Sleep, many times a very elusive entity, is a problem for many in society. I see patients everyday with sleep apnea. I don't treat sleep apnea. I am an anesthesiologist who deals, fortunately on a very short term basis, with all of the chronic debilitating disease of our way of life. Aside from the usual manifestations of obstructive sleep apnea (OSA) such loud snoring, daytime somnolence, irritability which by the way can be deadly as sleep deprivation on the roads is at epidemic proportions, the long term consequences of OSA can be deadly.
Sleep apnea most frequently is cause by repetitive episodes of complete obstruction of the airway during sleep. It is frequently preceded by loud snoring (partial obstruction) that progressively gets less and less until there is no snoring (complete obstruction) for a period of time. The individual has no idea this is happening. Only their significant other know for sure. After a variable period of apnea due to complete obstruction and no air movement (you need air movement to snore), the airway unobstructs itself fortunately allowing you to live yet another day of sleepiness and irritability. This has destroyed many a marriage but that is not the real problem.
During these periods of OSA which can happen many time per hour all night long day in and day out, the body's oxygenation level drops. What that does to your brain is a whole other discussion. There more common manifestations due to the repetitative stress of hypoxemia (low oxygen content) in the blood is high blood pressure. Most people with obstructive sleep apnea have hypertension. In fact, if the OSA is adequately treated, or better yet prevented, the high blood pressure frequently goes away. Ultimately his high blood pressure will damage organs. One of the vitals organs that can succumb to this repetitive stress is the heart. Untreated sleep apnea can and will eventually lead to heart failure.
This epidemic of OSA is directly correlated to the epidemic in obesity in this country. Obesity leads to obstructive sleep apnea. Loss the weight and you will no doubt sleep much better and feel much better during the day. If this sounds too familiar I encourage you to seek medical advice for this condition as it will result in chronic illness and an early demise.
Wednesday, June 26, 2013
Friday, July 20, 2012
You Are What You Eat
We put better gas in our cars than food in our bodies. Every general article on healthcare cost makes only a very brief mention of the role of prevention. Healthcare costs have steadily risen since the 80's. At $2.6 trillion dollars in 2010, it is 10 times what it was back then. 17.9% of our GDP goes to healthcare costs. New drugs and new medical technology, some of which is neither cost effective or very efficacious, are a major reason for the increase in costs. In our profit driven society, healthcare included, this is not going to slow down any time soon. 75% of our healthcare dollars goes to the treatment of chronic medical conditions such as heArt disease, hypertension, hypercholesteremia, diabetes, arthritis,and now, may we add a new one, obesity. These are primarily lifestyle associated diseases. These chronic illness are for the most part preventable. 75% of our 2.6 trillion dollars per year goes to treat preventable disease. This is only the money side of the crisis.
The third leading cause of death in the US (2002 data) behind heart disease and cancer is "medical care". Roughly a quarter of a million people per year die of medical care meant to alleviate our suffering and disease. Many of these deaths too are preventable through safeguards to prevent errors in care. However, roughly 106,000 patients die per year from appropriate care. These are bad reactions to drugs and procedures that are no one's fault. Call it had luck or whatever. Healthcare is risky business.
Having been in the profession as an anesthesiologist with cardiac anesthesia training, I have personally seen our population grow sideways. Diabetes, heart disease, hypertension, increased cholesterol are rampant. I calculate BMI's (body mass index, a measurement of obesity) on my patients that come to surgery and it is now rare to find a patient in the normal range of < 25kg/m-squared. Just the other day I met a 9 year old, 224 lbs and 5'1" with a BMI over 42 (greater than 40 is "morbid" obesity)
Obesity is a direct contributor to much of our chronic lifestyle diseases particularly type 2 diabetes, or so-called adult-onset diabetes. This adult-onset classification will no doubt need to be change as we are now seeing this is children. This type of diabetes is, itself, a direct cause of much of our chronic illness.
We live in a society driven by profit and at the present time, and for the past 40 years, unhealthy high animal-protein, high sugar food are the most profitable. We are what we eat. It we continue to consume such foods we will continue to increase the prevalence of chronic illness. Healthcare costs will continue to escalate. The will not only rise but they will exponentially increase as 10,000 baby boomers reach 65 years of age every day bringing with them all their maladies.
We need a major paradigm shift and the food industry itself is going to need to take the lead. Until we have support of industry it is virtually impossible to get our populous to change. We also need to change. We need to take more responsibility for our health. The healthcare profession is a risky industry. It also is a very profitable industry and very few players want it to change. Pharmaceutical companies do not want to cure anything. They want us to be dependent on their medications forever. Don't let anybody fool you. Few people do anything in this country if there is not a profit to be made.
We need to wake up. If we wait to long, most of our profit will be needed to pay for a sick malnourished, obese population. Our workforce will be very expensive to take care of. A company, a hospital though all companies will follow suit, refuses to hire people over a BMI of 35. That is 250 lbs, 5'10". Companies will increase outsourcing of labor to a healthier workforce. Unemployment will rise to levels not seen before. The only hope would be to label "obesity" a disability and then failure to hire based on it would be deemed illegal. What are we doing to ourselves.
When are we going to wake up. Look at the facts. I don't hear anyone really talking about this. Animal-based protein causes heart disease and many cancers. yes, this is a major paradigm shift. Yes, it may disrupt our economy temporarily. But not changing what we put in our bodies will destroy our economy. I have absolutely no doubt about that.
The third leading cause of death in the US (2002 data) behind heart disease and cancer is "medical care". Roughly a quarter of a million people per year die of medical care meant to alleviate our suffering and disease. Many of these deaths too are preventable through safeguards to prevent errors in care. However, roughly 106,000 patients die per year from appropriate care. These are bad reactions to drugs and procedures that are no one's fault. Call it had luck or whatever. Healthcare is risky business.
Having been in the profession as an anesthesiologist with cardiac anesthesia training, I have personally seen our population grow sideways. Diabetes, heart disease, hypertension, increased cholesterol are rampant. I calculate BMI's (body mass index, a measurement of obesity) on my patients that come to surgery and it is now rare to find a patient in the normal range of < 25kg/m-squared. Just the other day I met a 9 year old, 224 lbs and 5'1" with a BMI over 42 (greater than 40 is "morbid" obesity)
Obesity is a direct contributor to much of our chronic lifestyle diseases particularly type 2 diabetes, or so-called adult-onset diabetes. This adult-onset classification will no doubt need to be change as we are now seeing this is children. This type of diabetes is, itself, a direct cause of much of our chronic illness.
We live in a society driven by profit and at the present time, and for the past 40 years, unhealthy high animal-protein, high sugar food are the most profitable. We are what we eat. It we continue to consume such foods we will continue to increase the prevalence of chronic illness. Healthcare costs will continue to escalate. The will not only rise but they will exponentially increase as 10,000 baby boomers reach 65 years of age every day bringing with them all their maladies.
We need a major paradigm shift and the food industry itself is going to need to take the lead. Until we have support of industry it is virtually impossible to get our populous to change. We also need to change. We need to take more responsibility for our health. The healthcare profession is a risky industry. It also is a very profitable industry and very few players want it to change. Pharmaceutical companies do not want to cure anything. They want us to be dependent on their medications forever. Don't let anybody fool you. Few people do anything in this country if there is not a profit to be made.
We need to wake up. If we wait to long, most of our profit will be needed to pay for a sick malnourished, obese population. Our workforce will be very expensive to take care of. A company, a hospital though all companies will follow suit, refuses to hire people over a BMI of 35. That is 250 lbs, 5'10". Companies will increase outsourcing of labor to a healthier workforce. Unemployment will rise to levels not seen before. The only hope would be to label "obesity" a disability and then failure to hire based on it would be deemed illegal. What are we doing to ourselves.
When are we going to wake up. Look at the facts. I don't hear anyone really talking about this. Animal-based protein causes heart disease and many cancers. yes, this is a major paradigm shift. Yes, it may disrupt our economy temporarily. But not changing what we put in our bodies will destroy our economy. I have absolutely no doubt about that.
Monday, June 11, 2012
Chronic Disease is Preventable
"Obesity will crush the United States and we will fade in the rear view mirror in oblivion. We could have done something different. We should have done something different. We lacked the moral fiber and love for our children to do the right thing". (Weight of The Nation, part 3)
"What a tragedy, after all of these years of building up our healthcare in a circumstance where people are saved from premature disability and death, we can turn that all around. We can lose all of those gains. Do you want your children and your grandchildren to inherit a society where their hopes for a long and healthy life are not not even as good as your are? That can't be the right thing to do". ("The Weight of The Nation" HBO miniseries part 3)
"What a tragedy, after all of these years of building up our healthcare in a circumstance where people are saved from premature disability and death, we can turn that all around. We can lose all of those gains. Do you want your children and your grandchildren to inherit a society where their hopes for a long and healthy life are not not even as good as your are? That can't be the right thing to do". ("The Weight of The Nation" HBO miniseries part 3)
Saturday, June 9, 2012
We Need a Paradigm Shift
Great documentary on HBO, The Weight Of The Nation, about the obesity epidemic in this country. The Bogalusa, AL obesity study followed children into adulthood from the early '70s. Unbelievable, very disconcerting. You think healthcare cost are expensive now, just wait. Almost 20% is children are obese. 70% of adults will become obese. The beginnings of atherosclerosis is being discovered in children as young as 5 years old. Adult-onset diabetes is not so much adult-onset anymore.
Obesity is the single most influential factor in the causation of the majority of our most prevalent chronic illness today: hypertension, diabetes, coronary artery disease, heart failure, sleep apnea, arthritis just to name a few. How are we going to put our nation on a diet?
Obesity is the single most influential factor in the causation of the majority of our most prevalent chronic illness today: hypertension, diabetes, coronary artery disease, heart failure, sleep apnea, arthritis just to name a few. How are we going to put our nation on a diet?
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