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Dr. Bob is Robert Hsiung, MD,
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Posted by Greg on November 15, 2000, at 7:43:59
OK,
I'm in my third week of having laryngitis, still recovering from knee surgery, busier at work than I've been in ages working 12 hours on the job and usually another 2-4 at home, and I'm experiencing fatigue that is very reminiscent of when I was first diagnosed with depression. I take a multi-vitamin and additional B-6 every day. My first cup of coffee in the morning gives me a little jump start but any additional cups just make me sick to my stomach. It doesn't matter whether I sleep 4 hours or 14, I still wake up exhausted. All my free time is spent vegging on the couch unless I force myself to be active (yeah, right).
I'm desperate for ideas. Has anyone had any success combating this type of fatigue? Any thoughts, ideas, grandmotherly remedies, etc would be appreciated.
Greg
Posted by coral on November 15, 2000, at 8:21:43
In reply to The Fatigue Factor, posted by Greg on November 15, 2000, at 7:43:59
Dear Greg,
"All my free time"??? Working 12-16 hours a day? WHAT free time???
First thought is that you take some time to rest - like staying home and doing nothing but sleeping - I don't know what your job requirements are so I don't know if that's even a possibility.
Knee surgery is a major assault on the body, not only in terms of mobility, but healing. If you're walking and using the knee, healing's going to take even longer. It's not like a broken arm that can be stabilized and immobilized in a cast.
Re the laryngitis, have you seen your doctor? Is it possible you're also battling an infection? If so, that's a 24-hour-a-day battle, even when you're sleeping.
Not to get all "metaphysical" on you, but have you considered the cause of the laryngitis? Something you said that you regret? Something you're not saying but want to say?
Couple all of this with depression which is incredibly exhausting (I know that seems like an oxymoron, but not to someone who's experienced it), and you may be receiving warning signs that it's time to stop and regroup. Personally, it sounds like there's a slow, chronic leak of your psychic energy.
I've found that Centrum's "energy" formula has been very helpful in helping me regain my stride.
Eastern medicine believes that food is medicine and our bodies know what we need. Are you experiencing any cravings? How's your protein intake?
These are just random thoughts that may apply or not.
Good luck...Coral
Posted by Greg on November 15, 2000, at 9:01:26
In reply to Re: The Fatigue Factor, posted by coral on November 15, 2000, at 8:21:43
CPE,
My free time is generally my weekends, I try to catch up on my sleep then. During the week I usually average about 6 hours a night which I've been told that for my age is a decent amount. Right now my job is only going to get more demanding so taking time off is not an option.
I do have to do a lot of walking, but my doc has encouraged that along with riding stationary and mobile bikes. It just seems like the swelling is still pretty severe after 4 weeks and I'm a little concerned.
I have seem my family doc about the laryngitis and he says that because of the nature of that type of virus, there is little that can be done about it. He gave me an inhaler to help reduce the swelling of the vocal chords and has me drinking lots of cold liquids. My voice is almost back to normal (much to the dismay of those around me :^)). Hopefully I'll be past it in the next few days. I often say things I regret due mostly to the fact that I rarely don't speak what's on my mind... Betcha hadn't noticed that before huh? My meds are working well and I don't feel like my Bipolar or depression are out of control, but you're probably right, maybe I need to step back and re-evaluate. Maybe designating some of my workload to others would be helpful?
I will definitely give the Centrum a try, you are the third person to recommend it to me. I take a GNC multi-vitamin now. I'm not experiencing any cravings, if anything, I don't have much of an appetite at all. I am forcing myself to eat and trying to make sure that I'm eating healthy.
Thanks Coral for taking the time to respond, you have definitely given me things to think about. I will let you know how it goes. You are a good friend.
One last random thought... Could this be my inherently Lumptonian tendancies surfacing?
Greg SDS
> Dear Greg,
>
> "All my free time"??? Working 12-16 hours a day? WHAT free time???
>
> First thought is that you take some time to rest - like staying home and doing nothing but sleeping - I don't know what your job requirements are so I don't know if that's even a possibility.
>
> Knee surgery is a major assault on the body, not only in terms of mobility, but healing. If you're walking and using the knee, healing's going to take even longer. It's not like a broken arm that can be stabilized and immobilized in a cast.
> Re the laryngitis, have you seen your doctor? Is it possible you're also battling an infection? If so, that's a 24-hour-a-day battle, even when you're sleeping.
> Not to get all "metaphysical" on you, but have you considered the cause of the laryngitis? Something you said that you regret? Something you're not saying but want to say?
> Couple all of this with depression which is incredibly exhausting (I know that seems like an oxymoron, but not to someone who's experienced it), and you may be receiving warning signs that it's time to stop and regroup. Personally, it sounds like there's a slow, chronic leak of your psychic energy.
> I've found that Centrum's "energy" formula has been very helpful in helping me regain my stride.
> Eastern medicine believes that food is medicine and our bodies know what we need. Are you experiencing any cravings? How's your protein intake?
> These are just random thoughts that may apply or not.
> Good luck...
>
> Coral
Posted by coral on November 15, 2000, at 9:11:55
In reply to Re: The Fatigue Factor » coral, posted by Greg on November 15, 2000, at 9:01:26
Dear Greg,
But, of course, these are inherent Lumptonian characteristics but only HALF the story!!!! One of the true intents of Lumptonia is ease of existence (while battling cellar demons, the black "iffy's", doubt ghosts, shadow monsters, and psychic energy thieves.)
Now, as far as getting the right amount of sleep for someone of your age, does that statement hold true for someone of your age battling laryngitis, recovering from knee surgery, depression and bi-polar? Just a question < VEG >
CPE
Posted by Noa on November 15, 2000, at 9:17:50
In reply to Re: The Fatigue Factor, posted by coral on November 15, 2000, at 9:11:55
Perhaps your laryngitis, swollen tissues in the throat, are disturbing your normal sleep architecture--ie, you might think you are sleeping all 6 of those hours, but maybe you are not sleeping continuously, or having micro-awakenings, etc.
Posted by Greg on November 15, 2000, at 9:27:00
In reply to Re: The Fatigue Factor, posted by Noa on November 15, 2000, at 9:17:50
Noa,
I feel like I'm sleeping normally, but the one thing different is that I'm dreaming lately. I usually don't dream with the Ambien. And I'm talking, shall we say, weird dreams? Nothing scary or terrifying, just vividly bizarre stuff.
Greg
> Perhaps your laryngitis, swollen tissues in the throat, are disturbing your normal sleep architecture--ie, you might think you are sleeping all 6 of those hours, but maybe you are not sleeping continuously, or having micro-awakenings, etc.
Posted by Ted on November 15, 2000, at 10:25:38
In reply to Re: The Fatigue Factor » Noa, posted by Greg on November 15, 2000, at 9:27:00
Greg,
Laryngitis is usually caused by the common cold. The remedy is *lots* of sleep (on a regular schedule -- not weekend catch-ups), rest, and relaxation. As for the depression, stress reduction is probably number one.
You know the drill -- you have to watch out for yourself because no one else will. Tell your employer that you are ill and not getting better and that you *need* a rest and are cutting your hours back to 8 per day MAX, maybe less depending on how you feel.
I have had to do this in the past, and my managers have always grumbled; but when I recovered, they were happy to see my productivity rise.
>I usually don't dream with the Ambien. And I'm
>talking, shall we say, weird dreams? Nothing
>scary or terrifying, just vividly bizarre stuff.Funny -- When I was in the depths of my depressions, I would cease dreaming (and my quality of sleep worsened). It wasn't until meds, including ambien, that I started sleeping properly again and my dreams returned. I too have vivid dreams, and I can usually remember them well when I wake up now. As for bizarre, I don't think mine are any more bizarre than "normal", and I doubt yours are either; dreams are normally bizarre. :-)
Take care of yourself!
Ted
Posted by shar on November 15, 2000, at 12:29:33
In reply to Re: The Fatigue Factor » Noa, posted by Greg on November 15, 2000, at 9:27:00
Greg,
I quit ambien on about the third day of use because I had such weird, bizarre, and vivid dreams. I would wake up feeling really shaky and unsafe.I'm with Coral on the psychic energy drain. For example, when I went through parts of my divorce, the only surface disruption was a few appts. during the day with my lawyer. Otherwise my life looked pretty much the same. But the psychic drain was huge. I slept a LOT, had a harder time concentrating, was emotionally distraught and very stressed (and remember, good things can cause stress too). Distress and eustress, bad and good stress.
So, this success on the job could actually be causing your body to react the same way it would if you were in a negative stress situation (having a death in the family, moving to a new state, major types of disruption). So you have to treat yourself really well--even in terms of soothing yourself, pampering yourself--to feel a little stronger.
BTW, I have had the exhaustion thing go on. I would sleep in my car over my lunch hour.
Remember to eat, breathe, stretch, look at your surroundings, delegate stuff (I know that's hard, it is for me too), listen to your fav relaxing or soothing music. Etc.
Hope you feel more energetic--
xoxo
Shar
> Noa,
>
> I feel like I'm sleeping normally, but the one thing different is that I'm dreaming lately. I usually don't dream with the Ambien. And I'm talking, shall we say, weird dreams? Nothing scary or terrifying, just vividly bizarre stuff.
>
> Greg
>
> > Perhaps your laryngitis, swollen tissues in the throat, are disturbing your normal sleep architecture--ie, you might think you are sleeping all 6 of those hours, but maybe you are not sleeping continuously, or having micro-awakenings, etc.
Posted by medlib on November 15, 2000, at 13:16:11
In reply to The Fatigue Factor, posted by Greg on November 15, 2000, at 7:43:59
Greg--
Congratulations! You are clearly clinically normal. If you were NOT exhausted by the situation you described, you would be obviously manic. I only wish my fatigue were so honestly earned. BTW, it does sound like delegating may be absolutely essential to your mental and physical health.
RE: knee swelling
Have you checked in with your orthopod? It is not uncommon for significant swelling to last 2+ months post surgery; unless skin over the operated joint is consistently warmer than the other knee, or pain or swelling increases unreasonably, it's probably WNL. (Exercising the joint will increase both, temporarily; but it is important in the prevention of adhesions--internal scarring.) Also, that knee may remain slightly larger, even when completely healed.RE: sleep
Extreme fatigue may be your body's way of telling you that you need more than 6 hours sleep/night to heal while coping with a horrendous workload. (Contrary to popular opinion, you can't "catch up" on sleep. Extra weekend sleep merely disrupts your circadian rhythm, which can increase fatigue.) Ambien is very short-acting; I can't sleep more than 6 hours on it, either. You might want to try one of the longer-acting sleep aids for the duration (though you may need to program in a little extra wake-up time).RE: recovery
I don't want to go all Linus Pauling on you, but both wound healing and infection fighting require extra Vit C. Since you are quite rightly drinking extra fluids, and since Vits B & C are water-soluble, it would be helpful to spread intake of these extra vitamins throughout the day. Viral infections often reduce appetite; if you don't have time or inclination for lunch, an ice-cold protein drink plus StressTab should help. Take another STab with dinner. (However, if you exceed l000 mgs. Vit C daily, you may have a problem with diarrhea.)WARNING: Here follows the grandmotherly-type admonition which always accompanies chicken soup (a good source of Vit C) and other such remedies. (Feel free to disregard.)
You may be too young to remember Jimmy Carter; but, (IMHO) he is a highly intelligent man who was a lousy president, largely because he could not transcend his engineering-based inclination to do everything himself. Go ye and do differently.Now, if this excess of pedantic advice hasn't put you to sleep, you're probably at least a little annoyed. Do you know the reason that the tired are easily ticked off? Irritation is energizing--clears out the fuzzies, raises the heart rate and upsets the stomach just as well as caffeine! Awake and alert yet?
Well wishes---
medlib, aged but not yet venerable
Posted by NikkiT2 on November 15, 2000, at 16:16:19
In reply to Re: The Fatigue Factor, posted by medlib on November 15, 2000, at 13:16:11
Aw babes...
The dreams themselves can be very tiring. I dream, and always have, very heavily, and very realistically. I wake up exhausted some mornings. I guess it's a family thing, cos my dad was the same!!
But, you definately need to slow down. Alot! You gotta learn to delegate - if not I'll be on the next plane over and taake some of the work off you myself!!
Please, I care alot, and I need you to slow down. If you don't, you'll end up crashing again. You've made such progress recently (OK, the throat and knee aside) and it;s so damned good to see. I really, really don't want to see that happen.
So, if you won't do it for anyone else, please do it for me. eh?OK. I've become all mumsy and silly (and have a sticky l button - rice under it probably!). But I care alot, and you're running yourself ragged.
And about those bubbe baths we've discussed in the past - take some time out and have - say - one week or something...
OK. Hope I've bullied you enough ~grins and winks~
Nikki
xx
Posted by Greg on November 15, 2000, at 17:36:36
In reply to Re: The Fatigue Factor---Greg, posted by shar on November 15, 2000, at 12:29:33
I talked to my boss today about my fatigue today and her response was "Why did it take you so long to tell me about this?" I sometimes forget how understanding and caring she can be. I am going to delegate some of my workload so that I can work fewer hours. I'm also going to work from home a couple days a week so if I need to take a break and relax I can do so. This should also help me get some extra sleep during the week as well. I stopped and picked up the Centrum on my way home and plan on just taking the evening off tonight and just lump it. A nice hot bath sounds good too. Maybe I can finish that Tom Clancy book......
One other thing...I've been a little stuffed up the last two days and took a couple of Tylenol sinus pills about 11am today. About thirty minutes later I got this burst of energy and started feeling better. Anyone have a thought as to why a sinus med would make me feel less fatigued?
Anyway gang, thanks for all the feedback, suggestions and concern. You guys really are the best!
Greg
Posted by S. Howard on November 15, 2000, at 18:00:54
In reply to Delegate, Relax, Sleep, Lather, Rinse, Repeat, posted by Greg on November 15, 2000, at 17:36:36
Sinus meds are usually stuffed with phenylpropanolamine (whew!) if I remember right, that's close to the same stuff they use for diet pills.
Posted by S. Howard on November 15, 2000, at 18:04:38
In reply to Delegate, Relax, Sleep, Lather, Rinse, Repeat, posted by Greg on November 15, 2000, at 17:36:36
Oh I forgot to say, congratulations on cutting down your work hours. You may not be depressed at all! You might just need sleep!
-Gracie
Posted by Racer on November 15, 2000, at 20:09:40
In reply to The Fatigue Factor, posted by Greg on November 15, 2000, at 7:43:59
Hey, Buster Brown, forgive me for getting into this late, but here goes:
Did you read recently that sleep deprivation is linked to all sorts of bad things, including diabetes and heart problems? Also, as another who gets an upset stomach from coffee, try switching to a good decaf after the first cup. There's still enough caffeine in it to keep you awake, but it won't bother your stomach so much.
For your body in general, I recommend Chamomile tea. I'm the least nuts&granola type you'll ever find, but it really does help soothe me and help me relax and sleep. It's also great for sore throats, so it's likely to help you, too. My homemade remedy for everything, though, is this: boiling water, lemon juice, honey, nutmeg and a shot of brandy. The hot water relaxes muscles and loosens congestion. The lemon cuts through the congestion. The honey helps draw the congestion and acts as a mild anti-microbial. The nutmeg helps respiration. The brandy helps relax muscles so that all this can work.
Either that, or it tastes good and puts me to sleep!
If the Centrum doesn't help, Costco has a nice energy mix, which I take daily. Talk to your orthopedist about Chondroitin and Glucosamine sulfates. They're the newest thing for humans, Pain Free being one brand. Of course, they've been used for years and years for horses and dogs. I tell you, the horses benefit a huge amount.
Feel better, Buddy, and here's a smile for you.
Posted by Rach on November 15, 2000, at 20:40:36
In reply to Sinus meds, posted by S. Howard on November 15, 2000, at 18:00:54
I have recently found that my all day exhaustion is a little known (to me, anyway) but major symptom of hay fever.
One ingredient in sinus meds (maybe psuedoephidrin - ignore spelling, phoenetically: su-e-do-ef-a-drin) is banned in Olympics because it is a 'pepper upper'. Here (unsure about USA), Sudafed is a common brand name that is readily available.
Also maybe try an antihistamine, to see if it may be allergy related. But make sure you find a non-drowsy version or you'll be worse off! The non-drowsy will also have some form of PU. Sometimes you can even find a combination of the sinus & hayfever meds. (Hayfever stuff here includes Telfast, Teldane, Clorivax...)
If you're really struggling through the day, instead of coffee maybe you need some regular coke? (The fizzy kind you drink)
How is your sleeping at night going?
I love you GregStar,
R
Posted by stjames on November 15, 2000, at 21:36:35
In reply to Sinus meds, posted by S. Howard on November 15, 2000, at 18:00:54
>
> Sinus meds are usually stuffed with phenylpropanolamine (whew!) if I remember right, that's close to the same stuff they use for diet pills.James here....
It is easy to call it PPA, and it has just recently been shown to be associated with heart problems. Many stores are pulling the OTC meds that have PPA.
James
Posted by Shell on November 16, 2000, at 22:03:06
In reply to Re: Sinus meds, posted by stjames on November 15, 2000, at 21:36:35
> James here....
>
> It is easy to call it PPA, and it has just recently been shown to be associated with heart problems. Many stores are pulling the OTC meds that have PPA.
>
> JamesI just noticed yesterday that my pharmacy had nothing that contained PPA. There was a lot of empty space in the cough and cold section.
By the way, I would guess that pseudoephedrine (active ingredient in Sudafed) got its name because of its structural similarity to ephedrine. It is known to stimulate the CNS, and increases the quantity of norepinephrine in adrenergic nerve tissue (and can interact negatively with MAOIs). Perhaps that is why some people notice feeling a little more energetic after taking it. It also can decrease appetite. Unfortunately, I take it regularly and have never noticed either effect....such is life.
Shell
Posted by Noa on November 17, 2000, at 7:29:06
In reply to Re: Sinus meds, posted by Shell on November 16, 2000, at 22:03:06
Pseudoephedrine can hype you up a bit.
I noticed my drugstore had a sign saying they don't carry meds with PPA anymore.
Greg, where did you get the idea that 6 hours of sleep is sufficient????? It obviously is not enough!
Posted by Greg on November 17, 2000, at 8:16:05
In reply to Re: Sinus meds, posted by Noa on November 17, 2000, at 7:29:06
> Pseudoephedrine can hype you up a bit.
Is this a standard drug in most or all sinus meds?
>
> Greg, where did you get the idea that 6 hours of sleep is sufficient????? It obviously is not enough!I've been told that as you get older you require less sleep. Until recently, 6 hours always seemed to be enough to get by on.
Posted by Noa on November 17, 2000, at 9:19:43
In reply to Re: Sinus meds, posted by Greg on November 17, 2000, at 8:16:05
> Is this a standard drug in most or all sinus meds?
I think it is standard in decongestants. I don't know about sinus meds.
> I've been told that as you get older you require less sleep. Until recently, 6 hours always seemed to be enough to get by on.
I have heard about needing less sleep, but I don't know if it is noticeable at the sames ages for everyone. I think you also have to take into account that you are healing -- trauma to the knee, as well as some sort of inflammation or infection even, in the throat.
Plus, didn't you recently start some new meds--they might add to your sleep requirement.Don't go by the charts--go by your body, right?
Posted by stjames on November 18, 2000, at 2:10:16
In reply to Re: Sinus meds, posted by Noa on November 17, 2000, at 9:19:43
Don't go by the charts--go by your body, right?
James here...
You need to feel rested when you wake up (or shortly thereafter)
Whatever it takes is normal for you. There are some limits, if 2-3 hrs is enough
or 12 is not enough something else is going on. Older people need less than people
0-25, that is true. I don't feel there is a big difference between
middle age on. It is also highly individual. I do fine on 7 but best on 8 hrs.
I'm in the bad habit of getting less on weekdays and sleeping too much on weekends.
Being well rested makie a huge difference in mood. I did not start getting good sleep
till I started taking sedating AD's. For me they garrentee a good nights sleep, every nigh, with no
AM groggyness.James
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