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January 6, 2009



To stop breathing up to 100 times an hour sounds bad enough. But recent research also links sleep apnea to 50% of hypertension, 25% of congestive heart failure, and 60% of strokes. These staggering numbers inspired two Washington Hospital Center docs, otolaryngologist Stan Chia and oral surgeon Ziad Ali, to open the Sleep Apnea and Snoring Clinic, to raise awareness and provide all available treatments. For an update, we got a good night's rest and visited their WHC office.


Did we catch Stan and Ziad here performing Hamlet? They're an odd couple, because apnea is usually handled by a sleep specialist, who refers to an ENT or dentist; however, by joining forces, these two offer a one-stop-shop for the drowsy. They can customize treatment depending on the cause, such as uvula size or excess tissue on the soft palate. Treatments range from oral devices, to jaw surgery that moves the tongue and tonsils forward. These interventions have a success rate of up to 98%. By comparison, the traditional treatment, continuous positive airway pressure (CPAP), is so uncomfortable (a blast of air through the nose each night) that as many as 60% of sufferers prefer no treatment.


Sleep will be a luxury for Stan, who's expecting his first child in May. He's been at WHC for 3 years, after residency in San Diego. Ziad studied at University of Texas-Houston, and first had the idea for the clinic. When asked about its origin, he says "I saw our offices are next door, so I decided we could join forces." OK, maybe not a heartwarming story, but he says they've been driven by good results and plenty of patient success stories that begin with "I haven't slept like this in 10 years."


With the Vatican unavailable, we wanted to get some verification on a Christmas miracle we'd heard about. Paired-kidney exchanges at WHC happen just once every three years. The most recent occurred on Dec 17 between a husband/wife and mother/daughter. The mother had been wait-listed for three years, and while all her daughters were willing, their kidneys were disqualified, either for health reasons or immunologic incompatibility. Similarly, the wife was willing, but incompatible with her husband's blood type. When the paired match was discovered (daughter-to-husband & wife-to-mother), the surgery happened within three weeks, just in time for Christmas. Above, transplant coordinators Eloida Gonzales and Josephine Flores arranged the match, and Reza Ghasemian, MD, center, performed the back-to-back operations.


Reza performed the donor surgery laparoscopically, a minimally invasive procedure WHC introduced to DC 14 years ago. (Joseph Africa, with the help of Alejandro Aquino, performed the recipients' transplants.) Also unique: Reza removed the right side kidneys, a more difficult task. He tells us this year he hopes to merge their donor database with local hospitals to increase the likelihood of finding live donors for patients on chronic dialysis, cutting the four to six year wait to find a deceased donor.  He added "when it comes to recipient survival and quality of life, living donor kidneys are far superior to deceased donor kidneys. (We're not medical experts at Bisnow, but we would favor deceased donors, who'd be less likely to call in a favor.)

Medical writer Curtis Raye is ambinephrous, meaning he's donated both kidneys with equal success. Send story ideas, and an ambulance, to Curtis@bisnow.com.

Arent Fox
Cardinal Bank
Pecha Kucha
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