Category: Medicine Hat News

Posted on

Sleep Apnea Disturbs a Good Night’s Sleep

A tired man who did not wake up when someone drew a mustache on his face! (Ulrik Tofte)
A tired man who did not wake up when someone drew a mustache on his face! (Ulrik Tofte)

Now that you are back from your Family Day long weekend, it is time to catch up with your sleep. But if you suffer from sleep apnea then you will never feel rested.

Normally, breathing is regular. Apnea means cessation of breathing. Sleep apnea is a condition that interrupts breathing during sleep.

Sleep apnea may be central – that is due to instability of the feedback system that regulates breathing. Or sleep apnea may be obstructive – due to recurrent obstruction of the upper airway. Or it can be mixed – central followed by obstructive.

Today, we will confine our discussion to obstructive sleep apnea.

A typical individual with obstructive sleep apnea starts snoring shortly after going to sleep. The snoring proceeds at a regular pace for a period of time, often becoming louder, but is then interrupted by a long silent period during which no breathing is taking place (apnea). The apnea is then interrupted by a loud snort and gasp and the snoring returns to its regular pace. This behaviour may recur repetitively and frequently throughout the night.

Obstructive sleep apnea causes frequent night awakening, feeling of tiredness in the morning, abnormal daytime sleepiness, headaches, memory loss, poor judgement, personality changes and lethargy. It may also raise the blood pressure.

Who suffers from obstructive sleep apnea?

Obstructive sleep apnea affects two percent of women and four percent of men. It is a condition of middle-aged adults.

Contributing factors may include obesity, use of alcohol or sedatives before sleep, anatomically narrowed airways, and massively enlarged tonsils and adenoids. Genetic and environmental factors may also adversely affect airway size. The condition may run in some families.

Diagnosis of sleep apnea is made by sleep study.

Is sleep apnea hazardous to your health?

During periodic breathing, there is a change in the amount of carbon dioxide and oxygen in the blood and this results in irregular heart rhythm, change in the blood pressure and in the autonomic nervous system. Heart failure, heart attack and stroke are likely complications.

Chronic sleep deprivation caused by sleep apnea increases risk for motor vehicle accidents. The accident rate for such patients has been reported to be seven times that of the general driving population.

In 1997, a review article in the British Medical Journal evaluated all studies published between 1966 and 1995 on the association between obstructive sleep apnoea and mortality and morbidity. The authors concluded that there was limited evidence of increased mortality or morbidity in patients with obstructive sleep apnea.

A report published recently in the American Journal of Respiratory and Critical Care Medicine found middle-aged and older men with untreated obstructive sleep apnea have more than double the risk of experiencing a stroke when compared with their counterparts who don’t have obstructive sleep apnea. Among women, an increased stroke risk was observed only among those with severe obstructive sleep apnea.

The paper concludes by saying that it is not known if treating obstructive sleep apnea reduces stroke risk but treatment offers a number of benefits, including greater alertness and less sleepiness in the day and improved concentration and memory.

Next week we will discuss treatment of sleep apnea. Until then sleep well.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Posted on

Valentine’s Day for Love, Roses, Chocolates and…may be Diamonds

Valentines gifts with chocolates. (Hemera)
Valentines gifts with chocolates. (Hemera)

Make love, not war.

If there is love, there is peace.

When you think about love, you think about peace, happiness and tranquility. But, as we all know, love is not as simple as we think. Turn on the news and there isn’t much love out there.

Sometime ago, I saw a movie called “Crazy, Stupid, Love.” It is a 2011 romantic comedy-drama film with Steve Carell, Ryan Gosling, Julianne Moore and others. It is a pretty complicated story involving many characters. In the end, you wonder what was it all about. It must have been about crazy, stupid, love. Yes, it was about crazy, stupid, love.

Next movie which comes to my mind is “Love Story.” It is a 1970 romantic drama starring Ryan O’Neal and Ali MacGraw. I remember the movie as real tearjerker. The film, well known as a tragedy, is considered one of the most romantic of all time by the American Film Institute. How can a love story be a tearjerker, a tragedy and most romantic? The word “oxymoron” comes to my mind. Yes, the movie was about love and sacrifice.

“Love means never having to say you’re sorry”, says Ryan O’Neal’s character at the end of the movie. What does that really mean? Well, true love is unconditional. True love is transparent. True love means we accept and understand and allow our loved one to make mistakes, falter and stumble. True love means we offer them genuine compassion when they are trying their best. Although, we may think their best has to be even “better.”

Patience, is a great virtue, when you love someone. To me, that really sums it up. Love means never having to say you’re sorry.

Valentine’s Day is a good day to reassure our loved ones that what counts most in the world is love and without that there is no happiness. Diamonds, roses and chocolates may provide some competition but love trumps them all.

That brings me to “chocolate theory of love.” You have to be a chemist to understand that. I will try to simplify it. I confess, I am not a chemist but I do love my dark chocolates.

In the early 1980s, researcher Michael Liebowitz, author of the popular 1983 book The Chemistry of Love, remarked to reporters that “chocolate is loaded with PEA.” This became the focus for an article in The New York Times, many magazines and wire services. It came to be known as “chocolate theory of love.”

PEA stands for phenylethylamine or phenethylamine. It is also the name of a class of chemicals with many members well known for psychoactive drug and stimulant effects.

Aside from PEA, there are many other ingredients in chocolates which cause chocolate craving, fight depression and anxiety, and increase energy and stamina among high performance athletes. PEA like amphetamine, is responsible for releasing the hormones dopamine and nor-epinephrine in the brain, making a person feel elated and uplifted.

Is it an aphrodisiac? You will have to find that out for yourself. See if the “chocolate theory of love” is true. But, remember, it is good for your heart and brain. Enjoy.

Have a wonderful Valentine’s Day.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Posted on

Daily Siesta Keeps Me Healthy, Working and Wise

Palm trees and a hammock. (Goodshot)
Palm trees and a hammock. (Goodshot)

I finished my high school in Dar-es-salaam, Tanzania. It was in a boarding school. We had no high school where I was born, Musoma, a port on Lake Victoria. The climate in Musoma is little milder than the scorching, coastal, humid heat of Dar-es-salaam. Our classes would end at 2:00 p.m. and before starting our homework, we had to return to our dorms and take a siesta for an hour.

Few years ago, we were in Spain travelling by train. If we reached our destination after lunch then we could not find any food till the evening. Almost everything shuts down in the afternoon for a siesta. Then evenings are spent drinking wine and eating delicious tapas. That is at the very heart of their lifestyle and culture. They know how to live.

Taking “power naps” during internship, residency and then working as a surgeon became a habit for me. Now it is impossible to go without taking a nap. Depending on the circumstances, the naps can be anywhere from five minutes to 20 minutes long. It is very refreshing.

When it comes to taking naps, I am sure, many of you have had the same kind of experience as I have had, Men are well known for dosing off on the sofa after a meal while the TV is on. I use my naps as part of my meditation time. I start with slow deep breathing exercises and then slide into a snoring session. My alarm wakes me up and then I am ready and fresh to begin work.

Sometime ago, I read an article in the New York Times (NYT) titled “A Look at Who Naps” (July 29, 2009). It says one in three adults admit that on any typical day they take a nap. A survey taken in the U.S. revealed all kinds of individuals take naps.

If you are sleep deprived due to some reason of health, work or travel then, you will take a nap. Even the stoic ones, who feel they can sleep for four to five hours a night and carry on realise that they need to do some sleep catch-up time.

Americans average 6.9 hours of sleep on weeknights, according to the National Sleep Foundation. Ideally, a healthy adult should sleep seven to eight hours a night. If you are sleep deprived then you are not thinking as clearly as you would like to. If your are sleep-deprived for 24 hours straight, then you are cognitive equivalent of being legally drunk. Your performance suffers.

Studies have shown that the sleep-deprived among us are lousy judges of our own sleep needs. We are not nearly as sharp as we think we are, says the NYT article.

There is stigma attached to napping. Your associates, friends or family may think you are lazy or lack ambition. Of course that is not true. If that was the case then I wouldn’t be writing about it.

Confessed nappers include Albert Einstein, Winston Churchill, Thomas Edison and Presidents Ronald Reagan and Bill Clinton.

According to one sleep expert quoted in the NYT article, napping should have the status of daily exercise. Nobody has defined what constitutes a nap. The National Sleep Foundation points out on its Web site: “While naps do not necessarily make up for inadequate or poor quality night time sleep, a short nap of 20-30 minutes can help to improve mood, alertness and performance.”

And that is good for your health.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Posted on

Alcatraz – More Than Just An Abandoned Island

Alcatraz island as from San Francisco

Alcatraz island as from San Francisco

Prison hallway

Prison hallway

Welcome sign, reminder of brief Indian occupation

Welcome sign, reminder of brief Indian occupation

Famous inmates

Famous inmates

Sabiya and Noorali Bharwani on the island with San Francisco

Sabiya and Noorali Bharwani on the island with San Francisco

I find the island of Alcatraz very fascinating. I have visited the island three times. My last visit was about three months ago when my wife and I were in San Francisco for a conference of the American College of Surgeons. Recently, I noticed that there is a TV series called “Alcatraz”. And many Hollywood movies have been produced based on stories about the island and its famous inmates.

Alcatraz Island is located in the San Francisco Bay, 2.4 km offshore from San Francisco, California. The island is also known as “The Rock”. The size of the small island is 22 acres (89 030.8413 sq.m.) and reaches 121 feet (36.88 m.) above sea level. The island has no source of fresh water.

Most people know Alcatraz as an island for men too tough for any other prison. And these tough guys met their match on the windy, desolate, and inescapable Alcatraz. While the ghosts of the penitentiary continue to haunt the island, Alcatraz is more than just an abandoned prison.

Once upon a time, Alcatraz was home only to seabirds. In 1775,during the Gold Rush, the Spanish explorer Jose Canizares christened it La Isla de los Alcatraces. He was probably referring to the large population of black cormorants (alcatraceo) or the island’s pelicans.

In 1846, the Mexican Governor gave the island’s ownership to Julian Workman to build a lighthouse.

The US government got possession of the island in 1848 and began building a fort. A water tank was built. This was followed by a lighthouse and a foghorn. In foggy weather, it’s 1,000 pound bell was struck with 30 pound mechanical hammer every ten seconds. The garrison was completed in 1859 when 200 soldiers arrived to defend the port.

During the Civil War, Alcatraz held a number of Confederate sympathizers. In 1873, the island had Indian prisoners some of who refused to send their children to English only schools. Then came the 1906 earthquake in San Francisco, when civilian prisoners were transferred to the island until the city’s jails could be rebuilt. In 1912, a three-story cell house was completed.

When did it become the the Federal Penitentiary?

In 1934, Al “Scarface” Capone was one of its first prisoners. After that many prisoners came to Alcatraz because they were too much trouble in other prisons. During World War II, inmates made khakis, fatigues and cargo nets for the war effort.

During its 29 years of operation, the penitentiary claimed no prisoner had successfully escaped. A total of 36 prisoners made 14 escape attempts, two men trying twice; 23 were caught, six were shot and killed during their escape, and three escaped and were never found. The most violent escape occurred on May 2, 1946, when a failed escape attempt by six prisoners led to the Battle of Alcatraz. In 1963, Attorney General Robert Kennedy closed Alcatraz.

In 1969, 75 American Indians took over the island. The American Indian Foundation wanted legal control of Alcatraz under the 1868 Treaty of Fort Laramie. Some historical buildings caught fire and were destroyed so the US marshals forcibly removed the Indians, ending the occupation in 1971.

In 1973, Alcatraz became part of the Golden Gate National Recreation Area. It has become a big tourist attraction. It now has over 1.4 million visitors a year. There are gardens, and the wild inhabitants in the form of animals have returned. Today, over 100 different bird species visit the island, including the endangered peregrine falcon and brown pelican.

Who were the notable inmates in Alcatraz?

In 1934, Al Capone arrived on Alcatraz. He served just four and a half years of his sentence there before developing symptoms of tertiary syphilis and being transferred to the Federal Correctional Institution at Terminal Island in Los Angeles.

George “Machine Gun” Kelly arrived on September 4, 1934. He was a model prisoner. Alvin “Creepy Karpis” Karpowicz arrived in 1936. He constantly fought with other inmates. He spent the longest time on Alcatraz island, serving nearly 26 years.

Robert Stroud, who was better known to the public as the “Birdman of Alcatraz”, was transferred to Alcatraz in 1942. One myth needs to be clarified. Contrary to the popular film released in 1962, Robert Shroud, was not allowed to keep any birds but he did publish two books on them. And there were many other inmates.

Visitors can reach the island by ferry ride from Pier 33, near Fisherman’s Wharf in San Francisco. If you are in San Francisco, you cannot miss a trip to the Island.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!