that's right. i'm back and it's "sunday house call." i'm jamie colby. >> great to have you here. >> and i'm eric shawn. joining us as always dr. marc siegel, professor of medicine and author of "the inner pulse," and he's on the left. that dr. siegel on the left. >> all right. >> dr. samadyi is here as well. we'll pay attention. we'll help you get healthier

because we begin this week with a brand new story about sleep and its impact on bone health. all trying to protect our bones. people who suffer from sleep apnea, eric, may be more at risk of developing osteoporosis. dr. siegel, you're always a proponent of doing anything to avoid osteoporosis. >> sleep apnea is something 18 million americans suffer from, and what is it, an obstruction in your airway when you're trying to preet at night and you may not know it if you sleep alone. if someone is with you observe you for just snoring but periods where you stop breathing, where you're gasping for air and breathing very shallowly and then you recover and then the next day is number onecism tomorrow is fatigue and this interferes with your metabolism. why there's much higher risk of heart attacks and strokes with sleep apnea, and now this new

study looks like there's much greater risk of bone thinning leading to the risk of fractures. why would that be? bones rely on oksanen. this study is not proof. it's just that -- it's in the "journal of clinical endocrinology and metabolism." a fairly large study that looked at over 1,400 people and over 20,000 that didn't have sleep apnea. put together well and it's retrospective. i do not consider this proof. what's called an association, but here's what i want to say. it's an association with something that requires objectioxygen so it's suspicious. what could you do if you have sleep apnea. got to get masks. hopefully people will be complaint with the mask. my patients don't like this thing but it's really important. if that doesn't work there are dental devices that work. get that airway back open again. >> a shame oxygen doesn't come in pill form, a retrospective

trial that would have given people more information. what do we take from the study and what should we do? >> it's important for a lot of people at home to diagnose sleep apnea. it's really been the problem behind a lot of problems, causes met blirk syndromes, diabetes, high blood pressure and stroke and also sleep apnea causes three times increase of cancer and four times increase of stroke but you don't hear much about sleep apnea. think of a pneumonic stop. your partner is going to be snoring, they are s part, t, tired, gasping for air and may have high blood pressure. two out of four make sure you see the dock tomorrow. the other thing is called something called high body mass index. these patients are usually obese and usually age over 45 to 50. they are neck circumference, if you're a female with 16 or more

and men over 17 inches or more be careful with that and gender is usually men. >> tell me about that. men or women for sleep apnea. >> men are usually more susceptible to this. obesity has to do a lot with this, and, of course, as we said it leads to a lot of these problems so what do you need to do? talking about osteoporosis. get your bone density. supplement with calcium and vitamin d, exercise and even though i've been talking about cove all the time, one incident where you want to cut down on your cove because that increases our risk and learn about your assessment score. you talk about your risk and it spits out a number and tells you you're okay or you're at risk. >> this is the most important thing. if you smoke, stop smoking.

if you drink alcohol, stop drinking alcohol, and if you're obese lose weight. all of those things will decrease your sleep apnea and on top of that get a sleep study and if a slope study shows you have this problem try to use that cpap mask. it's difficult and life saving. >> this mask, if you've seen, it looks like a spacesuit, and it's a bit uncomfortable. about a year ago we talked about something called prevent, a band-aid which you put around the nostril which was a one-way valve. try that. about $70 a month. it's very easy to use. see your doctor, but you can try that >> you mentioned diabetes as one issue. that can be a very serious situation. complications range from heart attack and strokes, kidney failure to amputations, but doctors now say that the risk of developing serious medical problems from diabetes is actually on the decline. this is -- this can hit a lot of people, doctor. >> let me first give you the bad news which is exactly what you mentioned. the biggest epidemic in our

century as doctors. we are losing the battle with diabetes as far as the numbers are concerned. 26 million people have diabetes. 79 million have pre-diabetes on the way of becoming diabetes and we're spending over $200 billion in just the workup and diagnosis and consequences of diabetes. what does diabetes do to us, kidney failure, vascular issues and heart disease and stroke and everything we just talked about. this study that was just published in the "new england journal of medicine" is actually good news, push lid by cdc telling us all the consequences of diabetes that we just spoke b.heart failure, we're doing much better. reduced by 60%. that's great because our good doctors are taking care of cholesterol and use be the lipitors and bringing the blood pressure and kidney failure is down. 30% lower chance of amputation, so we have come a long way. but what we're doing is we're taking the consequence of diabetes and the symptoms.

not taking care of the source of it. what's the source of it, our lifestyle and diet and died to diabetes is really western life-style, too much food and too much prosperity and too much money and we're eating junk food. >> what should we do to prevent us getting diabetes. cupcake, t soda, can you do anything besides exercise? >> exercise is key and the number one thick can you do is losing weight. we're finding that this obesity epidemic we're seeing is tied directly to the diabetes endickic and 70 million pre-diabetics on the road to disaster. >> what does that mean? >> they have borderline numbers. i follow something called the hemoglobin-c, how much sugar there is on your red blood cell. >> and can you bring that down by watching what you eat? >> with exercise and with diet and losing weight. this study in my opinion is

really about, because i take care of diabetics every single day in the office. the key is looking at a consummate patient and not just the blood sugar and that's where we've made an improvement. we say if you're a diabetic you're at much greater risk of heart disease, much greater risk of losing your vision, too, which this study didn't go into. get your eyes checked and your heart checked and your cholesterol down as david mentioned and blood pressure down. if i can control the blood pressure in a diabetic and the cholesterol in a diabetic. >> it all comes together. >> you're right. i'm much more likely to put them on aspirin to decrease the risk of heart disease. going if i need to know a diabetic is on a much greater risk of all the complications. doctors are getting smarter at that but we still have to control blood sugar and there's been improvement about that also. blood sugar is directly related to kidney disease and also loss of limbs. those have improved. the reason that kidney disease is not improving as well and as

fast as heart disease because we're getting our diabetics to live longer. have blood pressure medicine that protects the kidneys now. there's aces and arbs, help protect the kidney. >> one of the things we've spoken a lot about on the show is the mediterranean diet and a great study that just came in comparing low-fat diet versus mediterranean, and mediterranean diet came up on top. as jamie always talked about, take your avocado and olive oil, good food for you. >> every sunday we preach perfect health and i confess at the beginning of the show being on the road this week for work made it very difficult to find hummus, for example, so, are you saying, eric is laughing, but he knows what i'm talking about. i had a double meat sonic, i did it, didn't have the sweet potato tops and do you expect people out there to be perfect or if they blow, it do you want them to just get back on track? i want to give people permission

to be real. >> i will tell you one of the best things that's happened to me personally besides being here on the sunday "house call" i take a lot of notes and i've been following some of the advice of myself and dr. siegel has given. it does make a difference if you just cut down on the portions and follow some of the things that we say. nobody is perfect. i want everyone to do like in moderation. if you think that it's going to be a radical change in your lifestyle, that's never going to work. take small steps, follow some of the advice and you'll be great and happy and you're going to continue to wear the green shirt as i'm wearing it. >> happy easter and passover. >> doc, same thing, do the best you can? >> he's making a great thing. take baby steps, eating less portions and carbohydrate, get the pasta and rice out of your diet and the bread out of your diet. the number one diabetics thing do wrong is eat too much bread. >> wawa's got hummus.

>> i was near a wawa. >> during the break tell me things i can look for. >> saying good-bye to allergy shots, ouch. coming up, details now on this new pill that the fda is looking at that has promising painless relief for millions who suffer from allergies. the doctor is on that next. how can you just stand there? what do you mean? your grass, man. it's famished! just two springtime feedings with scotts turf builder lawn food helps strengthen and protect your lawn from future problems. thanks scott. [ scott ] feed your lawn. feed it.

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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. this may be the thick that could actually help allergy sufferers stop and smell the roses. the day has approved a new under-your-tongue tablet to help adults get much-needed relief from hay fever without the pain of an allergy shot. good news, dr. siegel, for your allergy patients? >> yes and no. i don't think that this is something you can discard but it doesn't work that well. only works about 20% of the time, 25% of the time and let me tell you the theory behind it

which is something i like. tree pollen season, in the southeast, ragweed season later hon in the summer and then molds. don't have an effective way to treat this other than getting indoors, wearing a brimmed hat and sunglasses, not tracking the pollen into your house, taking showers frequently and not exercising in the middle of the day. talked about some of this. what else can you do? you can take antihistamines in advantage and get groggy from that. use your nasal sprays in advance, and a lot of people believe in allergy shots, but, a, they are very expensive, maybe not covered under insurance coming up, and, b, they are not 100% great for certain things, like you have to figure out what your source of allergy really is, so the first thing is you have to see an allergist. now they come along with something to stick under your tongue and they say this is instead of allergy shots, if you can't afford them. >> is it out yet, eric wants to know. >> it is out, but it's out for

ragweed and out for grass. not out for the tree pollen that everyone is dealing with right now, but it doesn't work that well, so i would say go to your allergist. see if you can tolerate allergy shots because if those work, see if you can define what your allergy is. and even if i tell you have a tree pollen allergy, may have allergy to other things, too. very hard to deal with. >> dr. samadi, does it work? >> i'm going to take it. look, i just had the horrible allergy, dry cough, runny nose and itchy throat and if you have it you're miserable so if this simple treatment, even though it works about 30% of the time, if i'm going to put it under my tongue, not going to get all these shots, not going to see the doctor so often, these shots are doing difficult. have to go every two weeks. the name is ragweed tech and it's made by merck and you can get it now. >> okay.

>> say it fast, it sounds the same. >> exactly. >> have to take it for three months before the season starts. it's once a day. it's siblingal -- it's siblingial. ma >> i'm for it also. i'm for trying. it doesn't work as well as sglots ask your doctor. >> i'm trying to change his mind. >> maybe he'll write you a prescription for it. eric? >> they said we've got two doctors. coming up here on sunday "house call," in our should you worry segment, the truth about medical errors and misdiagnoses. you're going to be shocked. with diabetes, it's tough to keep life balanced.

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back now with "sunday house call" in our weekly segment called should i wore? medical mistakes affect 12 million patients a year. 12 million people, that's a lot of people and this is rather frightening. >> that's it. recent pain just published. looking at 12 million people that went to all the urgent cares and outpatients. they walked out with the wrong diagnosis, and half of those, about 6 million of those were serious problem and medical issues. now we always like to kind of blame the doctors, but i have to tell you this is one time that i want to be their advocate. we are working hard. the exposure to the patients are getting less and less. we're seeing more and more patient so the mistake can happen. that's one thing. the other thing is that the patients have to be their own doctor.

you have to be their own advocate. what does that mean. when you come to see the doctor don't come in blank with no news or information, put the list of medications there for him to see. make it easy for the doctors and make sure all the diagnosis is there and the idea that no news is good news coming from the doctors that's a bad mistake. everybody patient needs to get a phone call and every patient has to see what happens to my diagnosis and blood test. follow up. >> we're coming into a time when more and more medical care is being given out in the emergency room and urgent care. the purpose of the e.r. isn't to do a long-term follow-up. make sure your life is okay and that you're not in any imminent dang. there was a study out of hopkins in 2005 saying this is twice as likely to happen with temporary staff. if there's a hospital used to

the staff, they may contact the primary doctor afterwards and give me some follow-up, jamie, but if they don't, i tell my patients i want to be in the room. >> let me know. >> david's point about patience and responsibility, when you go to an e.r. tell your primary care doctor what you came for and tell them what tests you have so i and another primary care doc can follow up. they missed lung cancer because people didn't follow up on x-rays and colon cancer because people didn't follow up. it's a teamwork follow-up thing. hospitals have outreach coordinators. ours does. my hospital has someone who calls me. >> for you or for the average patient. >> for the patient and reaches out to the primary care doctor. cannot count on that. the patient has to play a role and the primary care doctor has to play a role. >> how do you know if a storefront is accredited? >> do the research and it's registered all over, but one thing i want to say doctors, we have to admit we could be wrong. there are some errors that be

made. it's detective work and you have to put all the data and if you're not feeling better in a couple of days call and get a second opinion. >> great, and watch the show. >> the point of having a list of your medicines so there's no problems. >> thanks, guys, so much. >> are you looking for something that will keep you young. doctors say it may be exercise. coming up, how staying active is not only good for your health. it can help you look pretty darn terrific. if you've got copd like me... ...hey breathing's hard. know the feeling? 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. 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.

going to make it easy and i'm going to bottom line it for you. what is the point of living long if you don't look good doing it, right? right? there's a new study that says regular exercise will not only keep you looking healthier longer, but you're going to look

really good. >> i love the fact that you take the medical topics, spice it up and make it easy for people to really enjoy it. >> they're listening now, now that you just cut the momentum. dr. siegel, i was going to say speaking of looking fantastic, what can we do to live listenon and also look great. >> it's just a small study, but it took people that were sedentary, that lied on the house, and then they made them exercise and found that their skin was better over several months. why does this happen? it's because the inner layer of your skin known as the dermis gets thinner. but what happens as you exercise, you get more blood flow to the skin. so it looks like, again, this is a very small study, it needs to be reproduced with a larger

group. but as you exercise, the thick layer under your skin lasts longer. >> they did the epidermis, and the dermis. they compared the ones that kpael exercised a lot to the ones that don't exercised and the ones that exercised had better skin. what's the message out there? besides exercising, like we always talk about, it's good to exfoliate, get rid of all the dead skin, because you are get more oxygen, more collagen. take vitamin c, but hide drag, hydration, hydration, because fluid under your skin can give you that attractive skin. >> it is true, you feel better when you exercise, get that daily exercise for at least 30 minutes, you'll feel so much

better, your hormones and your brain. >> make sure you take your hormones. >> that's the medical term, everybody. "house call" back next sunday. >> all these doctors with great medical advice. four days after a ferry disaster off the coast of south korea, divers finally find a way inside the capsized ship. as they go about the grim task of recovering bodies, a just releases ased transcript of the ship's communications. the boston marathon proving that they're boston strong one year after the bombings that shook the city and the nation. and a look by two "boston globe" reporters takes us inside the case and a look at how the city's doing one year later. and a deadly shoot-out in eastern ukraine, what will it mean for an international deal