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Ask Dr. Gott 12/10
Brain won't shut off
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    DEAR DR. GOTT: I read your column regularly but have not seen any letters concerning my problem. I can't sleep. No, it's not sleep apnea, it's just that I can't turn my brain off.
    I go to bed at a regular hour, but all I do is lie there and think. When I do fall asleep after hours of thinking, I sleep for only two to three hours and wake up wide awake, and I just lie there thinking until morning. Is it safe to take sleep medication every night? I am 83 years old and in good health.
    DEAR READER: Most sleep-producing medications should not be used for more than a couple of weeks at a time. A far more satisfactory approach would be melatonin, a natural compound that governs our sleep patterns. It is available without a prescription. If you choose this option and it doesn't work, consider visiting a sleep specialist.
    Judging from the information in your letter, I believe you are experiencing insomnia related to nightly problem-solving and anxiety. Both conditions are treatable, but you might need therapy, too. This will help you work out your problems so when you are tired, you can sleep. Sometimes, even the most trivial problems, such as what chores need to be done he next day, can be better handled.
    To give you related information, I am sending you a copy of my Health Report "Sleep/Wake Disorders." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

    DEAR DR. GOTT: I am a 71-year-old man, and I have trouble with balance. I fall a lot. Can you help me? I had a mild stroke about two years ago. I have been to two different doctors in the last six months. One said the stroke caused the problem. The other said he did not know what was causing my balance difficulties. I need help.
    DEAR READER: I suspect that your poor balance is caused by your stroke. I believe that a course of physical therapy — including a balance program — would help you recover some of your independence. You also need medication to prevent another stroke. Your primary care physician can coordinate your treatment options, help you decide on an anticoagulant or refer you to a cardiologist. A cardiologist is your best option. You will most likely need to see him or her only once or twice a year, and your primary care physician should be able to handle routine testing and medications. Let me know how this turns out.
    To give you related information, I am sending you a copy of my newly updated Health Report "Stroke." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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