she's always been able it's just her way.day. but your erectile dysfunction - that could be a question of blood flow. cialis tadalafil for daily use helps you be ready anytime the moment's right. you can be more confident in your ability to be ready. and the same cialis is the only daily ed tablet approved to treat ed and symptoms of bph, like needing to go frequently or urgently. tell your doctor about all your medical conditions and medications, and ask if your heart is healthy enough for sexual activity. do not take cialis if you take nitrates for chest pain, as this may cause an unsafe drop in blood pressure. do not drink alcohol in excess with cialis. side effects may include headache, upset stomach, delayed backache or muscle ache. to avoid long-term injury, seek immediate medical help for an erection lasting more than four hours. if you have any sudden decrease or loss in hearing or vision, or if you have any allergic reactions such as rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing, stop taking cialis and get medical help right away. ask your doctor about cialis for daily use and a 30-tablet free trial.

>> eric: it's time for "sunday housecall". joining us this morning is dr. marc siegel, associate professor of medicine at nyu and author of the inner pulse, unlocking the secret code of sickness and health. >> jamie: he's not alone. dr. david samadi is here, the advicvicechairman of the departf urology at cedars mount sinai. shall we begin? we have been talking about the serious new warning about a popular antibiotic. we probably all have it in our medicine cabinet. the fda is saying zithromax can call potentially fatal irregular heart rhythm in some patients. if you have a sore throat, that's not what you're looking for. what should we do? >> i'm not ready to leave the antibiotic yet. i want to explain first the use of the antibiotic. a lot of people will be

motivated by fear now and run away from it. we actually have a lot of great medical uses for it because it stays in the system for a while. the trick about zithromax is when you give it, it stays around for a few days. if you could take it for five days and get ten days worth of bang for your buck out of it. that's really valuable, and it's useful for sinus infections, bronchitis, not so much for ear infections. for gonorrhea its useful. the problem is it's so popular because you only have to take it for five days that people are overusing it. we've talked on the show about how 95% of sinus infections are viral, same with bronchitis. a lot of people popping z packs don't actually need them. >> jamie: what's the tie to the irregular heart beat. >> now everyone is afraid to take them. this is a very rare complication that's true for the entire class. azithromycin as well. it's not new news. it was a study that came out last year in the new england journal that showed people with very low heart rates, people with heart arrhythmias, people

with medication for heart arrhythmias, people with low magnesium and low potassium are at a little bit of increased risk for a sudden heart arrhythmia where the heart beats irregularly and sudden death. we're talking about 47 people out of a million people who take the antibiotic. it's not a high number, so if i could get people out there to pay attention to the risk without overreacting, i'd be happy with that. >> jamie: let's get dr. samadi in because suddenly the fda is issuing warnings where the risk is low. why are they getting involved? >> they're taking it seriously and added more information on the labels. they want people to know if you have real heart disease, if you have arrhythmia, as marc mentioned, low potassium or low magnesium, you have to have a direct conversation with your doctor and say is this safe? what's interesting, jamie, you heard about vi oxide an vi oxide past.

it only happens while you're taking the z-pack between the day four and day five. that's when we usually see this. behind me you can see some ekg rhythm that's running on. what this medication does, it prolongs the qt, and some of this rhythm is normal. it with a prolong it, and it can give you a real problem. the advice that i have is this is certainly overprescribed. the doctors are really just -- it's a knee jerk reaction. sinusitis doesn't mean z-pack. flu and pneumonia doesn't mean z-pack. you've got to be careful. >> jamie: that rhythm behind you is normal. how do you know when you're having an irregular heart rhythm. >> your bloo bloop blood pressuu can have arrhythmias. you need to see your doctor. something that came up about z-pack is if you're on z-pack, you don't want to take mylanta. a lot of people take mylanta. that can reduce the effect of z-pack. this came up last year. if you don't take z-pack, what would you take. amockamoxicillin.

it's much safer, you know, and that's what you should be taking. >> eric: you can ask your doctor to switch. >> two final quick points. fear is not the best teacher. we're bringing it into the realm of analysis, not fear. it's brilliant that dr. samadi brought up what's behind the fear. for information for people out there, it's the second bump. you see the little bump and then the spike? it's the second bump. between the spike and that second bump is the qt we're talking about. >> it opens up a conversation between the doctor and the patient. >> jamie: if we start reading our electrocardiograms ourselves, we're in trouble. >> eric: we look at this thing going beep, beep, beep, beep. has this ever happened to you? you're lying in bed or whatever and you get pressure in the chest, and it's like oh, am i having a heart attack? you know what the symptoms are. >> jamie: now you're scaring them. >> eric: wait a minute. how do we know, and how can you tell, dr. samadi, let's say you have shortness of breath and sweating if it's a heart attack or if it's something else? >> eric sounds like a

cardiologist now. this is really important. we've talked about this. when you talk about chest or cardiac heart disease and heart attack, heart attack usually presents itself as a chest pain that may be radiating to the arm or to the jaw. one of the pneumonics we spoke about not too long ago which is pause, persistent chest pain. you may have an upset stomach and excessive sweating, nausea or vomiting that goes along with it that a lot of people don't know. if the field of cardiology, time is muscle meaning that the sooner you get the patient to the hospital, the less damage is going to be, so call 9-1-1. now, heart is a really important organ. it's a pump. seven liters of blood is being pumped by this beautiful muscle, and when you have a little clog in one of those arteries, the coronary arteries, all of a sudden you have cardiac heart attack which is attack on the heart. prolonged heart attack can lead to cardiac arrest which is one of the questions that you had,

causes arrhythmia. the heart is out of sync. you don't get enough blood flow to the brain and the lungs and the patient can die within minutes. that's when you want to make sure hav you have the shock andt them to the hospital. >> eric: marc, can you have pressure in the chest and feel uneasy or is it a sharp, sharp pain? >> this is your first question which is on heart attacks. it's usually chest pain or radiating down the arm or shortness of breath, but the other symptoms that david mentioned are also possible presentations, just nausea, not feeling well, fatigue, especially in women, jamie. you see he it more often with women, irregular symptoms. not the chest pain. you've got to be looking out for just not feeling well. the second point you brought up is about cardiac arrest. what is that? heart attack is where the arteries are clogged cardiac arrest, the heart stops beating all together. a heart attack can lead to the cardiac arrest, but you can get it from an irregular rhythm which is why we need defibrillators everywhere. that device shocks your chest

and puts you back in the regular rhythm you need. it's something we call call to shock time. how do we have before you call 9-1-1 and you actually shock the patient? too long. the usual delay, eric, is nine minutes. if you have a defibrillator with you and you do it within a minute, you can increase your risk, your ability to save a life up to 75%. 95% of the people who have cardiac arrest outside of the hospital never make it in because they're not shocked. >> eric: you have these defibrillators in offices and stuff. what if you're home? what do you do if you're home watching television. what do you do? >> when you're at home, you do cpr. if you know how to do it, that triples your chance of success. the very first thing you do, if you see a patient that grabs their chest, falls to the floor, not breathing. see if they're breathing and if they have a pulse. call 9-1-1. >> the biggest thing, you mentioned, who really should be carrying defibrillator and you and i probably won't need it. if you're at hig high risk and e

a long history, that would be safe. >> eric: chest pain, call 9-1-1. >> jamie: right away. i trained on the defibrillator here which is why i know how to say it now. it's really something great to do for your co-workers if they offer it at your company. mostly women, but it's a painful disease that affects about five million americans total. fibro my al gentleman. it's diagnosis and it's treatment. that's straight ahead for you on "sunday housecall". [ male announcer ] when it comes to the financial obstacles military families face, we understand. our financial advice is geared specifically to current and former military members and their families. [ laughs ] dad! dad! [ applause ] [ male announcer ] life brings obstacles. usaa brings retirement advice. call or visit us online. we're ready to help. learn more with our free usaa retirement guide. call 877-242-usaa.

otherworldly things. but there are some things i've never seen before. this ge jet engine can understand 5,000 data samples per second. which is good for business. because planes use less fuel, spend less time on the ground and more time in the air. suddenly, faraway places don't seem so...far away. ♪

that work the way you wish they would. like a front-end loader you can detach from your seat? or a mower deck you just drive over and cut through knee-deep grass no problem? yep. we thought the same thing you did. that's why we build them this way. that's how we run. nothing runs like a deere. visit your dealer or johndeere.com/howwerun to see the new signature series and 1 family tractors.

to prove to you that aleve is the better choice for him, he's agreed to give it up. that's today? [ male announcer ] we'll be with him all day as he goes back to taking tylenol. i was okay, but after lunch my knee started to hurt again. and now i've got to take more pills. ♪ yup. another pill stop. can i get my aleve back yet? ♪ for my pain, i want my aleve. ♪ [ male announcer ] look for the easy-open red arthritis cap. >> jamie: welcome back, everybody. some new attention on a disease affecting an estimated five million folks, mostly women, fibromyalgia. it's a condition characterized by continuous and extensive pain experienced through the body, a lot times in the hands.

dr. siegel, tell us a little more about this. why mostly women? >> you know, jamie, a lot of the jury is still out on this disease, and it confuses even doctors. it's a reported disease meaning parents tell you their symptoms. if they have this pain that you're talking about for more than three months, that's what we define as fibromyalgia, but it's not the joints themselves. it's muscles radiating out of the joints. it can be almost anywhere in the body. it cab in the chest, in the neck, in the knees, off the hips, and it really is debilitating, and people really have a big problem with it. it can occur after car accidents, a physical trigger, we call that. it can occur from an emotional trigger, from being very, very stressed. the treatments are very variable. sometimes anti-seizure medications work. sometimes anti-depressants work. physical therapy and exercise tends to work. more sleep tends to work. >> jamie: is it lupus? is it the same as lupus? >> no, absolutely not. no, absolutely not. lupus is a connective tissue disease. in this disease you may not see

any of those abnormalities in the blood. >> is it an auto immune disorder? >> these are excellent, excellent questions because you know, this is the kind of diagnosis that's done by exclusion. we don't really understand it well. that's the truth, and all the diagnosis that you're talking about, auto immune disease, lupus, lie lime lyme disease, gn intolerance is part of the spectrum. we're starting to understand this more and more. women go from doctor to doctor, they make them feel really bad as if it's in their mind. they go through multiple tests and studies and they come up with nothing, so the american college of rheumatology has come up with an excellent guideline that there are 18 tender points in your body from neck, shoulder, knees, and there's a whole list of them out there. if you have 11 out of those eighteen points and you have the pain for about three months, you're officially diagnos diagnh fibromyalgia and you're not crazy. this is the real deal. that's important to know. why is it important to diagnose

them? number one, you save a lot of money and time. number two, you stop taking the gallbladders and bowels for wrong reasons. they think they're bloatd, it must be gallbladder. we don't understand. the cause is unknown but genetic predisposition is one thing. there are certain families that have this more. certain trauma in your life, a horrible motor vehicle accident, loss of loved one, something triggers to have fibromyalgia. i think the treatment is a lot of anti-depressanpressant as a w dose, diet, cognitive behavioral therapy. i want people to know that low vitamin d is one of the things that can do this, and also diet drinks, aspartame. >> less caffeine also. >> this is one of the few times that coffee and caffeine is not good for you. glad you brought it up. >> jamie: you both offered such great perspective. we don't want folks

misdiagnosed. >> eric: breast reduction surgery. it's a procedure not usually associated with men, but it's more common than you think, and the doctors will explain why ... straight away. everyone's retirement dream is different; how we get there is not. we're americans. we work. we plan. ameriprise advisors can help you like they've helped millions of others. to help you retire your way, with confidence. ♪ that's what ameriprise financial does. that's what they can do with you. let's get to work. ameriprise financial. more within reach. living with moderate to semeans living with pain.is it could also mean living with joint damage. humira, adalimumab, can help treat more than just the pain. for many adults,

humira is clinically proven to help relieve pain and stop further joint damage. humira can lower your abilitto fight infections, including tuberculosis. serious, sometimes fatal events, such as infections, lymphoma, or other types of cancer, have happened. blood, liver and nervous system problems, serious allergic reactions, and new or worsening heart failure have occurred. before starting humira, your doctor should test you for tb. ask your doctor if you live in or have been to a region where certain fungal infections are common. tell your doctor if you have had tb, hepatitis b, are prone to infections or have symptoms such as fever, fatigue, cough, or sores. you should not start humira if you have any kind of infection. ask your rheumatologist about humira, to help relieve your pain and stop further joint damage.

>> eric: back now with the doctors. breast reduction surgery, you know, it's not often associated with men, but it's a condition that actually is quite common. dr. samadi, what is it and how do you know if you need it? >> it's a benign reason for this, and not a cancer. one out of four men actually have this, and a lot of it has to do with the balance of our hormones. when the level of evident jen goes up in men and by the way, men also make some e estrogen. when estrogen goes up and testosterone goes down, you see enlargement of the breast. this happens in male menopause. jamie just looked at me. >> jamie: did i? sorry, doc. >> male menopause. over the years testosterone can come down and you can have an enlargement. >> eric: at what age? >> usually over the age of 50. you're safe. now, there are also some medications, you know.

we in the field of prostate cancer give a lot of testosterone before radiation. you've heard of propecia. it's popular for hair. it's one of the things that can lower the active form of testosterone that can give also enlarged breasts, and many other medications, digoxin, so you want to go through the list of your medication. alcohol, big time. marijuana. these are all one of the reasons why they do this. now, surgery for this is very successful, and i let marc make the next few comments. >> the main points in like when you see this in newborns, most of them have it. puberty because you're getting a change in your hormone status as a man. as david mentioned, late in life when you start to make less testosterone and more estrogen. that's the key. you can find it on examination. it's usually one side more than the other side, but yo you can actually find a palpable mass and you have to start to move. you can treat with with anti-estrogens. if they don't work, surgery.

there's actually man boobs that is just fat. people who have these fatty things, it can be either way. it can be fat, or if it's hormonal, you're going to see the gynecom ooasti. >> what if you're like peter griffin? what do you do. >> if it's due to obesity, lose weighted. if you have tender and discharge from the nipples, that's dangerous. breast cancer in men is rare, but it's very aggressive and very dangerous, and you've got to see a doctor. >> 2500 cases a year of breast cancer in men. >> all right. >> eric: glad we talked about that. >> jamie: thanks so much, doctors. we have more ahead. you know, those large sugary drinks that new york city tried to ban until a judge stepped in? well, when it comes to your health, we're going to ask whether portion size and your drinking really matters.

[ male announcer ] this is george. the day building a play set begins with a surprise twinge of back pain... and a choice. take up to 4 advil in a day or 2 aleve for all day relief. [ male announcer ] that's handy. ♪ i'm here in your home, having a pretty spectacular tuesday. ♪ but i don't notice the loose rug at the top of your stairs. and that's about to become an issue for me. ♪ and if you got the wrong home insurance coverage,

ical bills ♪ coulget expensive. so get allstate. [ dennis ] good hands. good home. make sure you have the right home protection. talk to an allstate agent.

>> all right. sugary drinks are next. but first, the roll of alcohol in men geeping enlarged breasts. >>