you. ♪ time now for "sunday house call." >> joining us as always, dr. mark siegel, professor of medicine. also the autr of "the inner pulse." >> and dr. david samadi, chairman and professor of urology as lenox hill hospital. good to see you, doctors. >> we start with some startling news from the cdc. they've issued a stark warning about the ebola outbreak. they say ebola could end up infecting more than a million people by the new year. just a few months from now. the head of the national

institute of allergy and infectious diseases telling america's news headquarters yesterday that the virus can be stopped, he says, if everyone works together. >> giving logistic support, giving support in engineering and setting up the field hospitals, but not one nation or one organization is going to do it. so as the president said to the u.n. the other day, that really we need the community of nations to get involved. >> dr. siegel, it is such a heartbreaking crisis. first, what threat, if there is, is ebola here in our country? >> you know, eric, he went on to talk about that yesterday. here's what he said that i really think puts it in perspective. he said, look, projections are over a million cases by the end of january from the cdc. the world health organization, who's usually more inflammatory, says less. they say by the end of november, 20,000 cases. you know why are the difference? the cdc's projection is if nothing is done. a lot is already being done. >> they mean in africa? >> they mean in africa alone. i'll get to america in a second.

they mean in africa alone. that's if nothing is done. the united states alone is sending 3,000 military, sending public health officials, spending $1 billion to try to contain this, build places where you can go if you have ebola to be isolated, which is the key. right now ebola -- for every patient that gets ebola, two other people are getting it. that's a disaster. that's how infections spread. with intervention f they can cut it down to one person, that will help it to decrease dramatically. now, what about here? you ask the question what about here? well, here's what he said that i thought was really, really powerful. he said, if you get on a plane and you don't have symptoms but you were in contact with an ebola patient very closely with secretions, you could theoretically bring it here. because you might not get sick until you get off that plane. right now we're not restricting plane travel. if we do restrict plane travel, it's going to cost those countries billions. you get off the plane, get sick, you have flu-like symptoms, go

to an emergency room, and they don't necessarily know you have ebola. but in the united states with the cdc involved and with all the public health officials involved and the state health authorities involved, they're going to figure that out and isolate those people. so my prediction and his prediction is you're not going to see a big outbreak here. i think you will see cases here if it continues like this. you're not going to see a big outbreak. >> so on that point, how concerned should we be here in america? >> i don't think in this country we have a lot to be concerned about. as the cdc and w.h.o. mentioned, the risks are very low. the reason is because this is not airborne and not transferred through droplets. it's peop if people would cough and sneeze and ebola were transferred that way, we would be in big trouble. this is fluid contamination blood, those kinds of things. if you can isolate 70% of patients, you put a stop to the

growth of the epidemic. in this country, our health care system is totally different than in africa. there are a lot of people in the vicinity of healthy people. that's why they're having this spread. i also want to tell you that we're doing a lot of things. these numbers they're talking about, 1.4 million, doesn't make much sense. president whole ebola journey started this year around march of 2014 with 49 cases. we're hitting about 8,000. so this number around 20,000 to 25,000 sometime beginning of next year makes a lot more sense based on what's published. a billion-dollar investment. we have vaccines coming out. so we have maybe about 10,000 vaccines by the beginning of next year, which is a big deal. we have about 20 ebola treatment centers that are going up over there. look at this. 3,000 of our troops are going to be over there with 500 health care providers. this is a huge investment on this country. >> and the americans who were

infected basically have been cured. >> not only that, but eric, in this country, in our emergency rooms, even if one of these patients would come -- and we're going to see a few isolated cases here and there in different states. we're going to see them, but we can capture them. the e.r.s are all aware of this. we're going to isolate them. now you see these doctors are healing. in the recent month, they're also being admitted to nih. we'll see more of these, but i don't want people to panic. >> i want to talk about the vaccine for a second. and to david's point, i think with worldwide intervention -- it's not just the united states. the united states is rising into the problem here, but we need the whole world involved. we need the whole world bank to give money they've promised to the region. we need an outpouring of billions of dollars and public health boots on the ground to get this under control. the other thing that we have in the offing, which makes this

different than hiv, by the way -- hiv, of course, is also transmitted and you don't even know you have it. that's why it became a huge worldwide scorch. in this case, you have symptoms public health can follow. it's not going to take the course of hiv. in addition, they were talking yesterday about this vaccine. it already has passed stage one clinical trials at the nih. they tested it on 20 people. they're now going to look at those 20 people and see if it was safe. if it's safe, and he predicts it will be, they're going to go to phase two trials and give it to people in africa. a year from now you might see that vaccine making a difference. >> very good. >> ebola is going to be a 2014 bug, not so much 2015. we're going to end this thing. >> okay. thanks, doctors. well, it could mean the difference between avoiding a heart attack or not. but it turns out just 1% of men actually do this on their own. we're going to tell you what it

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about 7 million. these numbers are going to go to about 23 million in the future. we're losing a battle here. exactly what you said, they're not listening, or they're just not disciplined to do what we're going. this study from sweden, they followed about 20,000 men for 11 years. if you just quit smoking, simple quitting of smoking, it would reduce the risk of heart attack by 36%. that's just incredible. you know, exercise was helpful, but that was only about 3%. what was significant was the waist circumference. do you know how to measure that? take your height in inches divided by weight. women should be less than 35. i'll put this on the facebook for everyone out there. if you just lose the belly fat, which is a risk factor for heart disease, you would reduce that risk by 16%. these are significant.

>> we're just showing hamburgers. we're showing cheeseburgers and french fries. what's the best way to get this down? >> we got the wrong diet on that. look, i think you want to switch that burger to fruits and vegetables. that by itself -- also, eating the right food. the mediterranean diet reduces the risk by 18%. so exercise, healthy diet. it seems like we keep repeating ourselves. >> i want to ask dr. siegel this. i know you like to eat healthy, and so do i. but to tell a guy stop eating the hamburgers and cheese burgers -- >> portion control. >> that's what i was going to go. instead of a whole one, maybe a half. >> i love that idea. >> can i say something before you start? i'll say this on national tv. he actually has lost, i think, about eight pounds just by listening to what we do every day. i'm very proud of this. he exercises all the time before coming. >> absolutely true. i'm also inspired by president bush and the mountain biking i

do every year. and dave samadi. here's the thing i wanted to say. the study only shows 3% effect from exercise. i was looking at that and looking at that. here's to david's point. when you exercise, you actually eat less. so if i combine that elliptical or mountain bike with the "sunday housecall" mediterranean diet where you eat nuts and fish, there's a lot of good things in that diet. you have unsaturated fats rather than that cheeseburger. i think you see a big effect. cutting out smoking was the biggest. i was to switch gears for a second. what's the number one cause of death in women? >> it's heart. >> yeah, heart disease. this study was done, again n men. did you know that 24% of the time is the only amount of time that women are ever represented in studies on heart disease. it's always men. and it's really important. the nih is now giving $10 million to bolster studies in women with heart disease because women don't have the same kind of symptoms. they don't always have that

crushing chest pain. they might have a little nausea, pain in their shoulder. they might have pain in their neck or jaw. then get this statistic. twice as many times they're misdiagnosed as have psychiatric problems rather than the heart disease they're really suffering from. women are written off too quickly, too soon, and heart disease after menopause when your estrogen goes down and cholesterol goes up and your blood pressure goes up, you're at a big risk after menopause. >> excellent point. >> so we'll cut the cheeseburgers in half. >> there's one other thing you have to cut. salt. also, american heart association is find ing out we're taking about 3 perfe.6 grams of salt a. should be two. don't add salt to your diet. >> i don't do that at all. hopefully it'll work. >> you look great. >> thank you. talk about warning signs to your health, there's a big one you should know about. it's rapid weight loss. has that happened to you in coming up, what could be causing it, what you should do about it,

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and back now to "sunday housecall" and our weekly segment "should i worry?" i have lost 15 pounds over the past two months and i can't put it back on no matter what i eat. dr. siegel, should this person worry? what happens when you suddenly lose and don't know why? >> well, in a society where we're always trying to lose weight, i think this is a really good one to bring up. i don't know if the patient should worry, but your doctor better be worrying. and he better do something called a differential diagnosis where you figure out what else is going on besides weight loss? are you thinkrsty?

that could be diabetes. are you anxious? do you have a rapid heart rate? are you feeling flushed? that could be thyroid disease. are you having problems with diarrhea? that could be bowl disease. it could be something like colon cancer. i have to figure out what the possibilities are. number one on my list probably is depression and anxiety. that for sure leads to weight loss. i have to say to the patient, are you sleeping at night? are you worried during the day? what medications are you on? if you're taking stimulants -- >> it how does that work? you say depression and anxiety causes weight loss. >> actually, it decreases appetite. i want to know if the patient is eating properly. then it could rev up your metaboli metabolism. internists have to ask these questions. we think depression, that's for a psychiatrist. but a lot of patients that come into an internist's office are depressed, anxious, not eating. if you're not eating, you're going to lose weight. >> do you take their blood? how do you find out? >> it's interesting.

the way we think, you're talking about the medical mind and the surgical mind. depression is not on top of my list because i don't look for it. i usually look for cancer. so if i see some sort of a new lump or bump, we're talking about losing about 5% of your weight in the next six months wait. for me, cancer, cancer, cancer. is this person taking any chemo? look for diseases such as of the pancreas, or if there is blood in the stool, or chron's disease. you lose weight with too much low and that is a simple test. you can check the thyroid. your heart such, metabolism is up, changes in your skin and hair. weight loss, too.

everything else, diabetes is a huge epidemic in this country. we will see frequently, you are hungry, and the insulin is not functioning. >> do they test for all of this? >> they should be. >> by the way it is easy to do a scope in a pat scan. up explained weight loss especially with anemia, you check the colon and do cat scans. those are the big ones. >> if you have weightless, check with the doctor. >> yes. >> if you have questions, here is our e-mail www. www.housecalls.com and the sums are so necessary and important and they affect you will of us. >> thank you is correct. are you feels tired all of the

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>> they were responsible for way you look and feel. if your hour moans are out of whack it could mean big trouble. how do you know? what can you do? doctor, how do you know? >> there will be changes and you will feel it. for example, if you go to bed and you are tired and you wake up and you are still tired after six hours of sleep there is a problem. there are certain hormones we want you to remember. if there are changes in your skin or hair or you are gaining weight, you are starting to get the hot flashes, these are the changes as a result of the hormones. if you have a sleep problem, remember melatonin. if you are under stress, cortisol level is up. if it up for a long-term, though, it affects the immune system and causing belly fat. >> what causes the levels for go up?

>> stress and lack of sleep and lifestyle changes. the other thing that is important, thyroid. if you gain weight without eating too much, you are tired, losing weight, that is all low thyroid. we want people to check. the opposite is the high thigh provide. -- the high thyroid. the combination of the hormones is what you want to talk about with your doctor. when you have fat around the belly, you see crete too much estrogen and that is a risk for breast cancer. this is a great topic. >> do i have hormones, too, or do they leave at 17? >> let me take your pulse. >> you have hormones, we all have them. >> look, here is the deal, this are three types of main hormone:

thyroid, sex, and stress hormones. when you are under stress they go up and cause your blood pressure to go up, the stress. sex hormones change around menopause, and in addition to female menopause, there is male menopause, man-opause. you gain weight, lose your hair. you diet, you exercise, sleep better at night. that is another thing. thyroid is something i see in the office. with thyroid, a third of the women have thyroid, low thyroid, you are depressed or intolerant of the cold and fatigued, i am suspicious about the thyroid being low and i check that on everyone. >> what do you do? >> you give thyroid replacement, similar do what the body makes.

why consider it a medicine. thyroid replacement. >> this is your hormone. which is what you want to worry about. >> testosterone. you have plenty. when people are fatigued and they lose interest, libido is down, they worry about testosterone. >> women can, also, have low or high testosterone. when your skin breaks into akne and you have oily skin, worry about testosterone. ard above caution: people get the testosterone for no good reason. see your urologist. >> and some women with home growth problems, you need to see your gynecologist. >> thank you, doctors, thank you

so much. >> that does it for us on "sunday house call." >> thank you for muching and enjoy your sunday. >> on the buzz beader, as president obama expands the war on isis to syria, the media debate towns more serious and the criticism more muted boat on the left and right. >> the strike, i agree, was politically valuable and important and for the reasons we said. militarily i is a light show. >> what do you decide chris? are the war pundits backing the commander in chief on the war on terror? will journalists ask tough questions if the administration's military