By Andrea Kane
CNNhealth.com Producer

Pssst: Come here… A bit closer. I have a confession to make: One of my daughters has L-I-C-E. And it is driving me crazy, because it just will not go away, no matter how much I cut, comb and nitpick her hair. And I’ve been doing a lot of nitpicking lately – at times, I feel like a mama chimp grooming her child (minus popping the “prize” into my mouth). My daughter gets cranky having to sit there for an hour (especially when I pull an individual hair strand to remove an egg — aka: nit — that is cemented on) and I get cranky, too.

According to the CDC, there are an estimated 6 million to 12 million head lice infestations each year in the U.S. among children 3 to 11 years old. Lice are usually transmitted through direct head-to-head contact. Less commonly, they can be passed on via a hat, comb, pillow or other personal object (contrary to our worst fears, lice don’t dive-bomb from one person’s head to another’s). Cleanliness and socioeconomic status have little to do with getting head lice, although race may have an impact; African-Americans are less likely to get them.

Aside from being icky and itchy, head lice are not known to transmit disease (although hard scratching can cause a secondary infection). That said, you don’t want them hanging around.

Our “ordeal” started in mid-May when I stopped by the school nurse’s office for her to have a look-see because her two best friends had it (that, and she was scratching an awful lot). “You see right there — those are nits,” she said, pointing to what looked like a bitty grain of salt on the hair shaft.

The nurse instructed me to shampoo my daughter’s with an over-the-counter pediculicide (lice-killing) shampoo, then comb out all the nits because OTC shampoos do not kill all the eggs (only the heavy-duty, super-toxic, prescription shampoo does). The third step (after shampooing and nitpicking) is to delouse personal objects.

At the drug store, the choices were many: popular OTC shampoos (with either pyrethrins – derived from chrysanthemums — or their synthetic cousin permethrin), homeopathic treatments (that promise to kill lice without harsh chemicals), gels to help with the nitpicking– even an electric comb that electrocutes the lice.

I ended up buying the store brand, partially because it offered the most shampoo at the cheapest price (the shampoos are expensive and we are — except for my husband — a household of long, curly-haired females, so we needed quantity, especially since we didn’t want to skimp). I slathered it on my daughter’s hair, waited 10 minutes, then rinsed and, with a fine-toothed comb, I combed… and combed… and combed, trying to get all of the nits out. Have I mentioned that she has long curly hair? A lot of it? A thick underbrush of it? Well, it took a long time to through it all. Except that I didn’t get it all: We both grew impatient before I was done.

Then, I threw all of her bedding into the wash, boiled all the combs and hairclips, and quarantined her stuffed animals and brushes. And for good measure, my husband and I shampooed our hair and washed our linens (as luck would have it, there had been a thunderstorm the night before and we played musical beds). I also checked her sister’s hair: Nothing! Mom 1, lice 1.

The next day, the lice were gone. And for a few glorious days, I thought we had dodged a bullet.

With most of the OTC shampoos, you have to retreat between seven and 10 days after the initial treatment, when the eggs that the shampoo failed to kill the first time finally hatch and repopulate the hair — but before the nymphs can grow into adults capable of reproducing. The life cycle of lice is about three weeks.

But before we could get halfway to retreatment time, they were back. So I cut off six inches of my daughter’s hair and we tried another brand of OTC shampoo; this one did not work at all (lice can become resistant to a particular pediculicide). So I went back to the first shampoo and I bought the electric comb (which was pretty cool and did electrocute some lice, but apparently not all). When that failed, I tried the homeopathic shampoo that works by dehydrating the lice and their eggs (this one you have to leave on for at least an hour, instead of 10 minutes). At the time of each treatment, we washed linens, boiled hair accessories all over again. The stuffed animals never made it out of quarantine.

But still the lice returned.

After about a month, at wits end, I called my pediatrician’s office. The nurse on call told me I could try the prescription shampoo (did I detect hesitation in her voice or was that me projecting?) or I could try one more “weird” treatment. Since I wasn’t particularly excited about the prospect of using poison so close to my child’s growing brain, I chose the latter. She recommended “Dippity-do.” Yup: The pink or green hair gel popular in the ’50s and ’60s. (It now comes in other colors too.)

But, she warned, I’d have to wrap my daughter’s hair in plastic wrap and a shower cap and leave it on for 12 hours. Similar to other home remedies — like mayonnaise and olive oil — the idea is to smother the lice in a thick coat of glop. The advantage of Dippity-do over the oily foodstuff is that it is much easier to wash out of hair (and doesn’t stink like unrefrigerated mayonnaise).

If this doesn’t work, I’ll be tempted to pull out the big guns: No, not the prescription shampoo but the electric razor – and give my daughter a buzz cut.

Have you or a family member had lice? How did you finally defeat it? Did using harsh chemicals on a small child worry you?

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

Tuesday afternoon, I was hanging out in Harlem, working on a story we’ll be running later this month. A few blocks away, the barricades were up and police were directing traffic around the Michael Jackson tribute at the Apollo Theater.

Donald Childs, a bicycle repairman, was holding court on the north side of Marcus Garvey Park. Looks like Jackson was working the system, he told me, finding doctors all too willing to give him whatever he asked: “Yes-man health care.”

People in poor neighborhoods work the system, too, Childs said. “You go to a clinic and wait for hours to be see anyone. Poor people, people around here, just expect that. It’s the norm. [But] they know what to do if you really need a doctor. You go to the emergency room and you tell ‘em it’s asthma, or a heart problem.”

“My wife has pancreatic cancer,” Childs confided. “But when she goes to the emergency room, and she needs to be seen right away, she tells them it’s her heart.” It was painful to hear, but sad to say, not surprising. I’ve talked to a lot of people who struggle to find decent care for cancer.

A few yards away, I heard more about gaming the system. “There’s a dentist’s office at ____; they’re paying homeless people $10 for their Medicaid number,” Heidi Flores was saying. “There’s another one pays $15.” [With a Medicaid number, a doctor or dentist can file claims for reimbursement – in this case, presumably, for nonexistent services.] Her friend, George Cabassa, chimed in. “There’s another one where they give you a cleaning but they tell Medicaid they did everything and the kitchen sink.” He told me to check it out, handed me a phone number and strolled off.

No surprise here, the health care system we have is maddeningly complex. It’s full of rules, full of odd financial arrangements and full of loopholes.

Monday evening, I found myself relaxing in the office of the Rev. Dr. Joe Bush at Walker Memorial Church in the South Bronx, listening as he argued that we need something simpler: a government-run health system like the ones in Canada or Western Europe. The air conditioning felt good with the sidewalk still sweltering outside, but the pastor was getting agitated.

“The first thing they ask when you step up to the counter: ‘Where’s your card?’ It’s all about the almighty dollar.”

I asked about his own health coverage and learned something new: According to Bush, insurance companies consider pastoral work to be a high-risk profession – high-stress, with associated health problems. To cover himself and his wife, Bush pays $27,000 a year for a policy with a $2,000 deductible.

When I asked what he thinks of the argument that a “public option,” or government-run insurance plan, might drive private companies out of business, his answer came as no surprise: “That would be a wonderful thing,” he said, a smile lighting up his face. “It would be the best thing that could happen to America.”

That might be a dramatic point of view, but riding home on the plane I found myself wondering if a government-run system would make a cancer patient lie about a heart condition, just to get a doctor to take her condition seriously.

Did you ever lie or shade the truth, talking to a doctor, hospital or health insurer?

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 David Martin
CNN Medical Senior Producer

Michael Jackson’s sad and sudden death has brought the issue of physician qualifications to center stage.

Jackson’s personal doctor, Conrad Murray, was a cardiologist who was not board certified in cardiology. Board certification isn’t necessary to practice medicine, but many hospital systems require their doctors to be board certified in their specialties. Still, Murray had not been subject to any state or federal disciplinary in the last five years, according to HealthGrades, and Jackson reportedly got along well with him. That counts for something. In the coming days and weeks, investigators will determine whether doctors were prescribing narcotics for Jackson. For his part, Murray’s attorney has denied that Murray prescribed or administered the powerful painkillers Demerol or OxyContin to the pop star.

Unlike the rest of us, Jackson had the means to employ a personal physician, the kind of round-the-clock care that is usually privileged preserve of presidents and potentates.

When we choose a doctor, we simply want someone who will see us when we’re sick, who takes the time to listen, who can draw on knowledge and experience to find the right treatment when we need it. We assume the doctor is licensed. We assume if the doctor had been endangering patients, we’d know about it.

A couple of recent reports call that into question.

Medversant Technologies, which provides Web-based management tools for hospitals and others, recently reviewed the credentials of more than 7,000 practicing doctors and found that 1 percent were unlicensed or had licenses that were suspended or terminated because of state or federal sanctions; 6 percent more had expired licenses.

And last month, Public Citizen published a report taking a closer look at the National Practitioner Data Bank, designed to protect patients from incompetent or unprofessional physicians.

Hospitals that revoke or restrict a doctor’s privileges for more than 30 days because of misconduct or ineptitude are supposed to report this to the federal data bank.

But Public Citizen says hospitals look for ways to avoid reporting doctors. Some hospitals allow doctors to take a leave of absence rather than discipline them in a way that would require reporting to the database, the non-profit group said in the report, while others impose sanctions of 30 days or less to avoid reporting.

In 2006, the American Journal of Medical Quality published a study that found 60 to 75 percent of reportable actions were not reported.

How thoroughly have you checked out your doctor’s credentials? Have you ever gone to a doctor who you found out later was unqualified or unlicensed?

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 Naaz Malek
CNN Medical Intern

Kudos to my generation of women for being Empowered Patients! My generation is different from my mother’s. Young women today have resources, such as the Internet, that allows them to do their homework before a doctor’s visit and push harder for answers. Combine that with advancements in technology and the chances of detecting a problem earlier are greatly improved.

Take my 22-year-old friend for example. Let’s call her Sue. Her periods had recently gotten very painful. Her mother also had painful periods when she was young, but she never went to the doctor. Sue wasn’t going to sit this one out. She was miserable and she wanted answers. So she went to the doctor and after a sonography she found out that she has a small fibroid.

A fibroid is a tumor that grows inside a woman’s womb. In most cases it is non-cancerous. It’s common to see women in their 40s and 50s get a diagnosis of fibroids. But my friend is only 22! I didn’t think that was normal.

It turns out, I was wrong. I called Dr. Joanna Cain, chair of Obstetrics and Gynecology for Warren-Alpert Medical School at Brown University. She says fibroids are caused by increased levels of estrogen, and as young women are “at the height of hormonal activity” it is not uncommon for them to have this condition.

Dr. Melinda Miller-Thrasher, a doctor on the clinical faculty at Emory University, says she has been diagnosing fibroids in more females in their 20s in the past decade. Miller-Thrasher says this increase isn’t because more young women are developing fibroids. It is because they are going to the doctor as soon as they notice something unusual.

Because of the small size of the fibroid and her young age, my friend’s doctor asked her to just observe her period for time being. Thrasher says that sometimes the risks involved in removing a fibroid outweigh the benefits. Therefore in some instance not doing anything to the fibroid can be the best alternative.

So all Sue can do now is wait and watch to see whether her symptoms get worse. But at least she knows what’s wrong with her.

I’m proud of Sue for taking the initiative to find an answer, even though her mother didn’t.

Do you know anyone who benefited from going to the doctor as soon as he or she suspected a problem?

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 regular feature of CNNhealth.com, our team of expert doctors answers readers’ questions. Here’s a question for Dr. Gupta.

From Troy in Silver Spring, Maryland:

“I heard President Obama recently admit that he still smokes cigarettes occasionally. I know he is trying to quit but I’m curious what the health ramifications are for someone who just smokes once in a while?”

Answer:

Great question, Troy. More than 46 million adults in America smoke cigarettes. But 70 percent say they would like to quit, according to a Centers for Disease Control and Prevention study. There is no question that smoking is a hard habit to break. It’s been suggested that nicotine could be as addictive as heroin. And like many Americans reading this right now, the president also struggles to break the habit. Obama admits that,  “as a former smoker, I constantly struggle with it. …Have I fallen off the wagon? Yes.”

However, it’s a myth to believe that if you smoke only two cigarettes a week for example, or just on the weekends, that it won’t affect your health. Even a few cigarettes can increase your blood pressure,and  put you at a slightly increased risk of heart disease and stroke. Some studies show that young smokers who light up only occasionally have signs of artery disease. And though their risk of developing cancer is nowhere near that of a regular smoker, compared with a non-smoker, the risk is elevated.

One group the new anti-tobacco bill targets are so-called “social smokers.’” The concern is that social smoking can turn into a full-time habit very quickly. Big tobacco companies spend millions of dollars researching and marketing to this demographic.

What’s constitutes a social smoker? If you were to ask them, they’d tell you they don’t consider themselves smokers because they don’t do it every day. Studies show social smokers are younger, often  smoke only with friends at social functions and typically don’t typically purchase their own cigarettes in packs. Because of this, tobacco companies often market to social smokers in bars and clubs. The FDA will now regulate tobacco industry marketing in an effort to reduce social smoking in America.

Bottom line, Troy, is that no quantity of cigarettes is safe or healthy for our body. But for the millions of people struggling to quit right, don’t be discouraged if you slip up and smoke. Smoking one cigarette is much better than an entire pack. And by no means does it mean you’re a smoker again. Start fresh tomorrow. And check out www.smokefree.gov for great information on cessation and support programs.

Dr. Sanjay Gupta says his upcoming birthday motivated him to launch the fitness forum with viewers. He wants himself, and America, to get in the best shape of their lives.

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

Today, I am starting something I have wanted to do for a very long time.

Using this blog and my @SanjayGuptaCNN twitter account, I am going to try to harness some of the best practices people employ every day to stay in the best shape of their lives.

Truth is, there are hundreds of sites like this, so I want to make this one different. First of all, I am hoping it becomes a living, breathing forum that users, like you, use to share your best health and fitness tips. I learn new things every day from CNN bloggers and Tweeters. You all are a great resource of information.

I am also going to call on my friends and others I find inspiring to help as well.

For example, @JoePerez helped create something called the Daily Plate, which partners with the non-profit cancer foundation LIVESTRONG, where I sit on the board of directors. After surveying lots of different ways of tracking diets, I think this is one of the best. I will introduce you to Joe and the Web site, which I have come to know through the nonprofit Lance Armstrong Foundation, where I’m a board member.

There are also sites out there that will start to help you heart rate train. After doing lots of research, I believe this is one of the most effective and efficient ways of training. Ironically, my friends who listened to this recommendation from me say they work out less intensely and still increase their fitness more than before.

Speaking of LIVESTRONG, I hope to get my pal @LanceArmstrong to weigh in. Admittedly, he is a professional athlete who will be pretty busy training for a big race in July. After that, though, I hope he will share with you some of the great tips he has given me over the years.

Also well-known trainer, and friend of mine, @JillianMichaels who can provide logical, useful suggestions that can be applied to lots of different situations. I also hope to get tips from @RichRoll. We have met only via twitter, but he is living proof that you can go from being a 38-year-old who hardly ever works out to someone who is in fantastic shape, an ultraman in fact, and is biologically younger than he was 10 years ago.

Most of all, this will be a four-month forum dedicated to getting people in terrific shape.

While smaller waists and less weight are things that will inevitably occur as you start incorporating these tips into your life, the real goal is a longer, more functional and exceptional life – free of disease and dysfunction.

I am a neurosurgeon and a reporter for CNN, who has three kids. I have a fairly active travel schedule. I tell you all that, because, like most people, I am busy. Yet, it can still be done.

So join me right here and on my Twitter page. Also, let’s keep track of each other’s tips under the hashtag #1023 — which just so happens to be the date of a very big birthday for me.

Four months from now, I hope, we can all celebrate what we have done for our bodies and for our health.

By Elizabeth Landau
CNN.com Health Writer/Producer

Recently, after having dinner with a friend, my head felt achy and warm. As I reached for the bottle of Tylenol, I remembered that many medications have harmful side effects in combination with alcohol, and I’d just had a margarita at the restaurant. So, I left the pills on the desk and went to the Internet.

It seems that acetaminophen, the primary active ingredient in Tylenol, may lead to liver damage in combination with alcohol. Liver damage from chemicals is called hepatotoxicity. That’s why the warning label on products similar to Tylenol say you should ask your doctor before taking the product if you drink more than than three alcoholic beverages per day.

But what about one drink? And how long should a person wait after consuming alcohol before taking acetaminophen-based drugs?

I scoured the Web and found that many people had asked similar questions on forums such as Yahoo! Answers. Various Web sites had some suggestions, but not much specific to the precise timing of safe consumption of this medication after an alcoholic drink. Confused, I just put a cold washcloth on my forehead and went to sleep.

For the benefit of CNN.com readers with similar questions, I looked into the issue further.

Dr. Elizabeth Roth, an internist at Massachusetts General Hospital, said drinking before taking the recommended dose of acetaminophen-based medications may not be a big issue for some people, although she does not advise it. In patients without underlying liver disease and who are not chronic alcoholics, acute alcohol intake is not a risk factor for liver damage from acetaminophen, she says.

“The bottom line is that for the otherwise healthy person without chronic liver disease or a history of alcoholism, they don’t have to wait before taking two regular Tylenol after having a drink. But no medical advice fits all patients,” she said in an e-mail.

Other factors can increase the likelihood of acetaminophen-related liver damage, including old age, poor nutritional status, co-existing illnesses, and particular genetic makeups. Moreover, the toxic dose among individuals can vary. A person’s baseline levels of glutathione — a chemical involved in metabolism — play a role in the acetaminophen levels at which toxicity can occur, Roth said.

For alcoholics, acetaminophen-containing drugs such as Tylenol can be dangerous. According to one National Institutes of Health publication on alcohol and metabolism, liver damage effects may occur with as little of four to five “extra-strength” pills taken over the course of the day in people who consumed varying amounts of alcohol. Damage is more likely to occur when alcoholics take the pills after, rather than before, the alcohol has metabolized.

There is treatment for acetominophen poisoning — it’s called N-acetylcysteine (NAC). But always consult your doctor before taking products similar to Tylenol if you think you may be at risk for liver damage as a result of that medicine. And remember that an overdose of acetaminophen, with or without alcohol, is dangerous.

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 Matt Sloane
CNN Medical News Producer

When I first heard about the TOGA procedure, I have to be honest, I was a little shocked! TOGA, which stands for transoral gastroplasty, involves doctors putting a garden hose-sized tube down your throat, passing a camera and a staple gun through the tube, and stapling your stomach from the inside. Pretty cool, eh? It’s the latest procedure in “natural orifice surgery,” an innovative and attention-getting area of medicine. Gallbladder removal through the vagina, brain surgery through the nose, and now stomach stapling through the mouth – the very orifice where most obesity begins.

The procedure – if approved – could help take the place of laparoscopic obesity surgery, which comes with scars, and several days of recovery. Lose weight, no scars, very little recovery time, and the only complaint most people had in the clinical trials was a bad sore throat? Sounds great, but not so fast, says Dr. John F. Sweeney of the Emory University Center for Bariatric Medicine.

“This is really innovative, and it’s pushing the envelope on what we’re doing endoscopically,” said Sweeney, “But stomach stapling really doesn’t work long term.”

Lets take a step back. There are two types of obesity surgery. Restrictive operations make a pouch or sleeve inside the stomach, thus making it harder for food to pass, and creating a feeling of satiety, or being full. Malabsorptive operations actually re-route the gastrointestinal anatomy, so that there is less stomach surface area to absorb the nutrients you normally take in with food, thus causing you to lose weight. TOGA, as well as procedures like the LapBand are restrictive surgeries, and although they can be very successful at first, the long-term success rate is not stellar.

“Folks often aren’t compliant with their diet,” said Sweeney, “Sweet eaters easily defeat restrictive operations, other folks overeat and disrupt the staple lines.”

And according to a 2002 study in the journal Surgery, Body Mass Index (BMI) for patients that had undergone gastric banding operations declined for the first three years after surgery, but then began to climb – almost to pre-surgery levels in the years following.

So just who would be the right candidate for this procedure?

“The whole point of this operation is to make a pouch where large food will get stuck,” said Dr. Edward Phillips, chairman of surgery at Cedars Sinai Medical Center in Los Angeles. “So, if you’re a meat-and-potatoes kind of eater, you will probably do pretty well with this type of procedure.”

But having done dozens of TOGA procedures himself, Phillips says, “liquid calorie eaters” tend not to lose as much weight.

“If you eat alot of ice cream or liquid calories, those kinds of things are going to pass right through the sleeve very easily.”

Overall, in the first phases of clinical trials, the TOGA has resulted in an average of a 45 percent weight loss after one year. How it does after two, three or even five years? That’s the big question that will determine how revolutionary the TOGA really is, and we may not get the full story for another year or two.

When the procedure becomes available, would you have the TOGA procedure done to lose weight?

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 Madison Park
CNNHealth Writer

I was 22 years old when I plucked a gray strand from my tangled black hair.

I showed my mom the strange silver hair, and she shot me the “I-told-you-so” look.  She always told me that watching TV or being on the computer  would make me prematurely gray.

Her evidence: Every computer engineer she knew got gray in her 30’s, but she only knew one computer engineer. So I dismissed this as a kooky theory.

But my gray encounter sparked a curiosity. I’ve seen an occasional silver strand and sometimes a scattering of gray hairs on students, teens and even kids.  One mother wrote to CNNhealth after spotting a strand of gray hair on her 3½-year-old daughter.

Could younger people be graying earlier?  Could it be hereditary or are there environmental factors — like  TVs and computer screens– as my mother suggested?

While researchers have no definitive answers, scientists in Japan say that “genotoxic stress” damages cells which are responsible for hair color. When these melanocyte stem cells die, we get irreversible graying, according to a report released this month in the journal Cell.

Our DNAs are under constant attack by chemicals, ultraviolet light and ionizing radiation, said one of the authors, Dr. Emi Nishimura of Kanazawa University.

In nature, ionizing radiation can come from cosmic rays from the sun and stars, and radioactive materials in rocks and soil, according to the National Institutes of Health. But ionizing radiation also comes from man-made sources, such as X-rays, televisions, smoke detectors, building materials, tobacco smoke, and mining and agricultural products, such as granite, coal, and potassium salt.

“It is estimated that a single cell in mammals can encounter approximately 100,000 DNA damaging events per day,” Nishimura wrote in an email. “But is not clear which kind of sources for genotoxic stress are the major contributors to aging or hair graying.”

In Nishimura’s experiment, 7-to-8-week-old brown and black mice were exposed to whole-body X-rays. “If we try lower doses (of ionizing radiation), you can see a salt and pepper pattern in their hair,” Nishimura said.  “With a bit higher doses, you can see more white hair.  Most of the hair became white.”

While studies in mice don’t always apply to humans, they can provide scientific clues.

“We discovered that hair graying, the most obvious aging phenotype, can be caused by the genomic damage response” wrote the researchers from the Center for Cancer and Stem Cell Research at Kanazawa University in Japan. The results on mice ”suggest that physiological hair graying can be triggered by the accumulation of unavoidable DNA damage.”

I haven’t seen another gray hair in years, but I’m on the lookout.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. This week, Dr. Gupta answers multiple questions about bipolar disorder.

The Food and Drug Administration spent two days this week weighing whether three powerful drugs that treat bipolar disorder and schizophrenia should be prescribed for children. The drugs are called atypical antipsychotics. The panel specifically was looking at the risk, benefit ratio of Zyprexa, Seroquel and Geodon. These three drugs come fraught with controversy because the list of risks associated with them. Common side effects include weight gain, high blood pressure, type 2 diabetes and in some situations, sudden cardiac death. The weight gain is not small – in some cases, a teen can put on 40 pounds in a few months after starting the medications. They seem to interfere with part of the brain that corresponds to our ability to feel full.

Most doctors agree that the risks and side effects need to be weighed by doctor, patient and parent. Many experts CNN spoke to who see children with bipolar disorder and schizophrenia believe these drugs are safe and should be widely available for use when a child has a severe mental health problem.

I received hundreds of questions by e-mail and on twitter. Here are answers to a few of the most common ones.

From @cognimmune via Twitter.com:

“At what age can a child be diagnosed with bipolar disorder or schizophrenia?”

Answer:
That is a really great question and one that experts don’t really have an exact answer to. According an expert in child psychiatrist at Seattle Children’s Hospital, Dr. Christopher Varley, diagnosing a child less than 10 years old is very unusual and difficult to do. Most diagnoses are made in the early teen years.

From @shampm via Twitter.com:

“My daughter is adopted and we are having a hard time getting diagnosed [with bipolar disorder]. What can we do?”

Answer:
Diagnosing bipolar disorder can be tricky because many children, and adults, display different sets of symptoms. For instance, not everyone with bipolar disorder will have instant changes to mood or outbursts of anger. Although the main characteristic is a drastic change in mood/personality, one person with bipolar may experience manic depression for a long time, and others may have only short episodes. A person with bipolar disorder may also display changes in his or her sleep patterns, energy level and have difficulty making decisions.

From Tori in Florida:

“I suspect my 16-year-old daughter may suffer from bipolar disorder. How does one know whether to seek a psychologist or psychiatrist for treatment?”

Answer:
This is a an important one, Tori. The biggest difference between the two professions is that psychiatrists prescribe medications and psychologists do not. Psychiatrists are medical doctors and widely viewed as the best people to treat bipolar disorder because most patients with bipolar disorder do require medication. Psychiatrists are well qualified to identify which drugs might work best for a specific patient. But a major part of any therapy for this disorder is considered psychotherapy. And that can be provided by psychologists and other mental health professionals as well. Talk therapy can help you develop coping mechanisms and may help you keep you on your medications. Bottom line? After diagnosis, you may find a combination of treatment from both beneficial.

From Jackie in Massachusetts:

“I heard many of antipsychotic drugs are being prescribed to kids for who aren’t even diagnosed with bipolar disorder? Is that true?”

Answer:
Jackie, this is a question a lot of people have. What exactly are these drugs being prescribed for? A recent study published in the Ambulatory Pediatrics Journal looked at the trends in prescribing atypical antipsychotic medications. It found these drugs are prescribed only 37 percent of the time to treat bipolar and schizophrenia. What makes some critics cringe is that these powerful antipsychotics are being used almost one-third of the time to treat ADHD — which can often be treated with a less-potent drugs or behavioral therapy.

Here is the breakdown of how atypical antipsychotic drugs are prescribed:
- 37.1 percent bipolar disorder & schizophrenia
- 29 percent ADHD
- 13.8 percent nonpsychiatric diagnosis
- 7.5 percent autism
- 5 percent Tourette’s syndrome
Source: Ambulatory Pediatrics Journal

From John in West Virginia:

“I’m having trouble researching ADHD and bipolar disorder. The two seem similar. What is the difference and is it possible to have both?”

Answer:
John, to answer to the second part of your question, yes, it is possible to have both. But it can be really confusing. It’s a clinical diagnosis, and sometimes some of the symptoms sort of overlap, things like inattention, hyperactivity, impulse disorder, those are all things that are associated with ADHD. But specifically with bipolar, you tend to get what are pretty dramatic mood swings so you can have intense euphoria sort of followed by manic depression. That’s one of the big differences. What’s particularly difficult to distinguish in kids is that sometimes a treatment can be very similar as well, so that may be some of the trouble, there. I’d say if you are looking for a cardinal symptom of bipolar, extreme mood swings would be the main difference.