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HOUSE CALL WITH DR. SANJAY GUPTA

Health Care Fact: No Provisions for Rationing Care; College Student Gives Back After Spine Injury; Cancer from CT Scans?

Aired December 19, 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, HOST: Good morning. Welcome to HOUSE CALL: the show that helps you live longer and stronger.

I'm Dr. Sanjay Gupta. Thanks so much for watching.

First up, are the proposed changes in health care really going to keep your grandmother from getting the care she needs? Coming up, I'll address that issue.

And a 15-year-old boy, after suffering a life-threatening injury, he fights back and he's starting to bring inspiration to others. We're going to have that story, as well.

Also, herbs, they can cause toxic reactions when mixed with certain medications. We'll tell you what you need to know.

You're watching HOUSE CALL.

(MUSIC)

GUPTA: There's a term that comes up a lot when talking about health care reform. And that term is "rationing." What exactly does that mean?

Well, I decided to go the intensive care unit at Southern Regional Hospital to try to find out. What I heard, though, was a tale of three sisters.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): At 78, Thelma is the youngest, and then there's Carolyn, who is 80, and Helen, who's the oldest, she's 82.

(on camera): Are you worried with health care reform? A lot of people have been talking about...

CAROLYN MCCOY, PATIENT: I'm concerned with it.

GUPTA: Tell me why.

MCCOY: I try not to worry. Well, I have read some things that said that as you get older, you're liable to wait and wait and wait before you can have surgery. I've heard that they're going to look at the older people and you're going to wait longer than the younger people.

GUPTA (voice-over): It's not true, though a lot of people think so. A look at the reform bill in Congress, there's no mention of that, no mention of rationing, no mention of the government making so-called "end-of-life" decisions for seniors.

So, where is this notion come from? From a provision in the House health care bill provided for end-of-life counseling.

Republican Chuck Grassley says his Senate committee dropped that provision for fear it would be misinterpreted.

KEN THORPE, HEALTH POLICY EXPERT, EMORY UNIVERSITY.: And people are freaked out because there's a lot of bad information or misinformation being put out there by opponents of health care reform, by saying that we're somehow going to pull the plug on grandma. Those are just sort of fearmongering out there for opponents of reform.

GUPTA: Misinformation? Yes. And yet that fear is only growing.

(on camera): They're saying that the older people aren't as valuable as younger people?

MCCOY: Oh, certainly. Certainly.

GUPTA: Do you feel that for real?

MCCOY: Well, I personally feel that. But I feel like the government thinks so.

I have had two knees replaced. I've had a hip replaced. I've had spinal stenosis. And that was done at this hospital. That was back in 2000.

GUPTA: So quite a few operations.

MCCOY: Yes, I have.

GUPTA: How are you doing?

MCCOY: Oh, I'm doing great.

GUPTA: Here's where it gets a little bit difficult. Helen, the older sister, 82 years old, also had a hip replacement. But now, she's in the intensive care unit with problems with her heart and problems with her kidney as well.

UNIDENTIFIED FEMALE: Doing the best I can.

GUPTA: Yes?

UNIDENTIFIED FEMALE: Yes.

GUPTA: The three sisters have had more than 13 operations over the years, costing close to a quarter of a million dollars. I asked Carolyn, is it worth it?

MCCOY: I say, if you pay your premiums, you ought to get the same service that the younger person does. THORPE: There's no change in any of these pieces of legislation that would take the power away from the patient, and the physician ultimately making whatever choice is best for them.

GUPTA (voice-over): Dr. Radhakrishnan Nair is Helen's doctor.

(on camera): Should there be a cutoff at some point, just say, "Look, this person is just too old"?

DR. RADHAKRISHNAN NAIR, SOUTHERN REGIONAL HOSPITAL: The cutoff needs to be decided based on general health, their ability to go for rehabilitation after surgery and ability to withstand surgery.

(END VIDEOTAPE)

GUPTA: Imagine this: you're just a teenager -- can't even drive yet, and then you receive a life-threatening and life-altering injury. What do you do?

Well, if you're Matthew Sanchez, you fight, you press on, and then you give back in a big way.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): When he was only 15, a Friday high school football game forever changed the life of Matthew Sanchez.

(on camera): Can you just paint a picture for me of what happened this particular evening?

SANCHEZ: The running back was coming around on a sweep, and right before I hit the running back, the full back knocked my legs out from under me, and I actually just kind of went horizontal and hit him with my head down.

But a really sharp pain went through my body after I hit him and I hit the ground. It felt like an explosion went off in my body.

GUPTA: I'm kind of scared, you know, just hearing it. I mean, what -- were you scared? I mean, you're so calm now. Were you scared?

SANCHEZ: Yes. I was definitely frightened at the time, but kind of in a state of shock. But it's a really surreal feeling to tell your body to do something and not the have it respond.

GUPTA: Matthew was unable to move. You can take a look at his X-ray over here. Doctors here at Shepherd determined that he had a fracture at his C5 bone. And that's what was causing the problem.

And Dr. Donald Peck Leslie is the medical director here. He's made an amazing recovery.

But what are we looking at specifically?

DR. DONALD PECK LESLIE, MEDICAL DIRECTOR, SHEPHERD CTR.: Well, we had X-rays that were taken when he first got to Shepherd, as well as X- rays after his operative procedure.

GUPTA: So, here, you see the broken bone and over here, you see the screws, the plates and the cables on the back.

(voice-over): Over the next few weeks, Sanchez managed to regain feeling in his legs and struggled to learn how to walk again.

(on camera): How many hours a day would you spend here? How long?

SANCHEZ: I would probably spend maybe 30 minutes out of an hour and then come back after 30 minutes, just kind of rest and recover. It's surprising. It doesn't look like very far, but it will take -- it will take a lot out of you. It doesn't take long to wear you out.

GUPTA (voice-over): Just over a month later, Sanchez walked out of the hospital. After months of rehab, he was driven to get back to competition. He eventually completed seven triathlons in the past couple of years and now a cross-country bike trip to raise funds for the Shepherd Center's Share Initiative.

(on camera): I think it's striking for anybody to hear that you used to have trouble walking this distance and you're the same guy who cycled across the entire country essentially.

SANCHEZ: I knew I could do it, kind of, from the beginning. It was definitely a daunting task. I knew it would be hard and I definitely was scared of the challenges ahead.

GUPTA (voice-over): The Share Initiative enables veteran and active duty military to travel here for treatment.

(on camera): You wanted to raise money, you wanted to raise awareness. What was the point?

SANCHEZ: One, the doctor that was responsible for holding my head for 45 minutes on the field, actually, his son passed away in Afghanistan, Dr. Henderson's son. And, you know, so that's -- you know, kind of a tribute to him.

But on top of it, these men and women are over there doing things -- regardless of whether we feel it's right or wrong -- they're over there and they're risking their lives every day. We feel, like, that they deserve the best treatment possible.

GUPTA (voice-over): Since its inception last spring, the program has welcomed about 100 injured veterans and soldiers, many of them wounded in Iraq and Afghanistan. Their stories help keep Matthew Sanchez pedaling on his two-month journey across the United States.

And in part two, we'll hear from one of the soldiers he helped.

DILLON CANNON, INJURED IN IRAQ: He could be working and making money for himself right now, and he's trying to help out people, you know, like me.

(END VIDEOTAPE) (COMMERCIAL BREAK)

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Welcome back to HOUSE CALL. I'm Elizabeth Cohen, with this week's medical headlines.

Could getting a CT scan be putting you at risk for cancer? New research says maybe so. These sophisticated X-rays can emit high doses of radiation and now scientists from the National Cancer Institute estimate that radiation from abdomen and pelvic scans cause about 14,000 cases of cancer and scans of the head cause about 4,000 cases.

Now, it's important to keep in mind that the overall risk for any one person is small, but doctors certainly do more of these tests than they used to.

The American College of Radiology rejects these findings saying there is no evidence that any cancers have ever been caused by CT scans.

Experts we talked to said, look, the bottom line is that CT scans can be life-saving, but you should ask your doctor certain questions before having one and exposing yourself to the radiation. You should ask: is this scan really needed? Is there another test I could have that has less radiation? Am I getting the lowest dose of radiation possible -- is another question you should run by your doctor.

Now, for the thousands of women in this country who need testing for breast cancer, listen up. A study out this week could change what kind of tests you get. Researchers looked at dozens of previous studies about breast biopsies and found that needle biopsies were just as good as when doctors chose to do surgical biopsies. And the needle biopsy, which is much less invasive, usually has fewer side effects.

We spoke with an expert in breast cancer detection.

(BEGIN VIDEOTAPE)

DR. MELVIN SILVERSTEIN, DIR., HOAG HOSPITAL BREAST PROGRAM: The state of the art today is needle biopsy. A needle biopsy is far less expensive. It hurts less. It doesn't cause any significant scarring.

COHEN (voice-over): Which is why some doctors are now crying foul and pointing fingers.

SILVERSTEIN: Here's why it's happening: unfortunately, many of these patients are controlled by surgeons and it may be that those surgeons do not know how to do needle biopsies or do not have the skill to do it. So rather than refer the patient to somebody who can do it, they do an open surgical biopsy, which is, you know, 10 years behind the time.

COHEN: Surgical biopsies cost almost twice as much as needle biopsies, a cost difference that can run into the thousands of dollars. However, there are certain times when a needle biopsy isn't the best option. SILVERSTEIN: There are occasional cases where the lesion is in such a position that you simply can't do a needle biopsy. But those cases are few and far between.

COHEN: As with any medical procedure, make sure you check with your doctor first and know exactly which option will work best for you.

(END VIDEOTAPE)

COHEN: Just ahead: Your heart rate could give you certain clues about your heart health. We've got the numbers you should aim for coming up.

And, Sanjay returns with the story of Matthew Sanchez, an inspiring young man making a difference to total strangers.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, before the break, we brought you the story of Matthew Sanchez, recovering from a serious spinal injury. He decided to give back. How? By biking across the country to raise money for a special program at Atlanta's Shepherd Spinal Center, the place that helped him walk again.

(BEGIN VIDEOTAPE)

GUPTA: As Matthew Sanchez pedaled across America, he wasn't just thinking about the road in front of him. He was also thinking about people he might help by raising money through his cross-country odyssey -- people like Dillon Cannon.

(voice-over): Now medically-retired, U.S. Army Private Dillon Cannon had been in Iraq for less than a month when he was shot by a sniper in 2006. It fractured the vertebrae in his neck, leaving him paralyzed from the chest down. Two years later, he ended up here at the Shepherd Center.

CANNON: I knew I'd be fine if I could do stuff on my own because, you know, once I'm a little bit older and, you know, parents aren't there to help, you have to know how to take care of yourself.

GUPTA: Cannon is independent now, thanks to the Shepherd Center's Share Initiative and donors, like Matthew Sanchez.

CANNON: People doing stuff on their own time to raise money to help us out, it just shows that there's good, kind-hearted people out there that will, you know, go above and beyond what they need to do to help out somebody else.

GUPTA (on camera): Other people will watch something like this and say, "Why does Matthew get to recover, and so many others don't?" Why do you think?

SANCHEZ: I hope that there's a good reason, but I honestly don't know.

GUPTA (voice-over): We caught up with Cannon and Sanchez at the Shepherd Center, where their very different lives converged.

CANNON: Some people just get better and carry on with their daily lives and then, you know, not even look back at what, you know, got them here -- and why military personnel, I mean, out of the kindness of his heart, it shows that people like that, you know, go above and beyond what they have to do. And he could be working making money for himself right now. And he's trying to help out people, you know, like me.

(CHEERING)

GUPTA: By the way, that bike journey? It took 78 days.

SANCHEZ: I couldn't think of a better way to give back. I don't think that anybody can deny that these men and women are very brave and risking their lives on a day-to-day basis. And regardless of how you feel about that, it certainly is important that we support them and offer them the best care possible.

(END VIDEOTAPE)

GUPTA: I'll tell you, Matthew Sanchez is a really remarkable young man and he's doing very well. Good luck, Matthew.

Now, understanding your heart rate, it's really important. I'm going to tell you why later in the show.

And for all you herb lovers out there: beware, they can sometimes be dangerous if mixed with certain drugs. Stay tuned for that.

And we have this new weekly pop quiz. What you're looking at is a skull X-ray. Take a close look and see what you think is going on here. I'm going to tell you later in "Ask the Doctor."

Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, our job is to keep you safe here on HOUSE CALL, and as a part of that, we often warn you about drug interactions on this show. But you may not know that the food you eat could be mixing dangerously with your medication.

I want to give you some examples: grapefruit, chocolate and licorice. Now, grape fruit is a great nutrient-rich food, but when combined with certain medications that treat high blood pressure, anxiety, insomnia, malaria, they can become dangerous. The reason is a chemical in grape fruit seems to boost these medications, making it more common to suffer from side effects.

As for chocolate, caffeine in chocolate can sometimes affect classes of anti-depression medications, causing a spike in blood pressure. Plus, chocolate can also amplify the effects of drugs like Ritalin.

As far as licorice goes, it could interact with blood pressure and diuretic medications, actually, reducing their effectives.

So, check with your pharmacist about avoiding interaction.

(MUSIC)

GUPTA: Something else to be aware of, and that's herbs. Many people think of it as an herb, it must be safe. That's not always the case. Herbs can cause toxic reactions on their own or even when mixed with certain medications.

CNN medical correspondent Elizabeth Cohen is here to tell us the five herbs to look out for -- Elizabeth?

(BEGIN VIDEOTAPE)

COHEN: Sanjay, Americans spend nearly $15 billion a year on supplements. Everything from herbs to vitamins to fish oil to glucosamine, we seem to be crazy about them.

Now, Sanjay, in the vast majority of cases, people take these supplements and they're just fine. However, I've been talking to physicians who said that they have seen some patients get into real trouble by using herbs or supplements the wrong way. People sometimes think, well, they're natural, how could there be a wrong way? But there is a wrong way.

So, we've developed a list of supplement no-no's. So, let's take a look at things that you shouldn't be doing. You shouldn't be taking too high a dose of the herb or vitamin that you're taking.

Sanjay, I spoke to one woman who took too much Vitamin B6 and she ended up with numbness in her legs from her toes to her knees. She actually had trouble walking, as you might imagine.

Also, taking certain herbs before surgery is a problem. I spoke to a surgeon who said that he was operating on someone, all of a sudden, there was all of this bleeding, he didn't know why. It was because his patient was taking an herb and hadn't told him.

That leads us to failing to inform your doctor or your surgeon that you're taking herbs is really a problem. They may be prescribing something to you that might interfere with that herb or vice versa -- that's really a big no-no.

Now, let's take a look. I have a list of a whole bunch of herbs and supplements that you need to be careful. Let's talk about two of them.

St. John's wort, which is often taken for depression, can alter the potency of certain prescription drugs. So, it's really important you tell your doctor you're taking it. Also, Kava has been linked to liver problems.

For the entire list of supplements where you need to be careful, you got to read my column -- Sanjay?

(END VIDEOTAPE)

GUPTA: All right, Elizabeth. Thanks.

And for more information on what herbs you need to watch out for, you can read the column at CNN.com/EmpoweredPatient.

Now, here's a question: Do you know what your heart rate is even right now? It's an important number to know. It gives you clues about your heart health and it can help you train smarter as well.

Now, I want you to put your fingers to your wrist, count the number of beats for six seconds and multiply that times 10. It's not perfect, but it's a good estimate. Remember that number and learns what it means to your heart health -- coming up next.

(COMMERCIAL BREAK)

GUPTA: All right. So, did you count your heart rate during the break? Well, if you came up with a number between 60 and 80, your resting heart rate is about average.

Let me tell you how this works. Blood transports oxygen throughout your body. It picks up the oxygen in your lungs and delivers it to all kind of cells in your body from your fingernails to your hair follicles. The more efficient your body is at distributing oxygen, the lower your heart rate is going to be.

Now, if the number you came up with was below 60, chances are you're in pretty good shape. It's not unusual for athletes or people who do yoga or meditation to have a resting pulse rate in the 50s, 40s, sometimes even the high 30s. The last is usually reserved for very elite athletes.

Now, if your heart rate was above 80, it doesn't necessarily mean you're unfit. You have a lot of caffeine, you're under a lot of stress -- your heart rate is going to be higher. However, a higher resting pulse could mean that your fitness level is not quite up-to- par, and we're here to help you change that.

Something I've been focusing on is heart rate target training. It's actually pretty simple to do. First of all, calculate your maximum heart rate. The way that you do that, you subtract your age from the number 220. So, mine would be 180.

Now, you calculate a range between 60 percent and 70 percent of that number. Mine would be from 108 to 126. Try and keep your pulse rate in that range while you work out. You can get a simple heart rate monitor to wear while you're exercising or many cardio machines have heart rate monitors as well.

The longer your keep your body at that target heart rate, the more efficient your cardiovascular system will become -- and overall, the fitter you will be. Now, we've got a pop quiz for you. This is a skull X-ray. I want you to take a look at his and see what you think is going on. I'm going to tell you -- that's next in "Ask the Doctor."

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL. Time for my favorite segment of the show, "Ask the Doctor."

Every week, we've been posting a picture on our show page, CNN.com/HouseCall and asking for your guesses, either on Twitter at SanjayGuptaCNN, or on our Web page. And then we're trying to answer the question right here.

This week, we have a skull X-ray. And I want to point out a couple things to you. First f all, let's orient you. This is a patient who's lying on their back, here's the skull obviously, the eyes would be up here, and this is the spine, you can see it over here.

Focus your attention right here on this object over here. This is what's known as a shunt catheter. This is a catheter that's actually going into a natural fluid-filled space in the brain and you see the shunt is actually tunneled over here. The shunt continues and you drain fluid from the brain into the abdominal cavity.

These bright objects over here are staples -- skin staples that were put in at the time of the surgery.

That's our neurosurgical pop quiz this week. We'll continue to have those.

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/podcasting. And remember, this is a place for the answers to all of your medical questions.

Thanks for watching. I'm Dr. Sanjay Gupta.

More news on CNN starts right now.