Obstetrics & Gynecology in Augusta, GA

Ovarian Cancer

Ovarian cancer is the fourth leading cause of cancer deaths in American women with about 22,000 diagnosed and 14,000 dying from the disease each year. About 75 percent of women with ovarian cancer are diagnosed with late-stage disease. Only 15-40 percent of women survive for five years after initial surgery that is performed to remove cancerous tissue from the abdominal cavity in combination with chemotherapy. While those statistics are frightening, it is even more vital to place them in context. A look at the most recent list of the top ten causes of death for all women reveals ovarian cancer nowhere near the top.

1) Heart disease 22.9%
2) Cancer 21.8%
3) Stroke 6.1%
4) Chronic lower respiratory diseases 6.0%
5) Alzheimer’s disease 4.7%
6) Unintentional injuries 3.7%
7) Diabetes 2.8%
8) Influenza and pneumonia 2.3%
9) Kidney disease 1.8%
10) Infection 1.5%

Statistics can be helpful in assessing real risk, but the bottom line for many women is that ovarian cancer is a frightening disease because often by the time it is detected, the cancer is relatively widespread. Most women have heard stories of a friend or family member going in for a routine checkup only to find they have a mass in their pelvis and dying shortly thereafter. The media has catapulted devastating stories of both celebrities and everyday folks to front page news thus fueling the fears. Notables affected by ovarian cancer such as Gilda Radner, Loretta Scott King, and Dinah Shore have made coverage of ovarian cancer front and center in media channels, and , while it has created some undue anxiety, it has, more importantly, raised awareness for regular checkups and signs and symptoms.
One of the major disadvantages in the fight to detect ovarian cancer early is the absence of an effective screening tool. Cervical cancer has been dramatically reduced due to the effectiveness of the Pap smear in identifying precursors of the disease which allow treatment long before the problem advances. Mammograms have increased the survivability of breast cancer by facilitating early detection thereby allowing treatment to ensue at the earliest of stages. Unfortunately there is no equivalent test for ovarian cancer. Currently doctors utilize a combination of ultrasound imaging and various blood tests to try to detect early cancers, but their utility is hampered by too many false positives and negatives. Research is ongoing to find a blood test or series of tests to help in the early detection of ovarian cancer, but that may still be years away.

It’s also important to make a distinction between prevention and early detection. Preventative practices reduce a woman’s risk of ever developing the disease while early detection facilitates early treatment, but does nothing to prevent the onset. For example, long term use of oral contraceptives reduces the risk of developing ovarian cancer by approximately 50 percent. This can be an effective preventative tool in at risk women. Getting more advanced imaging tests (like an MRI) may be helpful in high risk women, but it is strictly related to early detection and does nothing as far as prevention.

One of the best tools at a women’s disposal for assessing risk is family history. There is ample evidence that ovarian cancer runs in families, especially in those who carry certain genetic mutations. Some estimates say that up to 10% of ovarian cancers can be directly linked to such mutations, the most common being the BRCA 1 and 2. Doctors have become fairly aggressive in testing women with ovarian cancer and subsequently their family members for this gene variant as its presence warrants much more aggressive monitoring. Not everyone who has this gene will develop ovarian cancer; however, theyare at increased risk for this and other types like breast and colon.

Other possible symptoms of ovarian cancer are abdominal bloating, gastrointestinal disorders, urinary symptoms, unusual vaginal bleeding (especially in the menopause), and unexplained fatigue. A word of caution: as you can see, almost all women will experience one or all of these symptoms at some time. Rarely is it due to cancer, so simply be aware and use any symptoms as a reason to get checked.

A recent study indicates there may be an association between the fallopian tubes and ovarian cancer. There is evidence that some types of ovarian cancer may actually arise in the distal end of the fallopian tubes, which often encircle the ovary. Surgeons are much more aggressive now in removing fallopian tubes in hysterectomies to reduce the long term incidence of ovarian cancer.
Treatment of ovarian cancer is largely dependent on the degree of spread. It often involves surgery followed by chemotherapy. Almost 90 percent of women who are diagnosed while the disease is still confined to the ovary (stage I) survive for five years.

Healthy Tips

A celebration is often the result of an accomplishment, a special event , or honoring memories.  These are good things, but do we really need the “special” to warrant a celebration? Wouldn’t it be great to be able to delight in the relatively mundane?  Some of the happiest folks I know are those who relish just being able to get out of bed in the morning.  We can celebrate our health, good or bad, by reflecting on what a true miracle it is that all these billions of cells are working in concert to allow us to walk, run, think, eat, love, write, and even occasionally complain.  In celebration of simply being alive, I have compiled a list of healthy tips (or rambling recommendations) collected over the years to promote, extend, repair and rekindle your health.  Let the celebration begin!


People who rarely spend time outside (elderly, housebound) are at a greater risk for osteoporosis due to a lack of vitamin D, which is increased in sun exposure.  400 IU a day in supplement form can help prevent brittle bones.

Taking 400 micrograms of folic acid a day before getting pregnant can reduce the likelihood of neural tube defects in the baby (spina bifida, etc.)

Exercise 30 minutes every day.  The more and bigger the muscles used, the less time needed to achieve fitness (cross country skiing best, walking is good, using the channel changer is bad.)

The more colorful your meals the better. Bright colored fruits and veggies contain greater anti oxidants and other protective substances.

Use herbs (Black Cohosh) and vitamins (E) to control mild menopausal symptoms.  Many are scientifically valid and may work for you.

It’s not brain surgery; to eat healthy go low fat, low sugar, high fiber and balanced.

Eliminate soft drinks.  An extra can of soda a day can add 15 pounds in a year.

Almost half of all doctor visits are stress related.  A great tool for stress management is regular, aerobic exercise.

The solution to permanent weight loss is not dieting, it is getting fit.  Only muscles burn fat, and only muscles that are used!

If you are pressed for time, three ten minute exercise sessions can be as helpful as a single thirty minute segment.

Most women over twenty need to take some extra calcium (500mg) The better the bones before menopause, the better they are afterwards.

Eating habits are formed at an early age.  Teach children as early as two to be aware of good and bad food choices.

Don’t focus on weight.  Your per cent body fat and/or your Body Mass Index (BMI) are better measures of health.  Throw away the traditional scales and get a device that calculates body fat and BMI.  They are reasonably priced and accurate.

A good doctor will always encourage and support getting a second opinion…so in important decisions, do just that.

Don’t limit yourself by thinking that health is strictly physical.  Wellness is a balance of mind, body, and spirit.

Don’t skimp on preventive care.  The Pap test and mammogram have saved millions of lives.

If you have a strong family history of ovarian cancer (in mother or sister) demand a yearly sonogram and CA-125 blood test to check your ovaries.  It is far from a perfect screen, but it is the best available so far.

Young women (ages 9-26) who are not yet sexually active should strongly consider getting vaccinated against the Human Papilloma Virus (HPV). It is the single biggest cause of pre-cancer and cancerous changes in the cervix.

Acupressure has been effective for the nausea associated with early pregnancies. The most common device used is “Sea Bands”, an elastic band that applies pressure to a point on the wrist.

Caffeine consumption is one of the leading causes of bladder problems in women.  Eliminating caffeine from the diet may reverse symptoms of incontinence, frequency, and urgency.

Some women in the menopause need testosterone supplementation along with estrogen and progesterone to help with a lagging sex drive.

Many herbal medicines and treatments can interact with prescription drugs.  When getting your yearly checkup, don’t forget to tell your doctor about any supplements or herbs you take on a regular basis.

Before any surgery, always stop taking Ginkgo, Ginseng, Garlic, or vitamin E.  They can increase bleeding and lead to problems with the surgery.

Always bring two things to every doctor’s visit: a written set of questions and a list of your current medications.

20 percent of cancer deaths are related to obesity.  Maintaining a healthy weight may be your best guard against developing cancer.

Aerobic exercise might be better for your brain than your body.  Early studies show that exercise can cause damaged brain cells to regenerate, possibly thwarting diseases like Alzheimer’s.

The average person makes about 250 decisions about food every day and most people don’t have a clue as to what influences their choices. Consciously think about what you are eating and you will generally eat less.

A massage once a week can not only reduce muscle fatigue and soreness, but it can be just as good for stress management as a session with a counselor.

The quickest way to get fit with exercise is to WALC.  Wind sprints (just periodically increase the intensity of the exercise) Aerobic (this type of exercise burns fat) Lift (lifting weights builds muscle, which in turn increases metabolism) Cross train (vary your exercise regimen and you will get fit faster).

We hope you’ll find these healthy tips useful!

Adult onset acne

“Hey doc, my face looks like a war zone.  I wouldn’t mind having the complexion of a sixteen year old if I could have the body of one also, but this is ridiculous for a grown woman!”  Gladys was a victim of adult onset acne, and she was not pleased.  She is not alone.  Some experts estimate that up to 50 % of women over 30 suffer from some type of acne or acne like complexion disorders.

     It is not known what triggers adult onset acne. The development of hormonal irregularities in the menstrual cycle may be a factor, or ovarian cysts may cause hormonal abnormalities that increase androgen productivity, resulting in acne breakouts.  The classic situation is one in which a woman experiences irregular cycles, setting up an over production of estrogens and testosterone.  These hormones stimulate oil production in the skin glands which in turn become inflamed and irritated. Sometimes these sebaceous glands continue producing a higher amount of sebum well into adulthood and thus acne infection continues even at that age. Androgens have also been associated with acne flare-up in women before menstrual cycles or sometimes during pregnancy.   Whatever the cause, it is not wanted or welcomed.

     Most acne treatments require prolonged care, from months to years. These treatments include topical creams and gels and/or oral medicines.  Once improvement is achieved, a maintenance dose is usually necessary. Women who develop adult acne typically have the problem for years, frequently through menopause.  The suspected hormonal disruptions that trigger adult onset acne are often treated by attempting to regulate the hormonal imbalance. The modalities used most in hormonal acne treatment are oral contraceptives and antiandrogens. (medicines that counteract the effect of too much testosterone in a woman’s system).

     There are several simple things to do to minimize adult onset acne.  Washing with soap and water once or twice daily is a good way to keep debris and oils from the day accumulating on the skin surface. Salicylic acid and benzoyl peroxide are both common over-the-counter treatments for acne. Benzoyl peroxide exfoliates the skin and the anti-bacterial agents in it clear the excess debris from the skin to help prevent infections.      

     Retinoids are a class of molecules in the vitamin A family. The retinoids are potent against acne because they stabilize abnormal growth and death of cells in the sebaceous follicle. These abnormal growth cycles are believed to play a key role in the formation of blackheads, whiteheads, and other acne. The danger in retinoids is that they cannot be used by pregnant women or women who might be getting pregnant because of the high rate of serious birth defects in unborn children.

     Topical and oral antibiotics are used together with other agents. Topically, antibiotics neutralize the skin-based bacteria and, when used with other agents, help deplete the excess sebum or oil secreted by the sebaceous glands, allowing acne spots to heal without infection.

     Oral contraceptives prescribed for women are based on their ability to regulate hormones.  A birth control pill stimulates the production of a protein that binds testosterone, thus reducing the androgen’s ability to affect oil glands.

     Occasionally, adult onset acne can be confused with a condition known as rosacea.  Although it is not exactly acne, its red-faced, acne like appearance can cause many physical, psychological and social problems if left untreated. In a recent survey by the National Rosacea Society, nearly 70% of rosacea patients said that this skin disorder lowered their self esteem, and 41% of patients said that they avoided social contact or functions because of their skin disease.

     The cause of rosacea in unknown and there is no cure, but with available medical help this skin disorder can be controlled and minimized. Its typical symptoms are redness on the cheeks, nose, chin or forehead, small visible blood vessels on the face, bumps or pimples on the face, and watery or irritated eyes.

    Whatever the cause, whatever the result, if adult onset acne is cramping your style, see your doctor because there is help.

Menopause or Mental Pause?

     Aileen blew into my office like a Summer storm.  “Help me, I’m a poster child for Hormones from Hell!”  After catching my breath, I assured her that there were many ways of dealing with the ravages of hot flashes, dry skin, mood changes and forgetfulness.  I started by reinforcing that menopause is not a disease. Inaccurately and unfortunately there is a pervasive sense that menopause is the “ultimate and inevitable bad experience” for aging women.  I jokingly explained that women were not designed to self-destruct at fifty!   

     Menopause is a normal, natural transition, and it is vital for women to view it with a positive perspective.  That simple understanding is the cornerstone in building a plan to thwart the symptoms of “the change.”  But it is equally important to realize that not everyone has a problem with menopause.

      As a physician, my experience treating menopausal women is that there are some universal similarities in women’s experiences, but because of every person’s unique physiology and life journey, this time in a woman’s life is very individualized.

      I am a “recovering traditionalist”.  I was trained in the old school approach to menopause (which means drugs, and if that didn’t work, more drugs). In almost thirty years of practice I have found that many women are not satisfied with their options and many discover that their “treatments” are worse than their symptoms.  Especially in this age of “estrogen panic” where the media (and many physicians) has touted misleading and confusing advice on hormones, many women are looking towards alternative treatments for their symptoms. One woman put it well.  She said, “Physicians have a duty to give a woman the best care they can provide, especially their options.  However each person is ultimately responsible for his or her own health.  We, the patients, need help, guidance, and a listening ear.” Those were powerful and challenging words.

   The general dissatisfaction among women is amplified by the observation that only 17% of eligible women in the US are taking some type of hormone replacement and up to 80% of women who start on hormones stop them after two years!  The needs of women are not being met!  This problem with compliance is due to poor communication and fear.  After all, treatment of symptoms is not limited to simply taking a drug.  Successfully navigating the potentially turbulent waters of menopause requires a more comprehensive approach.

Herbs, complimentary teachings, diet, and exercise all should be discussed along with hormones.  The main caveat surrounding these modalities is that they must be held to the same standard and scrutiny that safeguards traditional hormone replacement.

The major problem in meshing the traditional and complimentary approaches to health is a mistaken perception of mutual exclusivity.  These treatments can coexist and be complimentary.

  I am saying that choice and personal responsibility are keys to unlock a joyous menopause.

      This is an opportunity to live with passion and fulfill your life mission. This is a time to take stock of the past and choose your path for the future. The choice is yours. It is a choice that is difficult if not impossible to make wisely without sound information and guidance

Teens…When to see a gynecologist

I am convinced most women view visiting their gynecologist somewhat like having a root canal…with no clothes on!  This is a completely rational reaction as no “normal” woman relishes the necessary but unappreciated ritual.  You arrive on time and two hours later Nurse Ratchet puts you in a room cold enough to hang meat and then tells you to disrobe and put on a napkin.  By the time the doctor arrives you are so cold your skin has changed to an eerie shade of light blue: you look like a Smurf in a togo.  The doc asks you to scoot down…then scoot down some more and well, you know the rest.  Actually the whole thing takes only a few minutes and is not as bad as, say, an
IRS audit, but I am a male so what do I know!  I understand it is different on your side of the speculum.

So given this exam is something you relish passing on to your beloved daughters, much as you would Malaria or Scabies, when should a young woman be exposed to this sisterhood right of passage?  The American College of Obstetricians and Gynecologists  recommends a young woman’s first visit to the gynecologist be between the ages of 13-15.  Before you and she run screaming from the room, let me reassure you that those guidelines are rarely followed and, in my opinion, somewhat misguided.  I understand that Ivory Tower practitioners denote this visit as a “preventive” ,but I don’t know many 13 year olds who are comfortable talking herpes and contraception.  The College clarifies that no exam is needed at this impressionable age, but that then raises the question of its true necessity.  Unfortunately there are those folks who need a thorough and graphic discussion of various reproductive health topics at this age, as 14% of 15- year olds and 75% of 19- year olds admit to having at least one episode of intercourse. 

I know if I had told my daughters at thirteen they were headed to the gynecologist, they would have booked a slow boat to Australia.  Now, to be certain, anytime a young woman is having issues with her period, needs contraception, or specifically has questions about her health she should have unlimited access to a compassionate, non intimidating physician, but for most that will come a bit later.  The same national organization recommends starting Pap smears and exams at 21, and I think this is more realistic.  I certainly am not naive enough to assume women under the age of 21 are not having reproductive or gynecological issues, witness the unplanned pregnancy rate in this country, yet if a young woman is not sexually active, has no period issues, and has no specific gynecological concerns, I think 21 is a reasonable time to initiate gyn visits.

Much of the anxiety in both mothers and daughters regarding gynecological health revolves around knowing what is normal and what is not.  There are definitely genetic predispositions that would make mom’s and daughter’s experiences somewhat similar, but that is not necessarily the case.  For example, the median age for the onset of menses is 12.4.  That means there will be plenty of young women who start cycles at 11 and also some who don’t start until 14.  In general, a girl needs to be evaluated if she has not begun developing breast buds by age 13 or hasn’t started her cycle by age 15.  The average time between cycles for young women is 32 days, but that can vary wildly, especially in the first few years of menstruation.  A flow lasting longer than seven days or requiring more than 3-6 pads or tampons a day is considered excessive.  You can see this is somewhat subjective, so each woman’s situation should be individually assessed and analyzed.

There a number of common scenarios that change both the cycle amount and regularity, especially during the teen years.  Two frequent influences are stress and weight change.  Worrying about midterms, making cheerleading, or the soccer playoffs  can wreak havoc on cycle regularity.  Any change in weight (usually by at least 5-10 lbs) can also affect regularity and amount.  Vigorous exercise (take note you cross country runners, gymnasts, and swimmers) can cause what is known as exercise induced amenorrhea, or lack of cycles.  Many a pregnancy test has anxiously been checked by those whose unending athleticism led to missing a period.  The good news is that most of these irregularities resolve with stabilization in weight or a reduction in stress.  A more rare but serious cause of irregular cycles is eating disorders like anorexia and bulimia.

The goal of an effective young women’s health program is to provide education, advice, counseling, and compassionate care.  The age at which you begin your interaction with the system is largely dependent on your individual needs and health history.   

Vitamins and Women’s Health

Americans have the most expensive urine in the world!   Let me explain.

We are massive consumers of vitamins in this country, and unfortunately, much of the good stuff is eliminated from our body before it has any beneficial effect.  That is not to say that vitamin supplements are a waste, in fact, we strongly recommend that patients use certain vitamins and minerals.  Yet in a billion-dollar industry like the vitamin market, you must be a discerning consumer.  If you are going to take vitamins (and many of you should), you must first know your individual needs, and second, choose an appropriate dosage and quality.

    In general, most women in the country conform to the SAD diet (Standard American Diet), which leaves them short on some essential nutrients.  Vitamin supplements are used to either meet basic nutritional needs or to treat a particular problem such as anemia or hot flashes.  For most folks, the best way to make your body happy on a day-to-day basis is to eat balanced whole foods; but if you don’t (let’s be real here!), a basic multivitamin that contains Vitamins C, E, A, D, and the B series is essential.  Many will also contain important minerals for women including iron, calcium, magnesium, boron and potassium.   In spite of the many advertising claims otherwise, there is very little real difference among quality multivitamins.  We suggest doing your homework (a good place to start is www.ConsumerLab.com ) and get comfortable with a particular brand and then stick with it.  Your pharmacist or health food store may also be a great source of information.  Don’t walk into a discount warehouse or a grocery store and buy the first bottle you see. 

     Two vitally important caveats go with any vitamin or supplement.  First you must take an appropriate dose, and second, you must take the supplement for an appropriate time frame.  Herein lie many of the problems with vitamin use.  Dosage is important! That sounds simple, but consider what would happen if you took a tenth of an aspirin for a headache.  Probably nothing!  And it would be absurd to then conclude that aspirin doesn’t help headaches.  However, that is what happens all the time with vitamins and herbs.  The scientific studies that show beneficial effects of supplements are always performed with specific dosages, and it is essential to know what amounts are proven to be effective.  There are many reference books that list evidence based dosages from various studies. 

     Don’t forget that most vitamins and supplements don’t work overnight.  Many may take up to four to six weeks of continual use to achieve any benefits.  Some, like the antioxidants, need to be used on a regular basis to exert their action.    

    Certain individual vitamins have been shown to help specific problems.  Below is a list of common problems and their vitamin remedies that have at least one good study to compliment their use:

Hot Flashes, Breast tenderness,                             Vitamin E (d-alpha-tocopherol) 800IU /day



Antioxidant, immune enhancement                       Vitamin C (1-3 grams a day)

PMS                                                                                Vitamin B6 (50mg twice a day)

Anemia                                                                           Vitamin B12 (100 micrograms a day)

Vision                                                                              Vitamin A (2,500 IU a day)

Cold sores                                                                       Zinc  50 mg/ day

Bone health                                                                    Calcium 500-600 mg /day

                                                                                          Magnesium 200-400mg/day

                                                                                          Boron  3-5 mg / day

     As with all vitamins and supplements, always tell your doctor what you are taking, as there can be interaction between these substances and prescription medicines.

Eat For Life!

     The one question we are asked in the office most often, other than how to improve libido, is how to eat healthy.  Since 45 million people in this country are overweight, it is no wonder that this is on everyone’s mind. Simple is better, so here are some simple guidelines for eating healthy.

     Rule number one: Eat balanced meals.  What your mother always taught you is true.  There is no one super food, in spite of what the algae lovers claim, and there is likewise no naturally evil food (well, maybe Spam qualifies as evil).  We were created to survive on a variety of nutrients and no one food can provide everything you need, so mix it up to guarantee proper health.  Balance proteins, carbohydrates, and fats by selecting a wide variety of foods.  Spice up your life! Get crazy and try foods that are different from burgers, bacon, and barbecue!  Travel the world by making one night a week “ethnic night” and sample various foreign cuisine.  There are three sub rules in this category: eat whole foods whenever possible, mainly plants, and prepare them in as close to the natural state as you can.  In other words don’t fry, fritter, and fracture your food!  And one final caveat, don’t overdo it.  One given in proper weight management is watching total calorie intake.  How much you eat is just as important as the mix.

     Rule number two: Eat low fat meals.  This is not to demonize fat but to remind you that too much of some stuff is just not healthy.  In spite of the cacophony of nutritional advice out there, there is not a reliable expert around who tells you to eat more lard.  Some fat is necessary but we should all limit saturated and trans fats.  These include margarine, salad dressings, processed cakes, chips,cookies, and gobs of other nasties.  Become a label reader.  It’s right there in black and white.  If the serving size contains more than 5 grams of saturated fat, put the item down and run away screaming.  Total fat in your diet shouldn’t exceed 25% of total calories.  There are a number of fat counters available in Apps and online so it is relatively easy to calculate how much of the grease is sliding down your gullet.  Don’t forget there are some good fats.  For example, the omega 3 fatty acids found in abundance in some plants (flaxseed) and cold water fish (tuna, halibut) are critical in assuring good health and are essential for their anti-inflammatory actions.

     Rule number three: Eat low sugar. The average person will consume 160   pounds of sugar a year!  Most sodas will contain 40g of sugar in each can!  Sugar, or glucose in fancy doctor talk, is necessary for energy, yet most of us eat enough sugar to power a high school soccer team.  The low carb craze of recent vintage did make us aware of the evils of consuming to much sugar (carbohydrates=sugar); and the data supports that a low carb lifestyle is healthy.  Keep in mind that your need for sugar and energy is directly proportional to your activity level.  Marathoners need more carbohydrates than chess masters. 

     Rule number four: Eat more fiber.  This rule may be a bit of a surprise because it doesn’t get the airplay that the other rules seem to enjoy; however, fiber, both soluble and insoluble, is a key component of a healthy diet.  These are things that aren’t actually metabolized in the system put serve a variety of vital functions such as binding excess cholesterol, promoting bowel health, and regulating hormone levels.  The American Heart Association has stated that consuming 28 grams of fiber a day can reduce your risk of heart disease, the number one killer of both men and women.  Fiber is abundant in fruits and vegetables, grains, nuts, legumes, and tree bark. (Just seeing if you were paying attention).  Choosing foods high in fiber not only fulfills the need for roughage, but these foods also tend to be low in calories and filling. 

Sleep problems? You’re not alone.

It is estimated that over 40 million Americans suffer from some sort of chronic sleep disorder and almost 90% of those are unidentified or undiagnosed!  That’s a considerable number of folks exposing themselves to bad infomercials at 2 AM.  I must admit that I traditionally related sleep disorders to older people and shift workers, but a recent study from the National Sleep Foundation indicates that almost 36% of 18-29 year olds have a sleep issue that disrupts their life.  In a time of budgetary restraints and fiscal precariousness, sleep problems have been estimated to cause 16-20 billion dollars of economic losses to business and industry.  We don’t often associate sleep problems with other major population health risks such as heart disease and diabetes, yet sleep disorders are every bit as important to the health of the nation as other maladies.  Women are particularly hard hit as 79% report sleep disturbances during pregnancy, 36% report sleep problems in the peri-menopause and menopause time periods, and 24% say sleep problems interfere with them caring for their family.

Sleep deprivation can lead to chronic tiredness, moodiness, frustration, difficulty in controlling emotions, inability to concentrate adequately, and problems with abstract thought.  In other words, sleep deprived individuals are generally not happy folks!  There is good evidence that a lack of adequate sleep can lead to an impairment in immune function, metabolic problems, weight gain, and hypertension.  The National Highway Safety Administration has said, “Drowsiness has been the cause of 100,000 traffic crashes every year, killing more than 1500 Americans and injuring another 71,000.”  Some physicians believe sleep disorders are the most unrecognized common malady we face today.

The average adult needs about 7 1/2 to 8 hours of sleep a day to feel rested and allow the body to rebuild, refresh, and rejuvenate.  Obviously this number is a generalization as some individuals require less and some more, so it is vital to determine honestly your threshold.  In general, older adults require a bit less sleep to avoid problems; however, it is not as dramatic difference as some would imagine.  A common yet often missed cause of sleep problems are various medicines and drugs.  Caffeine, alcohol, nicotine, steroids, decongestants, antidepressants, and blood pressure medicines are just a few of the ingested substances that can keep you awake.

Healthy sleeping habits for the family

  • Fix a bedtime and fix an awakening time
  • Avoid napping during the day
  • Avoid alcohol before bed
  • Avoid caffeine containing beverages 4 – 6 hours before bedtime
  • Avoid heavy, spicy, or sugary foods before bed
  • Regular exercise is good but not before bedtime
  • Comfortable bedding
  • Bedroom cool, dark, quiet
  • Bedroom reserved for sleep – NOT a work room
  • Go to bed only when sleepy
  • If unable to sleep, move to another room
  • Return to bed only when sleepy
  • Avoid a visible bedroom clock with a lighted dial
  • Don’t let yourself repeatedly check the time!
  • Turn the clock around or put it under the bed


There are a few herbal medicines that have been minimally helpful in promoting sleep for some people.  These include Valerian root, Kava, Chamomile, and in older individuals-melatonin.  The worst thing to do is nothing…sleep problems rarely spontaneously resolve.  Don’t ignore the issue and take steps to a more restful sleep today.