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HOUSE CALL WITH DR. SANJAY GUPTA

One Athlete Must Choose: Cancer Treatments or a Gold Medal?; What Diet Has You Losing the Most Weight?; How to Avoid Medical Mistakes in the Operating Room; The Story of a 140-Pound Tumor

Aired July 19, 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: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta coming to you from Los Angeles. We've got a big show for you this morning.
First up, cancer treatments or a gold medal? It's an unimaginable decision that one athlete must now make.

And when it comes to losing the most weight, brand new research says one diet consistently comes out on top. Want to be surprised? Stay tuned for that.

Plus, don't become a statistic. If you're going to have an operation, I have some things for you that you have to know, essential things to avoid medical mistakes in the operating room.

Plus, the image I'm about to show you might be a little bit disturbing. That's a surgeon holding just a part, one part of a 140- pound tumor. Wow. I'm going to have the whole story for you.

We start, though, with the food safety update. The FDA says tomatoes are safe to eat again. I got to tell you, this story seems like it's never ending. For weeks, tomatoes were blamed for a salmonella outbreak affecting more than 1000 people in several states.

Now, the FDA is lifting that warning, but also gives alerts about jalapeno and Serrano peppers, which are still in place. The agency is still investigating the cause of the outbreak, but says the good news is the threat seems to be decreasing.

And what expectant moms eat might give their children asthma. That's right. New research shows that pregnant women who eat nuts or nut products every day, their children's risk of developing asthma could increase by more than 60 percent. That's compared to pregnant women who rarely or never eat nut products. It's interesting for you pregnant moms out there.

And a fight over Medicare spending came to a head this week. The president had wanted to curb health care spending by cutting Medicare payments to doctors by more than 10 percent. Congress earlier passed a bill that will stop those cuts and the president vetoed it.

Well, the saga continued this week. Congress overturned that veto. So what this all means is those cuts which went into effect July 1st are now halted. Now, many doctors told us that the cuts had gone through and might have had to turn away new Medicare patients. Keep many in mind something though. Insurance companies say if cuts aren't made, 2 million elderly people could lose their health benefits. We're going to keep very close tabs on this issue. And I'm committed to making sure you have what you need to know.

Now, making a possibly deadly choice. Treat you cancer or fulfill your Olympic dream. That's a decision facing U.S. Olympic swimmer Eric Shanteau. I'm going to cut to the chase. He's decided to go for the gold.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): He's been preparing for Beijing his entire life.

ERIC SHANTEAU, DIAGNOSED WITH TESTICULAR CANCER: Dreaming about the Olympics, it's, you know, that's for as long as I can remember.

GUPTA: But just two months away from realizing his dream, doctors gave U.S. swimmer Eric Shanteau devastating news: testicular cancer.

SHANTEAU: You get hit with, you know, basically the biggest low you can ever have in your life.

GUPTA: Then two weeks later, the biggest high. Twenty-four- year-old Shanteau won a spot on the U.S. Olympic swim team.

SHANTEAU: As far as my swimming career is concerned, that's obviously the biggest high.

GUPTA: Testicular cancer is an extremely treatable disease. More than 95 percent of cases are cured, especially when they're caught early. Luckily, Shanteau's was. He made the extremely difficult decision to wait until after Beijing to have his operation, placing trust in his doctors who are closely monitoring his condition.

SHANTEAU: I'm probably not going to be swimming in four years regardless. I'm looking at the end of my career here, whether I'm having treatment done today or in another month. It wouldn't -- it would make no difference.

GUPTA: Lance Armstrong, the world's best known testicular cancer survivor, is applauding Shanteau's fight. After Armstrong was diagnosed with the more advanced form of the disease in 1996, he went on to win seven Tour de France.

Did you think you were going to die?

LANCE ARMSTRONG, TESTICULAR CANCER SURVIVOR: You had moments, for sure, moments of weakness when you think I'm going to die or perhaps I'm going to die. I was totally committed, totally focused. And I had complete faith in my doctors and the medicine and the procedures.

GUPTA: But here's the question -- in Eric Shanteau's case, is holding off on his treatment smart?

OTIS BRAWLEY, DR., AMERICAN CANCER SOCIETY: It is not unusual for someone to delay getting treatment for several weeks or several months. I'm not advocating that everybody wait a period of three or four weeks. If they do it under medical supervision, it can be very safe.

GUPTA: With the odds in his favor, it's a small risk Shanteau is eager to take.

SHANTEAU: I'm not going to let it beat me. I'm not going to let it affect what I've been working for so long.

(END VIDEOTAPE)

GUPTA: The headlines are pretty startling. A New Jersey surgeon removes the wrong lung. In California, the appendix of a wrong patient is removed. Experts estimate hundreds of Americans are the victims of surgical errors every year.

And Elizabeth Cohen has some practical tips you can take to avoid becoming another statistic. Of course, this is this week's "Empowered Patient."

You know, you go to the hospital, Elizabeth. You expect a certain level of care. Your doctors and nurses, you put your trust in them. What can you do to protect yourself?

ELIZABETH COHEN, MEDICAL CORRESPONDENT: You know, it is a little hard to be empowered when you're having surgery, Sanjay, because you're anesthetized. But before you go into the OR, there are some things that you can do to make sure that you don't become one of those headlines you were just talking about.

GUPTA: Right.

COHEN: So here are three tips that we can talk about. One is communicate like crazy. And what I mean is that every doctor or nurse who comes your way, say my name is Elizabeth Cohen, I'm having arthroscopic surgery on my left knee, this is my date of birth so that they know who you are and why you're there.

Secondly, confirm the side of your surgery right before surgery with the surgeon, with the person who's actually doing the cutting. Confirm I'm having the surgery on my left or my right hand side.

Also, make sure you're marked. And if you don't know what that means, you can take a look at this. It means that the surgeon should be putting his or her initials on the surgical site so you make sure that, again, you don't become a victim of a wrong sided surgery. And look at that mark before you go into the operating room -- Sanjay?

GUPTA: You'll be delighted to know that I had that exact thing done that you're describing. I had my left hand operated on as you know.

COHEN: That's right.

GUPTA: And Dr. Magilveri (ph) came and he just signed his name on my hand. So that was good.

Hey, really quick, people leaving instruments inside the body. I mean, that's something you and I have both reported on. Is there any way can you avoid that? Sounds awful.

COHEN: You know, it is. And luckily, it doesn't happen as often as some other surgical mistakes happen. There's not much you can do because again, you're under anesthesia. But some surgeons advocate doing an X-ray always after every surgery of the surgical site to make sure that nothing has been left in. It'll be interesting to see if they start doing that on a regular basis.

GUPTA: As always, Elizabeth, thanks so much. Really good advice. And click on CNN.com/empoweredpatient to discover Web sites where you can check out the hospitals near you and find out the place that does the most of the type of procedure you need to have done.

Now, when it comes to the battle of the diet plans, a new study says one is the clear winner. Is it low-fat, is it low-carb, Mediterranean? We're going to have that in two minutes.

And walking around with a 140-pound tumor and not even knowing it. Huh? I'm a surgeon. And I found this unbelievable. How she survived. This woman's story is shocking. Stay with us.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL checking some of the week's most viewed stories on the health page now. World renowned cardiac surgeon Dr. Michael Debakey is buried in his white coat at age 99. Debakey, of course, is known for pioneering bypass surgery. And I had the chance to see him operate once as a medical student. You can check out my blog about that experience at CNN.com/health.

And an E.coli outbreak stemming from tainted beef sold in Ohio and Michigan sickens more than 40 people in five states. We're going to stay on top of that.

Finally in the battle of the diets, a new study finds low carb is the winner, helping people lose the most weight of those surveyed. Now, that research is largely funded by the Atkins Foundation. It also found a low-carbohydrate diet like Atkins improved cholesterol levels more so than a low-fat or Mediterranean diet, something to think about. Some surprising news there from many critics.

One note though, researchers encourage the low-carb eaters to get their protein from vegetarian sources. The overall study appears in "The New England Journal of Medicine."

Now, the South Beach diet sort of fits into that low-carb profile. And I had the chance to sit down with the author of that plan, Dr. Arthur Agatston. I started by asking him how his diet works and what people can expect in terms of results. (BEGIN VIDEOTAPE)

ARTHUR AGATSTON, DR., SOUTH BEACH DIET: Well, you see results very, very rapidly, even in the first phase of the diet. We tie in the phases. You lose several, several more pounds.

But you -- it helps particularly in pre-diabetics, which we now so many Americans are. It improves insulin levels. It helps with blood sugar. And improves your general health.

Remember, it's the belly fat which seems to melt away that's responsible for inflammation, that's a risk factor not just for heart attack and stroke, but for many forms of cancer, for Alzheimer's, for much of our Western disease. So it's how you feel is improving your health fitness, as well as burning calories.

GUPTA: It's worth pointing out you're a cardiologist. You added a lot of exercise into this book. About half the book is exercise now.

AGATSTON: Yes, it's funny. With the first book, some people complained there wasn't enough exercise, but I didn't really have anything new to offer. I believed in exercise. And there is a lot of new diet.

But you know, one of the major complaints of dieters is they hit a plateau. And the problem is once they do that, they're often at a healthy weight. It can be a little heavy and fit or they're absolutely slim. I mean, the thought that they can never be too thin syndrome. They want to be thinner.

If they starve themselves, they will yo-yo invariably. So if they still want to lose more weight, once they've lost cravings, their blood chemistries are normal, it means more exercise. But the exercise might mean hours.

And when Dr. Signorelli (ph) from the University of Miami and exercise physiologist introduced using interval training. It's been around for years for elite athletes. But he -- it's interval training for dummies. How all the rest of us can use it. And it's magical in the way you can burn more calories, less time, improve your insulin levels, your sugar levels. It's great.

(END VIDEOTAPE)

GUPTA: He is a pretty good doctor. We're going to have more of my conversation with Dr. Arthur Agatston in the coming weeks. But first, 140 pounds, that's how large this woman's tumor was. I just can't get over this. It was growing for more than 15 years and it was cancerous. Learn how this could all happen. You got it, coming up after the break.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL. This next story is absolutely amazing. Like many struggling to shed extra pounds, Linda Ritenbach tried every diet out there. Nothing seemed to work. No surprise, though, because her doctors made a remarkable discovery. A rare tumor had been growing inside her for more than 15 years.

Amy Easley of our affiliate KTVZ has the story.

(BEGIN VIDEOTAPE)

AMY EASLEY, KTVZ CORRESPONDENT (voice-over): Throughout her life, Linda Ritenbach has struggled with her weight.

LINDA RITENBACH, HAD 140 TUMOR IN ABDOMEN: And you get bigger and bigger and bigger until you keep going to your doctor and you go you're just fat. You need to lose weight.

EASLEY: But Linda tried every diet, every workout. But the pounds wouldn't go away. Doctors suggested weight loss surgery.

RITENBACH: But something in my head just kept going don't do that.

EASLEY: It wasn't 'til Linda went to a different doctor for flu like symptoms that she found out what was really wrong.

RITENBACH: He told me I was going to have to have surgery. And it scared me.

EASLEY: Doctors told Linda a 140-pound cancerous tumor was growing near her stomach. It had likely been growing for 15 to 20 years.

RITENBACH: My doctor told me that I had two choices. And that was I would either live or die. And I had 20 percent chance if I had the surgery. And if I didn't have the surgery, I would die at home or my family would find me. And I didn't want that.

EASLEY: It took doctors three surgeries over two months to remove the tumor.

GEORGE TSAI, DR., GENERAL SURGEON: That presentation was very unusual. And the type of tumor that wound up being resected was very rare. But I think it underscores that when things don't quite make sense and become a chronic problem, you want to keep looking until you find the answer.

EASLEY: Linda couldn't agree more.

RITENBACH: You know, you should have things checked out. Because if you don't, it could be what I had.

EASLEY: Her recovery presents new challenges every day. But giving up is something this woman won't do.

(END VIDEOTAPE)

GUPTA: Wow. Now, you're probably wondering at home how could this happen? Well, it's a rare slow growing tumor. Linda went to the doctor, she couldn't even fit into a CAT scanner. So doctors performed exploratory surgery discovering a ruptured appendix and the 140-pound tumor.

Now, the following images might be a little disturbing. But what you're looking at here is doctors actually in the middle of surgery removing the tumor. And this next image is a doctor actually holding just part of that 140-pound tumor. Absolutely remarkable story. This particular type of cancer is called liposarcoma. In case you're curious, Linda is doing great. She said she has much more energy than before. And we, of course, continue to wish her a speedy recovery.

Now, many of us are trying to squeeze in one last vacation before the end of summer. I wonder if my bosses are listening right now. I personally love the road trip. You got the open road, you've got lots of freedom, you got kids crying in the backseat. Yes, forgot about that.

Now, for many riding in the car, it can be unbearable because of motion sickness. Unfortunately, I know that feeling all too well. So I decided to find some relief for all of us.

Take a look.

(BEGIN VIDEOTAPE)

GUPTA: Everybody can fall victim to motion sickness at one time or another. The most common culprit, the car. You see, car sickness is simply caused by your sensory system getting confused. There's all sorts of signals being transmitted, but they aren't all matching up.

So here's how it works. Say you're in your car reading a book. Your inner ear, which is sort of the control center for balance, knows you're moving because the ear canals have fluid moving through them. But your eyes, another key source of information, only see the page of the book. And guess what? It's not moving. Therefore, you have a conflicting message. And that's when motion sickness starts to set in.

I for one get the most sick when actually riding in the backseat. So here, when you're looking straight ahead at the head rest, your brain starts to get a little confused. Your visual system can't keep up with all the twists and turns the car is making. So you start to get motion sick. You start to get sweaty, you get a little nauseated, and your heart starts to race.

Over the counter antihistamines can help. They get rid of some of the acid in your stomach, take care of nausea. Simply using soda or ginger, that can help as well in terms of settling your stomach. Opening the window, getting some fresh air. That might offer some benefit.

But your best bet if you're in doubt is to actually get behind the wheel. Get in the driver seat. Now you're in control. When you're in control, our eyes and your ears match up. They can take care of all those twists and turns. So those are some tips for you. See how they work out? Happy trails. (END VIDEOTAPE)

GUPTA: Now, the good news is the more you actually do the things to trigger your motion sickness, the less sick you're going to get in the long run. Training your body sensors to tolerate the mismatch, it really works. You can catch more of my health tips on how to survive a road trip online. Go to CNN.com/roadtrips.

Now, they claim everything is bigger in Texas. Seems like a good thing, but not really, especially when it comes to your health. So, I'm making a house call in Dallas, Texas when we return.

(COMMERCIAL BREAK)

GUPTA: Now we're back on HOUSE CALL. I'm Dr. Sanjay Gupta in Dallas, Texas, kicking off our "Fit Nation" tour. You know, it's so important for us to get off the television screen and actually get into individual communities. Try to give people the importance of moving more and eating less.

You all know this by now that 66 percent of the nation is either overweight or obese, but what to do about it? How do you get people to eat less and move more? Well, we are in Dallas, Texas. I'm going to introduce you to an on-air partner, somebody whose had a lot of success with this and can actually be a partner for you.

You know, they say everything's bigger in Texas. Right, Sujit Bhattacharya here. You know, the thing about it is that not everything is that way always.

SUJIT BHATTACHARYA, LOST 40 POUNDS: That's right.

GUPTA: And that's a good thing. Take a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Sujit Bhattacharya was always thin. But a busy job and eating unhealthy on the run eventually caught up with him.

BHATTACHARYA: I was living happily and blissfully ignorant about the fact that I was getting overweight and unhealthy.

GUPTA: Sujit feared he wouldn't be around to watch his daughters grow up. So he decided to make a change. He began counting calories and it paid off.

BHATTACHARYA: I have a budget for how many calories I have. And I know how to spend it. I can spend it on Hershey bars. I'll get a few Hershey bars and eat an intelligent lunch. I was about to lose a pound every three days just by gradually eating smart. And then the weight would just come right off.

GUPTA: And he no longer uses a busy lifestyle as an excuse.

BHATTACHARYA: We all get busy in our day to day lives. And we forget the simple things about eating right and exercising. But I'm still just as busy now as I was back before I was heavy.

GUPTA: Sujit says it's all about making small changes.

BHATTACHARYA: I went from a two percent glass of milk to a one percent glass of milk. And you can look at the calorie difference. That's 20 calories. But if you do that once a day over a year, that's 7,000 calories. That's two pounds you lost by doing almost nothing to your lifestyle.

My name is Sujit Bhattacharya and I lost 40 pounds.

(END VIDEOTAPE)

GUPTA: All right, Sujit, congratulations. Now, you're getting a lot of people around you to adopt these healthy changes as well.

BHATTACHARYA: All my friends, yes.

GUPTA: Well, we hope you can continue doing that and maybe inspire you at home as well. Congratulations to you again.

We're going to be traveling around the nation coast to coast as part of fit nation tour. We're going to have doctors, we're going to have fitness experts. We're going to have success stories like Sujit as well. Lots of fun activities. Go to CNN.com/fitnation. Check out and see if we're coming to a neighborhood close you to. And then of course, come join us. Fit Nation. More HOUSE CALL after the break.

(COMMERCIAL BREAK)

GUPTA: Now, it's time for you to ask me questions that are on your mind.

Straight from our inbox, Nancy in Nevada wants to know, "Why do doctors generally refuse to give you colonoscopies to people under the age of 50...when they can catch these cancers early enough to take care of them before it is too late?"

Well, Nancy, two reasons. Statistics and public health. Generally, colon cancers appear around age 50 or after. That's when doctors recommend people start getting checked every 10 years. Of course, having a family history puts you at higher risk. So more frequent checks may be necessary.

But you can help prevent colon cancer at every age by adjusting your diet to include less animal fat, more vegetables, and fiber, and more calcium and folic acid.

Now another question from Rebecca in Tennessee who asks this. "What exactly does Board certified mean? How can a patient check out a doctor to find out if there are any complaints against him/her?"

It's a very important question. Board certified means a trained expert in a specific area of medicine, who has also been tested by his or her colleagues. For example, to become a neurosurgeon, I did seven years of training, then a fellowship. And all that was after medical school. In order to get certified, a physician must complete certain residency requirements, oral written exams. And they must continue to pass periodic competency tests in their fields.

Now, one way to find out about complaints against your doctor is by contacting your state medical board. A list of those state boards can be found on the Federation of State Medical boards Web site at fsmb.org. Hope that helps, Rebecca.

Well, unfortunately, that's all the time we have for today. If you missed any part to have day's show, check out my podcast on CNN.com/podcast. Remember this is the place for the answers to all of your medical questions. Tune in every week and live a better life and a stronger life. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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