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HOUSE CALL WITH DR. SANJAY GUPTA
Financing Medical Breakthroughs: How President Obama's Stimulus Package May Lead to New Discoveries; Detecting Diseases Early: Helps Some, But Makes Patients Out of Others; Minor Head Injuries: When Should You Go to the E.R.?
Aired March 28, 2009 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ELIZABETH COHEN, CNN GUEST HOST: Hello and welcome. You're watching "HOUSE CALL," the show that helps you live longer and stronger. I'm Elizabeth Cohen, in this week for Dr. Sanjay Gupta.
First up: financing medical breakthroughs. How the president's stimulus package may lead to new discoveries.
And detecting diseases early -- it helps some but makes patients out of others.
Plus, minor head injuries. They can turn suddenly, tragically deadly. So, when should you go to the E.R.?
Included in the president's stimulus package is $8.2 billion to help fund medical research. Researchers who struggled in the past to find funding for their work are hoping for a piece of the pie.
COHEN (voice-over): Dr. Todd Waldman, a cancer researcher in Georgetown University wants to make brain tumors disappear. But that costs money.
DR. TODD WALDMAN, GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE: Frankly, the last five or six years has been a bit of a downer for biomedical researchers like myself. There's virtually no money to go around.
COHEN: So, Waldman is hoping for a piece of the stimulus pie, a chunk of the $8.2 billion in the stimulus bill for medical researchers. He wants the money to study the genes of people like Ted Kennedy and David Styles. They have glioblastoma, a particularly deadly type of brain tumor.
WALDMAN: The more quickly we can identify these new genes, the more quickly we can target them with new anti-cancer medications. We will buy more of the specialized genetics free agents with need for our research. Many of which are quite expensive. And we can begin to re-equip this laboratory with state-of-the-art equipment.
COHEN: Styles, who was diagnose with the cancer last year, is hoping for new breakthroughs and soon.
DAVID STYLES, BRAIN CANCER PATIENT: We just don't have that long, you know, unless we do something. You know, family and such and I really wanted to see my grandkids grow up and my daughters graduate from college.
COHEN: Waldman has applied for some of the stimulus money and is crossing his fingers.
WALDMAN: It's just a great breath of fresh air for us. And not just for us, but I think that for people who have diseases that could be treated by new discoveries and drugs, and I think that they could feel excited as well because there's going to be much more research and, you know, more hope.
COHEN: We're learning more about how the NIH plans to spend some of the $8.2 billion. This week, the agency said it will commit about $60 million of the stimulus money to help support autism research. That makes this the largest funding opportunity for researchers investigating the causes and potential cures for autism disorder.
The funding will help develop new tools to screen and diagnose autism. It will also pay for clinical trials to test early intervention methods, and to investigate the possible causes of autism.
Now, as we continue our look at America's health care and the president's stimulus plan, included in the money is $2 billion for health centers that provide primary care, which means more people will undergo standard tests for cancer and other diseases.
But as chief medical correspondent, Dr. Sanjay Gupta tells us, detecting diseases early is not always a slam dunk for the patient or for the health care system.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT (voice-over): At 80-years-old, Margie Graf was the picture of health -- a Wal-Mart greeter -- when a routine colonoscopy turned up a large polyp.
MARGIE GRAF, PATIENT: I was shocked that I had -- they found a polyp in me.
GUPTA: She came here for surgery, University Hospital, part of the University of Missouri health system. And the Dr. Mainor Antillon removed Graf's polyp.
DR. MAINOR ANTILLON, UNIVERSITY OF MISSOURI: It is very effective because if you remove the pre-cancerous lesion then the possibility of developing cancer is basically nil.
GUPTA: Antillon used the technique new to the United States, endoscopic submucosal dissection, ESD.
ANTILLON: This is the conventional needle knife that we utilize in the United States. GUPTA: Now, removing Graf's large polyp in a procedure like this one without major surgery is far less expensive with less recovery time.
ANTILLON: The patient is doing fantastic.
GUPTA: Margie Graf's husband of 57 years died of colon cancer. And an estimated one in 20 people will get colon cancer without screening.
ANTILLON: Every patient that develops colon cancer is a big burden to our health care, obviously. So those are the cases that we need to prevent by doing this procedure.
GUPTA: Dr. Gil Welch studied the costs and benefits of screening for cancer and other diseases. He says early detection does help some but makes patients out of others who may have never developed a problem.
DR. H. GILBERT WELCH, DARMOUTH MEDICAL SCHOOL: I think it's a recipe for telling too many people they are sick and treating too many people. Now, I think this almost always costs more money.
GUPTA: A recent study that examined 15 years of PSA screenings found that prostate cancer had been over diagnosed, treating men whose tumors were growing too slowly to ever be a threat.
But Margie Graf says she's relieved she underwent the procedure to remove her pre-cancerous polyp.
GRAF: I just thank God every day, you know, that I did and that it was OK.
GUPTA: Dr. Sanjay Gupta, CNN, reporting.
COHEN: Still to come on "HOUSE CALL," this bike messenger is in and out of traffic all day but could he also be driving up the cost of your health care? We'll tell you about the young invincibles who are daring to dodge the bullet.
But, up next: alarming new information about heart disease and race. A look at why African-Americans develop more heart problems at a younger age.
COHEN: Taking a look at some of this week's medical headlines.
A new study finds shocking racial disparity in heart health, specifically, that African-Americans develop heart failure at a rate 20 times higher than white people. Another way to look at it, the heart failure rates for the average 35-year-old black person is the same as that of a white person 20 years later. The main reason? High blood pressure among African-Americans; blacks are three to four times more predisposed to having high blood pressure than whites.
And before you bite into your next hamburger, consider this. A new study by the National Cancer Institute says if you want to live longer, cut out red meat. Researchers asked more than 500,000 people over age 50 about their diet then they followed them for 10 years. They found that people who ate the most red meat had a 30 percent increased chance of dying during those 10 years compared to those who ate the least amount of red meet. Now, people who ate white meat had a lower mortality rate even those who ate high amounts of white meat such as chicken and fish.
Up next, when even a bump in the head can take its toll. "HOUSE CALL" is back in 60 seconds.
COHEN: The sudden death of actress Natasha Richardson has many wondering, could this happen to me. That's the very same question the family of this little girl asks after seeing a report on CNN.
Morgan McCracken was hit on the head with a baseball. For two days, her parents thought she was just fine, but they ended up rushing her to the E.R. just in time. Now, I wrote about Morgan in my "Empower Patient" column this week. And we can help you determine when to take that bump on the head seriously.
Joining to help us with that is Dr. Alan Cohen, no relation. A neurosurgeon with Rainbow Babies and Children's Hospital in Cleveland and the doctor who treated Morgan.
Doctor, I want to know, if the McCracken's had not gotten Morgan to the hospital in time, what would have happened?
DR. ALAN COHEN, NEUROSURGEON: Well, Morgan had an expanding acute epidural hematoma, that's a blood clot, inside the skull, outside the brain. The natural history, as that expands, is to compress the brain, then cause brain damage and ultimately that can lead to death.
E. COHEN: And so, her father said that you told her that if she had gone to sleep when she had that headache and if they hadn't taken her to the hospital, you said she might not have woken up the next morning.
A. COHEN: That's right. She was deteriorating by the time she reached us at Rainbow, and an acute epidural hematoma is one of the most dramatic emergencies in all of medicine. And the speed with which we can make the diagnosis, get the patient to the operating room, remove the blood clot, and stop the bleeding, can literally make the difference between life and death.
E. COHEN: Well, since the incident with Natasha Richardson, we've been hearing from people with lots of questions about head trauma. So, let's get straight to those questions.
Here's one from the blog. Adam asks, "How can we judge what level of force is the tipping point to go to the emergency room? What are the criteria for actually going to the hospital?"
Now, Dr. Cohen, I've heard this a lot over the past week. If it's just a little bump, do you have to go? Do you not have to go? How do you decide?
A. COHEN: Correct. We all injure our heads, and not everybody who injures the head needs to go to the emergency room, and not everybody who goes to the emergency room needs to get a CAT scan. But there are some tell tale signs.
And if there's a head injury with loss of consciousness or amnesia for the event, if there's progressive headache or vomiting, confusion, dizziness, any alteration in the level of consciousness or a focal deficit like weakness or paralysis on one side of body, those are signs that we should check this out. When in doubt, check it out.
E. COHEN: Now, kids get bumps all the time. So, as you can imagine, parents are very concerned. Take, for example, Ross who sent us this e-mail. "My son had a mild concussion two years ago and underwent a CT scan which showed no signs of trauma. But should he go for a follow-up scan? He does have the random headache which sometimes requires Tylenol."
Dr. Cohen, what do you think?
A. COHEN: Headaches are a universal affliction. And we all get headaches. And there are about 45 million Americans who have chronic headaches, those are headaches that continue. And not all headaches are related to trauma.
So, in this case, I think, welcome to the club, we all get headaches. If the headache gets progressively severe or there's something out of the ordinary, then see a doctor. But not everyone who has a prior injury needs to go get another CAT scan.
E. COHEN: OK. That's some good advice there.
Now, let's move on to the long-term effects of a head injury. Consider the situation of a concerned mother named Laura who says, "My daughter suffered two incidents of head trauma when she was about 6 years old. In the last few years, she's been suffering migraines and worsening head pain. Is it possible that this is a result of what she experienced at a very young age?"
I guess there was an interval of years between the injury and the migraines.
A. COHEN: Yes. And injuries such as concussions, we read about now in sports, with football players and boxers and repeated concussions can cause serious problems, there is an entity of a post- concussion syndrome that can last from days and sometimes months and sometimes, very rarely, years. In this case, I'm not sure if the prior injury is related to the headaches, but the headaches themselves, if they become more severe, and if there's other symptoms that go on with the headaches, that should prompt a visit to the doctor. E. COHEN: OK. Dr. Cohen, thank you so much for joining us. I know people have so many questions about head injuries.
And for the full list of tips on how to determine when a bump on the head warrants a trip to the emergency room, actually I quoted Dr. Cohen extensively in my column, go to CNN.com/empoweredpatient.
Next: a viewer in Florida asks for help. She could be saving hundreds of dollars a month on prescription medications. My advice on how she can become a more empowered patient.
COHEN: Welcome back to "HOUSE CALL."
Every week, I get tons of questions on how to become a more empowered patient. Bernadine in Florida asks, "I am 60-years-old and unemployed. I do have a prescription supplement via AARP that pays up to 50 percent of my prescription cost. But even with that, my monthly prescriptions cost me over $300." She says, "I've had to stop taking one of my medications and take the other two every other day, or when I think I need it."
Now, we reached out to Bernadine because this is obviously not a good situation. She needs to be taking her medicines. And we found out that actually she's paying nearly $500 for her medications. She miscalculated. So, we set out to save Bernadine some money because she's lost her job and she really needs it.
So, here's what we were able to do. Let's start with the drug that Bernadine takes for her acid reflux. It's called Zegerid. It costs her $154 for a one-month supply. Now, Bernadine says she can't afford that, so we talked to some experts who suggested that she ask her doctor that maybe she could take instead an over-the-counter drug called Prilosec, which is $24 instead of $154. They said it might work just as well.
Now, Bernadine also takes some medicine for her herpes. It's called Valtrex and it costs her $197 a month. Now, the experts we talked to said she might do just as well on a generic drug Acyclovir. The cost for that drug, $4 a month.
Bernadine also has high blood pressure and for that, she's been taking a brand name drug called Azor, which is $138 a month. The suggestion that we got from a doctor at "Consumer Reports," she might want to try a generic drug called Benazepril, that would only cost her $22 a month and it's a "Consumer Reports" best buy drug.
Now, the bottom line is that Bernadine may be paying way too much for her prescription medications, and this is a woman who just lost her job. Instead of paying $489 a month, she might be able to pay just $50 a month. That is a huge difference. We totaled up her potential savings. It's $439 a month. That is a huge difference.
Now, you might have noticed that Bernadine's been taking only brand name drugs because, well, that's what her doctor prescribed her. This can be a big red flag that you are paying too much for your medication. So, be upfront with your doctor. That's the solution.
If you're prescribed a brand name drug, ask your doctor -- is there a less expensive generic that would work just as well. You will have to speak up. There might be other options out there. But your doctor might not think of those other options on her own.
Now, if you have questions about your health care, please send them to Empowered Patient@CNN.com. I'll try to answer some of your e- mails every Friday right here on CNN.
Still ahead: they're young, they're healthy and they're uninsured. We'll tell you about the young invincibles driving up the cost of your health care.
And later: why there's no need to hang up your running shoes as you age.
(BEGIN VIDEO CLIP)
ROBIN, IREPORTER: As far as health insurance goes, I have what is called catastrophic health insurance. Basically what happens is, if God forbid, I get hit by a car, something catastrophic kind of happens to me, illness, I just pay the first $5,000, which sounds like a lot. If I had to spend like seven days or 10 days in a hotel -- not hotel, hospital, or six weeks, I think it would probably work for me. So, that's kind of what I have.
(END VIDEO CLIP)
COHEN: Our iReporters have been weighing in on their health care concerns.
Now, important health insurance news for you, the American worker and it's something that many of you, unfortunately, already know. You're working without a net.
According to a new study by the Robert Wood Johnson Foundation, one in five U.S. workers does not have health insurance. That's 6 million more uninsured workers than in the mid-1990s. The problem: cost. Researchers say premiums for employer-based plans have jumped six to eight times faster than wages.
Now, some young people think, well, they don't need insurance. They're called the "young invincibles." They think they'll never get sick. But when young invincibles do need medical care, everyone else ends up paying for it. Is that really fair?
COHEN (voice-over): Twenty-four-year-old Austin Horse pops in and out for work on these city streets.
AUSTIN HORSE, BIKE MESSENGER: Hey, what's up.
COHEN: He's a bike messenger. His workday -- making fast-paced deliveries while averting serious accidents.
HORSE: Once, I was -- I was run over by a taxi. Another time, I had a limo cab knock me off my bike and I got stuck in one of the sewage grates up to mid-thigh.
COHEN: Fortunately, neither accidents resulted in serious injuries. But potential accidents loom around every corner, and Horse does not have health insurance.
HORSE: Part of why I don't have insurance is because I don't feel like I need it.
COHEN: That sentiment makes Horse what insurance companies call a young invincible. They're young and they feel, well, invincible. So, they don't buy health insurance.
DR. KEN THORPE, PROF. HEALTH POLICY, EMORY UNIVERSITY: Obviously, it's the healthiest part of our population. And so, health care and buying insurance is not at the top of their list.
COHEN: Thirteen million seven hundred thousand young people ages 19 to 29 did not have health insurance in 2006 according to a recently released study. Young people lose their health insurance at two junctures in life: college graduation and when dropped from their parents' insurance policies, usually at around age 23. Young invincibles don't get their own plans, according to experts, because it's just too expensive.
HORSE: From what I make, maybe one-third goes to rent and there's other utilities. Health insurance doesn't fit into that. Every now and then, you know, like a joint or something, or feel funny. And yes, I'll just have to stop. I try to nurse perhaps, like iced it if it's really bad, maybe take some anti-inflammatories.
COHEN: If more serious problems crop up, it's off to the emergency room. And if they can't pay ...
THORPE: All of us end up paying for it. Taxpayers pay for it. People with private health insurance pay for it. So, somebody's picking up the bill.
COHEN: During the campaign, Obama said he wanted universal coverage.
THORPE: What the president has proposed is to find ways to make health insurance less expensive by having the federal government provides financial assistance to pick up a part of the bill. If we're ever going to get towards universal coverage, we've got to find ways to get younger adults to purchase health insurance.
COHEN: Austin Horse says he's waiting for an affordable plan.
COHEN: Well, let's just hope that Austin continues to be OK on that bike. Up next: should you stop running as you age? We'll tell you how older runners can keep pounding the pavement well into their 80s.
COHEN: Running isn't just for the young and healthy, as Judy Fortin tells us, older runners with healthy joints can keep pounding the pavement well into old age.
JUDY FORTIN, CNN MEDICAL CORRESPONDENT: Amanda Wagner and Jessica Hove (ph) both turned 50 this year. But they're not letting age keep them from running up to five days a week.
AMANDA PEET WAGNER, RUNNER: It's a little bit harder, but that's just part of the challenge, I think.
FORTIN: Contrary to what some might think, researchers now say after 21 years of study, that if you're healthy and generally injury- free, there are few reasons to put away your running shoes as you age, even in your 70s and 80s.
DR. R. AMADEUS MASON, EMORY SPORTS MEDICINE CENTER: Running in general is not bad for your knees or your joints as you age.
FORTIN: Sports medicine expert Amadeus Mason says healthy joints and muscles respond well to appropriate stressing. But the key is to listen to your body.
MASON: The biggest risk that runners will face as they age with regards to injury is overtraining, by far.
FORTIN: Amanda and Jessica are already heeding the advice by resting when they experience pain. Neither woman show signs of slowing down any time soon.
UNIDENTIFIED FEMALE: I'm hoping to keep running as long as I can.
WAGNER: I do expect and hope to be running when I'm 60 and when I'm 70.
Here we go, let's go, Jessica.
FORTIN: Judy Fortin, CNN, Atlanta.
COHEN: That's all the time we have for today. If you missed any part of today's show, you can check it out on our podcast at CNN.com/podcasting. And remember, this is the place for all the answers to your medical questions.
Thanks for watching. I'm Elizabeth Cohen. More news on CNN starts right now.