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CNN Saturday Morning News
"Weekend House Call": Best Questions Of 2003
Aired December 27, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Good morning. Welcome to this special edition of WEEK END HOUSE CALL. Week in and week out, we get more e- mails than we can use in any one show, and we thank you for those, but never send anything to the trash bin. So on the last weekend of 2003, we're answering some of the year's best questions -- your best questions on everything from acne to zinc deficiency. Our focus begins with focusing.
Melanie in Los Angeles informs us: "Like many others baby- boomers, I need glasses to read. Oftentimes a correction to improve long distance sight is needed, as well. Is there eye surgery suitable to correcting ageing vision back to 20/20?"
Well Melanie, we consulted Dr. Keith Thompson he's founder and director of Emory Vision here, in Atlanta, here's his answer.
(BEGIN VIDEO CLIP)
DR. KEITH THOMPSON, EMERY VISION: Melanie, I'm just like you, in my 40s, and I have problems with reading. There are good options now, there are bifocal contact lenses. If you want to stay in glasses, you can have either bifocals added to the glasses or a -- what we call a no-line bifocal or progressive reading glasses add. There are some surgical options.
Generally the best thing to do is correct one eye, usually the dominant eye, fully for distance vision and leave your fellow eye just a little bit nearsighted and that gives you a good range of vision to see well both at near and at distance.
(END VIDEO CLIP)
GUPTA: Some 240 years after Benjamin Franklin invented bifocals, 50 years after contact lens appeared, laser beams and radio waves are bringing clarity to the visually impaired. LASIK may be the best known type of laser eye surgery, but there's also a method called PRK and LASEK, spelled with an "E." LASIK, with an "I," comes in two verities: traditional and what's known as wavefront. Then there's something known as CK, as well, or Conductive Keratoplasty, which actually uses radio waves to correct farsightedness that comes with middle age.
That brings us to another question we've got from David in Massachusetts. He says: "My No. 1 reason for not having laser surgery is concern about the potential for night vision to be worse than it is prior to the operation. What further advances offer the greatest hope for not impacting night vision?" Again, Dr. Thompson:
(BEGIN VIDEO CLIP)
THOMPSON: David, that's a very good question and in the refractive surgery field, we've worked very, very hard in the last five or 10 years to try to improve the quality of vision at night. Technology has improved dramatically in the past few years and the type of laser vision surgery we do now causes much less of a problem for patients at night.
So, whereas earlier patients may have experienced glare, halos, or starbursts around images, those side effects are much less today with modern laser surgery using wavefront sensors to help guide our treatment, and our -- and also lasers that are capable of correcting larger treatment zones, so when your pupil enlargens (SIC) at night, you still have a good correction and sharp vision when the lights are dim.
(END VIDEO CLIP)
GUPTA: And so-called traditional LASIK causes night vision problems in roughly three patients in a hundred -- important numbers. Wavefront LASIK cuts that to about one per 100. Both procedures carry other risks, as well, possible side effects. So spend time with your doctor before you commit to that.
Let's move on now to another vision problem. We get a lot of e- mails about something known as lazy eye. Here's a good question:
Bill in Florida wonders: "Has there been any progress for solutions to lazy eye? Is research being conducted? I have vision in one eye and pray one day to see normally."
(BEGIN VIDEO CLIP)
THOMPSON: Bill, lazy eye is a condition where the visual system doesn't develop normally and oftentimes this occurs early in life. And the visual system becomes fairly mature by age eight to ten. If the condition is detected early in life, and the best treatment is patching the good eye to allow the weak eye to develop normally and all the visual pathways to develop, if you don't catch it early though, and that eye becomes lazy or what we call amblyopic, then there's really no further treatment available later in life. So it's something that needs to be detected early and corrected in order to preserve vision in that eye.
(END VIDEO CLIP)
GUPTA: And an eye condition that strikes later in life, as well, is macular degeneration. Michele in Pennsylvania had a good question. She writes: "My father was recently diagnosed with MD, macular degeneration, and I am wondering if there are currently any surgical methods to prolong the inevitable progressive loss of sight?"
The answer Michelle, seems to be: Well, maybe. Not all macular degeneration is alike.
(BEGIN VIDEO CLIP)
THOMPSON: Michele, there's generally two major types of macular degeneration, and depending upon which type your father has, treatment may or may not be available. In about 80 percent of cases, the macular degeneration is just a progressive atrophy or loss of critical tissue in the retinal area. In that type of condition, of macular degeneration, so called "dry" macular degeneration, there is no surgical treatment available.
Another type of macular degeneration that occurs in about 20 percent of patients is caused by leaky blood vessels and we call that "wet" macular degeneration. In those cases, laser surgical treatment may be of some benefit. So, the best thing to do is to get your doctor to a retinal specialist and let him make a correct diagnosis to see if treatment's available.
I will say that on the type of macular degeneration that's more common, the "dry" macular degeneration, it's been shown that long-term therapy or supplements with zinc and anti-oxidants appears to have benefit in preventing progression of the disease and loss of the vision.
(END VIDEO CLIP)
GUPTA: It's the end of the year and we're clearing out our WEEK END HOUSE CALL inbox. Our next batch of questions is guaranteed to get under your skin. When our special edition continues, an indepth look at dermatology, warts and all. Stay with us.
(COMMERCIAL BREAK)
GUPTA: Welcome back to our special look at some of the best questions we never had time to answer. Well, beauty may be only skin deep, but there's a lot more to the skin than people realize. It's the largest organ in the body and it protects all the other organs from the dangerous of the outside world. It's a source of the most common cancers, by far, and some of the worst adolescent anxieties, and middle age miseries, that's not only scratching the surface.
Our expert dermatologist Rutledge Forney is here and she -- a first question for here comes from Leslie in New Jersey.
Leslie says: "There are thousands of products on the market for daily skin maintenance. Are the more expensive ones better or can I just get by with the drugstore brands?"
(BEGIN VIDEO CLIP)
DR. RUTLEDGE FORNEY, DERMATOLOGIST: Leslie, you can absolutely get by with the drugstore brands. The companies that produce the drugstore brands are large and they do a lot of research. They have products that have things like retinol in them, some of them have copper based products and things with salicylic acid in them. All those can be healthy for your skin. They don't have to cost a lot of money.
(END VIDEO CLIP)
GUPTA: And if the prospect of laugh lines doesn't strike you as funny, Talia from Buffalo can relate. She asks: "What are inexpensive ways to prevent wrinkles so you can look younger, as well as, be healthy?"
Again, Dr. Forney.
(BEGIN VIDEO CLIP)
FORNEY: Talia, the most important thing you can do is protect your skin from sun. So you need to think of sun block and SPF factors as your best asset against ageing. In addition, any kind of sun protection, hats and shirt sleeves are very helpful for anti-aging. From a cream standpoint, the most important thing you can use is something with retinol in it, it's certainly been shown to help with preventing ageing. In addition, some people think vitamins that have zinc and vitamin C can make a difference, and last but not least is aerobic exercise. Working up a healthy flush to your skin really does make you look younger and keep your skin to looking better.
(END VIDEO CLIP)
GUPTA: Sounds like good advice. And few of us have made it to adulthood without becoming keenly aware of how our skin can affect our psyches, our confidence, our self-esteem. Acne strikes pretty much everybody at some point or another in his or her teenage years. And surging teenage hormones are the reason. On average, five to 10 years pass from first zit to last zit, but an unlucky few suffer well into their 30s.
Jennifer in Arizona wrote, "I have unsightly blackheads and clogged pores all over my face. I am now 36 and my acne gets worse instead of getting better with age. What skin care routine is best?"
Well, Dr. Forney says adult acne can be controlled, but it's not a do-it-yourself project.
(BEGIN VIDEO CLIP)
FORNEY: Jennifer, this is a very frustrating problem and people who come in to see us and say that they have worse acne in their 30s than they ever had in their teenage years, are very frustrated with it. Acne problems, like Blackheads, really do need a dermatologist's care because the best products are available by prescription. Something with Retin-A in it or one of the retinoids is the only true way to attack the blackhead and clogged pore problem.
In generally, one of the problems with older age acne is because your skin is not as oily as it was when you were younger and the over- the-counter products are very harsh sometimes for people who have acne in their 30s.
In general, acne can be helped a lot with some of the over-the- counter products that have benzoyl peroxide in them or salicylic acid in them. Sometimes the retinol products, which are oil free, can be helpful for that as well. But in general, acne is a medical problem and you really need to have access to some of the prescription creams to try to help you control that problem.
(END VIDEO CLIP)
GUPTA: Good advice. And, acne sufferers of any age should know they're not bringing them on themselves. Hygiene, diet, and stress have no proven links to acne. Which incidentally, doctors don't consider just a cosmetic disease, nor as Dr. Forney pointed out, should patients merely let acne run its course.
In our last segment we talked about eyes, and here too, we're on dermatologist territory. Kelly from Ohio spoke for millions when she wrote: "How do you get rid of those puffy bags or dark circles underneath your eyes?"
Well Kelly, if you've got the will and the wherewithal, there's a way -- Dr. Forney.
(BEGIN VIDEO CLIP)
FORNEY: Well, this is also a very frustrating problem. The only way to get rid of those puffy bags or even to disguise some of the dark marks is actually with surgery. And the surgery can be very effective. However, not everybody wants to have surgery for this problem.
So, the next step is to either try to reduce the puffiness, which there are lots of over-the-counter eye gels, in particular, that can sort of help get the puffiness reduced temporarily, at least, for some of your special nights out.
The other thing is just a simple concealer. Those dark circles are caused because you have thin skin underneath your eyes and the dark circles are actually just a reflection of the vascular network underneath your eyes. You need the vascular network, you can't get rid of it, but you can hide it.
(END VIDEO CLIP)
GUPTA: So, our skin reflects our age and oftentimes our health or lack thereof. But, it's also a living catalog of the cuts, bumps and scrapes, even some diseases that we've accumulated over our lifetimes. Scars can be a badge of honor or painful reminders. And for most of human history, they are permanent.
But, Monica from Missouri asked, "Are there any surgical or chemical options to reduce the appearance of scars?"
(BEGIN VIDEO CLIP)
FORNEY: There are lots of things that will help with scarring. It all depends of whether it's a new scar or an old scar. With new scars, there are scar pads, which are available over-the-counter, which really can make a difference. There's a lot of science behind using these clear pads on scars. If you have an older scar that's either red or thickened, a doctor can help you with injecting the scars or there are some laser options which can smooth scars to make them less obvious.
(END VIDEO CLIP)
GUPTA: Millions of people would like their skin a lot better if there were less of it. When our special edition of WEEK END HOUSE CALL continues, we'll serve up some of the tastiest questions on eating right and losing weight. Making a resolution to be here, right here on WEEKEND HOUSE CALL after a break.
(COMMERCIAL BREAK)
All right, we're back. Now, if you believe what you read on the internet, 90 percent of the people who make New Year's resolutions vow to lose weight and/or eat more healthful diets. We can't vouch for that figure, but we do know that we get tons of e-mail on food-related topics year round.
For example, Tom in Virginia asked: "Is the Atkins diet or any high-fat, low-carb diet safe?"
Well we consulted a dietician. Dietician, Lisa Drayer of dietwatch.com.
(BEGIN VIDEO CLIP)
LISA DRAYER, DIETITIAN, DIETWATCH.COM: A low carbohydrate diet can be a safe option, as long as you're not staying in that first phase for a long period of time. That's when the carbohydrates are severely restricted to about, let's say, 20 grams on the Atkins diet, for example. That amount of carbohydrates is simply not going to give you enough energy to fuel your brain and also your muscles for exercise. So, that's one thing to be cautious of.
Also, if you have kidney problems, you want to stay away from a very low carbohydrate diet, because oftentimes these diets are higher in protein, which can be taxing on the kidneys and also be aware of the saturated fat in a lot of the foods on low carbohydrate diets.
For example: red meats, butter, cream, these all have high amounts of saturated fats, which can I boost cholesterol levels. So, we might not know that the saturated fats have better fats in the short-term, but potentially over the long-term.
(END VIDEO CLIP)
GUPTA: And if you're weighing a low-carb diet, such as Atkins, against a more traditional low-fat approach, consider this: A study found more weight loss at first from the low-carb plan and a greater increase in so-called good cholesterol. So-called bad cholesterol changed equally in both groups and after a year, weight and cholesterol, both evened out. Murali in Massachusetts asks, "My teenage daughter and I are both vegetarians. How can I make sure we get enough protein and minerals in our diet everyday?"
(BEGIN VIDEO CLIP)
DRAYER: It's a great question. Being a pure vegetarian or a Vegan, can pose the risk for nutrient deficiencies. The most important thing, I would say, is to include protein at meals and snacks, some good sources include tofu, also whole grains, and also veggie burgers are a good source for meals. In terms of snacks, you can try Edamame, soy milk, or even peanut butter with crackers, and nuts. Just be careful on calories there, if you're watching your weigh.
You also want to make sure that you're getting enough vitamins and minerals. As you mentioned, some of the ones to pay special attention to include vitamin B-12, calcium, iron, and zinc. Your best bet is to choose fortified foods, such as, fortified cereals, and also to take a multivitamin, which will cover you for these nutrients. And, if you are avoiding dairy, which it sounds like you are, take a separate calcium supplement.
(END VIDEO CLIP)
GUPTA: Now for all of our pregnant viewers out there, pregnancy and the months postpartum raise weighty questions for every woman and problems for many.
Christine in Canada, told us: "I just had my first child and need to lose 20-30 pounds. With a seven-week-old baby, I don't have lots of time." No surprise there. "I really would like to lose this weight. What's the best way?"
Well, Christine there are as many answers to that question, at there are dietitians, but most agree the secret is to make lifestyle changes that you that you can stick with.
(BEGIN VIDEO CLIP)
DRAYER: My take on weight loss is that losing weight is an individual thing. Everyone has different bodies and different needs. What I tell people is pick three mini goals. These don't have to be drastic changes in your diet or activity levels, but mini goals. For example: Let's say eliminating soda, taking a brisk 15-minute walk each day, or cutting portions in half. Now, the key is to be sure to stick with your goal. So, you might want to try one goal at a time, but you will be amazed at how quickly these changes can add up and you can lose a lot of weight over the long-term, which is the most important thing.
(END VIDEO CLIP)
GUPTA: Yes, it certainly is the most important thing.
Well, we wouldn't be human if we didn't look for easy answers to hard questions, and thus come pills and potions and compounds that claim to make the pounds melt off. Few have been as controversial as ephedra, also known as the herb ma huang. It's a stimulant, which means it increases the heart rate, and raises blood pressure, it's been linked to heart attacks and strokes and back in February, it was named a factor in the heat stroke death of an up and coming pitcher of the Baltimore Orioles.
You can buy it over-the-counter or online under the names Xenadrine, Metabolife, and Stacker 2.
Questions about this, lots of them. Candice in Alabama, points out: "There are many ephedra-free products now, but the health risks seem to be virtually the same as those products containing ephedra. Is there a diet pill that has no health risks?"
(BEGIN VIDEO CLIP)
DRAYER: It's a great question. And it's true, many of the ephedra-free products we see on the shelves now, do have a similar potential to do damage as the ephedra-containing products. Oftentimes ingredients are used which have similar stimulatory effects, for example: Caffeine or guarana, this is an herb that has stimulatory effects. So, you do want to be careful.
Others have high levels of vitamins, which can be potentially dangerous. Others have herbal ingredients, which can potentially interfere with medications. Some also have undesirable side effects, for example: A fat blocker, while it blocks fat, it may also block the absorption of fat soluble vitamins.
So, you do want to be careful. And, the most important thing to recognize is that manufacturers of these over-the-counter diet pills do not have to prove their products are safe or effective before they reach your hands. So, there really isn't any diet pill that poses no risk at all.
(END VIDEO CLIP)
GUPTA: As you do get closer to your ideal weight, you don't want to just look better, you don't want to just feel better, you have a better chance of avoiding the No. 1 killer of Americans. Stay with us for a heart to heart about hearts when this special edition of WEEK END HOUSE CALL continues. But first, this edition of "For Your Health."
(BEGIN VIDEOTAPE)
ANNOUNCER: Lupus is a chronic autoimmune disease that activities the skins, joints, blood, and kidneys. The immune system loses its ability to tell the difference between foreign substances and its own cells and tissues. The immune complex is built up in the tissues and can cause inflammation, injury to tissues, and pain. But, with treatment and close follow-up, lupus is not a fatal disease.
(END VIDEOTAPE)
(COMMERCIAL BREAK)
GUPTA: Welcome back to WEEK END HOUSE CALL. The biggest champagne event of the year is now only days away, but revelers who want to drink their health -- drink to their health may opt to bag the bubbly for Bordeaux or Cabernet or a dusky Merlot.
Dave in New York is considering it and he asks: "Is there really any validity to the research that suggests dirking red wine helps reduce risks for heart disease?"
Well, our expert is cardiac surgeon Dr. Mehmet Oz.
(BEGIN VIDEO CLIP)
DR. MEHMET OZ, CARDIAC SURGEON: Dave, although it's counter- intuitive to some, there is very good data that drinking red wine is beneficial to the heart. Much of it comes from France. Interestingly, the French, who eat a high-cholesterol, high-fat diet in the Leone area, in Southern France, also drink a lot of red wine and they seem to have a very low incidence of heart disease. So, there was a large trial done, called the Leone Trial, where people were randomized to drinking red wine and other foods that were typical of the French diet and they had about a 30 percent reduction, reduction in their incidence of having heart problems. So, I do think that red wine is beneficial and we've actually looked in the laboratory at why this may be so, and it turns out that red wine, in the skin of the grape, has resveratrol, which is a very strong antioxidant and this may be the key reason why red wine is beneficial to us. But, I must caution you, we're talking about one, to at most two glasses a day.
(END VIDEO CLIP)
GUPTA: Resveratrol -- say that several times fast. Well, you probably heard, heart disease is the leading cause of death in America, claiming one new victim every 33 seconds. But here's the good news, you don't have to be one of them. Five of the six major cardiac risk factors including blood pressure, bad versus good cholesterol, insulin levels, and weight, are all manageable. And, that brings us to this question from Tony:
He writes, "Even with good blood pressure and low cholesterol, does a person still have a chance for a heart attack?"
Again, Dr. Oz.
(BEGIN VIDEO CLIP)
DR. OZ: Tony, the amazing thing to me is that most Americans think if they keep their blood pressure down and keep their cholesterol low, they'll never have a heart attack. Unfortunately, the most common predictor of a heart attack is your genetics. The genes predict how you process food, they predict how much of an impact on your body the blood pressure will have. So, although we'd like to think we can control all these factors, the reality is, we can only help. Now that will stated, one person's normal blood pressure may not be another's, and so frequently we find that only about half the patients having heart attacks have the classic risk factors. If you look more carefully at these individuals who are able to control their blood pressure, their blood sugar, their lipids a little more meticulously, they could probably impact quite dramatically on their chance of having a heart problem.
(END VIDEO CLIP)
GUPTA: Really good advice from everybody.
Our thanks to Dr. Mehmet Oz, Lisa Drayer, Dr. Rutledge Forney, and Dr. Keith Thompson for helping us answer these backlog of questions. And, thanks to you, most importantly, for watching and sending in those questions. Keep those e-mails coming in 2004.
I'm Dr. Sanjay Gupta. "CNN Saturday Morning" continues now.
END
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Aired December 27, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Good morning. Welcome to this special edition of WEEK END HOUSE CALL. Week in and week out, we get more e- mails than we can use in any one show, and we thank you for those, but never send anything to the trash bin. So on the last weekend of 2003, we're answering some of the year's best questions -- your best questions on everything from acne to zinc deficiency. Our focus begins with focusing.
Melanie in Los Angeles informs us: "Like many others baby- boomers, I need glasses to read. Oftentimes a correction to improve long distance sight is needed, as well. Is there eye surgery suitable to correcting ageing vision back to 20/20?"
Well Melanie, we consulted Dr. Keith Thompson he's founder and director of Emory Vision here, in Atlanta, here's his answer.
(BEGIN VIDEO CLIP)
DR. KEITH THOMPSON, EMERY VISION: Melanie, I'm just like you, in my 40s, and I have problems with reading. There are good options now, there are bifocal contact lenses. If you want to stay in glasses, you can have either bifocals added to the glasses or a -- what we call a no-line bifocal or progressive reading glasses add. There are some surgical options.
Generally the best thing to do is correct one eye, usually the dominant eye, fully for distance vision and leave your fellow eye just a little bit nearsighted and that gives you a good range of vision to see well both at near and at distance.
(END VIDEO CLIP)
GUPTA: Some 240 years after Benjamin Franklin invented bifocals, 50 years after contact lens appeared, laser beams and radio waves are bringing clarity to the visually impaired. LASIK may be the best known type of laser eye surgery, but there's also a method called PRK and LASEK, spelled with an "E." LASIK, with an "I," comes in two verities: traditional and what's known as wavefront. Then there's something known as CK, as well, or Conductive Keratoplasty, which actually uses radio waves to correct farsightedness that comes with middle age.
That brings us to another question we've got from David in Massachusetts. He says: "My No. 1 reason for not having laser surgery is concern about the potential for night vision to be worse than it is prior to the operation. What further advances offer the greatest hope for not impacting night vision?" Again, Dr. Thompson:
(BEGIN VIDEO CLIP)
THOMPSON: David, that's a very good question and in the refractive surgery field, we've worked very, very hard in the last five or 10 years to try to improve the quality of vision at night. Technology has improved dramatically in the past few years and the type of laser vision surgery we do now causes much less of a problem for patients at night.
So, whereas earlier patients may have experienced glare, halos, or starbursts around images, those side effects are much less today with modern laser surgery using wavefront sensors to help guide our treatment, and our -- and also lasers that are capable of correcting larger treatment zones, so when your pupil enlargens (SIC) at night, you still have a good correction and sharp vision when the lights are dim.
(END VIDEO CLIP)
GUPTA: And so-called traditional LASIK causes night vision problems in roughly three patients in a hundred -- important numbers. Wavefront LASIK cuts that to about one per 100. Both procedures carry other risks, as well, possible side effects. So spend time with your doctor before you commit to that.
Let's move on now to another vision problem. We get a lot of e- mails about something known as lazy eye. Here's a good question:
Bill in Florida wonders: "Has there been any progress for solutions to lazy eye? Is research being conducted? I have vision in one eye and pray one day to see normally."
(BEGIN VIDEO CLIP)
THOMPSON: Bill, lazy eye is a condition where the visual system doesn't develop normally and oftentimes this occurs early in life. And the visual system becomes fairly mature by age eight to ten. If the condition is detected early in life, and the best treatment is patching the good eye to allow the weak eye to develop normally and all the visual pathways to develop, if you don't catch it early though, and that eye becomes lazy or what we call amblyopic, then there's really no further treatment available later in life. So it's something that needs to be detected early and corrected in order to preserve vision in that eye.
(END VIDEO CLIP)
GUPTA: And an eye condition that strikes later in life, as well, is macular degeneration. Michele in Pennsylvania had a good question. She writes: "My father was recently diagnosed with MD, macular degeneration, and I am wondering if there are currently any surgical methods to prolong the inevitable progressive loss of sight?"
The answer Michelle, seems to be: Well, maybe. Not all macular degeneration is alike.
(BEGIN VIDEO CLIP)
THOMPSON: Michele, there's generally two major types of macular degeneration, and depending upon which type your father has, treatment may or may not be available. In about 80 percent of cases, the macular degeneration is just a progressive atrophy or loss of critical tissue in the retinal area. In that type of condition, of macular degeneration, so called "dry" macular degeneration, there is no surgical treatment available.
Another type of macular degeneration that occurs in about 20 percent of patients is caused by leaky blood vessels and we call that "wet" macular degeneration. In those cases, laser surgical treatment may be of some benefit. So, the best thing to do is to get your doctor to a retinal specialist and let him make a correct diagnosis to see if treatment's available.
I will say that on the type of macular degeneration that's more common, the "dry" macular degeneration, it's been shown that long-term therapy or supplements with zinc and anti-oxidants appears to have benefit in preventing progression of the disease and loss of the vision.
(END VIDEO CLIP)
GUPTA: It's the end of the year and we're clearing out our WEEK END HOUSE CALL inbox. Our next batch of questions is guaranteed to get under your skin. When our special edition continues, an indepth look at dermatology, warts and all. Stay with us.
(COMMERCIAL BREAK)
GUPTA: Welcome back to our special look at some of the best questions we never had time to answer. Well, beauty may be only skin deep, but there's a lot more to the skin than people realize. It's the largest organ in the body and it protects all the other organs from the dangerous of the outside world. It's a source of the most common cancers, by far, and some of the worst adolescent anxieties, and middle age miseries, that's not only scratching the surface.
Our expert dermatologist Rutledge Forney is here and she -- a first question for here comes from Leslie in New Jersey.
Leslie says: "There are thousands of products on the market for daily skin maintenance. Are the more expensive ones better or can I just get by with the drugstore brands?"
(BEGIN VIDEO CLIP)
DR. RUTLEDGE FORNEY, DERMATOLOGIST: Leslie, you can absolutely get by with the drugstore brands. The companies that produce the drugstore brands are large and they do a lot of research. They have products that have things like retinol in them, some of them have copper based products and things with salicylic acid in them. All those can be healthy for your skin. They don't have to cost a lot of money.
(END VIDEO CLIP)
GUPTA: And if the prospect of laugh lines doesn't strike you as funny, Talia from Buffalo can relate. She asks: "What are inexpensive ways to prevent wrinkles so you can look younger, as well as, be healthy?"
Again, Dr. Forney.
(BEGIN VIDEO CLIP)
FORNEY: Talia, the most important thing you can do is protect your skin from sun. So you need to think of sun block and SPF factors as your best asset against ageing. In addition, any kind of sun protection, hats and shirt sleeves are very helpful for anti-aging. From a cream standpoint, the most important thing you can use is something with retinol in it, it's certainly been shown to help with preventing ageing. In addition, some people think vitamins that have zinc and vitamin C can make a difference, and last but not least is aerobic exercise. Working up a healthy flush to your skin really does make you look younger and keep your skin to looking better.
(END VIDEO CLIP)
GUPTA: Sounds like good advice. And few of us have made it to adulthood without becoming keenly aware of how our skin can affect our psyches, our confidence, our self-esteem. Acne strikes pretty much everybody at some point or another in his or her teenage years. And surging teenage hormones are the reason. On average, five to 10 years pass from first zit to last zit, but an unlucky few suffer well into their 30s.
Jennifer in Arizona wrote, "I have unsightly blackheads and clogged pores all over my face. I am now 36 and my acne gets worse instead of getting better with age. What skin care routine is best?"
Well, Dr. Forney says adult acne can be controlled, but it's not a do-it-yourself project.
(BEGIN VIDEO CLIP)
FORNEY: Jennifer, this is a very frustrating problem and people who come in to see us and say that they have worse acne in their 30s than they ever had in their teenage years, are very frustrated with it. Acne problems, like Blackheads, really do need a dermatologist's care because the best products are available by prescription. Something with Retin-A in it or one of the retinoids is the only true way to attack the blackhead and clogged pore problem.
In generally, one of the problems with older age acne is because your skin is not as oily as it was when you were younger and the over- the-counter products are very harsh sometimes for people who have acne in their 30s.
In general, acne can be helped a lot with some of the over-the- counter products that have benzoyl peroxide in them or salicylic acid in them. Sometimes the retinol products, which are oil free, can be helpful for that as well. But in general, acne is a medical problem and you really need to have access to some of the prescription creams to try to help you control that problem.
(END VIDEO CLIP)
GUPTA: Good advice. And, acne sufferers of any age should know they're not bringing them on themselves. Hygiene, diet, and stress have no proven links to acne. Which incidentally, doctors don't consider just a cosmetic disease, nor as Dr. Forney pointed out, should patients merely let acne run its course.
In our last segment we talked about eyes, and here too, we're on dermatologist territory. Kelly from Ohio spoke for millions when she wrote: "How do you get rid of those puffy bags or dark circles underneath your eyes?"
Well Kelly, if you've got the will and the wherewithal, there's a way -- Dr. Forney.
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FORNEY: Well, this is also a very frustrating problem. The only way to get rid of those puffy bags or even to disguise some of the dark marks is actually with surgery. And the surgery can be very effective. However, not everybody wants to have surgery for this problem.
So, the next step is to either try to reduce the puffiness, which there are lots of over-the-counter eye gels, in particular, that can sort of help get the puffiness reduced temporarily, at least, for some of your special nights out.
The other thing is just a simple concealer. Those dark circles are caused because you have thin skin underneath your eyes and the dark circles are actually just a reflection of the vascular network underneath your eyes. You need the vascular network, you can't get rid of it, but you can hide it.
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GUPTA: So, our skin reflects our age and oftentimes our health or lack thereof. But, it's also a living catalog of the cuts, bumps and scrapes, even some diseases that we've accumulated over our lifetimes. Scars can be a badge of honor or painful reminders. And for most of human history, they are permanent.
But, Monica from Missouri asked, "Are there any surgical or chemical options to reduce the appearance of scars?"
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FORNEY: There are lots of things that will help with scarring. It all depends of whether it's a new scar or an old scar. With new scars, there are scar pads, which are available over-the-counter, which really can make a difference. There's a lot of science behind using these clear pads on scars. If you have an older scar that's either red or thickened, a doctor can help you with injecting the scars or there are some laser options which can smooth scars to make them less obvious.
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GUPTA: Millions of people would like their skin a lot better if there were less of it. When our special edition of WEEK END HOUSE CALL continues, we'll serve up some of the tastiest questions on eating right and losing weight. Making a resolution to be here, right here on WEEKEND HOUSE CALL after a break.
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All right, we're back. Now, if you believe what you read on the internet, 90 percent of the people who make New Year's resolutions vow to lose weight and/or eat more healthful diets. We can't vouch for that figure, but we do know that we get tons of e-mail on food-related topics year round.
For example, Tom in Virginia asked: "Is the Atkins diet or any high-fat, low-carb diet safe?"
Well we consulted a dietician. Dietician, Lisa Drayer of dietwatch.com.
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LISA DRAYER, DIETITIAN, DIETWATCH.COM: A low carbohydrate diet can be a safe option, as long as you're not staying in that first phase for a long period of time. That's when the carbohydrates are severely restricted to about, let's say, 20 grams on the Atkins diet, for example. That amount of carbohydrates is simply not going to give you enough energy to fuel your brain and also your muscles for exercise. So, that's one thing to be cautious of.
Also, if you have kidney problems, you want to stay away from a very low carbohydrate diet, because oftentimes these diets are higher in protein, which can be taxing on the kidneys and also be aware of the saturated fat in a lot of the foods on low carbohydrate diets.
For example: red meats, butter, cream, these all have high amounts of saturated fats, which can I boost cholesterol levels. So, we might not know that the saturated fats have better fats in the short-term, but potentially over the long-term.
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GUPTA: And if you're weighing a low-carb diet, such as Atkins, against a more traditional low-fat approach, consider this: A study found more weight loss at first from the low-carb plan and a greater increase in so-called good cholesterol. So-called bad cholesterol changed equally in both groups and after a year, weight and cholesterol, both evened out. Murali in Massachusetts asks, "My teenage daughter and I are both vegetarians. How can I make sure we get enough protein and minerals in our diet everyday?"
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DRAYER: It's a great question. Being a pure vegetarian or a Vegan, can pose the risk for nutrient deficiencies. The most important thing, I would say, is to include protein at meals and snacks, some good sources include tofu, also whole grains, and also veggie burgers are a good source for meals. In terms of snacks, you can try Edamame, soy milk, or even peanut butter with crackers, and nuts. Just be careful on calories there, if you're watching your weigh.
You also want to make sure that you're getting enough vitamins and minerals. As you mentioned, some of the ones to pay special attention to include vitamin B-12, calcium, iron, and zinc. Your best bet is to choose fortified foods, such as, fortified cereals, and also to take a multivitamin, which will cover you for these nutrients. And, if you are avoiding dairy, which it sounds like you are, take a separate calcium supplement.
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GUPTA: Now for all of our pregnant viewers out there, pregnancy and the months postpartum raise weighty questions for every woman and problems for many.
Christine in Canada, told us: "I just had my first child and need to lose 20-30 pounds. With a seven-week-old baby, I don't have lots of time." No surprise there. "I really would like to lose this weight. What's the best way?"
Well, Christine there are as many answers to that question, at there are dietitians, but most agree the secret is to make lifestyle changes that you that you can stick with.
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DRAYER: My take on weight loss is that losing weight is an individual thing. Everyone has different bodies and different needs. What I tell people is pick three mini goals. These don't have to be drastic changes in your diet or activity levels, but mini goals. For example: Let's say eliminating soda, taking a brisk 15-minute walk each day, or cutting portions in half. Now, the key is to be sure to stick with your goal. So, you might want to try one goal at a time, but you will be amazed at how quickly these changes can add up and you can lose a lot of weight over the long-term, which is the most important thing.
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GUPTA: Yes, it certainly is the most important thing.
Well, we wouldn't be human if we didn't look for easy answers to hard questions, and thus come pills and potions and compounds that claim to make the pounds melt off. Few have been as controversial as ephedra, also known as the herb ma huang. It's a stimulant, which means it increases the heart rate, and raises blood pressure, it's been linked to heart attacks and strokes and back in February, it was named a factor in the heat stroke death of an up and coming pitcher of the Baltimore Orioles.
You can buy it over-the-counter or online under the names Xenadrine, Metabolife, and Stacker 2.
Questions about this, lots of them. Candice in Alabama, points out: "There are many ephedra-free products now, but the health risks seem to be virtually the same as those products containing ephedra. Is there a diet pill that has no health risks?"
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DRAYER: It's a great question. And it's true, many of the ephedra-free products we see on the shelves now, do have a similar potential to do damage as the ephedra-containing products. Oftentimes ingredients are used which have similar stimulatory effects, for example: Caffeine or guarana, this is an herb that has stimulatory effects. So, you do want to be careful.
Others have high levels of vitamins, which can be potentially dangerous. Others have herbal ingredients, which can potentially interfere with medications. Some also have undesirable side effects, for example: A fat blocker, while it blocks fat, it may also block the absorption of fat soluble vitamins.
So, you do want to be careful. And, the most important thing to recognize is that manufacturers of these over-the-counter diet pills do not have to prove their products are safe or effective before they reach your hands. So, there really isn't any diet pill that poses no risk at all.
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GUPTA: As you do get closer to your ideal weight, you don't want to just look better, you don't want to just feel better, you have a better chance of avoiding the No. 1 killer of Americans. Stay with us for a heart to heart about hearts when this special edition of WEEK END HOUSE CALL continues. But first, this edition of "For Your Health."
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ANNOUNCER: Lupus is a chronic autoimmune disease that activities the skins, joints, blood, and kidneys. The immune system loses its ability to tell the difference between foreign substances and its own cells and tissues. The immune complex is built up in the tissues and can cause inflammation, injury to tissues, and pain. But, with treatment and close follow-up, lupus is not a fatal disease.
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GUPTA: Welcome back to WEEK END HOUSE CALL. The biggest champagne event of the year is now only days away, but revelers who want to drink their health -- drink to their health may opt to bag the bubbly for Bordeaux or Cabernet or a dusky Merlot.
Dave in New York is considering it and he asks: "Is there really any validity to the research that suggests dirking red wine helps reduce risks for heart disease?"
Well, our expert is cardiac surgeon Dr. Mehmet Oz.
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DR. MEHMET OZ, CARDIAC SURGEON: Dave, although it's counter- intuitive to some, there is very good data that drinking red wine is beneficial to the heart. Much of it comes from France. Interestingly, the French, who eat a high-cholesterol, high-fat diet in the Leone area, in Southern France, also drink a lot of red wine and they seem to have a very low incidence of heart disease. So, there was a large trial done, called the Leone Trial, where people were randomized to drinking red wine and other foods that were typical of the French diet and they had about a 30 percent reduction, reduction in their incidence of having heart problems. So, I do think that red wine is beneficial and we've actually looked in the laboratory at why this may be so, and it turns out that red wine, in the skin of the grape, has resveratrol, which is a very strong antioxidant and this may be the key reason why red wine is beneficial to us. But, I must caution you, we're talking about one, to at most two glasses a day.
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GUPTA: Resveratrol -- say that several times fast. Well, you probably heard, heart disease is the leading cause of death in America, claiming one new victim every 33 seconds. But here's the good news, you don't have to be one of them. Five of the six major cardiac risk factors including blood pressure, bad versus good cholesterol, insulin levels, and weight, are all manageable. And, that brings us to this question from Tony:
He writes, "Even with good blood pressure and low cholesterol, does a person still have a chance for a heart attack?"
Again, Dr. Oz.
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DR. OZ: Tony, the amazing thing to me is that most Americans think if they keep their blood pressure down and keep their cholesterol low, they'll never have a heart attack. Unfortunately, the most common predictor of a heart attack is your genetics. The genes predict how you process food, they predict how much of an impact on your body the blood pressure will have. So, although we'd like to think we can control all these factors, the reality is, we can only help. Now that will stated, one person's normal blood pressure may not be another's, and so frequently we find that only about half the patients having heart attacks have the classic risk factors. If you look more carefully at these individuals who are able to control their blood pressure, their blood sugar, their lipids a little more meticulously, they could probably impact quite dramatically on their chance of having a heart problem.
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GUPTA: Really good advice from everybody.
Our thanks to Dr. Mehmet Oz, Lisa Drayer, Dr. Rutledge Forney, and Dr. Keith Thompson for helping us answer these backlog of questions. And, thanks to you, most importantly, for watching and sending in those questions. Keep those e-mails coming in 2004.
I'm Dr. Sanjay Gupta. "CNN Saturday Morning" continues now.
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