August, the French Have it Right!

When I was hired by Sanofi, the French pharmaceutical giant, I was encouraged to apply for "cultural training." I was surprised to learn how differently we Americans and our French bons amis (good friends) approach life. For example, the French like to "do their homework" before a project to avoid costly mistakes. We Americans believe it is better to get started ASAP and learn from our mistakes along the way. Another major difference is our approach to work. Americans live to work while the French work to live. Never was this more apparent than in August. Even the most ardent French worker takes the month of August to unwind, refresh, vacation, and rekindle their "Joie de vivre" (joy of life). Vive la France!

John A. Schmidt, MD 

Now Hear This! Our Office Will Be Closed August 19-24!

As mentioned in the July newsletter, our dear second daughter, Susan, is to be married on Saturday, August 23, on the glorious Eastern Shore of the Chesapeake Bay. The newlyweds will be honeymooning in Hawaii (They are avid James Michener fans!). The office will therefore be closed except for emergencies from August 19 through August 24. Please plan ahead and submit your refill and other requests as soon as possible. Thank you! (Can't wait to see how the groom, a Californian, deals with the innards of blue claw crabs at the welcoming party. The handles on the mallets will read, "Love, Honor, and Old Bay me." Good luck with the Old-Bay/Obey part!).

The Runkeeper App

Exercise is a great way to enjoy the summer but many of my patients find it difficult to motivate themselves. One way to catch the fever is to download the Runkeeper App onto your smart phone. Using GPS it captures and displays your route whether on land or sea. You can also track the exercise activities of your friends. For example, Rita's nephew was canoeing in the San Juan islands in Puget Sound and we could see his route including the distance paddled! Refusing to be outdistanced by her nephew, Rita proceeded to walk a greater distance on the golf course at Fairway Mews and then proceeded to brag about it on Facebook! Form your own Runkeeper group and challenge yourself and your friends!

What if I Snore?

Snoring, a frequent symptom in those with sleep apnea, is not included in the Epworth questionnaire because people can't hear themselves snore and because snoring and apnea are two different things. "Apnea" means no air is passing into the lungs. Blood oxygen levels decline, sometimes dramatically. Measuring arterial oxygen levels through the night is therefore a convenient and straightforward approach to detecting apneas. A dramatic fall in oxygen level leads to "arousals" or "startles," which are abrupt sleep-disruptive awakenings as the oxygen starved brain sends a strong signal to wake up and breathe deeply. Once again, many patients have no recollection of arousals but their terrified bed-mates almost always do as they lie awake waiting for their partner to resume breathing.

I will never forget watching my dear mom the night after her knee replacement surgery. She was snoring. When the snoring stopped, her oxygen level began to fall on the bedside monitor. Once the oxygen saturation level declined to about 70 percent, she would startle, sit bolt upright, open her airway, and take a huge breath. My brother, a dentist, who also suffers from sleep apnea, called the respiratory therapist who inserted a simple device into my mother's mouth to keep her airway open. The arousals went away instantly and her blood oxygen level never dipped. It was probably her first good night sleep in years! She now wears a CPAP device and sleeps fitfully. My brother carries his CPAP wherever he goes. He finds that he performs at a higher level (and his patients are happier too!).