this woman's life then canceled her office hours for days to sleep at her bedside to safeguard her recovery. The patient's surprise decision to sue blew her away.

FRIED: Every single morning I would go through and say, is there something else that I could have done?

KAYE: Dr. Fried's deposition, all 900 pages of it, took three days. The trial lasted 3 1/2 weeks. When it was over, the jury decided Dr. Wendy Fried did nothing wrong.

The cost of malpractice insurance is only going up. Two years ago Dr. Fried's premiums jumped 14 percent. She's cut back on expenses at home just to afford malpractice insurance. That fear of getting sued on top of the pricey liability insurance has forced hundreds of OB-GYN's to give up their practice.

Dr. Wendy Fried says she isn't quitting the baby business. She shouldn't, she says, because she's a good doctor. She says she can't quit because too many others are.

Randi Kaye, CNN, North Hills, New York.

(END VIDEOTAPE)

GUPTA: Well, that's just one look at what's happening with tort reform and happening with medical malpractice overall. Certainly a topic that we'll continue to talk about.

Talk about health reform. President Obama has been talking a lot about using advanced technology to cut health care costs over all. Elizabeth Cohen looks at one innovative program that could be part of that effort.

(BEGIN VIDEOTAPE)

COHEN (voice-over): You bank online. You shop online. Why can't you get your medical care online? Well, soon the doctor may be coming directly to your living room or my living room.

(On camera): Hi, Dr. Avila.

DR. PATRICIA AVILA, INTERNIST: How may I help you today?

COHEN (voice-over): It's a house call for the 21st century, a pioneering program where doctors see patients online.

(On camera): So it's $40 for 10 minutes. And here we go.

(Voice-over): Curious, I asked if I could try it out. I've been having a minor health problem that's been bugging me for months but I haven't had the time to go to the doctor to check it out.

(On camera): I have a question about a mole today. I woke up one morning a couple of months ago and I had this kind of funky looking, little red mole on my arm. And I'm a little worried about it.

AVILA: Has the color changed in any way?

COHEN: No, the color stayed the same.

AVILA: OK. Are the borders round, smooth or are they irregular?

COHEN: The border is pretty smooth.

(Voice-over): Around the clock, whenever they want, patients who belong to this health care system in Hawaii can dial up a doctor like Dr. Patricia Avila. She's an internist but you can also get a pediatrician or a dermatologist or any other specialists.

It's part of the latest trend in telemedicine. In Houston, patients can pop into a Wal-Mart to see a doctor via video.

Opponents say it's impersonal. Supporters say telemedicine makes doctors more available and saves money. It's the type of idea the president says could help solve the health care crisis.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Our recovery plan will invest in electronic health records. A new technology that will reduce errors to bring down costs.

COHEN: Back to my suspicious mole, the verdict is in.

AVILA: I would like you to monitor your moles on a monthly basis.

COHEN: There are limits to this online doctoring. The Dr. Avila tells me if my mole changes at all, I really need to see a doctor in person. But in the meantime, at least I've had my nagging health care answered without having to leave my home.

(On camera): Bye, Dr. Avila. Thank you.

(END VIDEOTAPE)

GUPTA: All right, Elizabeth, thanks.

Now if the saying you are what you eat is true, that means many of us must be feeling pretty sweet. And that's not a good thing. Just how much sugar is too much? We'll tell you after the break. Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL.

Here's a news flash for you. Americans eat too much sugar. You probably figured that out now. But how much? Well, the American Heart Association says we eat an extra 355 calories or 22 teaspoons of added sugar every single day. That can add up to about 35 pounds in just one year if you do the math.

Some new guidelines from the American Heart Association say women should consume no more than six teaspoons of added sugar a day. For men, around nine teaspoons.

Let's put a little bit of perspective for you. For women, 112- ounce soft drink would put you over your sugar target. Just one drink contains about eight teaspoons of sugar. Now keep in mind, we are talking about added sugar here.

There's sugar found in processed foods like soda and of course the sugar on the bowl on your kitchen table. What we're not talking about is naturally occurring sugars in fruits and dairy products. Those come with some added nutrients that your body needs.

If you still got a lot of questions about this, you want to figure out how much sugar you should actually be eating based on your physical activity and your age, you can check out mypyramid.gov.

All right. We know that you want to know more about H1N1. So we'll take your questions coming up on "Ask the Doctor." Plus there are health care workers out there right now on the front lines of a preventable epidemic. We're taking you to one community that's working to try and find a solution.

You're watching HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL.

You know the Census Bureau says there are more than 46 million Hispanics in the United States. They are currently the country's fastest growing minority and that's in more ways than one.

You know fastest growing is not always a good thing, especially when you're talking about waistlines. One Hispanic community says they are working to try and reverse the trend. We took a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Vista, California, sits just 50 miles from the Mexican border. Its population largely Mexican immigrants and Hispanic-Americans. Many of the families are low income and many don't have access to fresh fruits or vegetables. Add to that a diet high in fat and a lack of safe play spaces, and in some ways, it's the perfect recipe for obesity.

DR. KELLY MOTADEL, MEDICAL DIRECTOR, VISTA COMMUNITY CLINIC: I have children as young as 5 or 6 in my practice that are now starting to develop diabetes.

GUPTA: But a partnership of more than 100 local businesses, schools, health care providers and county officials is coming together to find a solution.

CHERYL MODER, DIRECTOR, SAN DIEGO CO. CHILDHOOD OBESITY INITIATIVE: We are working in two major areas. One is healthy eating to assure that all families, no matter where they live, have access to fresh, affordable, healthy foods, mainly produce fruits and vegetables. And that likewise, all families have access to safe, affordable opportunities for their kids to be physically active.

GUPTA: And although there is still work to be done, doctors like Kelly Motadel say they are making progress.

MOTADEL: There are days when you feel like you've said the same thing over and over and you're not sure that it's making the difference. But when you see those kids who come back and they haven't gained weight, and sometimes that's their only goal, is just for them not to gain weight, you realized that they are hearing what you're saying.

GUPTA: And parents are certainly looking for the help. YOLANDA CRUZ, VISTA AREA PARENT (through translator): Sometimes we don't know that much about how to feed our kids correctly. I've learned a lot in this program and my husband has, too.

GUPTA: With the communities' involvement there is an opportunity to change course and to change lives.

(END VIDEOTAPE)

GUPTA: We're going to stick with that theme as well. Coming in October, look for CNN's "LATINO IN AMERICA." We're going to score how Latinos are reshaping our communities and our culture. "LATINO IN AMERICA." That's this October only on CNN.

Up next, where does the term H1N1 really come from? You asked, we're going to answer. Your questions about H1N1 just ahead.

(COMMERCIAL BREAK)

GUPTA: It's time for my favorite segment of the show, "Ask the Doctor." Today we're taking your questions on something you've been asking a lot about, H1N1.

Let's dive right in. Matt writes this, "I thought diseases like this are generally named for their country of origin. Why do we call it H1N1?"

Great question, Matt. A lot of people asking about this. There has been a lot of confusion about this. Now here's the deal. The name actually has nothing to do with the location. The virus was first referred to as swine flu. That's because initial lab tests showed the strain was similar to the one that's normally seen in pigs.

The researchers later found the virus actually has genes from birds, humans and pigs so the name was changed to the more accurate H1N1. Now swine flu is a bit of a misnomer as you just heard.

H1N1, the letters actually refer to the types of proteins found on the surface of a virus, namely hemagglutinin, as you can see there. That's the H. And neuraminidase, which is the N. And the number 1 refers to the specific sub-types for each of these proteins.

Now, you know, we've been talking about H1N1 on this program and people who have had H1N1 know it can be a pretty miserable experience. I want to tell you that I know that as well. Not that's because I'm a doctor but because I was also a patient.

I contracted H1N1 a couple of weeks ago while covering the war in Afghanistan. It started as a cough, that kind of cough that really hurts, a stinging pain that makes you wince and you guard. You really hope that you don't have to cough again any time soon.

That's the thought that I might have a fever but of course I was in the middle of Afghanistan and the conditions were kind of hot, so maybe I thought it was that. The problem was the next day I wasn't feeling any better. In fact, I got worse. I was nauseated, my entire body started to hurt and I'm not someone who really gets sick ever. This was the sickest that I've ever been.

It's worth pointing out the irony of a medical reporter getting H1N1. This is a story that I was covering. Truth is, it really doesn't matter if I got tested as my doctor told me it was the only flu strain circulating and I had it.

There wasn't much doctors could really do for me, some acetaminophen, a sinus decongestant. I also got IV fluids given my inability to keep anything down. Within a couple of days I felt a lot better.

And truth is, a lot of people who get H1N1 are going to have the same symptoms that I just described and for most people it's simply going to mean a few miserable days hopefully spent in your home getting some pity from your family and not in a war zone like I was.

So I want to close the show with a simple message, has a deep meaning for me as a doctor and as a patient, take care of yourself. Listen to your body and stay well.

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. Also check out our Web site, CNN.com/housecall, and Twitter at sanjaygupta.CNN.

Remember this is a place where the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.

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