New Study Finds Glaucoma and Sleep Problems are Connected

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A new study links sleep problems with glaucoma, a leading cause of vision loss and blindness among United States adults.

Glaucoma and Circadian Rhythm

Michael V. Boland, M.D., Ph.D., Director of Information Technology and Associate Residency Program Director at the Wilmer Eye Institute at Johns Hopkins University, specializes in glaucoma and glaucoma surgery. He recently co-authored a study that suggests poor sleep could be either a risk factor or a result of glaucoma.

Glaucoma is a family of eye diseases that elevates inner eye pressure to dangerous levels and can damage the optic nerve. Deterioration of the optic nerve can lead to permanent vision loss or even blindness. Researchers have established a connection between chronic high eye pressure and damage to ganglion cells in the retina, which are hypothesized to impact circadian rhythm and sleep.

Analyzing Sleep Dysfunction and Glaucoma

To investigate the hypothesized connection between ganglion cell loss and poor sleep, Boland examined data from the 2005-2008 National Health and Nutrition Examination Survey. Boland reviewed responses from the nearly 4,500 survey participants: some with glaucoma, some with vision loss and some with no vision problems. Patients answered questions about sleep medication, sleep duration, sleep disorders, sleep disturbances and daytime drowsiness.

The results of the study established a connection between glaucoma and long and short sleep duration. Glaucoma was three times more prevalent in participants who slept ten or more hours per night compared to participants who slept seven hours per night.

Boland discovered patients with glaucoma were more likely to fall asleep very quickly or take longer to fall asleep. Glaucoma was more prevalent in patients who fell asleep in nine or fewer minutes or patients who fell asleep in 30 minutes or more. There was also a connection between glaucoma and pronounced daytime sleepiness.

<h2>Poor Sleep Quality Does Not Always Indicate Glaucoma <h2>

Sleep problems and glaucoma are not always related, but it is important to consult a doctor to help resolve sleep issues. The Centers for Disease Control and Prevention (CDC) declares insufficient sleep a “public health problem.” According to SleepHealth.org, between 50 to 70 million Americans experience poor sleep.

Sleep disorders are common among both genders and all ages and socioeconomic levels, and sleep deprivation can cause chronic health concerns. Poor sleep can lead to heart disease, accidents, hypertension, septicemia, cerebrovascular disease and diabetes.

Boland intends to continue researching the connection. He encourages more communication between physicians and patients.  In an interview with Ocular Surgery News, Boland explained, “Ophthalmologists may want to consider asking their glaucoma patients about their sleep quality.”

Currently, glaucoma affects more than three million Americans, but many are unaware they are developing glaucoma because the condition often has no noticeable symptoms in the early stages. This is why glaucoma is sometimes called the sneak thief of sight. Early diagnosis and early intervention are imperative to minimize optic nerve damage and preserve vision.

Make an Appointment for a Comprehensive Eye Exam

Are you struggling with poor sleep, frequent waking at night, daytime fatigue or forgetfulness? It is probably time to call your ophthalmologist. A comprehensive eye exam can provide you with a full evaluation of your vision health. Your eye doctor will check your prescription and test you for degenerative eye conditions like cataracts, glaucoma and macular degeneration.

Make healthy vision a priority by scheduling an appointment today.

New Study Says Physical Activity Can Prevent Colon Cancer

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A recent study links exercise with a decreased risk of developing abnormal colon tissue or polyps that can lead to colon cancer.

Proper eating habits and regular physical activity are two essential components for healthy living, but a new study at the Chinese University of Hong Kong suggests exercise is particularly important in preventing colon cancer.

Martin Wong, researcher at the Chinese University of Hong Kong and senior author of the study, says regular physical activity may make people 23 percent less likely to develop precancerous growths in the colon. Furthermore, those who exercise regularly may be 27 percent less likely to develop a particular type of precancerous growths that are aggressive and are more prone to progress into colon cancer.

Although the study did not reveal how exercise reduces the risk for colon tumors, the researchers believe physical activity could improve digestion, which reduces the time acid or carcinogens are in the digestive tract. Another theory is that exercise could lower blood sugar by making the body more efficient at using insulin to convert glucose into energy.

Inactivity, Obesity and Cancer Risk

According to the Centers for Disease Control, more than three-quarters of the U.S. population is not getting enough exercise and is putting their health at risk. The obesity rate is approaching 40 percent, and inactivity and poor eating habits are two of the main contributing factors.

Exercise provides many benefits besides decreasing colon cancer risk. Some of these benefits include:

  • Improved cardiovascular fitness
  • Weight management
  • Bone and muscle health
  • Lower cholesterol
  • Lower blood pressure
  • Improved mood
  • Enhanced brain function

Vandana Sheth, spokesperson for the Academy of Nutrition and Dietetics, underscores the importance of regular exercise. “Physical activity is inversely associated with any type of colorectal neoplasia in both men and women,” said Sheth. “Increasing physical activity and decreasing sedentary behavior can have a significant positive impact on our overall health, especially in terms of colorectal neoplasia.”

Get Screened to Prevent Colon Cancer

One common myth about colon cancer is that young people do not develop the disease. However, no one is too young to get colon cancer, and the incidence of young-onset colon cancer continues to rise each year.

The American Cancer Society recommends all adults at average risk for colon cancer begin colon cancer screening at the age of 45. Individuals who have certain risk factors for colon cancer should talk to their doctor about getting screened earlier. Some of these risk factors include:

  • Family history of colon cancer
  • Personal history of precancerous growths or polyps
  • Family history of hereditary colon cancer, like familial adenomatous polyposis (FAP) or Lynch syndrome

Call Your Gastroenterologist

How long has it been since your last colon cancer screening? Call your gastroenterologist and ask when you need to schedule your next exam. A colonoscopy is the most comprehensive type of colon cancer screening because it can detect and prevent colon cancer in a single procedure. The best news is that a clear colonoscopy means you probably will not need to be screened for another ten years!

Commit to your health by giving colon cancer a double-punch. Call your GI doctor and get some exercise.

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ASCs Produce Successful Results, Low Complications

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A new study suggests joint replacement patients may be happier going home on the same day as their surgery than staying overnight in a hospital.

If you are considering a total hip or total knee replacement, you may want to schedule it at an ambulatory surgery center (ASC). A new study presented at the American Academy of Orthopaedic Surgeons’ annual meeting suggests joint replacement patients may be happier going home on the day of surgery rather than staying overnight at a hospital.

More Patients Prefer Total Joint Replacement at ASCs

Richard Berger, M.D., an orthopaedic surgeon at Midwest Orthopaedics at Rush in Chicago has completed more outpatient total joint replacement surgeries than any other physician in the country. He and his research team studied patients who had the same hospital, surgeon, anesthetist and nurse. The only variable was whether the patient chose to be admitted to the hospital and to stay overnight or whether the patient chose to be discharged on the day of surgery.

The team anticipated the patients who chose to stay overnight in the hospital would be happier than the patients who opted to go home, but they were incorrect. Patients who returned home on the day of surgery reported higher levels of satisfaction than patients who spent the night in a hospital. Dr. Berger said, “The research shows that patients like to be given a choice, and while the clinical outcomes are excellent for both, joint replacement patients are happier when they return to the comfort of home.”

Patients who went home on the day of surgery reported satisfaction with staff communication regarding medication as well as pain management protocol. One patient said she was happy to be able to walk out of the center and rest at home in her own bed. She felt that she recuperated more quickly than friends who had joint replacement surgery in an inpatient setting.

ASCs Save Patients Money

Another benefit of outpatient total joint procedure is cost. According to Becker’s ASC Review, an outpatient procedure could cost up to 50 percent less than an inpatient procedure.

The number of total joint replacements is expected to increase by 77 percent in the next decade, and cost will be a significant factor in how patients make decisions. The number of inpatient joint replacement procedures is expected to rise only three percent, but outpatient total joint replacements are expected to increase by 457 percent for knee replacements and 633 percent for hip replacements.

Do you need a hip or joint replacement? Talk with your doctor about scheduling your procedure at an ASC. Patients who are in good physical health and are at low risk for complications are excellent candidates for outpatient joint replacement at an ambulatory surgery center. You could save hundreds of dollars on your procedure and recover in the comfort of your home.

Ask your doctor for a list of in-network facilities near you.

Mass. Doctor Promises Easier Hernia Surgery

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Many hernias can require surgery which mean weeks of missed work. A doctor in Wellesley, Massachusetts, who performs a unique surgery called inguinal hernia repair says the method can result in fewer complications and quicker recovery time.

Click here to view the full story.

OrthoArizona Now Offering Outpatient Anterior Hip Replacements in Phoenix

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Dr. Michael Wilmink of OrthoArizona is leading the minimally invasive approach of how hip replacements are done.

Hip replacements are notorious for being complex with an overnight stay at the hospital.  The surgeons at OrthoArizona have now taken the next logical step with refinement of this procedure to allow patients to have their hip replaced at Gateway Surgery Center and go home the same day.  Patients are able to leave the surgery center approximately 3-4 hours after their surgery, walking with a walker and ready to start their rehabilitation.

Click here to read the full article.

A Healthy Gut Could Improve Joint Replacement

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Healthy intestinal bacteria could improve knee and hip replacement outcomes, but unhealthy gut bacteria could increase the risk of infection.

Good Gut Bacteria Prevents Joint Replacement Infections

A new study at the College of Engineering and the Hospital for Special Surgery (HSS) at Cornell University claims gut health directly impacts the risk of contracting an infection during surgery. The research team performed knee replacements on mice and discovered the mice with unhealthy gut bacteria were more susceptible to infections.

The testing is still in the early stages, but the team believes their study may have significant implications for human joint replacement surgery. More than one million Americans schedule a hip or a knee replacement each year. Although post-surgical infections are rare, infections are a leading cause for replacing an artificial hip and the number one cause of replacing an artificial knee.

How You Can Improve Your Gut Bacteria

Improving the gut microbiome could become an important component of prepping for joint replacement. There are many ways patients can improve their gut health. Some of these include:

  • Increasing fiber intake
  • Selecting foods and beverages with high levels of polyphenols (seeds, nuts, berries, olive oil, coffee and green tea)
  • Eating a variety of probiotic-rich foods like kimchi, miso, sauerkraut and pickles
  • Drinking kombucha and kefir
  • Avoiding antibiotics or medicines that eliminate healthy bacteria
  • Avoiding processed foods and artificial sweeteners

Talk to Your Doctor

Talk to your doctor about how you can cultivate healthy gut bacteria. By making some changes in your diet, you can boost your immune system, prevent infection and improve your overall wellness.

Can Cholesterol-Lowering Drugs Prevent Glaucoma?

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A recent study published in JAMA Ophthalmology found statins, a type of drug that lowers cholesterol, could help prevent primary open-angle glaucoma, or POAG.

Doctors often prescribe statins to patients with high cholesterol to reduce the risk of a stroke or a heart attack, but statins could have another benefit. A research team from Brigham and Women’s Hospital claims using statins for five years or longer could lower the risk of primary open-angle glaucoma, the most common type of glaucoma.

What is Glaucoma?

Glaucoma is a family of eye diseases in which elevated eye pressure, or intraocular pressure (IOP), causes optic nerve damage and can lead to progressive, permanent vision loss. Since glaucoma often has no symptoms in the early stages, it is very challenging to diagnose. The Brigham and Women’s study suggests statin drugs can lower IOP and enhance blood circulation to the optic nerve, thus preventing  POAG.

Jae Hee Kang, Sc.D., an assistant professor of medicine at Brigham and Women’s Hospital, and a team of researchers followed more than 136,000 healthy men and women aged 40 and older. Between 2000 and 2015, the team identified 886 individuals with primary open-angle glaucoma. The results indicated using statins for five years or longer is associated with lowering the risk of POAG by 21 percent, compared to not using statins.

Kang is hopeful about the prospect of broadening the use of statins beyond cardiovascular health. She says statins could also enhance neurological function in the eyes and prevent optic nerve damage. However, the results of the study do not suggest individuals with a family history of glaucoma should take statins to prevent developing POAG. Statins may have negative side effects, especially in older adults.

Practical Ways of Preventing Glaucoma

If you are not taking statins, there are many ways you can prevent glaucoma by making healthy lifestyle choices. According to the Glaucoma Research Foundation, you can:

  1. Exercise daily — Include daily moderate physical activity in your schedule. Studies show moderate exercise like walking, swimming, biking or yoga can lower your eye pressure. You should try to avoid inverted yoga poses like headstands or downward-facing dog, as these poses may cause spikes in eye pressure.
  2. Eat a healthy diet — A diet high in fruits, vegetables, whole grains, lean proteins and healthy fats will help nourish your eyes with essential vitamins, minerals and antioxidants. It will also help you maintain a healthy weight.
  3. Protect your eyes — Eye injuries can cause glaucoma, so wear proper eye protection when you are using power tools, sports equipment or lawn equipment.
  4. Visit your eye doctor regularly — Glaucoma affects about three million Americans, but only half are aware they have the disease. Yearly comprehensive eye exams are essential for optimum eye health and disease prevention. Call your eye doctor to make appointments for the whole family.

Anyone can develop glaucoma, but some people are at higher risk than others. Take a Glaucoma Risk Assessment to determine your glaucoma risk.

Met Your Deductible? Schedule an End-of-Year GI Procedure

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Your elective GI procedure could be the most affordable at the end of the year after you have met your healthcare deductible.

What is a Healthcare Deductible?

Your annual healthcare deductible is the amount you must pay for covered medical procedures before your insurance company begins to contribute. One of the best ways to stretch your healthcare dollars is to schedule elective procedures after you have met your annual deductible. It’s almost the end of the calendar year, so if you haven’t maximized your health insurance benefits, now is the time.

Most deductibles reset on January 1, so evaluate whether you should schedule a recommended, routine procedure, like a screening colonoscopy before December 31. If you meet your deductible, your out-of-pocket responsibility for an elective GI procedure could be considerably less.

Get the Most Out of Your Health Care Plan

Here are five tips to help you get the most out of your health plan.

  1. Talk to your doctor about what GI procedures and tests are necessary or recommended. Obtain the procedure codes.
  2. Call your health insurance provider. Ask if you have met your deductible or if you are close to meeting it. Using the procedure codes from your doctor, request an estimate of costs for diagnostic tests, lab work and outpatient procedures so you can prioritize your spending.
  3. If you have a Flexible Spending Account (FSA) through your employer, call the customer service number on the back of your card or log into your account to check your balance. FSA funds do not roll over into the following year, so plan to use your FSA money on a GI procedure if you need one.
  4. Consider carefully before using Health Account Savings (HSA). HSA contributions do not expire like FSA contributions. You can accumulate HSA funds and save them for a future elective procedure, so use your HSA after you have depleted your FSA.
  5. Do not delay scheduling preventive screenings like colonoscopies. Medicare and most private insurance cover preventive tests. If you do not have a family or personal history of colon cancer, most screening colonoscopy procedures (including anesthesia and sedation) are covered at 100 percent.

Set aside a few hours to call your doctor, insurance provider and FSA or HSA account provider. These calls will not take as long as you might think, and they could save you thousands of dollars.

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Lead Exposure Could Increase Your Risk of Glaucoma

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POAG develops when the inner-eye fluid, called aqueous humor, does not drain properly. Gradually, eye pressure builds to dangerous levels and can cause optic nerve damage and permanent vision loss. This eye condition is complicated because it is incurable, and vision loss is permanent and irreversible.

For years, researchers have linked glaucoma to a combination of risk factors including age, heredity, medication and health history. This study is unique because it suggests your environment could affect glaucoma risk.

Bone Lead Levels Affect Glaucoma Risk

Oxidative stress can elevate eye pressure and damage the optic nerve. Sung Kyun Park, an environmental health scientist at the University of Michigan, led a study on lead exposure and oxidative stress. Park wanted to learn whether chronic lead exposure affected glaucoma risk.

Because blood tests only measure recent exposure to lead, they were inadequate to analyze long-term contact with lead. Park decided to measure lead levels in the knee and leg bones because bones store lead for decades.

Park analyzed patella and tibia lead levels from a subset of participants in the VA Normative Aging Study, a study that has followed 2,280 men since 1963. The research team tracked ophthalmologic and bone lead level data on 634 men and identified 44 new cases of primary open-angle glaucoma (POAG).

Park estimates POAG risk was about “five times higher with a 10-fold increase in patella lead and about three times higher with a 10-fold increase in tibia lead” (EHP).

Although this research found strong evidence linking long-term lead exposure and POAG, Park needs to conduct further studies. He wants to examine the effects of other metals on POAG, as well as exposure at an early age.

Know Your Glaucoma Risk

According to the Glaucoma Research Foundation, more than three million Americans have glaucoma, but only half are aware they have the disease. It is imperative that you know your own risk for glaucoma. You are at higher risk for glaucoma if you are:

  • 45 years of age or older
  • African American
  • Nearsighted
  • Farsighted
  • Diabetic
  • Taking steroids (orally, injected or eye drops)

You can learn more by taking our Glaucoma Risk Assessment. In only a minute, you can find out whether you are at elevated risk for vision loss.

Finally, you can take active steps to preserve your eye health by exercising regularly and eating a diet high in fruits, vegetables, whole grains and lean proteins. Annual comprehensive eye exams with your ophthalmologist are essential to evaluate your eye health and overall wellness. If it has been over a year since your last appointment, call your ophthalmologist to schedule a check-up.