SLEEP NEWS IN BRIEF

Sleep plays a vital role in good health and well-being throughout our lives. Getting enough quality sleep at the right times can help protect our mental health, physical health, quality of life and safety.

The way we feel while we’re awake depends in part on what happens while we’re sleeping. During sleep, our bodies are working to support healthy brain function and maintain our physical health. In children and teens, sleep also helps support growth and development.

What is Sleep Apnea?

Sleep apnea is a disorder in which breathing is repeatedly interrupted during sleep. The word “apnea” literally means “without breath”. An apnea is defined as a complete cessation of breathing that lasts 10 seconds or greater. There are two principal types of sleep apnea, “Obstructive Sleep Apnea (OSA),” and “Central Sleep Apnea” (CSA). By far the most common is obstructive sleep apnea, diagnosed on overnight sleep study .Obstructive Sleep Apnea results from repetitive collapse of the upper airway. Central sleep apnea is due to decreased output from ventilatory control centres in the brain.

Why Sleep Apnea is Harmful – The Cumulative Effect of Sleep Apnea

The longer Obstructive Sleep Apnea goes untreated, the greater the negative effects and associated health risks. If sleep apnea remains untreated, other health conditions may emerge including: high blood pressure, heart disease, stroke, diabetes, depression, reflux disease (GERD), atherosclerosis and gestational diabetes.

Why Sleep Apnea is Harmful- The Consequences of Sleep Apnea

Sleep Apnea causes: excessive daytime sleepiness, morning and daytime headaches, generalized irritability and impaired emotional functioning.

Snoring and Sleep Apnea in Children

You often don’t think of children of snoring or suffering from sleep apnea but a number of them do. Children with sleep apnea repeatedly stop breathing during sleep and the episodes last from 10 seconds to a minute or so. Usually, they occur because of an obstruction in the airways, commonly due to big tonsils and adenoids, obesity, family history of OSA, Down’s syndrome and sickle cell disease.  Sleep disordered breathing in childhood may be instrumental in delaying or damaging cognitive development. 

Diagnosis and treatment of Sleep Apnea

A sleep study test is usually done to diagnose sleep apnea and it is the most accurate test. The test measures how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is. Continuous Positive Airway Pressure (CPAP) is the most common treatment option for the management of sleep apnea. The CPAP machine is small and pulls in room air, compresses it and blows it into a tube which is attached to a mask worn by the patient. The pressurized air from the CPAP keeps the airway open, allowing the patient to breathe. While CPAP is the common treatment for Obstructive Sleep Apnea, other modalities of treatment do exist. They include: lifestyle changes, positional therapy, weight loss, oral appliances and surgical procedures. Patients who get Obstructive Sleep Apnea treated will return to a more normal sleep pattern allowing the body its much needed rest. Patients will also feel more awake and energetic allowing increased focus and activity throughout the day.

If you, your spouse and or family member snores at night and you suspect that you may have sleep apnea, please visit The Karen Hospital and we will schedule an appointment for you to evaluate your sleep health today!

References

1.      https://clevemed.com/sleepview/

2.      http://www.nhlbi.nih.gov/

SMOKING

The World Health Organization states that tobacco-related diseases are the single most important cause of preventable deaths in the world. What people don’t know or may be choose to ignore is that smoking and passive smoking leads to more than 20 major categories of fatal and disabling diseases, including cancer of the lungs, throat, stomach, oesophagus among other cancers. It is rather sad that what may have started as a little fun or a result of negative peer pressure influence develops into an addictive demon ravaging our insides leaving fatal diseases in its wake.

Smoking and cardiovascular disease

Betty Weru, a Respiratory specialist at The Karen Hospital fully understands the adverse health effects brought about by smoking. “Smoking causes a number of health conditions,” she says. Having worked both in the United States and at The Karen Hospital she has had a firsthand exposure to the detrimental state that comes with smoking. She says that smokers are at a greater risk for heart and cardiovascular diseases. These are diseases that not only affect the heart but blood vessels as well. They include conditions such as stroke and coronary heart disease. Stroke is brought about when a clot blocks the blood flow to part of your brain or when a blood vessel in or around your brain bursts. There is also the risk of developing peripheral artery disease which can lead to amputation of legs. This is because blockages caused by smoking can also reduce blood flow to your legs and skin. It also increases the risk of developing high blood pressure because damages to blood vessels include thickening and narrowing of blood vessels causing an increase in the heart beat. The risks are very high irrespective of how many cigarettes one smokes in a day.

Smoking and respiratory disease

She also says that smoking can lead to lung disease by damaging airways and the small air sacs (alveoli) found in the lungs. An example of lung diseases caused by smoking includes chronic obstructive pulmonary disease (COPD) that includes emphysema and chronic bronchitis. Cigarette smoking is attributed to most cases of lung cancer. Tobacco smoke can also trigger an asthma attack or make it worse. Smokers are 12 to 13 times more likely to die from COPD than nonsmokers.

Smoking and cancer

Smoking can lead to the development of cancer anywhere in the body. It also heightens the risk of succumbing to cancer and other diseases in cancer patients and survivors.

Smoking and other health risks

Every organ of the body is affected by smoking. Additionally, it makes it harder for a woman to conceive and also affect her baby’s health before and after birth. Smoking in pregnant women comes with a myriad of health effects to the baby such preterm (early) delivery, stillbirth (death of the baby before birth), low birth weight, sudden infant death syndrome (known as SIDS or crib death), ectopic pregnancy and orofacial clefts in infants.

Men's sperms are also affected by smoking; this can reduce fertility and raise risks for birth defects and miscarriages.

Women smokers past childbearing age tend to have weaker bones and are at an elevated risk for broken bones than women who have never smoked.

There is more; smoking not only affects your gums but teeth too and can lead to tooth loss. It also increases your risk for development of cataracts. This is the clouding of the lens of the eye making it hard for one to see.

Smoking is also a known cause of type 2 diabetes mellitus and can also make it extremely difficult to manage. For smokers the risk of developing diabetes is 30 to 40 per cent higher than for nonsmokers.

Other adverse effects brought about by smoking include inflammation and decreased immune function. It can also cause rheumatoid arthritis.

Quitting and reduced risks

For those courageous enough to stop smoking, their risk of developing cardiovascular disorders is greatly reduced. One year after quitting, your risk of getting a heart attack drops sharply. Two to five years after quitting, your risk for developing stroke could drastically reduce to about the same as a nonsmoker’s. After five years your risk of developing cancers of the mouth, throat, esophagus and bladder drops by half and that of developing lung cancer drops by half after ten years.

Should one decide to quit smoking help is available at The Karen Hospital. Betty Weru runs the smoking cessation programme. This entails conducting educational sessions whose main objective is to enlighten the client on the disease process; how their body is being affected by smoking. One is advised on what lifestyle changes to embrace in a bid to avoid triggers that would lead one to smoking again. There is also medication to help quit smoking and includes use of the smoking patch. She says that one of the biggest hurdles is consistency among those who want to quit. It is not usually an easy journey irrespective of how long you have been smoking but we promise to be there every step of the way.

Won’t lose, Can’t lose

Are you aware that there are people who are obese and cannot lose excess weight? This could be due to health conditions such as diabetes, arthritis and heart disease. One is termed as obese when their body mass index (BMI) is above 30. Body mass index is a measure of fats in the body against the weight and height of the individual. It is usually calculated using the formula weight (Kgs.)/height (m ² ) .A BMI of 18-25 is considered healthy.

There is hope though, in form of bariatric surgical procedures. These are surgical interventions used in the management of morbid obesity. Morbid obesity is characterized by an extremely high body mass index of over 40. It is often accompanied by conditions such as diabetes and heart disease.

There are two types of bariatric surgeries; restrictive and malabsorbtive procedures. Restrictive operations involve reducing the stomach capacity; this will result in satiety after minimal food intake. They include laparoscopic sleeve gastrectomy, gastric band and balloon procedures.

Malabsorbtive procedures interfere with the nutrients absorption capacity. This means that the amount of nutrients absorbed in the body is greatly reduced to only what the body needs. They include gastric bypass and duodenal switch.

Dr. Joshua Mwangi, a gastrointestinal surgeon, recently performed a laparoscopic sleeve gastrectomy (L.S.G) at The Karen Hospital. The intricate procedure is a restrictive surgical operation and involves removal of part of the stomach. Its main objective is to help patients lose excess weight.

 As the name suggests, it is a laparoscopy procedure. This means that it is carried out through insertion of narrow, lighted tubes into the abdomen through keyhole incisions. A video camera is inserted in one keyhole just above the navel. This will allow the surgeon to see what he’s doing since it is not an intrusive open surgery. Carbon dioxide gas is then pumped into the abdominal cavity. This is to lift the stomach and separate it from other internal organs such as the small intestines. Next, a tube is inserted though the mouth down to the stomach to help in mapping out how much of the stomach should be removed. Two other keyholes give access to surgical instruments that will help with the cutting and simultaneous stapling of the stomach walls.

According to Dr. Mwangi, the advantages of having the procedure done are numerous. It will definitely reduce complications such as diabetes. It is a cheaper procedure since patients spend very little time in hospital post operation. There is very little bleeding hence there will be no transfusions necessary. There will be very little scarring. It is also easier for the surgeon to carry out as compared to other intrusive methods.

Good news is one can notice the difference around two weeks after the procedure. It is expected that 50% of the excess weight will be lost within one year and one can be of a healthy weight within two years.

It is important to note that the decision to operate requires a multidisciplinary assessment. A panel comprising of a surgeon, a nutritionist, a psychologist, an anesthesiologist and a physician will evaluate the patient before a decision is reached on whether operation is the solution or not. Each one of them has an important role. The nutritionist tries to find out if the excess weight can be shed through diet management or exercises before opting for surgery. The physician ensures that the patient is not suffering from a thyroid condition any other illness that would result in complications during and after the surgery. He or she also ensures that the patient is not taking any form of medication whose side effects include weight gain. The anesthesiologist checks to see that the patient will be able to handle the anesthesia administered during the procedure and the psychologist ensures that the patient is of sound mind and is ready for the changes that come with having the procedure done.

How much does it cost? According to Dr. Mwangi, there are a number of factors that will determine how much it will cost. “Choice of equipment to be used, the size of the surgical team and the hospital where the surgery will take place are the main determinant of the operation cost,” he said.

Post operation care is very important if the objectives of the procedure are to be achieved. The patient is always advised to follow a soft diet as the wounds heal. Vitamin supplements are prescribed to ensure that the patient does not lack any nutrients as a result of the procedure. The patient will be evaluated to ensure that they are adapting well to the changes in their body. Most importantly their weight and any other medical condition such as diabetes is closely monitored.

Dr. Mwangi winds up by saying,” Our main concern is usually the excess weight, beauty is miscellaneous.” The tremendous weight loss will come with another less risky problem; excess skin. Not to worry though, one will be referred to a cosmetic surgeon for the much needed nips and tacks.

Magnetic Resonance Imaging

The Karen Hospital has taken giant strides in ensuring that nothing short of world class medical services are available in all its branches. It boasts of top of the range medical equipment and excellent medical care. We have a 3 Tesla Magnetic resonance imaging scan (M.R.I). It is the best in the country. This is a medical technology that uses magnetism to check for any problem in the body function. It can be used to check for abnormalities in the brains, blood vessels, heart, liver, spinal cord, joints, soft tissues, ligaments among others.

Dr. Geoffrey Ikundu, a radiologist at The Karen Hospital, said that the MRI scan has the ability to produce very clear images. When it comes to imaging the spine, it is the best method to use because one will be able to look at the nerves, blood vessels, vertebral column and everything else.

The difference between the M.R.I and other imaging technologies like the X-ray, CT scan and mammogram is that it uses magnetic frequencies while the above mentioned uses radiation for imaging. This means that the MRI is safer and can be used as many times as necessary with zero side effects.

Depending on what part of the body needs to be examined, a substance called contrast may be administered intravenously. This is to ensure that the area being imaged is enhanced and will be very clearly seen.

Before one can undergo an MRI, there are certain things that must be put into consideration. First, one’s medical history is to be noted. This is because certain conditions may result in complications. For instance people who have a history of renal failure cannot undergo an MRI. They may develop severe complications as a result of the type of contrast administered.  Therefore it is recommended that another imaging method be used or opt for an MRI scan that will not require the administration of a contrast. People with prosthetics and implants will be evaluated to see if whatever they have is compatible with the MRI or if an alternative has to be considered.

Due to the high levels of magnetism involved it is paramount that all metal objects and cards with magnetic stripe like ATM cards should be removed.  A walk through or handheld metal detector is used to ensure that no metallic objects go into the imaging room to avoid injuries and possible destruction of the equipment. There have been cases of serious injuries, fatalities and destruction to the machine after the strong magnet attracted metal objects. There are people who cannot have an MRI done; they include people with cochlea implants, pacemakers, bullets and gunshot pellets, sternum wires among others. Giving your full medical history honestly is very important.

The MRI is safe with pregnancy and it has been used to identify fetal position and anomalies. However, it is not recommended in the first trimester and contrast is not to be administered. This is because the possible effects to the developing embryo are still unknown. A doctor and a radiologist can evaluate the risks and advice on the best course of action depending on the gravity of the situation.

Depending on the area that needs imaging one, may be asked to refrain from food consumption for a few hours.

There are people who are claustrophobic and may not be comfortable during the MRI. Dr. Ikundu said that counseling is often offered. The patient is told what is expected and the importance of the imaging. Good news is, The Karen Hospital has a wide bore MRI with a diameter of 70 cm. This makes things more comfortable and less enclosed.

People with morbid obesity may have trouble fitting properly in the MRI machine.

For conclusive results it is important that one be as still as possible during the entire process. If it is absolutely necessary for imaging to be done on children who cannot sit still for long duration of time then they can be sedated.

“Obesity, lack of proper imaging techniques, uncooperative patient and interference by radio frequency noise may render the results inconclusive,” said Dr. Ikundu.” At The Karen Hospital, the MRI scanner is preprogrammed therefore the problem of lack of proper imaging techniques for instance using the wrong sequence is done away with,” he added.

One should expect their MRI results within 24 hours.

Being a top notch technology and the extremely helpful services that come with it means that it is slightly more expensive when compared to other imaging technologies such as X-ray, ultrasound and CT scan.

Clearly, The Karen Hospital measures up to world class medical care.

The Karen Hospital: What we are about

The Karen Hospital is a private multi-specialty world class healthcare facility providing emergency and critical care, acute medical and surgical services, diagnostics, rehabilitation, mental health, palliative care and educating the next generation of healthcare professionals.

Our hospital is renown as one of the go to places in Kenya in matters healthcare. This is largely due to our service care and the support system we extend towards the patients. Equipped with excellent facilities and highly experienced medical professionals, our hospital provides treatment in a sterile and hygienic environment to provide the best results for its patients.

The Karen Hospital strives to never lose sight of what makes our service unique. We understand that each patient is an individual with their own hopes and fears. We acknowledge the whole person, not just their illness. The essence of The Karen Hospital lies in our approach to bringing quality healthcare to our people hence establishing nine satellite centers in different parts of the country; these day-to-day interactions with our community are the defining moments that transform care from good to exceptional.

The Karen Hospital: So who said we are expensive, beyond reach?

As you drive past The Karen Hospital it stands out as a majestic architectural beauty. Many are scared by this sight and as if that is not enough the fact that it is in the heart of Karen scares them even more. Remember the saying “Do not judge a book by its cover?” Well, this is one such situation. Do not get me wrong, we are a world class facility, and equipped with the state of the art diagnostic equipment. However, we are affordable and offer quality service.

The other day as I was walking along the hospital corridors, I met an expectant lady. Like all pregnant ladies she was glowing and had a grin from ear to ear. She was looking for the imaging department. As it was on my way I offered to show her the way as I inquired as to how far along she was in her pregnancy. “6 months she said.” She went further to tell me that she had come to visit a friend and seeing as she was due for her obstetrics ultrasound and she was in a hospital she decided to get the scan done at Karen Hospital. When we got to the imaging department she asked how much the scan was. She was told Kshs 4,000. She seemed a bit confused by the answer she received and repeated the question just to be sure and she got the same response. “Kwani mko na bei poa aje?” She asked looking at me. “Well, we do have affordable rates ma’am,” I responded. She made the payment and got her scan done. “Nitaaambia marafiki wangu juu ya hii hospitali,” she said. After that the lady made the Karen Hospital her choice of hospital and started attending her antenatal checkups and delivered a beautiful baby girl in the month of November 2015.

The Karen Hospital: Where to find us

Since its inception in 2006, our hospital has grown with a substantial increase in our medical specialties, technologies, workforce and geographical outreach. The Karen Hospital is a one stop solution for all your medical problems.

Our head quarter is located in the heart of Karen. With the good road network and the bypass we are 20 minutes away from the City Centre. Over the 10 years that we have been in operation we have taken our medical services and expertise to the people. The aim of these satellite branches is to bring quality and affordable healthcare services closer to the people.

Accompanied by state of the art technologies and friendly staff you can find us at the following 9 locations and plan on doubling our numbers in the next few years:-

Ø  Nairobi CBD, Cardinal Otunga Plaza, 1^st Floor

Ø  Ngong Town  - Along Ngong Kiserian Road, Adjacent to AFC

Ø  Kitengela Town – Sony Plaza, Behind National Bank

Ø  Thika town –Thika Arcade, 4^th Floor

Ø  Nyeri Town – Caledonia House, Kenyatta Avenue

Ø  Karatina Town – Market Street

Ø  Nakuru Town- Post Bank Building, Kijabe Lane

Ø  Meru Town – Njuri Ncheke Street

Ø  Ongata Rongai – Geomack House, Opposite Nafrom House