dr. nancy snyderman. how does someone survive this kind of injury? >> in this situation it was a little bit of everything. good luck and the trajectory of the bullet. it went through a portion of the brain. phenomenal work on the part of the people of the hospital staff to get her into the emergency room and within the o.r. within an hour. frankly the fact she's 40. right now in the first 72 hours what they're looking for is any changes in her neurologic status. the big concern is they know they have the bleeding under control and to watch for infection and make sure that that brain isn't swelling, which it will. so with the bullet coming in over her ear here and out through her forehead, the doctors have taken off a piece of the skull to allow the brain to swell, and they long-term will watch for changes from damage to the speech area of the brain. but for right now in this first 72 hours it's all about stabilizing her, monitoring her hour by hour, then day by day. then we can talk about the long term. >> all right. dr. nancy snyderman, thank you. >

dr. nancy snyderman will be on hand to talk about the health benefits of getting the recommended amount of rest at the sleep to live institute's 2011 sleep summit. >>> in washington, maryland democrat barbara mikulski will make history when she returns to capitol hill this morning. mikulski will be sworn in for her fifth term as u.s. senator, making her the longest serving female senator in u.s. history. >>> and happy birthday to actress diane keaton who turns 65 years old today. happy birthday to her. >>> all day long, you can stay on top of the very latest developments in those stories and others as they break on msnbc. tonight be sure to watch brian williams with nbc "nightly news." >>> and, finally, here's a look at what's coming up later this morning on the "today" show. the latest details on what to expect from the new session of congress. >>> and the former ceo of anheuser-busch breaks his silence after the mysterious death of his girlfriend found inside his mansion. >>> now keep it on this channel for continuing local news, weather, sports and more. i'm veronica de la cruz. thank y

dr. nancy snyderman with us tonight. take it away. explain this one. >>> here's what we should remember. the fluoride has dramatically cut the number of cavities in the united states, but the hhs, health and human services is saying to the environmental protection agency that we have looked at the science and recommending some changes, perhaps too much fluoride is now initiating a little bit of a problem, a cosmetic problem in some children. the concern is that some young children might be getting too much fluoride. there's been an unexpected rise in the cosmetic condition called dental flourosis. that's when there's too much fluoride consumption during birth to the age of 8 when young teeth are being made. so if you look at the normal teeth on the left, you can see normal coloration. but that streaking and splotching on the moderate side, that's a mild case of flourosis, and that's what has people concerned. we've seen an increase of that since the '60s. now, two out of five have the problem. in 2004, our most recent data, it's up to

dr. nancy snyderman weighs in after this.hen you've had one too many days feeling sad or anxious... aches and pains, fatigue. when it becomes hard to ignore that you need help. that's the day you do something. depression hurts. cymbalta can help with many symptoms of depression. ightoudo ror a your depression worsens, you have unusual changes in behavior or thoughts of suicide. antidepressants can increase these in children, teens, and young adults. cymbalta is not approved for children under 18. people taking maois or thioridazine or with uncontrolled glaucoma should not take cymbalta. taking it with nsaid pain relievers, aspirin, or blood thinners may increase bleeding risk. severe liver problems, some fatal, were reported. signs include abdominal pain and yellowing of the skin or eyes. talk with your doctor about your medicines, including those for migraine, or if you have high fever, confusion and stiff muscles, to address a possible life-threatening condition. tell your doctor about alcohol use, liver disease, and before

dr. nancy snyderman is the chief medical editor for nbc news.s are closed, she's on a vent layer, so how is she able to communicate with doctors when they're doing these hour by hour checkups? >> they'll turn off the medicines and allow her conscious state to rise. they'll give her very simple commands. and they'll measure those commands. squeeze my hand. do you recognize me? the minute they're satisfied that they've done a basic neurologic check, she goes back into sedation. >> reporter: many thing had to go right, most important says dr. snyderman, the bullet's trajectory. it's called a through and through. >> it may be the most fortuitous path that it was high and just came through this quarter section of the brain. had the gunman shot her through and through this way or through and through this way, or lower, we'd be talking probably a life-ending altercation. >> reporter: also important, the congresswoman got to a top-notch trauma center fast, inside 40 minutes. oddly enough, even the day of the week broke lucky for her. this thing happened

dr. nancy snyderman. >> good morning. >> doctors say the congresswoman was shot through the brain. >> right. >> it's hard to believe she would survive that. how is that possible? >> most people don't survive it. a through and through of the brain, the mortality rate is at least 90%. what's fortuitous in this situation is the bullet reportedly went through a part of the brain that didn't hit any spinal fluid, didn't hit any major arteries. reports are that it went through the temporal lobe. that means it went in just above her ear and out through the forehead. in here and out here. the reason that's important is because this area has to do with speech. and the frontal area has to do with organization, affect, how you present yourself to people. as a congresswoman who must think about what she's going to say, say it, organize those thoughts and then have a certain way of presenting, i mean, certainly if she makes it through the next 72 hours and survives, that's great. then it raises issues about quality of

dr. nancy snyderman is here to answer your questions., they know exactly what is going on. what's the difference between tension and migraine headaches? >> we saw tension headaches, but it's not because you're tense. it's because the blood vessels constrict and as they open up, barts of your brain get flooded with too much blood. that's what causes the pain. we have tension headaches, migraine headaches, cluster headaches, and this is sort of the laundry list for classic tension headaches. this is the mild to moderate stuff. it feels like your hand is radiating pain or it's over your forehead. >> and the migraine sufferers? >> well, if you've ever had one, it's blinding. usually people have an aura ahead of time. light, noise is really sort of be so awful. you just want to climb under the covers in a dark room. the pain is almost on one side of the head, usually behind the eye. it is severe. and can really lead to nausea. you just want to clim noonb in o cocoon. >> rayasks, i have a rash of migraine headaches. when do you consider a head

dr. nancy snyderman is nbc's chief medical editor and joins us. good morning.ical advice? >> everybody. >> it's difficult, though, to know which ones you can trust. what's your rule of thumb? >> i think you can start with the search engine. people sort of make fun of the dr. google idea but most people will find a search engine they like and start to use it. but if you really smart you have to think like a reporter. you let one take you to another and take you to another. but when you start to look at sites these are the most important things. see if it's being paid for by someone who has something to sell. that should raise a lot of red flags. check for credentials. make sure there's a really august body behind it. make sure the facts are not only there but they are updated. >> interesting because a lot of the things on this list are kind of sort of the things that journalists would use. >> exactly. >> to make sure they would go with information or not go with information. we've got questions now from our viewers. one is an e-mail from kristen in los angeles.

dr. nancy snyderman, thanks, as always. et.a a oc lyo >>> good morning to you, it is 8:26. i'm laura garcia-cannon. want to check the forecast with christina. >> good morning to you. great visibility, it continues to be nice and clear in the south bay and along the peninsula this morning but some dense fog and north bay, freezing fog and black ice reported in the richmond area. take it easy through there. low visibilities in concord, fairfield, livermore, down to about a quarter of a mile. the case for just one more hour. then things will start to improve. 36 now in concord. hour by hour forecast shows you by noon today when you take your lunch break, upper 40s, low 50s and on your way home from work, the 60s, 60s in fremont today. la laura's back with more news after this. [ female announcer ] this is a strawberry pop tart... and this is a warm, fresh baked strawberry toaster strudel. we asked kids what they want... and we got a clear answer. the one kids want to eat. [ kids ] oooooooooooooh. toastestrudel. the one kids want t

dr. nancy snyderman to wonder again. >> we'll look back on this as yet one more time and one more awful casehen so many people knew a powder keg was about to explode and no one intervened. >> reporter: the obvious question, what about loughner's parents, randy and amy loughner, they have been in seclusion since the shooting rampage. when a neighbor brought them their mail, he came out and said they are ill, they are devastated. they say they had in idea how deeply disturbed he had become. >> nbc analyst clint van zandt is a former fbi profiler. clint, good morning to you. >> good morning, meredith. >> as mike just pointed out, we're beginning to learn more about jared loughner, who this guy is, the erratic behavior in college, even his teacher said he didn't like to turn his back on the man because he was afraid maybe he would have a gun. those postings online, disturbing videos, but even knowing all of this, clint, is there anything anybody could have done to stop what happened? >> well, i think your statement when you started meredith, you talked about his life, perhaps his mind spiraling

dr. nancy snyderman as well as "today" contributor and psychiatrist dr. gail salts.fords holding her own, following commands, remains cautiously optimistic but she's not out of the woods by any means? >> there's a window of up to 72 hours, where every hour they're lowering the sedation. she's probably on some kind of medication like propofol. they ask her very simple things, open your eyes, squeeze my finger, what they're looking for is a steady state. but then they went her heavily said tated because they want her body to rest and her brain as much as possible. >> the doctor said the swelling seems to have stabilized, that's a good thing. >> that's a very good thing. but 72 hours is the danger zone. we know the bullet went over her left ear into the back part of this temporal lobe and out of her forehead. they have taken out a plate about the side of your hand. they know that this part of the brain is going to swell. they want the brain to swell here, they don't want to brain the swell down into the neck because that's where the breathing area of the brain is and th

dr. nancy snyderman is nbc's chief medical editor. nancy, good morning to you. >> hey, meredith. >> hard to believe just six days ago congresswoman giffords was shot in the head, and had that bullet penetrated her brain in just a slightly different direction, she would probably be dead. but since then, she has put up two fingers, she's moved her arms and her legs, she's opened her eyes. doctors say they seem now to be tracking. is what we witnessing miraculous, given someone in her condition? >> it's a combination of miraculous, lucky that the trajectory of the bullet is what it was, and i think, we have to give a lot of credit to this stellar medical crew. they had her from a battlefield, through the icu, into the o.r., and back into the icu within 38 minutes. they treated this like it was a typical war zone. the physicians and everyone on the faculty there, it's made a huge difference in her recovery. what they said yesterday with her ability now to follow commands, just simple commands, but it shows that things are firing in her br

dr. nancy snyderman is nbc's chief medical editor and jim cremer is the host of "mad money" on m srkmsnbcformation. the e-mail said the board of directors granted me a medical leave of absence to focus on my health. is it a continuation of something he's had or something new? and we don't know. >> jobs and his family have kept this very close to the vest. you're right. there is going to be a lot of speculation now. the kind of tumor he had in the pancreas is the best possible kind if you are going to get one. when it spreads to the liver it can spread quickly. he was diagnosed in 2004. he underwent a liver transplant in 2009. any time you have an organ transplant you go on immunosuppressive drugs. in a cancer patient that concerns doctors because if you reduce a person's ability to fight off a tumor there could be a new tumor. he could reject the liver. there could be infection and at least those three things go to the top of the list. >> you talk about rejection of the donated liver. i thought that happened more quickly. might it happen at this stage of the game, a year after the transpl