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HOUSE CALL WITH DR. SANJAY GUPTA

How to Prevent Heart Disease; Disease Hunters Try to Stop Pandemic in African Jungles; Little Girl Born with Eight Limbs; Vaccines and Your Children

Aired October 4, 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. I'm Dr. Sanjay Gupta. We're making the rounds this morning of some of the most interesting medical stories.
First up, hundreds of Americans die every day unexpectedly from heart attacks. Our guest says it doesn't need to happen. Find out his solutions.

Then, meet the disease hunters trying to stop the next pandemic in its tracks in the jungles of Africa. I was there. I'll show you what I found.

And rare access to a little girl born with eight limbs. All the surgeons as they embark on a one-of-a-kind operation.

Finally, vaccines and your children. Learn how you can spread out the schedule if you're worried about possible risks.

We start, though, with the stunning death of TV news man Tim Russert. At 58-years-old, with good health care and a journalist curiosity, it took so many off guard that he could die from heart disease.

Yet, we also know about half of heart disease deaths every year come on suddenly, unexpectedly. So how can you avoid being one of those 50 percent? Our guest thinks he has the answer. He's cardiologist and South Beach diet author Dr. Arthur Agatston.

Welcome to the show.

ARTHUR AGATSTON, DR., CARDIOLOGIST: Good to be with you, Sanjay.

GUPTA: Well, you know, you and I have talked a lot about this sort of thing specifically. And neither you nor I have examined Tim Russert or his medical records. But one thing that came out was that he had a stress test not that long ago that was fairly normal. He had typical risk factors. And then he had this sudden death. What were your first thoughts? I mean, did this surprise you at all?

AGATSTON: Well, it's always shocking to me when somebody that young and somebody who I feel like I know, at least indirectly, dies suddenly because the great majority of heart attacks today are absolutely preventable. And while I don't know his case specifically, there was so much misinformation out there with the impression that these types of things are inevitable, what happened with the stress test.

And there's really been a great revolution in cardiac prevention. And it's largely gone under the radar. One of the best kept secrets in the country is doctors practicing aggressive prevention have essentially stopped seeing heart attacks and strokes in their practices. So it's important to use this horrible tragedy as a wake- up call and an opportunity to educate the public.

GUPTA: Yes, I mean, you've talked about that. And you and I have talked about the fact that you think there's no need for really anybody to have a heart attack in this country. I mean, you think the tests are that good. But you talk about tests like Cat scans, for example, for men at the age of 40 and for women, at the age of 50. Do those really help? I mean, he had the stress test and then he had the heart attack. How good are these tests?

AGATSTON: Well, the stress test doesn't tell you anything unless you have a flow limiting lesion, a blockage that's actually keeping blood from getting to your heart muscle. But most people, at least half, before they have their first heart attack, don't have such a lesion.

But Tim Russert, when they did the autopsy, he did have disease, what they called stenosis in many vessels. That's the rule, not the exception. So there's a long window of opportunity, why you have no symptoms that you're actually building up this plaque. And in fact, he had a Cat scan with a calcium score of 210 back when he was 48.

GUPTA: Right.

AGATSTON: That means he was at very high risk. And that in a sense did predict this episode ten years later. And this test should be more widely available...

GUPTA: Right.

AGATSTON: ...and less expensive than it is now, which it can be.

GUPTA: You know, it's interesting is that a lot of people at home may say, OK, what can I do right now? We talk about some of the things like cholesterol, blood pressure. One of the things that keeps coming out is just simply weight and more specifically waist circumference. How important is that as far as predicting your future heart disease?

AGATSTON: It's very important. It's clear that Tim Russert did have pre-diabetes. He had an increased waist circumference. And from what's been written, he had high triglycerides, a low HDL, a slightly high blood sugar and high blood pressure. Those are the criteria for pre-diabetes.

And that's where lifestyle, the proper diet, and plenty of exercise becomes really primary. One myth is you can just pop a statin and that's all you have to do, like a magic pill. The statins are great drugs. They decrease heart attacks by about a third, but that means two-thirds of people taking a statin destined for a heart attack will still have one. And particularly the pre-diabetics...

GUPTA: Right.

AGATSTON: ...like Tim Russert.

GUPTA: You know, one thing I just want to ask really quickly, about all these tests. In his case, the stress test didn't tell them enough information, probably, or his doctors enough information. Some people say doing too much testing can give you false positives. It has costs. Maybe radiation concerns. What's the downside? I mean should we really be using tests like Cat scans as a screening test across the country?

AGATSTON: Well, the Cat scans, there are a whole body Cat scans being done that I agree is too much radiation that shouldn't be done, but the Cat scan of the heart is limited. It's what's called gated. There's not much radiation. And there are not false positives.

It shows the amount of plaque that's there. It's been called false positive because the plaque you see isn't necessarily flow limiting. You don't need, if you do have plaque on the Cat scan, you do not need to go on to an invasive procedure. The more plaque that's seen, the higher your risk. And Tim Russert was a great example. He had a lot of plaque at a young age and was at high risk.

GUPTA: Dr. Agatston, you've helped so many people. You've helped me personally as well I should add. Congratulations on the new book. I hope to have you back on the show very soon.

AGATSTON: Thank you, Sanjay. Good to be with you.

GUPTA: All right, thank you, sir.

Now, find out why experts claim this simple vegetable could spell relief to a health crisis. And stopping a pandemic before it begins. Anderson Cooper and I traveled to Africa with disease hunters. It's fascinating stuff. We'll have it for you in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: And we're back with HOUSE CALL. You know, Anderson Cooper and I went deep into the jungles of West Africa with disease hunters. It was one of the most remarkable stories I've done. Hunters looking for the very beginnings of diseases before they jump from animals to humans. All of this in the hopes of stopping the ravages of a pandemic.

(BEGIN VIDEOTAPE)

ANDERSON COOPER, CNN ANCHOR (voice-over): This is the land where HIV was born. In these forests, it's spread from monkeys to chimps and from a chimp to a human. Some spots of blood splattered and a pandemic was born.

But what other viruses lurk in these forests, hide in the blood of these monkeys? We've been following the scientists who follow the hunters, hoping to discover the viruses before they discover us.

In a small hospital in Cameroon, we find children being treated for flesh eating disease. No one knows how it spreads, where it comes from. In the democratic Republic of Congo, we find a woman infected with monkey pox, another strange virus, exact origins unknown. It's already hit America.

GUPTA: We've been tracking for about three hours, following hunters around here in the forest as they try and find some meat, some food, to sustain their family. Take a look behind me over here. You see an animal hanging from a snare. That is a porcupine. That is very good news for the hunter who caught this particular porcupine because it is going to provide food and protein for a family of about nine people in his village. Very good news.

You also have Matthew and Moslin over here, who are global viral forecasters. They're traveling with the hunters trying to educate them about how to do safe hunting practices.

There are really two concerns. Is there too much hunting going on? Is there hunting going on to the point where you actually get animals that acquire the protected status. That's one concern. But also, from a health perspective, could these animals actually transfer pathogens and viruses from animal to human, things like Ebola, HIV, marburg (ph), SARS, even malaria as a pathogen. And it's happened in the past. Some of it has happened in jungles right here in Cameroon.

The goal of Matthew and Moslin, these global viral forecasters, is to try and intervene before that happens again.

(END VIDEOTAPE)

GUPTA: And for more on my travels and what I've learned, read my blog at CNN.com/health.

Coming up, an old idea takes new roots. How you can save money and eat healthy by playing in the dirt.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. You know, if you've walked down any aisle in the supermarket lately, you've seen some changes. Huge jumps in the price of your food basics.

For example, you're paying 28 percent more than you did last year for eggs. Milk and white bread, both up by about 15 percent. And your average pound of white flour, over 50 percent. It's not just the United States. Experts say bad weather, high demand, and fuel costs are creating a global food crisis.

Now, the hardest hit areas are the world's poorest countries. But there is some hope. I recently returned from Peru, where they may have found a simple and inexpensive solution for their food crisis.

(BEGIN VIDEOTAPE) GUPTA (voice-over): It's 2:00 a.m. in Lima, Peru. Soldiers cloaked by darkness. They strategize, unload gear, a covert military operation with a surprising objective.

(on camera): What you're witnessing here is the Peruvian government's answer to the food crisis. It's literally a fly by night operation. This is done in the middle of the night to avoid chaos, to avoid rioting. They've actually enlisted the help of the army, who have secretly put together these bags of food and are now going to knock on doors, one by one, and distribute them.

Now keep in mind, people in this area, about half of them, live near the poverty line. So they can't afford the food in these bags. They're going to get some rice, they're going to get some beans, oil, six cans of anchovies. 10,000 of these bags will be distributed tonight.

(voice-over): But door to door handouts simply aren't enough in this mountainous country. In some region, over 40 percent of children under age 5 are malnourished.

(on camera): When you're trying to get a sense of the food crisis problem, Vilma is a good example. First of all, she takes about 500 calories a day. That's way less than the 1500 she should get at a minimum. She comes from some of the most remote areas of Peru. And get this, she's pregnant. So she's trying to carry a baby, 500 calories a day, and take care of her four children at home with very little food as well. Food prices have gone up all over the world really. Are there solutions literally right underneath our feet?

PAMELA ANDERSON, INTERNATIONAL POTATO CENTER: We think potato is an overlooked opportunity.

GUPTA: In fact, Peru has more than 5,000 different types, all different shapes, colors, names. They grow everywhere. It turns out they're very easy to grow. They require less water than the other staple foods like corn or rice.

Now potatoes get a bad wrap in many parts of the world. In fact, they've been linked to the obesity epidemic. But a medium sized potato like this one over here, it's about 100 calories, great source of Vitamin C, fibers and minerals. And it doesn't have any cholesterol or fat. But still, Peruvian consumption of potatoes has gone down. And much of the economy relies on imported goods like rice and wheat.

ANDERSON: They need to start looking at potatoes, sweet potatoes as opportunities for securing their food.

GUPTA: Today, scientists are working to help farmers increase output and market the Peruvian spuds locally and abroad. 8,000 years after they were first cultivated, it may be a new beginning for the Peruvian potato.

(END VIDEOTAPE) GUPTA: Now, the World Food Program says in many poorer countries, families will spend 60 percent of their budget on food. Here in the United States, we spend more like 10 percent to 20 percent, but that number may be going up, which means more expensive healthy foods may not be a priority.

But there may be a way to put fresh fruits and vegetables on the table no matter your budget.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Cash strapped American families may be tempted to eat more fast food. That's because you get more calories and bang for your buck. A recent study found foods like candies, pastries, other baked goods and snacks cost $1.76 per 1,000 calories. Store bought fruits and vegetables, on the other hand, cost more than $18 for 1,000 calories. That's nine times more expensive. .

What are we growing in here?

LADONNA REDMOND, COMMUNITY ORGANIZER: Any number of things. There -- those are collared greens on the far aisle there. And those are turnip greens right next to them.

GUPTA: But there is another, cheaper alternative. You can grow it yourself. Ladonna Redmond planted the first seeds of what she calls urban farm sites in this gritty Chicago neighborhood when she couldn't find fresh produce nearby. There are no supermarkets around. Only convenience stores.

Urban gardens like this are part of a growing movement. Now the non-profit Urban Farming started three years ago in Detroit with the goal of eradicating hunger. It's added gardens in New York, Los Angeles, St. Louis, Minneapolis-St. Paul and Newark.

Burpee, the largest seed company in North America, says sales of vegetable seeds are up 40 percent over the same period a year ago. During World War II, some 20 million American families planted so- called victory gardens, producing more than 40 percent of the country's fresh vegetables.

UNIDENTIFIED FEMALE: So, this model has already been done. We're just duplicating it.

GUPTA: An old idea with healthy benefits, bringing corn and other fresh produce to inner city people.

(END VIDEOTAPE)

GUPTA: Now, if you can't grow your own, stay tuned in our "Ask the Doctor" segment, we got ways to eat healthy and stick to your budget at the grocery store.

But first, an incredible story about a little girl and her risky operation that made history. You're going to want to hear this amazing story. (COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. You know, for months, I followed the story of a baby born with eight limbs. Recently with pioneering surgery, doctors removed the extra limbs. I received frequent updates from the surgeon and got a rare glimpse into this little girl's transformation.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Like the goddess she was named for, Lakshmi Tatma had eight limbs when she was born in India's Bihar region back in 2005. In fact, villagers there believed she was the goddess reincarnated. Word spread to India's renowned surgeon Dr. Sharan Patil.

SHARAN PATIL, DR., ORTHOPEDIC SURGEON: In spite of whatever beliefs, as a medical man, I certainly thought she needs help.

GUPTA: Dr. Patil examined Lakshmi and recommended surgery to remove her extra limbs, even though it was a high risk operation.

PATIL: Amazing. First time I've seen anything like this.

UNIDENTIFIED MALE: There we go.

GUPTA: Tests revealed the heart, liver and lungs, just one working kidney. Another would be transplanted from the parasite.

PATIL: One of the cases here, other functioning kidneys located here.

GUPTA: The twins were also fused at the spine. They'd need to rebuild her pelvis. An agonizing moment as Lakshmi goes into surgery. A team of 30 doctors had prepped for a month. At 16 hours in, a critical milestone.

PATIL: The parasite is off.

GUPTA: After 27 hours, Lakshmi with two arms and two legs is transformed.

THMAPPA HEGDE, DR., SENIOR NEUROSURGEON: The hero in this whole story is Lakshmi.

GUPTA: Today, Lakshmi recuperates at a facility in Rajistan and still needs work on her spinal cord and clubbed feet, but doctors say her progress is remarkable.

PATIL: I see her growing up as a normal girl.

(END VIDEOTAPE)

GUPTA: What a great story. All of Lakshmi's organs are functioning properly. And doctors are hopeful she will be able to one day have a child of her own. We'd like to thank CNN's team of journalists around the world who covered this operation and also National Geographic. "The Girl with Eight Limbs," premieres Sunday, June 22nd at 9:00 p.m. Eastern and Pacific on the National Geographic Channel.

Coming up, vaccines and your children. Tips for working with your doctor to find out what works for you and your child. Stay with us.

(COMMERCIAL BREAK)

GUPTA: The autism vaccine debate has some parents concerned about the vaccinations their children receive. We know deadly childhood diseases can be prevented with these inoculations, but do kids really need all those vaccines at once? Well on this week's "Empowered Patient," Elizabeth Cohen explains what you should ask your doctor.

This is one of those debates that just goes on and on. I mean, what -- are doctors willing to make changes?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Well, you know as a dad of little kids...

GUPTA: Yes.

COHEN: ...that there's a schedule that the Centers for Disease Control puts forth and that pediatricians are supposed to basically follow with some flexibility.

And pediatricians I talked to said they are getting more and more parents wanting to change that schedule to make smaller, sometimes big changes. And even pediatricians who don't agree with those changes said that they are talking to parents and are making some changes if the parent really wants them.

Let's take a look at two changes that, again, pediatricians don't always agree with but sometimes are willing to do. You can talk to your pediatrician about spreading out vaccines. In other words, instead of getting four shots at one visit, maybe get two shots now and two shots in a month.

Also, you can ask your doctor about whether a booster is really necessary. Sometimes it is possible to do something called checking titers. In other words, that checks to see if you really need the booster or maybe your child got enough immunity in the first set of shots. And again, Sanjay, I want to emphasize that doctors aren't always willing to make these changes, but sometimes they are.

GUPTA: So you saw some at least willingness to listen to what is a lot of fervor on either side. What was the most common change the pediatricians were willing to make?

COHEN: The most common change, I don't know if you remember, but your daughters in the hospital probably got a Hepatitis B shot...

GUPTA: Right. COHEN: ...before they were even discharged. And some doctors are saying if the mom is Hep B negative, negative for Hepatitis B, we are willing to put that shot off and not do it right in the hospital. So that was the most common one that I found that doctors are willing to do if the mom is Hepatitis B negative.

GUPTA: We're probably going to get a lot of e-mails about this.

COHEN: I hope we will.

GUPTA: So I'm hope we'll -- I hope you'll come back and we'll talk more about it this.

COHEN: Sure.

GUPTA: Because I think it's important.

COHEN: Great, absolutely.

GUPTA: A lot of people curious. Thanks a lot, Elizabeth Cohen. To find out if your child can skip a booster shot altogether by asking your doctor for a simple test, read about it all at CNN.com/empoweredpatient.

Coming up next, eating healthy on a tight budget. That's the topic of our ask the doctor segment. You won't want to miss it. Stay with us.

(COMMERCIAL BREAK)

GUPTA: It's time for my favorite segment of the show called "Ask the Doctor," a chance for you to ask your own medical questions.

And here's one from our inbox. Christina from Minneapolis writes this. "I'm a 20-year-old college student and I'm trying to maintain a healthy diet. I live on a limited budget for food each month. Can you suggest cheap, healthy foods?"

First of all, congratulations for trying to do this. It's tough. It's a great question as well. As I mentioned earlier in the show, food prices are making it tough for many to afford healthy foods. But there are some ways you might be able to save money and be healthy at the same time.

First, when it comes to fruits and vegetables, look for what's in season. They're going to cost less. You're going to get more for your money. Another option, frozen vegetables, usually less expensive, they're going to keep for about eight to 12 months and tend to be a lot lower in sodium than some of the canned varieties. You can also freeze your own foods like berries. Freeze half of what you'd buy. You can defrost that and use them later in the year.

As for buying meat, ground beef prices have been on the rise as we've talked about. One expert we mentioned recommends stretching your dollar by adding a few beans. Now, they're a great source of protein and fiber. Plus, they're going to fill you up. So Christina, I hope that helps a little bit. It's great to hear a college student again so concerned about eating right.

Well, unfortunately, that's all the time we have for today. If you missed any part of today's show, be sure to check out my podcast on CNN.com/podcast. Remember, this is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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