March 2011

This story is based on a compilation of stories I have heard through my work  as a registered nurse in the Emergency Department and Hospice.  For the purposes of the story that I feel very passionate about telling, Jake is the character that will represent all the stories I have heard and the situations with which I have been involved.  Although this story is not based on any one person, it is never the less completely true and accurate.

This is about the man of my dreams, Jake. He is my best friend and husband of 35 years.  He is 56 years old and has never looked or acted older.  He struggles everyday and it kills me to see him suffer.  You see, he was diagnosed with Coronary Artery Disease 18 months ago and he has not been the same since the doctors told him the blockages in his arteries were too risky for any type of intervention.  He had been having this pain in his chest and arms at night and every time we tried to go for our treasured walks in the woods.

I miss the old him. We used to hike into the middle of the woods and go camping year-round.  We loved nature. Being in the woods together was like our little piece of heaven on earth.  Now, I am sure neither of us knows where our  “heaven on earth” is any longer.  Jake struggles every day just to muster the strength to get to work.  It is not uncommon for him to miss 4-5 days monthly because he had a bad night and could not sleep.  He is always going between the bed and the chair.  It is rare that he even sleeps for more than 2-3 hours uninterrupted.  He says he gets “the pain” at night and his arms ache.  He gets up to “pop a nitro, or two, or three”, as he says.  He wears oxygen more and more all the time to help deliver more oxygen to his ailing heart. That just worries me terribly. I am afraid I will wake up to find my husband gone. I know it will happen at some point, but I am not ready.

The same company has employed Jake since we were married all those years ago.  His boss has been so kind and understanding about his illness and the fact that there is no cure. The strain on his co-workers has been enormous, however, and that wears on Jake, a lot.  He often talks about how he “burdens them” and how “they should just can him for being so useless”.  Jake was their best salesman and he has numerous awards of recognition adorning his office, resting in memory of who he was and what he could accomplish with ease.  Jake was the money-earner for the company at one time, now he is costing his employer thousands of dollars in health care claims and sick time.  In addition, his absenteeism is placing his responsibilities on the backs of all his co-workers and long-time friends.  These are the things that drive him further into depression. Depression makes his chronic illness more pronounced and the symptoms take over.  Jake, from his perspective, is no longer living life.

Research on chronic illness and depression indicates that depression rates are high among patients with chronic conditions:

Heart Attack: 40% -65% experience depression

Coronary Heart Disease (without heart attack): 18% – 20% experience depression

Stroke: 10% – 27% experience depression

Diabetes: 25% experience depression

Chronic Pain Syndrome: 30% – 54% experience depression

Most disease processes can be controlled through preventative health actions such as yearly visits to the doctor, weight management through proper nutrition and exercise and stress management.

Maybe going for regular check-ups at the doctor and listening to our bodies really is the best way to ensure the best life possible, unfortunately, for Jake, it’s just too late.

For more information on the link between Chronic Illness and Depression:

By Melissa Naborowsky, RN

I often find that there are just too many things to do everyday: work, exercise, eating healthily, hobbies, friends, reading, socializing.  Too many times in the past, when there just weren’t enough hours in the day to get everything done, it was sleep time that was usually the first casualty.  After all, or so I thought, it was easy enough to function on a few hours less than the recommended eight hours daily.  So maybe I was a little tired, a little grumpier, perhaps a little slower to make decisions.  How bad could it be?

Did you know that not sleeping affects the judgment, reflexes, agility, and other motor functions?  In fact, people driving after not sleeping for an average of 18 hours tested worse than those with a blood alcohol content of 0.05%, almost the legal limit for intoxication in the United States.

Sleep Deprivation Impairment

The Centers for Disease Control (CDC) recently published a study that reflects one of the biggest problems in American health: sleep deprivation

CDC Sleep Deprivation Study

Getting enough sleep is one of the most basic keys to good health. Over one third of Americans don’t get at least seven hours of sleep daily and at least a quarter of those surveyed experienced problems throughout the day because of sleep deprivation.  Some of these problems are decreased alertness, irritability, change in eating habits (usually overeating), and stress within relationships.  Some other longer-term problems include increased dangers of high blood pressure and heart related maladies, psychiatric and mental disorders, and weight gain Health Risks

Even more dangerous in the short term is that sleeplessness can actually encourage risky behavior according to a Duke University study reported by Business Week. The study indicates that gamblers who stay up all night are not only fighting the odds that are stacked in favor of the house, but that their own lack of sleep is furthering their own decision-making process.  In other words, not only do the sleep deprived perform as badly as intoxicated drivers, but their condition could make them more inclined to get behind the wheel!

Establishing healthy sleep patterns is a challenge in today’s fast-paced world, all the more so for shift workers because their work hours interfere with the body’s natural or circadian rhythms.  Here are a few techniques that might help improve the quantity and quality of your sleep:

1. Establish a sleep routine that is followed regularly each time before going to bed.

2. Avoid television with 45 minutes to an hour before going to bed.

3. Avoid caffeine within four to six hours of bedtime.

4. Establish a regular bedtime and try to maintain it.

5. Avoid heavy, spicy, and sugary foods within an hour or two of bedtime

6. Ensure that the sleeping environment is dark and slightly on the cool side if possible.

7. “White noise” such as a fan or static can help drown out more intrusive noises.

8. Alcohol and other sedatives interrupt the dream cycle and will not help with restorative sleep.

9. Limit the bed’s use to sleep and sex.

10. Exercise is helpful for health and sleep but not within a couple of hours of bedtime.

Establishing good sleep habits and experimenting with some simple environmental changes can make it easier to experience the deep, restorative sleep we need for proper health.

By Jackie Ostrikis  MS, CPT