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April 23rd, 2010
05:44 PM ET

Fit Nation Q-A with Trainer Laura

Four months ago, Fit Nation chose six CNN viewers to train with, and compete alongside Dr. Sanjay Gupta in the Nautica New York City Triathlon in July. Angie Brouhard, one of those six participants, recently had a few questions about her training, so we asked Fit Nation athletic director Laura Cozik to weigh in.


April 23rd, 2010
04:35 PM ET

Colorful conversations: Dr. Lisa Sanders

Lisa Sanders was first inspired to save lives after watching physician and correspondent Dr. Bob Arnot use CPR to save a woman who had collapsed while they were shooting a story for CBS News about whitewater rafting. A few years later, Sanders went to medical school and today is an assistant professor of internal medicine at the Yale University School of Medicine. Her fascination is the work of diagnosis – the science and art of reading the clues of a patient’s symptoms. It’s an obsession she shares with the producers of the hit television show “House,” who rely on Sanders as a technical consultant. She remains a journalist, writing the “Diagnosis” column for the New York Times, and now has written a book, “Every Patient Tells a Story.” Dr. Sanjay Gupta asked Sanders how she knows she has an interesting story in her exam room.

Dr. Lisa Sanders: I’m an internist and I know my patients pretty well, but even then, you don't know what's going to walk in the door. Mystery cases, “fascinomas,” they don’t walk in the door with a sign that says, “I’m a weird case.” They present with symptoms like anyone else. And then it turns into something else.

Dr. Sanjay Gupta: Medical mysteries, what was it about that you decided to take so much time to devote to it?

Sanders: At the heart of a doctor-patient encounter is a little detective story. Sometimes, it’s not really hard. You come in with a fever and a runny nose and some body aches during flu season and you probably have the flu. But often enough, it’s probably not obvious, and I didn't know that. When I went to medical school, I thought I knew medicine because I had covered medicine for several years, and I thought I knew what was exciting about it. And when I heard doctors talking about the uncertainty and the excitement in their voices when they tried to figure out what was going on, I thought, “Wow, I never heard this story told.” I had never even been aware of this. I thought, like most people I think, that diagnosis was like math - you know, six times four is always 24. A fever and a rash, it must always be (DRAMATIC PAUSE). But it’s not. In TV, which is my only experience in medicine, a diagnosis is a one-liner. It’s “I’m sorry, you have leukemia.” That's it! That's the diagnosis! Then you move on to the treatment and the happy cure. I was interested in finding out what happens to lead up to that line.

Gupta: Part of your work is teaching medical students and new doctors to listen, to find things that maybe they wouldn’t have caught if they weren’t listening. But my sense is, maybe that is based not just on your intuition but on your knowledge. Are new doctors allowed to order more tests and things like that, because they don’t have the intuition, the experience and the knowledge that you – or certainly someone like Greg House – has?

Sanders: There’s nobody telling you you can’t order tests, except for insurance companies (LAUGHS). But in some ways, I think great diagnoses are made by the newest doctors. Faith Fitzgerald, who’s a wonderful doctor who teaches at the University of California, told me that unusual diagnoses are often made by the oldest or the youngest doctors. The old, because they've seen it all, and the young because they don't know that whatever they think it is, isn't possible.

To see more of Dr. Gupta’s conversation with Dr. Lisa Sanders, tune in to “Sanjay Gupta M.D.” on CNN at 7:30 a.m. ET, Saturday-Sunday.


Filed under: Cancer

April 23rd, 2010
11:49 AM ET

First full face transplant successful in Spain

By Elizabeth Landau
CNN.com Health Writer/Producer

Doctors in Spain say they have performed the world's first complete face transplant  according to European news agencies.

The patient, a man injured in a shooting accident, had been unable to breathe or swallow, and had difficulty speaking, the BBC reported. He was a farmer who shot himself in the face in 2005, the Times of London said.

He had undergone nine failed operations before being considered for the transplant, the BBC said.

The transplant operation took place in Barcelona in March, but the details were just announced. The patient received cheekbones, nose, lips and teeth from a donor.

The medical team's leader, Joan Pere Barret, told a news conference that the patient was satisfied when he saw his new appearance. He has scars on his forehead and neck, but they will be concealed in the future, Barret said, according to Spain's El Mundo.

Although this is the first total face transplant, there have been partial face transplants in France, the United States, China and Spain. The first was when doctors operated on Isabelle Dinoire in Amiens, France, in 2005. She had been mauled by her dog.

In 2008, the United States had its first-ever near-total face transplant. Connie Culp, injured by a bullet in 2004, received the nose, upper lip, and cheekbones of a donor in a 22-hour operation at the Cleveland Clinic. Read more about Culp's case

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 22nd, 2010
03:30 PM ET

Migraine relief on the horizon?

By Caitlin Hagan
CNN Medical News associate producer

A cutting-edge treatment for migraines is in the final stages of development and may be on track for regulatory approval within the next few years. Telcagepant, a drug manufactured by the Merck Corp., seems to relieve headache pain without causing vasoconstriction, or the narrowing of blood vessels.


The current class of medications used to treat acute migraine pain causes blood vessels to narrow – vasoconstriction - as a means of relieving the headache. Because of that, the drugs, known as triptans, are not recommended for any patient with a history of coronary heart disease or risk factors such as hypertension.

Telcagepant would be the first safe therapy for migraine suffers who also have risk factors for cardiovascular disease.

"Imagine patients who are 45 or 50 years old who have had a single heart attack in the past so I can't give them anything for their migraines," says Dr. Timothy A. Collins, a neurologist at the Duke University Medical Center who is not affiliated with the development of Telcagepant.

"[This medication] would allow us to treat a previously poorly treated population."

Telcagepant has performed well in clinical trials when used as an acute treatment. But early last year Merck abruptly ended a clinical trial testing Telcagepant as a preventive medication because some trial participants developed liver problems. The company is currently establishing protocols for another safety study that will look at whether there are underlying issues when the drug is taken to relieve pain. The results of that study will determine whether Merck begins the regulatory approval process to get the drug approved for general use. There is no guarantee that Telcagepant will be approved.

Experts agree that if the drug were to be put on the market, it wouldn't replace triptans as a migraine therapy, just add to the list of available medications already on the market.

"For acute therapy of migraine in patients with coronary heart disease, we have anti-inflammatory, we have narcotics - which no one likes to use - and we have older drugs that cause worse vasoconstriction than triptans," says Collins.

"So for there to be a non-narcotic that doesn't cause vasoconstriction, this would be very significant change in the market for what we have to give patients." Collins advises migraine sufferers not to wait for Telcagepant to get approved before making an appointment with their doctor.

"Only half of all people with migraines talk with their doctors and only half of them get prescriptions for their headaches," he says.

"Ask your doctor for something to stop headaches that isn't a narcotic and if you have more than two headachse days a week, talk about migraine headache prevention medication."

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 22nd, 2010
02:39 PM ET

Reader comments about older moms

By John Bonifield
CNN Medical Producer

Today CNN senior medical correspondent Elizabeth Cohen and I wrote about women in their 40s having kids. New CDC numbers say women over 40 are having babies at rates we haven't seen since the 1960s. Younger moms under 40 are actually having fewer babies than previously. One expert we spoke to about this trend told us that whatever can go wrong goes wrong at an increased rate for women who are older and starting a pregnancy.

CNN.com users have been weighing in on this topic. Here's what some of them have been saying.

"The risks are real"

Despite the risks, many users say it's possible for women over 40 to have a health child.

"I had my last child at age 40," one user comments. "There are naturally fewer women having babies after 40, so percentages of babies born may seem higher, but in reality one can still have every bit as healthy a child as a younger person."

Another user writes, "I had my daughter at age 42 (she is now 4) and she turned out just fine. The pregnancy was extremely difficult compared to being pregnant and giving birth to my first child at age 23. The risks are real, but with proper care mother and child can be delivered safely."

"I am a better parent"

There's also been disagreement among users about whether older mothers make better parents than younger moms.

"I think I am a better parent than I would have been in my 20s," one user says. "I do not agree that a couple in their 20s would be better parents. They may be physically stronger or live longer, but will they stay married? Will they feed their kids junk food, mostly because they haven't yet figured out how to eat healthy themselves? Are they emotionally ready to selflessly give up their own lives and make another life the most important?"

Other users say comments like that are a little judgy.

"A person at any age can be a good parent, just as much as they can be a bad parent," one user writes.

"I'm running on fumes"

Some older moms have been weighing in about how much energy it takes to raise their kids.

"The hard part is being 54 like I am now and having a soon-to-be 11-year-old who has boundless energy and goes 24/7. I need to dig deep to the reserve tank when I'm running on fumes in order to be there for him. It's not easy. But I have no regrets," one mom comments.

Another mom says, "We are healthy and active but can be hard to keep up with 2 very active boys."

One mom credits her boys with keeping her young.

"Having to keep up with them, play sports with them...has kept me more fit than most women my age," she says.

"The baby I lost"

Some users are commenting on the heart break over high-risk pregnancies that didn't go well.

"I had a miscarriage at age 40, and though I had a beautiful daughter a year later (she's almost eight now), the baby I lost will always be a sad spot in my heart," she says.


Filed under: Fertility • Parenting • Pregnancy • Women's Health

April 22nd, 2010
01:15 PM ET

What are good non-meat sources of protein?

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 BLOGGER, DAWN:

"What is the most effective way to get extra protein without meat, chicken or fish in my diet?”

Answer:

Dawn,  I can tell you, it is a myth that you need to get all your protein from a meat source. And that rule of thought is something that a lot of people have, so I appreciate you reaching out to me to ask this question. There are many alternatives and ways you can incorporate extra protein in your diet.

First let me explain why it's so important for your health. A diet rich in lean protein is going help build muscle and bone mass that adults start to lose as we age. It is going to help prevent arthritis, and overall it is going to help you maintain healthy skin and organs.

Some of my favorite foods that are high in protein are nuts, soy products and even tofu. Yes, I know many people like to scrunch up their nose when they hear tofu but give it a try! Add it to some stir-fry; add a little sesame oil for some good flavoring. Also, check out the nutrition labels on some of your favorite low-fat dairy products. A cup of cottage cheese has 28 grams of protein; yogurt has 11 grams.

Another question that comes up quite a bit is whether protein shakes are also a good choice. I think they are potentially a good option when it comes to trying to improve your protein stores. However, you want to make sure to examine the ingredient label carefully. Let me give you a couple of quick tidbits when it comes to protein shakes. Look first at the type of protein in the shake. If the source of protein is an animal source (egg whites, whey, milk protein) or a soy protein, it can be considered "high quality" protein. And make sure the type of protein is the first ingredient listed and that it doesn't contain a laundry list of ingredients. The more ingredients, the less real protein it contains. A little rule of thumb to remember is that protein typically has about 4 calories per gram so if you're seeing a lot more than that in a particular shake, you're probably getting a lot of added stuff.

How much per day? Women over age 18 should consume about 46 grams of protein a day; 56 grams per day for men.

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 20th, 2010
06:07 PM ET

Many who think they’re lactose intolerant aren’t, panel says

By Trisha Henry
CNN Medical Producer

30 to 50 million Americans fear they are lactose intolerant. But are they?

According to a new report, many people who think they're lactose intolerant may not be

According to a new report, many people who think they're lactose intolerant may not be

Most people have some degree of difficulty digesting dairy, experts believe. One recent report suggested that the symptom trigger was not simply consuming dairy, but specifically the amount and the form.

The symptoms of lactose intolerance - diarrhea, abdominal pain, gas and/or bloating - occur after drinking or eating milk products. While most babies are born with enough of a specific enzyme in the small intestine to digest milk, this decreases and levels off as we mature into adults. You shouldn't have more symptoms at 60 than at 15, assuming your diet stays the same, says Dr. Marshall A. Wolf, a professor of medicine at Harvard Medical School.

A 14-member panel, organized by the National Institutes of Health Consensus Development Program, looked at more than 35 studies. The experts were surprised to learn that many people avoid drinking milk in fear of getting sick when their stomachs could most likely handle more than they think. People are self-diagnosing based on previous symptoms or their family and ethnic backgrounds without actually getting a diagnosis from a doctor, the panel concluded. The bottom line: People who think they are lactose intolerant need to consider whether they are getting enough nutrients before cutting milk from their diet. The panel also found that limiting consumption of dairy foods containing lactose can leave many people without the necessary amount of calcium and vitamin D important for bone growth, and can lead to osteoporosis and other adverse health outcomes.

"Many people, having observed symptoms of lactose intolerance, assume they are allergic to milk and therefore avoid it completely,” said Wolf, a member of the panel. “But it turns out, it's not an allergy, it's a quantitative problem. Even those without the necessary enzyme can digest small amounts” of dairy.

However he does say that there is still a lot to learn on this topic. "Theoretically, if you replace the nutrients you get in milk with other food sources, you probably would end up neutral but we don't know that."

The report suggests that lactose intolerant consumers should not be afraid to start incorporating more dairy into their diet. One tip, the experts say, is to drink milk at different times throughout the day rather than all at once. Also, eat or drink dairy products with other foods. The report also recommends yogurt and cheese as a better alternative to milk.

Visit the Consensus Development Program http://consensus.nih.gov/ to read more about the report.

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 20th, 2010
04:04 PM ET

Fit Nation participant dishes on tri tribulations

For the past three months, six CNN viewers have been training to compete in the Nautica New York City Triathlon on July 18th in Manhattan.  Stanley Saballett, one of the six competitors, checks in during one of his training sessions in the great outdoors. 


April 19th, 2010
04:19 PM ET

Indoor tanning linked to addictive behaviors

By Georgiann Caruso
CNN Medical Associate Producer

Indoor tanning among U.S. college students is linked to addiction, anxiety and substance use, according to a study released today.

Researchers polled more than 400 undergraduates ages 18 to 25 in the northeastern U.S, almost half of whom said they used tanning beds. The researchers, using language similar to screening quizzes for alcohol and substance abuse, asked the respondents about their indoor tanning as well as their use of alcohol and other substances. They found that people who tanned also tended to use alcohol and marijuana; they were also more likely to experience symptoms of anxiety. The authors noted that "repeated exposure to UV light” may have results similar to those often cited by substance abusers: relaxation, increased socialization and improved moods.

They suggested more study of a short anxiety and depression screening for those who participate in indoor tanning.

“Treating an underlying mood disorder may be a necessary step in reducing skin cancer risk among those who frequently tan indoors," the authors wrote.

Dr. Darrell Rigel, past president of the American Academy of Dermatology and now clinical professor of dermatology at New York University, agreed. “We haven't convinced people in theory that 100 percent of people should be wearing sunscreen and 0 percent of people should be going to tanning beds. …Maybe the reason our current strategy is not working is because tanning is an addictive behavior. If that's true, then we have to attack the public's perception of this just like we would attack alcoholism and drug use. We have to bring in behavioral scientists who are addiction experts to come up with a better plan to deal with this issue.”

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 16th, 2010
05:49 PM ET

3 questions with Jamie Oliver

If you still think of Jamie Oliver as The Naked Chef, you have some catching up to do.

That show gave Oliver his start, but he has since become a crusader for healthy food for schoolchildren. Starting in a school cafeteria in the Greenwich section of London, Jamie’s campaign to change the way British schoolchildren eat took him all the way to the halls of Parliament, resulting in the British government committing 650 million pounds to improving the school food program.

Now, Oliver has turned his attention to the United States – and in particular, the town of Huntington, West Virginia, deemed the most unhealthy community in the country.

A series of six shows detailing his work in Huntington titled “Jamie Oliver’s Food Revolution” is airing now on ABC. Sitting down with Oliver, CNN’s Dr. Sanjay Gupta had a chance ask him about his goals:

Gupta: The average person comes into a grocery store here in the states to buy food. Are we doing something wrong?

Oliver: I think one of the problems that we've got is, generally speaking soft drinks, in my experience are being consumed instead of any form of water. Snacking is just an unpoliceable meal – it's just whenever they want, and rarely has that much food nutrition. Really, it normally is largely based on sugar. And the meals, when you get around to them, will either be a [take-out], delivery, or processed boxed foods. There's nothing wrong with nugget per se, there's nothing wrong with a burger per se, it's normally when you get the cheaper versions, they've got all the other bits in them as well. I mean, something like a burger can be four ingredients but why is there 40?

Gupta: The thing I keep coming back to is that nobody wants to do wrong by their kids I don't think, so where is the problem here? Is there someone who wears a black hat in this whole thing?

Oliver: No I think the black hat to be worn is in education. We haven't done enough in England or America about food education for 30 or 40 years. If you understand the basics of food from an early age – if you have an open-mindedness about food because you've been exposed to a lot from an early age, then it allows you to make different decisions as you grow older and have your own kids. The families I've worked with that have massive problems – they don't not love their kids – they love their kids – they know they're all obese including themselves and they know all the problems – they've seen all the statistics, but they haven't got the tools to sort of shop or cook their way out of it really.

Gupta: People say they don't have time, people say they don't have money to eat well.

Oliver: Shopping is where you're going to spend the second-largest amount of money in your own life – other than your own house and your kids- but shopping is a massive bill in your annual spend. The families I worked with [spend] $150 a week. That's eight grand a year, and that's proper money. That is buying versions of all of these things- buying cucumbers, we're buying lettuce, leeks, potatoes. There are little tricks you can do in supermarkets: The minute they bag it up and grate it, they're gonna charge you for it. The minute you take erratic sizes, it'll be much cheaper. Whatever's in season and local will be cheaper and of course when they're doing deals and bargains – buy one, get this free – you might not want free. What's the point in buying them if you don't want free in the first place?

To see more of Dr. Gupta’s conversation with Jamie Oliver, tune in to “Sanjay Gupta M.D.” on CNN at 7:30 a.m. ET, Saturday-Sunday.


Filed under: Body Image • Children's Health • Weight loss

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About this blog

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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