Sleep Apnea is Hazardous to Your Health and Well Being

Published May 25, 2012, Pawtucket Times

In 2003, Rehoboth resident Art Warner got strong messages from his surrounding environment about his health, both during the day and at night.

At that time Warner discovered he had great difficulty staying awake at his job, oftentimes falling asleep right at his desk. Coupled with his sleepiness during work hours and his wife’s constant elbowing in the middle of the night to wake him up because of his loud snoring, a very tired Warner became extremely frustrated. His worried wife would regularly watch as he stopped breathing during his sleep as he snored. The overweight, middle aged man was finally forced to recognize the he had a health condition that could not be ignored.

After an examination from Warner’s primary care physician, he signed him up for a sleep lab study, which surprisingly revealed to the patient “sleep apnea.” This serious sleep disorder caused hundreds of short stops of breathing each night, which kept Warner, a public relations executive, from getting a good night’s sleep..

Ultimately, it was a medical treatment prescribed after the sleep lab study that would finally allow Warner to get the sleep he needed and stop his snoring. No longer falling asleep at his desk, or getting sleepy behind the wheel while driving his car, instead a good night’s quality sleep has resulted in Warner living “a totally different life,” because he feels rested.. With this newly-found lifestyle, he has more energy to workout at the gym, and even stay up past midnight.

Very Observable Symptoms

According to the Sleep Apnea Association, 12 million Americans [including Warner] have sleep apnea, a common medical chronic condition in which the person has one or more pauses in breathing, or shallow breathing when asleep The Washington, D.C-based group estimates that another ten million people may remain undiagnosed.

Dr. Michael A. Pomerantz, a pulmonary specialist who reads sleep lab studies for Rhode Island-based Coastal Medical, reports that untreated sleep apnea is associated with an increased risk of high blood pressure, heart disease, stroke, obesity, diabetes, in addition to traffic accidents caused by falling asleep at the wheel. “Those are all pretty good reasons to be evaluated,” he says.

Snoring, night time awakening and day time sleepiness are three prominent symptoms of having sleep apnea, adds Pomerantz. Frequently, a bed partner may observe heavy snoring or long pauses (lasting at least 10 seconds) in breathing during their companion’s sleep, causing the sleeper to wake up periodically throughout the night, states Pomerantz.

According to the medical literature, the typical sleep apnea male patient is over age 40, obese, and familial. Smoking and alcohol also increase the risk of this medical condition. Dr. Pomerantz, who has practiced his medical specialty for over two decades, adds that 50 percent of sleep apnea patients also complain of early morning headaches.

Diagnosing and Effectively Treating Sleep Apnea

If sleep apnea is suspected, an over night visit at a sleep lab is considered to be the best diagnostic test to this serious medical condition, notes Dr. Pomerantz, who has successfully completed his sleep board certification . Among other things, the patient is hooked up to equipment by wires which monitor the level of sleep, in addition to the airflow to determine if the sleeper is breathing or not, the deepness of sleep, oxygen levels, chest wall movement, and pulse rate, he says.

For treating milder cases of sleep apnea, Dr. Pomerantz recommends simple ‘life style’ changes and treatments such as shedding weight, avoiding alcohol, sleeping on your side or abdomen, or keeping nasal passages open at night by using prescribed medications. A dental device can also move a jaw forward to make breathing easier.

In moderate to severe cases, a C-PAP, or “continuous positive airway pressure” machine can deliver an increased air pressure through a mask covering the nose or mouth. The air pressure generated by this machine is somewhat greater than that of the surrounding air, just enough to keep the person’s upper airway passages open, preventing the apnea and snoring.

“Compliance with sleep apnea is not always great,” Pomerantz, says, because patients may feel discomfort with the C-PAP machines. “For some patient it’s only a matter of getting use to it and finding a more comfortable mask,” he says, because their masks may feel overly confining or obstructive.

New Studies Link Sleep Apnea to Cancer

In addition to those research studies associating sleep apnea with increased risks of hypertension, cardiovascular disease, depression and early death, the New York Times recently reported that two new research studies presented at the American Thoracic Society conference this week have discovered that this chronic condition has been linked to an increased risk of cancer in humans.

According to the paper, in one study Spanish researchers followed thousands of patients at sleep clinics, finding that those patients with the most severe forms of sleep apnea had a 65 percent greater risk of developing cancer of any kind. Meanwhile, lead researcher Dr. Javier Nieto, chair of the Department of Population Health Sciences at the University of Wisconsin School of Medicine and Public Health, says that his study of 1,500 government workers studied over 22 years showed nearly five times higher incidence of cancer deaths in patients with severe sleep apnea to those without the disorder, a result that echoes previous findings in animal studies.

A Personal Note…

Clearly research studies show that not being treated for sleep apnea or using your C-PAP machine, if diagnosed with this chronic disorder, is hazardous to your health and well-being…

As one afflicted with sleep apnea, this writer has experienced it all – from “denial” about the severity of my snoring to finally being sent by my partner to the couch for my very loud snoring that shook the walls of our house. Co-workers teased me about falling asleep at noon time meetings or towards the end of my workday. Even with these severe symptoms, I denied having this medical problem for years until the urging of a friend who had a severe case of sleep apnea nudged me to “get it checked out” . With my ultimate diagnosis and finally the treatment with a C-PAP machine, my snoring has virtually ceased, and I now wake up refreshed and well-rested. One of my few regrets in life was losing years of “deep” sleep because I chose not to see my physician to address my sleep apnea.

For more information about sleep apnea, visit the American Sleep Apnea Association’s website, www.sleepapnea.org. If you have sleep apnea symptoms, visit your physician.

Herb Weiss is a Pawtucket-based freelance writer covering medical, healthcare and aging issues. His Commentaries are published in two Rhode Island Daily’s The Pawtucket Times and Woonsocket Call.

No Rocking Chairs for These Country Farmers

Published May 11, 2012, Pawtucket Times

Some aging baby boomers can’t wait to relax in their later years, with visions of travel plans on the horizon, or lists of hobbies & projects tucked away. But a growing number of seniors, like Ruth and George Handy, continue to work long after the traditional retirement age of 65 simply because they enjoy it.

Just 20 minutes from the City ofPawtucket, you will find a small rural home situated on over 100 acres of land – a ‘secret garden’ of sorts – that has widely become known as a gem of a place to purchase fine produce and beautiful lush and unique plants. Just drive down a small country road off U.S. Route 118 in Attleboro, and you will find Ruth and George Handy hard at work in their green houses, pruning, primping and selling thousands of flowering annuals, perennials and tons of vegetables from 8a.m to 7 p.m. – 7 days a week.

Mostly by word of mouth, customers make this yearly spring pilgrimage to Fine Farms, traveling as far away asVermontandBoston, and then travel back home with their vehicles filled to the brim with colorful flowers and varieties you won’t find in many of the big-box stores.

According to Ruth, her locally grown flowers and vegetables are fresher than those shipped to and sold by the growing number of super center, superstore or mega stores. “There really is a difference,” she asserts. “We give daily, tender loving care to our plants and they usually tend to be healthier and even grow bigger.”

Working Hard But Loving It

“Most people think that we go south for the frigid winters, but we are working hard for ten months out of the year,” says Ruth, a tanned, petite woman who is wearing a pair of blue jeans, a sleeveless blue cotton shirt and garden Crocs. Together Ruth and George, her husband of 43 years, are tilling 22 of their 120 acres by themselves. This acreage has been in Ruth’s family since 1903, a legacy for which she is most proud.

“Retire? Never! We love what we do,” says the 77-year-old farmer’s wife. At 75, George begins with his long work day at 4:30 a.m., usually finishing up and eating his supper around 9:00 p.m. This is not a job for anyone to do, she says.

According to Ruth, because of the economic downturn that caused the closing of many of their wholesale accounts, compounded with the spiraling price of fuel, theAttleborocouple shuttered two out of their six greenhouses. However, “this year we still planted about 20,000 packs of flowers and vegetables and 1,500 hanging plants,” prides Ruth, who explains “they start planting around January and in March they begin to transplant the seedlings”.

And that’s not all. In between planting, harvesting and then selling produce at The Corn Crib farm stand later in the summer, Ruth is a part-time instructor of water aerobics and chair exercises at the Attleboro YMCA. Ruth even penned The Fine Farms Cookbook, a compilation of 25 years of collected recipes and is currently writing a novel with her cousin. George also is active and regularly works out in his home gym. Both are avid readers of mysteries and historic novels.

By mid-April the four remaining greenhouses are filled with huge hanging baskets, including a variety of colorful plants, from petunias, begonias, and impatiens, to a variety of herbs. As Mother’s Day approaches there still remains a large variety of flowers and baskets for the rest of the month. At the same time, George begins planting a couple of acres of corn to be harvested in July. When the greenhouses are depleted, usually in June, the couple shifts their focus on their vegetable fields. .

By mid-July its harvest time and fresh vegetables are sold at The Corn Crib. The Handys offer many varieties of bi-colored and white corn along with onions, potatoes, cucumbers, and tomatoes, at this quant farm stand, a mile down the road at the intersection of Tremont and Anawan Streets off Route 118 inNorth Rehoboth.

Over the past 25 years, avid gardener, Patricia Zacks, has bought her flowers and vegetables from Fine Farms. Three generations of thisPawtucketresident’s family have traveled intoMassachusettsto visit the Handy’s greenhouses. “This has been my spring ritual every year, first with my mom and now with my son. It is always a treat for the eyes to be one of the first customers in the greenhouses – the colors are breathtaking!” In the summer I’ll travel for their corn – there is nothing more enjoyable than vegetables freshly picked just hours before being cooked”.

Take Time to Smell the Roses

Ruth explains that that George has been farming the land for over 60 years, since he was a teenager. . Ultimately her husband bought The Corn Crib and the farm fields from her father, Hyman Fine, who continued to operate the flower business and greenhouses. In 1972, her father died suddenly at a School Committee Meeting and George became responsible for all aspects of the farm business.

“The first year was very difficult for us, but as each year passed, the farm became more profitable and better run,” says Ruth. Even in their mid-seventies the Hardys continue to farm while the younger generations are going their own way. The couple have three children and 6 grandchildren, but no one is really interested in shouldering the long hours it takes running the family farm.

While Ruth and George work hard in their later years, they believe in setting time to enjoy the simple pleasures of life.

“Slow down and enjoy nature that surrounds you,” Ruth advises. As a child she just could not wait to leave the farm to travel to the “big” city. But now she appreciates the peaceful rural life of the farm and “would not trade her lifestyle for anything else.”

George urges aging baby boomers and seniors to look at their age as just a number. “Don’t let [your age] limit you,” he counsels, noting that he works as hard now in his senior years as he did in his 20s. “Work keeps me young,” he adds.

For more information about Fine Farms, call (508) 226-0616 or go to http://f-i-s.com/finefarms/. Or write 353 Smith Street, Attleboro, MA 02703. Or email, Finefarms@aol.com.

Herb Weiss is a Pawtucket-based freelance writing covering aging, health care and medical issues. His Commentaries are published in two Rhode Island Daily’s The Pawtucket Times and Woonsocket Call.

Complete Streets Legislation Stalled in House Committee

Published May 19. 2012, Pawtucket Times

A properly designed road system helpsolder Rhode Islanders to successfully “age in place” and stay safely and comfortably in their homes for as long as they choose. But the benefits of so-called Complete Streets design benefits people regardless of age, abilities or mode of transportation. AARP Rhode Island has joined a broad-based coalition of 17 aging, health and transportation groups and smart growth advocates to push state policy makers into making the Ocean State’s streets, highways and byways more accessible and safer for all users. Out of 2,111 legislative proposals submitted this year for consideration by the Rhode Island General Assembly, H 7352 and S 2131, its companion measure in the Senate, would accomplish this lofty goal.

Coalition members fear that their efforts to make sure that the state’s transportation infrastructure becomes more user friendly for all ages and abilities is in jeopardy with the House Committee on Municipal Government which has held H 7352 for further study. While the Senate passed the companion measure (for the second year in a row) last month, this House Committee might just kill the legislation unless it can be resuscitated.

The Details of H 7352

The legislationwould require that whenever the state is building or modifying a road, planners and designers must consider Complete Streets design concepts – that is, considering safe travel by all users, current and projected, particularly pedestrians and bicyclists of all ages and mobility capabilities. Features of Complete Streetsdesign include sidewalks, paved shoulders suitable for use by bicyclists, lane striping, bicycle lanes, “share the road” signage, “road diets” (narrower lanes to discourage speeding and leave room for pedestrians and bicyclists), roundabouts, crosswalks, pedestrian control signalization, bus pull-outs, curb cuts, raised crosswalks and ramps and traffic-calming measures.

Meanwhile, this legislation allows common-sense exceptions, such as on interstate highways, where pedestrians and bicyclists are prohibited, and on projects where the space is too limited or costs would be disproportionate to the use such features would likely get.

Furthermore, this legislation also requires the State’s Department of Transportation to issue a report within two years detailing what it has done to comply with the law, how it has changed its guidelines on such features as lane width, design speed and more, and what best practices the agency has employed. It would also be required to include information on exceptions made, and why they were made.

In a press release touting the passage of S 2131, bill sponsor, Senator Louis P. DiPalma, noted that the legislation’s goal is to plan streets that encourage people to use healthy, greener, transportation modes whenever possible, contributing in their own health as well as the wellbeing of the environment.

“Cars shouldn’t be the only consideration when public roads are being built. The health and environmental benefits of walking, bicycling and other active modes of transportation are well know, and we should be building our roads in ways that are safe for those activities and encourage people to choose them,” said Senator DiPalma.

Pushing for Safer Roads, Highways and Byways

In her testimony before the House Committee on Municipal Government, AARP State Director Kathleen Connellsaid the goal of H 7352 is to direct the Department of Transportation to plan with all users in mind. “Making it easier for older people to get around is an obvious reason we’re involved, but Complete Streets design promotes public safety, helps revive our towns and cities and increases property value,” she said.

Molly Clark, Manager, Health Promotion and Public Advocacy for the American Lung Association, also testifying to support H 7352, predicted that Complete Streets design that would promote walking and bicycling and this would ultimately improve the health of Rhode Islanders.

Also attending the Committee Hearing, Co-Chair John Flaherty, of the Coalition for Transportation Choices, advocated for 21^st century transportation system “that’s good for the economy, good for the environment and that provides clean, healthy and affordable transportation choices for all Rhode Islanders.”

There is no fiscal note estimating the true costs of H 7352 due to the multitude of factors that must be considered. However, bill supporters believe that this legislative proposal does not necessarily add costs to the road construction project.

Addressing concerns about the legislative proposals “possible” fiscal impact on the State’s budget, Senator DiPalma notes that H 7352 has been crafted in such a way to reduce the fears of fellow lawmakers that there could be initial and future costs if the legislation is enacted. Provisions would protect the state’s coffers by requiring common sense exceptions to take effect if a road construction design project incurs a cost that is disproportional to its benefits, he says.

It’s All About the Economy

Doing it right the first time makes economic sense,” says AARP Associate Director for Advocacy Deanna Casey.

Enacting H 7352 is just good economic policy, adds Scott Wolf, Executive Director of Grow Smart Rhode Island. According to Wolf, “forRhode Islandto thrive economically it needs to attract and retain talented young people. These people, research shows, are looking for places that are vibrant, user friendly and possess an abundant natural and architectural beauty.”

Wolf stated “Rhode Island has many of these ingredients but we need to be much more user friendly with regard to transit, walk ability and bike ability to maximize our appeal to this new segment of workers. He added, “Adopting an aggressive complete street strategy that requires all roads built to accommodate bikes, pedestrians, and mass transit as well as autos could do a lot to increase our appeal to this critical cadre of mobile young talented workers.”

In these tough economic times usually a price tag on a legislative proposal is just enough for General Assembly leadership to doom a legislative proposal’s passage by not taking action on it. Just refer it for further study. Complete Street supporters are puzzled by the inaction in the House panel because of the protections built into the measure to rein in initial or future costs of a project. At press time, the City of Pawtucket along with eight other cities and towns, have already passed resolutions supporting the Complete Street legislation being considered by the Rhode Island General Assembly and another eight communities are also considering supporting this legislation by enacting resolutions. Most important, the State’s Department of Transportation is not even blocking passage but endorsing it.

According to the National Complete Streets Coalition, in 2011 alone “over 140 jurisdictions adopted a policy, up from 80 that committed to Complete Streets in 2010. In total, 352 regional and local jurisdictions, 26 states, the Commonwealth of Puerto Rico, and the District of Columbia have adopted policies or have made written commitment to do so.”

Elections are looming and House and Senate leadership are looking to adjourn in early June. The Rhode Island General Assembly must move quickly in the waning days of the 2012 legislative session to join 26 states that get it. House leadership must do the right thing to make streets, highways and byways more accessible and safer for all Rhode Islanders, regardless of age, abilities or modes of transportation. That is to pass H 7352.

Herb Weiss is a Pawtucket-based writer covering aging and health care issues. His Commentaries are published in two Rhode Island Daily’s The Pawtucket Times and Woonsocket Call.