Greyhound -greyhound wrote:I hope DrBandage reads this and can interpret it (I know s/he's not a pulmonary specialist) for the rest of us.
You're very kind to mention my name. I will certainly take a long look at the articles. I can offer my opinion as a physician, but I know there are lots of folks here that are "scary smart" when it comes to this type of technical information.
Probably a strong suit of medical training IMHO is the devotion to the study of how to evaluate the "truthiness" of medical literature. Journal clubs were and are a key part of medical school and residency. There is indeed a very stringent scientific approach that is applied to the evaluation of research papers. Extensive knowledge of statistical theorems is a must, as is critical thinking.
But, having said that, I will quickly acknowledge that sleep medicine is very much ignored in basic medical training. It's so sad, because as part of training in med school and internship we are required to deliver babies, assist in surgery, and all manner of things that we may never need to do. But, everybody needs to sleep well to be well. (I just made that up, but I like it!).
So how is it that something so essential to good health and happiness is so underappreciated, underdiagnosed and undertreated? Beats me. It's not like we were lazy in our training (don't get me started). But I really think there should be far more emphasis on such things as nutrition and sleep.
Sleep science is truly in its infancy as -SWS has pointed out so eloquently (among many, many other things!). Even one generation ago, there was no such thing as CPAP, while surgery has been practiced for centuries! Even one generation ago, there was no internet message board like this to help others achieve what all of us need and deserve in regards to what so many take for granted.
The medical community responds, albeit painfully slowly, to the public's demand to know. (E.g. alternative medicine courses are now a vital and growing part of virtually all med school curriculums.) Medical and civic leaders will look back one day on this neglected issue and recognize that it is indeed a very complex health issue absolutely riddled with problems in just about every facet imaginable.
You certainly never miss it until it's gone, but when it's gone you're in deep doo-doo. Even as a physician, I have been severely challenged to get this issue under control and reclaim my life. It is heart wrenching to think about the challenges facing others who may not have the advantages that I have. This is an equal opportunity ailment, so you can bet that the poor and the undereductated members of our society are completely adrift. I shudder to think about how difficult compliance and progress has been even with the resources available to me, both as a physician and as an avid reader of this board.
People like Rested Gal, and Mile High Sleeper, and so many others have helped save the quality of life, and indeed the life itself for so many of us. Those who share so willingly are this century's version of a cyber Mother Teresa figure. I am speaking quite literally when I assert that people such as these save innumerable lives, prevent early death, and all the horrible morbidities that accompany untreated sleep disturbances. How many people would have been "lost to follow up" as we doctors say without the Collective Wisdom that this site and others makes available to all of us? Why didn't my visit with several Sleep Docs yield even one mention of the support groups that are available and boards such as this?
Just as vaccines pay tremendous dividends for the cost involved, "word of mouth" through the online community offers extraordinary opportunities for improving the lives of others in our society, for the cost of a keystroke!
I'm starting to feel a rant coming on!
Anyway, paraphrasing the bottom line: no one makes a bigger mistake than he does nothing because he can only do a little.
This problem is not going away, and it will continue to claim lives and quality of life until it is given the attention that it deserves. Send "letters to the editor", talk to your friends about this disease. Tell your doctor about this board. Complain to Patient Relations if your diagnosis and treatment were inadequate. Notify regulatory agencies about quality of care issues. Elevate the definition for community Standard of Care for sleep deprivation and its ilk.
Information is power, and the status quo prevails until there is enough critical mass to change things. Just as people "never" spoke powerfully about such issues as mental illness, abuse by the clergy, domestic violence, child and elder abuse, our issue will be only our own until we own it.
<End Rant>.
