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MAY you always _______ (fill in the blank!)
"May" is one of the most important words in our language because it names the month we most closely associate with motherhood and new life. The word "may" is also important because it simultaneously conveys hope and humility. May I have your blessing? May I have your hand in marriage? May is also about wishing. May you always have your health! May we always be as happy as we are today! When I fill in the blank, it usually has something to do with relationships. May you always have a best friend! May is a special word! Use it often!
John A. Schmidt, MD
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Desperate for Shut Eye? Improve Your Sleep IQ!
Sleep is a critically important part of healthy living. Scientists still wonder why we need it and dedicate so much time to it. As reported by BBC Earth, some interesting observations have come from animals that sleep with one eye open! They rest one side of the brain while keeping the other wide awake. "Rest" is, of course, a misnomer. During sleep the "resting" brain goes offline and busily sorts through all of the day's events deciding what to file, what to discard, and what to keep for review. That's why "sleeping on it" can sometimes be the easiest way to solve a problem. Conversely, ruminating on problems that have no ready solution can often wreck a good night's sleep. Techniques to put such problems "in the parking lot" before we slumber can therefore be very beneficial indeed (see below).
"Insufficiency" means not enough sleep. The first step to maximizing "sleep efficiency" is practicing good sleep hygiene. This means going to bed at the same time each night and rising at the same time each morning, avoiding large meals, caffeine and alcohol close to bedtime, avoiding nicotine, darkening the room, wearing an eye mask and ear plugs to shut out ambient light and noise, turning off distracting electronic devices, and putting the dog (and your snoring human with restless legs-JK!) on the floor! Exercise is conducive to sleep provided it was done earlier in the day!
Sleepio and Shuti are online programs that use CBT-I to help you sleep better. If you are a person who uses sleep medications month after month, you should give one of them a try and hopefully end an unhealthy dependence on sleep medications.
Bottom Line: Everyone has a bad night's sleep from time to time-it's normal. Those with persistent insomnia, defined as three nights per week for at least three months, should consider CBT-I as their first option using one of the on-line tools mentioned above or seek the help of a sleep therapist trained in CBT-I. Medications are useful for short term use, as a bridge to CBT-I, or for those failing CBT-I.
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Spinal Fusion in Patients with Spinal Stenosis
The spinal cord and its roots travel inside the spinal column in a channel called the spinal canal. The spinal column is made of bone and flanked by joints. Because bone is hard, many think of it as a static tissue. Nothing could be further from the truth! Bone is constantly remodeling and it can grow, even in adulthood. Bone grows in response to excessive mechanical stress. It is nature's way of buttressing arthritic joints. You can easily convince yourself of this by feeling those bumps that often develop around finger joints from years of opening vacuum sealed containers! Those bony outgrowths are called osteophytes. When osteophytes grow in the direction of the spinal cord, the canal narrows ( stenosis) and the soft spinal cord becomes compressed resulting in wicked back, buttock, and leg pain.
Surgery for spinal stenosis is popular in the United States. The surgery, called laminectomy, removes some of the bony osteophytes pressing on the spinal cord and its roots. The surgery has been increasingly combined with spinal fusion where hardware (rods and screws) is used to immobilize the lumbar spine, adding to the cost, complications, and post-operative recovery time.
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Expanding the Definition of Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease ( emphysema) results from inhalation of cigarette, cigar, and e-cigarette smoke from you and/or the people around you. Doctors have traditionally made the diagnosis when pulmonary function tests ( spirometry) show delayed exit of air from the lungs on forced expiration ( FEV1). But all practicing internists, myself included, have encountered severely symptomatic smokers whose pulmonary function tests are normal. Do they have COPD? Yes, because as shown in the May 12 issue of the New England Journal of Medicine, such individuals suffer the same symptoms and adverse outcomes even though they have preserved pulmonary function. The authors used a questionnaire called the COPD Assessment Test which is available on line. If you or a loved one is a smoker and have been lulled into a false sense of security based on normal pulmonary function testing, take the questionnaire, find out if you have COPD, and take corrective measures to preserve your life!
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Now Hear This!
The office will be closed on Monday, May 30, in observance of Memorial Day. On behalf of myself and my dedicated staff, we extend our utmost gratitude to those men and women who have served our country and preserved our freedoms! Thank you! You are our heroes!
In case you hadn't noticed, Ms. Clark is an Air Force veteran. Thank you, Ms. Clark, for your service!
I also wish to extend my deepest gratitude to those of you who have sent cards and Mass Cards celebrating my dad. He was a veteran and he will be remembered in a special way this Memorial Day!
On a happy note, my mom celebrated her 88th on May 25 along with our son, John III. Sixty-one years apart, they have a special relationship made all the more so by dad's passing.
May you have a wonderful holiday weekend with the ones you love!
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Board Certified Internist
Dr. Schmidt is one of the leading internists in Monmouth County offering Medical Home services.
He is an Associate Attending in the Department of Medicine, Jersey Shore University Medical Center, and Clinical Assistant Professor in the Department of Medicine, Rutgers Robert Wood Johnson Medical School.
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"As full of spirit as the month of May, and as gorgeous as the sun in Midsummer."
William Shakespeare
Congratulations to our patient, Mrs. Mildred Piechota, now more than 100 years old and still going strong!
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