>> eric: that time on sunday for "sunday house call," joining us as always is dr. marc siegel associate professor of medicine at langone medical center and the author of the book "the inner pulse." unlocking the secret of sickness. >> jamie: keeping us healthy, too and dr. david samadi, the vice chairman of the department of urology, chief of robotics at the mt. sinai medical center. great to see you. let's get healthy. the first topic is important for so many folks. a startling reality affecting 1 in 8 american couples. and it is infertility and health experts now raise red flags

about the diagnosis, specifically for women believe it or not in their 20s, doctor, tell us, why women in their 20s. >> actually when people are at the age of 40, 67% of them can still have children which is amazing and 45, goes town to 15%, and we are tending to overlook young women as you said, jamie and it turns out that 11% of women under the age of 30, can't conceive. they tried for a year, that is the definition, if you try for a year and are not able to have a baby then it is designated as infertility and here's the good news. for young women there is usually a reason and we can find out the reason an older women it may be the eggs are aging and they don't work as well and for young women it is often hormonal or your tubes are blocked or you have a problem with polly cystic ovaries or you are exercising too much, vigorous exercise, smoking or alcohol, we can get to the bottom of it and i encourage people and it happens where i'll taking care of both

sides of a couple, get married and try for a year and panic, maybe thinking of in vitro fertilization or a drug to them help but the key is to look for those underlying problems and underlying reasons and the other thing is. that it is not always the woman. at least 40% of the time its the man that is the problem and, david, you are the expert in this. so... >> infertility, thank you, marc. look, the bottom line, simple way of thinking about infertility is that mr. sperm and mrs. egg have to get together and, have one year of unprotected sex to be able to produce the magic kid, that is a definition of infertility and now we look at the female part and i think to cover a little bit, the first thing you need to know, for females is to get a blood test and look for something called fsh, follicular stimulating hormone and, if the mark is high and the aentsz

mollarim is low, that is a sign of infertility of women and for men it is something else -- i apologize for throwing the names out here. >> jamie: you are looking directly at me and i know i don't have that! >> dilated, big veins around the testicles, increases the temperature and in urology, we talk about food -- it almost is like the sperm pops like popcorn in a microwave and the best way to do it is to ligate the veins and, the other thing is -- sunday morning show, we look at... >> eric: the quick point to talk about, you know, warmth. for a man and that is not good. >> temperature is not good, one of the reasons why getting into

sauna, you know, hot water, all of that really causes the sperm not to work well but, you know, basically, you have to look at the female and men to really put it together and find out what it is. >> what about boxers versus jockeys. >> there is no science behind it. >> jamie: if you have an issue, don't blame one or the other, get checked and you told us about two tests they can have and definitely seek someone of your expertise. >> hormone levels. >> eric: and this is enough to stress a guy out. >> jamie: yes. >> eric: before the commercials i asked folks to make a list of what stresses men out. and, you know, topping the list, here the official list, ready? finances. followed by family, and relationships, job stability of course and, just a fast-paced life and, dr. samadi, how do guys and women, how do us guys do with stress more effectively? >> we have had the discussion before and you always wanted to know what does stress do to our bodies? all the things that you mentioned are really the

external forces, that affect our body. how do we fight this and there is a defense mechanism we have spoken about in the past and how do you maker body stronger? and, sleep, for example, is one over those things, because all of the repair in the body happens while you sleep and taking antioxidant and clearing free radicals are the way you defend against stress. now, having said that, the stress affects your entire body, and affects your hormones, and, some of the hormones you have talked about between, you know, fight or flee, epinephrines where it makes your hands sweat and heart rate goes up, it affects heart disease and your heart rate will go up and your cortisone level goes up and breaks down your immune system and the first thing is recognize that you are stressed out. that is the first thing and denying it is a big problem and find a way to deal with it. whether it is yoga, swimming, meditation, talk to other people, and that is the best way to manage stress. >> eric: you can take a time out. why can't guys our age take a time out and say i'm going zen

now and, closing the door. that's it. >> two points, i want to tell you something -- false alarm, about how we don't react well to stress because of the fight or flight response, we build up these hormones in our body and, more epinephrine and adrenaline and is basically bad for our health and the other issue is, there is a difference between men and women, and a study that came out in usc, university of southern california, two years ago, emphasized that point, we men, eric don't deal with emotion well and bottle it up and dote get it out and women are better than men and, i'm afraid, it is a stereotype and we don't go to the doctor or deal with health issues and we worry and as the survey shows, we worry about our finances and jobs and we worry about our relationships but -- >> men try to solve the problems and solve the issues and women, they approach it more emotionally and are able to think about every angle and, we think differently and, there is no question, there is a big difference between men and women when it comes to management of

stress. serving we'll work on that. >> jamie: got everything you need, eric. >> eric: the longer list. >> take a vacation! >> jamie: we'll take a quick break but we'll be right back. coming up, there is a very special interview with the wife of presidential candidate governor mitt romney, speaking about her life with multiple sclerosis. you may not have known that she has it and she'll help a lot of people who do and, she talks to dr. siegel and that is next. >> it certainly does change your perspective on life. i like to say ms has been my greatest teacher. [ music playing, indistinct conversations ] the charcoal went out already? [ sighs ] forget it. [ male announcer ] there's more barbeque time in every bag of kingsford charcoal. kingsford. slow down and grill. syou know, i've helped a lot off people save a lot of money. but today...( sfx: loud noise of large metal object hitting the ground) things have been a little strange.

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romney, wife of governor mitt romney and in an interview our dr. seiegel sat down to talk wih her about ms and the emotional time in her life when she was first diagnosed. listen. >> it was a very dark time in my life when i was first diagnosed and i went into a pretty dark place for a long time and i think the thing that happens, when you have a disease like this it takes everything away from you, for instance i was weak and fatigued and so anything i was doing en my normal life i could no longer do and all of a sudden the rug is pulled out from beneath you and you are left with nothing you go through a phase, who am i and what good am i in the world and i started feeling sorry for myself and had a pretty rough go, it is a very humbling thing to go through and it is pretty dark, and the thing that was

wonderful, and how i got out of that place was really the help of my husband and my children. >> jamie: that was really terrific and, dr. siegel, what else do you want us to know about multiple sclerosis? >> she's actually quite strong and showed a certain courage a lot of my patients diagnosed with that have shown but the biggest problem with multiple sclerosis is you don't know what -- >> jamie: it difference for everyone. >> and nobody knows when the next exacerbation is coming and that is where the fear comes from and she stalktalked about fatigue and inability to think of and, she calls it ms-fatigue, a profound fatigue and in addition you have problems with vision and balance up to 1/3 of people are paralyzed from this, and there is pain involved and it is called the great imitator of neurological diseases because it mimics almost any neurological disease and it was very, very troubling, and is still troubling, but, finally, there has been breakthroughs

over the last several years and we have come to see it as an immunological disease and our own body is fighting against us. the lining of the nerves, milan sheaths, get attacked by your own body and that is why the conduction of the nerves get off and it causes many different symptoms but we're using medications that stave it off, interfer ron drugs... >> jamie: like cancer therapy. >> yes. but there's a lot of side effects to these particular drugs there is one now that actually affectser platelets and we're worried about that and another causes encephalitis and swelling in the brain. >> jamie: can you not treat ms or it always... >> it depends how mild it is. that is an excellent question them. first time it comes on, people have a temporary loss of vision and you give steroids and stop and wait. for most patients we end up offering the treatments i

mentioned but sometimes it is better to wait because of the side effects and she also talked about alternative treatments she has found therapeutic, including riding horses and talks about the love between the horse and the patient. and, it is not just... >> jamie: i have to tell you horses are magical. i love them. but, dr. samadi what is the difference between ms and, let's say, als which also seems neuromuscular. >> they are very similar and as mark mentioned it has to do with the auto-immune disease, your body is going to fight against all of those things and the information doesn't travel fast and they haifa teeing and all of the things we spoke about and over time can even end up in a wheelchair but i want to speak about her character because i think you are looking at someone, she said she went to a dark place, and, you don't know unless -- what it feels like unless you are there and you are perfectly fine and you then

can't walk and you feel tired and the fact she has beaten the disease... it is a chronic disease, and a decade after she has to deal with breast cancer. this is a strong woman who keeps coming back and who supports her family through the tough time, through the politics or through the disease, and, so, that is a great message for a lot of patients and i deal with patients with cancer, and is a great come back and message of hope for everybody out there. having said that, i think what i'm interested in, is really the diagnosis, the difference between the questions that you asked, with ms, the mri of the brain would show some plaque in the white matter. that is the way -- look at the mri and see if they have it and we look at the spinal tap, and, see if the mylan is delegate -- has degradation and it i'm sure she is going to do really well. >> jamie: i would say her faith

plays a big role. >> she is very strong, very strong. >> and congratulations to marc for doing such a great interview. >> thank you. >> jamie: thank you, dr. siegel. >> eric: very, very powerful message. arthritis also affects millions of americans, coming up, new information on one of its most common forms, and a sign that you should be look out for, next on "sunday house call," stay with us. if you have copd like i do, you know how hard it can be to breathe and what that feels like. copd iludes chronic bronchitis and emphysema. spiva helps corol my copd symptoms by keeping my airways open a full 24 hours. plus, it reduces copd flare-ups. spiriva is the only once-daily inhaled copd maintenance treatment that does both. and it's steroid-free spiriva does not replace fast-acting inhalers for sudden symptoms. tell yr doctor if you have kidy problems, glaucoma, trouble urinating, or an enlarged prostate. these may worsen with spiriva. discuss all medicines you ta, even eye drops.

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♪ >> eric: back now with "sunday house call" and the doctors and information on a condition that affects about 27 million americans. it is osteoarthritis. the most common norm of arthritis. some warn it is difficult to diagnose because it can affect people in different ways. dr. samadi, what do i look out for, how do you know if you potentially have it. >> who doesn't have arthritis or a friend with arthritis? it is a common one and the signature of arthritis, eric, is as you work during the day, the pain gets worse, and when you rest, you are relaxed, the pain goes away and that is a signature of arthritis and what is really arthritis? the cartilage between the two bones, really wears off and it is a smarter of aging and unfortunately all of us will get there at some point. and the cardio cushion wears off and the bones start to rub

against each other and they cause pain and the muscles around the joints, whether the fingers or the knees, start to get tense and we look at the symptoms to diagnose arthritis. and over time there will be deformities and you see some of the joints of people that can barely type or hold a cup and surgery is really the way to go. now, a lot of times what we do is, we take care of them with non steroidals, nonweight bearing exercises, yoga, swim and there are some recommendations i have for people, who put it off and herbs, glucosamine sulfate you can take, 750 milligrams twice a day and chondroitin, and, the herbs from china or africa you can use for arthritis. >> eric: and you get up in the morning and your joints are stiff... >> that is an indication, stiffness or pain or creaking in the joints. and, as david said, fingers, knees, hips and neck and lower

back are areas that are usually affected and it is different strokes for different folks and it depends who you are and you have to see your physician about this and you should not. the best tip i will give on the show, do not auto medicate yourself with nonsteroidals every day without consulting anyone, because you know what those drugs do? eventually they are bad for your kidneys and bad for your liver and i don't want people out there taking nonsteroidal medications, every, single day. you have to toss them up with different things, tylenol one day and physical therapy and glucosamine, chondroitin, and you have to get a program that works for you and physical therapy is a good place to start. >> eric: and look out for it. >> jamie: i'm glad you raised the physical therapy thing and we have to keep moving and know how important it is to get out and exercise and how do you do it when it is this hot? that is next. [ gans ] [ marge ] psst.

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>> thinking about exercising outside today? we have to warn you about dehydration and heat exhaustion. it can be a dangerous mix. dr. siegel? >> there's something called the heat index. our weather people talk about it the whole time. you sweat to cool down your body. you can't sweat after a while if it's too humid. you have to drink a lot of electrolytes, not just water to get electrolytes and fluids back

in you. if you start to feel very fatigued or not thinking clearly, get out of the heat before you have a heat stroke. very young and very old are most at risk because they don't have the insulation. it's like a house with insulation. it doesn't do as well if you're very young. >> should you start drinking before you feel that way? >> absolutely want to make sure that you're well hydrated. if your core temperature is above 105 that's a definition of heat stroke. it's a medical emergency. if you see somebody really fatigued, is not acting like the way they normally do, take them to the emergency room and as mark mentioned, get them out of the heat. if you need to exercise, do it early in the morning or late at night and well hydrate. cover yourself with really cold towel to bring your temperature down. >> all right. >> heat can be a killer. >> both doctors say no alcohol at the beach. >> that's right. >> thank you. >> thanks, doctors. great advice every sunday and "house call" is now on twitter. yep, "sunday house call". twitter. tweet them. we'll be talking about health questionan