Insomnia!!!

Standard

teddy-is-sleeping-vector-583552Hi, it’s Dr. Louella again. Would you imagine that after that talk about the basics of health I haven’t yet gotten enough sleep? While people looked forward to this, another long weekend in Trinidad, I didn’t. I knew that preparing for the Indian dance on Friday would take all day. Today I’m opening my office and then am part of a community-based clinic. I must attend a wake tonight then church tomorrow and event planning after. Breathe doc!

But there was a time, not so very long ago, that I wanted this very sleep but could not get it. I experienced insomnia for the first time in my life the end of 2013 into 2014. Now I know this is common among patients, but when you yourself suffer with something you sit up.

And my doc tried everything. He was a psychiatrist so I trusted his judgment and tried very much not to practice self-medicating. But I knew the medical options were limited.

First he thought the air-conditioning in my bedroom was too cold. If you research it you will see that environmental factors have a lot to do with sleep. You need a dark room. They advise you turn off your TV, computer, cell phone, anything with a lighted screen, about an hour before going to bed.

They repeatedly say the bed is only for sleep and sex. But we are all guilty of lazing around, reading, talking, using the computer, watching TV etc. on our beds.

Then what about the noise factor? Our bedrooms should be quiet except for some soothing or isochronic music (did not work for me though; isochronic tones got me tense).

Now these things never mattered to me before. I used my computer, watched TV and chat on my bed. Then next moment I was asleep. It is when you begin to have problems that you need to start examining your environment.

Is your partner’s snoring affecting you. Let him visit an ENT doctor or research solutions on the net. Maybe it’s frequent awakenings from a crying child. Can no one babysit for a couple of nights for you to get back your rhythm? At the other extreme we have the elderly who may need mild sedation at night to prevent them from disturbing the household.

I turned off my air condition and used the fan and still couldn’t sleep on my own. Then I admitted to my doctor my frequent trips to the bathroom. That obviously disturbed my sleep. He wanted me to do less water guzzling (or as they say abstain from fluids for an hour or two before bedtime). When I said it was small amounts of urine he said I needed to learn to hold it, to retrain my bladder.

Good advice. But it didn’t work. I still awoke frequently and couldn’t get back to sleep. This is when I started doing my own research as to what else was out there. I had been using melatonin, which is supposed to be a natural sleep aid, but it just wasn’t kicking in.

I focused on trying to get myself to relax prior to bed. Against my will I had a warm cup of milk, I did not exercise too close to bedtime, I tried mild meditation, and progressive relaxation. As I said, the isochronic tones were not for me but my radio chimed love music throughout the night.

I tried to have a routine time to go to bed and to wake up. I saw where it was said that you ought to limit daytime naps to 30 min and then not after 3 pm. Now, mind you, I have no qualms in telling this to my patients. Because that’s what ‘they say’. But to me it was a bunch of hogwash since I have been taking afternoon naps for years and sleeping perfectly.

In this present scenario, when I missed a nap I slept no better at night. At least if I could get an hour or two under my belt during the day I would feel better.

Of course I know someone who sleeps a lot during the day may having difficulty sleeping at night. I didn’t sleep all day. And the elderly with little physical activity or who sleep all day, may be also unable to sleep at night.

Another rule that I broke is where they say if you haven’t fallen asleep after half hour, get out the bed. Go do something. When you’re sleepy again come back. Sounds good. But when I’m battling with my bed to sleep I’m down for the long-haul. (Maybe that’s why I usually lost the battle).

I feel for my patients a lot more in this area of insomnia after having been through this myself. It was terrible!!! You “awake” on mornings totally unrested, eyes heavy and burning, head groggy. And of course you have to go to work that day.

I only got a good night’s rest when I used the benzodiazepines (e.g. Valium, Ativan) my doctor prescribed. He kept trying to reset my clock with them and started and stopped them. He was particularly concerned about not aggravating another condition I have, that is triggered by lack of sleep.

But we all know benzodiazepines are addictive. You simply cannot take them for long. By now I thought I had figured out what caused my insomnia…anxiety. I never realized anxiety could cause such horrible insomnia. I was getting insights for my patients all the time. But I couldn’t shake the anxiety.

I had always thought that patients often had trouble sleeping because of their thoughts at night. But I had no self-defeating thoughts at night (except “I can’t sleep; I’m gonna die”). I learnt that it was also the daytime thoughts, fears, worries, ruminations that play on our subconscious and prevent us from sleeping at night.

My doctor next prescribed antipsychotics. I went along with it because things were not improving. Within three days I had horrible side effects so I stopped. I realized I had reached the end of the line. This anxiety thing had to stop. I willed my mind to be calm and trust in the Lord I believe in.

In two days, I was sleeping naturally again. It had to happen. I came from a history of beautiful sleep and I was not now going to be condemned to a life of insomnia.

I’ve been sleeping well since, making it two and a half months. I’m still working on the anxiety and have insights to share on this.

I know that a lot, a lot of people have problems to sleep. Please try some of these methods I mentioned above, I can always clarify, and above all, be anxious for nothing (KJV).

Dr. Louella. Over and out!

The Very Basic Rules of Health

Standard

474657739Hi folks. Dr. Louella here. Did you miss me? I wasn’t feeling too well these past couple days. Took two days off work. When I was younger, people, usually the younger ones, would say, “You’re a doctor and you’re sick!” and look in amazement. I would simply explain to them that we are human beings like everyone else and the same imperfect medicine we apply to them applies to us too.

But it’s worse when you’re a doctor. I recently read an article from the UK which expressed the same things I experience. You’re both doctor and patient, there’s no one to turn to, you’re not objective when it comes to yourself, you shun any unpleasant treatment.

So why was I not well? It comes from breaking the basic rules of health, as I am going to discuss with you, and indeed I have discussed with many of my patients. Let’s put aside all the fancy medicine for a moment, all the gadgets and the tests, the antibiotics, the vitamins and the painkillers.

The basic rules of health are to eat well, drink plenty water, sleep well, be active, exercise and don’t be stressed.

So which one did I break? … not enough rest. I am frequently guilty of that. Caused me to faint at a bank. Also think I strained my abdominal muscles lifting some very heavy books. I’m still in pain.

Now, do not take these basic rules lightly. Many people come to me run down saying they think they need some vitamins. Now, vitamins are still controversial but there’s no harm in taking them because we do have deficiencies in our diet that we are not aware about. But vitamins ain’t food! We can last a lifetime on food alone but certainly not on vitamins alone.

Are you having three square meals a day? Basic. No, you miss breakfast because you can’t eat that early in the morning or more likely because there is no time. Well have a juice or a fruit or a cup of milk, something. Pack up breakfast and take it with you to the office. You miss lunch because you’re too busy or dinner because you’re trying to lose weight or it isn’t convenient. No wonder so many of us have stomach problems or experience lack of energy.

I’m sure I explained already that to lose weight you eat small amounts more frequently. You don’t miss meals. Our meals also need to be balanced with sufficient veges, peas and beans and fibre and less of the rice, flour, meat and sweets.

Do you drink sufficient water? Many people don’t. 6-8 glasses a day is a rough estimate. You may require more but not much less. Many people do not like to or do not make the time to drink enough water but our bodies are made up mainly of water and all systems need it to function efficiently.

What about sleep? That’s my Achilles’ heel. I literally started to feel that there weren’t enough hours in the day to get a proper rest, 7-9 hours, and do everything I wanted to do.

But that’s the quickest way for your body to be run down, for you to be less alert, less focused. You make more mistakes without a good night’s sleep, have more memory lapses and are more irritable. It also feeds both anxiety and depression. We need to plan our days so that we get the essential sleep.

You don’t need a doctor to tell you to eat right and sleep right. You need to know the importance for yourself. There is no medication that can replace these things. As I say, basic.

Being active. Many of us lead sedentary lifestyles. A family doctor may sit at a desk for hours with little breaks in between. The office worker, the computer geek, often does the same. The little old lady will sit on the comfy chair all day. The housewife may whip up her chores early in the morning then relax all day. These are common but unfortunately unhealthy scenarios. We must keep moving throughout the day. Obesity is so rampant because we do not do this.

Exercise is something you need to add to that active lifestyle. It increases your heart rate, breathing and the energy you expend. But we don’t like to exercise!!! It takes up our time, and certainly takes effort. It even hurts sometimes. The exercise buff is the exception rather than the rule. But we all know we need to exercise. It’s no secret. Exercise has a long lists of benefits. You lack energy? …Well exercise.

Lastly, let’s talk about stress baby. It is a relatively new buzz term isn’t it? But it’s so real. It incorporates worry, anxieties, fears, depression, all sorts of negative emotions we allow to play on our minds and disturb our psyche. Stress is not the situation or person that is affecting you, but your response to them. Two persons can have completely different responses in identical situations. If we are stressed we cannot function properly.

We often blame others for our problems. But if we do that, we can never solve them because we cannot change the other person. We need to change our attitude to acceptance and move on.

We cannot be dwelling on our past. Those monsters can only hurt us if we bring them into the present. And worrying about the future does not help either. I tell that to clients who insist on worrying about their children and grandchildren as a duty.

We often find inadequacies in ourselves. But we should not dwell on these. Sure, we all have faults, but there are so many wonderful things in each of us that we can be grateful for and focus on instead.

I ask my patients, when last did you have a vacation, or a break? Do you have any me time, especially those wives and mothers. I’ve come across miserable housewives caring for husbands, children, parents and/or in-laws with no time for themselves and feeling unappreciated by those they care for.

For me, I know, I need a time everyday to feel like I am me. Not a doctor, daughter, sister, friend, just me. Just to exist for a few moments. Nothing to rush and do next.

So, please people. These tips I am giving here are worth thousands. Take care of yourself. Do what is necessary. Avoid unnecessary doctor visits. He cannot do for you what you ought to do for yourself. Eat right, sleep well, a little exercise wouldn’t kill, in fact it prolongs lives. And deal with the stressors.

And if you do break these rules know that you will suffer and who will put humpty dumpty back together again? …  Take care. Dr. Louella.