By Miriam Falco
CNN Medical News Managing Editor

20 years ago today, the Berlin Wall began to come down. I vividly remember standing in the CNN newsroom with tears rolling down my cheeks, watching images of people crawling on top of the wall. It was something I never imagined I would see, having spent the first half of my life growing up in West Berlin. Now a lot has happened in the past two decades – on both sides of the pond. But one of the things that sticks in my mind as a person, as the journalist in me continues to cover health reform in the U.S., is that growing up as a child in West Germany, I always had health insurance. Now it wasn't the upper-echelon, "you'll get a private room in the hospital" kind of coverage. But if my siblings or I were sick, we went to the doctor – it was as simple as that. Not so in the United States, where over 45 million Americans lack any kind of health insurance and many million more may be covered, but are one major illness away from bankruptcy.

The reunification of Germany didn't come cheap and the German government is facing fiscal crises too, including a health care system that is going broke. But as the years have gone by my friends in Deutschland who needed treatment for cancer or multiple sclerosis or the common cold – got it, no matter if they had a job or not. Now the U.S. Senate has been tossed the health reform hot potato, after the House of Representatives narrowly passed its health care bill this weekend. We’ll see what happens next.

Do you think every American has a right to health coverage? Or does the ongoing political battle cause your eyes to glaze over? Tell us what you think.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Caleb Hellerman
CNN Medical Senior Producer

Yesterday I gave a short talk at a meeting for psychologists and others who work with people suffering from psychological trauma. Our panel was about how the media handles stories about mental illness. It’s a topic that felt especially poignant a few hours later, when a gunman shot and killed at least a dozen soldiers at Ft. Hood, a U.S. Army post in Texas. The alleged gunman: a military psychiatrist. At this point we don’t know what led to the shooting – was it a premeditated terrorist attack? A case of workplace rage? Was the gunman unhinged by fear of his upcoming deployment? Did he suffer some kind of a breakdown after hearing too many stories from traumatized soldiers?

Those are mysteries we’ll have to unravel in the coming days. What’s clear is that many people at Ft. Hood – a virtual city of more than 30,000 people – have just been through a terrifying experience. That doesn’t mean they'll develop a pathological condition – like post-traumatic stress disorder – but especially if they witnessed the shootings or lost loved ones, they are at risk for lasting problems.

Beyond that, news coverage of a violent event can itself be deeply painful for readers and viewers, especially if they’re trying to recover from an unrelated trauma of their own. At our panel yesterday, people raised some issues that I hadn’t much thought about. Reader comments, for instance. Two clinicians pointed out that people sometimes post hurtful comments online, which can re-traumatize the people being written about – for example, a rape victim in a crime story.  A handful of news organizations, including CNN, moderate message boards and eliminate comments that are overtly offensive or full of profanity. But one very animated audience member – he described himself as a former reporter – said that’s not nearly enough. He thinks it’s a disgrace that any news organization would publish anonymous reader comments – that it only encourages damaging words.

What do you think? How should news outlets like CNN strike a balance between telling the story, getting feedback from you and not making life worse for the people we cover?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Robert in Kansas:

“I heard this week that the H1N1 virus has now turned up in pigs. Does this mean it can get into our food supply and I’ll get sick if I eat it?”

Answer:

Great question. The U.S. Department of Agriculture did recently announce that a commercial herd of pigs tested positive for swine flu. The USDA continues to stress that you will not infected with the HIN1 virus from eating pork. In fact, the infected pigs in Indiana weren’t destroyed. Once they recover from the flu, they will go to slaughter according to the USDA. Officials experimentally infected pigs earlier this year to see whether their blood and meat also became contaminated. They concluded that the H1N1 virus stayed contained in the respiratory tract of infected pigs and the virus did not infect the meat. The World Health Organization and World Organization for Animal Health have also concluded that humans can not be infected with the H1N1 virus from consuming pork. For more information about H1N1 and food safety, click here.

From Cheryl:

“While at my doctor's office, I asked about the H1N1 vaccine. I was told it will be very expensive, like $300. Since I do not have health insurance, the expense of the H1N1 vaccine will factor into whether I get it.”

Answer:

$300 is an excessive amount to pay for a free vaccine! That’s right – it’s free. The federal government has purchased the H1N1 vaccine and is shipping it out to states free of charge. They’re even picking up the tab for the syringes, needles, sharps containers, and alcohol swabs. Centers for Disease Control and Prevention has also stated private clinics may not charge patients a co-pay or other out-of-pocket charges for the vaccine. The only thing you should be paying is perhaps an administrative fee for your office visit but in many cases that fee is being waived as well. I would double check with your doctor again on the price. If the office still attempts to charge you $300, I would decline and instead contact your state’s health department to locate public clinic administering the vaccines near you. You can also track the vaccine’s shipments in your state through the CDC’s Web site. Check it out by clicking here.

By Andrea Kane
CNNhealth.com Producer

Last winter, I was told that my young daughter had walking pneumonia. Walking pneumonia? My mind, fueled by alarm, raced: What is walking pneumonia? (A very mild inflammation of the lungs.) Is it serious? (While it can become serious, it is not usually a problem and often heals on its own.) Is she going to be alright? (Of course.) She had very mild symptoms – a cough, a fever – and she wasn’t all that uncomfortable. Her pediatrician said some people let the walking pneumonia resolve itself (that’s how mild it is!), but that I might want to opt for a course of antibiotics. Not wanting to risk complications, and wanting to ease her symptoms sooner rather than later, I quickly agreed (antibiotic-opposed husband be darned). Thanks to access to medical care, my daughter was well within a couple of days; she and I quickly put the episode behind us.

The story ends differently for the more than 2 million children who die of pneumonia – walking pneumonia’s much more deadly cousin - every year. Save the Children, an international humanitarian organization, reports that pneumonia (which can be cause by bacteria, viruses, fungi or parasites) kills more children under 5 worldwide than measles, malaria and AIDS combined. Pneumonia accounts for 20 percent of all deaths in this - the youngest and most vulnerable – age group. That’s one child dead from pneumonia every 15 seconds. The vast majority of deaths – 98 percent – occur in South Asia and sub-Sahara Africa.

A great many of these deaths could be prevented with existing inexpensive vaccines or treated with inexpensive antibiotics. But the families of children in the 68 countries most affected by pneumonia either don’t know about available vaccines and antibiotics, don’t have access to them or can’t afford them. And that’s a tragedy.

But the flip side of tragedy is hope. Global health authorities, including WHO and UNICEF, are recognizing November 2 as the first-annual World Pneumonia Day and have outlined a six-year action plan to take the first steps in beating back this beast. The GAPP plan, as it is called, includes education, protection, prevention and treatment efforts, targeting both governments and individuals.

Dr. Bill Frist (the former U.S. Senate Majority Leader and a trustee of Save the Children) and Dr. Richard Sezibera (Rwanda’s Minister of Health) write in this week’s edition of The Lancet, “… lives continue to be lost from this preventable and treatable disease, and, until recently, there was little outcry.”

I for one am glad there is new attention being brought to bear on an old adversary. No parent should have to mourn the death of a child from a preventable and treatable illness.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Rebecca Leibowitz
CNN Medical Intern

I had H1N1. It started with a cough, which quickly progressed to a headache, body aches and a 102-degree fever. A rapid flu test came back positive, confirming my diagnosis. Although this nasal swab test for H1N1 is not very reliable, so much so that it is no longer being used, I had all of the symptoms of the flu. H1N1 was pretty much the only strain circulating in late August, so chances are very high that I did indeed have it. I spent the next three days isolated in my apartment, pumping my body with vitamin C and chicken soup. Then I was fine. I felt great and I was no longer contagious; I could go to class, to the grocery store and to the gym without fear of infecting others. To my friends, I was finally “swine-free.”

My decision whether to be vaccinated against H1N1 has been made for me. Since I most likely already had H1N1, and therefore have built up immunity to the virus, I will not be getting a vaccination. However, millions of Americans are facing the decision of whether to vaccinate themselves and their children against the novel influenza A virus.

The Centers for Disease Control recommends the following high-priority groups get vaccinated: pregnant women; people who live with or provide care for infants younger than six months; health workers; people aged six months to 24 years old; and people 25-64 years old with certain pre-existing conditions.

So, when my mom told me that her doctor recommended she not get the H1N1 vaccine, I was confused. As a chronic Lyme disease sufferer (who is well under 64) and a social worker who works with very young children, my mom fits into one of the high-risk groups. Why, then, did her doctor advise her against getting it?

As I later discovered, there are several reasons why people are apprehensive about getting the H1N1 vaccination. My mom’s doctor told her that he did not see the evidence that the H1N1 inoculation protects one from getting the virus, a concern he also raised regarding the seasonal flu vaccine. This contradicts what the CDC has been saying for weeks. CDC Director Dr. Thomas Frieden recently told reporters that the vaccine should work very well because “it is an excellent match with the strains of the virus that are circulating.”

There is also widespread concern about the safety of the vaccine. During the 1976 swine flu epidemic in the United States, those who received the vaccine for that strand of swine flu were proven to have an elevated risk of contracting Guillain-Barré syndrome. Guillain-Barré syndrome is a disorder in which the body’s immune system attacks part of its nervous system. The most common complications from Guillain-Barré syndrome are breathing-related, and patients are often placed on respirators. The majority of people who contract the disorder recover, but it can be fatal.

The CDC says that it expects the H1N1 inoculation to follow a similar safety profile as the seasonal influenza vaccine, which has not been associated with increased risk of Guillain-Barré. Officials also say that this new pandemic vaccine is much “purer” than the 1976 inoculation. The expected side effects from the 2009 H1N1 vaccine are similar to those from the regular flu shot, including soreness or swelling at the point of injection, low-grade fever and body aches. The CDC and the Food and Drug Administration will be closely monitoring the safety of the immunization. The Vaccine Adverse Event Reporting System exists so that health care providers can report vaccine concerns directly.

And then there are those who think natural immunity is better and safer than any vaccine and are suggesting “swine flu parties” are the way to go – get yourself infected with H1N1 and your body will build up immunity. Most doctors and the CDC strongly advise against this method of protection.

What factors have influenced your decision whether or not to get the H1N1 vaccine? What advice has your doctor given you? Have you come to a decision whether to vaccinate you or your children?

By Ashley J. WennersHerron
CNN Medical News Intern

Breast cancer runs in my family; even my dad had it. I routinely do self-checks, always terrified that I'll find some indication of my worst nightmare.

Two weeks ago, I did. I found a lump the size of a pea buried in the skin between my right breast and my armpit. I paled, I cried, I panicked about the future, and then I did the sensible thing. I searched the Internet. Typing "Right Breast Lump and 20-Year-Old Woman" into Google didn't reveal anything. Neither did "Breast Cancer in 20-Year-Old Girl." I fruitlessly searched every site I could think of, turning up contradictory results.

An hour into my self-diagnosis, it occurred to me to call a doctor.

Living away from home and my usual doctors, I called my insurance provider. After 45 minutes on hold, an operator listed four doctors in Manhattan that would accept my insurance. The first three were booked through November. The fourth could see me the week before Thanksgiving.

The thought of not knowing for nearly a month was unbearable. Tears welled up in my eyes and fear was obvious in my voice when I confirmed a time with the receptionist. She must’ve heard how scared I was, she told me that they could squeeze me in early the next day.

The next morning, after arriving an hour early, I was told that the doctor’s office was out of network for my insurance. They’d take me, but I’d have to cough up almost $200 just to be seen, and I’d have to pay out of pocket for testing –up to $3,000.

I was shocked. Something was wrong with me and I was getting it checked. I was being responsible. I had called my insurance company, thinking they would send me somewhere I could afford. Not only was I worried about a potentially serious health problem, I was also concerned that I wouldn’t be able to have it looked at because it was too expensive. It turned out that the doctor’s office was willing to work with me. Maybe they just wanted to get me, crying and hyperventilating, away from their other patients out of their waiting room. But they took me; they didn’t turn me away.

The doctor examined the lump and sent me for a battery of tests.  After being poked and prodded and monogrammed and sonogrammed, I waited.

Eventually, I was told the good news—a benign cyst and an inflamed lymph node. Two completely harmless conditions that I could have agonized over for weeks and weeks, if I hadn’t known what it could have been.

If you are truly concerned that you might be sick, get it checked out.  A lot more doctors’ offices than you might think are willing to work out payment plans. It’s worth knowing what you are facing.

Hopefully, it’ll end up being nothing, but if it is something worse, catch it as early as possible.

Have you ever ignored a health problem, because you thought you couldn’t afford to get it looked at? Are you putting off going to see a doctor because you don’t want to know if you are sick?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a  feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Shannon:

"I have a 4-month-old infant and I recently had myself and my 6-year-old son vaccinated for H1N1. My question is, will my infant also gain my immunity to H1N1 through my breast milk? I hope so." 

Answer:

This is a great question and a huge concern for many parents whose children are less than 6 months old and therefore too young to get the H1N1 vaccine. Unfortunately, there is no clear answer to your question, Shannon, so the best we can do is spell out what we do know.

We know that any time you breastfeed your 4-month-old, you pass on potent antibodies (proteins that your immune system produces to fend off disease in the body) that protect him or her against a whole range of infections.

We also know a bit about other vaccines and breast milk, for example, the pneumococcal vaccine that protects against things like pneumonia and meningitis. According to the National Institute of Allergy and Infectious Diseases, mothers who received that vaccine produced antibodies that were detectable in their breast milk, and passed them on to their babies. What is not as clear is whether those antibodies actually conferred immunity to their newborns.

The Centers for Disease Control and Prevention guidance about breast milk and the flu vaccine is a tinge more hopeful, albeit far from conclusive: "By breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant's chances of getting sick with the flu."

While experts wrestle with this question, you have already taken a positive step – and significantly reduced your baby’s chances of getting the H1N1 virus – by getting yourself vaccinated. The next step is to create a "cocoon of protection" around your baby by making sure that other caregivers in the family also get vaccinated.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Miriam Falco
CNN Medical Managing Editor

For all the (legitimate) talk about the new H1N1 influenza virus, it's worth a reminder that this new flu strain is not all we have to worry about as fall turns into winter (except for Colorado, which evidently has winter now).

There's also something called "RSV." As a medical reporter, I've come across this term a few times. As a new mom of a 6-month-old, I've paid a little more attention and did some research. RSV, or respiratory syncytial virus, can cause upper- and lower-respiratory infections.
The symptoms include runny nose, dry cough, low-grade fever, sore throat, mild headache and general discomfort. But in severe cases, it can cause bronchiolitis (infection of the tiny airways in the lungs) and pneumonia. According to the Mayo Clinic, severe symptoms include "high fever, severe cough, wheezing - a high-pitched noise that's usually heard on breathing out (exhaling), difficulty breathing, and bluish color of the skin due to lack of oxygen. "

RSV is so common that virtually every child will be infected before his or her second birthday. Fortunately, only a small percentage of infants develop severe illness. Luckily for my little guy, he's apparently no longer in the highest risk group, since most children hospitalized for RSV infection are younger than 6 months of age, according to the CDC. However, a study published in the New England Journal of Medicine in February suggests that among children 5 and younger, RSV infection is responsible for approximately 1of every 334 hospitalizations, 1 of every 38 visits to an emergency department, and 1 of every 13 visits to a primary care office each year in the United States.

Older people and adults with underlying illness can also be affected, but young children are at highest risk. One way to limit the risk to your child is to require folks to wash their hands before picking up your baby. Kissing can also spread RSV.

On August 30, the CDC stopped counting only H1N1 hospitalizations and deaths and started counting all hospitalizations for H1N1 and pneumonia; the new numbers will probably include cases of RSV too.

Consider this your reminder that in addition to H1N1 or swine flu, there are other viruses that lurk around. So if you or your children or parents get sick, it's not automatically always swine flu.

Have you had an experience with RSV that you can share with others?

By Val Willingham
CNN Medical producer

As a medical producer I am often asked where I get my story ideas. Most of them come from contacts I know. Other times I read about certain events or people I think would make interesting TV stories. I've even pulled a couple of ideas off my gym's bulletin board. Who knew that women's rugby was becoming popular? If you keep your eyes and ears open, "good" story ideas always seem to materialize.

That's how I met Ronn Wade. A few years ago, when I was suffering from insomnia, I flipped on the National Geographic channel, only to catch a special on mummies. Most of it was shot in Cairo, some in Peru and other exotic locales. Then the story switched to Baltimore. The director of the anatomical services division of the University of Maryland School of Medicine, Ronn Wade, along with Bob Brier, a professor of philosophy and Egyptology at Long Island University took a donor cadaver and decided to mummify it using the same techniques as the Egyptians. Removing the organs one by one and placing them in canopic jars, extracting the brain with a hooked instrument, wrapping the body in bandages treated with special oils, Wade and Brier took weeks to preserve the body. I was fascinated. I knew I had to interview Ronn Wade.

Since that time I have worked with Ronn twice. Although he deplores the title, most people refer to him as the “Mummy Man”. He not only was the co-creator of the modern mummy, now on display at the San Diego Museum of Man, he also oversees a collection of 200, 18th century medical mummies called the Burns Collection. His department is also responsible for providing donor cadavers for local hospitals and medical schools. But what's most intriguing about Ronn's research is his ongoing effort to find a better way to preserve bodies with a treatment called plastination. By immersing donor cadavers in a plastic-like substance, made up of polymers, Ronn can actually take the organs, skin, anything found in the human anatomy and cut it into sections, much like slices from an MRI, but you can hold them in your hands. By looking at these slices, doctors and medical students are able to learn how diseases develop, why they develop, and in many cases, how they can be treated.

With today's fascination with the Twilight saga, displays like "Body: The Exhibition”, and television shows such as True Blood, Ronn Wade could probably do his own reality show. But death is more than gore and corpses to him. To him it's a teaching tool and a way to learn more about life.

Why do you think we are fascinated with death? We'd like to hear your thoughts.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

Jillian Michaels and Dr. Sanjay Gupta at a Fit Nation event in St. Paul, MN

Editor's Note:  Four months ago, Dr. Sanjay Gupta began his “Four months till 40” quest to get in the best shape of his life by his 40th birthday, which is today.  Along the way, he checked in with personal fitness trainer Jillian Michaels, who is our guest blogger today. 

By Jillian Michaels
Guest Blogger

Motivation – "a reason for doing something or behaving in some way”. Motivation, it’s one of the most illusive American traits. Many of us can’t get motivated in the first, place let alone stay motivated.

So many of us go through our lives lost. Slogging away at a job we hate, in a body that is unhealthy, living a life that is unhappy. Some of us putting everyone else’s needs above our own. Meeting our “responsibilities” and doing what society tells us we are supposed to. The reason our motivation wavers like a candle dancing in a squall is because we have forgotten how to dream. You see motivation must come from an authentic internal desire to be and have more and we as Americans either don’t feel worth it or don’t feel capable or don’t feel worth it and capable. Sigh…

The way to get motivated and stay motivated is to identify, define, and emotionally connect to your dreams. Your dreams are your eternal motivation. They inspire us to our greatest heights, comfort us through hard times, and bring about the realization of our destiny. They are the first steps towards happiness and success and although dreaming is as natural as breathing, most of us have forgotten how. We are terrified to hope, paralyzed by thoughts of failure, ashamed of our desires and for absolutely no good reason.

Often, when we do get motivated it is a fleeting moment of bravado based in passion, but not practicality. In that moment of daring to try we are frantic for overnight results that will validate our ability to achieve the goal at hand. For this reason we engage in self-destructive behaviors like fasting, yo-yo diets, archaic surgeries where we remove parts of our internal organs. It would seem that nothing is unthinkable when we are in a place of desperation.

Sadly, these types of behaviors have the opposite effect- in some cases resulting in long term damage to our health and subsequently our morale to an even greater degree. Thus begetting the vicious cycle of hopelessness and helplessness that makes our health and happiness elusive.

Here is the good news: You DO have the power to change anything in your life, in any way you choose, at anytime you choose it.

People come to me on “The Biggest Loser” having hit the end of the road. Having tried “everything” imaginable to get healthy they show up weighing 500 pounds, with one foot in the grave. The reason I am able to help them is because I am able to educate them. You see with the proper information you have the ability to make powerful choices that affect positive change. Then, when contestants see results success begets success. Their self image is redefined as a person who CAN achieve and who IS worthy of all the good things this life has to offer. Instead of saying, “Why me? What makes me special? Why do I deserve health, wealth, love, etc?” They leave saying “why not me?”.

If they can achieve this empowered state of mind so can you. Start by writing down your dreams. Then educate yourself on how to achieve them SAFELY and effectively. Take deliberate action with your goals in mind. Then, take stock of your accomplishments and let them feed your self worth and self esteem for when times get tough. Success is a matter of attrition and when you feel your inspiration leaving you, know this: There is an abundance in this world. There are people who are rich, healthy, happy and in love. WHY NOT YOU?

How do you stay motivated?