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HOUSE CALL WITH DR. SANJAY GUPTA

Is Your City One of the Most Polluted?; Pollen Content Rising: How You Can Fix it in Your Home; Health Care System in Shambles; More People Getting Diagnosed with Head and Neck Cancer

Aired May 3, 2008 - 08:30   ET

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


SANJAY GUPTA, CNN HOST: Welcome to HOUSE CALL, the show that helps you live longer and stronger.
First up, a list you don't want your city to be on. We've got a new report on the air that you breathe every day.

Then pollen, it's hitting critical mass across the country. Learn how your home could be part of the problem. More importantly, how to fix it.

And exposing a health care system in shambles. I got to tell you, I'm just back from New Orleans, and I was shocked by what I saw.

Finally, head and neck cancers, why more people not usually at risk are getting diagnosed.

We start, though, with news that could dramatically affect your family's health. A study says two out of every five people in the United States live in areas that have unhealthy pollution levels. That might be putting them at risk for chest pains and respiratory problems.

Now, children are especially at risk because their lungs are still developing. The American Lung Association's 2008 state of the air report lists Pittsburgh and Los Angeles as the most polluted cities, while Cheyenne, Wyoming came in as the cleanest. You can check out our Web site, cnn.com/HOUSECALL to see how your city rates.

Now, it's important to note that air pollution causes airways to become irritated. That can lead to an immediate drop in lung function. It's especially critical for people with asthma since any type of air contamination from pollen to pollution might be a trigger.

(BEGIN VIDEOTAPE)

BEATRICE AIST, ASTHMA PATIENT: I would cough. Every other word, cough. Or trying to get enough air to be able to speak more than three words a phrase.

GUPTA (voice-over): Beatrice Aist was diagnosed with asthma. And in that moment, she joined more than 20 million other Americans suffering from the chronic lung disease that causes coughing, chest tightness, shortness of breath, and wheezing.

DAVID GROSS, WASHINGTON HOSPITAL CENTER: The airways get inflamed. And when they're inflamed, they tend to react and constrict.

GUPTA: It can happen at any age, although it's more common in children. Now there are a number of triggers that can bring on an attack, allergens like pollen and animal dander, or environmental irritants like cigarette smoke and air pollution, even exercise. Doctors say even mild asthma can be life-threatening. In fact, every day there are 5,000 asthma-related emergency room visits and 11 deaths. Every day. There's no cure, so getting the proper treatment is crucial.

GROSS: With care, we think most of those asthma attacks are preventable. But unfortunately, not all of them are. Some can be incredibly acute.

GUPTA: The standard care is medication, mainly in the form of inhaled steroids.

GROSS: Well, it's really our main line of attack against asthma. And they're very successful and very safe when they're used. And the side effects are very low as well.

GUPTA: Beatrice says after just six months of medication, her symptoms improved significantly.

AIST: Less coughing and a better quality of life. I feel like I'm living.

(END VIDEOTAPE)

GUPTA: Now, the most common form of asthma is called allergic asthma. It's triggered by allergens in your environment. Dr. Stanley Feinman from the Asthma and Allergy Clinton in Atlanta, Georgia examines the hot spots where pollen and dust could be lurking in your own home.

(BEGIN VIDEO CLIP)

STANLEY FEINMAN, DR.: One of the problems we have when patients are allergic to pollen is outdoors, on furniture, covers. Patients who are allergic to trees, we know that the tree pollen that's close to the house, they're going to have a higher exposure of the pollen to that type of tree.

Another problem that we see is pets, because pets come outside. And pets will have dander collect on their fur. And they do collect on their fur. Obviously, if they come back inside, then you can get more pollen that is brought back inside.

One of the things here, we see the way pollen is collecting on the screen. And fortunately, the windows are closed here. So that certainly helps keep the pollen outside. We do encourage patients who have pollen allergy to keep their windows closed, especially during this time of the year.

Well, you can see that pollen is definitely a problem here. And it's collecting, you know, on the doors. And it will collect on us as well. It's recommended when we come inside have an area by the door that you can keep your shoes, so you can take your shoes off, so any pollen that's on your shoes is not tracked through the house.

It's also a good idea to wash your hair when you come in from exercising or any activity outdoors before you go to bed so that you can get the pollen out of your hair.

We're talking about patients who have pollen allergies. Most of those patients also have allergies to indoor allergens. In children's rooms, stuffed animals can be a particular problem. So we do recommend removing the stuffed animals and maybe keeping one or two that you can clean on a regular basis.

Curtains can collect dust. Also, upholstered furnitures such as the sofa here and throw pillows are dust collectors. And carpeting can collect dust and also animal dander. So we do encourage people to vacuum their carpet at least twice a week.

When people have allergies, we do recommend that they have good air filtration systems in their homes and change the filter on a regular basis. And there are good, efficient air filters that you can get, which have Merv ratings, which is minimum efficient rate value of eight or better. And you can buy these at retail stores and change them yourselves.

(END VIDEO CLIP)

GUPTA: All right, great tour. Thank you, Dr. Stanley Feinman.

Well, just ahead, riding with emergency responders in a city that's on the brink.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: The worst thing that ever of happened was I waited five hours on the bed with a stroke.

GUPTA: With a stroke?

UNIDENTIFIED MALE: With a stroke, yes.

(END VIDEO CLIP)

GUPTA: What surprising steps New Orleans hospitals are taking to stay afloat. It's remarkable.

And later in the show...

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I don't know how to tell you this because I just can't believe it myself.

(END VIDEO CLIP)

GUPTA: The devastating diagnosis this actress received. Why it nearly destroyed her career. Stay with us.

(COMMERCIAL BREAK)

GUPTA: This is HOUSE CALL. I just came back reporting in Peru, examining innovative steps the government is taking to feed the poor and prevent the spread of HIV. A lot of it seems to be working.

Then I traveled to Larolla (ph), investigating a health crisis in one of the most polluted cities in the world. Children with lead levels up to four times higher than what's acceptable. Find out why some are pointing the finger at the United States.

We're working on those stories now. Watch for them in the coming weeks. But first, more HOUSE CALL in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: What you're looking at occurred nearly three years ago. Hurricane Katrina devastated New Orleans and seemed to tear apart the city's already ailing health system. Now in the days immediately after Katrina, I reported on the patients and the doctors stranded by those floodwaters.

I just headed back to New Orleans, hoping to see a health care system in recovery. Instead, it appears to be at a breaking point.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Packed waiting rooms. Patients with fewer options. Nearly three years after Katrina, the city's hospitals are in critical condition.

So we're here in an ambulance obviously. This particular call is about a woman who's face is numb, she's vomiting, she complains of headache. We're all just going to go check it out and see what happens.

These particular paramedics get about 15 calls a day, which is a lot. Each call comes with a challenge, find a hospital with available space. Tell me what a typical day is like in this particular hospital over here.

JAMES MOISES, DR., TULANE MEDICAL CENTER E.R.: When I walk into the emergency department at any time, there's probably at least 10 to 15 patients waiting to be seen. The emergency department's full because the hospital remains full.

GUPTA: More patients and fewer hospitals. A survey last year found 9 out of 10 New Orleans residents feel that there are not enough hospitals to take care of them. About half the hospitals have opened up here in New Orleans since Katrina. Think about it. Labor costs are up. Utility costs are up. Insurance costs are up with not enough help.

But as we investigated, we found that something's happening here that's never happened before. Five hospitals that together treat 90 percent of the patients here are joining forces to stay afloat.

MARK PETER, DR., CEO, EAST JEFFERSON GENERAL HOSP.: We're all in this together, you know. You know, in the old pre-Katrina days, maybe it was a good thing when your competitor wasn't doing very well. But if somebody has to cut services now, it negatively impacts the rest of us.

GUPTA: Even with the support, all five of the hospitals are on the brink of cutting mental health and pediatric programs. Before the storm, together the hospitals made a $12 million profit. Last year, they suffered a combined loss of $135 million.

PETER: That loss is not sustainable.

GUPTA: It's an effect that trickles from the bottom line to the front line. I asked paramedic David Renois how bad things are.

DAVID RENOIS, NEW ORLEANS PARAMEDIC: The worst thing that ever of happened was I waited five hours on the bed with a stroke victim.

GUPTA: With a stroke?

RENOIS: With a stroke, yes.

GUPTA: And that's something you need to get to the hospital within 90 minutes they say, right?

RENOIS: Yes, sir.

GUPTA: Now back to our emergency call. Remember the woman whose face was numb? She's heading to a hospital now. As things stand today, it'll be at least a two-hour wait before she is seen by a doctor, even though she's been taken in by an ambulance.

Just one more patient living in a city that's in critical condition.

(END VIDEOTAPE)

GUPTA: And hospital officials say they are heading back to Congress for the fourth time since that storm hit to ask for more funds before they have to start cutting some of those services.

Now, a quick update on tainted doses of the blood thinner Heparin. Family members, very emotional testimony of some of the 81 people killed after receiving the drug testified at a Congressional panel this week. That same panel is blasting the drug's maker Baxter Pharmaceutical and the FDA. The FDA says tests link the tainted Heparin to Chinese production plants.

Also, new research points to the possibility that some osteoporosis drugs could cause a heart problem. Researchers found women who have taken the drug Fosamax have an 86 percent higher risk of having an irregular heartbeat than those who never took it. Now I should stress something important here. This condition isn't usually life threatening. And the study authors told us that for most women, the benefits outweigh the risks.

Infections contracted at clinics, doctor's offices, and hospitals are among the top ten causes of death in the United States. Get this -- kills almost 100,000 people every year. As a doctor, this is a really disturbing number I guess to most people, but there are steps you can take to protect yourself and your family.

Elizabeth Cohen joins us now with more. Elizabeth, what is - what's going on here?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: What's going on here, Sanjay, is that, as you know, hospitals are germy places. So people come in uninfected and they get infections while they're there.

But the good news is that you can do something about this problem. It's a big problem, but it's not like world peace where there's not much you can do. You can take steps to help yourself and your family.

So let's take a look at just three of the things. There are several more in my column that you can do to help yourselves and your family. First of all, this is so important -- make sure that the health professionals who come at you in the hospital to touch you, that they wash their hands in your presence. And that might be an uncomfortable thing to ask someone to do. And so in the column, we have some suggestions for how to kind of lighten things up.

Also, avoid getting a catheter if you can. You can say do I really need that catheter? Are there other alternatives? And certainly, if you have to have one, get it out as soon as you can. Those can become breeding grounds for infection.

Also, remind nurses if you need a preoperative antibiotic. Some operations, that's a necessity. But a lot of times, it just gets forgotten. And people either don't get the antibiotic or they have it in them for too long, which can also be a problem. They have the IV in for too long. So you want the antibiotics started and ended at the right time. Sanjay?

GUPTA: Elizabeth, you'll be happy to know that in most hospitals, at least the hospital I work in, there's those little dispensers, soap dispensers just about everywhere now to make sure we wash our hands before going into the patients' room. You know, but you also mention getting infections at the doctor's offices as well. How common a problem is that?

COHEN: You know, that's not nearly as common as infections at hospitals. But we have all heard the reports of doctors who reuse syringes. It's unusual, but it happens. There have been 14 outbreaks since 1999 of Hepatitis because doctors used syringes over and over again. So you can ask your doctor, when they use the syringe or ask the nurse, you know, I read in the newspaper, I heard on CNN that some doctors reuse syringes. I can't imagine you do that, but do you do that? And it's a way to sort of approach the subject.

GUPTA: They can tell them they heard it from Elizabeth Cohen. COHEN: That's right.

GUPTA: Any other last advice about the doctor's office specifically?

COHEN: Yes. And this one is specifically about -- for parents. When you go to the pediatrician's office, Sanjay, I know they have this in mind, I don't know about the office you and your family use, but there are toys and books in the waiting room. Bad idea. You don't know how many grubby kids' hands have touched those toys and books. Bring your own.

GUPTA: And it's a good point. By definition, people are often sick in the doctor's office or the hospital.

COHEN: Absolutely.

GUPTA: Thanks, Elizabeth. As always, make sure to check out the rest of Elizabeth's top five tips at CNN.com/empowered patient.

Now coming up, what this man was eating could have cost him his life. The incredible story of how he turned it all around. That's later in the show.

Up next, rare cancers, but they're on the rise. What may be behind it, after the break.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. Head and neck cancers kill thousands of Americans every year. And researchers are finding more people may be at risk than previously thought. Concern over lack of awareness has one actress speaking out about her own personal battle.

(BEGIN VIDEOTAPE)

COLLEEN ZENK PINTER, "AS THE WORLD TURNS": I thought I was going to die. The pain -- the pain was not to be believed. It was horrible. Horrible. I don't want anyone else to have to deal with it.

GUPTA: In 2007, Emmy nominated daytime actress Colleen Zenk Pinter was diagnosed with tongue cancer, a type of head and neck cancer with a potentially devastating impact on her life and her career.

PINTER: I'm an actor. Without a tongue, how can I possibly work?

GUPTA: Oral cancers of the head and neck often appear on the base of tongue, in the throat, tonsils, voicebox, even the esophagus. They usually affect those who smoke, drink, or have a family history. But Pinter had had none of the traditional risk factors and says even her doctors were shocked.

PINTER: He said I don't even know how to tell you this because I just can't believe it myself. It was the first time that I'd heard the words "cancer."

GUPTA: More than 35,000 Americans are diagnosed with oral cancers every year. Over 7,000 die. And Dr. Amy Chen says more and more adults not traditionally at risk are getting diagnosed.

AMY CHEN, DR., AMERICAN CANCER SOCIETHOLLAS: There have been anecdotal reports that there seems to be more of these non-smokers and non-drinkers being diagnosed with head and neck cancer. Head and neck cancer, particularly in the base of tongue and the tonsils, may be linked to human papilloma virus or HPV.

GUPTA: Johns Hopkins researchers report that between 1973 and 2004, the incidents of HPV-related oral cancers nearly doubled for people in their 40s. Researchers continue looking into the trend, but say early detection is key.

CHEN: Like all cancers, unfortunately, it can be fatal. However, it is certainly not a death sentence. The earlier the lesion is diagnosed, the less invasive the treatment will be and the faster that the individual can get back on the road to recovery.

GUPTA: A lesson that rings true for Colleen Pinter. After three complex operations, she's cancer-free and back on the set, using her TV character in a series of public service announcements to raise awareness.

PINTER: Please ask your dentist for an oral cancer screening. It could save your life.

(END VIDEOTAPE)

GUPTA: Now to be clear, oral cancer screenings can easily be done during your annual physical or dental exam if you're worried about this. In the early stages, symptoms can often be mistaken for other conditions. So if you notice specific changes like a persistent lump or sore in the mouth or throat, difficulty chewing or swallowing, ear pain, swelling of the neck, or change of hoarseness of the voice, be sure to talk with your doctor or your dentist.

Now just ahead, I'm answering your questions in my favorite segment. It's called "ask the doctor." Find out why this man's cousin diabetes diagnosis may have saved his life. That's just 90 seconds away.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL, the show that helps you live longer and stronger. Brandon Hollis was overweight most of his life. Six-packs of soda, cookies and nachos, those were the staples of his diet. But then it all changed.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Brandon Hollas grew up in the small Texas town of Cameron, where eating healthy was an afterthought. BRANDON HOLLAS, WEIGHED ALMOST 400 POUNDS: We were allowed to eat chili cheese nacho for lunch and with grandma's cookies on the side and a Dr. Pepper. And I've made that lunch for several days of the week.

GUPTA: As Brandon grew older, the nachos, cookies and most of all, the soda would catch up to him.

HOLLAS: I would drink about a six-pack a day, which was -- that 200 calories a pop.

GUPTA: By college, he weighed close to 400 pounds. Until...

HOLLAS: I had actually a cousin before the age of 11 was diagnosed with diabetes. And I really think that really opened my eyes that there's some serious health problems if I don't do something about my weight.

GUPTA: So he began reading up on health and fitness at the school's library. He also began working out.

HOLLAS: Within six months, I had dropped 50 pounds.

GUPTA: Now almost half his former size, Brandon says a lack of education contributed to his weight gain.

HOLLAS: I didn't really know much about portion control or good nutrition growing up. Just knew I liked the food that was put in front of me and didn't think about the sacrifices of it.

GUPTA: Brandon's happier, he's healthier, and he's preparing to finish his master's degree. He's also in prime shape for perhaps the biggest day of his life -- his upcoming wedding.

HOLLAS: My name is Brandon Hollas and I've lost 180 pounds.

(END VIDEOTAPE)

GUPTA: We want you to send us your weight loss story as well. CNN.com/fitnation.

Now if you have allergies, should you take your medication all year long? A common question. We're going to answer that and more next on "Ask the Doctor." Stay with us.

(COMMERCIAL BREAK)

GUPTA: Time for my favorite segment of the show called "Ask the Doctor," where I get to interact with you directly. We find out about the medical questions that are on your minds.

Here's a question from Joanie in New York. She writes this, "I'm plagued with allergies during the spring and fall. Should I take medication just during those times or all year-round?" Excellent question, a common question as well. It really depends on the individual. Now, if you're symptom-free during the summer and winter months, then you might be off the hook. There's no need to continue your allergy medication, although keep in mind the key words here are symptom free. If you're not free of all symptoms, complications or infections and have a slight flare-up, you could be on allergy medication, should be on allergy medication all year long.

Now here's another question a viewer had for me. This one's from our roving camera.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: When should I start thinking about breast cancer?

(END VIDEO CLIP)

GUPTA: That's a great question. As you might know, breast cancer is the most common cancer among women. Now, the American Cancer Society recommends clinical breast exams every three years until age 40, at which time they recommend beginning yearly mammograms and clinical exams.

However, and this is important, if you have a family history of breast cancer, talk to your doctor about starting those screenings earlier. And you know, healthy lifestyle can help. Keep your weight in check. Limit the alcohol you drink. And for more details on early detection, go to cancer.org.

Well, unfortunately, that's all the time we have for today. If you missed any part of my show, be sure to check out my podcast on CNN.com/podcast. Remember, this is the place for the answers to all your medical questions.

Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.

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