Thursday, October 17, 2013

Restless Legs Keeping You Awake?

Do your legs ache, squirm, feel antsy and seem to want to MOVE to get comfortable when you try to go to sleep at night? How about during the day- do you need to get up and walk around to relieve that same irritating sensation in your legs when you are supposed to be sitting in a meeting or parking yourself in front of a computer? Does walking around or at least moving your legs relieve the discomfort? If so, you may be one of the estimated 3-15% of the population with a disorder known as restless leg syndrome (RLS).

This disorder can be a sign of underlying issues such as iron deficiency, pregnancy, kidney problems or  drug side effects, but also may be an isolated medical problem. About half of the time, there is a family history of other blood-relatives having the restless leg syndrome. The incidence increases with age, and is more common in Caucasians.

How is RLS diagnosed?
Restless leg syndrome is primarily diagnosed by your history, with focus on four issues:

  • Strong urge to move your legs
  • Symptoms worse at rest
  • Symptoms worse at night
  • Urge relieved by movement, but come back quickly with rest

Your doctor may need to do blood tests to determine if you have a low iron level (ferritin) and/or low red blood cell count (anemia), and occasionally a formal sleep study may be necessary to fully identify RLS.

How is RLS treated?
If there is an identified cause, such as a medication or iron deficiency, then the treatment obviously targets that trigger. Medications that are more likely to cause RLS include antihistamines and decongestants, antidepressants, anti-nausea medications, seizure medications and stimulants.

If no cause can be identified, then there are several different medications which your doctor may try.
For very intermittent symptoms, a drug traditionally used for Parkinson's disease (Sinemet) can be taken on an "as needed" basis. For people who suffer from symptoms the majority or every night, other neurologic medications (Requip, Mirapex, Neurontin, Lyrica, or Neupro) may be tried on a nightly basis.

What about alternative therapies? There's always SOAP...

BOTTOM LINE: If your squirming legs are keeping you from restful sleep, don't suffer in silence- talk to your doctor and find out if you have restless leg syndrome!

Wednesday, October 16, 2013

Can't Sleep? You're Not Alone...

One in ten American adults have suffer from insomnia (defined as inability to adequately sleep for at least fourteen consecutive nights). Whether it is trouble with falling asleep or difficulty staying asleep (waking up either multiple times or simply way too early), this lack of restorative sleep leads to more than simply daytime fatigue. Sleep deprivation causes trouble with concentration and memory, irritability and other mood disturbances, and actually can lead to higher rates of infection, diabetes, heart disease, and cancers. As such, I'm going to spend the next several blog entries talking about insomnia issues and solutions.

While some sleep disturbances (such as sleep apnea and restless legs) will definitely require medical interventions, the good news is that a great deal of sleep issues can be significantly improved or solved with some behavioral modifications. What can you do?

Sleep Hygiene Improvements:

  • Eliminate or greatly reduce caffeine- even morning coffee affects the quality of your nighttime sleep. (You can keep the coffee- but wean to decaf!)
  • Exercise in the morning (or at least a few HOURS before bedtime)
  • Avoid "screen time" in the two hours before bed- do your dishes/laundry/non-screen chores if necessary, read a book, play with your pets or enjoy the lost art of conversation
  • Take a warm shower or bath just before going to bed
  • Use ALL your senses to relax during that bath- smell, sight, sound (think lavender soaps, soft music or nature sounds, and candle light- there is a reason SPA's use all these!)
  • Go STRAIGHT to bed after the shower- don't get sidetracked by housework or electronics
  • Make your bedroom dark and cool (consider blackout shades and ceiling fans)
  • COVER THE CLOCK (no peeking at your phone or clock to watch the minutes tick by one after another!)
  • Until you are sleeping WELL again, move the pets OUT of the bedroom. 

BOTTOM LINE: If you suffer from insomnia, talk to your family doctor to try and identify the cause, and include these sleep hygiene tips along with any necessary medications to maximize your long-term success.

Tuesday, October 8, 2013

I Got Mine! Did You Get Yours?

As we zip into the holiday season, give yourself the GIFT of a flu vaccine NOW so you are not struck down with this illness at the busiest time of year! Flu shots have been available for a few weeks and seem to be available everywhere.  Clinics, schools, grocery stores, pharmacies and many employers are all offering flu shots these days. Add a flu shot to your grocery list- I'll bet the pharmacy there is stocked and you won't even have to add an extra stop on your weekly errands.

Who should get the flu vaccine?
The Center for Disease Control and Prevention (the CDC) recommends annual flu vaccines for everyone over the age of six months.

What is different this year?
This year, we have quadrivalent vaccines (that include protection against four strains- 2 influenza type  A strains, and 2 influenza type B strains) in addition to the usual trivalent vaccines. Pick one or the other, you don't need both. If you have egg allergies, make sure to ask for the trivalent vaccine that is egg-free.

But I hate problem, just ask for the vaccine that is delivered via a nasal spray! The only caveat here is that this is a live vaccine, so there are some restrictions: you must be age 2-49 years, not pregnant, have no major problems with immunity (such as having AIDS or cancer), not take aspirin daily, and not have asthma.

Hate needles and have asthma? There is also a trivalent shot that has a tiny needle which is injected just below your skin, rather than into the muscle.

What is FLU? Influenza is not a simple cold, nor is it a twenty four hour stomach virus. The flu causes fever, chills, cough, runny/stuffy nose, muscle aches, headaches, fatigue, and sometimes involves vomiting and diarrhea (more often in kids). Colds and allergies tend to bother you from the neck up- stuffy, sore throat, headache- but don't knock you down for the count, and coughs are generally less bothersome.

How is the FLU spread? This virus is spread from infected people when the cough, sneeze or talk, via tiny respiratory droplets, and the scary part is that you are contagious a full day BEFORE you develop symptoms (as well as for about a week after you feel sick.)

How can you prevent the FLU? Get vaccinated. Get vaccinated. Get vaccinated! 

Who should NOT get vaccinated? Those with bad reactions to vaccine in the past; infants younger than 6 months; and those people with a history of an uncommon disease called Guillain-Barre. If you are sick with a fever, wait till this illness is over before getting the vaccine.

BOTTOM LINE:  FLU SEASON has begun again- get vaccinated!

Thursday, October 3, 2013

It's BA-ACK! Halloween Candy

Despite the 90 degree days we are still having in Texas, the calendar tells me it is already OCTOBER. Of course, the grocery stores have been featuring HALLOWEEN CANDY for nearly a month already! Did you resist? Or are you tossing in a bag of bite-sized candy on impulse as you check out?

If so, it's high time to realize that we are now officially in what I call the "treat yourself" season, as we hit the trifecta of food oriented holidays: Halloween, Thanksgiving and Christmas/Hanukkah. We tend to celebrate with nonstop EATING, and then what do we do every January? That's right, make New Year's resolutions where LOSING WEIGHT tops the list!
This year, let's THINK AHEAD...

Let's SAVE THE HALLOWEEN CANDY for...yes, HALLOWEEN! Start in the grocery store. Do NOT BUY the candy till the DAY BEFORE Halloween. It's way easier not to eat it when it is still sitting on the shelf in the grocery store, rather than sitting on your desk at work or your kitchen counter top. We all grab a small handful of treats when they are openly displayed in front of us.

Do the calories add up? You bet. Here are some of my favorites: Snack Size Butterfinger: 170 kcal, Fun Size Kit Kat- 50 kcal, and ONE single, plain M&M-4 kcal. Now, if you stop at ONE, it's really no big deal. but if you eat a handful of M&Ms each DAY for the next few weeks, or grab a couple fun size chocolate treats, BOOM-you will gain a pound right there. (Remember one pound is 3600 kcal- do the math.)

BOTTOM LINE: Don't wait for NEW YEARS to make a resolution for better health- start NOW by limiting Halloween CANDY to HALLOWEEN DAY!

PS. It's a new month, so CHANGE THOSE AIR FILTERS!