Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
I want to remind all my readers that I enjoy hearing from
you. It is not necessary to mention in your letters "do not
print my name," as I never do. All correspondents should know
that it takes about six weeks for answers to questions to
appear in my column, so if you need a more immediate answer,
you should include a self-addressed envelope with a stamp,
and you will be answered at once.
An Email letter asked in light of the terrorist activities in
Israel, what do the terms "lightly, moderately" and "severely
injured" mean?
In general, when news reports in other countries refer to the
condition of patients as "satisfactory," "serious," or other
terms, they are completely arbitrary and are set by the
treating doctor. However, in this country, the terms relating
to injuries from terrorist injuries do have some
guidelines.
Dr. Rieck, my colleague from Tel HaShomer, related to me that
the military defines light injuries as having no immediate
danger to life, limb or internal organ. Moderate injuries are
a danger to a limb or internal organ, whereas serious refers
to life-threatening injuries. May we never know from this,
and may we see a yeshua bekorov.
Sleep is a subject that we physicians are taught little
about. I have received two letters on the subject. Sleep has
stages to it, with the deepest one being called rapid eye
movement sleep, or REM. We all need a certain amount of this
type of sleep a night. In other words, quality of sleep is
more important than quantity. People vary in the amount of
sleep they require and its quality. Newborns generally sleep
20 hours a day, while the champion sleepers among adults are
teenage girls. Elderly people have less quality sleep, with
frequent wake periods.
People who are poor sleepers and those who sleep as soon as
their head hits the pillow can generally do little to change.
Not eating before going to sleep, a comfortable bed, regular
sleep and rising patterns, and a dark room all contribute to
quality sleep. The role of milk before sleep and the drug
melatonin are unknown, also the long term use of sleeping
medications probably causes dependence and should be
discouraged. Alcohol is also not a solution. Daytime sleep
can be a problem for those having trouble sleeping at night.
All this applies to jet lag as well and on jet travel.
Relaxation techniques are the best.
People with a change in sleep pattern can be showing signs of
depression. Teenagers love to test themselves by staying up
late and sleeping little. We do know that not sleeping enough
causes trouble with concentration, foul moods, and depresses
the immunological system. Many avreichim come up to me
and ask me for energy medications or vitamins, when the
solution is simply to get more sleep.
Sleeping too much can be from depression, boredom and
burnout, or from the fact that some people just enjoy
sleeping. Anemia, medications, mono, migraines and infection
can also be found in people who sleep too much. Obviously,
this should be looked into medically. So in summary, what is
the proper amount of sleep? Enough that you do not experience
daytime drowsiness and problems concentrating.
Someone requested I have a guest psychiatrist write more on
psychiatric illness. I am working on this suggestion. As to
what this writer took offense to, I will comment that I
wanted to illustrate that psychiatric illness can affect
anyone. Another person requested a column on thyroid
disorders. Endocrine (hormone) disorders will be our topic
for discussion in the coming weeks. Write me in care of the
Yated.
A message from Glaxo, sponsor of this column. Vomiting
after chemotherapy can be challenging, but Zofran has changed
all that. This is the strongest anti-vomiting medication that
we have in our arsenal. From Glaxo.
