RIP Tim Russert

[Snoredog]

as reported by Nightline:

had asymptomatic heart disease thought to be under control...

...and an enlarged heart

My perspective:
....sounds like classic untreated OSA to me, he certainly fits the mold from physical appearances, makes you wonder sometimes about medical treatment we receive...

in any case sorry to see him go, RIP Mr. Russert

[bap40]

It just goes to show you that we never know what is right around the corner and to appreciate what we have.

[thimarine]

My wife said Tim Russert did not look well several months ago. She said he had that "look" like I did before I started cpap about 16 months ago. I'm not sure what "look" she's talking about, but he was my age, just a couple of months younger. My OSA was untreated for who knows how many years. Ironically, I'm the same height and was about the same weight as Tim Russert. No one knows what caused Russert's enlarged heart, but I do know that in my cae the doctors wanted to do all kinds of tests when I complained of constant tiredness. If it weren't for a resident at the VA endo-diabetes lab suggesting a sleep study, my severe OSA would never have been diagnosed. I feel like I'm still in recovery from all the damage done to my insides over the years. But, the point I'm getting at is how totally ignorant many MD's are about OSA and it's effects on the person as a whole. Did Tim Russert suffer from OSA? Who knows, But, maybe this is another one of "those" deaths that could have been prevented if there was more education about OSA. Those of us who have the problem tend to say "hey maybe" whenever we hear about deaths like these when there is no way of knowing. I think that's a natural reaction. The only thing I know for sure is that we as a community of sufferers and recoverers should do our best to educate the medical community and, failing that, suggest to as many people that we know who are suffering the same symptoms, that they insist on a sleep study.

God Bless Tim Russert's family. I enjoyed his commentary immensely. He was a voice of reason.

[roster]

....sounds like classic untreated OSA to me, he certainly fits the mold from physical appearances, .....

The moment I heard the news that is the first thought that came to mind.

Not a sure thing, but the odds are so high I would be willing to bet on it.

It's a shame to lose Tim Russert at such an age. .

[Bonnie]

On the national news tonight it was said that he had a stress test a few weeks ago. What he had is all too common according to his doctor. His arteries were not blocked but had plaque build up on the sides of a main artery give way causing a blood clot and an immediate fatal heart attack.

Good guy, he will be missed.

[Snoredog]

[quote="Bonnie"]On the national news tonight it was said that he had a stress test a few weeks ago. What he had is all too common according to his doctor. His arteries were not blocked but had plaque build up on the sides of a main artery give way causing a blood clot and an immediate fatal heart attack.

Good guy, he will be missed.

[Auricula]

http://skepchick.org/skepticsguide/inde ... ic=11310.0
Post by: Jayhox on June 13, 2008, 10:18:15 PM I believe his heart attack was caused, in part, by obstructive sleep apnea (OSA). Pure conjecture, sure, but I see people like him on a daily basis in my office who are prime candidates for having OSA, and Mr. Russert fit the profile perfectly: Thick neck, a few pounds overweight, severely collapsed bite with both upper and lower jaws significantly retruded (note how short his lower face height is). Judging from his appearance, his orthodontist probably extracted teeth prior to placing braces, constricting his jaws even further. This retrusion of the mandible (lower jaw) can actually significantly reduce the airway space, causing snoring and even sleep apnea. In small, constricted jaws, the tongue has nowhere to go, so it falls back, blocking the airway. OSA causes hypertension, low oxygen saturation, and host of other problems which predispose a person to heart attacks.

It's tragic, because in many cases it's preventable and reversible.

Again, pure speculation on my part, but if I was in Vegas, I'd bet my last dollar that my observations are correct.

[roster]

Auricula, Thanks for posting that and thanks to JayHox.

[Auricula]

You are welcome, Rooster. I have continued to read about this issue and here's something else I found:
http://www.healthcentral.com/heart-dise ... s/?ic=4027
I'm always surprised
Anonymous
Tuesday, June 17, 2008 at 03:27 PM

If I were a betting man, I'd say that Sleep Apnea is a likely cause of Russert's untimely death. I'd like to know if he suffered from Excessive Daytime Sleepiness, athough with many that suffer from OSA, EDS is not something they complain about.

I've read that he had an enlarged heart, and type 2 diabetes. When I look at him, I see his recessed chin and thick neck. Classic signs of OSA. I wish I knew if he snored, and if he had a High BP which did not respond to meds. The latter group have an 80% chance of having OSA.

I'm wondering why the medical community does not wake up to Sleep Disordered Breathing. With all of the cardovascular issues that Tim had, 4 questions asked by one of his physicians may have saved his life.

1. Do you snore?

2. Has anyone witnessed you stop breathing at night, or have gasping awakenings?

3. Are you too sleepy during the day?

4. Do you have, or have you ever been treated for high blood pressure?

With 2 yes answers, the chances of OSA are high.

[rwk]

Thanks Snoredog, I haven't seen my doctor since he prescribed a baby asprin and 500 milligrams of niacin everyday. I'm 49 years old and my father and grandfather both had strokes...now I know why he prescribed what he did. Your answered a few questions I had.

[roster]

..........
I'm wondering why the medical community does not wake up to Sleep Disordered Breathing. .......

It is too late for me but for younger people, I hope this happens soon.

[Mile High Sleeper]

Right on, about doctor and patient education and the 4 diagnostic questions.

My enlarged heart was back to normal after a year on APAP.

[roster]

........
My enlarged heart was back to normal after a year on APAP.

Interesting. I never studied it and just assumed "once enlarged, alway enlarged".

[Snoredog]

Thanks Snoredog, I haven't seen my doctor since he prescribed a baby asprin and 500 milligrams of niacin everyday. I'm 49 years old and my father and grandfather both had strokes...now I know why he prescribed what he did. Your answered a few questions I had.

I tell ya, I take my 325mg enteric coated aspirin every night without fail. You have to do your own research on it so you are comfortable with using it, but several years ago I researched the research on efficacy of aspirin and its ability to prevent clotting and there is a huge amount of it to go through. The general consensus I found was the stuff works and it works very well in some studies as well if not better than Plavix, heprin and some of those other anticoagulants.

I took Plavix for several years after having 2 strokes but eventually went off it (dangerous to do that as found in recent news), but when I lost insurance they were wanting up to $225 for a month's supply of Plavix, that was the deciding factor for me, I stayed on the aspirin and dropped the Plavix. Been off it now 6 years and taking enteric aspirin for 8 years.

But if you apply a bit of common sense to the etiology behind it, it is not too hard to figure out, chronic hypoxia from OSA leads to thick blood, higher levels of CO2 leads to inflammation to the arterial system which makes your blood vessels stiff and hard (common folk call it hardening of the arteries), once that inflammation flares up your liver produces more cholesterol to make the repair to the blood vessels (cholesterol levels go up), your platelet counts increase (mine was over 850,000 when they should have been under 400,000).

So when you think about it, they have all the tests and scanning ability in place to properly diagnose this but they can't seem to put it altogether. They have the CRP test to measure the level of inflammation, they have blood tests to measure platelet counts and level of clotting ability with hematological tests, they have blood gas tests to measure your level of CO2. They have imaging techniques now so fast it can map out the level of blockage in your heart and visually see an enlarged heart with color nuclear.

This is why I and my Cardiologist D.O generally doctor do not believe in cholesterol lower drugs, because if you use those you are not really getting to the root of the problem you are only masking it. I once went on WebMD and asked that nurse Nancy a simple question, "what causes hypertension?" at least she was honest, she said "we don't know".

So I am in agreement with my Cardiologist, control the inflammation by what ever means you can, that means addressing OSA with CPAP therapy, that reduces the arterial inflammation caused by hypoxia, taking supplemental vitamins known to be good for your blood vessel health in restoring flexiblity such as vitamin C, niacin. The aspirin taken is to lower same inflammation and for its anti-coagulant ability. I take enteric coated type so it doesn't dissolve in the stomach and contribute to an old ulcer I was diagnosed having before starting aspirin therapy. I only keep uncoated aspirin around in case of emergency should I be having a TIA, so far not a single one in 8 years, that is pretty good considering I used to have a TIA every 2 weeks for over a year and a half.

So all you people who worry about weather your AHI is below 5 or not, to me that don't mean anything, I use CPAP because I know it keeps me from becoming hypoxic, because any use at all (even if not the correct pressure) offers a health benefit in lower arterial inflammation which is good for your overall health.

My family has a history of arthritis, many take medication for it. I'm the only one on CPAP only one that doesn't need medication for it. I did however once try lowering my aspirin dose to that 81mg dose at the request of my daughter who is a doctor, man every joint in my body started hurting, I was all stiff when I got up, classic symptoms of arthritis, I went back on that 325mg dose and that all went away.

My mom is 89, she takes her aspirin every day too, when she walked into UCLA Royce hall to watch my daughter get her doctorate she says why are all them other family members in wheel chairs, I have to be a good 20 years older than they are

[rwk]

Again, thanks Snoredog for the wealth of information. That's one of the reasons I stay with this website daily. I adapted seamlessly to CPAP without any problems, and my numbers have always been good, but there is an incredible amount of information to be had here.

I think we will be the first generation in the history of humanity to gain the benifits of CPAP since the dawn of existence, and many of the diseases that it might help or prevent may evidence themselves in the coming years. As with most people, having a family history of a disease, and approaching the years of it's previlence, I have an involved interest in it's causes.

I know of many who are trying to combat "hardening of the ateries" with a low carbohyrate diet (caveman diet). i could never adapt to it, though...I need the fiber too much! I think your approach is better.

And, having somewhat hijacked this thread from poor ol' Tim Russert...I have to admit he was somewhat of a hero of mine, as he was to many. He came from working-class roots, never forgot where he came from, and did his job outstandingly...in such a down-home, down to earth manner, and even wrote a book about his dad, how cool is that, huh?!! And yes, I think he may have had untreated OSA just by his appearence and build. This, of course, is from an "armchair diagnosis" perspective. If he had been on the hose for 10 or 15 years, who knows?