6 B
SIUSLAW NEWS ❚ SATURDAY, JULY 18, 2015
TO YOUR
GOOD HEALTH
Breakfast,
lunch leave
man dazed
DEAR DR. ROACH: I am 71, with
high blood pressure, COPD, diabetes
and spinal stenosis. I smoke. After I
eat breakfast or lunch, I rapidly fall
into a daze during which I can hardly
hold my head up. Sleep seems to be
the only solution, but I still feel tired
and listless the rest of the day. I have
had this condition for over a year, and
it is making me very depressed. I have
read about CFS and autoimmune con-
ditions, and the prognosis is not good.
There must be some treatment for me.
— A.P.
ANSWER: Fatigue is a common
symptom, but it is perhaps the most
nonspecific one we deal with in med-
icine. Many conditions primarily
cause fatigue. The specific condition
of chronic fatigue syndrome, by defi-
nition, is unexplained after a clinical
evaluation. In your case, I would con-
SALOME’S STARS
ARIES (March 21 to April 19) A bit
of Arian contrariness could be keeping
you from getting all the facts. Turn it
off, and tune in to what you need to
hear. It could make all the difference
this week.
TAURUS (April 20 to May 20)
Getting an answer to a vital question
involving financial matters might take
longer than you’d expected. A new
factor might have to be dealt with
before anything can move forward. Be
patient.
GEMINI (May 21 to June 20) Use
your good sense to see what might
really be driving a colleague’s work-
place agenda. What you learn could
lead to a new way of handling some
old problems.
CANCER (June 21 to July 22) A
change of mind might once again turn
sider some important possible causes.
Although COPD and even spinal
stenosis certainly can cause fatigue,
the association with eating makes me
wonder about your blood sugar levels,
since poorly controlled diabetes can
cause fatigue. Smoking doesn’t cause
fatigue, but quitting smoking certainly
will help your COPD from progress-
ing. All sleep disorders, but especially
obstructive sleep apnea, cause fatigue
that might not improve with sleeping.
I always consider thyroid disease,
hemochromatosis and multiple sclero-
sis in anyone with profound fatigue.
This list is only a small part of the
many conditions a clinician is on the
lookout for in someone with fatigue.
Depression certainly may cause
fatigue, but it is also common in peo-
ple whose primary issue is a medical
cause of fatigue.
If after a thorough evaluation your
diagnosis turns out to be chronic
fatigue syndrome, the most effective
therapies are cognitive behavioral
therapy and a graded exercise pro-
gram.
Since your symptoms happen after
eating, it might be wise to see if cer-
tain foods are more likely to cause it
by keeping a food diary. Many people
find sugary foods cause loss of energy.
Many people have come down with
the mysterious illness chronic fatigue
syndrome. The booklet on it explains
the illness and its treatment. To obtain
a copy, write: Dr. Roach — No.
304W, 628 Virginia Drive, Orlando,
FL 32803. Enclose a check or money
order (no cash) for $4.75 U.S./$6
Canada with the recipient’s printed
name and address. Please allow four
weeks for delivery.
DR. ROACH WRITES: Many
people have written about treatment
for obstructive sleep apnea. I recently
recommended CPAP machines
(including, if necessary, repeated vis-
its for proper fitting) and singing. I
haven’t discussed oral appliances,
which move either the jaw or the
tongue to change the anatomy of the
back of the throat, allowing the airway
to stay open during sleep. Only a few
studies have been done on these, but
they suggest that the oral appliances
are nearly as effective as CPAP for
people with mild or moderate OSA.
People with severe OSA probably
should use CPAP, since it is more
effective.
These are certainly an option for
people who can’t tolerate a CPAP
despite several attempts by someone
skilled at selecting the right mask and
plenty of patience to learn to use it
properly.
out to be a good thing. True, most of
your co-workers might not like the
delay, but as before, they might appre-
ciate what follows from it.
LEO (July 23 to August 22) You
revel in golden opportunities this
week. One cautionary note, though: Be
careful to separate the gold from the
glitter before you make a choice.
Someone you trust can help.
VIRGO (August 23 to September
22) Marriage is important this week, as
are other partnerships. Don’t let your-
self be overwhelmed by sentiment.
Instead, try to steer a path between
emotion and common sense.
LIBRA (September 23 to October
22) Dealing with someone who has let
you down is never easy. But the soon-
er you’re able to clear up this problem,
the sooner other problems can be suc-
cessfully handled.
SCORPIO (October 23 to
November 21) A “friend” who is will-
ing to bend the rules to gain an advan-
tage for both of you is no friend. Reject
the offer and stay on your usual
straight and narrow path.
SAGITTARIUS (November 22 to
December 21) After all the effort
you’ve been putting in both on the job
and for friends and family, it’s a good
time to indulge your own needs. The
weekend could bring a pleasant sur-
prise.
CAPRICORN (December 22 to
January 19) You might want to do
something new this weekend. Close
your eyes and imagine what it could
be, and then do it, or come up with the
closest practical alternative.
AQUARIUS (January 20 to
February 18) Your good deeds bring
you the appreciation you so well
deserve. But, once again, be careful of
those who might want to exploit your
generous nature for their own purpos-
es.
PISCES (February 19 to March 20)
Trolling for compliments isn’t neces-
sary. You earned them, and you’ll get
them. Concentrate this week on mov-
ing ahead into the next phase of your
program.
Siuslaw N ews
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