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HOUSE CALL WITH DR. SANJAY GUPTA
President-Elect Has Big Ideas About Health Care: Can They Become Reality?; Veterans More at Risk for ALS; Swimming With the Fishes
Aired November 8, 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, welcome to HOUSE CALL, the show that helps you live longer and stronger.
The president-elect has big ideas about your health care, so we went to the experts to find out if they can become reality.
There's a mysterious disease out there with no known cure. Something that surprised me about it: veterans are more at risk. We'll investigate.
Plus, swimming with the fishes, an amazing opportunity for some very deserving veterans.
We start, though, with the news of the week. Senator Barack Obama elected president. What does that mean for your health care? He's vowing to revamp and to provide everyone in this country with health insurance, but is this really realistic? We went to the experts.
GUPTA (voice-over): President-elect Barack Obama promised to make health care reform a priority in his first 100 days. His goal? Make insurance available for everyone who wants it.
BARACK OBAMA, PRESIDENT-ELECT: No one will be turned away because of a pre-existing condition or illness. If you have children, they will be covered, too. If you change jobs, this insurance will go with you. And if you can't afford this insurance, you'll receive a tax credit to help pay for it.
GUPTA: He wants to make the same health insurance that's available to government employees also available to every citizen. The estimated cost, up to $65 billion a year. President-elect Obama says the money will come from rolling back President Bush's tax cuts. The average family will save about $2,500 a year. The idea, more people in the pool will drive premiums down.
KAREN IGNAGNI, CEO, AMERICA'S HEALTH INSURANCE PLANS: The concept that now President-elect Obama has advanced is a very important one, having all Americans in the system does play an important role in making coverage available as efficiently as possible.
GUPTA: Other medical experts are cautiously optimistic. DAN SMITH, PRESIDENT, AMERICAN CANCER SOCIETY: He has put forward some big ideas on health care. And I think that, obviously, the devil will be in the details.
GUPTA: Some of those other details include requiring doctors and health care facilities to switch to electronic medical records and the safe reimportation of drugs from other countries.
OBAMA: We'll tell the pharmaceutical companies, thanks but no thanks for overpriced drugs. Drugs that cost twice as much here as they do in Europe and Canada and Mexico.
GUPTA: So, how soon before you'll be able to order your next batch of meds from Canada? The FDA cautions that may not happen any time soon. They tell CNN most imported drugs are not FDA-approved and have not been shown to be safe, regardless of what country they come from.
Obama will also push for insurance coverage of preventative care, with the focus on wellness as opposed to just managing sickness. Also increases in funding for cancer and stem cell research.
IGNAGNI: That is a very tall order from where we are today. Now the question is, is turning the proposals that were made during the campaign into legislative proposals and specifics.
GUPTA: Now this coming week, we celebrate Veterans Day, as you all know. And on HOUSE CALL, we're committed to veterans' health and finding answers to the medical conditions that sometimes are caused by their service. This is a story I wanted to do for some time, a story best told through the words and the voice of Thomas Cutty. He served in the Army for more than 20 years. Now, he faces a devastating illness and a battle he was never trained for.
THOMAS CUTTY, VETERAN: My name is Thomas Cutty. This job takes two hands. I'm a sufferer of ALS. This is a disease where one day you wake up and you can walk, and the next day you can't. And once you lose it, you never get it back. It's known as Lou Gehrig's disease, which means we've known about it since at least the '30s.
LOU GEHRIG: Today I consider myself the luckiest man on the face of the earth.
CUTTY: And nobody's done anything about it. When I heard I had Lou Gehrig's disease, I thought, like polio, didn't we cure that in World War II? I was diagnosed with it in February on Valentine's Day. I was hoping for chocolates, but I'll take what I get.
There have been recent studies that have proven that if you are a veteran, your chances of developing ALS are double that of anybody else. Recently, the VA agreed to count ALS as service-connected for all veterans, regardless of when you served. I applied for the paperwork in March. This is one of several. I've been told it can take up to a year for them to make a determination on what they're going to do.
Meanwhile, I've been progressing. Several times, I've fallen and landed on my face. People lose the ability to talk. You can't tell your children you love them. I'm slowly being trapped in my own body. It is scary.
What I do all day long is I tell myself in six months, I will probably be in much worse condition. And in six months, I would give anything to be where I am today. So, today I'm happy with what I have.
Most days I can't open jars. We have such a short life span that a soldier who is diagnosed today could be gone in less than two years. With the number of people that we've brought on since we started the war on terrorism, I mean, the numbers for people living and dying with ALS could just triple.
The way we are in the military, if you show us an enemy, we'll defeat it. And every American that wears a uniform feels that way. It's really hard to identify what you're fighting. I'm just fighting to stay alive.
GUPTA: ALS or Lou Gehrig's destroys nerve cells in the brain and spinal cord, which leads to muscles wasting away, leaving people unable to walk and eventually unable to breathe as well. There's no known cause, there's no known cure, but there are researchers working around the world to find one. And that's what we want to bring to you today.
Joining us from London is the scientific director and vice president of the ALS Association, Dr. Lucie Bruijn. Thank you very much for joining us.
LUCIE BRUIJN, PH.D., SCIENTIFIC DIRECTOR, ALS ASSN.: Thank you.
GUPTA: You know, this is something as I mentioned I wanted to do for some time. I was sort of so struck by this. You heard Thomas Cutty there in that piece saying if you're a veteran, you're twice as likely to develop ALS as compared to someone who's not a veteran or served in the military. You're working on studies sort of around that issue. Why would that be?
BRUIJN: Well, it's an interesting why and it's a very difficult one to resolve very quickly. It's likely that there must be an exposure in the environment. But on top of that, it's probably an individual genetic susceptibility. So it's a gene environment interaction most likely.
This does give us an opportunity, however, to try and work this out. As you indicated correctly, most of ALS is completely unknown. There are about 5 percent to 10 percent of the cases that are passed through families, for which we know some of the genes, but the majority we really are very unsure. We do think there are environmental factors.
We have been able to, through this finding that there is a susceptibility in the military, to build registries through the Veteran Affairs and to really get all the cases that we can as well as their DNA to try and match the two together. So we are actively looking at this, but it's certainly challenging.
GUPTA: You know, it's interesting. You heard Thomas Cutty again say that he thought this had been cured, you know, when he first was diagnosed with it. He thought that had gone the way of polio. And in fact, a lot of people don't know a lot about ALS. They know about Parkinson's. They know about MS, but not ALS. Why doesn't it get the same attention?
BRUIJN: Partly because the numbers are small. However, I quickly remind you as he said in the clip, two to five years is generally the life span. And we should really compare it with Multiple Sclerosis, which is better known. However, there are more people with the disease because they live longer. So, this is the challenge. And this is why it's so important through our veterans that people become more aware of the disease.
GUPTA: You know, there's a lot of people watching that may have the disease or know someone who has it. What is on the horizon? I mean, what can they expect in the next few years in terms of possible treatments?
BRUIJN: Well, I would say I'm very excited. I'm obviously here in London for a very large ALS meeting, where we discussed this with clinicians, neurologists. Firstly, there are many clinical trials, trying to test ideas and therapies. And they should contact us. They should contact their local, but really find out about those.
The other thing is that in terms of research, there's a lot of activity. Ten years ago, it would be hard to get a small group of people focused on researching this disease. We have tools, we have clues, we know some of the genes. In fact, this year a new gene was identified for us. It's a cause for a few of the ALS cases, but it's so exciting because it's our handle in.
And there's a whole wealth of knowledge we're learning from stem cells, some very exciting findings that we can actually start making motor neurons in a dish from patients' skin. And this is important for drug development, finding treatments and understanding the disease.
GUPTA: You know, it's amazing. And I wish we had more time because I'd love to talk about the stem cell potential therapies in the future. We're going to have you back. This is something we're going to stay on top of. And I hope that we'll have some good news from you in the future. Dr. Bruijn from London, thanks so much for joining us.
BRUIJN: Thank you very much.
GUPTA: The harrowing story of a Marine I operated on in Iraq. He's alive today, but he's struggling. He told me the country should be doing more to help wounded vets.
And later, addressing the mental scars of war, a surprising underwater approach.
And a transplant doctor accused of abuse. Did he quicken a dying patient's death to harvest his organs? That trial's underway. We got it for you in 60 seconds.
GUPTA: And we're back with HOUSE CALL. A transplant surgeon in California is on trial accused of abuse. Prosecutors say Dr. Houghton Risrock (ph) tried to speed along a patient's death by overprescribing morphine and a sedative, so the patient's organs could be removed more quickly. Now Risrock (ph) says he's innocent. His attorneys say the patient died of natural causes. If convicted, the doctor could face up to four years in prison.
Also, there's some results out on a long-term study on a treatment for menopausal women struggling with a low sex drive. The new study by the makers of Intrinsa (ph) finds the testosterone patch boosts desire. Women on high doses of the drug had more satisfying sex over a four-week period than women who were taking a low dose or a placebo.
Now, one thing I do think is important to point out, four women out of the 313 women who in the study developed breast cancer after taking it. It's not known still if there's a link. And Intrinsa (ph) has not yet been approved by the FDA.
Recovering from the mental aftermath of war.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Everybody's changed. Even if they don't have any injuries, you come back and they're changed.
(END VIDEO CLIP)
GUPTA: Five years later, a patient I can't forget. His incredible story of survival.
GUPTA: Welcome back to HOUSE CALL. America's veterans come home from war mentally and physically changed forever. Jesus Ladonna knows that memories of the war will always loom over him. But with each passing year, he inches closer to feeling like things are okay. Here's his amazing journey.
GUPTA (voice-over): There are some things you never forget. A cold, inky black night just outside Baghdad. Eerie quiet. Then, chaos. I was in Iraq covering the military's Devil docks medical team. In moments, I would go from reporter to neurosurgeon. (on camera): They don't have neurosurgeons on this particular medical unit at least this far forward.
(voice-over): A 24-year-old Marine, massive head trauma, a sniper's bullet. He was declared dead twice. But by the time he reached me, hope. A faint pulse. In a makeshift operating room with rudimentary tools, I operated. That Marine, Jesus Vidana, is now 30. We've re-united several times over the past five years.
JESUS VIDANA, SUFFERED TRAUMATIC BRAIN INJURY: I think there was some confusion.
GUPTA: He asked and I finally told him how he was saved. Your brain round here was hit and blasted, if you will, a bit by the bullet. We were able to get this blood collection off, remove some of the damaged brain, and get that bullet out of there and stop all the bleeding. I didn't think you were going to survive that. I didn't think you were going to live through that.
VIDANA: My own recovery --
GUPTA: Jesus survived the war, but the toll it extracted is steep.
VIDANA: I don't talk about it. It will consume me, you know. It will tear in me. And needs to get out. Like everybody's changed. Even if they don't have any injuries, they come back and they're changed. Not all change is good, I guess.
GUPTA: Jesus is changed. Are you going to get married?
VIDANA: Maybe. I don't know. I...
GUPTA: Can you do it? I mean, can you have that sort of relationship?
VIDANA: Sometimes I feel like I'm so damaged that I don't want to, you know, damage my own kids if I ever have any.
GUPTA: That's a tough thing to hear, Jesus.
VIDANA: Well, I feel -- sometimes I feel overwhelmed with life.
GUPTA: But he is coping, getting psychological help, getting a few shreds of hope, something he says many fellow vets don't have.
You think the country's doing a good enough job taking care of its vets?
VIDANA: I think more could be done. They should be entitled to all the care they can get, because the war doesn't end when you come home. And it goes on in your head.
GUPTA: For now, Jesus is winning that war in his head.
(END VIDEOTAPE) GUPTA: Well, as you might imagine, Jesus and I are connected in a remarkable way. We'll be staying in touch with Jesus and, of course, bring you any updates.
You know, mental illness is taking a toll on U.S. soldiers. We're committed to investigating this at HOUSE CALL. According to the Department of Veteran Affairs of the approximately 150,000 veterans of Iraq and Afghanistan, 25 percent have been diagnosed with some form of a mental disorder. And in the most recent study done by the Pentagon, about 1 in 6 veterans of the war suffer from PTSD. More than half of them will never seek any help.
Many vets with those injuries feel the VA system is ill equipped to handle them. So for help navigating the veterans health system, check out the American Legion Web site, at legion-.org.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: It's beautiful down there. Peaceful and you just forget that you're in a wheelchair or anything.
(END VIDEO CLIP)
GUPTA: Underwater with injured veterans. A unique therapy in the world's largest aquarium. Their remarkable swim straight ahead.
GUPTA: Under enemy gunfire, Army medic Sergeant Christopher Waiters (ph) fought to rescue two crew men from this flaming tank and went back to recover the body of a friend who didn't survive. For his courage, Waiters (ph) received the nation's second highest award for valor. We're honoring him and all of our military personnel for serving our country. Thank you.
Some paralyzed veterans from Georgia had had a unique opportunity recently to swim with some of the biggest fish in the world. Judy Fortin takes us inside and underwater at the Georgia Aquarium in Atlanta.
JUDY FORTIN, CNN MEDICAL CORRESPONDENT: Retired Army Specialist Scott Winkler has rolled his wheelchair down many ramps since he was paralyzed five years ago while serving in Iraq. But he says nothing compares with the chance to swim with thousands of fish, including whale sharks at the world's largest aquarium in Atlanta.
SCOTT WINKLER, U.S. ARMY (RET.): Mentally, you're actually taking a stress break from life itself. Physically, it's great rehabilitation and stuff like that. And emotionally, you feel free. Your spirit's lifted. You're able to enjoy yourself for once.
FORTIN: Retired Army Private First Class Orlando Perez likened the experience to floating on air. He suffered a spinal cord injury during basic training 13 years ago. ORLANDO PEREZ, U.S. ARMY (RET.): Never thought that being disabled was going to bring me to do so amazing. It's, I think, how overcoming the disability, not letting the disability overcome you.
FORTIN: Therapeutic recreation specialist Susan Oglesby says the experience offers a new kind of freedom for paraplegics.
SUSAN OGLESBY, GEORGIA AQUARIUM: They have to move differently from their injuries. They come into the water, they realize they can do this, they can probably do anything.
FORTIN: She says floating in the water is liberating.
OGLESBY: The water is a great equalizer. Once you get into the water, you're floating, you're weightless, and everybody becomes equal.
FORTIN: Equally excited, too.
PEREZ: It's beautiful down there. Peaceful and you just forget that you're in a wheelchair or anything.
WINKLER: It's like you're in space. It's like you're in -- totally different. It's almost like you're an able body again. It makes you feel so free.
FORTIN: At least for a little while.
Judy Fortin, CNN, Atlanta.
GUPTA: All right, Judy, that was something. Thanks.
Still ahead on HOUSE CALL, we're following up with our fit nation winner, cashing in on the 5,000 bucks we gave them, helping more kids. Stay with us.
GUPTA: And we are back with HOUSE CALL. A simple camcorder, a DVD burner, a little seed money. That's about all one PE teacher had when he decided to start a program to change the lives of the students. He's our fit nation winner. And we caught up with him recently for an update.
GUPTA: Two years ago, we told you the story of Todd Sisneros, a physical education teacher in Nevada, who felt his students weren't getting enough exercise.
TODD SISNEROS, TECLUB FOUNDER: PE time's being cut in a lot of places. There might be unsafe neighborhoods. And so when they have it at home, you now have parents that work different shifts or whatever. They can't drive their children to youth events. GUPTA: So, he set out to fix the problem. With just a home video camera and the help of the students, Todd created Mr. S's DVD workout for kids. As the winner of CNN Fit Nation contest, we gave him $5,000 to expand his DVD program and expand it he did.
SISNEROS: Today at our school, about 400 went out. And we have 8,000 going out across the entire tri-state area.
GUPTA: And he hopes to continue growing the program.
SISNEROS: I believe in it. It's scientifically designed. We proved it's psychologically designed to help these kids out. I want to see future volumes come out. I want to see it done in Spanish. I want to see it start filtering out from here into states into PE curriculums. And I want to see it move across the entire country.
GUPTA: So why did we believe in Todd? No one can explain it better than he can.
SISNEROS: PE class, you have everyone standing around waiting for their turn. And a lot of times kids that need it the most are just standing around. Where Teclub's different is everyone is active 100 percent of the time. It's a shot in the arm. It's a start at an early age to get these kids on the right path.
GUPTA: Congratulations, Todd. Keep up the good work.
GUPTA: And we are back with my favorite segment of the show, "Ask the Doctor." Take a listen.
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UNIDENTIFIED FEMALE: Is there any way we can alleviate the cost of prescription drugs?
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GUPTA: Great question. Common question as well. People are certainly feeling the pinch with the cost of prescription medications going up about eight percent just in the last year alone.
But you can cut costs. First of all, know how your prescription plan works so you know what options you have to save money. If you can -- and this is a big one -- order your medications online or by mail. This can really save you a lot of money. And talk to your doctors about what they're prescribing for you. Ask if a lower cost or generic drug could be just as effective.
CNN's personal finance editor Gerri Willis also recommends checking out drx.com. You can find out who's offering the lowest price at any given time. Another question now. This one comes from Rachel in New York. She writes this. "Would you recommend fish oil supplements for healthy people to prevent heart disease, especially if there's a family history?"
Well, Rachel, first of all, great job for being proactive and knowing that you have this family history. Fish oil contains Omega-3 fatty acids, which are beneficial really, I think, for anyone's heart. Healthy or those who are at higher risk. So yes, I would recommend taking fish oil supplements. In fact, I have a family history of heart disease and I take them myself.
Research suggests that taking fish or a fish oil supplement can reduce the risk of heart attack and heart disease in the long run. Also, of course, make sure you eat right, you exercise. And also consult with your doctor. Good luck, Rachel.
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, cnn.com/podcast. Remember, of course, 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.