Advancing Care - 2023 | Issue 4

Got GERD? Get relief with new treatment at L+M Hospital 

You just had a big meal—and now you’ve got “heartburn.” It’s the most recognizable symptom of acid reflux, and it happens to nearly everyone at some point in life. But if you regularly have acid reflux/heartburn symptoms more than twice a week, you may want to consider a new procedure that is available at Lawrence + Memorial Hospital. 

Acid reflux occurs because a valve at the end of your esophagus doesn’t close properly after food enters your stomach. When the acidic contents from your stomach move back up into your esophagus, it causes an uncomfortable burning sensation in your chest, neck and throat. Other symptoms include nausea, a chronic cough and difficulty swallowing. 

Brian Bates of Waterford knows the symptoms well. Now 60 years old, he began experiencing heartburn and acid reflux as a teenager. “In my 20s, I saw a doctor who told me it was no big deal. I just needed to cut down on eating chocolate, don’t drink coffee, stay away from alcohol and spicy foods. Basically, he told me to stop living,” Bates said.

Continue reading to learn how you can get relief from GERD

Melatonin: Does it really help you sleep? 

It’s 2 am and you can’t sleep. The alarm clock is set to go off in just a few hours. Is it time to reach into the medicine cabinet?

According to Amit Khanna, MD, medical director at Lawrence + Memorial Sleep Center and a sleep medicine specialist with Northeast Medical Group, many sleep problems can be better managed with a change in behaviors, schedules and habits, rather than taking medications. 

“People should consult their doctor or a sleep specialist before taking melatonin because this hormone does not address any underlying health problems that may be disrupting sleep. Many treatable medical issues – such as anxiety, sleep apnea, restless legs syndrome or mood disorders like depression — can cause insomnia, said Dr. Khanna. 

In a 2022 survey, more than half of American adults reported using some kind of sleep aid for insomnia; 11 percent turned to nonmedicinal, over-the-counter products such as melatonin. Sold as a supplement, melatonin is a hormone that influences sleep. It helps to regulate the timing of your overall sleep-wake cycle and set your circadian clock, the internal timekeeper that tells your body what time of day it is. Depending on when melatonin is taken, small amounts can alter the timing of your internal clock.

Many people believe taking melatonin will help them fall asleep faster. While some research suggests that melatonin may slightly reduce the time it takes certain people to fall asleep, taking it incorrectly may actually aggravate – rather than help – sleep issues, said Dr. Khanna. “Melatonin should really be handled as any other medication, in conjunction with advice from a health professional. While it may help, it could also have negative consequences.”

Should you decide to give melatonin a try for your sleepless nights, remember there’s no guarantee it will work for you, Dr. Khanna noted. “Melatonin affects people differently. Some may have great results using it, others may not benefit at all. Like any sleep aid, melatonin should be used sparingly when attempted,” he said, adding that it should also be noted that melatonin is labeled as a “dietary supplement,” which means the FDA does not have the same oversight as other medications. “Research has found that the melatonin content in supplements can vary quite widely. It is important to select a product with the USP Verified Mark to allow for safer use.”

Think proper dosage and timing when it comes to melatonin, said Michelle Kelley, PharmD, clinical pharmacy manager, Lawrence + Memorial Hospital and Westerly Hospital.  “Make sure you’re taking it at the same time every day – because if you take it at different times during the day, you can confuse your circadian clock,” she said.

What dosage is recommended for people who are having problems sleeping? “For insomnia, we typically suggest doses of 3 - 5 mg in the evening about one hour before bed. In elderly patients we recommend a reduced dose of 1- 2 mg to limit confusion or disorientation,” Kelley said. 

The most common side effects include headache, dizziness, nausea and drowsiness. On rare occasions, Kelley said melatonin can cause some feelings of depression, confusion or irritability. 

Melatonin can interact with and affect other medications you may be taking. “Some common ones are anticoagulants, antiplatelets, contraceptives, diabetic meds and immunosuppressants,” she said. “We suggest avoiding melatonin all together in patients who are diagnosed with autoimmune diseases – and, of course, we always recommend consulting with your doctor or pharmacist before taking any vitamin or supplement.” 

So with all of these caveats, why do some people swear by it? According to Brittany Langdon, PharmD, a pharmacist with Yale New Haven Health, melatonin may benefit from the “placebo effect” – if you believe that it works, then you will start to relax and fall asleep. 

“Some studies have suggested that melatonin can improve both the time to fall asleep and total sleep. Other studies show a placebo being equally as effective,” she said. “In the end, melatonin may be modestly effective for short periods, but people with long-term sleep problems should consult their doctor to find a more reliable solution.”

10 tips for a good night’s sleep

Having trouble falling asleep? Here are 10 tips from Lawrence + Memorial’s Sleep Medicine Program that may help you relax. 

1. Make sleep a priority. Try for 7 - 9 hours of sleep each night. Children should get between 9 and 12 hours. 
2. Get up at the same time each morning to help set your biological clock.
3. Maintain a healthy diet. Your weight, blood pressure and cholesterol can cause health problems associated with poor sleep. Finish eating meals 2 - 3 hours before bedtime. 
4. Get regular exercise. It helps you fall asleep quicker and promotes deeper sleep. Avoid heavy exercise 2 hours before bedtime.
5. Minimize napping. If you need to stay alert, take a 20 - 30 minute “power nap” before late afternoon.
6. Avoid caffeinated beverages and minimize alcohol and smoking, especially in the evening. 
7. Develop a bedtime routine to help you relax:
   • Make a “worry list” of your concerns and put it aside. This helps stop you from taking problems to bed.
   • Try muscle relaxation exercise, deep breathing, yoga or meditation.
   • Avoid drinking a lot of liquids in the evening so your sleep isn’t interrupted later by trips to the bathroom.
   • Take a hot bath an hour or two before bedtime. 
8. Create an ideal sleep environment:
   • Avoid watching TV or using your phone or computer while in bed.
   • Keep the room temperature moderate.
   • Keep the room dark for sleeping – use light-blocking curtains if needed.
   • Turn the clock away from the bed or cover it up.
   • Use a sound machine to block out sounds that may disturb you.
   • Don’t sleep with your pets. They can disrupt your slumber.
9. If you are still awake after 15 - 20 minutes, get up and do another quiet activity. 
10. Talk to your doctor. Uncontrolled anxiety worsens during sleep and certain drugs or supplements may also affect your sleep. If you have an urge to move your legs at night, you may have restless leg disorder (RLS), which is treatable. 

Schedule your mammogram online

An annual mammogram is an important, proactive way women can take care of their health. Mammograms are the best tests doctors have to find breast cancer early-- sometimes up to three years before a lump is felt. 

Mammography is a type of imaging that uses low-dose X-ray to examine breast tissue. There are two types of mammograms: 

• Screening mammography is recommended each year to examine breast tissue and check for breast abnormalities. 
• Diagnostic mammography may be recommended to further examine an area of concern, lump, cyst or follow-up after a screening mammography. 

Breast tomosynthesis, also called 3-D mammography, may also be used in a screening or diagnostic mammography. This allows the radiologist to view the breast in thin "slices" rather than as a whole, which improves the detection of lesions and reduces the need for additional views of the breast.

Yale New Haven Health offers screening mammography at 15 locations across Connecticut and one location in Rhode Island. No prescription is needed at most locations if you are 40 years and older and have not had a mammogram in the last year.

Schedule your mammogram appointment online now. 

Pediatric Specialty Center opens in New London

Yale New Haven Children’s Hospital – the #1 ranked children’s hospital in Connecticut by U.S. News and World Report – recently opened the doors to a new Pediatric Specialty Center in New London. The center, located at 3 Shaws Cove (Suite 205), offers families a full range of specialties and programs that include allergy/immunology, endocrinology and gastroenterology. Family-centered care is delivered by a team made up of board-certified medical and surgical pediatric specialists from Yale Medicine, advanced practice providers, registered nurses, social work, psychology, nutrition services, child life specialists and other staff members who partner with patients and families to provide the specialty care needed. 

Find a specialist that’s right for you. Call 877-925-3637 (877-YALE-MDS). 

Learn more about YNHCH Pediatric Specialty Centers throughout Connecticut.

Quit smoking with Tobacco Treatment Program at L+M

Lawrence + Memorial (L+M) Hospital is offering an eight-week Tobacco Treatment Program that provides quitting strategies for smoking and tobacco products. Our program uniquely provides counseling and a support group.  The program is led by our team of exercise physiologists and respiratory therapists specially trained in tobacco treatment.

Classes will be held on Mondays from Sept. 11 – Nov. 6 (no class on Oct. 9) from 5 – 6 pm.  The first and last class will be held in-person at L+M Hospital, Baker Auditorium, 365 Montauk Ave., New London. All other classes will be held via Zoom.

A fee of $50 will be collected for participant materials.

To register, contact Lisa Chatowsky at 860-442-0711, ext. 2354. Limited space is available. 

Amputee support group meets monthly 

A free monthly support group for people with amputation and their families and friends is offered on the last Wednesday of every month. The group meets from 4 -5 pm in Baker Auditorium at Lawrence + Memorial Hospital, 365 Montauk Ave., New London. For more information, contact Dave Deshefy at 860-442-0711 ext. 2393.

L+M Travel Clinic helps you stay safe on vacation

Planning a trip? Get the right vaccinations to stay safe and healthy during your travels. Northeast Medical Group offers a Travel Clinic at Lawrence + Memorial Hospital that provides routine and travel vaccinations administered by Infectious Disease specialists. Due to high demand in travel, please schedule your appointment at least one month in advance of your departure. Call 860-444-3735. 

For information on health advice to international travelers, including advice about medications and vaccines, visit Traveler's Health at the Center for Disease Control and Prevention. 

Billing questions? 

Yale New Haven Health offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.