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HOUSE CALL WITH DR. SANJAY GUPTA

Hits Athletes Take to the Head Can Result in a Long-Term Injury to the Brain; Overindulging in Alcohol: When That Might Spell Trouble; Common Infection That Lead to Brazilian Model's Death is Also a Leading Cause of Death in the United States

Aired January 31, 2009 - 07:30   ET

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


DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL, the show that helps you live longer and stronger.

Some new news to share with you. Blow after blow to the head, new research shows the hits athletes could take lead to a surprising long-term injury to the brain.

And, overindulging in alcohol. Find out when having just a few drinks might spell trouble.

Also, a common infection ends in death for a Brazilian model. You may have heard this, but did you know it's one of a leading cause of death in the United States as well? You might not even know it exists.

All eyes are on Tampa this weekend for the Super Bowl. But in addition to the game, doctors are going to be looking at the hits that athletes are taking. Some of them can lead to concussion, we know that, but according to a new study, those concussions can start a cascade of traumatic injury to the brain.

A warning: Some of the video we're about to show you is graphic.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Punishing blows have become an inextricable part of many sports.

TED JOHNSON, SUFFERED MORE THAN 100 CONCUSSIONS: So many tackles were with my right side.

GUPTA: Ted Johnson took his share as a linebacker for the New England Patriots.

JOHNSON: I've got maybe, you know, four or five, six documented concussions.

GUPTA: Those were just the dizzying knockouts. By his count, Johnson suffered more than 100 mild concussions.

Impossible to test for, a concussion is a vague injury, invisible -- until now.

(on camera): This is the brain of an athlete, is that right? DR. ANN MICKEE, BEDFORD VA HOSPITAL: Right. That's right.

GUPTA: That's the only thing you know at this point.

MICKEE: That's right.

GUPTA: How many brains have you looked at so far?

MICKEE: From athletes?

GUPTA: From athletes.

MICKEE: I think this makes eight.

GUPTA: And what have you found in the first seven?

MICKEE: They've all had changes of traumatic encephalopathy.

GUPTA (voice-over): A new study confirms what some scientists have long suspected -- concussions starts an injury cascade that looks like this.

MICKEE: I think what's been surprising is that it's so extensive. It's throughout the brain, not just on the superficial aspect of the brain but it's also deep inside.

GUPTA: This is a healthy brain. And this is the brain of a former NFL player in his 40s. Those brown tangles, they indicate brain damage that could eventually kill cells. The trauma in this NFL player's brain looks a lot like damage in this brain, a 70-year-old who suffered from dementia.

(on camera): Did it surprise you to see some of these things?

MICKEE: Oh, absolutely. Absolutely. To see the kind of changes we're seeing in 45-year-olds is basically unheard of.

GUPTA (voice-over): Years removed from the football field, Ted Johnson is still tackling side effects of all those concussions: depression, headaches, anger issues.

JOHNSON: I almost forgot what I was like before -- before the hits. I couldn't remember. And I just lost myself for the last three years.

GUPTA: Johnson and former pro wrestler Chris Nowinski are part of the Sports Legacy Institute which asks athletes to donate their brains to continue the study into the impact of concussion.

(on camera): Is there a message for the football players, is there a message for the NFL here?

MICKEE: Well, I think the message is, that we need to identify what constitutes a significant head injury and we need to treat it sufficiently. And I think that probably means resting an injury a lot more than we rest it. (END VIDEOTAPE)

GUPTA: You know, it was fascinating to be there. You see concussions are often seen as fairly benign injuries. Now we're learning, just small hits over time can create big problems later in life. So, here's more of my conversation with Doctor Mickee in her laboratory.

(BEGIN VIDEO CLIP)

GUPTA: You're a neurologist.

MICKEE: Right.

GUPTA: I'm a neurosurgeon. I think it'd be fair to say that concussions are still a somewhat vaguely diagnosed thing, right?

MICKEE: Absolutely.

GUPTA: What is a concussion?

MICKEE: It could be a sense of fogginess or being dazed or seeing stars or it can be a loss of consciousness. A concussion was defined as "the absence of physical damage to the brain." There's no bruising of the brain. There's no hemorrhage into the brain. You do a CT Scan, you don't see anything, was there a concussion, there's no skull fracture.

But I think what we're discovering now is that concussion is a microscopic injury. And it's a metabolic injury. And it's -- we see changes in axons and changes to the nerve cells that are occurring at a much more microscopic level.

GUPTA: What is the message of the research then?

MICKEE: Well, I think, you know, if we can just draw attention to the fact that multiple traumas, concussive, probably sub-concussive injuries sustained over an individual's lifetime, but probably, more importantly, sustained in early adulthood, can lead to a progressive neurologic deterioration that appears to show up in their midlife.

We think it starts at a time that they have these repeated traumas and it sort of starts to trigger a cycle that sort of go -- progresses but is undetected until 10, even 20 years later when they come down with some behavioral changes, memory loss, depression, and actually the beginnings of this chronic neurodegenerative change -- the beginnings (ph).

GUPTA: College athlete right now ...

MICKEE: Right.

GUPTA: ... or high school athlete even, if they're watching this or their parents are watching it and they may have had a concussion. What would you -- what would you tell them? MICKEE: I would tell them to take it very seriously. I would tell you, not only to take it very seriously but make sure it gets a lot of rest. And I think, personally, they all need at least a month of rest after a concussion.

(END VIDEO CLIP)

GUPTA: You know, we contacted the National Football League about this research and they told us this: "Hundreds of thousands of people have played football and other sports without experiencing any problems of this type and there continues to be considerable debate within the medical community on the precise long-term effects of concussions. That's to say we're currently funding an independent medical study of retired NFL players on the long-term effects of concussion, which we hope will contribute to the overall understanding of this issue."

Fascinating stuff.

Now, a blockbuster drug is under scrutiny. An ADHD medicine for kids might be causing hallucinations. We've got details in headlines -- straight ahead.

Plus -- when indulging in a few drinks goes too far. Do you know your limits? Why men might be more at risk of overindulging to the point of abuse.

(COMMERCIAL BREAK)

GUPTA: You're watching HOUSE CALL. Buffalo wings, blue cheese dressing, lots of beer, sound familiar? Well, it's Super Bowl weekend, it's OK to splurge -- a little bit. But can overindulging lead to something more serious?

And, a month ago, she was young. She was healthy. She was on the path to international stardom. A life cut short by a little known but fairly common infection.

Also, people struggling with high cholesterol, listen up to this -- this for you. Find out about a cholesterol busting diet. We got it here on HOUSE CALL.

Back in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

Taking a look now at some of this week's medical headlines in our health alert.

Plavix, the popular blood thinner is getting a second look by the Food and Drug Administration. The FDA is reviewing whether patients taking Plavix along with certain heartburn medications may have trouble metabolizing the medication, potentially, limiting its ability to reduce to blood clots. Now, the FDA does plan to issue some recommendation after its review, but that could take several months.

There are also some troubling findings for children on medication to treat ADHD or Attention Deficit Hyperactivity Disorder. For now, 49 clinical studies suggest that ADHD drugs can lead to hallucinations in some children, even at normal doses. Cases of children hallucinating about snakes, worms, and insects are all being reported in the findings.

And something to consider for men who like to drink. One in five men risks developing a problem with alcohol in their lifetime. That's more than twice the risk to women, that's according to a new broad survey of medical studies. The survey in the British medical journal, "The Lancet," it went on to say, about 15 percent of men are at risk of alcohol abuse, while 10 percent are at risk of full-on dependence.

Now, a lot of people say they want to cut back on alcohol especially in the New Year. HOUSE CALL in January, as you know, is all about resolutions. This week: How to stop overindulging in alcohol and when it might become a problem.

With us this morning is Doctor Tom Horvath, a psychologist who specializes in addiction. He's also the author of "Sex, Drugs, Gambling & Chocolate."

Welcome to the show.

THOMAS HORVATH, PSYCHOLOGIST: Thank you.

GUPTA: You know, the study. I'm not sure if you read it out of "The Lancet." They're talking specifically about men versus women. Why so much a bigger problem in men first of all?

HORVATH: I don't think we really know. Perhaps as women get to an equal footing in the workplace, they'll drink as much as men do. Perhaps drinking is about male bonding or male competitiveness. But these particular statistics should not blind us to the broader observation that all human beings overindulge and some of them just do it more than others.

GUPTA: You think about overindulgence, and you think about addiction overall, people talk about the fact that this is a disease of the brain. But when someone becomes addicted to a substance, it's because they get some sort of feel good chemical being released in their brain. And that's why they become addicted to some versus just calling it a weakness of character, if you will.

Is addiction a disease of the brain or is it a weakness of character?

HORVATH: Well, there's some middle ground in there that I think people ought to think about. The problem with people asking themselves, "Is my addiction a brain disease," is that for moment people the answer would honestly be "No, it's really not that bad."

GUPTA: Right. HORVATH: And the problem with that answer is that they then decide, "I don't need to do anything about it." Rather, the question should be: What problems am I having in this situation with this level of alcohol consumption, let's say -- and that would point to what I need to do about it.

GUPTA: Right.

HORVATH: And often, there are changes that need to be made.

GUPTA: So, following up on that -- how do you know when it goes from just being what you might call simple overindulgence or even occasional overindulgence to being a problem?

HORVATH: Well, that's a question I encourage people to ask in a different way -- because four drinks in a large man at a Super Bowl party across an afternoon is a very different experience than, say, a small woman having one drink just before a job interview. So you very much need to consider the context in which the drinking is occurring, and then you need to consider it in the context of the other balance points in your life.

Ideally, we identify a crucial balance point, so many drinks, let's say, for a particular person in certain situations and then stay within that. If you're not staying with within that, then you need to take more direct steps to make changes.

GUPTA: These balance point, I mean, is there something that you sort of use as criteria in your job as a psychologist -- I mean, when it starts to interfere with someone's way of life or if they start acting differently? How do you know if someone is in your office that it may be a problem for that person?

HORVATH: Well, let's take a simple example and let's go weight because it's easier. If I aim to weigh 170 pounds ...

GUPTA: Yes.

HORVATH: And the scale starts showing me consistently that I'm above that, then I need to eat less. That's very simple. If as a result of my drinking, I'm interfering with activities and goals that are valuable to me, that's a sign that my drinking needs to cut back. That's a very personal decision.

GUPTA: Right.

HORVATH: I've had people come to me who want to stop drinking one or two drinks a night because they feel it interferes with their capacity to communicate effectively with their families.

GUPTA: Yes.

HORVATH: So, that's a real issue.

GUPTA: Really, just quickly, I just got a little bit of time. What are some tips -- I know this is a hard question to ask at the end -- but what are some simple tips you might offer our viewers?

HORVATH: Well, one, start with what you like about what you're doing. If you like to drink because it's relaxing, you need to learn other ways to relax. Also think about the big picture. What are the real important objects and goals in my life? My families, my kids, serving God, doing a good job -- that sets a context in which overindulgence doesn't really fit in.

If you need to get outside help and some people do, then consider the self-empowering support groups such as SMART Recovery or Moderation Management which have a very different approach to recovery than Alcoholics Anonymous and are more suitable for most people. Similarly, if you're seeking treatment, then consider a self- empowering approach. In the United States, treatment is dominated by the A.A.-based approach, but if you just do a little Internet searching ...

GUPTA: Right.

HORVATH: ... say for non-12-step treatments or alternatives to A.A., you'll find other approaches as well.

GUPTA: A lot out there. Tom Horvath, psychologist -- thanks so much. This is important topic to our viewers. Thank you for being with us.

HORVATH: My pleasure.

GUPTA: All right. Now, you want to know a surefire way to lower your cholesterol in just a few weeks. Well, stick around for my Ask the Doctor segment. We're going to have that later on the show.

Plus, how a young model's life was cut short by an unusual complication from what is actually a common infection. We've got details on that next.

Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We are back with HOUSE CALL.

A Brazilian model, Mariana Bridi da Costa, the 20-year-old beauty, died after her hands and feet were amputated in a desperate bid to save her life. These were hard things to hear. Doctors first diagnosed her with an ordinary urinary tract infection less than a month ago, but that bacteria spread throughout her body and was extremely drug resistant.

Elizabeth Cohen joins us now with the rest of this a really tragic story.

It was hard to hear when she got her hands and feet amputated. What else you have been hearing?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Oh, it really is so sad. I mean, you take one look at those photos of her, Sanjay ...

GUPTA: Yes.

COHEN: ... and you say, how did this happen? She was young. She was healthy. She was 20-years-old.

GUPTA: Right.

COHEN: What happened? So, I've been talking to experts about this. And they said, you know, it happens more than you might think. What happens -- and you've probably seen this in your practice unfortunately, someone might have a skin wound or someone might pneumonia or a urinary tract infection and it just kind of goes out of control and sepsis develops. It's very rare to happen in a young healthy person but it does happen.

For example, Jim Henson, the creator of "The Muppets."

GUPTA: Yes.

COHEN: He died at age 53 from sepsis.

GUPTA: Right.

COHEN: It was pneumonia that went out of control. I also interviewed someone else. Carl Flatley, whose daughter Erin was 23- years-old. She went into the hospital for just a hemorrhoid surgery, something very minor and five days later was dead of sepsis. It does happen.

GUPTA: I mean, you think about this and someone whose immune system may not be working that well or something else -- but how would an average person know that an ordinary infection or something that they think is ordinary is on its way to becoming sepsis?

COHEN: Right. Here are some things to look out for. This is what the experts, they told me. They said, look, if you have, let's say, a skin infection, you don't think much of it, but be aware, if you develop a fever, for example, that's something that you want to keep an eye on.

Or for example, if your blood pressure gets very high or very low, and some people can take their own blood pressure, if you're concerned, take your blood pressure and see if it's gotten very high or very low.

Also, rapid breathing is a sign that's something is going wrong as is extreme confusion, which you, the patient, might not notice but someone around you might notice that ...

GUPTA: Yes.

COHEN: ... that maybe a sign that you need to have some kind of very quick follow-up care. And, Sanjay, I want to mention. I asked these doctors -- why? Why did -- most of us get infections and we're just fine. It's not a big deal. And they said, "We don't know. We don't know why some young, healthy people get simple infections that escalate. We just don't know."

GUPTA: Yes. That's good tips. A sad story, though.

COHEN: It is a sad story.

GUPTA: OK. Thanks, Elizabeth, as always.

And you can read more of Elizabeth's column and her tips by visiting her Web site, CNN.com/empoweredpatient.

Now, look at this. How a diet low in saturated fat and rich in fiber could help you dramatically lower your cholesterol in just four weeks. No medications here, just your diet. It might help you.

And, a different kind of diet for football fans ahead of the big game. It looks pretty tasty.

More HOUSE CALL after the break.

(COMMERCIAL BREAK)

GUPTA: We are back with HOUSE CALL.

Time for my favorite segment, "Ask the Doctor." Let's get right through it.

Dave from Fort Myers, Florida, e-mails us this question. He says this, "I suffer from restless leg syndrome. Is there a cure for this?"

Well, Dave, there's no cure for restless leg syndrome. And I should point out, as well, there's some dispute as to whether or not this is a disease that actually even exists. I'm not sure what you're experiencing exactly.

Let's talk about some of the things you can do besides taking medications. Baths and massages to relax your muscles if that's the problem. Reduce your stress that can sometimes aggravate symptoms. Establish a good sleep routine as well. Try to fall to sleep in a cool, quiet room. Going to bed a little bit later at night sometimes helps as well.

Good luck. Hope you find relief with that.

We got this question from Jackie in Staatsburg, New York. She had a question that many of you had after a recent show. It was a question about a cholesterol-busting diet. She says this, "Sanjay, and you another doctor talked about diet that she stated gets a 30 percent lowering of LDL cholesterol in a month. Could you let me know what it's called?"

Well, Jackie, it's called the "portfolio diet." He heard about it from CNNHealth.com's Doctor Melina Jampolis. Now, we call Doctor Jampolis for some more details and she told us that the diet isn't a specific diet, but rather, a mix of cholesterol-lowering foods. Let me give you some details. Foods like plant sterols; these are found in nature but in smaller dosage. So, they're added to foods like butter spreads, yogurts, even tortilla chips, to pump up the concentration. Also, soy protein foods, including soy milk, soy burgers, almonds and viscous fiber from oats, barley, psyllium and the vegetables okra and eggplant.

Now, this was a very strict diet. In the study, she referenced all the food was provided. Her research has noted some dramatic results. Nearly a 30 percent, as you mentioned, reduction in LDL cholesterol -- that is the bad cholesterol -- and it happened after just one month.

Jackie, in case if you want more information, and anybody else, you can read the Melina's full response to you and everyone else who wrote in and asking about this diet, just log in again to her Web site: CNNHealth.com.

Now, a woman in California delivers eight babies. You probably heard about this. It maybe only the second live-born set of octuplets born in the United States. Baby number eight surprised a team of 46 doctors who had expected seven babies.

(BEGIN VIDEO CLIP, KABC)

DR. MANDHIR GUPTA, NEONATAL-PERINATAL MEDICINE: I was right there, you know, had taken care of. We thought was the last baby and then the Doctor Henry said, "Oh, we have one more." And it was, at first, a little bit shocking for maybe one or two seconds, but then, it was more of an excitement that we need manage that baby and we managed that baby, actually, very, very well.

DR. KAREN MAPLES, LEAD SURGEON, OCTUPLET DELIVERY TEAM: He thought it was a bad joke. Tell the truth.

(LAUGHTER)

(END VIDEO CLIP)

GUPTA: You know, and the whole labor, they said, took about five minutes as well. Can you imagine, just eight babies, that last one being a surprise? Six boys, two girls, ranging in weight from one pound eight ounces to three pounds four ounces. They're all doing well and they're all breathing on their own as well.

Now, it is Super Bowl weekend. You know what that is? A nutritionist's nightmare. So, we got to help you plan to keep your game day diet in check. We got it when HOUSE CALL returns.

(COMMERCIAL BREAK)

GUPTA: You know, some football fans will be doing more than watching the big game this weekend. As Judy Fortin tells us, they're going to be loading up on some extra calories as well.

(BEGIN VIDEOTAPE) JUDY FORTIN, CNN MEDICAL CORRESPONDENT (voice-over): A spread like this on Super Bowl Sunday may be a couch potato's dream, but it's a nutritionist's nightmare.

JULIE SCHWARTZ, EMORY SCHOOL OF MEDICINE: It would be very possible to consume thousands of calories.

FORTIN: Registered dietitian Julie Schwartz says those calories come from piling the plate with fattening foods like wings.

SCHWARTZ: There's really not much meat. So, you're basically eating fried chicken skin dipped in a high-fat dressing.

FORTIN: Schwartz has a healthier plan.

SCHWARTZ: Have half your plate be fruits and vegetables and the other half be those other foods.

FORTIN: She recommends skipping the chips and digging in to vegetable-based salsa with baked tortilla chips. And if you're worried about drinking your calories ...

SCHWARTZ: For every alcoholic beverage you consume, have at least 16 ounces to 20 ounces of water. And that helps because you're hydrating with the water.

FORTIN: And don't just watch your favorite players get a workout. Join in.

SCHWARTZ: Instead of sitting and being that couch potato that is just glued to the TV, get up, high five, cheer, jump around.

FORTIN: Showing your team spirit while watching your waistline.

Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right. Judy, thanks.

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, this is the place for the answers to all your medical questions.

Thanks for watching. I'm Doctor Sanjay Gupta.

More news on CNN starts right now.

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