in coach asked for this self-y. she did it to bring attention to the troops. betty wagner hospitalized with alzheimer's had been wearing her diamond ring for 67 years, but a few days ago, someone snatched it from her finger. police officer lori graber went to the hospital to file a theft report and saw the loving gazes between betty and her husband. she bought a new ring for betty and left it at the hospital with a note that read, a promise kept for 67 years is worth something. i'll be back at the top of the hour. right now, keep it here for sanjay gupta, m.d. >> thanks for joining us today, in a few minutes, we're going do talk about the increasing frequency of botched plastic surgery operations. i grew up watching joan lunden, she's the woman who co-hosted

good morning america for 17 years. i'm a big fan of hers. she's one of the gracious and most sweet people i've been lucky to know. it was a punch in the gut when we heard this week that she's been diagnosed with breast cancer. on thursday, joan had her second round of chemo, and today she's joining us to tell us the whole story. welcome to the program. >> i'm happy to be here with you. >> thank you, like i said, big fan, love watching you for so many years. how are you feeling? >> you know, i'm actually feeling great. i'm almost a little surprised how great i'm feeling. i do understand that there will be a cumulative effect. but i started the chemo right ai with a, i thought it was very important to not be paralyzed but to jump into action, get a lot of opinions, which can be very confusing, and put a team together. that's what i did. i've been very proactive. and that's kind of kept --

that's put me in the right frame of mind. >> and you're known for that, you -- with your healthy living and your advocacy around these issues. i want to talk about the confusion you describe in a second. how did you hear -- how did this all sort of transpire. did you get a phone call ultimately after the exam? what happened? i get my mammogram every year, and as soon as they started doing 3-d mammograms i paid the extra money and got that, even though it's not covered by insurance. i figured, go for the best. i was told years ago, i have dense fibrous breast tissue, like a lot of women do, and that makes it very difficult to see things in a mammogram, and i should always follow it up with an ultrasound. this year i came out of my mammogram they said, you're all clear. i'm all happy go lucky, one more year i beat it. even though i never really expected to get it, but you always hold your breath.

every woman holds your breath, not just while the mammogram's happening, we hold our breath in the lobby, while we're waiting. the ultrasound she kept going back to one spot. they brought in a radiologist, you'll have to do a core biopsy. they did, we'll have to send this out. my husband went back with me, and i knew the minute the doctor walked in the office. you could tell by her demeanor. and she said, you definitely have breast cancer. and i immediately went to a cancer surgeon that she recommended and my gynecologist -- i called a few places, got a recommendation so i could learn more. and by the time i got to her, then i learned what the pathology was, and i learned that i have something called triple negative. this didn't come about from estrogen or proguesteren.

this is a subset. breast cancer, you think of it as one thing. every woman has a dinner kind of breast cancer, as far as the pathology, where it is, and you really need to get a lot of opinions, which is scary. these brilliant doctors sometimes disagree with each other, you have to at some point put your hands -- put yourself in the hands of a team, and decide what's best for you, and because -- i want to make this clear, because i mean, i've got so many thousands of people writing to me on twitter and facebook. what i say i'm doing, doesn't mean that's what you should be doing, you can't do exactly as your mother did or your sister did or your friend did. every woman's breast cancer is different. >> one thing, again, and this is more of a psychological question. i remember my mom went through this. she wondered if she had done something wrong to bring on the breast cancer. and it was a heartbreaking thing

to hear from her. how can you be blaming yourself. >> i think most women do. i think we say we must have done something wrong. and i -- it was compounded for me, because i was afraid if i come out with this, everyone's growing to say, oh, sure she's a health advocate and then she goes and does this to herself. one thing i learned is, these things just happen on their own. especially mine,ei triple negative. i don't think they completely understand how it comes about. it's not fed the normal ways through hormones. and i was scared that people would think i let them down. and that made coming out with it, but i'm going to be perfectly candid, in the first two days or so, i just wanted to go away somewhere, and not let anyone find out. i also felt like i didn't want to tell the kids, because my younger kids would be worried. we were advised by everyone, that that was really a mistake,

my husband knew it was a mistake. he owns summer camps for the children. he always says, you have to be honest. keeping family secrets bring up issues later in life. my little ones are little, i have twins who are 11 and twins who are 9. you do it in kind of an age appropriate well. they seem to be doing well with it, fortunately i was able to end that conversation with. because i caught it early my prognosis is excellent. so while i'm going to have to have all this medicine and the surgery, by the end of the year, it will be gone. >> well, joan, i'm so delighted you joined us and talked about this, and so many fans out there, after all these years, we're still getting great advice from you, i appreciate it. >> thanks. >> thanks for being here. >> my pleasure, sanjay. i want to turn now to dr. montgomery rice. she's counciled a lot of women on the issues we were just talking about.

welcome back. >> thank you. thank you for having me. >> i know you're a fan of joan lunden as well. >> yeah, we talk about 1 in 8, 1 in 8. i'm hanging out with my girlfriend girlfriends, there's eight of us. one of us will be diagnosed with breast cancer. >> topics we talked about before. her breast cancer was not picked up on a mammogram. that's a screening test we commonly talked about. she had an ultrasound that ultimately found this. what do we learn from that? >> women, particularly younger women have more dense breasts. when we think about the 2-d mammogram that we customarily use, we understand that, you know, there are a lot of false positives and it wasn't as sensitive, ultrasound is what we used next to sort of get through some of that density, we have a lot of false positives, we're

seeing the technology that's come out, the 3-d mammogram. using the same type of radiat n radiation, it's able to look at the breast in different layers, like you think about 3-d, and able to really sort of take what may be an image and sort of look at it from all sides and all arcs and we can then now see more of really what is a mass, so definitely ma'mmography has impro improved. >> is 3-d mammography better, should women get 3-d ma'mmograpy now. >> it's still experimental. there's probably one in every state, is what i read. there's a big study that came out that a 3-d mammogram, looking at 400,000, they had about 200,000 of those, had the digital mammogram, and had the 3-d, and it had 15% lower race of false positive, and about a

30% overall increased chance of picking up the breast cancer. >> it's better weeding out things that weren't cancer? >> yeah, exactly. >> joan mentioned insurance didn't cover it for her. it's not been approved in that way yet, what should a woman do? women are going to hear the story of joan lunden and say, she got a mammogram and didn't find it, she got an additional test. if a woman gets a normal mammogram, how much solace and comfort can they take in that? >> we have to continue to look at the technologies evolving, we still are aligning with the american cancer society. doing your mammograms every year at age 40. self-breast examinations starting at age 20, doing it every month. no one would know your breast better than you as a woman. no one would know that, when you feel something suspicious, go to your doctor. if you have a family history, we started doing more sophisticated screening earlier, we may add the ultrasound or you may get

the recommendation for the 3-d mammography. at this point we cannot make any different screening recommendations based on the information. but we are hoping that we're going to see more research, and that women are going to continue to ask these hard questions of us. looking at tests, what's the best way for me to be diagnosed sooner. one thing that joan said, the sooner you're diagnosed, get into treatment, the higher your chance of having a great success story to tell. >> and everyone's different? >> everyone's different. getting a second opinion, even as a physician, and i know good doctors. i would always get a second opinion. >> i'm glad to hear you say that, i get asked all the time. it's not offensive. i think it's a good thing. always a pleasure to have you on the program. always learn a lot. thank you so much. >> all right. when we come back, plastic surgery gone wrong. 50 million operations a year, what happens when it's truly botched with some serious

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medications you are taking, and if you have kidney or liver problems. using invokana® with a sulfonylurea or insulin may increase risk of low blood sugar. it's time. lower your blood sugar with invokana®. imagine loving your numbers. ask your doctor about invokana®. more than 15 million cosmetic plastic surgery procedures are performed in the united states alone. most of the time, patients turn out just fine. a new show brings to light what happens when plastic surgery goes terribly wrong. i want to warn you ahead of time, some of the images you're about to see are pretty graphic.

>> i feel like frankenstein. >> at the end of the day i still have a deformed nose. >> i got a tummy tuck 13 years ago, and my coochie is on my tummy. >> how many surgeries have you had on your nose? >> six. >> i lost faith in anybody making it better. >> i made incisions through the bottom of the areola. the first thing i found is the implant was upside down. >> surgeons on the e! network on the tv show "botched." they join us now. >> thank you for having us. >> how did this come about, this idea of doing a show about operations that had gone wrong? >> we've been plastic surgeons for a long time. we practiced together in the beginning of our careers. and i don't think people really realize that plastic surgery is like all other forms of surgery.

there are risks involved and complications. in this country you're seeing a lot of nonboard certified plastic surgeons or doctors with no training in plastic surgery, and there is some really serious complications that come about as a result of that, so we thought it would be a great idea to show all the problems that happened and how to fix that. >> it's amazing, i went through the board approval process for neurosurgery a few years ago. i was struck by this. a lot of hospitals don't actually require someone to be board certified, they should be board eligible. it's a much more fragmented system than people realize. what is a complication versus a patient being unhappy with their result. how do you distinguish these things. >> even though we talk about informed consent, we tell every

patient you're looking at a scar, swelling, bleeding, the usual. it's like you tell your patients, however, with cosmetic surgery, sometimes patients may have buyer's remorse or even when you try to communicate with them well in regard to realistic expectations, it doesn't meet their needs and it can be unhappy. there's really two different things. >> the most common plastic surgery is breast augmentation. the most common result is scarring. it presents pain in 30% of the cases normally. >> i get this question all the time, i'm sure you guys do as well. can i please recommend a doctor or specialist for xyz, whatever it may be. if someone is saying, look, how do i find a plastic surgeon who i'm least likely to have a complication with, most likely to give me a good result. besides going online and reading what you can find there, what do

you recommend? how do you find people who you think are really credible and are going to likely do their job? >> i think you first of all, want to look for basic things like board certification, goodin sadding with the local medical board. you want to do some research online, and you have to be careful, there's a lot of reviews where patients are unhappy because their expectations weren't met, go to their office, look at their before and afters, get a feel for their practice, see if you can potentially talk to some of the patients. >> yeah, i mean, that's actually one of the biggest things we do, we'll actually screen the patients to make sure they're good for us. when they come in, after they found the right doctor, we want to make sure they're realistic, if they're not, we're not going to have a good outcome, the relationship is going to be in trouble at that point. >> i always tell patients, i should talk to the nurses as well. sometimes residents, if you're in a teaching hospital. >> oh, yeah, we sure do. >> we give us a real peek behind

the curtain at sometimes awful situations, but hopefully situations that are fixable as well in many cases. just watching that teaser reel, it's hard to take your eyes off of it, i wish you luck. >> we really appreciate it, thank you very much. up next, tlc reality show stars are heading to capitol hill. fighting for a fix they say will help seriously ill children. when folks think about what they get from alaska, they think salmon and energy. but the energy bp produces up here creates something else as well: jobs all over america. engineering and innovation jobs. advanced safety systems & technology.

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three million kids around the country have complicated medical conditions, often times requiring specialty care from

various doctors. what happens, many of these kids end up visiting one of 250 children's hospitals. there are tests that are repeated, procedures that are unnecessary and all of this can be a drain on families, both in terms of time and money. >> the doctor's going to do tomorrow, see if you have a heart rate there. >> it doesn't have to be like this. you may know her as half of tlc's the little couple. >> how are you? >> she takes care of premature babies at texas children's hospital. >> how did henry do overnight. >> not only that, she spent much of her own childhood going to doctor after doctor after being born with a form of dwarfism. her surgery for cancer was complicated because of her dw f dwarfism. but today she's in remission. this week she went to capitol hill to lobby for a bill that

would better coordinate medical care for children. >> and dr. arnold joins me now from capitol hill, welcome to the program, doctor. >> thank you so much. >> you're making rounds on your patients and capitol hill. talking to lawmakers. what are you telling them? how are you presenting the case he here. >> i'm really excited to be here, because we're advocating for the children's ace act. we're advocating, advancing care for exceptional children. we have a lot of children right now that regardless of whether or not they live in a city that has a children's hospital, may not have good access to that care, and medicaid funding, the majority of these patients are on medicaid care, they -- medicaid support depends and varies depending on the state you live in. one of the things that we found would be most challenging.

since i work at a tertiary care hospital, we have patients that do come from those cities that don't have children's specialty care, when they come to us, we don't have access to their records, their films, we have to repeat ct scans, other imaging, and we have trouble just coordinating the care for when they go home, so the doctors and nurses that are close to them, are able to manage things when they're not in our care. there's really a need now as this population of children is growing exponentially to have better coordination of care and a medical home. >> we're talking about things that could be addressed if the system were more coordinated. you have two of your own children that need specialty care. if what you're pushing for goes through, how does your life change, especially with regard to your own children? >> well, you know, i think it's going to change dramatically for medicaid patients.

the majority of the patients i care for as a physician are under medicaid, it really does help to bridge care for those medically complex children out there that don't otherwise have insurance, private insurance or commercial insurance. for my kids, it's going to really help them better coordinate their care, i don't have to kworry about our orthopedic surgeon in delaware getting the information he needs. for me, for example, as of late, our insurance company told me they're no longer going to support us go to due upon. that's scary for me, because i know the experts are there. not all families have this knowledge, having this networking and children's hospitals working together, it becomes known, so families can go -- you know, they're free to travel to delaware for one thing, and texas for another

because that provides the best care for their baby. >> thanks so much for joining us, appreciate it. >> thank you for having me. it's a pleasure talking to you, thanks for your time. that's all the time we have. cnn newsroom continues right after a quick break with randi kaye. okay, listen up! i'm re-workin' the menu.

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