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SANJAY GUPTA MD

Coming Back From the Dead; Warning: Changes Ahead; Born To Run

Aired November 2, 2013 - 16:30   ET

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


DR. SANJAY GUPTA, CNN HOST: Ahead this half hour on SGMD:

What's about to change in your insurance. And even if you're not signing up for a new Obamacare policy, what it could mean for you.

Plus, what we'd like to call smart science. Three tricks to help you run better.

But, first --

(MUSIC)

GUPTA: We've been investigating the impact of prescription drug overdoses in America for some time on this program. As you may know, someone dies every 19 minutes in this country because of such an overdose. And today, I want to talk about a medicine that some people say could help stop this epidemic, but only if we get it in the hands of more people, not just doctors, but average people as well.

Now, look, it's controversial. But you're about to see this incredible video showing how it might work.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): What you're looking at is pretty shocking. A heroin addict overdosing. Her name is Liz. She's been using drugs since she was 11. Today, she's 29.

Adam Wigglesworth and Louise Vincent were both with her that night in August. They both volunteer with a program in Greensboro, North Carolina, that provides clean needles and other assistance to addicts.

ADAM WIGGLESWORTH, SAVED FRIEND WITH NALOXONE: She seemed to be pretty unresponsive and we noticed a blueing of the lips and lack of oxygen and her breathing became quite shallow.

LOUISE VINCENT, SAVED FRIEND WITH NALOXONE: Well, once someone's not breathing and responding to any sort of stimulus, you give them breath, and at that time I usually administer the Naloxone.

GUPTA: Now, watch what happens next.

UNIDENTIFIED MALE: We gave her about 60 units of Narcan.

GUPTA: Narcan, also known as Naloxone, can reverse an overdose from heroin and other drugs like Oxycodone.

UNIDENTIFIED FEMALE: Liz?

GUPTA: Another sternal rub, another shot of Narcan.

UNIDENTIFIED FEMALE: (INAUDIBLE) give her some more Narcan.

UNIDENTIFIED MALE: Giving her the rest of this whole CC.

GUPTA: And, finally, Liz begins to come to.

UNIDENTIFIED FEMALE: Liz? You OK? You went out. We're giving you mouth to mouth resuscitation. We're giving you some Narcan. You overdosed.

Can you sit up?

LIZ, HEROIN ADDICT REVIVED BY NALOXONE: Yes.

UNIDENTIFIED FEMALE: All right, come on.

GUPTA: When someone takes heroin, the drug locks on to receptors in the brain. It slows the body down. Lock up too many, and you stop breathing. Naloxone can free up those receptors, essentially bringing you back to life.

You might wonder, that video of Liz, is that real? We showed it to four emergency room doctors who all said, yes, this is what a recovery with Narcan looks like.

LIZ: I can't believe that somebody cared about me enough or, you know, loved me enough to bring me back.

GUPTA: Back to right a life that somehow went wrong. We met Liz on the day she checked into rehab, packing up her things, taking another look at the album of her 19-month-old daughter.

LIZ: You know, I had felt so separated and just, like, disassociated from my daughter because I felt like, you know, basically like I wasn't good enough to take care of her. I can't finish school. I can't hold down a job. I can't, you know, do any of this, like, normal stuff that everyday people have absolutely no problem, like, it's not a challenge for them.

GUPTA: Naloxone gave Liz a second chance.

It also gave Linda Wohlen a second chance. She remembers the day she found her son Steve faced down in the front yard.

LINDA WOHLEN, SAVED SON WITH NALOXONE: My husband ran out and started rescue breathing. And I ran in and got the Narcan. It was right here. He was laying on his back. Totally blue.

So, the Narcan as soon as it got into his nostrils, he started to stir and wake up, and came to. Thank God for Narcan. GUPTA: Narcan or Naloxone is distributed as part of Massachusetts opioid overdose pilot prevention program and Dr. Alexander Walley is the medical director.

DR. ALEX WALLEY, MASSACHUSETTS OPIOID OVERDOSE PREVENTION PILOT PROGRAM: Initially, this program was targeted towards high-risk injection drug users. We soon started to hear about parents going to needle exchanges.

GUPTA: Today, the program distributes Naloxone to addicts, first responders, and Learn to Cope. That's a support group for parents of addicts.

Linda has been going to Learn to Cope meetings for the past nine years.

UNIDENTIFIED FEMALE: Nasal Naloxone or Narcan, the overdose reversal antidote is available weekly at all LTC meetings. If you're in this room, you should have Narcan.

GUPTA: Learn to Cope has distributed hundreds of Naloxone kits to its members who have managed to reverse at least nine overdoses.

UNIDENTIFIED FEMALE: Tingeing of the lips, fingernails bluish. Anything like that also.

UNIDENTIFIED FEMALE: OK.

UNIDENTIFIED FEMALE: If you can't arouse them.

UNIDENTIFIED FEMALE: It's ready to administer.

UNIDENTIFIED FEMALE: OK, right.

UNIDENTIFIED FEMALE: And it will go up one nostril, a half.

WOHLEN: It's one of those things that, you know, you can't believe that you're signing up for this. But the reality is if you have an addict, you should have Narcan.

GUPTA: In the United States, overdoses kill more people than car accidents, and since 1990, prescription drug overdoses have more than tripled.

WALLEY: I think it makes a lot of sense to, for example, co-prescribe Naloxone with chronic pain medication so people will have it in their home, in their medicine cabinet and instruct their family members how to use it. So if somebody is overdosing then they can administer it to them while they wait for help to arrive -- just as you would for an EpiPen.

GUPTA: But Dr. Ed Boyer also warns it won't always work.

DR. ED BOYER, UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL: It requires people understand that the medications, you know, last longer. The medications may be more potent than individuals anticipate. The absolute need to call 911 has to be -- has to be made clear.

GUPTA: As a parent, Linda knows what it's like to want to save your child.

WOHLEN: You must, must, must have Narcan if you have an addict. You must, absolutely. Because the whole trick of it is to keep them alive until they finally get it.

(END VIDEOTAPE)

GUPTA: Now, you might have noticed that none of the people called 911. I tell you, I think that's a terrible oversight. If you do see that someone's unconscious, you need to immediately call for help before you jump in. Keep that in mind.

In many cases, some doctors think Naloxone might give addicts and their friends and their family a false sense of security as well. It could be a lifesaver. But these are clearly some pretty tough issues.

Now, coming up, it's open enrollment time. How to protect your wallet and what you need to know to avoid being zapped with any big surprises.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: There were some pretty tense exchanges I'd call them on Capitol Hill this week when HHS Secretary Kathleen Sebelius testified before Congress.

(BEGIN VIDEO CLIP)

KATHLEEN SEBELIUS, HEALTH AND HUMAN SERVICES SECRETARY: I am as frustrated and angry as anyone, with the flawed launch of Healthcare.gov. So, let me say directly to these Americans -- you deserve better. I apologize. I'm accountable to you for fixing these problems. And I'm committed to earning your confidence back by fixing the site.

(END VIDEO CLIP)

GUPTA: You know, as the secretary and her team are working to fix the site, as you heard, you are left some questions about Obamacare.

So, here to answer them is Nancy Metcalf from "Consumer Reports."

Thanks for joining us.

NANCY METCALF, CONSUMER REPORTS: My pleasure.

GUPTA: The big thing was people were told that, look, you can't keep your policy. You have to buy a new policy that might be more expensive, it might cover more, but it's more expensive. And they don't -- I mean, did they -- are these people being asked to buy something that they don't need? I mean, what would you tell those folks?

METCALF: Well, the reason those policies are being canceled is because they don't -- they're not adequate to the rules of the new law, and the thing that's not adequate about them is they don't cover everything that they need to cover, the policies that are being canceled might not have prescription drug coverage, they might not cover doctor visits. The new policies that are being sold have to cover all that stuff.

GUPTA: And they offer certain protections in terms of, again, not being discriminated against on pre-existing conditions. People get sick, sometimes people could be dropped or they could -- their premiums go could up, all those sorts of things.

METCALF: Yes, but the whole purpose of the new law was to replace the individual insurance market which has not worked well for people with anything wrong with them for many years.

GUPTA: When you hear these stories like men being asked to buy maternity coverage, for example. It's a great headline.

METCALF: Right.

GUPTA: But can you talk about the idea of individual versus group insurance, group risk.

METCALF: Well, the whole idea of insurance is that you pool the risk of all kind of health care that you might need from cradle to grave, from maternity care to hospice care. That's what employer insurance does, that's what Medicare does, that's what Medicaid does. The only group that hasn't had that are the people in the individual market and this gives them the same comprehensive coverage that everybody else already has.

GUPTA: Yes, and, you know, it's worth pointing out, if you didn't do that, then women when they become pregnant would suddenly have to pay more and that's nobody -- everybody would think that would be ridiculous as well.

METCALF: Well, that's the situation we have now. People may not realize but in 25 states right now, you cannot buy an individual policy with insurance -- with maternity coverage, period. You have to pay for it out of your own pocket. Nobody thinks that's a great idea.

GUPTA: No. As a father of three kids, we saw that and heard a lot about it.

So, these consumers who are getting these cancellations notices and their bottom line is, I'm being forced to buy something that's more expensive. It's different from what I heard from the president and it's different from what I thought I was going to get.

METCALF: What these policies are policies at some point after the health reform law was passed in March of 2010. People who have policies older than that can indeed keep them. They may not want to because they're probably getting pretty expensive. What these people need to understand is you don't have to buy what the insurance company wants to give you. In fact, I don't think you should. You need to go to your state marketplace and look at your options. Very important if you just take what the insurance company gives you, you could be passing up thousands of dollars of subsidies and help with cost sharing.

GUPTA: I think this is a very important point.

METCALF: Yes.

GUPTA: As part of the notice, you may get a recommendation for which plan to immediately sign up for. It's worth taking the extra beat and visiting a Web site like yours and doing a little bit of home work.

METCALF: Exactly. We have a Web site healthlawhelper.org we've created at "Consumer Reports," run through a simple series of questions and you will see whether you are eligible for these subsidies and then you can go to your state marketplace and you may be able to get -- in fact, probably will be able to get replacement coverage, that's quite a bit cheaper than what your insurance company wanted to sell you.

GUPTA: Let me ask you a couple of quick questions. A lot of people say the marketplace is not something I'm worried about or thinking about. What does it all mean for people who have insurance through their employers right now? How are their lives going to change?

METCALF: They're not.

GUPTA: Not at all?

METCALF: They're not.

I mean, the vast majority of people who have employer coverage have good coverage. The employer helps pay for it. They're all set.

GUPTA: Is your Web site working OK?

METCALF: Yes, it is.

GUPTA: All right. Good news. Can use some help out there.

Thanks so much for joining us. Really appreciate it.

And up next the man who inspired the barefoot running craze, he's going to show how anyone can run faster and get more fit with less effort. Shoes or not?

Stay with us.

(COMMERCIAL BREAK)

GUPTA: It's marathon weekend in New York City. That got me thinking. That's 26.2 miles. It's a long way. But Daniel Lieberman who is a Harvard professor of evolution said human beings are actually made for this. We're the endurance champions of the animal world. He's got this new book out. It's called "The Story of the Human Body." And he says that anyone can learn to run faster with less effort.

(BEGIN VIDEOTAPE)

DANIEL LIEBERMAN, HARVARD PROFESSOR OF EVOLUTION: The question really was, how did people hunt before the invention of technology such as the bow and arrow which was only about 100,000 years ago? We think our ancestors evolved to run that animals galloped in the heat and therefore they can run them into heat stroke and kill them. The Vitruvian man.

This is a treadmill that has got a force plate built into it. It's like a fancy scale that measures forces in every dimension. Each one of these markers is just reflecting light that hits it and then bounces back to a camera and it's just telling us where the joints are. It's basically put together a picture of his body.

So, Beau is running in a way a lot of Americans run. He's running with a typical running form. He's running with a cadence of 150 steps a minute and he's leaning a fair amount at the waist. Most evidence suggests this is not a very good way to run.

You see when he hits the ground there's this big impact beat, it means there's a very rapid rate of rise so that first peak is what's called the impact peak and that's the body slamming into the ground really hard.

Beau is now running with what I would call natural running form or good form running, so he's got good posture. He's not leaning at the hips. There's a little bit of lean maybe at the ankle but not at the hitches and he's running with a very high cadence. He's running 170 to 180 steps a minute.

This peak is what happened when he was running at a -- at a faster cadence without the lean. And you can see the first peak has basically disappeared or if it does appear it's very much more gradual.

GUPTA: And we're here with Professor Dan Lieberman now on a nice day in the park. Thanks for joining us.

LIEBERMAN: It's my pleasure.

GUPTA: I'm fascinated by this. And I really want -- if we can for just a moment take a look at my stride and we'll come back and talk about it.

LIEBERMAN: Sounds great.

GUPTA: Two cameras are on me, so maybe that wasn't my exact gait.

LIEBERMAN: You run pretty typically for most Americans. I mean, you have good posture --

GUPTA: It does sound good.

LIEBERMAN: You have good posture. But I would say there are two things that you could benefit from and the first is your cadence. So, the rate at which you're turning -- using your legs, your step frequency.

GUPTA: Let's get an idea how I'm running in terms of cadence. You have the metronome here.

LIEBERMAN: Yes. So, this is the metronome. Just a simple little device, actually a great thing for runners to get. And this, you know, tells your frequency and you are running at this frequency about 155 steps per minute.

GUPTA: And that's a little bit too slow.

LIEBERMAN: That's very common but it's a little bit too slow. And you really want to be up. You want to be to like about 170 or 180. So, I'm going to turn this right up there. You want to be like this, right?

What that does is it makes you less likely to over stride, so your foot is less likely, your ankle, is less likely to land in front of your knee because you never want that to happen.

GUPTA: Because you're not reaching?

LIEBERMAN: That's right. If you land out in front of you, what that does that, you know, for every action, there's an equal and opposite reaction. So if you hit the ground with your foot going forward, the ground is going to push you back and that's going to slow you down.

GUPTA: You're hitting the brakes.

LIEBERMAN: Exactly. You're hitting the brakes and you need to have more effort to reaccelerate your body after it decelerates in the first part. Secondly, when you hit up front, your knee is more straight, your ankle is going to be pointed upward and that stiffens your leg. And when you stiffened, your leg, that means that you hit the ground harder. So, you can actually hear it, when you over-stride and you make more sound when you run and good runners are quiet.

GUPTA: Run quietly.

LIEBERMAN: Yes, exactly. Running quietly is very important.

The three key elements of good form are good posture. You don't want to lean at the hip. A lot of people lean at the hip.

GUPTA: You heard people going uphill are trying to create an advantage. Does that help at all?

LIEBERMAN: You don't want to lean at the hips. You want to lean at the ankle, if you're going to lean anywhere. Like you're about to kiss your boyfriend (ph), just lean forward but you do it with your ankle, not your hip, right? So running is like kissing, right?

GUPTA: You barefoot run?

LIEBERMAN: I love to barefoot run.

GUPTA: A lot of people say this is a fad. I mean, you studied this. You studied the way we evolve and what's happening to your body as you run. Do you think it's a fad?

LIEBERMAN: Well, if it's a fad it's about a 2 million-year-old fad because, you know, we've been running for millions of years and shoes were only invented recently. But that said, most of us grew up wearing shoes and we're not adapted to being barefoot anymore. We don't have the strength in our feet. Our calf muscles aren't very strong. So, if you've been running with shoes all your life and you decide to take your shoes off and become barefootist, you're going to get hurt. So, it's very important to try it gradually and slowly, cautiously and adapt your body.

GUPTA: Some of the same principles, quicker cadence, run quietly, don't overextend -- those things very much apply when you're barefoot running.

LIEBERMAN: I think it's even more important when you barefoot run because, you know, a running shoe has all sort of features in it to protect you, right? So, for example, if you're going to land our heel, you want a shoe like this, which has a lot of cushioning, right? It's going to protect you from that high forces --

GUPTA: Coming down, yes.

LIEBERMAN: What matters most is how you run not the kinds of shoes you wear. I mean, after all, our soldiers run in boots, right? You can run in anything.

(END VIDEOTAPE)

GUPTA: Now, if you're ready to run, bike, or swim, not in that order necessarily, then it's time to get your tri on with us. Look, you may be making excuses. You may be tired about the excuses about your health, so just stop doing it. Instead logon to CNN.com/fitnation and tell us why you should be member of next year's team, our Fit Nation team, and you could be well on your way to a new and better you. Good luck. I want to see you.

A check of your top stories at the top of the hour.

But up next, sleep -- your way to better health. I'll explain.

(COMMERCIAL BREAK)

GUPTA: You know, as the weather cools down, things tend to heat up. Statistically speaking, that is, in the bedroom. In fact, more children will be conceived next month than any other month of the year. Now, if you're planning to expand your own family, you may want to pay attention to this next study that caught a lot of people's eyes this past week. They found this relationship between diet and specifically male fertility, the quality of a man's sperm. What they found was processed meats like bacon or hamburgers appeared to be related to a lower percent of what they morphologically normal or well-shaped sperm. The men that ate dark meat, for example, fish such as salmon and tuna had a higher total sperm count. And more white meat fish such as cod and halibut, it's more normal shaped sperm.

It's fascinating stuff and none of this frankly should be that surprising I think when I looked at the study. It simply is saying that diet can affect your reproductive health. We've known that a long time.

But also, keep in mind that researchers only look at what's known as associations. Not causes. Not to say that men who ate more processed meat and less fish could have just an unhealthier diet overall, and that could be contributing to all of this.

You know, daylight saving time comes to an end this weekend and that means it's time to fall back. You remember that? Snag an extra hour of sleep.

Now, sleep, we talk about this quite a bit. But, you know, one way to think about it is that it sort of cleans the brain of toxins that can build up during waking hours. There was this new study, in fact, really remarkable images conducted at the University of Rochester showed that brain cells, they kind of shrink during sleep and because of that, that better helps cerebral spinal fluid sort of wash the brain clean.

Researchers also suggest that failing to clear away those toxic proteins could play the role in the development of some brain disorders and even things like Alzheimer's disease.

So, go ahead, chase life. Actually enjoy that extra hour sleep.

That's going to wrap things up for "SGMD. But stay connected with me at CNN.com/Sanjay. Let's keep the conversation going on Twitter @DrSanjayGupta.

Time now, though, to get you back into the "CNN NEWSROOM" with Don Lemon.