• Is Sleep Apnea Making You a

    Morning Zombie?

    Do you wake up feeling like a zombie? Do you have trouble keeping your eyes open at work or school, or even while driving? You might be one of the 12 million-plus Americans feeling the effects of a disorder known as sleep apnea. Even though you may be getting to bed at a reasonable hour and assuming you’re getting a normal night’s sleep, sleep apnea can subtly interrupt the quality of your sleep, making you feel tired and lethargic in the morning. Sleep apnea has many other affects on the body, but this is certainly one of the most recognizable symptoms of a disorder you may not even be aware you have.

    Serious Consequences of Sleep Apnea

    Most people don’t know they have obstructive sleep apnea, usually caused when the soft tissue in the back of the throat collapses when sleeping, says Patrick J. Strollo, Jr., MD, medical director of the UPMC Sleep Medicine Center. That leads to a drop in oxygen levels, prompting the brain to send a surge of adrenalin signaling the person to wake and take a deep breath. That kick-start also leads to a spike in blood pressure.

    According to the National Institutes of Health, this common disorder causes breathing pauses while you sleep. These pauses can last a few seconds, or even minutes — as often as 30 times, or more, an hour.

    “It’s a burden on the cardiovascular system and affects the quality of your rest,” says Dr. Strollo. Left untreated, sleep apnea can lead to serious health problems and even cause deadly accidents.

    10 Signs You Might Have Sleep Apnea

    Not everyone who snores has sleep apnea, but it is a major clue. Since sleep apnea only occurs during sleep, a family member or bed partner might be the first to notice.

    Common signs and symptoms include:

    • Loud and chronic snoring — sometimes with pauses.
    • Choking or gasping following pauses
    • Feeling tired or sleepy, even after sleeping all night
    • Waking up with a very sore or dry throat
    • Daytime sleepiness, or lack of energy
    • Morning headaches
    • Restless sleep, waking up during the night, or insomnia
    • Trouble concentrating or problems with learning and memory
    • Depression and irritability
    • Sexual dysfunction

    Consult your primary care physician or family doctor if you’ve experienced any of these symptoms. If left untreated, sleep apnea can have serious consequences on your waking life and your health. For more information, visit the UPMC Sleep Medicine Center online or call 412-692-2880.

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  • What You Need to Know About


    Updated 10/24/2014

    On Oct. 23, 2014, Craig Spencer, MD, became the first person in New York City to test positive for Ebola. Spencer recently returned from Guinea where he treated those afflicted with the Ebola virus. He is currently in isolation at Bellevue Hospital Center in New York. Three people who were confirmed to have been in contact with Spencer are also isolated for observation. Representatives from the Centers for Disease Control and Prevention were sent to NYC on Thursday and will confirm the test results.

    On the worldwide stage, the European Union (EU) met at a summit on October 24 and planned to contribute to aid to fight the spread of Ebola in West Africa. The organization pledged $1 billion Euros (roughly 1.26 billion USD), in addition to the 600 million Euros (approximately $7.6 million USD) pledged by the European Commission.

    According to the World Health Organization, nearly a million doses of an Ebola vaccine could be available by the middle of 2015. Clinical trials are expected to begin on five other Ebola vaccines in January 2015 in the hopes of helping to stem the outbreak.

    Updated 10/23/2014 

    Beginning Wednesday, Oct, 22, 2014, the Department of Homeland Security (DHS) declared that all international travelers coming from Liberia, Guinea, and Sierra Leone be given a health screening at one of five major U.S. airports. Travelers coming from these countries, which have been most heavily impacted by the Ebola outbreak, must make a stop at either Chicago’s O’Hare International Airport, New York’s John F. Kennedy International Airport, Newark Liberty International Airport, Washington Dulles International Airport, or Hartsfield-Jackson Atlanta International Airport.

    These major hubs will serve as checkpoints where these travelers will undergo testing for Ebola, complete an interview, and have their temperature checked. In addition these travelers will be closely monitored for 21 days by public health officials through daily check-ins. The travel restriction was instituted as a result of demand from bi-partisan lawmakers on both sides of the aisle. Secretary of Homeland Security Jeh Johnson said, “We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly.

    On October 20, health care providers at Emory University Hospital declared a patient Ebola-free after she tested positive for the disease on September 9 and was admitted to the hospital. The patient was one of four treated for the disease by experts at Emory. One patient was cleared to leave on August 19 and another on August 21. The fourth patient was admitted on October 15 and remains in the hospital.

    Updated 10/21/2014 

    Thomas Eric Duncan became the first casualty of the disease on U.S. soil. Duncan was exposed to the disease in Liberia before returning to the U.S. He died in a Dallas hospital on October 8, 2014, after being treated for the disease. By the time Duncan began an experimental treatment, his case of Ebola was too far advanced to respond. A deeper look at Duncan’s case shows that it is actually harder to catch Ebola than most Americans may believe.

    Sunday, October 19 marked the completion of the 21-day incubation period that health officials observed, monitoring individuals who Duncan had been in close contact with since his return to the U.S. October 20 marks a full month since he took several flights from Monrovia, the capital city of Liberia.

    To date, and as expected since he was not contagious at the time, no one on Duncan’s flight has fallen ill. Duncan’s family and fiancé – whom he lived with while he was experiencing the symptoms of Ebola,such as sweats, a fever, and vomiting – have not shown signs of the disease either and have been declared free of the virus.

    In addition to Duncan’s family having been given a clean bill of health, a Texas health worker who was traveling aboard a cruise ship in the Caribbean also tested negative for the disease. Once she and her husband had been tested for Ebola, they were given clearance to drive home. The remaining 4,000 vacationers on the ship were also allowed to leave a few hours after pulling back into port.

    Amesh Adalja, MD, an infectious disease specialist at UPMC and a senior associate at the UPMC Center for Health Security, says the risk of it spreading in the U.S. is very low because it can only be transmitted under specific conditions.

    Ebola is a deadly disease, it’s a scary disease, but it’s not very contagious. It doesn’t spread through the air; it only spreads through intimate contact with blood or body fluids,” says Dr. Adalja.

    “It is far less contagious than the flu — a respiratory virus easily spread by sneezing and coughing. Also, Ebola is only contagious when a person has symptoms. With the flu, a person is contagious the day before symptoms appear.”

    Although the risk of Ebola spreading is low, the Centers for Disease Control and Prevention (CDC) and other agencies have taken steps to prevent that from happening in this country. That includes increased airport screenings before and after entering the United States from Ebola-affected countries. In addition, the CDC has issued Level 3 travel warnings urging U.S. residents to avoid nonessential travel to Guinea, Liberia, and Sierra Leone in West Africa. The West African nations of Nigeria and Senegal have recently been declared Ebola-free. The country has not registered any new cases of Ebola in 41 days.

    Protocols also have been established to ensure health care facilities are prepared to properly detect and handle the disease. UPMC facilities are ready, says Dr. Adalja. Each hospital in our system has comprehensive and detailed action plans in place.

    “We know how to stop the spread of Ebola. But it’s crucial for hospitals to prepare in advance,” he says. “UPMC has easily accessible protocols from the moment a patient arrives in the Emergency Department through their hospital stay — how we screen that person, how we isolate that person, how we test for it, who we communicate with — it’s all laid out.”

    About the 2014 Epidemic

    According to the CDC, the 2014 outbreak is the largest in history and the first documented appearance in West Africa. About half the people who contracted the virus have died. In the U.S., the Texas patient who had recently traveled from Liberia died on Oct. 8.

    Ebola Facts

    • A person infected with Ebola is not contagious until symptoms appear.
    • Symptoms of Ebola may appear anywhere from two to 21 days after exposure, but the average is eight to 10 days.
    • Early symptoms include:

    o Fever (higher than 101.5° F)

    o Headache

    o Diarrhea

    o Vomiting

    o Stomach pain

    o Muscle pain

    o Unexplained bleeding or bruising

    How Ebola Spreads

    Ebola is spread through direct contact with:

    • Blood and body fluids (urine, feces, saliva, vomit, sweat, and semen) from a person sick with the disease; and
    • Items contaminated by blood or body fluids from an infected patient, like needles, medical equipment, clothing, or bedding.

    Are You at Risk?

    If you’ve traveled to an area with an outbreak, or had close contact with someone sick with the disease, you may be at risk. The CDC recommends that you:

    • Check for signs and symptoms for 21 days.
    • Take your temperature every morning and evening.
    • Call your doctor — even if you do not have symptoms — to evaluate your exposure level and consult with public health authorities to determine if any actions are needed.
    • Continue normal activities, including going to work, while you are symptom-free.

    If You Get Sick after Travel to an At-Risk Area

    • Get medical care immediately if you develop a fever (higher than 101.5° F).
    • Alert your doctor about your recent travel to West Africa, or contact with a person sick with Ebola, and symptoms before you go to a doctor’s office or emergency department. Calling ahead will help the doctor or emergency department care for you — and protect others.

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  • Recipe: Homemade

    Pumpkin Spice Latte

    Fall is finally here and we are officially excited about EVERYTHING pumpkin! Instead of buying the famous coffeehouse drink, skip out on the saturated fat, carbohydrates, and sugars by crafting your own version of the pumpkin spice latte in the kitchen. You may be used to waiting in a long line for this tasty treat, so you’ll be pleasantly surprised to find you can whip up this recipe in half the time. Better yet, this version uses real pumpkin, not syrup! Pumpkin is low in fat and calories, and also packs a healthy dose of antioxidants, vitamin A and vitamin C, as well as iron. Pumpkin is also a great dietary source of fiber.

    So, save yourself some calories, money, and time spent in line by adopting this version of a fall favorite!

    Pumpkin Spiced Latte


    2 cups skim milk

    2 tablespoons canned pumpkin

    2 tablespoons Stevia

    2 tablespoons vanilla extract

    1/2 teaspoon pumpkin pie spice

    1/2 cup hot brewed coffee

    Whipped cream, pumpkin pie spice and ground nutmeg, optional


    Combine milk, sugar, and pumpkin in a small pan over medium heat until steaming.

    Remove heat, stir in pumpkin pie spice and vanilla

    Transfer the mixture to a blender. Process for 15 seconds or until foamy

    Pour into two mugs, add ¼ cup coffee

    Top with whipped cream and a pinch of pumpkin spice

    Nutritional Facts

    1-1/4 cups (calculated without whipped cream) equals 307 calories, 0 g fat (5 g saturated fat), 33 mg cholesterol, 346 mg sodium, 39 g carbohydrate, 1 g fiber, 22 g protein

    Do you have any favorite healthy fall recipes you enjoy with seasonal fruits and vegetables? Share them with us in the comments!

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  • Infographic:

    Colors of the Eye

    From the famous lines of beloved songs to the stories of ancient legends, eye color has captivated audiences throughout time. The origins and genetic makeup associated with eye color makes the color of one’s eye more complex than a simple collection of aesthetic traits, however. Genes and pigment concentrations are two important factors in determining eye color. Some eye colors are more rare than others and can be linked to genetics or family origins and heritage.

    Hannah Scanga, MS, a genetic counselor at the UPMC Eye Center, explains, “The two primary genes that influence the color of the eye, primarily brown and blue eyes, are OCA2 and HERC2. Additional genes influence other eye colors and specific variations, including green or hazel eyes and gold rings.” The scale of eye color from most to least common is brown, blue, hazel, green, and silver.

    According to Ellen Mitchell, MD, “Concentrations of the pigment melanin in the iris of the eye is the primary determinant of eye color. Higher amounts of melanin lead to darker colors while lower amounts result in lighter eye colors.” Dr. Mitchell continues, “The pigment lipochrome also plays a role in determining eye color, specifically green eyes.”

    Eye color can also change due to factors like pupil size, emotions, and age. However, if these changes are drastic or only occur in one eye this may indicate a medical condition and you should discuss symptoms with a doctor.Eye Color Infographic

    Are you still curious about some of the fascinating facts behind blue (green, or brown) eyes? Visit the UPMC Eye Center website to learn more about the latest breakthroughs in the field of optometry and the different eye conditions we treat. Call 1-800-446-3797 to schedule an appointment today.

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  • 5 Ramen Noodle

    “Health Hacks”

    It’s that time of year again. The time when college students flock back to campus, ready to ace their tests, reunite with friends, and feast on the infamously unhealthy Ramen Noodles. Unfortunately, the beloved college-food was the subject of a recent health study, which linked it to series health issues. Even more disheartening? These issues were gender specific. Women who ate the noodles at least twice per week saw a 68 percent increase in their risk of cardiometabolic syndrome, while men saw no notable difference in their risk. But with all-nighters and deadlines looming, it’s not easy to toss the prepackaged delicacy into the trash for good. So what’s a busy college kid to do?

    Leslie Bonci, director of sports nutrition at UPMC Center for Sports Medicine, commented on the story and assured students that it doesn’t take much effort to make Ramen healthier. So next time late-night hunger strikes, try these simple steps to save your wallet and your health:

    Ramen Graphic

    1. Ditch the Seasoning

    The sky-high sodium content is the biggest health issue, so try adding flavor another way! Use water or broth and flavor it with garlic, ginger, herbs, chili, or sesame oil.

    2. Add Veggies

    If you live on campus, grab some vegetables from the salad bar to use in your Ramen. Otherwise, break out the frozen veggies to give your noodles an extra kick of nutrients!

    3. Pack in the Protein

    Chicken, shrimp, tuna, tofu, grilled salmon, eggs…the list goes on! Any protein you choose will make your Ramen healthier and keep you feeling full longer than Ramen alone.

    4. Use your Leftovers

    Have extra food from last night’s dinner? Combine it with ramen noodles (sans seasoning) for a delicious reworking that makes you forget you’re eating leftovers.

    5. Go Dry

    Cook the noodles, drain, and lightly toss in your favorite dressing or sauce! Think low-sodium soy sauce, Italian dressing, vinaigrette, or teriyaki sauce.

    6. Get Creative

    There are dozens (if not hundreds) of Ramen recipes for you to try. There are even Ramen Noodle cookbooks! So don’t settle for boring noodles, spice it up with a creative recipe.

    Eating habits tend to change when entering college mode, as campus life warrants an active and hectic lifestyle. Quick, convenient and unhealthy meals often take center stage, landing healthy eating and cooking in the bleachers. When you’re looking to get creative with regular old Ramen, check out some of our health hacks. Think of it as teaching an old dog new tricks, but this time you’re the dog and the tricks are disguised as noodles. Bring your dorm room dining to a new level while also becoming more conscious of the ingredients your putting in your body!

    How do you make your Ramen healthier? Share your ideas below!

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Marathon Nutrition Q&A from UPMC’s Google Hangout

by Sports Medicine

We received some great questions during our UPMC Marathon Nutrition Google Hangout. Below are the answers to all of the questions. Thank you to everyone who listened in.

1.   When running the half, how often should you hydrate? and if using a GU or something similar when should you use it? What kind do you recommend? – Emily M.

How often you should hydrate depends upon your sweat rate. Weigh yourself before and after a long run. Convert that difference to ounces ( 16 ounces = 1 pound) and add to that the number of ounces of fluid you drink during your run, then divide by the number of hours you ran. The number you get is the number of ounces you should drink per hour on a training run or during the half.


130 lbs (pre run weight) – 128 lbs (post run weight) = 32 ounces +20 ounces of fluid consumed over a 2 hour run = 52 divided by 2 (2 hour run) = 26 ounces per hour

Water alone is sufficient for the first hour. After that you can look to add about 30 grams worth of carbohydrates – a GU, chews, chomps, Bloks  ( look at the package portion size) – in addition to water . Or you can substitute 16 ounces of sports drink.

Whatever you do, use what sits best in your stomach, in addition to what tastes best for you. If you are a salty sweater, you may be better off with Gatorade chews or a sports drink.

2.    How soon before the race is carb loading advised? During my long runs, I get hamstring / quad cramps around mile 20-23. Besides training harder, is there any nutritional tip ? (GU / hydrate around mile 18?)/ Thanks  – Jignesh U.

Start adding in more carbohydrates 3 days before the race, but only a little more at each meal such as ½ cup cereal, rice or pasta, a slice of bread, a serving of crackers, or a piece of fruit.

To help with the cramps, you need to determine if you are a salty sweater – sweat burns your eyes, tastes salty in your mouth and leaves a gritty residue on skin or clothes. Having more salt, such as adding salt to meals the day before and morning of the race, as well as adding salt to a sports drink can help. You need to try this out during training runs to see how it feels. The GU provides the carbohydrate for energy but won’t help with the muscle cramps. Make sure you are well hydrated.

3.    I have heard about carb depletion before carb loading in preparation for long races, what is the idea behind this and how do I carry it out? – Hannah P.

Carb depletion is the old way of carb loading. One would limit carbohydrate containing foods, and do exhaustive exercise to deplete muscle and liver glycogen stores, and then load up with carbs- the theory being that one could supersaturate the depleted stores and have more energy available for endurance exercise. The problem is that this method also causes the cells to hold a lot of water and runner would complain of feeling stiff the first few miles, so instead- try to increase your carbs as part of each meal/snack in the 3 days leading up to the race- this will accomplish the same goal but much more comfortably!

4.   What is the ideal food to eat for dinner the night before the race and for breakfast the morning of the race? – Sean T.

Nothing too high in fiber, protein or fat. Make sure it is easy to digest.

Favorite meals from our Hangout panelists include pasta with sauce or butter and cheese, or a sandwich with some soup.  For breakfast they mentioned coffee, half a bagel or a piece of bread with some peanut butter. Key is to stick to what you know works and will give you sufficient energy. Be careful to not overdo it or else you risk having an upset stomach during your run.

5.   So much focus is on nutrition prior and during the race (as it should be!), but what about after the race? What should I eat to help me recover? – Julia K.

So how do you discover your recover? What should post race eating look like? Sooner than later is better. Ideally eat something within 15 minutes of finishing if you can! Go for the carb-protein combo such as a cold bottle of low-fat chocolate milk, or a Greek yogurt with granola, if you are not too tired to chew! A fruit smoothie with added protein isolate also works. If you want savory, you could do cheese on a Bagel thin, or beef jerky and crackers if you have enough energy to eat them!

6.   What kind of breakfast do you recommend before running the half? Is a peanut butter sandwich too much protein before a half? – Maura S.

For the breakfast before your half marathon- first rule- eat what you have trained with. NO NEW FOODS on race day! If a peanut butter sandwich felt good in training, it will work! In general, breakfast should be 2-3 hours before the race- so a peanut butter/honey sandwich, or yogurt with granola, or oatmeal with nuts, dried fruit, or even a scrambled egg wrap would work if you have trained with these foods

7.   Seeking advice on what to eat and when to prevent post-run digestive issues. Sorry :( – Christine H.

To prevent gut issues be sure to stick to what you know works. Race day is not the time to experiment.
No high fiber foods before long runs – such as bran, beans, cabbage family foods. Be careful with how much fruit you eat since it can go through you more quickly. Caffeine can also have a laxative effect. And remember these three little words: “Less is More” during the race. After the first hour, aim for 30 grams of carbohydrates per hour so either a GU, gel, chomps, chew or bloks with water OR sports drinks, but not both.

8.   Is carb overloading still practiced or recommended? – Liz A.

Carbohydrates are the best fuel source for running. It is recommended that you start carboloading three days ahead of time by adding a tennis ball-sized amount more to each meal.

9.    What if you do not like pasta? What else can you eat for carbohydrates? – Melissa R.

Rice, risotto, quinoa, potatoes (baked not fried) or just bread are all good alternatives.

10.   In your opinion, is an energy gel helpful for running a half marathon, or not really necessary? – Clare C.

Unless you are running a blistering pace, you may want to do a gel in the second hour (if you think you need it), but be sure to have it with water.

11.   I typically take in 20 grams of protein during a long run in the form of a clif builder bar spaced out along the route.  Additionally, 1 gel per 45 min- 1 hour, and few chews.  What is your view on protein intake during a run? – Tony D.

Protein is important to build muscle and repair post run, but not during. Protein during a run actually delays the carbs in your gut from leaving your stomach and getting to your muscles, so wait until you are done and have some protein along with your carbs.



About Sports Medicine

UPMC Sports Medicine is the region’s largest and most experienced center dedicated to caring for athletes of all levels. For more than 25 years of world-class care, we’re proud to offer more services, have more physicians, and treat more student athletes than any other sports medicine provider in the region.