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April 30th, 2010
12:23 PM ET

What would you do if you thought you were going to die?

By Dr. Sanjay Gupta
Chief Medical Correspondent

As a doctor, I watch people facing death daily. As a reporter, I have gone to dangerous places and have often been put in harm’s way. As a father of three girls I have often thought, "What if something happens to me?" It is a frightening prospect and a daunting question.

Recently I met a man who had a remarkable answer to that question. The story of Bruce Feiler profoundly connected with me and left me speechless. It made me rethink how I’d live my life and how I would take care of the three little girls I might leave behind.

In May of 2008, Bruce was in great health. Happily married, the father of 3-year-old twin girls Eden and Tybee, a best-selling author who had traveled the globe.

Bruce was at the top of his game. At his annual physical, a routine blood test revealed something was wrong with his bones. A follow-up bone scan would reveal an abnormality on his femur—or thighbone. Doctors weren’t alarmed since it was the bone Bruce broke riding his treasured bike at age 5. In fact, Bruce recalls his doctor saying, “It looks like nothing. Don’t worry, it’s not like you have cancer.” Over the coming days, as Bruce waited for test results and lived with the uncertainty of an undiagnosed growth, he would repeat that mantra—“NOT CANCER, NOT CANCER.” Meanwhile his wife, Linda, had a hunch something was wrong. When we sat down at their home in Brooklyn she told me, “You know as a wife, as a spouse. You know as a parent when something’s just off. And he just didn’t look himself.”

Days later, a follow-up X-ray and MRI confirmed Linda’s worst suspicions. Bruce was had bone cancer called osteosarcoma. It’s not a common cancer; only about 900 people are get it each year. More than 2/3 of diagnoses come before age 40. Bruce was 45.

His thoughts immediately turned to his girls. And what would happen if he died and they were left fatherless. In the middle of the night he came up with an idea – contacting six of his closest friends and asking them to be there for his girls if he died. He asked them by reading each a letter he wrote - “ Dear Friend, As you know, I recently learned that I have a seven-inch cancerous tumor in my left leg. That afternoon, Tybee and Eden, who had just turned three, came running to greet me, laughing, giggling, and falling to the ground. I crumbled. I kept imagining all the walks I might not take with them, the ballet recitals I might not see. Would they wonder who I was? Would they yearn for my voice? I believe Eden and Tybee will have plenty of love, plenty of opportunities in their lives. But they may not have their dad. Will you help be their dad?”

All six men said yes -and Bruce created for Eden and Tybee what he would call “The Council of Dads.” A group of men who would be with him, his girls and his wife as he fought this rare and aggressive cancer.

I followed Bruce’s journey and will tell you what his prognosis is in a very special half-hour airing this weekend and then a special hour airing Father’s Day. It’s called “Dads for My Daughters” and I am confident it will inspire you, as it did for me, to think how you live your life and the legacy you want to leave behind.

Bruce has written a book about his experience called “The Council of Dads: My Daughters, My Illness and The Men Who Could be Me.”

Watch a preview of Bruce Feiler’s story this weekend on “SGMD,” Saturday-Sunday, 7:30 a.m. ET

Do you know a survivor dad? Tell us about him.


April 29th, 2010
01:12 PM ET

What kills a person with Alzheimer’s?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From CNN.com blog commenter, Dennis:

“How does Alzheimer's eventually take a person’s life? I had two grandparents with this disease and both died of other things. Can you explain?”

Answer:

This is an important point, Dennis. Alzheimer's does not kill a person directly. You're not going to find Alzheimer's, for example, as a cause of death on a death certificate.

What happens as the disease progresses is controlling a lot of your body's functions simply becomes more difficult; things like eating, going to the bathroom, walking, even swallowing become a problem. And if you're not eating and you're not moving around, infections can set in. Blood clots can form as well. Your immune system starts to get weaker, putting your body at higher risk for infection – an example of this is pneumonia.

So basically the complications from Alzheimer’s disease are what ultimately take a person's life. I hope this helps.


Filed under: Alzheimer's • Expert Q&A

April 28th, 2010
12:28 PM ET

Sight of sick person can trigger immune response

By Elizabeth Landau
CNN.com Health Writer/Producer

You may cower in disgust when someone sneezes near you, but just seeing that person may make your immune system prepare for battle, a new study suggests.

Research published in the journal Psychological Science found that when people viewed a slide show of photos depicting symptoms of infectious disease - pox, skin lesions, sneezing – their immune response became more aggressive against bacteria. The study was led by Mark Schaller at the University of British Columbia.

One group of participants viewed a slide show of furniture followed by the disease slideshow in a separate session, and the other group saw the furniture photos and then, on a later occasion, images of people holding firearms. Everyone involved had blood samples drawn before and after viewing the slideshows.

Scientists compared the white blood cells of participants who viewed the disease slide show against those who saw the gun depictions. They found that the white blood cells of people who saw the disease images tended to respond more aggressively to bacteria than the group that saw the guns.

Researchers also looked at emotional state, and found that participants’ stress levels were higher after the firearms presentation than after the infectious disease images. Similarly, they found that the level of participants’ disgust with the pictures of ill people did not have an effect on the immune response.

This suggests that even though the firearm slide show was more stressful, but also depicted a threat, the immune reaction was not as aggressive as with the infectious disease images, the authors wrote.

The study, while small at 28 participants, is the first empirical evidence linking visual perception and immune system aggressiveness in the presence of bacteria, the authors wrote.

Having this immune response may have had its advantages in the days of early humans - even though they may have recoiled at the sight of other sick people too, their immune responses would have helped them live in proximity with others. But this phenomenon may also have disadvantages, the authors note. A 2004 study in Psychological Bulletin, led by Suzanne Segerstrom at the University of Kentucky, suggested that persistent priming of the immune system could have negative effects overall.

“The overall implication is that the link between perceived disease cues and immune responsiveness may have important consequences for human health and welfare,” the authors of the new study wrote.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 27th, 2010
04:17 PM ET

Defibrillator dangers

By Trisha Henry
CNN Medical Producer

The Food and Drug Administration is recalling more defibrillators.

The FDA is recalling Nihon Kohden and GE Responder models of automatic and semiautomatic defibrillators due to faulty components. In November the FDA recalled Powerheart, and CardioVive external defibrillators because the models were found to have defective parts and may not work properly.

The FDA says that about 280,000 defibrillators are used worldwide and that the recalled models may not work during attempts to rescue people in sudden cardiac arrest. SCA is responsible for more than 300,000 deaths each year. SCA causes the heart to stop functioning. In more than 90 percent of cases death occurs. But studies have shown 90 percent of victims can be saved when CPR and a defibrillator are used within the first minute.

The recalled defibrillators, made by Cardiac Science Corporation, may fail to properly deliver a shock and have been found to have faulty parts that may cause them to fail at delivering that lifesaving shock. Other issues with the devices include failures in accurately reading and analyzing the heart rhythm as well as failure to recognize the pad placement during use.

Recalled defibrillators should be repaired or replaced. The FDA says the recalled defibrillators should be used unless another defibrillator is available. It says the potential benefits of using the available external defibrillators outweigh the risk of not using any of the affected external defibrillators or the risk of device failure.

For more information and an updated list of the affected models click here.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 27th, 2010
01:46 PM ET

Heart disease risk heightened in nearly half of Americans

By Elizabeth Landau
CNN.com Health Writer/Producer

Heart disease is America's No. 1 killer, and nearly half of Americans have one or more conditions - hypertension, high cholesterol or diabetes - that puts them at risk, according to a new report from the U.S. Centers of Disease Control and Prevention.

One out of eight adults, or 13 percent, have two of these conditions, and 3 percent have all three, the CDC said in its analysis of people over 20 years old from 1999 to 2006. Forty-five percent have at least one of the three.

African American individuals have a greater likelihood of having at least one of these three conditions than non-Hispanic white people and Mexican Americans, the study found. White Americans more commonly have high cholesterol than African Americans and Mexican Americans. As for diabetes, African Americans and Mexican Americans have a higher prevalence than white individuals.

The portion of adults with undiagnosed conditions is significant - more than 15 percent of adults have one or more of the conditions, but had not received a diagnosis. About 8 percent have undiagnosed hypertension, 8 percent have undiagnosed hypercholesterolemia (high cholesterol), and 3 percent have undiagnosed diabetes, the report said. These proportions were similar across ethnic groups.

Heart disease is the leading cause of death in the United States. Read more about it from the Mayo Clinic Health Library.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 27th, 2010
12:09 PM ET

Surgical equipment price a shocker

By Sabriya Rice, CNN Medical News producer
and Elizabeth Cohen, CNN Senior Medical Correspondent

When Dr. Linda Galloway learned she needed surgery to save her vision, she scheduled the procedure immediately with her ophthalmologist.

What an eye-opener it was when the hospital bill arrived. She noticed several high-priced items, including a charge of $863.20 for disposable forceps.

"Surgical instruments can be expensive but I think $863.20 is really outside of the realm of realistic prices," she complains.

Then Galloway, an obstetrician in Orlando, Florida went online and found similar forceps for $1,155 for a box of six, or $192 each.

"I was outraged. I tried to get an explanation as to why I was charged that amount of money," she said. When she called the billing department, the answer upset her even more.

"They said when you signed consent for the procedure, you allowed us to charge anything we wanted to and therefore, this is what it is," she recalls.

Galloway says she was especially upset because with her insurance plan, she has to pay 20 percent of her medical bill and if the hospital is going address her as a consumer, then she wants them to level the playing field.

"I need to be in power to do things.  If you're going to charge me this amount of money, then I need to know exactly what instruments you're going to use and what medications you're going to use. Because I can then buy them outside and bring them to the hospital."

Florida Hospital, the place where Linda had her surgery says their charges are fair and compatible with other hospitals.

"Like all other hospitals across the country, [Florida Hospital] bases charges on a charge master that serves as a guide,” a spokeswoman wrote in an e-mail.  She says that an independent contractor compares Florida Hospital’s charges with those of other hospitals and that the results show “we are in the mid-range in that pricing structure."

But is markup of more than four times the market rate really reasonable?

According to the American Hospital Association, the prices increases are necessary.

“A hospital is a very expensive enterprise to keep open 24 hours a day, 7 days a week, 365 days a year and ready for any medical need or emergency. And that does lay out a basic level of cost that has to be captured through the charge structures," says Rich Umbdenstock, president of the AHA.

Umbdenstock says that hospitals have to compensate for programs such as Medicare and Medicaid that traditionally underpay, and that each hospital has to set prices in a way that helps their bottom line.

"The hospital has to be able to bring in more money than it spends or else it won't be there for the next patient.”

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 27th, 2010
10:30 AM ET

How does race affect breast cancer risk?

By Trisha Henry
CNN Medical News Producer

It's been long known that Hispanic women are less likely to get breast cancer than white women but now a new study examines why.

Researchers at the University of Colorado at Colorado Springs studied women with breast cancer. Among the white women, between 62 percent and 75 percent had known risk factors for breast cancer – behaviors or traits that have been found to increase one’s chances of getting the disease, for example, use of hormone replacement therapy.

Among Hispanic women, between 7 percent and 36 percent had known risk factors. "The whole intent was to shed light on why there are these differences," said the study's author, Lisa Hines, a University of Colorado at Colorado Springs assistant professor.

Traits found in Hispanic women in the study that did increase their breast cancer risk included having their first period younger, not breastfeeding their children and having a low level of physical activity. But other factors that usually increase the risk – alcohol consumption and higher body mass – didn't appear to have as much effect.  In general, Hispanic women were found to have more traits that would keep them in the clear than those that put them at risk. Even in premenopausal women, being taller and having a family history of breast cancer increased the risk of getting breast cancer in non-Hispanic white women but was found not to among Hispanic women.

Hines found that when it came to hormone replacement therapy, "post-menopausal non-Hispanic white women who had used hormone replacement therapy recently had an increased risk of getting diagnosed with breast cancer," but in Hispanic women, "there was no relationship with recent hormone replacement use" and breast cancer. The study also suggests the difference in estrogen exposure could be because of genetic, environmental, or lifestyle factors that make someone more likely to develop post-menopausal breast cancer. While previous studies have found that Hispanic women have a lower rate of breast cancer than non-Hispanic white women, they experience a higher risk of mortality after diagnosis. The question remains, what makes these two groups so different? Hines says it will take more research to determine what is causing fewer Hispanic women to develop breast cancer and "if there is something biologically that is making Hispanic women less susceptible, maybe someone can develop a strategy that can kind of mimic that."

The study found overall, non-Hispanic white women had a higher incidence of breast cancer compared with Hispanic women for every age group examined. This is one of the largest studies that have both non-Hispanic white women and Hispanic women in it and it's the only one to review both groups simultaneously.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 26th, 2010
08:41 PM ET

Unhealthy behaviors can triple, quadruple death risk

By Ann J. Curley
CNN Medical News Assignment Manager

It’s no secret that certain lifestyle behaviors can have a negative impact on our health. A new study in the  Archives of Internal Medicine finds that the combined impact of smoking, physical inactivity, alcohol consumption, and eating a diet low in fruits and vegetables, can triple or quadruple our chances of death compared with practicing none of those behaviors.

Norwegian researchers interviewed 4,886 adult individuals in the United Kingdom in 1984 to 1985. Researchers calculated a health behavior score based on whether the individuals smoked, drank alcoholic beverages, ate fruits and vegetables in their diet, and participated in physical activity. One point was given for each behavior. Participants were followed for a mean period of 20 years. 1080 participants died, 431 from cardiovascular disease, 318 from cancer, and 331 from other causes. Each negative behavior  combined to increase the risk of death, especially smoking.

Lead study author Elisabeth Kvaavik, Ph.D., of the Department of Nutrition at the University of Oslo, Norway, described the significance of their study as showing that “health behaviors work together to have a combined effect on risk of dying that is quite strong and significant.”

“Doing all four poor behaviors increased the risk of dying between three and four times depending on cause of death, compared with having none of these poor behaviors," according to Kvaavik. "But also having, for instance, two poor and two healthy behaviors, doubles the risk of dying compared to having only healthy behaviors.”

Kvaavik said that one of the most interesting findings of their study is that “having all these poor behaviors had the same effect on risk of death as being 12 years older.”

Modestly changing behaviors can have a big health impact. Kvaavik says she wants people to learn that “…modest improvements in all these lifestyle factors may significantly reduce the risk of dying and improve health."

Specifically, she mentioned eating  fruit and vegetables more than three times daily, quitting smoking, exercising two hours or more per week (or about half an hour per day) as well as limiting alcohol to  two glasses of wine or beer per day for women and three glasses for men. These goals, she said, should be achievable for most, otherwise healthy, people.

"It is not necessary to do strenuous exercising, eat very many vegetables or to totally avoid alcohol to improve health. Modest improvements will help," she said.

She notes one exception to her guidance on modest behavior. “Smoking should be avoided, as this is the factor with the strongest individual effect on health of those studied here. That only modest improvements will reduce the risk of an early death may encourage many to try changing their lifestyles.”

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 26th, 2010
02:41 PM ET

Genes may influence how much you smoke

By Elizabeth Landau
CNN.com Health Writer/Producer

New research suggests that  smoking habits may have genetic influences. Although the effect is subtle, the findings highlight that genes are important in influencing cigarette consumption, said Helena Furberg, assistant professor of genetics at the University of North Carolina, Chapel Hill, one of the authors.

Three new studies collectively looked at data from more than 140,000 people who had some measure of smoking behavior. They found genetic regions associated with the quantity of cigarettes that people smoke daily. The research appeared in the online version of the journal Nature Genetics.

Researchers from the University of North Carolina, Oxford University and the Icelandic company deCODE conducted the studies.

A single-letter variation in the sequence of the human genome was previously found to be associated with nicotine addiction and risk of lung cancer. Scientists found this on chromosome 15, an area that harbors three nicotine receptor genes. This area also figured prominently in the new smoking analysis.

The individuals studied all had European ancestry, but researchers are going to expand their study to people of African and Hispanic origin, Furberg said.

These genetic associations are not deterministic, she said. If someone has these genetic variations, that does not mean he or she will smoke, or have a hard time quitting. And the idea of genetic personalization may be far off.

"At this point, if you’re trying to quit smoking, don’t wait until we have personalized therapy," she said.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 26th, 2010
12:15 AM ET

Watching R-rated movies, early alcohol use linked

By Caitlin Hagan
CNN Medical Associate Producer

It's a scary headline for parents of middle – schoolers. A new study in the Journal on Studies of Alcohol and Drugs found among middle -school-aged kids who were allowed to watch restricted R-rated movies whenever they wanted, almost a quarter started drinking alcohol early. Only 3 percent of middle – schoolers who were never allowed to watch R-rated movies engaged in early onset drinking. The researchers were looking at whether there was an association between parental restriction of R-rated movies and alcohol use early in life.

"Behavior is complicated and there are lots of things that contribute to why you do something," explains Dr. Susanne E. Tanski, an assistant professor of pediatrics at Dartmouth Medical School and lead author of the study. "But seeing things onscreen makes behaviors more normal."

The study used data from nearly 2,400 middle – school students. At baseline, none of the participants reported previous alcohol use. Researchers followed up with the teens between 13-26 months later, asking whether they had alcohol without parental consent and how often their parents allowed them to watch R-rated movies.

The study did not measure how often the teens were drinking, only whether they were. It also did not ask whether the teens developed any problem behaviors related to alcohol use.

A similar association has been well documented with tobacco use but not all experts agree on how great the media's role is in the development of these behaviors.

"The longer you can wait to have your children exposed to illicit drugs and alcohol, the less of a chance they're going to have significant problems later," says Dr. Scott Teitelbaum, an associate professor of both Psychiatry and Pediatrics at the University of Florida.

"But when you look at any sporting event you're going to see a predominance of beer commercials, right? Are you going to make the same argument that letting middle – school kids watch sports makes them more likely to drink too?"

"No one is suggesting that R-rated movies alone are the cause of early onset drinking but it's certainly a factor," says Jim Steyer, CEO, Common Sense Media.

"Good news is that parents can really learn from this and set clear rules about what media their kid consume."

Tanski recommends kids consume two hours or less of entertainment media a day. That includes all television, all movies, and online gaming.

"As a mom of two young boys, I recognize how much of a challenge it is," says Tanski.

"But we should know what our kids are consuming in respect to media like we know who their friends are and where they're hanging out."


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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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