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July 2007 eNews

Drowsy Driving a Dangerous yet Preventable Hazard for Holiday Drivers

Featuring Susan Rohr, DO, Sanford Sleep Disorders Center

Susan M. Rohr

America's highways will soon be bumper to bumper with road-tripping vacationers eager to enjoy their favorite 4th of July vacation spots. Sadly, many drivers will hit the road without having had enough sleep, oblivious to the dangers of drowsy driving.

"Sleepy driving can be equally as deadly as drunk driving," says Susan Rohr, DO, a physician with Sanford Sleep Disorders Center. "Our attention and reaction times are slowed under the influence of alcohol and when we are sleep deprived which can lead to deadly accidents behind the wheel."

According to NHTSA, driver fatigue is the direct cause of 100,000 car crashes each year, and the results are both deadly and costly: NHTSA estimates 1,550 deaths; 71,000 injuries; and $12.5 billion in diminished productivity and property loss. Researchers believe that these numbers are underestimated, given that an estimated 1 million crashes are produced by driver inattention - a side effect of fatigue.

Drowsy driving is an all too common danger on America's roadways. Those who claim that they have never operated a vehicle while feeling drowsy are in the minority, as NSF's 2005 Sleep in America Poll showed that 60 percent of adults had done so in the past year. Furthermore, one out of five drivers report having actually fallen asleep while driving; that's a staggering 32 million people!

"Most of us have had at least one episode of driving while drowsy and utilized many useless techniques to combat the sleepiness (rolling down the windows, turning up the radio, drinking a cup of coffee),” adds Dr. Rohr with Sanford Sleep Disorders Center. 'The bottom line is that the only solution for drowsy driving is a good night’s sleep. For most people, that consists of 7-8 hours of sleep per night on a regular basis. For those of you with sleep apnea, you should not drive if you have not slept with your CPAP therapy the night previously. So if you are drowsy while driving, don't risk a deadly accident, pull over and get some sleep or allow someone else to drive!"

Are you feeling sleepy? Pull Over!
Though you may be alert when you first begin your drive, drowsiness may soon set in. Trying to beat traffic or arrive at your destination early by driving while sleepy puts you and other motorists at risk. The following warning signs indicate that it's time pull over and stop driving:

Difficulty focusing, frequent blinking and/or heavy eyelids

Drifting from your lane, swerving, tailgating and/or hitting rumble strips

Yawning repeatedly

Trouble remembering the last few miles driven

Missing exits or traffic signs

Trouble keeping your head up

Tips for drowsy-free driving

Here are some tips for avoiding a crash caused by drowsiness during Memorial Day weekend and year round:

Get a good night's sleep before you hit the road. You'll want to be alert for the drive and for your vacation, so get to sleep early the night before you go.

Don't be too rushed to arrive at your destination. Many drivers try to maximize the holiday weekend by driving all night or without stopping for breaks. However, crashes caused by sleepiness are among the most deadly. It's better to allow the time, drive alert, and arrive alive.
Use the buddy system. Just as you should not swim alone, avoid driving alone for lon distances. A buddy who remains awake for the journey can take a turn behind the wheel and help identify the warning signs of fatigue.

Take a break every 100 miles or 2 hours.

Avoid alcohol and medications (over-the-counter and prescribed) that may impair driving performance and magnify the effects of sleepiness.
Avoid driving at times when you would normally be sleeping.

Pack a cooler filled with caffeinated beverages. Caffeine takes effect in about 20-30 minutes. If you start to feel sleepy, drink a caffeinated beverage and then pull over for a 30 minute nap before getting back on the road.

For more information on sleep and sleep disorders, visit www.sleepfoundation.org or www.sanfordhealth.org/Services/SleepDisordersCenter/

Healthy Eating

By Teresa Beach, Registered Dietician, Sanford USD Medical Center

Apple-Cabbage Slaw

Combine the first 4 ingredients in a bowl, toss well. Combine sour cream and next 5 ingredients, add to cabbage mixture, stirring to coat. Combine apple slices and lemon juice. Drain apple, discard juice. Arrange apple slices around the salad. Makes 4, 1 cup servings. Serve with lean deli meat on whole grain pita bread and a glass of low fat milk.

The Facts on Vasectomies

By: Jeffry Meyer, MD, Sanford Clinic Family Medicine 49th & Oxbow

Vasectomy. The word alone strikes fear in the hearts of men. After all, who would ever consider cutting into a perfectly good set of testicles? Fact is; it is one of the easiest, safest and most reliable forms of birth control. In the next few paragraphs I hope to ease your mind and dispel some of the misconceptions about the procedure. Although pain is the biggest concern among men I counsel, it is rarely an issue. Yes, there will be some pain during and after a vasectomy. However, I have rarely seen anyone need anything more than ibuprofen. Other complications are also rare and manageable. I will discuss those more later.

First of all, consider it a permanent procedure. If there is doubt, don’t do it. Discuss it with your spouse and bring her along to the consultation. I was once approached by an 18-year-old boy who had recently impregnated his girlfriend, but a vasectomy was not the best choice for him. There is a device known as the vas clamp that does increase your odds for reversal. They are very expensive and often not covered by insurance companies. Vasectomy reversal procedures are also available. They are also expensive and not always successful.

The flip side of this is they are not guaranteed. Failure rates vary greatly depending on the study. One study quotes .02-.2% failure in the first year following the procedure. This is comparable with female sterilization (tubal ligation), and the birth control shot (depo provera). Other common methods also fail. Birth control pills .16-3%, IUD’s .5-5%, and condoms 1-33%.

Typically two months after the procedure your doctor will have you submit a semen sample for analysis. Although the connections to your testicles have been cut, there are always sperm in the genital tract. It usually takes about 15 ejaculates to clean these out. The life of a sperm cell is around 72 days. There should not be any “living” sperm after this amount of time.

There are several different methods to do a vasectomy. Talk to your doctor about how they do it. I use a method called a “no scalpel vasectomy”. This method involves one small incision in the midline of the scrotum from which both vas deferens can be grasped, cut, clipped and cauterized. Yes, I do use a local anesthetic. The procedure takes between 20 and 60 minutes. Most men choose to have them done on a Friday, and can return to almost any job by Monday.

It would not be right to talk about surgery without mentioning the risks. I already mentioned pain which is usually mild and short lived. There is also a small amount of bleeding and likely some bruising. As with any surgery, infections may occur 3.5-4% of the time on average (less with no scalpel method). Antibiotics are used to treat infections. I don’t prescribe preventative antibiotics. Bleeding into the scrotum occurs in 2% of cases. These will resolve with time, but may take weeks or months. An unfortunate but unlikely complication. Sperm granuloma (painful lump on vas deferens) occurs in 3-5% of cases. Most of these resolve with time as well.

The "urban legends" of smaller penis, loss of manliness, increased cancer risk, impotence, endocrine, pulmonary, neurological, and psychiatric disorders have all been studied and simply do not occur. Even the volume of your ejaculate is minimally affected. Most of your ejaculate is not sperm.

Vasectomy is certainly not for everyone. The procedure is usually covered by insurance. However, I hope I helped to answer some questions and ease some fears.