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. hi, everybody. i'm jamie kolby. it's time for sunday housecall. >> i'm eric shawn. joining usering dr. marc siegel, associate professor of medicine at nyu's langal medical center and author of the inner pulse to unlocking sickness and health. >> and dr. david samadi is here. he's a professor, too, and great to see both of you. thank you for joining us. i wanted to begin with this new research in the fight against alzheimer's. there's a study that finds doctors may soon be able to detect the disease years before the first symptoms set in.

dr. siegel, how early? >> this is pretty exciting. it's out of johns hopkins and published in a major journal called neurology and it looked at the idea of looking at the fluid that's around the brain, the csf, we call it. that fluid we're going to talk about in the second topic as well, but it's not only a cushion, but it absorbed waste products and protein from the brain the brain makes when it's working. if you have these two very abnormal proteins, if they build up in the fluid around the brain, it may be a marker that five years down the line, you might have a problem thinking. you may be forgetful, you might have a problem with daily activities. you may be on the verge of mild dementia or alzheimer's. if we knew five years in advance, if you could predict five years in advance, maybe we could come up with treatments that prevent it before it happens. that's what we do with heart

disease. we have high blood pressure, we treat that in advance. we're hoping we can treat in advance and this is the first time we have seen a marker we can focus on. >> how do you find it? is there a test for these markers? >> they're looking at the ratio between the protein and beta amaloid. they're coming up with this kind of results among normal, cognitive people. we've had these results in the past on alzheimer's patients, but now for the first time, 265 patients go through now symptoms, normal people, and now with a family history of alzheimer sknz finding out if you have too much of the protein and not enough beta amaloid, there's a high risk of having alzheimer's. just like we have cholesterol or blood pressure, we can predict it. it's fascinating because we can see who is headed toward it. we don't have a treatment, that's the problem. the way to do this is to get the

spinal fluid, and more study needs to be done to duplicate this. where are we going? $200 billion spent on alzheimer's. it's a health crisis. if we could delay this and if we can push it further back until the pharmaceuticals will come up with this, we'll be okay. eric is going to -- >> what should -- eric is going to say, what should i ask my doctor for? but not everybody wants spinal fluid. >> we're not ready for that. what you can do monday morning, everything is going to come together. listen up. saturated fats, right? that's all the meat and dairy we talk about. that increases your beta amaloid. all these doughnuts and foods we talk about it, replace them with vegetables and berries. exercise, exercise actually can reduce the level of beta amaloid in your brain, and finally, sleep, which we'll talk about, is also going to reduce it.

if you can do it at least for monday morning, you have an option. >> notice how dr. samadi pronounces the word alzheimer's. that's the correct pronunciation, and think about this. this is a little on the nothingative side. if you knew, eric, that five years from now, you were going to have a problem thinking or you were going to be forgetful, you could say, look, we better do something about this now. what's your home situation? who are your care takers? how can we predict the future? that's a big deal in medicine. >> a lot of patients don't want to know if you can't treat it. >> we're getting there with treatment. but we want the treatments early. >> speaking of the brain health, do you know your brain when it's sleeping is actually really busy when we're asleep. researchers have found the brain operates waste flushing system that stays active during shut-eye, so what is this waste flushing system that the brain is involved in while we're dreaming? >> this is even more fascinating

and i'm preparing for this segment and i really get into this whole thing as a urologist. what happens to the building after it shuts down at 5:00, 6:00. cleaning people are coming in, cleaning up the waste so tomorrow when you show up, everything is beautiful. that's what's going on in our brain. the university of rochester is finding out there's a whole lymphatic system, the spinal fluid goes through our brine while you're sleeping, cleaning up the toxins you're talking about. beta amaloid. incredible. so what happened? your cells in the brain actually start to shrink by 60%. or the reason for that is they need to open up space for all these bubbling cleaning people coming in and clean up the toxins. they also, what happens is they start their activity ten times to make sure. that's why sleep is important. that's why getting seven hours of sleep, when you cut it down

to three hours, what happens is you leave the toxins behind. in the morning, you wake um, you're forgetful, tired. what was the name of that thing gon again? you don't remember. the other thing that is important and i think you will find it interesting, if these cleaning people are going in and cleaning up the toxins in our head, maybe they're lazy. maybe they're not doing their job. maybe we should push them. if we can push the glimphatic system to wash out all the toxins, we'll be able to treat alzheimer's or delay this. >> we talk about the tox ainsto. like everything in our body? all the cells in our body are making waste products. before this, we studied what happens to the body in sleep. this is the first time we're looking at the cells. they expand when we're awake. you're covering the united nations, the brain cells are expanding. they shrink when you're

sleeping. your cells are growing, getting ready for the next day. as the brain cells shrink, the spinal fluid comes in and vacuums out the debris and bad products formed during sleep, including beta amaloid. all the bad proteins we don't want get oud of there. >> can that be enhanced? is there anything we can do to enhance the cleaning system? >> i think we can. one of the messages here is sleep is good for you. look what is happening. we're rejuvenatding. those of us who replace sleep with caffeine, bad idea. look what sleep is doing. and probably down the road there will be treatments that can increase the amount of claeanin of the brain that goes on. especially in disease state. >> the theory is we have talked about, for example, coffee can reduce the risk of alzheimer's or diabetes, and these guys are going to go and clean up, so this is a great way to go. finally, where is the waste being dumped?

in the liver. that's why we don't want you to drink too much alcohol because if your liver isn't ready to accept the toxins, liver disease can lead to alzheimer's. >> i'll take a nap over a cocktail any day of the week. are naps good enough or do you need the seven hours in a row to get the cleaning people doing their thing. >> you need the seven hours in a row. the problem with alcohol is it interferes with that cycle. for people who aren't getting enough sleep, if you nap during the day, the next study will show it's coming in during day as well. this is in mice, by the way. it's in mice, not in people yet. >> the same concept as plaque, cholesterol plaques, the same concept that can cause heart attacks, they can cause brain attack, which is alzheimer's. >> interesting to talk about the fact that the brain can kind of heal itself in that way. fascinating. i also want to talk about this condition that half of people over the age of 60 have.

and how fiber, you know, it's good for one thing. it can also help something else. we'll tell you about that. >> and do you like oreos? who doesn't? could they be as addictive as drugs? you know, it's hard to just have one. but there's a new study out about oreos. you have to love them. the doctors will fill us in on what the research supposedly found. ♪ ho ho ho [ female announcer ] at 100 calories, not all food choices add up. some are giant. some not so giant. when managing your weight, bigger is always better. ♪ ho ho ho ♪ green giant help the gulf when we made recover and learn the gulf, bp from what happened

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to prove to you that aleve is the better choice for her,

she's agreed to give it up. that's today? [ male announcer ] we'll be with her all day to see how it goes. [ claira ] after the deliveries, i was okay. now the ciabatta is done and the pain is starting again. more pills? seriously? seriously. [ groans ] all these stops to take more pills can be a pain. can i get my aleve back? ♪ for my pain, i want my aleve. [ male announcer ] look for the easy-open red arthritis cap. welcome back to sunday housecall. it's estimated than half of our population has some form of divertrichiaular by the time they're 50 years old and the majority of people don't know they have it. >> it's diverticular.

>> it's a trick, i get it, for halloween. okay. what do we do about it? i thought you get pain with that. >> you can. i'll walk you through that. we call it tics in medicine. we call them tics and they're pockets, little pockets in the colon. usually we pick them up with a colonoscopy. you get that colonoscopy at the age of 50, you see the pockets. they may not give you disease for a long time, you may have inpocketing in your colon and not get sick. that's diverticulosis, the pockets. they come from low-fiber diets. if you don't eat that, you get the pockets. what can happen with the pockets? they can get inflamed, they can get infected. they can start to bleed. it's tricky for an internist like me to diagnose this because sometimes it doesn't show up on a c.a.t. scan, sometimes i have to make this diagnosis if someone comes in with abdominal

pain on the left side, the lower left side. they have fever, cramping, especially in an elderly patient, makes me think this. you have to treat it with antibiotics. sometimes they have to be hospitalized. almost all of the time, it can be cured with antibiotics. sometimes a surgeon like david has to get involved and remove part of the colon. usually that's not necessary. people who have this problem where they get diver tik yer tickialites, you need to be on a high-fiber diet. and the last thing is sometimes these things can bleed. that's a particularly difficult problem in the elderly. inyou see an elderly patient come to the emergency room with lower g.i. bleeding, you worry this could be it, especially if they have pain on the left side. sometimes you have to do an emergency procedure to stop the bleeding.

>> what are some of the best forms of fiber? >> fruits and vegetables is number one, and constipation is the number one reason people try to push and push the part of the bowel and colon into these pouches. and again, by itself, it may be asymptomatic, no symptoms. in fact, 50% of americans over 65 have it, so no big deal. the abdominal pain and bloating and gas will come and go, but you get in trouble when something gets stuck, gets inflamed, and divirticulaulates. >> the right side is the appendix, the left lower quadrant is divirticulate. the best treatment is to make sure they're nothing by mouth, no food, you give them the

antibiotics and they do well. if this recurs, multiple episodes, we have to take that part of the colon and they do fine. >> pain on the left side. >> left lower quadrant. make sure you're not constipated. going back to your question, met amusil is an easy fiber. if you don't want to eat the vegetables, add fiber. 25 to 30 grams of fiber will be sufficient to get you through this. all the time, we used to say corn, seeds, not good for you. now we see it's fiber. the new research shows that's only a myth so you can have all the fiber you want. >> drink a lot of water. >> pain, left lower quadrant pain, fever, high white blood count. diarrhea, cramping, see your doctor. >> all right. we got it. >> we'll get to the middle next week. >> ovarian cysts on the week. >> speaking of men, you know your psa level? what does it mean when it comes to the health of your prostate?

the dean of prostates in the nation is dr. samadi who will explain it all in our should i worry segment next. your psa. stay tuned.

back now with sunday house call. it's now time for should i worry? our weekly segment about everything that worries us. here is a viewer e-mail. this one about prostate cancer. i had surgery for prostate cancer and now my psa is going up. why is that? and should i worry? >> dr. samadi, should we worry? >> so this question comes up once in a while. it's a rare incident that we

would see the psa after surgery would go up. the main benefit of surgery is that the remove the entire cancer. patients are in control because they know exactly what type and how much cancer they have in their prostate. guess what? the psa after surgery should be undetectable or zero. that's why i prefer surgery over radiation as a first line of treatment. if you have an aggressive krr, the psa was high to begin with, sometimes, 10% of the time, the psa can come back after surgery. that's when radiation has a role. so you can give radiation after surgery, but it would be difficult to do surgery after radiation. all these ads that we see, i want people to be careful because with surgery you remove the cancer, the patient is in control with the option of radiation after. what i will tell this person is that we have to see how fast and when the psa is coming back. if it comes back way after his surgery, then it's not a huge

problem. it also sdpendz depends on the doubling time. we want to see what the speed of this psa is. is it goes from 0.1 to a year or two and then goes to 0.2, i'm not concerned. that's benign cells. >> what is normal? >> it should be zero. psa is very, very sensitive after surgery. and that's a big part of it. >> tell folks what it means if it isn't see row after surgery? >> if it comes back, doubling, soon it's going on be 0.2, 0.4, 0.8. in that situation, we have the option of giving radiation. don't panic. what if you don't have surgery, the normal -- like i'm normal -- a normal person. every year you get the number back, 3.1, 9.2, wa do i look for? >> i'll tell you what to look for, but i also want everyone to know that was dr. samadi on the

right of his screen. that was me filming him and he was tremendous as a robotic surgeon. there he is again, look. that's his hands. those are his hands there. and that's the robot. >> mark, he was -- as a doctor, you came in and he saw it for himself. because you can see oh, the robotics, set set ra, but you saw the movement. >> before we move on -- >> so basically, i follow a trend. you know, there's a magic number, a psa of four if it gets higher than that. i need to know the family history. i need to know the family history. i need to know if he had a family trend. here is the point. if i see a trend going up, or i failed something on the prostate on my exam, do not stop. everyone out there should not only get a psa, you should get a prostate exam. if i have a concern, i send the

patient to a specialist. but there's no absolute number. this is a great screening rule in the right hands. it's part of the art of medicine. >> by the way, a couple months ago, we started this program to give back to the community for anyone who say diagnosed with prostate cancer, they can come to my facebook, twitter, ask questions and we can give them our opinion. i don't want this person to panic. we have the options. we can study it and do the right thing for him. >> great, great question because you would assume it would be zero forever and if cells are left behind, you want to know. thank you, doctor. how about cookies, you like cookie? put it down for a second because they may be as addictive as hard drugs. especially, it turns out, these interesting cookies. milk's favorite cookie, in fact, could keep you hungry for more. what to do about the double stuff. if you've got it, you know how hard it can be to breathe and man, you know how that feels. copd includes emphysema and chronic bronchitis.

spiriva is a once-daily inhaled copd maintenance treatment that helps open my obstructed airways for a full 24 hours. you know, spiriva helps me breathe easier. 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. stop taking spiriva and seek immediate medical help if your breathing suddenly worsens, your throat or tongue swells, you get hives, vision changes or eye pain, or problems passing urine. other side effects include dry mouth and constipation. nothing can reverse copd. spiriva helps me breathe better. does breathing with copd weigh you down? don't wait to ask your doctor about spiriva. she loves to shop online with her debit card. and so does bill, an identity thief who stole mary's identity, took over her bank accounts,

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chocolate chip cookies? i'm just asking. but there is a biological reason why we're picking this topic for you. what's up with the double stuff? >> everyone out there knows othero is america's favorite cookie. and it's also the rat's favorite cookie. rats love oreos. they took a bunch of rats, injected them with cocaine and alcohol and morphine, rather. cocaine and opiates. or they gave them a choice of eating oreos. and the ones that ate oreos ended up on the side of the maize waiting for more, waiting for more. those that got cocaine ended up on that side waiting for cocaine. research concluded, and previous research has shown this, that what happens in your brain, and there's a protein in the brain that cause these to happen. in the brain, your body starts of less receptors for doe pa mean.

doe dopamine gives us energy, makes us happy. the brain of the rat only made dopamine only in response to the cookie. >> it's not about oreos. it's t about the pressure center in our braen that's sensitive to sugar, fat and salt. and you heard me before, many times i said our food unfortunately is contaminated and i got a lot of mooep e-mails about that. now i will tell you that it's addictive. because by putting the sugar in hat fat foods, you sort of desensitize your pleasure center in your brain and it becomes addictive like cocaine. that's what people need to know. how do you avoid it some of whenever you put something in your mouth, look at it and find out if it's right for you. pay attention. by doing exercise, you sort of go -- it's pseudo dopamine. the endorphin would act like a dopamine. >> i'm not giving up oreos. >> moderation, eric.

>> those rats newseled right up to the cookies and so would we. >> keeping in mind, that study is online for all of you. that's going to do it for us. in thank you for watching sunday house call. media buzz with howard kirk starts right now. here's howard. >> on the buzz beaters this sunday, as congress votes to reopen the government and avoid a devastating default, the media virtually unanimous in declaring the outcome for disaster for republicans. even many conservative xhen taters, even many fox xhen taters are saying that. >> you can see in the standing of the republican party now, suffers or enjoys, depending on how you want to put it in the polls, it's at low ebb. >> i think it's hard for republicans to spin this as a win, as you suggest. i think clearly the president got most of what he wanted. >> but on balance, if this was a battle, the democrats definitely won.