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SANJAY GUPTA MD

Extreme Teen Texters; Interview with Dr. Lisa Sanders

Aired April 24, 2010 - 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. I'm Dr. Sanjay Gupta. Welcome to a place we're going to learn how to live longer and stronger. I'm your doctor but I'm also your coach.

Here's something that got my attention. Some of today's teens are sending 3,000 texts a month. I got three kids. I think about this all the time. That's 100 a day, and I can tell you -- some doctors are really worried about those statistics.

And this woman, her name is Lisa Sanders -- Dr. Lisa Sanders. And she's a technical adviser for the television program, "House." She's going to tell us a lot of things, including the one thing you don't want to do when solving a mystery, a medical one, and that is order more tests. We'll explain.

And, finally, a medical mystery. It's something that we put in to our bodies every day and the government may now be trying to regulate how much of it we can have.

Let's get started.

(MUSIC)

GUPTA: I can tell you, more and more adults are doing this, but teens already have it down to a science. We're talking about texting. And for many, it's a social lifeline. But there's some evidence it could also be an addiction.

A new study finds many teens send upwards of 100 texts a day.

CNN's Deb Feyerick has some surprising new research.

(BEGIN VIDEOTAPE)

DEBORAH FEYERICK, CNN CORRESPONDENT: On your mark, get set, go!

(voice-over): How fast can your average 15-year-old text a single line? Let's just say faster than someone not in high school.

(LAUGHTER)

FEYERICK (on camera): Mine's not even English.

(voice-over): For 10th grader Sara Matzkin on the right, Sarah Marshall in the middle, and April Polubiec, texting may be as important as talking. (on camera): How many text do you send and receive every day?

SARA MATZKIN, TEEN TEXTER: Probably around 200.

SARAH MARSHALL, TEEN TEXTER: Definitely a lot. A couple of hundred.

APRIL POLUBIEC, TEEN TEXTER: It varies.

FEYERICK (voice-over): Varies studies show to the tune of well over 3,000 texts a month for the average teenager. The question now: are teens texting too much?

MARSHALL: It's right by my bed when I go to sleep and right by my bed when I wake up. It's like the first thing I go to.

FEYERICK: Eighty percent of all kids own a cell phone and the rate of texting has skyrocketed 600 percent in three years.

(on camera): But why is it so important for you to know when somebody's trying to reach you?

POLUBIEC: You feel like you're missing something. If someone like text me and I missed it, I feel like missed out on the moment like ...

FEYERICK: Do you sometimes feel your mood changing depending on how often you're receiving the texts or the speed?

UNIDENTIFIED FEMALE: Yes.

FEYERICK: Like what? Give me -- give me some examples.

MATZKIN: Well, I mean, like if someone responds right away you're like, yes, like, they responded. But if they respond like two to three hours later, you're like, what's going on?

FEYERICK (voice-over): Sound addictive? Well, could be. Doctors say texting and the instant gratification of getting a text back floods the brain's pleasure center with the mood-enhancing dopamine.

DR. MICHAEL SEYFFERT, CHILD NEUROLOGIST: Studies have shown that those kids who are texting have that area of the brain light up the same as an addict using heroin, and they will actually describe, when I don't have it, I feel bad, I feel anxious or I feel sad.

FEYERICK (on camera): So, it's like the new nicotine?

SEYFFERT: That's a good description. Yes. And for many, it may well be.

FEYERICK (voice-over): Brain doctor Michael Seyffert treats teens with sleeping disorders at this New Jersey sleep clinic, and has discovered that one out of five of them are interrupting their sleep to text, triggering problems. SEYFFERT: With a lack of sleep, they're having a problem performing. They're going from "A" or honor roll students to, you know, barely passing.

FEYERICK: That's the worst case.

These teens, on the other hand, get good grades and take part in afterschool activities, though texting does sometimes get them in trouble. And while the behavior can be addictive, teens, like Sarah Marshall, say they're confident they can quit cold turkey.

MARSHALL: Maybe I'd have some like withdrawal symptoms like I'd get anxious and like wonder like what's going on. But once I realized that nothing bad is happening, it's fine without my phone.

(END VIDEOTAPE)

GUPTA: OK. Again, that was Deb Feyerick with that report.

You know what else we hear that texting can lead to injuries like chronic pain of the neck, the arm and the hand. That's right. I mean, you see people texting like this. Sometimes people just use one thumb. I mean, that's terrible. Most people use two thumbs.

But over time, the point is that you can develop tendinitis and even arthritis in your thumb. I'm surprised I haven't developed that yet.

A lot of people hunch over, as well, when texting, sort of like this. That can cause neck and back pain, we hear. I'm getting a text even as I'm talking to you now.

But there are some tips out there to follow for pain-free texting. Stand up straight when texting. Try resting your device on a flat surface at some sort and lean your back up against a chair if you're sitting. Also, use both thumbs. That cuts down on the strain.

And last and most importantly, try to cut down on the overall texting. Good luck with that, right? Text like this.

Now, she's a former TV producer. She became a doctor. And now, she's an adviser, a technical one, for the television program "House." I sat down and had a fascinating conversation with a medical detective.

And I also decided to take a trip to the grocery store. My wife would be so happy. But I did it to answer some of your questions, to find out what's available here that can keep your eyesight sharp.

Stay with SGMD.

(COMMERCIAL BREAK)

GUPTA: Well, one of my favorite things to do is try to answer questions from you directly at home, our viewers. And one of the questions we got today was from Carly in North Carolina, who asked specifically about food choices changing as we age.

I decided to come to a grocery store to answer a full plate of questions. As a father of three kids, as a husband as well, I do a lot of shopping for the house.

And one of the places I like to shop is the perimeter of the store. Why? You get a lot of healthy foods, a lot of healthy vegetables. Try to eat seven different colored foods a day.

Also, keep in mind, Carly, that the same habits that we have of purchasing when we're younger they got to change as we get older. It's one of the places I spend a lot of time is here, in the green section, making sure you get plenty of spinach, plenty of kale, good for your eyes, good for your bones -- all these things that you need, particularly as you age.

Stay away from processed foods as much as possible. Make sure you get enough dairy, that's really important. Not just milk but also cheeses, as well.

And if you want to have meat -- certainly, there are some good options as far as meat goes. You want to make sure you get meat that has fewer calories, has less fat. Sometimes it costs a little bit more money, but certainly, sometimes worth the cost, as well.

We got another question now, Deborah, one of our CNN.com bloggers, writes about protein sources that aren't meat. What are some other options she's talking about here.

And I can tell you -- first of all, it is a myth that you need to get all your protein from meat. It's something that we thought about a lot when we're younger. But there are lots of different options out there.

For example, come to an aisle like this, you'll find foods like tofu. People like to scrunch up their nose when they hear tofu. Stir fry that, put sesame oil on that. Cottage cheese can also be very good, about 19 grams per serving. Incidentally, women need about 46 grams per day; men about 56 grams per day.

One of the things that comes up quite a bit is discussion about protein shakes. Are protein shakes potentially a good option when it comes to trying to improve your protein stores?

And the answer is that sometimes they can be. Let me give you a couple of quick tidbits when it comes to protein. There are a lot of options out there, obviously.

You want to look at the labels. You want to make sure you see the type of protein, the amount of protein early on. You also want to make sure that it's coming from an actual food source that protein is, something like eggs, for example.

Incidentally, a rule of thumb, protein typically has about four calories per gram. So, if you're seeing a lot more than that in this particular shake, you're probably getting a lot of added stuff. We got another question from Jack, specifically talking about sodium. He says his doctor told him he needed to cut back. How to do it -- he asks.

I can tell you, Jack, first of all, this may be one of the most important questions I'm going to answer. And when it comes to sodium, we simply eat too much. On average, about four grams per day, as an adult. And we really need about half that, about two grams per day.

You know, the study that came out that said if you get down the two grams per day, we could potentially save 150,000 lives a year simply from the one thing, frozen foods. They're going to have a lot of sodium for lots of different reasons, but mainly because sodium is a good preservative. That's why it's in there.

But also, canned foods. You know, a lot parents, again, like me, will go to canned foods. The problem is, you can get about 950 grams, almost a gram of sodium just from something like this -- far too much for an adult and far too much for most kids, as well.

Cereals, also. Obviously, an important food choice for many homes. Make sure to read those labels, again.

One thing about reading labels, as well, when you're reading labels, try to find foods or foods like this that have less than five ingredients. That's really going to help.

And when it comes to that sodium again, one thing that we do in your house, we never leave crackers and our cookies just sitting out on a big box. We'll pour a little bit into a small table, and that's important to try and find salt substitutes, as well. We don't leave salt shakers out there, but if you find a substitute like this, no salt for example, or just some flavorings, you can both cut down on your sodium, increase your potassium, and possibly solve a lot of those problems.

Again, like I said, I love these questions. Keep them coming. We'll try to get to as many as we can.

(COMMERCIAL BREAK)

GUPTA: And we are back with SGMD.

You know, when I was in medical school, one of the things I learned was the importance of listening to patients, and that's the focus of a new book called "Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis." And the author, Dr. Lisa Sanders, is here today. She also writes for "The New York Times" magazine "Diagnosis" column and also a technical adviser for the hit television program, "House."

DR. LISA SANDERS, AUTHOR, "EVERY PATIENT TELLS A STORY": Yes.

GUPTA: Pretty interesting background there.

SANDERS: I like to keep busy. GUPTA: I think, one thing people may not know about you is that you were a television producer first and then you went to medical school. And now, you're sort of dabbling in both.

SANDERS: Not really. No. I was a television producer. That was great. In my mid-life crisis, I decided to go to medical school and be a doctor.

GUPTA: So, you're a producer for 12 years and then went back. I mean, was there something specific? You called it a mid-life crisis. But what happened?

SANDERS: No, it wasn't really a crisis. You know, a couple -- a few years before I made the decision to go to medical school, I was with a correspondent I worked with, Bob Arnot. And we were shooting something about white water rafting on a river in North Carolina.

And I was looking at him and the monitor and he was coming down, the white water looked fantastic and he was doing his stand-up and then, suddenly, he just disappeared from the screen and the camera sort of runs around looking for him and he's up on the bank and he's pulling this elderly woman out of the water. And I'd never seen this in real life, but then he did CPR and she came back.

It was really -- it was really amazing. And I thought, wow. I've never saved anybody's life and I probably never will. And it sort of struck me that maybe I wanted to. And I didn't quit television right then and there, but it did plant the seed that maybe there was something else I wanted to do.

GUPTA: This mystery patients, what is it about the mysteries? Is it -- is it -- the way to solve the mystery, is it the doctor simply pays more attention? That they're more astute? They order more tests? How do you go about solving a mystery?

SANDERS: Well, I'd say, the one thing you don't do is order more tests.

GUPTA: Except for us.

SANDERS: I mean, certainly ...

(CROSSTALK)

GUPTA: Spinal tap and functional MRI.

SANDERS: He is special.

GUPTA: Does that drive you crazy though?

SANDERS: Television has its own requirements. Drama. You know, when medicine is done right, it's not exciting, right? It's very boring. So, medicine is not really exciting and television needs to be exciting. So, you know ...

GUPTA: Just inject a little drama. Fair enough. Order more tests as the case may be.

SANDERS: But they love -- you know, that show really loves what I love in medicine which is this detective story. You know, "House" is really Sherlock Holmes.

GUPTA: So, what is -- what are the ingredients to solve a mystery?

SANDERS: Well, I don't know that anybody knows, but I think, certainly, paying attention is very important. When doctors tell me they never see any interesting cases, you know, I feel bad for them because I think it means that they're not fully paying attention all the time. That they're may be a little bored with their job and they're not paying attention. So, I think paying attention is very important.

GUPTA: How do you -- is this part of your a discussion with your medical students? Your new residents about this very idea of listening to the patient, the art of the diagnosis? How do you -- how do you get people to understand that?

SANDERS: Well, I tell them that fascinating cases are passing in front of their nose every day. And if they're not seeing them, it's because they're not paying attention.

You know, even if somebody has just a classic hospital disease, a pneumonia, the chances are excellent that their pneumonia is going to be a little bit different than somebody else's pneumonia. But also, sometimes, some percentage of the time, that pneumonia is going to be something actually different. And if you're not paying attention, you're going to miss it.

GUPTA: Well, that's just a little bit of look inside the mind of a medical detective. You know what? She's going to stick with us now and give us the most important thing that we can look for in our own doctor.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: We are back with the program SGMD.

Dr. Lisa Sanders joins me. She's author of "Every Patient Tells a Story."

What should a patient look for in a good doctor? A doctor that's going to be diligent, figuring out things, maybe not ordering too many tests -- all the things that we've been talking about. How does a patient find doctors like that?

SANDERS: Well, I think the first thing to do is to ask your friends. Not just ask them, who's your doctor, and do you like your doctor? Because most people say they like their doctor. But say, really, why do you like your doctor? Because there are things that you might like in a doctor that other people won't like. You know, I like somebody direct, straightforward, cuts to the chase. My husband does not. He needs somebody to pretty much take him out to dinner before he gets any information.

So, you need to know yourself. But more important, the most important thing is: is that doctor paying attention to you? Is that doctor listening to what you have to say?

I think that we have to reformulate a doctor/patient relationship. I actually think a doctor and a patient are experts who are working together from different perspectives on the same problem. The doctor is the expert on bodies in general and diseases in general, but the patient is the expert on this particular body, and these particular symptoms.

And if you don't work together, then you're not going to -- you may not get the answer as easily as you should.

GUPTA: That's really well put.

What if you're the patient and you like your doctor, for all the reasons you said, but you don't agree with them. They've come to -- they're going down this road. They think it's X, Y or Z, and you're pretty convinced you're over here.

What do you do, then, as a patient?

SANDERS: Well, I think there's room to negotiate. My husband, when he quit his job to write a book, started getting these dizzy spells. And to me, I wasn't even in -- I wasn't even in medical school at time and I said, oh, this is stress. And he said, no, no. This is real. This is real.

And he went to his doctor and he said, I think I have a brain tumor. And the doctor goes, no. This is stress. And he said that.

And the third time he came back and said, I really think I need the head CT. The doctor goes, OK, fine -- and got a head CT. Of course, it was completely normal. And that solved all of his problems.

GUPTA: Was that right to do for that doctor, though?

SANDERS: Well, you know, I think that there's no -- certainly, we can't see inside the skull, and I think that patients are able to feel things inside their body that they may not be able to express. So, as it turned out, my husband did not have a brain tumor -- and thank goodness -- but, you know, it would be pretty arrogant if somebody is so insistent to consistently go absolutely not, because there are brain tumors that don't cause weakness. I mean, I don't have to tell you that.

GUPTA: You're going to keep doing what you're doing? I mean, you're writing a column for the "New York Times," you're technical adviser for the show, obviously, a practicing physician. You're where you want to be in your life? SANDERS: Yes. So far, so good. I mean, I wake up every day happy and excited to be here and find out what happens next.

GUPTA: It's great discussion, fascinating stuff. I really appreciate the time. I learned a lot and I always enjoy this. Thank you.

SANDERS: Thank you.

(MUSIC)

GUPTA: So, school lunches have long been a focus on the fight against obesity, but a national security threat? Well, a group of retired military officers say school lunches are simply making American kids too fat to fight. The report claims 27 percent of Americans age 17 to 24 are now too overweight to join the military and their focus is on these school lunches.

So, we decided to do, look at what a typical school lunch looks like. This is taken directly from a menu on a Friday in April. You can take a look there.

You have a pear, you have a chocolate treat, baked beans, fish nuggets. All in all, all that is going to total up to over 800 calories -- about 853 calories and 23 grams of fat. But, again, that's just meal specifically.

But here's the real problem as I could see it. Even if these students chose the healthy lunch, this is what it might look like. That's not a bad looking salad. It's a chicken chef salad and you have skim milk.

Five hundred thirty-two calories just in the salad alone, 18.87 grams of fat; 90 calories in the skim milk. Again, if you add all that up, 622 calories, nearly 19 grams of fat.

Healthy lunch, not so healthy lunch -- but really not that much different and I tell you, as a parent and a doctor, spending some time looking at the actual numbers like that, it makes all the difference. Even a salad can be loaded with fat and calories. In fact, my wife and I even used this exact sort of thing as a criteria when picking schools.

It is best to be informed about this sort of thing.

Which leads us to our medical mystery. Do you know what this is? Something you put in your body every day. And now, the government may be trying to regulate how much of it you can actually eat.

(COMMERCIAL BREAK)

GUPTA: And we are back with SGMD.

You know, the U.S. military operation in Haiti is winding down. Right now, about 2,200 U.S. troops are helping with earthquake relief efforts. And that's compared to 22,000 at the peak. And by June, forecasting forward, U.S. officials expect only about 500 National Guard and reserve troops to be stationed in Haiti doing humanitarian work. Officials say that aid agencies and groups like USAID help continue to expand their efforts which making dropping numbers like this even possible.

But now, it's time for our medical mystery of the week. You know what this is? Well, it's something we put in our bodies every day. And the answer, not that hard -- it's salt.

But here's the point. This week, government regulators plan to work with health experts in the food industry towards establishing the first legal limits ever for sodium in processed foods. As I talked about earlier, frozen foods -- they contain a lot of sodium. It turns up salt is a preservative. So, most of these foods are going to have higher levels than you might think. Canned foods as well, like soup. This can sometimes have your entire day's worth of sodium in just a can. Something you think is a healthy option.

Now, the Institute of Medicine, which is a sort of a science arm of the National Academy of Science, is urging the FDA to cut back the sodium recommendations and create what they call a national average, as they're trying to figure how much salt you're likely to eat in a particular day and bring that number down. Again, the concern being that high levels of salt can increase your risk of heart attack and stroke.

And we should point out that this doesn't come without controversy. In fact, there's this thing out there called the Salt Institute. They represent salt makers and they say that all of this is over-regulation. The government is essentially conducting a clinical trial on society.

But, you know, we keep coming back to something we talked about a few weeks ago. The Stanford study that found that we could save 150,000 live as year -- think about that -- simply by reducing salt. Really not a mystery after all.

Now, if you missed any part of today's show, be sure to check out my podcast on CNN.com/podcasting. And be sure to tune in 10:00 p.m., next week. All week, I'm going to be hosting with my pal Anderson Cooper, "A.C. 360." We're going to be looking into the secrets of the high cost of medicine.

Remember, this is the 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.