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One City Has Closed Its Health Department: What Happens to the People in Need?; How to Get Some Rest Even in the Most Stressful of Times; Possible Health Benefits From Living on a Food Budget; 10 Secrets You Should Never Keep From Your Doctor

Aired March 7, 2009 - 07:30   ET


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

Today, we're taking you to one small city which has been forced to close down its health department. What happens to the people in need?

Also, losing money -- no surprise -- also seems to equal losing sleep. Does that sound familiar? We've got some strategies to get you some rest even in the most stressful of times.

And, are you fibbing to your doctor? The 10 secrets that you should never keep from your doctor.

Now, as the nation faces a financial crisis, one city has taken on what some consider to be a drastic measure to cut costs. And it could affect more than just the bottom line.

So, CNN senior medical correspondent, Elizabeth Cohen, joins us with some details.

Sound interesting, Elizabeth.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: It is interesting. It's actually -- some people say -- a very sad story, Sanjay. I'm talking about the city of Amesbury, Massachusetts. A little place, 16,000 people, but a big budget deficit, $800,000.

So, this week, the mayor of the city of Amesbury decided to just basically get rid of the public health department. The three people including Terry Harson (ph), public health nurse, now do not have a job. You see her packing up her office right here.

Let's talk a little bit about what this public health department used to do. They used to arrange, for example, for vaccinations for people who couldn't afford to get them in other places, also, care for the poor and the homeless. Also, they track diseases that were going on in their area. And now, the public health department, well, Sanjay, it no longest exists.

GUPTA: Do they -- I mean, do they have another plan for this sort of thing or they just simply going to get rid of all those services? COHEN: Well, the mayor of Amesbury says that he's going to arrange to provide those things and services but with for less money. So, he's going to contract out. He's going to work with other surrounding communities. But the folks that we've talked to in Amesbury, they were very concerned that these services, really, would never be done again.

GUPTA: Yes. When you talk about closing down a health department, what is the long-term impact for something like that?

COHEN: You know, there are several long-term impacts. So, let me talk about just one very small one. I think it sort of illustrates the point.

The public health department used to arrange for senior citizens to get taxis to go to the hospital when they weren't feeling. A taxi to the hospital, $15. That's it.

Now, some of these senior citizens are going to have to take ambulances. An ambulance to an emergency room is more than $400. That is obviously a huge difference. So, some people are saying that it was penny wise and pound foolish, as it were.

GUPTA: Hopefully, they're watching your report right now, because that does seem like a crazy way to do things, and obviously, not a very financially prudent way, either.

Elizabeth, thanks a lot.

COHEN: Thanks.

GUPTA: I guess you're coming back later on show as well. We'll look forward to that.

COHEN: That's right.

GUPTA: Now, another way economic turmoil is affecting your health. According to the National Sleep Foundation, 1/3 of Americans are losing sleep over the economy, 60 percent say personal finances are the culprit, 10 percent cite site job concerns, and eight percent say healthcare costs.

Here's what's keeping some of our viewers up at night.


UNIDENTIFIED FEMALE: Could you please define sleep for me? I don't get much of that these days.

UNIDENTIFIED MALE: I don't get more than six hours of sleep. I'm not exactly relaxed by the idea of that my 401(k) is losing $10,000, $20,000, $30,000, $40,000 every time I look at it. So, I don't even look at it anymore.

UNIDENTIFIED MALE: I've got issues other than the economy. I've got six children that keep me awake at night. (END VIDEO CLIP)

GUPTA: You know, and adding to all of this, clock spring forward for Daylight Savings Time this weekend. I got to tell you, I'm tired enough without losing that extra hour.

So, joining us today now is Dr. Russell Rosenberg, a psychologist, a sleep specialist.

Thanks so much for coming.


GUPTA: You're the man of the hour, man of the day. A lot of people are asking about sleep, no question. And I was telling you just from the break, I was in India and then I flew to the west coast. Now, I'm back. I'm getting very little sleep. But everyone keeps telling me that stress and sleep are inversely proportional. The more stress, less sleep. Why is that?

ROSENBERG: Well, there's no doubt about it that stress can have a terrible impact on your sleep. And we can't afford to lose any more sleep. There's really sort of a relationship between both the biology of our brain as well as the stress that we're feeling psychologically and emotionally. And it's a tough cycle to get out of.

Indeed, also, when we are under a lot of stress, we engage in a lot of bad behaviors that disrupt sleep, like too much alcohol, too much caffeine, too much worrying and so forth. And that all interrupts sleep.

GUPTA: You know, I've always been curious. Older people -- do they, in fact, sleep less? Is it also related to some of the things you're talking about?

ROSENBERG: You know, it turns out that the research shows that all the people sleep about the same amount over the 24-hour period. But they just end up with a lot of medical disorders that end up disrupting sleep. And sleep disorders like sleep apnea and restless leg syndrome and pain syndromes as you probably well know can really interfere with sleep.

GUPTA: Well, how does someone know when they should be seeing you? You're a sleep specialist. You know, I think, as you heard from our piece, a lot of people have sleep problems from time to time. But when is it bad enough that they need to see you?

ROSENBERG: Usually, when the problem goes on for over a month, and you've done the best that you can. There are a lot of resources out there to find out what you need to know about your own sleep, like I'm on the board of those directors of the National Sleep Foundation and has a lot of good tips about what you can do about sleep.

But when you've done your best, talk to your family doctor first. Not everyone needs to go to a sleep specialist to deal with the problem. And then, sometimes, your own family physician may see you need to go to a sleep specialist.

GUPTA: As you know, Dr. Rosenberg, it's very popular topic for us on HOUSE CALL. In fact, now, on this week, we asked how many hours of sleep does the average person get a night. Forty percent of you answered about six or less hours. So, many of you aren't getting nearly enough sleep which can really affect your health, as we've been talking about.

We decided to hit the streets to get some more questions for Dr. Rosenberg.


UNIDENTIFIED MALE: What would be a good way to get quality of sleep, if you can't always get the quantity of sleep?


GUPTA: I think -- I think about the same thing. I mean, I don't get enough but is it a way to make my sleep more efficient?

ROSENBERG: You know, it turns out that you need the sleep that you need. There's no way to cheat sleep. I often like to say you can't sleep faster. So, you've got to get the sleep that you need.

And good quality of sleep is important, but you can't say that four hours of good quality equals eight hours of total sleep. There's really just no substitute for getting good quality and quantity.

GUPTA: So, if you haven't been doing well in terms of your sleep all week long, you've got the weekend coming up. Can I recharge my batteries truly or have I lost something here?

ROSENBERG: Oh, sure, you can catch up on sleep. And most people sleep-deprive themselves through the week and then try to catch up on the weekends or times off by taking some naps or sleeping a little bit longer. That sort of pattern isn't ideal, but it does help you cope with the sleep loss during the week. But after four or five days of chronic sleep loss, you really do feel the effects.

GUPTA: I'm feeling it right now. No quite -- and I hardly ever complain about that. Really quick, we just got a few seconds left. Ambien, other sleeping pills -- when do you recommend them? How long can you stay on them?

ROSENBERG: Well, it turns out that the research now shows that many of these sleeping pills are much safer than we believed. Not everyone should be taking them because they can -- you can become dependent upon them. But they do offer a good alternative for people for insomnia as do some of the behavioral therapies. There's something called cognitive behavioral therapy that psychologists and other healthcare professionals can provide or even a sleep disorder center can provide.

GUPTA: We're going to have you back on the show. I can almost guarantee it. This is such a popular topic.

ROSENBERG: Thank you.

GUPTA: Dr. Rosenberg, thanks so much for being here.

ROSENBERG: My pleasure, thank you.

GUPTA: Really good stuff.

Now, can you imagine eating on just $176 a month? Getting the proper nutrients when you're just simply getting by. And how being honest with your doctor about those hard topics might save your life.

Stay with HOUSE CALL.


GUPTA: We're back with HOUSE CALL. We got some leading health news this week.

Administration officials tell CNN that President Barack Obama is planning to sign an executive order on Monday to overturn Bush era policy that limited federal tax dollars for embryonic stem cell research. Now, the Bush policy barred the National Institute of Health from funding research on embryonic stem cells beyond preexisting cell lines.

Supporters believe this new order will expand stem cell research, helping to eradicate diseases such as diabetes, Parkinson's. Critics worry that this will lead to the increased destruction of embryos.

Also, a new report illustrates a growing problem. One in three Americans under age 65 were without health insurance at some point between 2007 and 2008. That's according to Families USA. And this week, leaders from all parts of industry met at a White House summit on healthcare with President Obama, calling for a comprehensive overhaul of the health care system.

Here at HOUSE CALL, we promise to translate what all this means for you, and we're going to be taking your questions next week on health care. So, e-mail your questions at

There's also more evidence this week that a positive disposition can protect your health. New research shows older women who were optimists were less likely than pessimists to have high blood pressure, be diabetic, or smoke. And if that's not enough for our reason to think positive, those optimistic women were also 30 percent less likely to die from heart disease. While we're at it, other population studies have shown optimists live seven years longer. Is that enough good news for you?

HOUSE CALL is back in 60 seconds with possible health benefits of living on a food budget. Stay with us.

(COMMERCIAL BREAK) GUPTA: Reality check now on the recession and simply getting the fuel you need to survive. More than 31 million Americans are in the food stamp program. That's nearly 13 million households. What's it like to have just over $6 a day in order to eat?

Well, CNN's Sean Callebs spent last month finding just that out.


SEAN CALLEBS, CNN CORRESPONDENT (voice-over): The first challenge was learning to shop and find a way to eat three meals on just $6.28 a day. Arkasia Darrensburg agreed to help. She's been on and off food stamps for several years.

Rule number one, name brands are out the window.

UNIDENTIFIED FEMALE: You think you're getting a good deal, two for this, two for that -- in reality, really not.

S. CALLEBS (on camera): Because it adds up the budget.


S. CALLEBS (voice-over): Rule number two: steaks and fish are way outside the budget. I had to count on ground beef, chicken and eggs for most of my protein.


S. CALLEBS (on camera): I like that. That's in my window.

(voice-over): The first trip to the store 30 days ago took a big chunk of my cash, more than $70. I remember thinking -- no way I'm going to pull this off.

At the end of the first week, I traveled from New Orleans to Spring Lake, New Jersey, a long-planned trip to spend some time with my teenage son Ryan. To put it mildly, he was less than confident I could pull this off.

Are you surprised I'm sticking to this so well?

RYAN CALLEBS, SEAN'S SON: Yes. Usually, you eat a lot more.

S. CALLEBS: This healthy usually?


S. CALLEBS: I eat this healthy.

(voice-over): That's a debate for another time. In Ryan's kitchen, dinner with food I had packed for the trip.

(on camera): It's a repetitive diet that gets old (ph). Rice and pasta, beans, a lot of things like that. So, I might as well have some chicken tonight. I still have a lot of money left. I'm not worried so much now about the money. I'm worried about eating stuff that's nutritious.

(voice-over): Then, it was back to New Orleans. By the third week, I was more comfortable in the kitchen. I felt like I was in a groove and would make it.

Then, the last few days, a major problem. My money was gone and I was left with things I just didn't want to eat. Plus, stuff that's just bad for you. Instant mashed potatoes, mac and cheese, and this can of chowder I bought for $1 that came loaded with 70 percent of the recommended salt intake for an entire day.


GUPTA: And, Sean Callebs joins me now.

First of all, it's funny watching the video of you very early on. I mean, you clearly lost weight ...


GUPTA: ... just looking at you now.

First of all, how big are you? How much did you weigh at the beginning of this?

CALLEBS: Yes. Probably around 220 to 225. I went to a doctor about a week ahead of time just to get kind of checked out. But I probably lost about seven to eight pounds in just four weeks, which is pretty significant considering I wasn't trying to.

GUPTA: How did you feel? I mean, energy-wise, anything else?

CALLEBS: I really wanted to ask you about this as a physician because I've been running a lot and I could run between four or five miles ahead of time, and I felt pretty good. And then, at the end, running three miles, I felt winded. I mean, is it because carbs that give you energy but I wasn't eating nearly as much protein as I thought? I don't know why. You know, maybe it was all in my head. But I felt a lot more tired.

GUPTA: And you probably were having some pretty drastic changes in your diet all of a sudden ...


GUPTA: ... compared to what you had before. You -- even though you had this amount of money, they say there was actually a lot of money as compared to people who are on the food stamps program.

CALLEBS: Right. We had a blog up and we had hundreds and hundreds of e-mails. I've never had this kind of response about one story. And a lot of families wrote in and said, you're whining. $176 is a lot -- you know, there are a lot of families out there living, you know, working without a net. And they have to find a way to make ends meet. They can do things like grow a garden in some areas, can fruits and vegetables. They buy stuff and make it from scratch. I didn't have that luxury.

GUPTA: Right.

CALLEBS: So, because I had to buy stuff in case I got sent somewhere for a story or just saw it in that piece, to go visit my son. So, I took prepackaged foods with me.

GUPTA: Really quickly, in terms of stretching your dollar, any quick tips for people going to the grocery store this weekend?

CALLEBS: Well, don't -- look, I made a lot of mistakes. You saw them at the end. Don't buy the prepackaged stuff like instant mashed potatoes, nightmare. Instant macaroni and cheese, it doesn't taste good. That one can of soup, I don't even think I'll donate that because, it's 70 percent of the sodium for one day in that one can.

So, buy stuff -- you can buy fruits and vegetables, you know, you have to make it last. You have to find a way to stretch it. And snacks went out the window; diet coke went out the window.

GUPTA: All that stuff. I was one of many that followed your journey along. I'm glad to see you in person, glad you're doing so well.

I appreciate it, Sean. Thanks for joining me.

CALLEBS: Thank you.

GUPTA: Well, here's a scary thought. What you don't tell your doctor could hurt your health. Straight ahead -- we've got the top 10 things you should never fail to mention.

Also, higher test scores for health. Why some teachers are trying to bring back a tradition that is disappearing from schools. I'll tell you what it is.

Stay tuned to HOUSE CALL.


GUPTA: We're back with HOUSE CALL.

Now, here's a question for you. Do you tell your doctor everything? Come on now, be honest. Well, if you don't, you're definitely going to want to pay attention to this. Elizabeth Cohen is back with some things patients lie about and why you should never to it.

People lie to their doctors, Elizabeth?

COHEN: They do. Maybe some patients have lied to you, Sanjay. Who knows. Who knows.

GUPTA: Yes. What did you find out?

COHEN: Well, I asked a couple of doctors, what do you think people lie to you about? And they've said, "We know that they lie," and they said, "They shouldn't lie because it really helps us treat them better if they're honest," obviously.

So, here's some of the things you should never lie to your doctor about. First of all, you should never lie to your doctor about your crack habit. If you're doing illicit drugs, just tell them.


GUPTA: It sounds like Letterman.

COHEN: That's right.

If you're doing those, just let them know, there's HIPPA laws to protect privacy. You need to know those drugs obviously affect your body.

GUPTA: Sure.

COHEN: Also, if you need cheap medicines and your doctor is sitting there about to write a prescription for something you fear is expensive, say, "Look, is there a generic, is there something less expensive that I can take."

Also, if your doctor says, "Are you eating right and exercising regularly?" Don't just nod your head if that's not true. Tell him -- yes, you know what, I eat junk food and I'm a couch potato -- because, again, that's something that your doctor needs to know. And your doctor can help you come up with a plan to eat right and exercise.

GUPTA: You know, I almost fear to ask this, but why are patients so embarrassed to tell their doctors some of these things?

COHEN: Well, the doctors who I talked to said that they think it's a couple of things. One, they think the patients want to be good boys and girls. They want to make their doctors happy. So, they don't want to admit that they're couch potatoes. They don't want to admit that they don't always take their medicines ...

GUPTA: Sure.

COHEN: ... that they are supposed to take. And also, it's just plain, old embarrassing. I mean, who wants to admit they're having financial troubles? Who wants to admit that they, you know, do drugs that they shouldn't be doing?

GUPTA: Yes, that's a good point. There are some pretty intimate details that they share with somebody who sometimes is a stranger.

COHEN: Right, exactly. But you have to just think of it as almost like a business transaction. You'd just need to tell him.

GUPTA: That's right.

COHEN: And your privacy is protected and he's going to help for your health in the end. GUPTA: That's right. Good stuff as always, Elizabeth. Thanks so much.

And be sure to read the full list of important things to tell your doctor. It's on Elizabeth's Web site:

What is happening with school recess? Many elementary schools give students little or no playtime and could lead to more childhood obesity. We'll tell you about it.


GUPTA: We're back with HOUSE CALL.

You know, when I was a kid, we played until the sun went down and the street lights came on. And schools had playtime after lunch. Remember those days? There was also less childhood obesity.

Times have changed. Some are crying foul.


GUPTA (voice-over): Monkey bars, kick ball, we all remember recess. But according to a recent study for the Centers for Disease Control, in some communities, those memories are all that's left.

SARAH LEE, CDC RESEARCHER: Nationwide, we know that 67 percent offer recess every single day for all students in their schools for at least 20 minutes.

GUPTA: CDC researcher Sara Lee says that leaves more than a third of schools offering recess to just some students or not at all. And the reason may surprise you.

LEE: Definitely, schools are crunched for time. And one of the biggest reasons is because of the pressures for improving test scores within core academic subjects.

GUPTA: But along with higher test scores may come higher obesity rates.

LEE: The equations for the increase in obesity we've seen over the last few decades is lack of physical activity combined with higher intake of energy through food. The more activity kids get through physical education and through recess, the better.

GUPTA: So, in an effort to bring attention to the problem, Lee has joined with the Cartoon Network's Get Animated program to spread the word, and she's starting to get some major league help.

DWAYNE WADE, MIAMI HEAT: I mean, recess is where everything started for me, you know, when it came to loving sports. And I just wanted to be active and wanted to get out there with the rest of the kids.

GUPTA: Lee and Dwayne Wade agree, recess can do as much for a child's brain as their bodies.

WADE: It's not just about sports but you get to meet other kids, and you get to, you know, gain relationship.

LEE: There is evidence that shows recess can actually improve classroom attentiveness, concentration and time on task.


GUPTA: They call it "Rescuing Recess," aptly named.

Up next: you got questions, we got answers. Our "Ask the Doctor" segment, my favorite segment, is right after the break.


GUPTA: Time for our segment, "Ask the Doctor." Here are some of the medical questions on your minds.

Barbara in Georgia asked this, "I walk four-plus miles a day. Approximately how many miles before I need to replace my shoes?"

Well, first of all, great job staying fit. Walking can be a great way to do that.

Replacing your shoes regularly can do several things. First of all, it can help you avoid serious injury. And podiatrists recommend replacing your walking shoes every 1,000 to 1,500 miles or so. At four miles a day, we calculated that. That average out to about every six to nine months.

Runners need to be even more vigilant because the foot experiences more shock. Runners should replace their shoes every 350 to 450 miles, about every three to four months, depending on how much you are running. Also, consider replacing your shoes if the shoe is uneven on flat surfaces, if the heel is significantly worn, or if you experience pains in your arch, heel, lower leg or lower back.

Barbara, again, good job. I hope that helps you.

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

And remember, HOUSE CALL 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.