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September 27, 1996     Cape Gazette
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September 27, 1996

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HEALTH & FITNESS Sleep lab opens gateway to sweet dreams Part I of this series describes the experi- ence of a man who suffered from a sleep disorder for more than 20 years before fi- naUy being diagnosed and cured. Part H of the series will address the medical issues of sleep disorders and how Beebe Medical Center's sleep laboratory can help those suffering from the problem. By Kerry Kester Sleeping disorders are not always just in- conveniences that make people feel a little sluggish as they go through the day. Some sleep disorders, such as sleep apnea, pose a serious or even life-threatening threat. Dangers caused from sleep apnea, a condi- tion where automatic breathing is interrupted during sleep, include increased risk of heart attacks or strokes, in- creased risk of automo- bile or other accidents, and personality changes such as de- HOWE pressmen. Beebe Medical Center's sleep disorder lab, under the direction of Michael Salva- tore, M.D., F.A.C.P., a pulmonary special- ist, offers a new lease on life for patients suffering from sleeping disorders. Russell Howe, 71, of Lewes, suffered from sleep problems for more than 20 years before he was successfully diagnosed and treated by Salvatore at Beebe's lab. In June, Howe went to see his doctor in Georgetown when he started having what appeared to be heart pains. Howe's symp- toms were consistent with those of conges- tive heart failure, so his physician sent him to Beebe's emergency room. While there, Daniel Lindenstruth, M.D., cardiologist, examined Howe. Lindenstruth admitted Howe for observation and tests, but he found no heart disorders. However, while Howe was linked to a heart monitor, pieces of the puzzle began fitting together. "During as much as 100 times a night I would stop breathing," said Howe. Physi- cians also determined that Howe' s oxygen level was very low. "Dr. Salvatore and Dr. Lindenstruth were the first to put it together," said Howe. Sal- vatore recommended Howe spend a night at the sleep lab, and Salvatore soon deter- mined Howe was suffering from sleep ap- nea. The low oxygen level was creating the symptoms that made Howe believe he was suffering from heart problems. According to Salvatore, it's typical for people not to recognize their own sleeping disorders. "The patients themselves are usually poor judges of the symptoms," said Salvatore. "Usually somebody else notices the problem because it is chronic." Howe's wife was instrumental in identi- fying his sleeping problem. His sleep dis- order led to not sleeping in the same room with his wife. "She couldn't sleep because I couldn't sleep. The big problem was I was snoring so loud. We got to the point where she wouldn't sleep with me any- more." The couple stopped traveling because the sleeping problem made accommodations and activities too difficult. When they eventually forced themselves to make plans for a trip to England, the trip proved some- what unpleasant. "She would wake me, and I tried different positions," said Howe. "I felt really sorry for her, but there was noth- ing I could do." Trips after that either in- cluded separate rooms or they simply avoided traveling. Howe's normal routine at home, he said, was to get up at 10 a.m. "I'd get up in the morning, and I'd go out to have my coffee on the porch, and an hour later I'd be sleep- ing again," he said. He was constantly fa- tigued, and needed to nap daily. "My best sleep would come in the daylight hours," he said. Daytime sleepiness posed other problems as well. "I couldn't trust myself to drive alone, because I would fall asleep driving," said Howe. "I never had an accident, but I fell asleep while driving many times. I'd be riding along, and all of a sudden I'd just nod off." He said he tried to keep awake by lis- tening to interesting radio programs, "but that just wasn't enough to keep me awake." He had other lifestyle problems as well. "Never in the evening could I watch televi- sion, because I'd fall asleep," said Howe. Breathing at night became an open threat about |0 years ago, said Howe. "Many times I'd find myself sitting on the edge of the bed, gasping for breath. When I slept on my back, I'd wake up and I'd be chok- ing." He said he developed a fear of sleep- ing on his back. "I was afraid to, because when I did, I was afraid my tongue would block my throat. "As soon as I'd lie down, I'd feel I was losing my breath, so I'd sit on the side of the bed and fall asleep there - sitting up." Sometimes, he'd tip out of that position. Waking to a clunk on the head when he'd fallen against the wall became a fairly regu- lar routine. "When you don't sleep, you don't think of it as a physical problem," said Howe. He said he rationalized the sleeping problems. Perhaps he'd had coffee too late in the Continued on page 38 Rheumatologist to serve Cape Region patients By Kerry Kester Cape Region patients with rheumatologi- cal disorders will soon be able to have spe- cialist care for their problems. At the end of October, Jose Antonio Pando, M.D., will start his medical practice - specializing in rheumatology and internal medicine - in both Lewes and Millsboro. Rheumatology includes a variety of im- munological diseases, said Pando. "Our spectrum is very large, and there hasn't been anyone taking care of that in this com- munity," said Pando. Common rheumato- logical cases include osteoarthritis and rheumatological arthri- tis, but there are many other diseases rheuma- tologists diagnose and treat. Osteoarthritis, he said, involves minimal PANDO inflammation. "It's the wear and tear on the joints that affect main- ly the knees and hips," said Pando. Rheumatoid arthritis, on the other hand, in- volves significant inflammation. It is caused when certain cells in the immune system begin to interact with each other in a particular manner which prompts the de- struction of the joints. New research indicates that aggressive treatment early after diagnosis is more ef- fective than waiting until the disease pro- gresses. "You have to be more aggressive treating these kinds of conditions," said Pando. "Accessing the patients early makes the difference in the cures of the diseases. "We also deal with some other immuno- logical conditions," said Pando. Less com- mon cases are Reiter's syndrome, a reactive arthritis that is usually found in conjunction with another illness, and psoriatic arthritis, which impacts the skin, although it can also affect joints. Lupus is another common disease rheumatologists treat. It is a long-term in- flammatory disease that is most common in women of child-bearing years, although anyone can be afflicted with it. Continued on page 38 Edgehill, VNA offering flu shots to Sussex Countians Edgehill Pharmacy and the Vis- iting Nurse Association (VNA) have teamed up again this year to organize flu shot clinics through- out Delaware and Maryland's eastern shore. With an increasing- ly elderly population, serious flu epidemics continue to be a con- eern of the medical community. Through their "Fight The Flu" program, members of the VNA will work with Edgehill Pharma- cy's many outlets to immunize several hundred residents of com- munities throughout the area. Beginning Thursday, Oct. 3 and continuing through Thursday, Nov. 14, registered nurses from the VNA will administer flu shots at different Edgehill Pharmacies. Cost of a flu shot through the Fight The Flu Program will be $10. Medicare Part B will be ac- cepted for full payment for the shots. Influenza (commonly known as the flu) is a contagious respiratory disease caused by a virus. It usu- ally occurs in the U.S. from No- vember through April. It can cause fever, chills, cough, weak- ness and aching in the head, back, arms and legs. when someone who has the flu sneezes, coughs, or even talks, the flu virus is expelled into the air and inhaled by anyone close by. Even someone who is just coming down with the flu and doesn't feel sick yet can pass it along this way. Experts stress that yearly flu vaccinations are the best defense, yet less than one third of the high risk population receives a flu shot. Flu shots are very effective. 70 percent of persons immunized are fully protected while the other 30 percent experience partial protec- tion with symptoms that are much less severe. Ultimately, everyone can benefit from a flu shot. A re- cent study published in the New tF.aLTIt TOHCS Bruce Benton Bruce Benton is the vice lresi - dent of EdgehiU Pharmacy. England Journal of Medicine found that younger people who get flu shots also benefit by suf- fering fewer upper respiratory ill- nesses, miss less work, and have lower medical bills. The following are the Edgehill Pharmacy locations and dates where the flu shots will be given this fall: Thursday, Oct. 3 - Pecan Square, Salisbury, MD, 3 p.m. to 4 p.m.; 234 Tilghman Rd., Salis- bury, MD, 5:30 to 6:30 p.m. Friday, Oct. 4 - 1120 S. Cen- tral Ave., Laurel, DE; State Line Plaza, Delmar, DE, 5 to 6:30 p.m. Wednesday, Oct. 9 - 3350 Hayman Drive, Federalsburg, MD, 3 to 4:30 p.m.; 1401 Middle- ford Rd., Seaford, DE, 5:30 to 7 p.m. Friday, Oct. 11 - Peddlers Vil- lage, Lewes, DE, 2 p.m. to 4 p.m.; 444 Savannah Rd., Lewes, DE, 5:30 to 7:30 p.m. Tuesday, Oct. 15 - 100 N. Railroad Ave., Wyoming, DE, 5 to 7 p.m.; Hamlet Shopping Cen- ter, Dover, DE, 1:30 to 3:30 p.m. Friday, Oct. 18 - West Glen- wood Ave., Smyrna, DE 5 to 7 p.m. Saturday, Oct. 19 - Ocean Pines, Berlin, MD, 9 to 11 a.m. Tuesday, Oct. 22 - Liberty Plaza, Harrington, DE, 1 to 3 p.m.; Georgetown Plaza, George- town, DE, 4:30 to 5:30 p.m. Friday, Oct. 25 - Mason- Dixon Village, Selbyville, DE, 11 a.m. to noon; Nanticoke Crossing, Longneck, DE, 2 p.m. to 4 p.m. Saturday, Oct. 26 - 3700 Rte. 1 Bay Mart, Rehoboth Beach, DE, 11 a.m. to 1 p.m.; Rt. 26, Millville, DE, 11 a.m. to 1 p.m.