it's time for "sunday housecall". joining us as always, dr. marc siegel, associate professor of medicine at nyu's medical center. he's the author of the inner pulse, unlocking the secret code of sickness and health. >> jamie: also with us, dr. david samadi, the vice chairman of the department of neurology. doctors, good morning to boast you. great to see you. >> jamie: i will point out we're all wearing blue because march is colon cancer awareness month. we were all thinking about it this morning. it's the third leading cause of cancer deaths among both men and
women in the u.s. in fact, it's estimated that in 2013 about 51,000 people will die from colon cancer, so dr. siegel, we know a bit about it. we he know we should get checked. what else do we need to know? >> let's start with the fact that we should get checked. that's one cancer we can really check and know what we're finding. we have over 100,000 cases of colon cancer per year and 40,000 erectile cancer. over 80% of this can be prevented if you screen with a simple colonoscopy over the age of 50 routinely. earlier if you have a family history or certain risk factors. why do i want to screen your colon? it's not for colon cancer. it's to look for polyps. they're prett cursor for colon cancer and they're found in 30 to 50% of americans. most never become colon cancer. if i find one, not me specifically, i'm not doing the screening. if they found one and removes it, it dramatically reduces your chances. what else can you do, jamie? you can decrease the amount of red meat in your diet, increase
the amount of fruit and vegetables in your diet. a new study out of harvard seems to show if you exercise more and lose rate, you decrease your risk of developing colon cancer in about 50% of cases because they found, and this is something david and i talk about all the time, a genetic marker. they found a jen domestic marker that in about half of the cases, exercise and diet will help a lot. we need to know that because we want to know which group you're in. so exercise, diet, cutting down on red meat increasing fruit an vegetables. >> jamie: the fruit and vegetables, dr. samadi, is that a fiber thing? >> it's one of the major risk factors as marc mentioned, red meat. it's a big risk factor and low fiber. you want to make sure you add all the fruits and vegetables. obviously a lot of african-americans are susceptible to this. we talked about inflammatory bowel disease and colitis is a risk factor. certainly age up over 50 is the reason we start colon o colonosy unless you have family history.
i want to mention to a lot of people exactly how you know if there are signs and symptoms of colon cancer. that's the question that comes up all the time. it starts with having absolutely no stooms which is what we see with -- symptoms which is what we see with many cancer. you may have it without having any symptoms. the highlight of colon cancer is blood in the stool, and if you see blood in the stool, if it's really dark, it's probably from upper tract, from the stomach. if it's really fresh blood, it's from hemorrhoids, but if it's mixed with stool, that's colon cancer. changes in the bowel habits, simple things such as cramp and abdominal pain, simple things like that, you don't want to dismiss. if you have unexplained weight loss, certainly that's a big one, and finally, anemia. blood loss. if you gradually lose some of the blood, you may be fatigued or tired. make sure you talk to your doctor about this. colon no, sir copy is ocopy is . >> eric: i'm getting mind this
week. everyone unc says oh, man, do you have to do that, you drink that stuff all night. >> eric, here's what people need to know. the colonoscopy isn't the issuing. it's the prep. these days they can put you to sleep if you want. the next thing you know, when is the procedure? you've already had it. the prep is the issue. i urge everyone to go through it. it takes a couple hours. you can have a virtual colonoscopy. >> jamie: they're not as effective. >> i believe if you can have a colonoscopy, you should get it. >> eric: get the colonoscopy. it's important. new information about calcium, brand new study concerning that. it's very important for bone health. new research shows women who take large amounts of calcium, they could be at an increased risk of heart disease and even worse, dr. samadi, what happens if women take too much calcium? >> we've talked about a lot about calcium, important for bone health after 65 or 70 when
you have osteoporosis. calcium and vitamin d become more significant. this study is from sweden looking over 60,000 patients. a long period. what they're finding out is if you're taking over 1400 milligram of calcium, you would increase the risk of heart disease, cardiovascular disease, and double the risk. that's really important. there's a concept out there that more is merrier, and that is absolutely i don' wrong. jamie, you would have a spike in the blood, and a lot of this calcium can get absorbed, but a lot can hit your heart and it affects the muscle and the way it contracts. that can cause heart attack and heart disease. some can get deposited in the kidney and we see kidney stones. too much is not good. anything less than 600 is not good. the range is really between 600 to 800 for calcium. that's the number that you want to take. >> eric: you look at the tablets and see 6 to 800. >> the best way, eric, is diet.
get your vitamin d from the sun, get your calls from broccoli, spinach, dairy food. >> eric: what if you're vitamin d deficient? >> that's where i was going to start. there's an epidemic of vitamin d deficiency. people should know that vitamin d helps you absorb calcium. that's one of the reasons we need it. a lot of us are taking stomach medications, anti-acids which make our stomach less acid i can. you need acid in your stomach. for post menopausal women, especially, i think some need a supplement. i tend to supplement it with vitamin d3 which has calcium in it. that's one way to go. you have to take it on an individual basis. is the patient vitamin d deficient? what are the reasons they need calcium. i completely agree with david on both points. a study shows w below 600 milligrams a day increases your risk of stroke. this study, two times your risk of heart 1400 milligrams. the amount you
get has to be in the right range. >> eric: what about men? >> same thing. i want to follow up with what mac said. there's a lot of marketing out there and hype about vitamin d, and more and more alternative doctors are talking about take 2000, 5,000. they're increasing the dose. you need to talk to your doctor and find out exactly what your needs are. there's no magic number. just 600 to 800 milligrams for calcium and vitamin did is what you need. >> eric: can they find it in the blood? >> you can get blood test and they can check your calcium. >> jamie: i wanted to ask you if you're lactose intolerant. we haven't done this topic in a while. maybe we will. you can't drink milk, you can't eat cheese. i know they have alternative products. do they have as much calcium? you can get it no fortified cereals. >> jamie: you just took away meat in the last discussion. >> there are ways you can get it in diet. fortified cereals. i think you can get it through a supplement provided you don't
overdo it. vitamin d3, a thousand units, doesn't have more than 4 or 500 milligrams of calcium in it. there'if you took that a couplef times a week, provided you were vitamin d deficient. >> jamie: you have to test for vitamin d. >> more is not merrier, that's the big message. don't go and pick up something off the shelf because your neighbor is taking some calcium. >> check with your physician. >> jamie: the sad thing is these lights don't count as getting sunshine. thanks, docs. we have much more. troubling new details on a problem that puts all of our lives at risk, and how more and more doctors could be misdiagnosing a problem that you have or even failing to diagnose an illness in patients who need a diagnose fast. everyone's retirement dream is different;
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>> jamie: welcome back, everybody. the doctors are still here. we've got a lot of great information this morning, and now this. there's a new study that has found that patients are at risk of serious complications, and the reason why may be very disturbing to you because it's missed or incorrect diagnoses coming from their primary care physicians. not our dr. siegel, of course. >> tell you highway i avoid this. >> jamie: why is this happening. >> i want to scar scare people . they found about 190 missed diagnoses or problems in the primary care office, but the study only looked at two weeks later. i've got news for you. a lot more occurs even later than that. this is a pretty common problem, and it goes across the board from heart failure to pneumonia to urinary tract infection to missing prostate cancer to referring to proper specialists or overreferring. you know why it happens? i think it's because doctors don't think outside the box, ball they say here's what i'm looking for. you have chest pain, i'm looking for your heart problem.
they forget about doing a full screening of every patient that comes into their office. >> jamie: do they really have time nowadays, dr. siegel? >> there's a basic examination you can do, jamie. with this time factor you can listen to everybody's heart and lungs and examine everybody's abdomen, take a history. patients can come in and say hey, doc, did you listen to me? what exactly do you think i have? what's your thought process because patients need to advocate more. >> jamie: those two questions can really make a difference without a doubt. >> i think so. the doctor is thinking okay, i thought it was this today, but tomorrow maybe i think it's this, especially primary care doctors. >> jamie: we need -- if there will even be primary care doctors down the road, not that many students go into it. >> that's right. >> here's what i want to ask you, dr. samadi. on the one hand doctors are worried about mall practice and they have to cover themself by doing a thorough exam. on the other hand they have to book a lost patient lot of patie their monthly expenses. >> before we start blaming the doctors for this, i think part of it is because medicine has
become very complicated. we're looking at diseases that have many, many common symptoms, and somebody will come in with chest pain and short of breath. what exactly is it? is it heart disease? is it heart attack? is it pneumonia? is it bronchitis. >> jamie: acid reflux. >> exactly right. it could be a triple a, aneurysm of the aorta. a lost disease have common symptoms. it's our be work as a detective to narrow it down. how does that work? we used to have better communication skills. over time exactly what jamie said happens. time are getting shorter and shorter. the average time doctors spend with a patient is seven minutes. during that seven minutes you go through our soap notes, subjective objective assessment plan, come up with the whole diagnosis for this poor guy that's sitting sitting in front of us that's waiting for three hours in the waiting room and seven minutes in the office. on top of that they come up with this whole electronic medical record. you've heard of this, so instead of paying attention to our patients, everybody is typing
and not even seeing the interaction. >> jamie: not everybody. >> well, in general, this is the pressure on the doctor. that's the system. i think what we should do is patients should come in more prepared. they should get all the forms ahead of time. they should give the doctors all the information they need, and ask the question what is your concern, doctor, and have a communication. that cuts down on some of the mistakes we're seeing. >> one final point is one of the ways you deal with complex symptoms like david is saying, chest pain, abdominal pain, something that can have a lot of possibilities is you order it in your brain about what are the ones you woul worry about the m? you rule out the heart first if it's chest pain. if it's the abdomen, you want to rule out something like a surgical emergency. you try to order it in terms of biggest risk. >> jamie: repeat the two questions you say to ask. >> what are you thinking, doc, and what are you going to do next to try to figure it out. >> eric: good point. go see your primary care person at least once a year so they know who you are and have that communication. >> jamie: that's a good idea. >> eric: did you hear about this last week, new research about a healthy diet that they say
works. we've heard a lot about the mediterranean diet. what it is, how do we do it. it doesn't involve a lot of meat. >> jamie: you gave it away. >> eric: all that good fish. we'll tell you about that coming up. look, if you have copd like me, you know it can be hard to breathe, and how that feels. copd includes chronic bronchitis and emphysema. spiriva helps control my copd symptoms by keeping my airways open for 24 hours. plus, it reduces copd flare-ups. spiriva is the only once-daily inhaled copd maintenance treatment that does both. spiriva handihaler tiotropium bromide inhalation powder does not replace fast-acting inhalers for sudden symptoms. tell your doctor if you have kidney problems, glaucoma, trouble urinating, or an enlarged prostate. these may worsen with spiriva. discuss all medicines you take, even eye drops.
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>> eric: back now with the doctors. we've heard a lot about it, the med terrainan diet. what is it? >> this is one of the most important segments we're doing right now. the new england journal of medicine study coming from spain looking at 7500 patients, follow up of five years. this is the first time. a real landmark study that shows mediterranean diet shows reduction in heart disease by 30%. that's significant because all the statins we give to patients only helps by 25%. all these studies about diet and food and nutrition and heart are all observational studies except this one which is a really good randomized study. i like dr. martinez from spain who has done an amazing job. what are we talking about, you ask? we're talking about extra virgin olive oil, we're talking about
salmon, fish, nuts are absolutely great for you, fruits and vegetables, and really replace and push all that red meat and processed meat out of your diet. what you do is you don't want to have a drastic change. you want to do it very slowly, but this is a very significant and exciting one, and i encourage a lot of people to really start doing this. >> eric: fish, chicken, turkey? >> jamie: they left something out. you're in spain and not drinking red wine, sangria? is that okay? >> well, let me tell you about the study a little more. the study had three groups. the first group they took people -- these are people at high risk of heart disease. high blood pressure, high cholesterol, many on statin drugs. they had family history. they smoked. they said what can we do to improve things? one group they gave nuts to, walnuts, hazel nuts, almonds. the third group they gave a low fat diet. that was the control group, by the way.
there's a problem which is they didn't get exactly the low fat diet they were supposed to get and they didn't get the fish that the first and second group got. it's not a perfect study, but i actually like it also the same as david does. i think it adds more evidence to the fact that fish, that omega threes, that nuts, that olive oil and even more important, jamie, cutting down on red meat, cutting down on the dairy like we said in the first segment, eating more fish and poultry, all of that improves life span and decreases your risk. in this study it was mainly stroke you had less risk of. other studies have shown less heart disease. i think it's the ticket. >> eric: have chicken and fish instead of the meat. nuts, you don't want salte saltd nuts. >> that's right. eric, what's important about this is they actually stopped the study in the middle because the results were really, really significant. that's really important. this is not one of these observational studies that we're bringing to you. it's the real deal. i want tea people to pay attentn
to this. start not dripping the bread in the olive oil. add it to your salad and nuts and stick to a healthy diet. that's more important than exercise and taking some of these statins. >> jamie: dr. colby weighing in. cut the stress if you can. we're going to go. a topic we're interested in, eric, too. thank you both for that. also, when you have your next birthday, there's really no reason to stress out. we have really good news for you because scientists now say 72 is the new 30. that's next. i have a cold, and i took nyquil, but i'm still stubbed up. [ male announcer ] truth is, nyquil doesn't unstuff your nose. what? [ male announcer ] alka-seltzer plus liquid gels speeds relief to your worst cold symptoms plus has a decongestant for your stuffy nose. thanks. that's the cold truth!
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