Shift-Work Sleep Disorder is a condition which normally affects people who find themselves having to work during times that are more normally used for sleeping so-calledd ‘graveyard shifts’). In addition to having increased grogginess and insomnia, those who experience SWSD also have difficulty falling asleep during the times they have set aside to sleep during, despite making the environment very sleep friendly.
Shortness of breath or “Dyspnea” is, as the name implies, the feeling associated with having difficulty breathing or not being able to catch one’s breath. Shortness of breath is very often associated with diseases like Asthma as well as COPD and should not be taken lightly especially when a patient suffers from Shortness of breath chronically.
Chest pain is a symptom often associated with some of the most serious of conditions such as heart attack or stroke. However, it can also be indicative of many pulmonary and respiratory problems. If the origin of the chest pain is ruled to be non-cardiac, and thus not life threatening, it can many times be attributed to pneumonia, bronchitis, asthma, or a number of other respiratory diseases.
More commonly known as simply “coughing up blood” hemoptysis is a condition often indicative of some sort of infection of damage to the lungs. This condition can range from blood spatter being expelled while coughing to blood laced mucus bring expelled while coughing. However, in the case where blood laced mucus is being expelled from the body, Hemoptysis can sometimes be misidentified as a lung problem when it is, in fact, a sinus problem/infection which has caused said blood laced mucus to drip into the throat causing irritation and cough.
Apnea, simply put, is the cessation of movement in the muscles that expand and deflate the lungs. Apnea can be induced in a number of ways including chemically (through anesthetics), mechanically (through choking), and psychologically as is the case when crying or laughing for extended periods. It is most commonly known for its use in the condition “Sleep Apnea” where the patient, though asleep, suffers bouts of 20-30 minute periods where the time between breaths can be delayed as long as 30 to 60 seconds.
A nodule is described as a mass with a diameter of less than 3 cm which is surrounded by healthy functioning lung tissue. These nodules are most commonly forms of benign cancers which can either be removed or monitored relatively safely. However, around 10-20% of these nodules go on to be identified as malignant cancer. The percent increases for the elderly, overweight, and smokers.
The effects of snoring can have ramifications that go far beyond the simple disturbing of a partner at night. There are a number of causes for snoring to happen including the relaxation of the neck muscles during sleep and the miss positioning of the jaw and associated muscles during sleep. The resulting partial blockage of the airway in the throat can sometimes be the first indication of what may eventually become a more serious sleep apnea. The less successful intake of oxygen also causes a less restful sleep as well as drowsiness and irritability upon waking up.
Dr. Millstone has been a practitioner of Medicine in North Florida since 1982. He specializes in Pulmonary and Critical Care medicine. He is also an avid equestrian who enjoys a good history book when he finds some down time. Some of Dr. Millstone’s achievements include:
Dr. Rothstein has been a part of the Pulmonary and Critical Care Associates (PACCA) since 1987. Dr. Rothstein is a nationally known educator for his CME presentations on Sleep and Wake Disorders as well as innovations in Pulmonary Care. Additionally, Dr. Rothstein strives to maintain an active lifestyle and enjoys skiing and other extreme sports. Some of Dr. Rothstein’s achievements include:
Dr. McCoskey has been practicing Pulmonary Medicine and Critical Care since 1999. Previous to that he was engaged in being an emergency physician and an internist. Dr. McCoskey enjoys a good game of golf and taking rides in his convertible (with the top down, of course). He also has some experience in academia where he served as an Associate Professor of Pulmonary and Critical Care at East Tennessee State University. Some of Dr. McCoskey’s achievements in medicine include:
Dr. Laos’ journey of medicine started as far back as 1986 in Lima, Peru when he graduated from Medical School from Cayetano Heredia University. His first job stateside was in Miami at the famous Cedars Medical Center where he worked in General and Vascular Surgery. From there he moved to work in Gainesville as an Asst. Professor in the Department of Medicine for UF; eventually finding his way to Jacksonville where he now works full-time as a physician for PACCA. Some of Dr. Laos’ achievements include:
Dr. Venegas graduated from the Universidad del Norte Medical School in Columbia. She went on to complete her residency Stateside at the Montefiore Medical Center in New York. She specializes in Medical, Surgical, and Neuro-Surgical Intensive Care while also dedicating a great deal of time to training critical care staff herself (upwards of 300 hours per year). Other areas of interest for the doctor include preparations for disaster management. Some of her other Achievements include:
Dr. Chen’s extensive career and education began in 1985 at Pennsylvania State University. After graduating with a Pre-medicine degree there, she spent the next decade achieving more medical and academic accolades in places such as Temple University School of Medicine, University of Pittsburg Medical Center, and Case Western Reserve University Hospital. The latter of which she served as Chief fellow in Pulmonary and Critical care medicine. Dr. Chen is Certified by the American Board of Internal Medicine for both Pulmonary and Critical care medicine. She is almost a member of such prestigious Organizations as the American Thoracic Society and the American College of Chest Physicians. With Dr. Chen’s previous experience with Big Brothers/Big Sister Mentoring program, she is uniquely understanding in the importance of maintaining both individual patient, as well as community based relationships to continue improving the repertory health of all whom she treats.
Kate has worked everywhere from Jacksonville to California to Virginia. She is most well-versed in Pulmonary, Critical Care and Sleep Medicine. Kate is also a certified Sleep Educator who has developed basic sleep treatments as well as nutrition plans based on her research of metabolism to help those who suffer from Sleep Apnea. In 2010, keeping with her desire to remain active in her lifestyle, Kate completed the famous Gate River Run in Downtown Jacksonville. Some of Kate’s Achievements are:
After Graduating Magna Cum Laude from UF, Scott served as a Navy Lieutenant from 1994 until 1999 where he worked as a Physician’s Assistant in the Medical Service Corps on the USS John F. Kennedy out of Mayport here in Jacksonville. Since then he has dedicated the whole of his professional career to helping better the Jacksonville medical community. His work has taken him from the Navy to Shands, to St. Vincent’s until finally landing him at present with PACCA as a Physician Assistant. Some of his notable accomplishments are:
Jennifer is a self-described “motivated, results oriented medical professional…[with] the ability to be flexible, assertive, and adaptable.” Confidence such as this comes from having 10+ years in a hospital setting and over 600 hours of clinical rotation. As an RN, Jennifer has specialized in Women’s health, pediatrics, emergency medicine, and gastroenterology. Her career as an RN began in Annapolis, MD at Anne Arundel Medical Center. She later moved to Chesapeake, VA to continue her career before settling in Orange Park, FL as an ARNP for PACCA. She discovered her niche with PACCA in inpatient/outpatient evaluation and specializing in the detection of lung cancer. Some of her Achievements include:
Phil’s medical career began in 1993 as a Clinical Instructor at FSCJ (formerly FCCJ). From there he moved onto the Kindred Hospital where he managed the Respiatory Therapy Department and was involved in Quality Improvement programs. His dedication to the betterment of North Florida medicine continued through his work at the Orange Park Medical Center before eventually landing him with PACCA where he performs cardiopulmonary diagnostics and non-invasive Doppler diagnoses. His achievements include:
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