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Sanjay Gupta MD

Surviving Holiday Hell; Controversial Migraine Treatment; Top Chef's Thanksgiving Tips

Aired November 23, 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: Welcome to SGMD.

Love it or hate it, less than a week now to go until Thanksgiving. Get this stat -- most of us are going to eat about 3,000 calories in just that one meal.

And we're going to spend some time showing you how to cut your calories with the help of top chef Hugh Acheson.

We'll also tell you how to stay sane, after all, who could forget this?

(BEGIN VIDEO CLIP, "PLANES, TRAINS & AUTOMOBILES")

UNIDENTIFIED FEMALE: Yes, dad wants ambrosia, so I guess we'll get those miniature marshmallows. I'll do the crescent rolls, you do the cranberries. You know I can't cook.

(LAUGHTER)

Yes, well, I'll see you tomorrow then. Gobble gobble. Bye-bye.

(END VIDEO CLIP)

GUPTA: You may remember that clip from the hilarious 1987 movie "Planes, Trains and Automobiles." We are getting old. Steve Martin and also the late great John Candy.

Look, I'm going to tell you: the holidays, they can be a trying time -- you know this -- for families from all across the country.

So, joining me with how to survive holiday hell as many people call it, our very own Richard Quest. He's in New York and from Los Angeles, behavior expert Wendy Walsh.

Welcome to both of you.

Wendy, it's a -- it's a different kind of stress, right, a special kind of stress, if you will, over the holidays. Because you say getting together with relatives is the closest thing we have to a time machine. What did you mean by that?

WENDY WALSH, BEHAVIOR EXPERT: Exactly. It's because we are just sort of held in our chairs by a centrifugal force which is our early family systems, be they good or be they bad, no matter how old we get, we become the 12-year-old at the table again, and the sibling rivalry stuff comes up again and mom's favorite gets special attention. Everything goes back to that early family table.

GUPTA: I was never mom's favorite. I know exactly what you're talking about. You know, Richard, you know, I think a lot of this is about expectations, right? We have all these expectations of what the holiday season's going to bring. And then all of a sudden, it's very hard to meet those. And you say only a fool will go into this thinking everything will be fine.

RICHARD QUEST, CNN INTERNATIONAL'S "QUEST MEANS BUSINESS": Wendy's put her finger on it perfectly! You know, Sanjay, it's not about expectations. It's about going into war! Think of it this way, there are -- you go home to your family and there are land mines everywhere. There are elephants in the room that you walk around.

Why is cousin Joey got blond hair? Shhh, we don't talk about it. What is happening to Derrick and Sara? We don't talk about it.

GUPTA: Right.

QUEST: How long -- how many drinks has Uncle Arthur? Sshhh, we don't talk about it.

This is a time for backbone and steel because, frankly, only the brave get out of this in one piece.

GUPTA: And if there's a lot of drinking, then all of a sudden you're talking about everything. Nothing's off the table.

QUEST: Exactly.

GUPTA: Is it psychological warfare, Wendy?

WALSH: I think in some ways it can be, one of the things Richard is talking about, you're talking about from the other side of the pond, where there's a lot of repression and things not talk about. Here in America, I think we talk about too many things and we need to learn to restrain ourselves a little bit.

(LAUGHTER)

GUPTA: I don't know if you've met Richard Quest yet. He doesn't fit your stereotypical across the pond.

QUEST: Wendy, I need a few sessions on your sofa to get rid of my repression.

WALSH: But I do think, listen, we get together, Sanjay, for one reason. Remember, our ancient people, our biology remembers this, we get together during the darkest days of winter, because our ancient people, the sun went away, the food was gone, we huddled together around fires and shared the last little bits of food and hoped that spring would come.

GUPTA: Right. WALSH: So it is wrought with fear from a biological level. Then we go back to the early childhood events that may have been negative, let's be honest, there may have been terrible traumatic events that happened in our childhood.

But now, we have this great opportunity. We can enter with an adult eye. We can enter looking for forgiveness. We can enter looking to spread love.

I mean, we share genes with these people. We share pheromones, we share humor and we should be able to find a way to share love.

GUPTA: It's a great point. It's a lot to take on, though. And one of the things you wrote about as well was this idea that some people kind of jet in and they're going to jet out. They're not going to try to get the whole experience.

Richard, let me ask you -- I mean, because maybe you're the perfect person to ask, once you have had enough, how do you diplomatically extricate yourself from the situation?

QUEST: You need the diplomatic skills of Madeleine Albright and Hillary Clinton all rolled into one.

GUPTA: Or Richard Quest.

QUEST: What you cannot do, what you cannot do is the age-old, my cell phone, oh, hello, yes, oh, I must go immediately, I'm sorry, I've got -- that won't work. You need to set the parameters early. So, if you're going home, you should make it clear that you may have to leave a little bit early because of a dinner at "X" or, again, back to your expectations.

Now, look, if you're having a really good time, then you can make your host feel even better by saying, oh, no, I'll cancel that. If you're not having a good time, your host is ready for you to say, oh, thank you so much.

And be forceful. Don't be put off. Remember, you're not inviting somebody to let you leave. You're just merely excusing yourself. It's about etiquette.

When you're flying -- look, It's like when you're flying and the person next to you will not stop speaking and you want to go to sleep and they are a pain in the proverbial, you don't say, would you mind shutting up. You say, you say, you will excuse me if I get some rest. My mother's meeting with the other side.

GUPTA: You are brilliant! So many people are going to use this advice, Richard, I guarantee.

Richard, do you have siblings?

QUEST: Three sisters.

GUPTA: Wow. WALSH: Wow.

QUEST: Need I say more? Including --

WALSH: I love it.

QUEST: Including a twin who's seven minutes older than me, and you think I've got a complex.

GUPTA: Well, do you have any advice for Richard, Wendy, regarding the social class sibling rivalry?

WALSH: Richard, I will say this -- you know, as siblings leave the family they go up and down the various social classes and there's lots of rivalry over a kind of mustard or lettuce or beers or cabernet, et cetera. Stay out of that mess. Just be who you are.

But more importantly, in a sobering way, I want to tell you, if you don't work out your stuff now with your parents or if there is old real injuries, you're going to be working it out at a deathbed or at a tombstone. So, go in there and be brave and talk about things that matter, Richard, you can do it.

GUPTA: Wendy Walsh, Sir Richard Quest, very good advice. Thank you to you both. Thanks for joining us. Happy holidays.

WALSH: Same to you.

GUPTA: I think we've well established, our families as much as we love them can cause some real headaches sometimes this time of year.

But up next an operation, believe it or not, for extreme migraines. I'm going to take you inside the operating room.

(COMMERCIAL BREAK)

GUPTA: Nearly 10 years ago, plastic surgeons at the Cleveland Clinic, they noticed something curious after performing certain operations known as brow lifts. Some patients came back saying they used to have frequent migraines that then went away after the operations. The surgeons became intrigued by this and they began to experiment and today they toss around the word "cure" or at least something close to it.

(BEGIN VIDEOTAPE)

KOREN HA, SUFFERS FROM MIGRAINES: I just want to have a life. I operate on half a life.

GUPTA (voice-over): Koren Ha says she has about 15 good days a month.

HA: Hold on.

GUPTA: The other 15, she deals with crushing migraine pain.

HA: It feels like a boa constrictor around my head. It feels like a snake going around like this and just so much pressure.

GUPTA: And get this -- the pain is so bad, even sad movies are out of the question.

HA: I can't even cry. "Beaches" was a killer with Barbara Hershey.

Did you see that? Oh.

GUPTA: It's been happening since she was 9 years old. A maddening loop. She's OK one moment. The next, fighting massive pain.

HA: I tried oxygen tanks. I tried acupuncture. Every migraine medication, every seizure medication, anti-depressant, everything.

GUPTA: Well, almost everything.

UNIDENTIFIED FEMALE: And what are we doing for you today?

HA: Surgery.

UNIDENTIFIED FEMALE: What kind of surgery?

HA: Migraine surgery.

GUPTA: Migraine surgery. It's a controversial treatment for what many neurologists say is an intrinsically brain-based problem.

DR. KAVEH ALIZADEH, PLASTIC SURGEON: So I'm just going to make a couple marks over the areas we talked about.

GUPTA: Koren's plastic surgeon said the tight muscles and connective tissue are literally choking her nerves, especially in the neck and that may mark the beginning point of her migraines. So he plans to make incisions and remove bands of muscle in what he says are trigger points, frown lines around the eyes, the temples, the base of the skull, basically, relieve the pressure.

HA: I'm anxious. I've been anxious, like, for a while now because it's, like -- it's, like, a new life so --

ALIZADEH: OK. We're going to start. Can you go up to 20, please? I'll take some gauze.

I have identified the nerve. That's half the battle.

GUPTA: Koren's surgeon, Dr. Kaveh Alizadeh says that 90 percent of patients at his practice emerge from operations with fewer headaches. And he says for 60 percent, the pain goes away completely.

ALIZADEH: We have patients that are almost three years out and they're still reporting no headaches.

So how are we doing?

UNIDENTIFIED MALE: Doing very good.

ALIZADEH: No migraines. Literally they say it was like a switch.

GUPTA: For Koren, there was no switch.

ALIZADEH: That's healed great.

GUPTA: Seven weeks later, she still has sporadic headaches.

HA: So, I'm hopeful, but I don't want to, like, count my chickens.

ALIZADEH: Sure. When you have lived with pain for so long, you're, like, is it going to come, when is it going to happen?

GUPTA: To be sure, migraine surgery has its detractors. Common concerns among neurologists that the study suggesting this method works is flawed and the patients, well, they are most likely experiencing a placebo effect. The American Headache society calls migraine surgery a last resort option that is not appropriate for most sufferers.

ALIZADEH: I think it is good to have people that are skeptics because that's how science gets advanced forward. Any neurologist or pain specialist who is skeptical about this should actually start collaborating with surgeons.

GUPTA: We caught up with Koren 12 weeks now after surgery. Her headaches, she says, are down to three a month.

HA: Three a month for me is very good. I had a tough recovery, but it's definitely working for me. Definitely looking for 100 percent, but, you know?

(END VIDEOTAPE)

GUPTA: It is safe to say that many neurologists do remain skeptical about this, but Dr. Alizadeh who you just met said the procedure can be helpful to a certain subgroup of patients. And to see if someone's a good candidate, surgeons will often test by injecting Lidocaine or Botox into the suspects trigger areas. If that helps, they say the operation could be a more permanent fix. I wish Koren luck.

Up next, cutting the calories around your Thanksgiving table. You might have to do this without sacrificing the taste. We invited top chef Hugh Acheson. He's going to come by right after this.

But, first, today's "Human Factor."

(BEGIN VIDEOTAPE)

ANNOUNCER: Gail Devers got away quickly.

GUPTA (voice-over): For 15 years, Gail Devers, was one of the fastest women in the world, known almost as well for her long fingernails as her Olympic and world championships.

GUPTA: Devers qualified for her first Olympics in 1998, but when it came time to compete, her body failed her. GAIL DEVERS, THREE-TIME OLYMPIC GOLD MEDALIST: I ran slower than the first time I ever ran when I ever stepped on the track.

GUPTA: Her hair started falling out. Her once long nails broke and she started losing a lot of weight.

DEVERS: At my worst, I was under like 85 pounds.

GUPTA: Her symptoms continued for nearly three years without a diagnosis.

GUPTA: Her specialist confirmed Graves disease, an autoimmune disease of the thyroid gland. Devers got radiation treatment, but as a side effect, she developed painful blood blisters on her feet.

It was so bad, doctors nearly amputated her feet.

DEVERS: I just remember sitting there going, oh my gosh, oh my gosh.

GUPTA: Eventually, doctors found a way to treat them, and a year and a half later, Devers was back in her running shoes competing in the 1992 Olympics.

Today, she's married with two children and helping other kids achieve their goals.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: My next guest is a familiar face in homes all across the country, you know this guy, Hugh Acheson. He's a judge on Bravo's "Top Chef" and he's the author of "A New Turn in the South."

Thanksgiving, the stats are enormous, 3,000 calories for one meal, potentially on average. Not everybody. There are ways to do this a lot better, still have a great meal but not overdo it.

HUGH ACHESON, TOP CHEF: Yes, I think that's really important. Historically, it's really a rich meal and we want to lighten it up and we want to take the seasons that's growing out there and really relish in it.

So, my new rule these days is I want half of the dishes on the table to be vegetables and I don't want them to be fat-laden vegetables, I want them to be fresh nice dishes. So, here, we've got a beautiful roasted beet and carrot salad with a little house made cheese.

GUPTA: It looks great.

ACHESON: Parsley and the tops of the carrot greens. This is just Brussels sprouts with cranberries. This is beautiful. Two different types of kale with pears and pecans and roasted tiny sweet potatoes in there.

GUPTA: My friend Anderson Cooper is saying he just recently discovered kale at all because it's become so popular. He didn't know what kale was until recently.

ACHESON: Kale salads are on the rise and now they are getting attacked. There's a backlash now against kale. When things become popular, there's suddenly the backlash against them. Kale has just had its moment. Let it have its moment. It's really good for us.

GUPTA: That's how we Americans are -- we build things up to tear it down.

ACHESON: Dana Cowin (INAUDIBLE), if I see another kale salad, it's like I love kale salad. It's kale salad.

So, we've got a pork tender loin, beautiful local pork, with these tiny beautiful roasted apples I put everywhere, and then we've got a leek bread pudding, kind of like a stuffing, but I don't have a turkey here, so I wanted to do a variation on the stuffing and this is so good. Tons of sweated-down leeks and it mimics the richness, and that's what I want to see. I want that feeling, that lovely feeling of being full at the dinner table afterwards, but I don't want to laden myself out. So --

GUPTA: So, you don't have turkey or honey-baked ham or something like that, right?

ACHESON: Yes. But you can. What I want you to do is just think in the availability of your area and then adapt to it. If you like the spiral ham, go for the spiral ham. If you like the roasted turkey, go for that. But what I want for you to do this.

GUPTA: Yes.

So, half the table. If you look at this, about hour of the eight dishes if you say, three of the six in this case, vegetables.

ACHESON: Yes, exactly.

GUPTA: How long does it take to prepare something like this?

ACHESON: Not too long. Food is meant -- we position food as being this complex thing which is really confusing and really difficult to do well. And it's not. I mean, all of these recipes are really easy to do.

They're written for home use and it's really easy just to go to your farmers' market and find great carrots and great beets and do this salad. It's great to cook Brussels sprouts, our mother made them in putrefied cabbages, and this is refreshing good. This is really simple vinaigrette. This is a dessert which a cranberry and a simple tart that we made with brown sugar and a little custard that's awesome, really fresh, really good.

So, that's all we're looking at. Food, you want to plan it out like you're a restaurateur or a chef and really map out the day and make sure you're fitting in enjoyment and time with the family. But then surround yourself. My 9 and 11-year-olds, they want to cook in the kitchen, it's great. GUPTA: It's part of your family traditions?

ACHESON: It is the best time I will spend with my kids always, we have fun and plan meals and get things going and you are spending time with them but also giving them life skills. If you give them life skills, they'll eat better for the future. That's great.

GUPTA: And you know, I think it's good advice, this idea, because I want to spend time with my kids and I think sometimes we choose convenience and as a result make some poorer food choices.

ACHESON: I think that's really good point because people say I want to get the meal at the fast food restaurant or whatever it may be, to make my life easier, so maybe I can spend time with my kids. How about go to the grocery store or farmers' market with your kids and cooking with them for an hour and a half and enjoying the stories and as you listen to music on the radio and you engage with them and see them, and then it's real. But you are giving them life skills. They are not learning much by buying fried chicken in a bucket.

GUPTA: I couldn't agree more. And you heard it here. It's one of the best times in his life, cooking with his children. Hugh Acheson, everybody. Thanks a lot. Happy holidays.

ACHESON: Yes, you, too.

GUPTA: We'll be right back.

(COMMERCIAL BREAK)

GUPTA: Last week, the American Heart Association came out with these new guidelines about who should be controlling their cholesterol with statin medications. Now, I'll tell you this generated a lot of questions from you at home so I wanted to spend just a moment today reminding you of the basics.

(BEGIN VIDEOTAPE)

GUPTA: Best way to control cholesterol is to really watch what you eat. It's basic advice but makes so much sense when we didn't have all the choices that we have nowadays in terms of fatty foods, processed foods, we were just much better at controlling heart disease.

Well, cholesterol is this waxy substance that our body makes by itself. The problem is it's also in a lot of foods that we eat and because a lot of those foods, we're getting cholesterols that are much higher than we as humans should probably have.

The best way to think about good cholesterol and bad cholesterol is that the bad cholesterol is a stuff that sort of builds up in your blood vessels. It can cause blockages. It can rupture and cause problems with your heart.

Good cholesterol the best way to think about that, it sort of sweeps up the bad cholesterol. Think of it as the cleanup crew. Statins are a type of medication. There are many different brands of this medication, but it basically interferes with the way cholesterol is made, absorbed and cleaned out of the body. If you interfere with that mechanism a bit, you can decrease someone's cholesterol and you can also increase the amount of cholesterol that is sort of wiped away from the blood vessels.

Statins can have some pretty significant side effects, not necessarily life threatening in some cases, but you can develop significant muscle problems. You can also develop problems with your liver. What they're not sure of and a very important question is will it actually prolong life in a vast majority of people? And that still remains to be seen.

(END VIDEOTAPE)

GUPTA: So, here's the bottom line. Hopefully this makes you more knowledgeable, but also initiates a conversation with your doctor. You need to know your family history. You need to know your cholesterol levels. You need to chase life.

Now, before we go, a quick reminder about our Fit Nation challenge. Listen, you've been doing it. I did, too, making excuses about your health.

So, let me help. You've got just one more week to tell us why we should choose you for next year's team. You can logon to CNN.com/FitNation. Learn more there. Also upload your video submission.

We're going to train together. We're going to transform your body and your mind. I call it hitting the reset button.

That's going to wrap things up for SGMD. It's time now to get you back into the "CNN NEWSROOM" with Martin Savidge.