NOT a well-known entity even to many physicians is the Overlap Syndrome. One example of this is the combination of COPD (Chronic Obstructive Pulmonary Disease) and OSA (Obstructive Sleep Apnea), with closely related respiratory symptoms. There is a 66 percent association between COPD and OSA in the general population. In the United States, there are about 81 million people with OSA. The U.S., Brazil, and Colombia have the highest incidence of OSA, with about 170 million in the Americas.
COPD is a long-term inflammation of the lungs, commonly caused by smoking and environmental air pollution, which irritates and destroys the lung tissues, making it harder to breathe. OSA is a condition that causes breath-holding for a prolonged period during sleep, resulting in lowering of the oxygen level in the blood. It adversely affects vital organs deprived of normal oxygen level, and the patient is not able to have a restful sleep. People with OSA wake up tired and feel sleepy. The impaired sleep leads to increased risk for high blood pressure, heart disease, stroke, Alzheimer’s and even cancer.
Having both COPD and OSA is a common combination among people. Each has its own treatment. Smoking cessation and breathing healthier air are both beneficial to COPD and OSA. Newer expensive inhalers, like Breztri and Trelegy, are effective in improving airway exchange and easier breathing for this overlap duo.
When confirmed by a Sleep Study, OSA is effectively treated with the use of CPAP (Continuous Positive Air Pressure) machine during sleep. This is the state-of-the-art, clinically proven, effective, standard management for OSA. Other advertised nasal and oral gadgets are a scam, a waste of money, and provide a false sense of security. These purveyors of fake treatment are doing a great disservice to humanity. They are basically criminal. Their gadgets do not treat the pathology which is in the throat. The CPAP does open the airway in the breathing pipe effectively with positive pressure, allowing normal oxygenation of the lungs and all other organs and provides a more restful sleep.
The marketed “Insure” surgically implantable nerve stimulator is recommended for those unable to tolerate CPAP machine. It requires an operation and not guaranteed to work for everyone. The gold standard in the management of OSA is still the use of CPAP device, which could even be monitored (from the patient’s home) wirelessly (thru the internet) by the treating pulmonologist in the office.
If one has restless sleep and wakes up tired, sleepy by mid-afternoon, always feeling “blah,” a Sleep Study is in order. Frequent breath-holding while asleep is dangerous to health and to life itself. Some who died in sleep were suspected of dying from heart attack brought on by too much prolonged breath-holding. The body needs non-stop normal oxygen blood level to stay healthy and sleep is vital. If you think you might have OSA, talk to your physician if you need a Sleep Study.
Oxygen and a restful sleep are two wonderful commodities that are free for the taking. Let’s ensure our body gets both in a healthy fashion.
Heart angiogram
Cardiac catheterization, known to laymen as heart angiogram, is a radiologic video procedure using dye to view the function of the heart and patency (or blockages) in the coronary arteries (responsible for angina or heart attack). The goal of a coronary angiogram is to find out what heart arteries are blocked, which could then be stretch-opened with a balloon at the end of the catheter inside the artery and a coil spring-like stent is left inside to prop it open. Or, in multiple blocked coronary arteries, coronary bypass could be done, preferred over angioplasty.
Since coronary angiogram was accidentally discovered by cardiologist F. Masson Sones, Jr., on October 30, 1958 at Cleveland Clinic in Ohio, the symptom of angina (chest pain) was enough indication (with a positive stress test) for the performance of cardiac cath and coronary angiogram.
Today, after decades of peer reviews, the indication (justification) to do coronary angiogram is much stricter. For those with chest pain, the cardiologists are now required to try maximal intensive medical treatment first (using calcium channel blocker and beta blocker pills). On top of this, a CTA (Computed Tomography coronary Angiogram) is also required to be tried to find out if there are any significant blockages in the coronary arteries. Only when medical trial fails to relieve angina on a long-term basis would coronary angiogram be officially justified medically and reimbursable by insurance companies. Clinical studies (COURAGE and ISCHEMIA Trials) confirmed this protocol as the medically sound standard practice in interventional cardiology. This has significantly reduced the number of coronary angiograms around the world.
Weight loss cures diabetes
Obesity has been known to be one of the causes of diabetes mellitus Type2 (DMT2) for decades. Being overweight not only increases the risk for diabetes but actually causes this metabolic disease. Worldwide, there are about 463 million adults with DMT2. Many are undiagnosed. In the United States, about 37.3 million people have diabetes mellitus T2.
DIRECT (Diabetes Remission Clinical Trial) in the United Kingdom has shown that among T2 diabetics, who lost significant weight (more than 10 kilos or 22 pounds) sustained over 12-24 months) could lead to remission (reversal) of DMT2.
I know of patients who lost 40-50 pounds and achieved their normal weight of 130-150 pounds for 12 months or longer by staying away from carbohydrates and controlling their daily total calorie-intake and exercising, and who were able to stop taking their insulin shots and maintained normal blood sugar level. Is this remission or a cure? Whichever it is, this “transformation” is amazing and is definitely an inspiring discovery for all diabetics. Obviously, this takes a lot of discipline, hard work, and personal sacrifices. Knowing how diabetes damages our organs, increases our risk even for cardiovascular illnesses, including cancer, and how it shortens lives, the great hurdle, and pains of dieting and exercise (not by taking pills, which are dangerous) is worth it. Health is, indeed, wealth!
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The opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of the Asian Journal, its management, editorial board and staff.
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The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.
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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, Health Advocate, newspaper columnist, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: FUN8888.com, Today.SPSAtoday.com, and philipSchua.com; Email: [email protected].
