September 2006
5 things you can do starting today to cure the nightmare of insomnia
That’s it! No more Mr. Nice Guy. With big drug companies selling so-called quick fixes and promising a good night’s sleep that only pills like Lunesta and Ambien can provide-while totally ignoring the horrible side effects-I can’t sit quiet any longer. (As you can tell, I’m fired up.)
It would be one thing if these pills actually fixed the problem, but they don’t. Not only do prescription sleeping pills not solve anything, but they’ve created a whole new line of troubles all their own. Things like finding crumbs and smears of peanut butter on your pillowcase in the morning (from the sleep-eating) and having no recollection of how they got there. Or waking up to sirens and flashing lights in your rearview mirror, when you don’t even remember how you got in the driver’s seat of your car.
Any company pushing drugs that could put you in situations like that is just plain irresponsible. And I can’t stand to see you put yourself at that kind of risk. Especially because, like I said, prescription sleeping pills don’t address the actual cause of the problem. And, most of the time, what’s causing the problem is you.
That’s right-I said it. When it comes to sleep, you are your own worst enemy. Because, even if you don’t mean to, your insomnia is almost always caused by your own bad habits. And a pill won’t help fix those problems. All they really do is turn you into an insomniac with a sleeping pill addiction.
In fact, when it comes to insomnia, I don’t even like recommending natural supplements like Valerian root or melatonin. Even those things come with a risk of dependency and a chance of making your problem worse.
So I’m not even going to bother telling you which drugs or supplements to take. Instead, (now that I’ve calmed down a bit), let’s focus on what you can actually do to stop tossing and turning and get the rest you need.
Energize yourself
You can start by skipping your afternoon nap. Sleeping too much in the late afternoon throws off your body’s clock. As a result, you might find it harder to sleep at night, or sleep until morning. If you absolutely must have a nap, keep it to 30 or 40 minutes in the late morning. Use the time you would have spent napping in the afternoon for some exercise.
I know I talk a lot about exercise’s health benefits, but it’s especially true when it comes to sleeping. Afternoon exercise relieves the stress that builds up throughtout the day. Also, the gentle mood lift that it causes often helps you go to bed worry-free. And worrying is a big cause of insomnia.
You do want to avoid heavy exercise after dinner, though. It revs up your body too much, making it harder to fall asleep. (If you have to exercise at night, keep it light and simple with an easy 30-to 60-minute walk after dinner. But overall, I say stick to afternoon exercise.)
Make your meals (especially dinner) sleep-friendly
If you struggle with insomnia it should go without saying that you need to keep a careful eye on your caffeine intake-but I’m saying it anyway because I’ve found that a lot of my patients think that just skipping their after-dinner cup of coffee is enough. And it’s not.
You need to stay away from caffeine after lunch, at the very least. But you’d be smarter to just cut it out completely.
Caffeine stimulates the production of the stress hormone epinephrine, which is great if you need a burst of energy and alertness. But it’s a bad idea if you need to sleep.
If you’ve got a long-standing coffee habit, taper down over the course of two weeks, cutting your intake by 25 percent every four days until you’re completely coffee-free. Or try replacing the caffeinated version with decaf a little bit at a time until you’ve completely made the switch. I promise, you’ll sleep better and feel better for it.
But it’s not just about your choice of beverages. What you eat-and when and how much-also plays a role in how well you sleep. We’ve all been conditioned to think of dinner as the biggest meal of the day-a time for the family to gather around the table and talk, over a heaping platter of meatloaf and mashed potatoes. But eating too much in the evening can lead to an ornery stomach that keeps you from a good night’s sleep.
Try making lunch your biggest meal of the day and keeping dinner pretty light. (There’s no rule that you can’t still use the time at the table to connect with your family just because you’re having tuna salad instead of spaghetti.)
Of course I’m not saying you should go to bed hungry. Cravings can keep you from falling asleep, and hunger pangs can wake you up at 3 am, both of which are counter-productive.
If you find you’re hungry in the evening, have a small snack. Bananas are a particularly good choice because they raise your levels of serotonin, a neurotransmitter associated with healthy sleep.
Make your bedroom a place for sleeping
Once you have your daily activities and meals taken care of, it’s time to look at what you can do to make your bedtime conducive to sleep. And the best place to start with that is in your bedroom.
First of all, you have to make your bedroom a place for sleeping and nothing else. It should be free of outside distractions.
That means getting rid of the television, the computer, and any bright lights. Take out the phone while you’re at it. (That means cell phones too.) No arguments. No rationalizing. If you want to sleep, you have to cut out all these devices that are distracting you from that, plain and simple.
This is also a good time to put some thought into your mattress.
There’s this myth out there that everybody needs an extra-firm mattress. That’s nonsense. The truth is that some of us benefit more from softer mattresses.
Hard mattresses can impede your circulation. Your body reacts to the discomfort by frequently changing positions, often causing a restless night’s sleep.
A good-quality pillowtop or Memory Foam mattress might be a good pick. Of course, not everyone can afford to just go out and buy a new mattress. But there are some great inexpensive foam mattress pads out there that are great for softening up a too-firm mattress.
Set the mood
Next, it’s time to work on the things you do in the hour or so before it’s time to go to bed. And that means creating a calm environment for yourself by cutting out the stress, and throwing away the to-do list.
I hear too many patients say, “But doctor, I have stuff I absolutely must do before I go to bed.”
Sometimes it’s laundry. Sometimes it’s cleaning the kitchen. Sometimes you have work to catch up on. But if you really want to sleep, then something’s gotta give. And it’s gotta give at least an hour before bedtime.
When you let yourself get too worked up before bedtime, you’re not going to doze off as soon as your head hits the pillow. That’s why I like to avoid anything that might be too mentally or physically intense in the hour leading up to my bedtime. And I tell my patients to do the same.
For some of my patients, keeping calm means avoiding newspapers and violent TV shows. For you, it could include listening to music, practicing relaxation techniques, taking a warm bath, or playing with your dog.
Pick a bedtime and stick with it
While you’re trying to figure out your relaxing bedtime routine, you should put some thought into what your bedtime actually is. This means figuring out what time of night you are most likely to go to bed and fall asleep quickly. Once you do that, you need to start going to bed at that same time every evening and waking up at the same time every morning-even on weekends.
This can be a difficult thing to figure out, especially for people who are prone to going to bed at different hours every night.
But keeping a regular sleep schedule trains your body’s clock to develop a sleep-wake rhythm, encouraging better sleep. An important part of this is not going to bed until you’re actually sleepy. (Remember: Trying to force sleep will make the problem worse.)
So if you’re not falling asleep, don’t just lie there: Get up and walk around. Go into another room and read a book. Or try books on tape-anything to calm down a racing mind.
Instead of lying in bed wide awake night after night, try going to bed later by 30-minute intervals every night until it takes you less than 15 minutes to fall asleep. Then stick with that as your bedtime. ACD
Killing more than pain
It’s become far too easy for a patient to walk into a doctor’s office, complain of back troubles, and get a prescription for their painkiller of choice. And it looks like a lot of those folks don’t need the prescription at all.
A study released in July showed that accidental deaths caused by prescription painkillers rose 91 percent between 1999 and 2002, and that a great number of those deaths were most likely due to abuse.
That rise comes along at the same time that we’re seeing an increase in the number of these drugs sold every year. So it doesn’t take a rocket scientist to figure out that these drugs are seriously overprescribed.
During the study, the researchers looked into the backgrounds of the people who died and saw that a lot of those patients did not meet the profile of those suffering from chronic pain (the only reason anyone should be allowed a painkiller).
The simple truth is that if your pain isn’t debilitating, and if it’s not chronic, chances are you don’t need a painkiller.
6 tips for a good night’s sleep
1. Try eyeshades and super-light, molded, foam earplugs to reduce noise.
2. Use light-blocking shades on your windows.
3. Buy a white-noise machine or run an air cleaner to mask bothersome noises nearby.
4. Try aromatherapy with essential oils. Lavender and wood rose are especially known for their calming effects.
5. Soak in a warm bath. Try a bath oil to help you relax.
6. Sipping a little warm milk or herbal tea can be a soothing ritual.
10 most common symptoms I hear
And what you can do before you ask:
Should I worry?
Is it what I think it is?
By the time some patients get to my waiting room, they’ve already diagnosed (and often misdiagnosed) themselves with cancer, diabetes, lupus, or heart disease, usually based on some symptom or ailment they’ve never experienced before and found horrific descriptions of on the Internet.
What’s so tricky about new symptoms is that you don’t always know if they’re part of a bigger underlying problem or if they’re no big deal.
Important as it is to treat symptoms and sicknesses seriously, it’s also important that you keep an open mind, and remind yourself, “Hey–there are a lot of other, less serious things that this could be.”
Of course you should never hesitate to ask questions about any medical problem that has you worried. All I’m saying is don’t let some fly-by-night website convince you that you have some rare, lethal blood disease usually found only among peasants in rural China. With just a little background knowledge, you may be able to eliminate that worry right off the bat.
So here are 10 of the most common complaints that I hear almost every day, which often turn out to be no big deal.
1. A headache
Headaches are probably the most common complaint in doctors’ offices-I know they are in mine. But despite all the potentially big problems they could indicate, they’re rarely life-threatening.
If your headache throbs, happens on just one side of your head, and comes with nausea and sensitivity to light or sound, and if it’s painful enough to keep you from going to work, it’s probably a migraine. (I told you about the best ways to deal with a migraine in the August issue, which has also been posted on the Web site.)
If your headache doesn’t meet any of the above symptoms, or if your symptoms include a tight neck or shoulders, it could be a tension headache caused by a mix of stress and exhaustion. In that case, you may just need a little R&R. I know that’s easier said than done between deadlines, cell phones, and family matters. But it’s important to take the time to unwind. Two good at-home tension headache therapies are a warm bath with lavender oil, and, my favorite, a massage.
Of course, if you’re getting new, sudden, severe headaches, call your doctor immediately.
2. Heartburn
(gastro-esophageal reflux disease)
The major concerns with heartburn are the risk of esophageal cancer or ulcers-which usually only happen if your condition goes untreated. But there’s good news. In many cases you can treat your heartburn at home-without the purple (or any other color) pill.
First of all, weight is the biggest -and the most controllable-factor affecting your heartburn. When you weigh too much, all that extra flesh pushes on your stomach, forcing acid back up into your esophagus.
Also keep in mind that your heartburn probably has very specific triggers, like caffeine, spicy food, chocolate, tomatoes, or mints. And like it or not, you have to cut those out too.
3. Lower back pain
As soon as some people experience lower back pain, they start to worry that something’s seriously wrong-maybe a slipped disk, a pinched nerve, or even a tumor.
But most of the time, lower back pain is just caused by sore or strained muscles. Sharp, unrelenting pain could actually be muscle spasms, which is just your body’s way of telling you to slow down.
If you do have a strained muscle, applying an ice pack can definitely help, as long as you do it within the first 24 hours after you injure yourself.
If you’re experiencing muscle spasms, a heating pad, alternated with a little ice, can also help a lot. And don’t rule out therapeutic exercises or a massage to fix the problem. (But if your pain comes with incontinence, leg weakness, or any similar extreme symptoms, or if none of this has worked after two or three days, it’s time to see your doctor.)
4. Chest pain
With heart disease a growing problem in our fast-food-obsessed, couch potato nation, it’s not surprising that people assume the worst about even the slightest chest pains.
You’ve got to remember, though, that different problems trigger different types of chest pain. Most chest pain is caused by a strained muscle in your chest, a flare-up of inflammation in your ribs, some regular old heartburn, or maybe a panic attack. And each one feels a little bit different.
Sharp, burning, fleeting pains made worse by arm movement are more likely heartburn or a musculoskeletal problem.
Panic attacks, however, are usually marked by a sudden chest pain, especially if you’re a non-smoker under 50, who would otherwise be considered healthy. (The problem is that most people suffering a panic attack usually feel like they’re dying. In fact, they’ll often use those very words: “I feel like I’m going to die.”)
Even though it may be a panic attack, don’t take a chance. Take a few deeps breaths and head for the closest emergency room.
Dull, heavy pressure (like someone’s sitting on your chest) is more likely to be cardiac-and this is the type that requires immediate attention. Other heart attack symptoms include pain or numbness in your shoulders and arms, shortness of breath, and anxiety.
5. Swollen neck or armpit gland
Any time you feel a foreign lump in your body it’s completely natural to think, “Oh no. What if it’s a tumor?” But it’s important to remember that there are other reasons for lumps, especially when they’re in your neck, throat, or armpit.
Lumps in those places are often just inflamed lymph glands reacting to a local infection-a cold, a sore throat, or maybe a skin breakout, for example. Lymph glands are collections of special cells located in key places to help fight infections. When they go to work, the result is often swelling and discomfort.
Swollen lymph glands are usually just a good sign that your immune system is doing its job. I know they might be a bit tender, but hang on. They’ll calm down in a few days or maybe a couple of weeks, depending on how long it takes for your infection to clear up. (Ironically, swollen lymph glands that don’t hurt are actually more likely to be associated with cancer.)
If you’ve taken care of any infection you might be battling and your swollen glands don’t clear up, your doctor should give your medical history a thorough check, monitor you closely, and possibly schedule a biopsy, which can determine for certain whether there’s a bigger problem.
6. Dizziness
Dizziness usually comes in two flavors: regular old lightheadedness and room-spinning vertigo. And while things like a tumor, irregular heartbeat, or hypertension sometimes cause this symptom, more often it’s something much less serious and easily treatable.
Vertigo usually follows a virus, which can mess up the balance of your inner ear. It tends to go away after a few days, but it can still be upsetting. As annoying as it is, the best thing to do is give it a few days to clear up on its own.
Light-headedness, on the other hand, can be the result of many things, including dehydration, too much blood pressure medication, or emotional stress. If it persists or gets worse-or is accompanied by nausea and vomiting-you should consider getting a CAT scan, just to be safe.
A note about lightheadedness: If it comes with a pounding or rapid heartbeat, it might be an irregular heart rhythm. If this describes your case, see your doctor right away.
7. Runny nose
Most people get a runny nose and immediately decide they need an antibiotic. And, unfortunately, a lot of doctors out there do the same thing.
But the truth is, most sinus infections-the primary culprits behind runny noses-are viral and don’t respond to antibiotics. Or it could just be allergies, which don’t respond to antibiotics either.
Chances are a little butterbur or some stinging nettle, coupled with a good old Vick’s nasal inhaler could clear things up in a few days.
If you develop more symptoms, like a fever, thick, colored mucus, sinus pain, or just feeling crummy, you may have a bacterial sinus infection that antibiotics actually can help. And in that case, checking in with your doctor makes sense.
8. Blurry vision
Blurry vision is associated with a lot of things, including two of the biggest health problems out there: diabetes and macular degeneration.
But before you decide you’re going blind or diabetic, ask yourself one question: Have you had your eyes checked lately?
Even if you’ve had 20/20 vision most of your life, your eyesight can get worse as you get older. I’ve seen patients who never needed glasses, then, in their late 30s or 40s, suddenly found themselves squinting at traffic signs and newspapers.
You should be getting your eyes checked annually, even if you don’t wear glasses. A trip to the eye doctor can rule out any major problems. It could turn out that your blurry vision is just a sign that your eye’s lens has stiffened up with age, and now you need reading glasses.
If you’ve already been diagnosed with macular degeneration or diabetes, or if those diseases or other vision problems (like glaucoma) run in your family, and your eyesight is getting worse, you do need to talk to your doctor. It could be a sign that your condition is getting more serious-and with eye problems, once they develop it’s often too late to treat or reverse them.
9. Numb hands
Now nobody wants a numb anything. And in some cases, numbness can be symptomatic of a bigger problem like diabetes or a stroke.
But if numbness happens mainly in the thumb, index, and middle finger, and if it wakes you up at night, it could be carpal tunnel syndrome (CTS), especially if you often engage in some repetitive manual task, like typing, throughout the day.
CTS happens when a tight band of connective tissue in your wrist reacts to overuse by swelling and pressing on the nerves passing through it. Rest, wrist splints, and correcting faulty movement patterns can all fix the problem. If not, surgery may help, though it’s rarely needed.
10. Hearing loss
Sudden hearing loss is worth a call to your doctor any day. But it usually turns out to be the result of a very minor problem: earwax buildup. Fortunately, cleaning it out works wonders-though it can be somewhat uncom- fortable when the buildup is bad enough to cause temporary hearing loss.
One easy way to prevent wax buildup is simply to eat fewer saturated fat from meat and dairy products, which is more likely to stiffen up your earwax. Instead, get more healthy fats from fish, nuts, seeds, and olive oil, which are less stiff (and better for you anyway).
If you’re past the point where a diet change can help, go to your doctor or nurse, and have him flush the wax out. It’s cheap, fast, and is one of the most effective methods out there. ACD
HOMETOWN HEALING
Scratching the buggy itch
Mavis is a bundle of energy. She’s in her late 50s and is an avid hiker and gardener. (In fact, she only eats vegetables that she grows.) She’s so healthy that, to be honest, I rarely even see her in my office.
She has just one problem: She spends so much time outdoors that she often gets attacked by mosquitoes. And when she does, she gets some of the biggest whelps and bumps I’ve ever seen from plain old bug bites.
One day Mavis walked into my office literally covered in red, swollen bug bites, scratching her arms and squirming so much I could barely get a good look at her.
Unfortunately, when summertime rolls around, all the news organizations start playing up the importance of insect repellents-usually chemical ones like DEET, which studies have shown can actually melt plastic. Who wants that on their skin? I’m sure you don’t, and neither did Mavis.
So instead I had her try some of these natural cures I’ve discovered through the years.
An ounce of prevention
Mosquitoes have an extremely sensitive sense of smell, and the powerful odor of garlic-even through your skin after you’ve eaten it-drives them away.
If you’re planning to spend a lot of time outside, throw a bunch of garlic into your dinner the night before.
Even if you don’t like the taste of garlic, that doesn’t mean you should rule it out. I often recommend a powerful garlic supplement from a company called New Chapter. This one has a deodorizer in it so it won’t offend your spouse, but it’s so potent that mosquitoes can still sense it. This is really one of the only garlic supplements that I would recommend for this particular purpose.
Next there’s one that you’ve probably never heard of before. One of my colleagues learned about this home remedy during one of his son’s lacrosse games a couple months ago and passed it along to me later.
That night, when everyone seemed to be getting eaten alive by mosquitoes, one of the parents broke out a package of fabric softener dryer sheets. He told everyone in the bleachers to rub themselves down with the dryer sheets to repel the bugs. People were skeptical, until a few minutes later when they noticed they weren’t slapping away the mosquitoes anymore. The other day I was out hiking and decided to try this one for myself, just to make sure. And it worked for me too.
A pound of cure
Of course, you can douse your dinners with garlic and rub yourself with dryer sheets, but occasionally some tricky mosquito will still get through. If you do get bitten, here are a couple of things you can do to relieve the itching and swelling.
Onions contain substances called isothiocyanates that break down prostaglandins. (These are local inflammatory compounds that your body produces in reaction to the bug bite or sting.) But it works a bit differently than garlic: In this case you actually apply the onion directly to the sting or bite.
Whenever you get a bad bite, take an onion, cut it in half, and rub it on the affected area for a few minutes. The swelling and itching usually goes away pretty fast. If you need to, run the bite under hot water for a minute or so. This helps flush out the chemical irritants caused by the bug bites (and maybe dilutes some of the onion smell too).
Making a paste of apple cider vinegar and meat tenderizer and applying it to the bug bite or sting also works wonders. The vinegar kills germs and reduces local swelling and inflammation, while the tenderizer has enzymes that break down proteins carried in insect venom, making it harmless.
You need to keep the solution on for at least a few minutes until the pain subsides. The key is to apply it pretty quickly after you get stung or bitten. ACD
YOUR QUESTIONS ANSWERED
Navigating the supplement maze
Q: I’m always hearing about all of these vitamins and herbal supplements I should take: multivitamins, extra vitamin D, fish oil-and so on and so on. But I don’t want to end up taking a big bag of pills every day. And I couldn’t afford it even if I wanted to. I’m 62 years old, on no medications, and I’m basically just looking to stay healthy. Help me sort through the supplement maze!
–Nancy K., Milan, Ohio
A: This is a problem faced by a lot of people, especially those living on a fixed income.
First, you do need to be taking a good multivitamin. This is pretty much a blanket insurance policy. Most multivitamins have enough vitamin C and B, zinc, and folate to keep you at the recommended daily levels. Make sure that your multi-vitamin also includes vitamin E with mixed tocopherols and 5,000 IU of preformed vitamin A (retinol), plus beta-carotene with mixed carotenoids.
Vitamin D3 (cholecalciferol) is another must-have in your supplement regimen. This form of vitamin D stays active in your body for up to a month, unlike other forms that might only stay with you for a couple of days. You need to get at least 1,000 IU every day, but very few of us get enough vitamin D in our diets at all, let alone enough D3 (this form of vitamin D also helps you maintain the right levels of calcium and phosphorous in your bloodstream). Even people already taking a multivitamin don’t always get enough, since most multis only have between 200 and 400 IU. Try supplementing with about 1,000 IU every day. Nowadays, up to 10,000 IU a day is considered safe (though amounts that high should be doctor- supervised).
Next, even if you’re taking a multivitamin, you might not be getting enough calcium or magnesium. You need at least 600 mg of both nutrients every day, preferably both in the citrate forms, which are easy to find and better absorbed than calcium carbonate and magnesium oxide. And, just like vitamin D, few people actually get enough of these nutrients in their diets alone. Calcium and magnesium play key roles in more than 300 bodily reactions, and help prevent diabetes, fatigue, and high or low blood pressure.
Fish oil is another supplement that, in my opinion, just about everyone should be taking. This stuff has healthy amounts of the omega-3 fatty acids-EPA and DHA-that help protect you from heart disease, dementia, diabetes, and cancer, mainly by reducing inflammation in your body. You need a total of at least 1,000 mg of EPA and DHA every day. Most products include 180 mg of EPA and 120 mg of DHA per pill, so two capsules, two times a day, gets you up to 1,200 mg.
If you’re worried about cost, most of these are as inexpensive as supplements get. They usually cost less than $30 for a month’s supply, if that much, depending on what brand you choose. Wal-Mart, COSTCO, and even your local drug store should all have quality, affordable brands.
Of course, it’s important to remember that all of these are intended as an addition to a diet that’s already balanced and healthy. Supplements alone are never as good as the real thing, thus the name “supplement” instead of “replacement.”
The text contained herein does not constitute medical advice. America’s Country Doctor advises that you consult your own physician before acting on any recommendations contained within this publication.
Posted in Newsletter.
