Depression/Anxiety = Bad Sleep Habits/Time Management/etc?

[Tom]

Obviously I have a few issues, otherwise I wouldn't be up all night long. But first, some background.

I've had trouble sleeping normally virtually my entire life. Stay up late, sleep late, sleep whenever, wake up whenever, don't sleep, sleep all day and all night, sleep 4 hours in the morning, 4 in the evening, vice versa, you name it I've done it. Everything except sleep like a NORMAL person (which to my way of thinking is go to bed after the news, wake up in the morning about 7:00 give or take. Heck, going to work anytime before 9:00 is cruel and unusual punishment for me! Oh yeah, and I have a LOT of trouble staying awake and alert at work - if I dont stay on my feet, I'll get the nods. But I also don't have enough energy to stay on my feet an entire shift, either - would have to take a break sooner or later.

I also suspect my blood pressure is really loopy - if i take enough BP meds (Atenolol 50mg BID, lisinopril 20mg QD) to keep my blood pressure down I nearly faint or seize when sitting down after a few minutes. For a long time about a year ago I wondered if I really was having a seizure problem, but an EEG and CT scan showed no problems. If I go off my BP meds, my BP goes over the moon, and my head hurts like a watermelon splitting open. Not sure it has anything to do with my bad sleep habits but I thought it might be worth mentioning.

Same deal with blood sugar - I REALLY should be taking insulin, and did very well when I was on it last fall. But then I lost my primary job due to dirty politics and with it my insurance. Dont have $300-$400 a month it costs for the insulin (I have to take a lot for it to be really effective), and oral meds have quit being effective a long time ago.

So my BG always runs too high, which makes me thirsty of course, which makes managing my bladder difficult, espescially given that I really need a urodynamics evaluation again as SCI Nurse recommended last fall. But, with it being a $4000 test and no insurance, its almost completely out of the question. It still mystifies me how my bladder can hold so much yet at the same time spaz out at the most inconvient times, like when I stand up. I think that's my weight aggravating things - if I dropped some pounds my bladder wouldn't kick off so much, often in the middle of nowhere. I also wonder how much anxiety plays a role - is part of the problem up in my head? My urologist says I simply have to cath more often (6-8x a day), which is fine EXCEPT for some reason cathing is MUCH HARDER when my volumes are smaller (<800cc's) than when higher (>1000cc). unless my bladder is very full the sphincter is so tight its almost impossible to insert a catheter in. Also, my urologist, who is by consensus the best one in town, keeps insisting I have a UTI, writes an Rx for antibiotics (which I'm loathe to take unless I'm obviously ill, but at this point i'm fine - just cloudy urine is all) , but I never hear back from the doc's office for C&S results (had an appt/UA 3 weeks ago, no phone call since.) But then again, thats par for the course - I had to call every few days for SIX WEEKS after I got my EEG/CT scan done. It was like the tests either got thrown into a huge stack and the neurologist looked at it a month later, then threw it into another huge stack and so on - basically I had to prod them to follow up and let me know the results.

Finally (sorry this is such a long ramble), I had to sign up at the local health clinic a couple months ago (no insurance, part time job). The doc started me on Celexa, but after a couple months all its done is kill my sex drive or what was left of it (had ED ever since my prostate infection/abscess, but was otherwise OK) and cause me to gain even more weight (definitely NOT a good thing.) Didn't help a bit. So i need to try something else, but what? I think anxiety is my larger problem (esp when trying to sleep, but also i hate crowds, hate a lot of stuff - traffic, the rat race, etc, etc. Always agitated a bit (I constantly scratch this or that,itch, have for years, eat fingernails, fidget a lot, etc). When I get really stressed out I have the disposition of a rattlesnake, then alternatively withdrawn (withdrawn, agitated, withdrawn, agitated).

Bottom line, i know I have a real problem with depression, but I don't know how to break the cycle. Even when I sleep at night and wake up reasonably early, I'm SO TIRED (no matter how much I sleep) that getting out of bed is nigh impossible. Only thing that gets me out is work (I usually work 3-11p), but because I don't get up in the mornings and take care of business, etc - my life suffers (financial problems, etc).

At any rate, does anyone have any advice for my situation (or any part thereof)?

BTW: I just got back to full time at my old job, so HOPEFULLY I should become eligible for benefits, etc after the 120 day waiting period. But till then, requesting this test or that doctor is pretty much out of the question - I'm stuck with what I got.

I guess what I need is some advice on advocating for myself and getting a doc to listen, etc. Any and all help or comments are appreciated. Thanks.

Tom (life is a wreck )

[LaMemChose]

Congrats on returning to full-time employment.

Sorry you're having a hard time, Tom. Fortunately you can do something about most of your health issues.

You've said you're very obese. If you want lower b/p, better control your diabetes, sleep better, lose the weight. Exercise. Stop smoking if you do.

Perhaps that's easier for me to say than for you to do, but if you're truly concerned about your health, make changes.

It may not be as easy as taking pills to lower your b/p and or insulin to control your sugar, but you have options to improve your health.

As for sleeping, with regular exercise and weight loss it is very likely you'll have an easier time of sleeping. You may have a breathing problems due to your obesity.

Lose the weight. Exercise. Better control your sugar with healthy food choices.

If you're seriously concerned about your health, change what you can. You can change quite a bit.

Check with the clinic or health department or the American Diabetes Association for info on what a health diabetic diet is. You can even get such info on line. Educate yourself. Then, do something about it.

You can bet your arse if those of us here could have our SCIs reversed with diet and exercise, we'd be in the gym 24/7. Many of us exercise as best we can anyway.

If you are really concerned about your health, make the changes. If you're not, don't.

This one's up to you.

[LaMemChose]

Tom, I did a quick search for info on diabetes and message boards for such using Google. There were more choices than I care to link here, but here's the one for the ADA.

American Diabetes Association www.diabetes.org

There are many, many message boards for diabetes. I was surprised at the numbers of them.

Also, you many wish to check with the American Heart Association for info on high blood pressure and for info on what you can do to help yourself.

Good luck.

[betheny]

I got sick and had to change my diet. Fast food went away, totally. Now I'm still sick, but my husband's blood sugar, cholesterol and blood pressure dropped AMAZING amounts. His endocrinologist said "I don't know what you did-but keep doing it!"

We really are poisoning ourselves. Read labels. If it's multi-syllabic, or not something you'd see in your great-grandmother's recipe files, it's an ingredient your body doesn't need. Try it, throw in time outdoors, exercise if possible. Start slow, build up. You'll sleep so much better and the rest will fall into place.

[SCI-Nurse]

Not properly managing your diabetes is very dangerous. You increase your risks for cardiac death, stroke, skin problems, and blindness. You must get this under control now. Since you are working again, you may have to private pay for your meds until your insurance kicks in.

There are programs designed to get you low cost medications if you are uninsured. Have you looked into these?

I suspect your sleeping problems are related to sleep apnea, which would require more tests to confirm. It is more common in people with SCI, and with obesity.

Talk with your physician about a different anti-depressant. There are so many available now, it is generally easy to find one that does not have the side effects you are having. Talk with him about Welbutrin as a starting point.

You can't depend on your physician's office getting back to you on any test results. They are too busy. You have to advocate for yourself, and call back to get the results, and keep calling until you get them.

It is unfortunate that you did not get onto Medicaid when you were out of work.

(KLD)

[Tom]

Thanks for the kind words, Mem. Yeah, I'm a fat bastard all right. And I know that if I don't turn things around muy pronto I'm gonna stroke out or get another case of sepsis and don't get lucky like I did last summer.

I reckon you know this already, but a lot of caregivers/PCA's seem to have more issues than the average working Joe. The lifestyle just doesn't encourage healthy living habits. Fortunately I don't smoke and almost never drink, which is a start. unfortunately, I procrastinate.

Yeah, its hard to cultivate better habits. I don't want to come off as making excuses, because in the end no matter what the finger points at me. I think deep down that if you have something worth living/working for (like a motorcycle back in '02-'03) you change whatever you have to in order to promulgate that situation. I keep telling myself don't give up, work on better habits, etc, etc. I know that if I keep at it things will improve, slowly but surely. Nowhere to go but up now. (I was homeless for 6 weeks last fall, slept in my car, drunken kid smashed my car the night the Cards won the series, then slept in rental SUV, rental company and insurance refused to let me keep the car more than a few days, had to turn in car, employers didn't like it, decided to terminate me under the guise of 'not having reliable transportation' even though I had bought a beater car just a few days after turning in the rental (got axed 5 days after buying the junker)). The holidays were a BAD time for me - no job, no unemployment (got screwed), no friends/no family, no money, no food, etc, etc. Like treading water with the proverbial ball and chain shackled to ya. anyway, its been rough going. But slowly getting better little by little.

I just hope to improve things to where I feel like I'M in control of my life, both fiscally and healthwise. I bet peace of mind would follow like a storm.

Okay, just yakking along now. I need to get a couple more hours of Z time before work, gotta go. But I feel a little better already

Tom

PS: I DID apply for Medicaid - twice in fact. Got run out the door both times, stated reason - not totally and permanently disabled.

[betheny]

BTW, I have the same problem w/ advocating with the docs. My endo wanted me to do some irreversible procedure to kill my thyroid. I refused until I could do some research. Turns out it is not recommended for people with certain rare complications-like me. She is STILL not pleased w/ my refusal, and tells me to do what I want, won't advise me or order lab tests for hormone levels. The point is, she wanted to kill my thyroid, because it makes her job easier-just prescribe replacement thyroid. The fact that the procedure makes the immune system attack the eyes harder? Not her problem, she's not an eye doctor or an immunologist, and doesn't care if I go blind, apparently.

Needless to say, I'm endo shopping. It sucks, and is so aggravating to be doctoring myself without the benefit of lab tests or ability to write prescriptions..

[LaMemChose]

Originally Posted by betheny

I got sick and had to change my diet. Fast food went away, totally. Now I'm still sick, but my husband's blood sugar, cholesterol and blood pressure dropped AMAZING amounts. His endocrinologist said "I don't know what you did-but keep doing it!"

We really are poisoning ourselves. Read labels. If it's multi-syllabic, or not something you'd see in your great-grandmother's recipe files, it's an ingredient your body doesn't need. Try it, throw in time outdoors, exercise if possible. Start slow, build up. You'll sleep so much better and the rest will fall into place.

You said it, B. It's kewl Steve is getting the health bennies of the changes in diet for your thyroid.

My rule of thumb is that if I cannot easily pronounce it, if it's a chemical or has sugar or caffeine in it or is too far from straight out of the ground or processes removed from off a tree or vine, I won't eat it. If it's fried or has hydrogenated fats in it, I won't eat it. If it's less than a whole grain, has white flour in it, I won't eat it.

I've gotten rather picky, eh? Maybe so, but I feel so darned much better eating more whole foods and ditching processed stuff.

A neighbor's grandchildren visited her yesterday. They saw me and asked if I had any candy or gum. Told them no, but I had apples and bananas and oranges and grapes and pears they were welcome to eat. They turned up their little noses.

It wasn't the fault of the children. They want what they're accustomed to having and apparently that's junk food and sodas. I don't keep it and I wasn't hitting a snack machine to feed their sugar monster.

I'm not very tolerant of health problems which may be addressed and aren't by an individual. I readily admit this. I feel frustrated when I know someone can change his/her life, would be healthy and won't. If changing how I eat and exercising would give me ab status or at least greatly reduced disability, you bet your bumbum I'd do it immediately.

No matter what I do or don't eat, no matter the amount of exercise I get, I'm still going to have major disability. I want to be as healthy as I can possibly be so I live as healthy a life as I can.

It comes down to personal responsibility. If a person is unhealthy due to lifestyle choices, make the change. Otherwise that person lives with the consequences.