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Did You Take Your Vitamins Today?

One of the most common questions that I get is, "are there any specific vitamins that I can take for this condition?" In light of the slew of often conflicting studies regarding the benefits of taking vitamins, I was reminded of my wife’s ordeal just after she delivered our first son, Jonas. 

 

In Korean culture, it’s customary to serve seaweed soup just after delivering a baby. The benefits touted include being good for the mother in general, lessens post-partum bleeding, and various other reasons. There’s probably some truth to the bleeding issue since seaweed or kelp has high amounts of iron and iodine, both of which are needed to promote clotting and normal body function.

 

My mother helped us out by cooking meals for Kathy, but one thing she always served was seaweed soup. Sometimes it was the only thing. Kathy got so sick of seaweed soup from that experience that even today, she cringes at the smell of seaweed. What she craved during those first few weeks was a good normal meal—not seaweed soup for breakfast, lunch and dinner. Apparently, my mother thought that since it’s good for you, the more the better.

 

This same line of reasoning is how most people in our country think about vitamins. I won’t get into all the controversy and the pros and cons of vitamin usage. The point I want to make is that for anything related to your health (and everything else in life), there’s no magic bullet. If you’re not eating well, no amount of vitamins will cure your ills. If you don’t sleep well, no amount of dieting or exercising will keep the weight off for good. Whatever good habit you develop or good food you eat, it has to be done in light of a much bigger, holistic, integrative approach. 

 

If compound A is good for you due to it’s antioxidant properties, then due to all the marketing messages you receive (dozens of times every day), you’ll be convinced that if you have a lot of it, you’ll cure yourself of that nagging health issue. It’s only natural that the larger the quantity or the more concentrated it is, the higher the perceived benefit. That was the logic that my mother used when she overdosed my wife on seaweed soup. What my wife really needed was a well-balanced, nutritious meal, which included a healthy portion of seaweed soup. We also need a a wide variety of vitamins taken from different food sources, in conjunction with a regular exercise regimen, good quality sleep and proper stress management routines. An overdose of one particular beneficial food or habit, taken out of context, may end up being detrimental for you.

 

If you think about this issue from an "organic" standpoint, vitamin pills are one of the least organic substances you can eat. By definition, an organic product is something that’s naturally occurring that has not been processed or purified. Vitamin pills, by definition, are highly purified and processed substances, artificially taken out of their natural environments. Even organic milk or any other natural or organic food products with added vitamins by definition is not organic, since highly purified vitamins were "artificially" added. 

 

One of the frequently proposed mechanisms which explains why people feel better when they take vitamins is that by nature, people who take vitamins are more apt to lead healthy lifestyles, eat better and engage in activities and habits that are health-promoting. Whether or not this this true, you can imagine why this makes sense. There will always be a magic "pill." If it’s not a vitamin, it’ll be exercise. If not exercise, it’s relaxing music. If you’re acutely aware of how your body feels in response to various foods or activities, then you’ll naturally adjust and gravitate towards activities that make you feel better.

 

In the classic movie, Kung-Fu Panda, everyone is trying to discover the secret ingredient of life. In the end, they all discover that there isn’t just one thing—but that the true secret is actually YOU. The total, whole, complete conglomeration of all the countless ingredients that make up you as a person—that is the secret. When any part of your natural you becomes separated from the whole or overwhelms everything else in your life, that’s when things start to fall apart.

Truckers And Obstructive Sleep Apnea

I was recently interviewed on Sirius Radio’s trucking channel, "The Road Dog Channel" by Mark Willis, host of the program, "The Loading Dock."  We had an hour-long interesting conversation about the how common sleep apnea is amongst truckers. One study found that 28% of commercial truck drivers had sleep apnea. More than 1/3 were found to have moderate or severe sleep apnea. We know that untreated sleep apnea can lead to weight gain, obesity, high blood pressure, diabetes, heart disease, heart attack, or stroke. 

 

Another study stated that over 5000 deaths occur every year where a commercial truck was involved. However, one caller did mention the caveat is that a majority of these accidents were due to the passenger cars’ fault. Regardless, drowsiness during driving is a killer, no matter who’s doing the driving. 

 

There seems to be much more awareness in the trucking community about the dangers of untreated sleep apnea, not only for the safety of the public, but also for the health of the commercial driver. In conjunction with various sleep-related non-profit organizations, there are many screening programs and trucking company directed efforts at early detection. 

 

The Federal Motor Carrier Safety Administration has proposed more stringent rules regarding mandatory screening and criteria for return to work once the sleep condition was treated. As we all get more and more overweight, I guarantee that this is become a bigger issue than what it is now.

Sleeping Pill Use Amongst Young Adults Triples

I did a double take when I read this article in the New York Times. Among young adults aged 18 to 24, use of prescription sleeping pills tripled from 1998 to 2006. We know that chronic insomnia is associated with depression and anxiety, and possibly heart disease later. It also mentioned another study that revealed that 50% of all college-aged individuals suffered from a psychiatric disorder within the past year, of which 25% sought treatment.

College students have a lot of reasons to have insomnia, including the erratic sleep schedules, eating late and doing all-nighters. But one interesting comment made by a psychiatrist is that these are the same people that were raised on Ritalin. This is an interesting comment.

I’ve discussed before many studies in the past that a significant number of children with ADHD have obstructive sleep apnea. When treated properly for obstructive sleep apnea, many children do much better. I’ve seen children come off Ritalin after a routine tonsillectomy. We’re probably picking up and treating only a small fraction of all children with obstructive sleep apnea. Many of them will be diagnosed and treated for ADHD instead. So what happens when they grow up? 

Since they continue to have jaw narrowing and dental crowding, they’ll still have sleep-breathing issues. Yes, many will "grow out of it," but a significant number will go on to develop insomnia, depression, anxiety, and panic disorders, and high blood pressure and heart disease later in life.

 

 

What All Pregnant Women Must Know

My wife Kathy is expecting our third son any day now, and her experiences during her current and past pregnancies bring up some important issues that all men and women, pregnant or not, should know about. Even though poor sleep, nasal congestion, post-partum depression, and weight gain are almost an accepted part of pregnancy, these can be especially problematic for those women who struggle to bounce back way beyond their first year after pregnancy. Besides the excess weight that they can’t seem to take off, many of these women find that their health and energy level are considerably worse off than it was prior to being pregnant.

However, there are measures you can take prior to delivery to help you get back to the way you felt before you became pregnant. There are some important concepts related to pregnancy, that are often overlooked by many medical professionals but  if looked at from my sleep-breathing paradigm, explains why these events occur, and what you can do about it.

What You Don’t Know Can Harm You

In my book, Sleep, Interrupted I allude to a eureka moment when my wife helped me to realize what helped her to rid herself of her post-partum depression after our first two sons were born.

It’s a given that you’ll gain weight if you’re pregnant. What many of us don’t think about however is that when you gain weight in your abdominal area, the fat cells inside your tongue and throat area get enlarged as well. This fact alone can have significant consequences for pregnant women, during, and especially after pregnancy.

As I explain exhaustively in my book, all modern humans are susceptible to upper airway narrowing and collapse due to various degrees. And because the airway is a uniquely dynamic apparatus that’s modified by any change in the soft tissues surrounding the area, weight gain can dramatically impact the rate of inspiration and expiration especially while we sleep, when the muscles and soft tissues lose tension and lose slack.

As I’ll explain further, this is one reason why, even those who are not pregnant, can progress into the extreme end of this sleep breathing problem called obstructive sleep apnea.  Similarly, any amount of weight gain can move you up on this line to some degree. This is why many pregnant women begin to snore, especially in their third trimesters.

Complications During Pregnancy

Pre-eclamspia and gestational diabetes are two common conditions during mid to late pregnancy. These conditions are thought to be distinct clinical conditions specific to pregnant women. Pre-eclampsia is a potentially dangerous condition where the mother to be develops severe high blood pressure with a risk of kidney failure, and death for the baby.

Gestational diabetes is another dangerous condition for both the mother and the baby. There are many studies that have reported an association between obstructive sleep apnea and these two conditions during pregnancy, but they are typically seen as occasional, isolated events. Doctors usually recommend dietary and lifestyle changes and then resort to medications when conservative options don’t work.

But despite numerous studies showing that women with pre-eclampsia can be effectively treated with CPAP (continuous positive airway pressure), it’s thought of as a rare oddity and has not gained attention as a very common way of treating pre-eclampsia. The same situation applies to gestational diabetes.

The Importance of Sleep Position In Pregnancy

Women are recommended to sleep on their left side during pregnancy, presumably due to less pressure on internal vital organs and blood vessels by the growing fetus. This is especially true in the third trimester. But one thing to consider is that as women gain weight, if they go on to develop mild or significant sleep-breathing problems, by necessity, they naturally will prefer to sleep on their sides anyway.

Similarly, many people with sleep-breathing problems already sleep on their sides or stomachs already for the following reasons: Due to various degrees of jaw narrowing, the tongue and voice box (which grow to their normal size), takes up too much space inside the mouth. These are the people who gag easily when a doctor presses the tongue depressor forcefully so that the back of the throat can be seen behind the tongue. For these people when they lie down flat on their backs, the tongue falls back partially due to gravity making the airway that much narrower. In this position, the person usually breathes through a slit only 2-3 mm wide. While awake, breathing is normal since your throat muscle tone increases as you inspire.

However, once you fall off to sleep, and especially as you enter deeper levels of sleep, by definition, all your muscles, including your throat and tongue muscles, must relax. With only 2-3 mms of opening, and with tongue muscle relaxation, your tongue will fall back, causing obstruction. Most people will wake up consciously or subconsciously after a second or two, and then turn over to the side. However, if you stopped breathing for 10 seconds or longer, then you just had an apnea. Most people compensate partially by sleeping on their sides or stomachs, but this is usually not good enough.

This is why when pregnant women gain weight, the fat cells in their throat will narrow the throat, and aggravate this vicious cycle. During this process, if you happen to also catch a simple cold or suffer and allergy attack, the mild inflammation that occurs in the breathing passageways can further narrow the throat, aggravating more tongue collapse. Once you obstruct, tremendous vacuum pressures in your throat causes mild amounts of normal stomach juices to come up into your throat, causing more inflammation and narrowing in the throat.

It’s also been shown that these same juices can go up into the nose, aggravating nasal congestion. Nasal congestion aggravates further tongue collapse by causing a vacuum effect downstream.

This is why given these circumstances, gaining weight during pregnancy, albeit normal, should be gradual and moderated.

Progesterone’s Secret

Although pregnancy and in particular the weight gain that it induces many unfavorable side effects for women, there’s one unique advantage that pregnant women have during pregnancy that many men with sleep breathing problems don’t have called progesterone.

Progesterone is a hormone that vitally involved with a woman’s reproductive cycle (along with estrogen). During a woman’s monthly cycle, estrogen helps to stimulate egg development and release, whereas progesterone promotes uterine health, to support any possible embryo development. One little known feature about progesterone that even many doctors aren’t aware of is the fact that it acts as an upper airway muscle dilator. This can have profound effects on your tongue, giving it more muscle tone.

For pregnant women, this slight muscle tone is, in effect, what helps them to counteract what could be a detrimental side affect to their weight gain during pregnancy. However, during post-pregnancy when these levels taper off, is another story.

Studies have shown that tongue muscle tone is lower in post-menopausal women and increased significantly when progesterone is added.

Imagine the effects of diminishing progesterone just before womens’ periods, or during menopause, when progesterone begins to slowly drop beginning in the early 40s. The same thing occurs during pregnancy: progesterone shoots up during pregnancy and drops immediately after delivery. During pregnancy, despite all the expected weight gain, progesterone (besides maintaining uterine health) prevents the tongue from falling back. But once a woman delivers and progesterone drops, you’re left with all the added weight of pregnancy without the added protection of progesterone. No wonder women have trouble sleeping the first few weeks after delivery (besides having to feed the baby every few hours).

In retrospect, these factors severely affected the way my wife felt right after my first son was born. It took her almost a year before her post-partum depression resolved completely after our first son was born. Only after she lost all her pregnancy weight did she begin to feel better.

Breathe Better, Sleep Better, Feel Better

Although pregnancy can impact the way you breathe, and thereby affect the way you sleep during and even after you deliver, there are simple ways to minimize the negative side effects and expedite your post-partum recovery process.

The first thing you must do is to keep all your airway passages clear and congestion free and this includes your nose. If your nose is stuffy, the simplest thing to do is to apply nasal saline, which come in various nasal applicators from sprays to pumps to Water-Pik machines. Another popular way of getting salt water into your nose is a Neti-pot, which is an Indian Alladin’s lamp-like container where you mix your saline and pour it into your nose.

If your nostrils collapse when you breath in, then nasal dilator strips (Breathe-rite is one brand), or internal nasal dilator devices (Nozovent, Breathewitheez, Nasalcones are three examples) may help. Sometimes women are placed on allergy medications for pollens, dust or pets. This should be done under a care of your medical doctor. If none of these options work, it’s time to see an ear, nose and throat doctor.

If you normally like to sleep on your stomach or side, then your tongue may be susceptible to collapse. There are various dental devices that are available for snoring and mild to moderate obstructive sleep apnea. Although not officially designed for use in pregnant women, these devices are not harmful for the baby and can only help the baby since it helps the mother sleep better.

If you have any of the complications of pregnancy or if your fatigue is to severe to the point where you are incapacitated, a consultation with a sleep doctor may be warranted. CPAP, or continuous positive airway pressure, has been studied and found to be useful in a handful of small, preliminary studies.

The most important thing to do after delivery is to try to lose the pregnancy weight. This is obviously easier said than done, but there is a direct correlation between your persistent weight and how you will feel. You may want to consider working with a healthcare professional (your medical doctor, dietician or trainer). The devices mentioned during pregnancy may be appropriate for afterwards the delivery as well.

Whether or not you’re pregnant, breathing well while you’re sleeping is vital to your overall state of health. But if you’re pregnant, it’s even more important that you breathe well, especially in the immediate period just after you deliver.

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Click here for Top 10 Tips from our expert fitness consultant, Tara Marie Segundo, on how to lose your post pregnancy weight quickly and easily.

 

Q: What’s a Neti-Pot?

 

A:  A Neti-Pot is an ancient Indian method of nasal and sinus cleansing, where one uses a small tea-pot shaped container to pour salt water into the nose. The saline solution is not very different from other forms of nasal saline recipes that are widely available. There are many different ways of getting salt water into your nose, including bottles that spray, mist or pump saline. Some come in aerosol cans. Another, more aggressive way of irrigating your nose is to use a Water-pik machine which sprays the saline under high pressure. You’ll need to get an inexpensive nasal adaptor if you want to use this device.

The Neti-Pot is similar to all the other methods mentioned above, but is unique in that it uses gravity to pour large volumes of saline into one side of your nose. It’s applied by bending your head over a sink and tilting your nose to one side. The nozzle of the Neti-Pot is placed on the higher nostril and slowly emptied into the nose. The saline goes to the back of the nose, turns around the back of the septum, and comes out the lower, gravity-dependent side. The head is turned to the other direction and the other side is then addressed. There are video demonstrations of this technique on YouTube.

 

Get On The Fast Track To Weight Loss After Pregnancy

 

Once the excitement of seeing your newborn settles down, and the fog of post-partum breaks, one of the biggest concerns women have after delivering is: “How quickly can I get back to my pre-pregnancy weight”.

One of the worst things you can do at this time is to expect too much, too fast. Just as it took 9 months for your body to gear itself for birth, you must allow yourself time to go back to the way it was. To help you get on the right track, I invited our guest fitness expert, Tara Marie Segundo to guide you on how you can lose weight quickly and effectively, without spending a lot of time or money.
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Ok, ladies, reality check: you just delivered your bundle of joy and it finally hits you—your little one accounts for only about 7 lbs. of the 30 or so that you gained during pregnancy.  You leave the hospital looking like you are still pregnant, and you start to wonder if things are ever going to make it back to the their original spot…sound familiar?

The good news is that your body will one day return to some semblance of your pre-pregnancy state, and there are things that you can do to help hasten this process.

Whether you delivered via C-section or the good old-fashioned way, getting your doctor’s clearance before returning to exercise is a must.  Pregnancy and delivery present quite a trauma to the body, and a certain level of healing must occur before you place additional physical stress on yourself with exercise.

Once your doc gives clearance, you can consider these tips to help you drop your pregnancy weight:

1.  BREAST FEED IF YOU CAN.  Breastfeeding can help you shed your excess weight while eating your regular diet. Producing milk uses 200 to 500 calories a day, on average.  This may not sound like much, but that can add up to about a pound a week without making any other changes in your daily routine.

2.  DO SHORT BOUTS OF EXERCISE THROUGHOUT THE DAY.  As a mom caring for a newborn, you can’t expect to have long periods of time during which you can exercise.  Take advantage of 10 minutes here, 15 minutes there, to squeeze in some movement.  I had a client that had a treadmill in her home and everytime she got a short block of time, she would jump on the treadmill and kick out a brisk walk.  She clocked an hour a day by doing 10 minutes here and there.  This allowed her to care for her new baby and make use of the brief breaks that she had.
 
3.  MAKE EVERY CALORIE COUNT.  If you are breast feeding, it is recommended that you do not eat less than 1,800 calories a day so you can produce milk for your baby.  If you are not breast feeding, your doctor may allow you to diet.  Regardless, every calorie eaten needs to be nutritious.  Your body is in recovery and you need to provide yourself with foods that offer you what your body needs to thrive.  Make every calorie count toward the betterment of your health.  In general, if man made it, don’t eat it.  Stick to fresh whole foods that come from nature.

4.  BE REALISTIC.  You spent 40 weeks pregnant, so give yourself a break and don’t sweat it if it takes a full year to really feel like yourself again.  You may lose the excess weight quickly, but other shifts in your body may take more time to return to their pre-pregnancy state.  You will look and feel better if you don’t pressure yourself to do too much, too soon.  Do what you can, when you can, and enjoy your beautiful new baby in the meantime.  Most new moms report to me that it took them roughly a year to feel like themselves again.  Please don’t put undo pressure on yourself.

5.  PROCEED SLOWLY.  Right after you deliver is not the time to launch into a brand new, physically challenging exercise routine.  With your doctor’s OK, it is safe to slowly ease back into what you were doing before you were pregnant.  Walking (alone or while pushing a stroller) is a great form of exercise.  If you are a runner, there are some wonderful jogging strollers on the market.  If you can get to the gym, using a treadmill or an eliptical trainer is a gentle way of doing some cardiovascular training.

6.  DO SOME FORM OF RESISTANCE TRAINING.  Best case scenario, you have been doing resistance training all along and it helped you with your delivery.  If you have never embarked on a resistance training program before, work with a trainer at your gym that is knowledgable about working with women that have recently delivered a baby.  If lifting weights is not your cup of tea, there are other forms of resistance training that are very effective, including resistant bands and tubing and using your own body weight.  If you can’t afford to work with a personal trainer, most gyms offer a wide variety of conditioning classes.  Always mention to the instructor that you just had a baby so she can help you make any necessary modifications.  The name of the game in weight control is increasing your metabolic rate, and building muscle will permanently rev your metabolism.  Muscle requires calories to sustain itself and you will use more calories (even at rest) if you increase the muscle mass on your body.

7.  BE CREATIVE.  If you can’t afford to go to a gym and you can’t buy a decent piece of exercise equipment like a treadmill for your home, you must be creative.  The idea is to keep moving.  Turn on your favorite music and dance, buy a jump rope and use it throughout the day, walk up and down your stairs, etc.  You want to get moving and keep moving as soon as possible.  This will not only help you physically but will also help you stave off post partum depression.  There are a plethora of exercise DVDs on the market that specifically target different populations.  Do some research and find a few that are designed to help moms bounce back after baby.  Invite some of your new-mom girlfriends over and have an exercise class together!  This comraderie will be good for both body and spirit.  If you really want to be creative, use your baby as resistance!  Holding a 12 lb. baby while doing pliés is no different than holding a 12 lb. dumbbell.  Lying on your back and pressing your baby up and down works your triceps as much as holding a light barbell would.  There are “Mommy and Me” classes devoted to these sorts of creative exercises that involve your little one, so ask your friends or your doctor and find the one that works for you.

8.  DRINK PLENTY OF WATER.  Most of us go through life dehydrated.  As a new mom, the last person you think about is YOU.  Be sure to drink plenty of water (one gallon daily would be great, but at least 3 liters) and do not wait until you are thirsty.  Drinking water will not only help you with weight loss and metabolism, but it will also keep you feeling full and curb hunger.

9.  EAT 4-6 SMALL MEALS A DAY.  Your body will absorb and metabolize food more efficiently in smaller doses, and eating every 3 hours or so will keep your energy up.  Taking care of a newborn is hard work and you will feel better if you don’t wait too long between your own feedings. 

10.  EAT HIGH FIBER FOODS.  Eating a lot of fiber is always ideal, but when you are trying to shed body fat, it is the golden rule.  Eating high fiber foods (and drinking plenty of water) will make you feel full more quickly and leave you feeling full longer.  I personally live by this rule:  I eat a large volume of food every day, but it is not calorie-dense food.  I eat plenty of steamed and raw veggies that leave me feeling full without eating too many calories.  High fiber foods and drinking a lot of water will also keep you regular.  Recently giving birth and constipation don’t go together, and that’s all I am going to say about that.

All of this basically adds up to common sense, creativity and patience.  Take good care of your body and it will take good care of you.  Do the best you can, when you can, as often as you can and relax about this process.  Mother Nature knows what to do, and you WILL feel like yourself again soon!

Enjoy!

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Tara Marie Segundo, M.A. is a WNBF Natural Figure Pro, personal trainer, freelance writer and radio and TV personality based in New York City.  For more information or to book an appointment, call 877-692-6221 or visit www.taramariesegundo.com.

When Your Cold Is Not A Cold

It’s cold and flu season again, and for many of you, drinking lots of liquids, getting enough sleep and eating chicken soup will be enough to bring you back to health. But for some others, you’ll have persistent or lingering problems that may make you wonder, could it be something else?

Whether it’s a chronic cough, a lump in your throat, headaches, or post-nasal drip, there are a variety of symptoms that can mimic routine colds or flu symptoms. The challenge is in determining what exactly is causing your problem so that you can address it properly.

Cold Versus A Flu: What’s the Difference?

Most routine colds are self-limited, and go away within 4-7 days. Common symptoms of colds are a low-grade fever, a runny or stuffy nose, mild cough, and a mild sore throat.

A flu infection, however, is caused by a different virus, and tends to be more severe, with higher fevers, chills, muscle aches, worse headaches, slightly longer course, and increased generalized fatigue. If you’re otherwise healthy and you follow the typical precautions (rest, fluids, sleep, etc.), both the common cold and the flu will eventually go away. But if you have an underlying medical problem, are more stressed than usual, or run yourself ragged despite your infection, then either the infection may not go away, or slowly turn into something else, or be left with one major symptom that just won’t go away for weeks to months. This is when the real problem begins.

When Colds Never End

There are a number of different conditions that can aggravate your cold and flu symptoms. For example, if you have any degree of underlying allergies, this can make your symptoms even worse, with continued nasal congestion, post-nasal drip or ear and sinus congestions and fullness. If you have a history of allergies, either removing yourself from whatever you’re allergic to or taking an over-the-counter allergy medication may help.

One of the more common situations that cause chronic or persistent symptoms is if you have sinusitis. Persistent nasal congestion can back up your very narrow sinus passageways (or the Eustachian tube for the ears) and after an initial negative pressure sensation, fluid can build up and get infected with normal bacteria that live inside your nose.

However, it’s been shown in recent studies that what most people describe as a "sinus infection" is not truly a bacterial infection, but mostly due to pressure or clear fluid. In this case, opening up the sinuses or ears, starting with conservative methods such as vigorous nasal saline irrigation may help. More aggressive decongestants such as over-the-counter (OTC) decongestant pills or sprays (only for a few days at most) are other options. Antibiotics are rarely needed, since most cases are not really due to bacterial infections. If you can open up your sinuses, your body is able to do the rest.  Click here for a FREE brochure on which OTC medications are best for your cold symptoms.

Another interesting fact about sinus pain and headaches is that the pain itself in most cases is not caused by an infection, but by a migraine attack of the nerve endings in your sinuses. In contrast to your classic migraine headache (pounding one sided headaches with sensitivity to bright lights and noised, nausea and vomiting), irritation and inflammation of the nerves in your sinuses can cause pain, pressure, post-nasal drip, and sometimes nausea. In some cases these sinus "headaches" may respond to anti-migraine medications, such as Excedrin Migraine or Imitrex. In this situation, avoidance of certain foods that can trigger migraines is also recommended (such as caffeine, alcohol, MSG, aged cheeses, red wine).

Colds and Acids Don’t Mix

Acid reflux can’t cause colds or flus, but colds and flus can definitely cause acid reflux. For some people, the inflammation from the infection causes narrowing in the nose and throat, leading to stronger than usual vacuum forces in the throat via the following mechanism:

Due to modern human’s unique oral cavity anatomy, our tongues can easily fall back, especially if on our backs (due to gravity) and when in deep sleep (due to muscle relaxation). Many people with this condition naturally like to sleep on their sides or stomachs, but any degree of even mild narrowing due to inflammation can trigger a vicious cycle, where the tongue falls back, leading to partial or total obstruction. (I talk about the reasons why some people are more susceptible to this in my newly released book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. For more information or to download sample chapters click here.  

Once the tongue falls back and obstructs, as you try to take in a few breaths, tremendous vacuum forces are created in the throat, literally sucking up normal stomach juices into your throat. Your stomach juices include not only acid, but bile, digestive enzymes, and bacteria. Even small amounts of these substances can irritate not only your throat but studies have shown that these can even go into your ears, sinuses and lungs. This causes more inflammation, which narrows the airway even more, causing more tongue collapse. If your nose is stuffier, then vacuum forces are created downstream and the tongue falls back easier. Notice the multiple vicious cycles.

Acid irritation in the throat will produce the classic throat acid reflux symptoms, such as chronic throat clearing, lump sensation, difficulty swallowing, hoarseness, chronic cough, post-nasal drip, and tightness in the throat. This condition frequently coexists with a variety of other upper respiratory conditions.

Not too surprisingly, sinus headaches, post-nasal drip, and throat acid reflux frequently go hand in hand. It’s also been shown that people who are prone to these issues also have what’s called chronic rhinitis or non-allergic rhinitis. This is where your nose’s nervous system is hypersensitive to weather changes such as temperature, humidity, and pressure changes, and other irritants such as chemicals, fumes, scents or odors. This is thought to be due to an imbalance in the involuntary nervous system of your nose.

Sometimes, a patient will come in extremely stressed and concerned about the possibility of cancer, as they’ve smoked in the past, or a parent died of throat or lung cancer. In almost all cases, after a thorough history and  examination of the throat structures, patients are reassured that their symptoms are most likely due to the conditions that’s causing inflammation, such as acid reflux, or allergies.

Why Antibiotics Aren’t The Cure

So now that you know what may be causing your chronic problems, what can you do about it? In most cases oral antibiotics are not the answer (although this is too often prescribed by most doctors). In certain cases patients swear that within a day or two of being given a certain class of antibiotics (macrolides, which include azithromycin or clarithromycin), they felt significantly better, which proves that it was a bacterial infection. One possible explanation is that the macrolide antibiotics have a unique property where it stimulates the smooth muscles of the stomach, causing more contractions and thereby pushes the stomach juices and contents down faster into the intestines. So the less acid is lingering in the stomach, the less it can come up into the throat to cause problems. This is probably why many patients feel better after being given a Z-Pak for throat pain. General surgeons use these medications intravenously to stimulate bowel function after major abdominal surgery.

So now that you know the improper way to treat a cold or flu, what should you do to feel better? The first thing to address is to make sure you are able to breathe well through your nose. Try nasal saline sprays or any of the other various ways of getting saline into your nose. Saline acts as a mild natural decongestant, helping to open up nasal passageways and sinuses. The only downside is that it has to be repeated frequently. If you have any allergies, try to find out what you’re allergic to and get it under control. You can start with over-the-counter allergy medications and if that doesn’t work, you may need to see your doctor about your allergies. Worst case scenario, you may need to see an allergist. If your nose is still stuffy, you may want to consider seeing an ear, nose, throat specialist to figure out if you have an internal structural problem that needs to be addressed.

Some people have naturally flimsy nostrils. Sometimes, this occurs years after rhinoplasty, since narrowing the tip of the nose also weakens the sidewall cartilages that support the nostrils. In this case, Breathe-rite nasal dilator strips may help. If this is not strong enough, or if it won’t stay on, there are various internal nasal springs or clips that can be used (Nozovent, Breathewitheez). Having a stuffy nose internally can also aggravate this nostril collapse problem.

One of the most important habits to avoid is eating close to bedtime. If you have stomach juices lingering from a recent meal and you lay down to sleep, if you have even mild partial to total obstructions, you’ll vacuum up these juices into your throat, which can then go into your nose. This causes more inflammation and more obstruction with arousals. You should try to avoid eating about 3-4 hours before you go to bed.

Alcohol is another substance that should be avoided close to bedtime. It may make you drowsy and fall asleep better, but because it relaxes your muscles, you’ll stop breathing and wake up more often. Again, use the same 3-4 hour rule. What this means is that you can still have a glass or wine or beer with an early dinner.

Many of you will naturally want to sleep on your side or stomach, but if you normally like to sleep on your back, try sleeping on your side or stomach, whichever is more comfortable. This will lessen the degree of tongue collapse due to gravity.

I alluded to sinus pain and pressure being like migraine. Even if you’ve never had a migraine, try to avoid certain foods that can trigger migraines (already mentioned above).

Lastly, it’s not too surprising how often people push themselves while sick. It’s just common sense that you should rest, take it easy, and care of yourself. This involves regular exercise, eating healthy, and taking part in activities that is calming and relaxing. If all these conservative options don’t help, then it’s time to see your doctor.

Does Oprah Have Sleep Apnea?

Oprah’s recent revelation in her magazine that she’s back above the 200 pound threshold made a lot of headlines recently. She was quoted as saying that rather than falling off the wagon, the wagon fell on her. Oprah attributes her weight problem to an ongoing thyroid condition. An excellent detailed description of her thyroid condition can be found on Mary Shomon’s site. 

 

Ninety percent of women with obstructive sleep apnea in this country are undiagnosed. Instead, they are treated for the signs and symptoms of obstructive sleep apnea, such as weight gain, depression, hypothyroidism, diabetes, high blood pressure and heart disease. It doesn’t matter if you’re a celebrity—many women are susceptible to sleep-breathing problems, especially if you’re peri or post-menopausal.

Here are the tell-tale signs that Oprah may be suffering from untreated sleep apnea, including:

 

     • yo-yo-like weight fluctuations

     • her highly publicized diets and weight loss programs

     • her well-known thyroid hormone imbalance

     • an admitted food addict and cravings for junk food   

     • her feelings of depression and anxiety  

     • her chronic fatigue

I can prove that Oprah has sleep apnea—all she has to do is to undergo a formal sleep study.

The Pinkberry Factor

My younger son, Devin, wanted some ice cream after lunch, so we stopped by a local ice cream and snack store. On the way out, the the owner wanted us to taste their new frozen yogurt. He gave us a very large sample, and we were pleasantly surprised. My first impression was that it tasted very similar to the popular Pinkberry brand, which we like very much. But there was something missing. It wasn’t Pinkberry.

If you’ve experienced Pinkberry, you know what I’m talking about. Yes, their yogurt is good, but their experiences is unique. From the initial ambience and music to the smile and obviously scripted greeting where they call you by your first name, the entire experience is what makes it so satisfying. Other companies that understand this include Apple and Disneyland. 

This concept should be applied in healthcare as well. Seeing the best doctor is like your typical good frozen yogurt. But what really promotes true healing is the entire experience from the first phone call to the greeting as you leave the office. It’s the support staff that sets up the patient so that the doctor can spend quality time with the patient and provide the best possible care. 

Most doctors are still stuck 50 years back thinking that all you need to do is to provide good medical care. But back then you didn’t have all the nonsense and third party issues that prevented you from benefitting from your optimal medical care. We can learn a lot from other industries and companies that know something about customer service and just plain common courtesy. 

Have you ever experienced a memorable visit to a doctor’s office? 

Can Sleep Apnea Cause Alzheimer’s?

Researchers found that when people with Alzheimer’s and OSA are treated with CPAP, cognition and memory improves. This study was published in the November edition of the Journal of the American Geriatrics Society. They estimated that about 70-80% of Alzheimer’s patients have at least 5 apneas every hour. The authors concluded that CPAP may be an effective tool to improve cognitive skills if someone with Alzheimer’s also has OSA. They pointed out, however, that it’s unlikely that OSA causes dementia, and that the lowered oxygen levels and sleep fragmentation is what can aggravate poor cognition and memory loss.

 

Copyright © 2008 Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring · Design by Fervent