On Restless Leg Syndrome (Series: Pt .2)

Gary Polk, M.D.

Gary Polk, M.D.

The Role of Genes, Family History and Gender

RLS symptoms are not rare; it is one of the most common movement disorders. Some authors feel that after obstructive sleep apnea, RLS may be the most significant sleep disorder (4). In one circadian study as many as 15% of those surveyed had noted “restlessness of the legs”.

One interesting finding of the survey was that French Canadians had a higher frequency of symptoms compared to Canadians of English descent, indicating a potential genetic role in RLS. Large numbers of patience with RLS symptoms have a positive family history of RLS as well.

Although no specific gene abnormality has been found as a cause of RLS, patients with familial RLS (as compared to sporadic RLS) have an earlier onset and severity of symptoms. Overall it is estimated that the prevalence of RLS is 5-10% of the population. Additionally, there does appear to be an increased frequency in women compared to men by a 2 to 1 margin.

Impact On Quality of Life

RLS can have a significant negative impact on the quality of life. Quality of life surveys often show a decreasein vitality, physical functioning and general health in RLS sufferers compared to the general population. Other quality of life parameters negatively affected include social functioning and mental health. The disturbances caused by RLS were similar to other chronic medical conditions such as hypertension, diabetes mellitus, and osteoarthritis.

Poor Sleep

RLS sufferers often complain of poor or restless sleep. Many patients have marked difficult falling asleep at night due to leg discomoft. They also appear to have an increased frequency of awakenings during the night. Patients with RLS tend to spend more time awake during the night than the general population. Also about 80% of RLS patients have associated stereotypical leg movements, known as periodic limb movements of sleep that can disturb their sleep or the sleep of their bed partners.

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Why see a Rheumatology Specialist? (Featuring Dr. Ming Chen, ADC, Rheumatologist)

What is Rheumatology?

Rheumatology is the area of medical expertise concerned with the diagnosis and treatment of diseases of the muscles, bones and joints. It can include knee pain, hip pain, back pain and more.

In this video, watch Dr. Schwartzenburg give an overview to a real patient about Rheumatology.

Inside Look: Rheumatology with Dr. Schwartzenburg

Rheumatology Treatment Options

Rheumatology Treatment Options Part 2

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Specialist Bio

Rheumatology

Dr. Ming Chen, Amarillo Diagnostic Clinic, P.A. Specialist, Rheumatology

Dr. Ming Chen, Amarillo Diagnostic Clinic, P.A. Specialist, Rheumatology

Dr. Ming Chen

Call Amarillo Diagnostic Clinic to schedule an appointment with Dr. Ming Chen at 8063580200

Could Hearing Loss and Dementia Be Connected?

From a New York Times Health Interview

Interview by 

Published: February 11, 2013
Pam Belluck is a health and science writer for The New York Times.

Pam Belluck is a health and science writer for The New York Times.

PAM BELLUCK: I’m Pam Belluck, I’m a health and science writer for The New York Times. And this week, I am interviewing Katherine Bouton, who has been a long time editor for The New York Times and it now a contributing writer to our science section. And she has written a book called, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You.” And it’s a look into her own personal journey with hearing loss and a look into the research behind hearing loss. Katherine has written a piece that looks at a very interesting and surprising connection that some scientists have found between hearing loss and dementia. Katherine, first of all, welcome to the podcast, thank you for joining us.

KATHERINE BOUTON: Thank you very much.

MS. BELLUCK: And why don’t you tell us a little bit about what the scientists have found here.

MS. BOUTON: In studies over about the past…beginning in 2011 and continuing now—a new study was just published last month—is that there seems to be a strong association between hearing loss and both the earlier onset and more serious degree of dementia even with milder hearing loss, but especially with very severe hearing loss. For somebody like me who has a hearing aid and a cochlear implant but I still don’t hear very , this is alarming news.

MS. BELLUCK: All they have found at the moment is what’s called an association. So we don’t have any kind of causal connection—either that dementia either causing hearing loss or vice versa. But they do have three interesting theories about what could be happening. Could you lay those out for us?

MS. BOUTON: Okay, I should mention that the primary researcher on this is Frank Lin, who is at Hopkins and his database are two or three different long-term epidemiological studies. The first was based on the Baltimore Longitudinal Study of Aging. I went to see him after that first study was published and he had three things to offer.

The first made a lot of sense. It was that people with hearing loss tend to isolate themselves and isolation is a risk factor for dementia whether you’re hearing or hearing-impaired.

The second is something that he calls cognitive load — and which I call cognitive overload. What happens is that when you aren’t hearing very well, even with corrected hearing you’re trying so hard to hear the person that it makes it very hard to actually listen to what the person is saying. It’s very hard to absorb the information. When I did my interviews for this book – and I did a lot — I taped all of my interviews and I had someone else transcribe them because I couldn’t hear the tapes. I went and I got my transcriptions back I was constantly surprised by what I had asked, what I had heard, what they had answered. Every interview was like doing the whole thing fresh twice over.

The third possible explanation is the one that is most alarming and it’s the one that scientists like Dr. Lin and others are beginning to look at, and that’s that there’s an underlying pathological mechanism that has an influence on both hearing loss and dementia. It could be something environmental. It could be something genetic. They just don’t know.

These studies so far have relied on self-reported use of hearing aids. The next study that Dr. Lin is doing — he’s submitted a grant application now — is to specifically study how hearings aids are used, how often they are used, how carefully they were fitted, how much continual contact with the audiologist there is, whether the hearing-impaired person uses any assistive technology in addition to the hearing aids or the cochlear implant.

MS. BELLUCK: I’m interested in what you’re saying about corrected hearing. You are somebody wearing a hearing aid and a cochlear implant and according to the research that would not necessarily make a difference here. According to his research so far, people who are wearing hearing aids — it didn’t protect them from getting dementia. So does that tend to suggest some support for this idea that there being this underlying biological mechanism that might cause both?

READ THE FULL STORY…

A Conversation with Dr. Douglas Lewis

Douglas Lewis, D.O.

 Dr. Lewis has joined the Amarillo Diagnostic Clinic staff recently, adding experience to the group in the field of Neurology as well as his warm and comfortable personality. We sat down with him to talk about the move.

Here’s what he said:

Where did you practice before coming to ADC?

I was in private practice just up the street on 9th. It was a successful solo practice. I had a lot of wonderful patients. And now, I’m happy to continue their care at ADC.

Dynamics are different coming from a clinic. How has that been?

Dynamics are different. One of the reasons I decided to join the group was the other physicians along with the quality of care at this facility. It is a great group for sure.

We love Dr. Milligan. Because you are both Neurologists, are you looking forward to working with him? One thing about Dr. Milligan is his dry sense of humor…

Yes. He’s dryer than I am, I suspect. He’s great. A good guy.

How many years were you in private practice?

I was in private practice for eight years.

Where are you from?

I’m from Colorado Springs and attended high school there.

Where did you receive medical training?

I went to medical school at Des Moines University in Iowa. I did an internship in New Jersey and then my Neurology internship in Detroit where I also did a fellowship in Neuro-Physiology.  Once I finished my medical education, I came here and worked with a large physician group for about six years. After that, I went into private practice where I remained for the next eight years.  I’ve been in practice for about 14 years.  The years go by fast.

Do you visit Colorado often?

Yes, I do. I’m actually going in the near future. My high school buddies and I still get together every year and go camping for a weekend.

Where do you like to go?

We go all over. This year we’re going up near Steamboat, a long trip for me. But, it fits in okay.

Do you have family?

Yes. My wife is from the Amarillo region. I have two sons at home and a daughter who is currently attending Optometry School.

What are some hobbies you enjoy other than camping?

We like to ski, snowmobile, and other Winter activities.  We also enjoy water skiing in the Summer.

If you were opening up a keynote in front of millions of people, what’s something interesting you’d say?

Now, that would be hard. I am opening up a keynote this weekend at the Juvenile Diabetes Research Foundation. I am a diabetic and have been on the Juvenile Diabetes Research Foundation board for the last couple years. I am opening up the walk this weekend.  I don’t know what I will say but I am sure it will come to me before then.

Being a doctor, you are the source of information everyday, it’s a totally different mindset. What’s that like?

Sure. It’s been about everything I expected it to be. I like it.

Common Questions (ADC)

Where is Amarillo Diagnostic Clinic located?

Our physical address is 6700 West 9th. We are located at the intersection of West 9th and Quail Creek.

Will Amarillo Diagnostic Clinic accept my insurance?

The physicians at Amarillo Diagnostic Clinic do participate in and accept most insurance plans. There may be some tests or services that your physician orders which are not covered by your insurance. In this instance, ADC’s staff will do their best to notify you in advance of the test or service being performed. We highly recommend you contact your insurance company and be up-to-date on your coverage plan. We too, are concerned over the rising cost of health care; and in an effort to assist you, we will file insurance claims on your behalf. However, you will be expected to pay any co-pay or deductible amounts at the time services are performed.

Is a referral needed to see a physician at Amarillo Diagnostic Clinic?

Some insurance plans do not require a patient to obtain a referral from their primary care physician for certain procedures; however, others do. You should check with your insurance company or the Amarillo Diagnostic Clinic appointment staff to see if a referral is needed. It is the responsibility of the patient to obtain all necessary referrals.

Can I call and speak directly with my doctor?

It is not always feasible to speak directly to your physician when you call the Clinic. Your call is very important to us and will be returned by your physician’s nurse as soon as possible.

Why did it take so long for my return my phone call?

It is very important that your doctor’s nurse have all of the information necessary to return your phone call. This information could be lab results, X-ray and/or other diagnostic test results and your patient records. It takes a reasonable amount of time for this information to be gathered properly in order to better serve you or your family member.

If I have an emergency, what should I do?

In an emergency, you should go to the emergency room in order that immediate care can be delivered. Amarillo Diagnostic Clinic is not an emergency treatment facility, and you should never come to Amarillo Diagnostic Clinic for urgent or emergency care. At your request, your Amarillo Diagnostic Clinic physician will be notified of your condition and reason for emergency care by the emergency room staff.

How long will I be at the Clinic?

At Amarillo Diagnostic Clinic, we have the ability to provide an extensive variety of services all under one roof. To better serve you or your family member, your physician may order tests or exams that take time to complete. The time you spend at the Clinic will depend upon the test that your physician has ordered for you.

More Common Questions

Certificate Arrives!

Our certificate from the American Academy of Sleep Medicine has finally arrived. Congratulations to the physicians and staff at ADC Sleep Disorders Center!

Certificate of Accreditation - Amarillo Diagnostic Clinic

Planning for Your Healthy Baby: Pregnancy and Diabetes (Amarillo Diagnostic Clinic)

By Rachel Pessah Pollack, MD

Do you have diabetes? Are you thinking about getting pregnant? If so, there are things you need to do for the health of you and your baby during pregnancy. Your blood sugar control is very important.

Diabetes during pregnancy is on the rise.

Amarillo Diagnostic Clinic Blog

More and more people are getting diabetes. There are about 1.5 million new cases per year. As a result, many more women with type 2 diabetes are becoming pregnant.

Elevated blood sugar (glucose) levels during pregnancy are bad. They can cause a higher risk of birth defects, miscarriage, birth injury, preterm delivery and certain complications such as pre-eclampsia. By being careful with blood sugar levels before becoming pregnant and during the early weeks of pregnancy, these potential problems can be prevented.

Here is what you can do to optimize your care and ensure a successful outcome:

Schedule your doctors’ visits

*Your doctor may send you to a specialist before you get pregnant to help you with your diabetes control.

*Obstetrical [ob-steh-trih-kal] care – some patients with diabetes may see obstetricians [ob-steh-TRIH-shen] who specialize in high-risk pregnancies. Your doctor will help you make this decision based on how long you have had diabetes and how well your diabetes is controlled.

•Eye disease – every woman with diabetes should see an eye

doctor for an eye examination before getting pregnant. You may

be counseled on the risk of getting diabetic eye disease (retinopathy

[reh-tin-AH-pah-thee]). Eye exams are also recommended in the

first trimester, during pregnancy, and after birth. Sometimes the

eye disease may become worse with pregnancy; however, this risk

can be prevented with laser surgery.

•Kidney disease – all women with diabetes who want to get pregnant

should be checked for diabetic kidney disease (nephropathy [neh-

FRA-pah-thee]). A urine test is used for this test.

•High blood pressure – your doctor will want to make sure that

your blood pressure is under good control before you get pregnant.

You may have to switch or add blood pressure medications.

•Nerve disease – your doctor may suggest you see a foot specialist

(podiatrist [poe-DYE-ah-trist]) to determine if you have diabetic

nerve disease. This is also known as peripheral neuropathy [per-

IH-fer-al noor-AH-puh-thee]. It is important to take good care

of your feet before and during pregnancy and to check your feet

each day to keep infections at bay.

Focus on healthy eating now

Before pregnancy, it is a good time to pay close attention to what you eat. Eating properly is important to achieve and maintain normal sugar levels throughout pregnancy. You are hopefully already following a healthy diabetes diet, including fruits, vegetables, and fiber. You can continue to eat the same foods as you plan for pregnancy. However, be aware that, during pregnancy, how many carbohydrates there are in each meal is the most important factor affecting your blood sugar control, both before and after your meals. It may be useful to meet with a registered dietician or diabetes educator before you get pregnant. This will help you learn how to count calories and choose healthy foods. In addition to watching your diet, all women who want to become pregnant should take a daily prenatal multivitamin containing at least 400 micrograms of folic acid. Folic acid prevents neural tube defects, such as spina bifida [spine-a BIH-fid-a] in babies.

Target normal blood sugar levels

Studies have shown that poor blood sugar control during pregnancy can lead to poor pregnancy outcomes and risk for birth defects. During the first trimester, the baby’s organs are forming and normal sugar levels can decrease the risk of any problems during this period. For this reason, it is very important to wait to conceive until blood sugars are under excellent control.

Hemoglobin A1C, which is a measurement of your blood glucose control over the prior two to three months, should be checked before you get pregnant to help with your overall diabetes treatment plan. Talk with your health care provider about what your blood sugar range and A1C level should be both before pregnancy and during pregnancy to reach your goal of a normal blood sugar. Blood glucose self-monitoring is recommended by many different diabetes organizations (each has different target levels). During pregnancy you will be asked to check blood sugar levels one to two hours after the first bite of your meal. This is different from when you weren’t pregnant.

Review your medications for safety

Before you get pregnant, have your doctor review your medications and determine if you need to switch them to ones that are safe in pregnancy. Some examples are listed below:

•Diabetes medications – Many of the diabetes pills that are taken

when not pregnant cannot be taken when pregnant. Before you

get pregnant discuss with your doctor whether you may need to

start insulin before or during pregnancy. Or, you might find out

that diet and carbohydrate monitoring are all you need. In

general, if insulin is needed, you will likely need to use more

insulin the further you get into your pregnancy, especially during

the third trimester. Although there is some good data with certain

pills for diabetes, it is not known how safe and effective they are,

and insulin is often recommended to control blood sugar.

•Blood pressure medications: ACE inhibitors and ARBs used

for blood pressure control and kidney disease are not advised

during pregnancy, since they are likely to harm the baby. Before

you get pregnant, consult your health care team about changing

your blood pressure medications.

•High-cholesterol medications: “Statins,” a class of medication used

for its cholesterol-lowering effects, should be stopped before you

get pregnant.

Evaluate your pre-pregnancy weight

Women with diabetes who are overweight or obese have a higher chance of having problems during pregnancy. These problems include higher rates of cesarean section, high blood pressure, birth defects, and premature infants. The good news is that if you are overweight and are able to reduce or normalize your body weight before you get pregnant, you can prevent many of these poor outcomes from occurring. Losing just a few pounds can help you maintain better control of your sugars and lower your blood pressure.

Plan to exercise

Once your doctor has decided that you are healthy for physical activity, add exercise to your daily regimen. Choose activities that you enjoy and are most likely to continue with and have a goal of 30 minutes of aerobic exercise most days of the week. Keeping fit will help with both weight loss and control of your blood sugar. Check your sugar level before and after exercising because you may need to eat a snack to prevent low blood sugar during physical activity. Continue your exercise routine during pregnancy unless your doctor advises against it.

Avoid bad habits

It is very important to get counseling from your doctor before you become pregnant so that you have a healthy pregnancy. Women with diabetes should be screened for depression, tobacco and alcohol use, drug abuse, weight management, and exercise.

• If you are a smoker or are still drinking alcohol, the perfect

time to stop is before you get pregnant.

• If you are abusing drugs (prescription/non-prescription),

now is the time to stop and get help if necessary.

• If you have missed doses of insulin or if you don’t take your

medications as prescribed, focus on taking the best care of your

body as you prepare for pregnancy and avoid missing doses.

Know when you need to wait

It is important for each woman with diabetes to know when a pregnancy is not safe. If your diabetes is not under good control, you should wait to become pregnant. By working with your health care team and making adjustments to your treatment, you can improve control of your blood sugar and ensure a healthy outcome for you and your baby.

There is a lot of planning to be done. However, you must remember that the patience and additional work is worth the end result: your healthy baby!

Dr. Rachel Pessah Pollack is a second year endocrine fellow at Mount Sinai Medical Center in New York City, where she also received her internal medicine training. She is the AACE Fellow-in-Training Representative and has a special interest in pregnancy-related endocrine disorders. She has published articles and given presentations on gestational diabetes, Cushing’s disease during pregnancy, and iodine deficiency during pregnancy. This fall she will be joining a private endocrinology practice in New York.

Flu Season is here – Amarillo Diagnostic Clinic

2012 is quickly approaching. And with the new year, come new deductibles. So, be sure to take advantage of the rest of the year by scheduling your next appointment at Amarillo Diagnostic Clinic. Also, remember that cold weather can bring flu. Make your check up count by getting your flu shots.

Amarillo Diagnostic Clinic - The answer for flu season

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