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Sanjay Gupta MD

H1N1 Vaccine Being Rolled Out; Finance Committee to Vote on Baucus Bill; Woman with Cancer Battling Medical Bankruptcy; Poisoned Marines; Uninsured and Illegal

Aired October 10, 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.

We've been talking about H1N1 or the swine flu since the spring. Now, the shots are here. What you need to know about this and what are the risks and benefits of getting the vaccine?

Also, think about this: toxic water and male breast cancer. Could there be a link? It might be happening at Camp Lejeune.

And a dialysis clinic runs out of money. What happens next? Well, patients sometimes have to fend for themselves. We'll have their stories.

You're watching HOUSE CALL.

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GUPTA: All right. As things stand now, 37 states have widespread flu activity. And if you dig down on the numbers, 99 percent of those cases are related to H1N1. Now, the injectable vaccine is being rolled out. But don't start lining up just yet.

Here's how it's going to work. Health care workers, young children and those who care for them are going to be inoculated first. Everyone else starts lining up for shots or the nasal mist probably around the end of October or early November, depending on where you live. That's what we're hearing.

We've been getting lots and lots of questions about this particular vaccine. There's a couple that stood out and I want to get right to them.

This is from Lynn who writes this: "I'm allergic to egg-based vaccines. What are going to be the alternatives for folks like me?"

Well, the H1N1 vaccine, both the shot and the nasal spray, is being made using eggs as sort of a template, the same way that the seasonal flu shot is as well. So, it is not recommended for people with severe egg allergies.

Several allergists we spoke with said the people with mild reactions can get vaccinated and if you have a severe allergy, ask about getting a skin prick test with an allergist ahead of time. Many are actually giving the flu vaccine and they can vaccinate you as well right there at the allergist's office. So, that's possible an alternative for you, Lynn.

Keep in mind, the only one in a million people have a severe allergic reaction to the influenza vaccine.

Let's take up one more question from Kat in Maryland who writes this, "Is it possible to get swine flu, or the regular flu for that matter, twice in the same season?"

Well, that -- that is a great question, and one that I know both personally and professionally. Now, in some way, I went through the most difficult vaccinations that you can go through by getting the infection, along with lots of other people. And you do get some protection after you get the flu.

There are a couple of caveats here. The virus can change and it can start to mutate itself. CDC tells us they think they have a pretty good match on this vaccine and they also say it can't hurt to get a vaccine after you had the flu because you can get some longer protection from that.

Now, there's another issue that we've been talking about a lot as well. Senators are going to have a lot to think about this Columbus Day weekend. The finance committee is expected to vote on the Baucus bill on Tuesday. We now know it's expected to cause around $829 billion over 10 years and it's not expected to add to the deficit. This is still being worked out.

I think the real question for a lot of people is: what does it mean for you at home? And for that, our congressional correspondent, Brianna Keilar, joins us from Capitol Hill.

Brianna, a lot of people are a little fatigued about health care. They've been hearing a lot about it over the past few months. And there's a lot in this the bill that they need to know about, including some cuts and possibly new taxes.

BRIANNA KEILAR, CNN CONGRESSIONAL CORRESPONDENT: Sanjay, the Baucus bill does have some cuts to Medicare, $400 billion in cuts over 10 years, in fact. And while that sounds like a lot, let's put this in perspective. It's about 3 percent of the total spending of Medicare.

Republicans say this is still going to hurt senior citizens. Democrats say it is negligible. The AARP says seniors have much more to gain from the Baucus bill than they do to lose because this plan also will cover a lot of seniors who fall into that prescription drug benefit gap that is known as the doughnut hole.

Also some taxes to consider in the Baucus bill. The primary one is on "Cadillac" health insurance plans, those high end insurance plans, a tax that would be paid by insurance companies. But keep in mind, there are also other taxes attached to other health care reform bills in Congress, including one in the House that would tax wealthy Americans, families that make over $1 million and the issue of taxes -- it's just not settled at this point.

But some other key points to remember about all of the health care proposals before Congress at this point, all of them would give subsidies to low-income and middle-class Americans to help them pay for health insurance. They would also stop insurance companies from denying coverage to people on the basis of preexisting conditions, and they would also stop insurance companies from capping the benefits that consumers receive, either on a yearly basis or over the course of their lifetime, Sanjay.

GUPTA: All right. Brianna, lots of good information there.

You know, something I realize as we've been covering all this talk about health care. There's a lot of talk in Washington about health care costs and it seems to completely eclipse the people who are truly struggling. I sat down with a woman who survived three bouts of cancer and is now facing medical bankruptcy. This is her reality and she did have insurance.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Four years ago, Leslie Elder staggered into an emergency room with a stabbing pain in her abdomen. The doctor's diagnosis -- grim.

LESLIE ELDER, DIAGNOSED WITH CANCER: Your right kidney is breaking apart. You have a tumor. All I could think of is, what am I -- I have no insurance, what am I going to do?

GUPTA: Her problem started nearly 20 years before. In 1987, Elder and her husband Jim, middle-class homeowners, bought a comprehensive health policy. They paid their premiums faithfully. A year later, Leslie got sick. It was breast cancer.

(on camera): Did you worry about paying for it, paying for the medical care?

ELDER: No, at that time I had good coverage.

GUPTA: She beat that cancer. Then, the unthinkable. Thirteen years later, she was diagnosed with breast cancer again.

ELDER: As I'm recuperating, I receive $21,000 of bills that I was responsible for.

GUPTA: The same insurance and you're probably not thinking about the bills again.

ELDER: Of course, I wasn't. But it would be the same as it was before, wouldn't it?

GUPTA (voice-over): No, not exactly.

ELDER: Four hundred and seventy-one...

GUPTA: Since Elder's first cancer diagnosis, the cost of health insurance had skyrocketed. A recent Kaiser Family Foundation study found that over the past 10 years, a typical family insurance premium more than doubled. The Elders say theirs has quadrupled.

ELDER: We're not poor. We didn't -- I didn't plan all of this cancer. What happened here?

GUPTA: The premium would have been even higher, except the Elders were playing a risky yet common game. To keep their premiums affordable, they kept raising their deductible. So, by Leslie's second cancer diagnosis, their deductible was up to $5,000 and her story became the anatomy of a medical bankruptcy.

Elder is convinced that her carrier, Nationwide Insurance, raised her rate exorbitantly because of her history of cancer.

ELDER: They had me between a rock and a hard place, ain't nobody else going to insure her, totally uninsurable -- totally.

GUPTA: Nationwide denies any inference that the company inappropriately raised the Elders' rates. The company says that increases were done in full compliance with state laws.

But, keeping them honest, we've reached out to the Florida office of insurance regulation which oversees companies, like Nationwide, and are supposed to protect consumers like the Elders. The agency said that in Florida, there's no law that limits the amount of rate requested by an insurer but that it tries to insure that premiums are not excessive or unfairly discriminatory.

The Elders asked, what does excessive really mean? After all, they are on the edge of bankruptcy. Although, a relative paid for her kidney cancer treatment, she has depleted the family savings and is still paying for her second breast cancer treatment.

ELDER: There is no good policy. You're going to be paying and paying and paying.

GUPTA: The Elders eventually dropped their policy. They have no insurance. And Leslie says she hates the odds she's facing.

(END VIDEOTAPE)

GUPTA: Three cancers, no insurance. Now, that's what's happening for a lot of people. If you're somebody like that and you need some help getting through red tape with your insurance company or just finding insurance, we've got some great resources for you. Try this one: www.patientadvocate.org, or healthcareadvocacy.org. Both of these sites -- we've look in to both of them -- they're going to put someone in your corner to try and help you. You actually can talk to somebody when you get a hold of them as well.

Now, marines and their children are getting sick. Could toxic water at Camp Lejeune be to blame?

And we're not saying, of course, that you should abandon all those fresh foods you eat to stay healthy. But a lot of healthy foods could make you sick. We'll tell you why.

You're watching HOUSE CALL.

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GUPTA: And we're back with HOUSE CALL.

Some interesting news out this week that we want to put into context for you. Some of the healthy foods you eat could be risky for your health. There's an advocacy group called Centers for Science and the Public Interest, and when they break this down, they say there are about 10 foods out there that account for 40 percent of food-borne illness. And this is all outbreaks and FDA-regulated food that we're talking about.

Now, leafy greens top the list. I wasn't surprised here, we did an entire special on a lot of health issues surround spinach production, for example, and food safety overall in the country. The rest of the top 10 includes eggs, tuna, oysters, potatoes, cheese, ice cream, tomatoes, sprouts and berries.

Now, a lot of those foods are foods that you probably eat. I eat them as well. Your best defense against getting sick is to store things the right temperature and be very careful not to cross- contaminate.

HOUSE CALL is back in 60 seconds.

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GUPTA: We're back with HOUSE CALL.

I want to get right to a story that you're only going to see here on CNN. A growing number of marines who serve at Camp Lejeune are coming down with male breast cancer, relatively rare usually. The men say they and their families were poisoned on the marine base. That's the allegation.

As a result of CNN's reporting on this story, a Senate committee heard from the men this week. Abbie Boudreau with our Special Investigations Unit has her story.

(BEGIN VIDEOTAPE)

ABBIE BOUDREAU, CNN INVESTIGATIVE CORRESPONDENT (voice-over): These are the faces of a rare disease, male breast cancer, marines or children of marines who believe their illnesses came from drinking and bathing in toxic tap water at Camp Lejeune decades ago. Within two weeks after CNN's story first aired, a number of men coming forward with this disease has nearly doubled. The total is now 40 men, all marines or their children.

MIKE PARTAIN, SON OF MARINE: That's blowing me away. I mean, I expected to find some, but to double our number with just one story, and it just -- it begs to ask: how many people are out there with male breast cancer from Camp Lejeune? BOUDREAU: Mike Partain was one of those we first interviewed. As a result of the story, he was asked to testify before the U.S. Senate Veterans Affairs Committee. Partain was born at Camp Lejeune 40 years ago.

PARTAIN: I was conceived and carried while my parents lived on the base. During the time of my mother's pregnancy, we were exposed to high levels of tetrachloroethylene, trichloroethylene, dicholoroethylene, benzene and vinyl chloride in the tap water provided to my family by the Marine Corps.

SEN. KAY HAGAN (D), NORTH CAROLINA: Mr. Chairman, between 1957 and 1987, marines and their families at Camp Lejeune drank and bathed in water that was contaminated with toxics at concentrations up to 280 times what is currently considered safe by the Environmental Protection Agency.

BOUDREAU: Senator Kay Hagan is from North Carolina, where Camp Lejeune is located.

HAGAN: My heart certainly goes out to the marines and their families who were exposed and affected. A compelling CNN piece just last month highlighted cases of former marines and their families who have been diagnosed with male breast cancer. Today, there are over 40 individuals of those cases.

MAJ. GEN. EUGENE PAYNE, JR., U.S. MARINE CORPS: The Marine Corps is deeply concerned, with all the military and civilian families who are experiencing or have experienced any health issues. And we understand that there are those who believe their health concerns may be a result of time spent at Camp Lejeune.

BOUDREAU: The marines point out, however, that several scientific studies "have not identified a link between exposure to the historically impacted water at Camp Lejeune and adverse health affects." With no proven link, many of those who are sick are denied V.A. benefits.

North Carolina Senators Hagan and Richard Burr say those who are ill deserve help.

SEN. RICHARD BURR (R), NORTH CAROLINA: If they were at Camp Lejeune for those years, that is absolutely essentially to the V.A. side to take care of them.

BOUDREAU: Partain told CNN that would be a start.

PARTAIN: It is up to the Senate and up to Congress to force the Marine Corps to answer these questions and hold their feet to the fire when they give the answers and make them explain their answers. That's the only way we're going to get to the bottom of the truth with this.

BOUDREAU (on camera): Senators Hagan and Burr have just sponsored a bill that would give V.A. medical benefits to marines and their families who may have been exposed to contaminated water at Camp Lejeune.

Sanjay, back to you.

(END VIDEOTAPE)

GUPTA: Abbie, thanks a lot. Great reporting there.

Nicotine addiction is the hardest to quit, and a lot of people know that. But there maybe a vaccine that can help you kick the habit. We're going to have that in "Ask the Doctor."

Stay with HOUSE CALL.

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GUPTA: We're back with HOUSE CALL.

You know, there's a dialysis clinic that runs out of money and it's forced to shut down. That's how the story begins. Dozens of patients subsequently left with little to no help, and without dialysis, they could potentially die. Complicating all these matters, many of the patients are illegal immigrants. What a story!

Elizabeth Cohen followed one patient as he tried to get help.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT (voice-over): Ignacio Godinez is in the United States illegally, and has been since he was 14 years old. Three years ago, his kidneys failed for no apparent reason. He was grateful when Grady Hospital in Atlanta gave him free dialysis three days a week. Without dialysis, Godinez would likely die in two weeks.

(on camera): A few months ago, you got a letter from Grady.

IGNACIO GODINEZ, DIALYSIS PATIENT: Yes. I got a letter saying that they were going to be closing.

COHEN (voice-over): Grady told about 100 people, including about 60 illegal immigrants, that the dialysis clinic is closing. One solution Grady offered, a free plane ticket back home. Godinez told them, "No thanks."

(on camera): So, if you showed up in Mexico, could you just get dialysis, do you think?

GODINEZ: No.

COHEN: Do you feel they've given you some good options?

GODINEZ: No. What this -- they just put us in the street like we're not humans.

COHEN (voice-over): Grady says 10 illegal immigrants said yes to the offer of a free trip home. The rest were offered three months of treatment at a private clinic paid for by Grady. The financially- strapped hospital funded by taxpayers said they had no choice but to kick these patients out. Their clinic is losing $3 million a year.

Dr. Danielle Ofri, an internist who takes care of immigrants in New York calls the situation at Grady, heartbreaking but not unexpected.

DR. DANIELLE OFRI, INTERNIST: The reality is, the people are here. And so, when they come to our hospital, you can't not care for them. You can't turn them away when they are sick. So, we have this issue that's alive and well in our hospital.

COHEN: There are 7 million undocumented and uninsured immigrants in the United States costing taxpayers about $1 billion a year. Health care reform won't help.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: None of the bills that have been voted on in Congress and none of the proposals coming out of the White House propose giving coverage to illegal immigrants -- none of them. That has never been on the table...

COHEN (on camera): Some people would say you're not a U.S. citizen. Why should we give you free dialysis? We don't have enough money to take care of Americans.

(voice-over): To answer my question, Godinez showed me his pay stubs from the natural gas company where he started working at age 15.

GODINEZ: We paid taxes just like everybody else do.

COHEN: On Saturday, Godinez went in for his last dialysis treatment at the Grady Clinic. Then he learned about Grady's offer to pay to go to a private clinic for three months only. We went with him. When he showed up at that clinic, they sent him away, refusing to give him dialysis.

(on camera): Are you scared?

GODINEZ: Yes.

COHEN: What are you scared of?

GODINEZ: Well, to be really sick, and then, that's going to be the worst, I'm going to die.

COHEN: Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: Grady is a hospital where I work at as well as a neurosurgeon. But I can tell you, this is happening all over the country.

Here's a question for you, if someone was having a heart attack or a cardiac arrest, would you know what to do? We got the latest CPR news in "Ask the Doctor." Stay with HOUSE CALL.

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GUPTA: And we are back with HOUSE CALL. It's time for my favorite segment of the show, "Ask the Doctor."

Let's get right to it.

Pauline in California asks this, "Please tell me more about the nicotine vaccine trial and where I can sign up. My husband and I have smoked for over 30 years and we are desperate."

Well, as you might imagine, Pauline, you and your husband are not alone. Many people and quit every single day, and there's a lot of emphasis on possibly trying to create a vaccine to prevent people from smoking.

Here's how it works. You smoke, you get nicotine that crosses over from the blood through the blood brain barrier and actually causes what's known as a "surge of dopamine." Look at that, that's a dopamine, that kind of makes you feel good.

If you take the vaccine ahead of time, you get these little antibodies that bind to the nicotine. The ends binding here and when they try and cross over the blood brain barrier, they sort of bounce off and they come back out so you can't actually get that same sort of surge of pleasure hormones. It's still very early in clinical trials. It's not ready for the mass audience yet.

As far as how to sign up, we're told the trial should be ready by the end of the year and there's going to be locations all over the country. Go to clinicaltrials.gov to try and sign up.

Now, we got another question now from April in Missouri who writes this: "If a person has a weak heartbeat, do you give CPR and breathe for them?"

Well, this is an amazingly timely question, April. Technically, CPR is only intended for a person whose heart has stopped. Now, there are new American Heart Association guidelines say to check for signs of life first and if the person is unresponsive, go ahead and start CPR after calling 911.

Those new guidelines also say that non-medical professionals, people who aren't necessarily trained in this, should focus just on chest compressions, no breathing, just push hard and fast in the middle of the chest, 100 times a minute even and stop for nothing.

For more strategies on saving lives and to hear some remarkable stories of survival, tune in to my special. It's called, "Another Day Cheating Death." It's next weekend only here on CNN.

And also, check out my book by the same name. It's hitting store shelves on Monday, which is also the day we're going to try something new. I want you to tweet me directly if you can at SanjayGuptaCNN, and use the hashtag "miracle." Now, here, give me your own stories about how you may have had near-death experiences or even cheated death yourself. We're going to do contests and give away books, autographed copies of the book if you do this and you'd be entered to win those.

Also, if you have a book club, for example, this is a book that you're going to discuss at your book club. I can show up via Skype at that book club event as well.

Now, take a look here. These aren't your typical athletes. We're going to show a new way to stay young, mentally and physically active as well with just a remote control.

Stay with HOUSE CALL.

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GUTPA: We're back with HOUSE CALL.

You heard us say it before, we are the show that helps you live longer and stronger. In that vein, you've never seen a sports tournament quite like this one.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Team shirts, commentators, cheerleaders, trophies, fierce opposition -- it has all the makings of a championship event, but this is no ordinary competition.

TED CARPENTER, CEO, TEXANPLUS: What's going on here today is the largest Wii bowling senior championship ever held.

GUPTA: TexanPlus, one of the Houston area's largest Medicare HMOs came together with Nifty after Fifty, that's a senior-only fitness program to get these seniors moving in a high-tech way, using Nintendo's Wii video game bowling system.

CARPENTER: We have 600 participants who are bowling and they've brought with them another 1,500 family and friends.

GUPTA: But it's more than just a fun way to stay in shape, these seniors could also be saving themselves from a major medical concern.

According to the Centers for Disease Control and Prevention, falls are the leading cause of injury deaths among seniors, cost Americans nearly $20 billion a year. Those are statistics that Dr. Sheldon Zinberg says, "could be improved simply by exercising."

DR. SHELDON ZINBERG, FOUNDER, "NIFTY AFTER FIFTY": Proper exercise can improve bone mineral density, improve balance, joint stability, and result in a decrease in falls by almost 89 percent.

GUPTA: Improvements that are good for the seniors and good for insurance companies.

CARPENTER: The healthier our seniors are, quite frankly, the better the plan works.

GUPTA: But saving money isn't what brought these elderly athletes here today.

SARAH PILGREEN ,WII BOWLER: It was great. And we all did good.

GUPTA: For Sarah and the NCI West End Bowlers, it's about making friends, having fun, staying active.

PILGREEN: I think it's very important for us as we get older, to stay in sports and whatever we can do.

(END VIDEOTAPE)

GUPTA: Good for them.

We're out of time today unfortunately. If you missed any part of today's show, be sure to check out my podcast CNN.com/podcasting.

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