Secrets to Living Longer

Natasha Richardson’s Tragic Death
The New York Medical Examiner’s office has made a statement regarding actress Natasha Richardson. The cause of her death was an epidural hemorrhage due to blunt impact to the head.

Ms. Richardson fell while taking a private ski lesson on a beginner slope, and according to the ski resort, “she [initially] showed no sign of injury, and was talking for about an hour.” She then complained of a headache, at which point she was taken to the hospital and died shortly thereafter.

Her tragic story stunned the nation. How could this happen? Neurologist Dr. Neil Martin, the Chair of Neurosurgery at UCLA Medical Center, joins The Doctors to comment on her sudden death.

Dr. Martin explains that an epidural hemorrhage is a blood clot that forms over the surface of the brain, can enlarge silently over minutes or hours, and is the one kind of problem that can be associated with what is called a lucid interval.

“You have the injury,” the doctor says, “you’re ok for awhile, and then you start going downhill. Increasing headaches, repetitive vomiting, confusion -- and when those signs appear, rapid deterioration into coma can be right around the corner.”

“Because there’s no room in that skull for expansion,” Dr. Travis adds. “So when you start to bleed, it pushes the brain towards one side, and within an hour, you can become brain-dead.” Hear more from Dr. Travis about Ms. Richardson’s death.

“Brain death is death,” Dr. Martin says. “When the brain is gone, the patient is gone.”

“Time is critical in these kinds of circumstances,” the neurosurgeon emphasizes. “The key issue is the pressure on the brain inside the restricted environment of the rigid skull. So if you can get to a patient early enough, before there’s been catastrophic pressure and pressure affects, an epidural hematoma can be removed completely and the patient can be discharged in a week, very often.”

Watch how an epidural hemorrhage progresses

Our thoughts and prayers are with Ms. Richardson’s family at this time.

Warning Signs of Head Trauma
People fall down and hit their head all the time. So how do you know the difference between a bump on the head and something more serious?
• Abnormal pupil size
• Abnormal gaze
• Abnormal behavior – even if it’s subtle
• Drowsiness
• Disorientation
• Vomiting
• Lethargy
• Loss of consciousness

• Slurred or repetitive speech

“If they’re not perfectly normal,” Dr. Jim counsels, “then take them in to the emergency room.”

Robot Docs

The RP-7 robot is a mobile, wireless device that allows a physician to be in two places at once. The robot is connected to the Internet via a laptop computer, and is controlled by the doctor, who can use a joystick to manipulate movements.

Critical care specialist Dr. Herbert Rogove uses the robot in his practice and says, “I can be there, I can examine the patient, and the only thing I can’t do is touch the patient. But I can listen to his or her lungs, heart, console the families, answer questions and be available to the nurses.”

The Doctors agree that the technology is an excellent tool and has many applications in the field of medicine, one of which is allowing residents of rural or remote areas access to specialized and/ or advanced medical care.

“It’s helped me help patients who ordinarily can’t get specialists,” Dr. Rogove explains. “The level of care in this country should be the same, so it [the robot presence] levels the playing field, medically.”


Virtual Brain Surgery

Dr. Martin uses 3-D imaging, developed by UCLA Medical Center, to visualize and remove 52-year-old Sue’s brain tumor, which was the size of a tennis ball. Watch the breakthrough surgery .

The software utilizes a GPS targeting system to locate and remove brain tumors and other abnormalities with minimal invasion to the skull cavity. Dr. Martin notes that he can even download the same images to his phone, which are helpful to view ahead of time if he’s heading into a trauma surgery.

See a demonstration of the 3-D software

Brain Tumor Warning Signs

• Sudden change in vision
• Difficulty talking, walking or maintaining balance
• Weakness in one arm or leg

• Worsening headache

DNA Testing
If someone handed you an envelope that contained all the secrets to your medical future, would you open it? Elissa Levin, a genetics counselor from Navigenics, a DNA testing laboratory, explains that 99 percent of DNA is the same from person to person, and the variations in the remaining 1 percent are what make us unique. Navigenics charges approximately $500.00 to conduct tests using a saliva sample.

Navigenics Tests for the Following Genetic Markers: Celiac disease Colon cancer Crohn’s disease Type 2 diabetes Glaucoma Heart disease Macular degeneration Osteoarthritis Prostate cancer Breast cancer

Hypobaric Pod

Endocrinologist Dr. Karen Herbst has been using a hypobaric pod called a CVAC System , or mini-altitude chamber, in her research on blood-insulin levels.

The pod simulates going up and down in altitude. “It’s like running up and down a mountain 300 times in 30 minutes,” Dr. Herbst explains.

“We think this pod can be used for more than just diabetes,” the endocrinologist continues. “We can use it for aging, for fat disorders and metabolic disorders.”

Early research indicates it aids in the treatment of metabolic function, insulin and diabetes by increasing red blood cell count, hemoglobin and may increase mitochondrial density.

Colon Cancer Colon cancer is cancer of the large intestine, or colon, which is the lower portion of the digestive tract. Most cases of colon cancer begin as small cell growths, or polyps. Though the polyps are initially benign, or non-cancerous, they can develop into cancers. For this reason, it is vital to have regular exams to detect and monitor the growth of polyps.

Elissa from Navigenics says that one-third of the risk of colon cancer is inherited, but two-thirds is caused by lifestyle and diet. The average person has a 5 percent risk of developing colon cancer.

Prevent Colon Cancer

• Have regular screenings
• Limit red meat
• Limit fat intake
• Limit alcohol intake
• Eat plenty of vegetables and leafy greens
• Ask your doctor about baby aspirin
• Eat a healthy diet
• Exercise

Macular Degeneration
Opthamologist Dr. Sanford Chen explains that macular degeneration is a progressive degeneration of a portion of the retina, the macula. The average person has a 3.1 percent risk of developing the disease.

The best way to protect yourself from macular degeneration is to take preventative measures:

• Get regular eye exams
• Protect your eyes: don’t wear cheap sunglasses. Invest in a pair of sunglasses that adequately shields your eyes from the harmful rays of the sun.
• Eat lots of green, leafy vegetables
• Don’t smoke
• Control high blood pressure

• Control diabetes

Learn more about macular degeneration.

Wearable Defibrillator
Heart disease is the leading cause of death in America. A portable defibrillator worn at all times can make the difference between life and death. Patients at high risk of cardiac arrest can wear the LifeVest wearable defibrillator with electrodes attached to their chest, which monitor the heart. If the heart muscles fail, the electrodes send a signal to the defibrillator to shock the heart and stimulate the muscles to beat again.

Dr. Randy A. Lieberman, director of cardiac electrophysiology at Harper University Hospital and assistant professor of medicine at Wayne State University School of Medicine, specializes in the diagnosis and treatment of cardiac rhythm disorders and heart failure. He has been instrumental in prescribing the  LifeVest and says that timely defibrillation is the single most important factor in saving a sudden cardiac arrest victim’s life.

Unicef's Tap Project

Waterborne illness is the second largest killer of children under five. The Tap Project is a UNICEF initiative that helps provide clean drinking water to communities and villages around the world.

March 22 through 28 is designated as World Water Week, and participating restaurants will donate $1 for tap water for children in need. One dollar can provide a child with clean drinking water for 40 days. Click here to see how you can help.

Type 2 Diabetes Diabetes is a disease in which the body does not properly produce or process the hormone insulin. Although there is no cure for diabetes, many serious consequences can be avoided if it is properly managed. The average person has a 25 percent chance of developing diabetes.

How Diabetes Works

When food is digested, it is broken down into glucose, which is then released into the blood stream. The pancreas responds to the elevated glucose levels (also known as blood sugar levels) and produces insulin, which binds to the glucose and shuttles it from the blood vessels into the cells of the body. Organs, muscles and other tissues use glucose as energy.

Without proper insulin regulation, glucose can’t get into the cells and instead builds up in the blood. Not only does glucose cause harm in the blood stream, it doesn’t get to the parts of the body that depend on it for basic cellular function.

High glucose levels can damage the kidneys, eyes and heart as well as increase the risk of heart attack, stroke and dehydration. If left unchecked, high blood sugar degrades blood vessels, nerves and organs.

Type 2 diabetes is the most common form of diabetes. “It’s more of a lifelong accumulation of bad habits such as not exercising and eating poorly,” pediatric endocrinologist Dr. David Geller explains. “It used to be that type 2 diabetes was truly an adult-onset disease. But now, we see that bad habits occur earlier and earlier, so it starts the clock ticking much earlier. We now see type 2 diabetes in teens and young adults.”

The type 2 diabetic’s pancreas still produces insulin, but the body is unable to process it properly. The result is an insulin-resistance, which leaves high levels of glucose in the blood stream. To compensate, the pancreas produces more and more insulin to bind with it and eventually the pancreas “maxes out” and shuts down.

If you find that your insulin levels are elevated or high, or if you are diagnosed as pre-diabetic, it is critical to control your blood sugar levels through changes in diet and exercise. The good news is that if you make these changes, most pre-diabetic conditions are reversible, unlike diabetes. “Consider it a warning sign,” Dr. Geller cautions.

Symptoms of Diabetes
Increased thirst and frequent urination Increased hunger Weight loss Fatigue Blurred vision Dry mouth Frequent urination Nausea and occasional Vomiting Numbness or tingling of the hands or feet Frequent infections of the skin, urinary tract or vagina

Preventing Type 2 Diabetes

• Exercise - make sure to get at least 30 minutes of activity per day
Maintain a healthy weight Maintain a healthy cholesterol level Take a yearly glucose tolerance test Take a yearly fasting glucose test Eat a healthy, balanced and nutritious diet Talk to your physician about a personalized plan Get involved with research! If you’re overweight or pre-diabetic, science needs you. Participants are often financially compensated, and are treated with the most medically advanced programs available to date.

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OAD 3/23/09