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Ask Dr. Gott 4/16
More sleep isn't enough for tired teen
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    DEAR DR. GOTT: I am a 17-year-old female, 5 feet 9 inches, 130 pounds, athletic and in relatively good health.
    My problem is that I am constantly tired. About 90 minutes after lunch, I fall asleep. I can't control it. This has been happening for quite awhile. I get plenty of sleep at night (eight to nine hours). Getting more than that does not seem to help.
    I was wondering if I could be diabetic or hypoglycemic. Could these conditions possibly be the culprit? If so, how could I tell easily? I don't know what else it could be. Please help me. My schoolwork is suffering because of it.
    DEAR READER: You need a thorough examination and testing by your family physician. In particular, you should have blood work to check for anemia, thyroid disorders and abnormal blood-sugar levels.
    If the testing is normal, the next step is to see a neurologist. This specialist can test you for several disorders. I would be most interested in the outcome of testing for narcolepsy. This is an unusual brain condition that results in an uncontrollable desire to sleep or sudden attacks of falling asleep at intervals.         It is often associated with a condition known as cataplexy, which is sudden attacks of muscle weakness.
    Your uncontrollable sleeping in the afternoon is not normal. The strange nature of your symptoms may make diagnosis difficult. I urge you to speak to your parents about it, seek medical help and be persistent until someone can tell you what is happening.
    To give you related information, I am sending you copies of my Health Reports "Sleep/Wake Disorders" and "Medical Specialists." Other readers who would like copies should send a self-addressed, stamped No. 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

    DEAR DR. GOTT: I need help. I have seen several doctors, but none can put my symptoms together and come up with a diagnosis. I am anemic, have fluctuating high blood pressure, throat and sinus inflammation, inflammation behind my eyes, Meniere's disease symptoms, an elevated rheumatoid factor and elevated Ig antibodies.
    I am only 47 years old and have been healthy my whole life. I need a diagnosis or at least a hint of what could be wrong with me.
    DEAR READER: I urge you make an appointment with a rheumatologist (immune system specialist).
    Inflammation of the throat, sinuses, area behind the eyes and anemia suggest that you have an autoimmune disorder. These symptoms are common in Wegener's granulomatosis, a rare disorder that involves vasculitis (inflammation of the blood vessels). Wegener's could also explain your         Meniere's-type symptoms, because ear infections are common and can cause hearing loss, tinnitus, pain and more. Blood pressure is also affected by vessel inflammation.
    I suggest you mention the possibilities of Wegener's and vasculitis to the specialist, as well as request an antineutrophil cytoplasmic antibody test (positive in 80 percent to 95 percent of sufferers). Wegener's may be fatal if left untreated, so seek medical help.
    If I am off base, I apologize. However, based on your symptoms and tests, a rheumatologist is your best bet. You should also be tested further for rheumatoid arthritis, lupus and similar disorders to explain your abnormal rheumatoid factor and Ig antibodies.
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