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Sleep Disorders, hammer toe - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2349 Questions
User :   I took an ambien last night, actually 2 10mg pills over two hours but never fell asleep. I have to take a flight this morning. Is it ok to take a couple xanax for the flight?
Doctor :   Hi
User :   hello
Doctor :   Ok
Doctor :  
Are your prescribed Ambien?
User :   yes
Doctor :  
Ok
Doctor :  
What is the dosage, frequency and duration recommended by your doctor?
User :   10 mg
User :   1 each night if needed
User :   i've been on and off for a year
Doctor :  
Ok
Doctor :  
How often do you require it say in a week?
Doctor :  
Are you with me?
User :   yes
User :   5 of seven nights
Doctor :   Ok

User :   i went 2 weeks without but had strange sleeping patterns
User :   so i got a refill on fri
Doctor :  
Were you getting sufficient sleep with it before?
User :   when i could fall asleep
Doctor :   Sorry, could you be clear on that?
User :   i wouldnt fall asleep til 3 or 4 am
User :   but once i was asleep i got 8 hours
Doctor :   Ok

User :   im currently unemployed so maybe boredom keeps me up
Doctor :  
Ok
Doctor :  
Do you have problems like anxiety?
User :   socially yes. speeches a lot. and airplanes
Doctor :  
Ok
Doctor :  
Are you on Xanax as well?
User :   i just found out my plane is cancelled, so not leaving til 6 pm now. yes i am on xanax but very sparingly
Doctor :   Ok

Doctor :  
What is the dosage?
User :   i think .25
Doctor :  
and is it also for sleep issue?
User :   the lowest
User :   no i asked for them for speeches during school and airplanes
Doctor :  
Fine
User :   just to have if i feel i need one
Doctor :   Ok

Doctor :  
The better approach would be to have an xanax and ambien
Doctor :  
when you are having a bit of anxiety
Doctor :  
So follow that
Doctor :  
but take it very rarely
Doctor :  
You can sleep better with better lifestyle
Doctor :  
and exercises
User :   do we have time for another question
Doctor :   Sure

User :   do you know of friedreich's ataxia
User :   ?
Doctor :  
Yes
User :   my older sister got it when she was young she is now 28 and i am 26
Doctor :   Ok
User :   i have "hammer toe" on my left foot
Doctor :   Ok

User :   not sure if its really hammer toe but the toes curl a bit and overlap
Doctor :  
Ok
User :   the right side does not
Doctor :   Ok

User :   and my gait is akward and balance gets thrown off every now and then
User :   but
User :   i have hip dysplasia bilateral. the right side was operated on but remains weak
Doctor :   Ok

User :   are these the beginning signs of ataxia or can they be hip related
Doctor :  
Dysplasia is a pathological finding
Doctor :  
if you are aware
User :   i dont know what thta means
Doctor :  
Dysplasia, what you meant?
User :   pathological?
Doctor :  
by that term
Doctor :   What you meant by the term Dysplasia?
User :   developmental dysplasia of the hip
Doctor :  
Ok
Doctor :  
fine it is the same
User :   i had an osteotom 3 yrs ago
Doctor :  
Ok
User :   but havent regained the strenth from the muscles they cut. i quit physical therapy too soon cuz i had no insurance
Doctor :   Ok

Doctor :  
You should have continued
User :   i know you arent a specialist
User :   i know
Doctor :  
Physical therapy does help
User :   i go to the gym now and remember the excercises
Doctor :  
Yes I am a General Practitioner
Doctor :  
and not a specialist
Doctor :  
Fine
Doctor :  
Are you able to do the exercises equally on both right and left sides
User :   the right side is still difficult
User :   i find myself lifting my leg when i get in a passenger door
User :   or putting on shoes
Doctor :   Ok

Doctor :  
It shall improve gradually
Doctor :  
Physical therapy shall also help
Doctor :   Do go for it if affordable
User :   should i be worried about the curled toes as a sign of late onset friedreichs?
User :   ive always had them as i remember
Doctor :  
Ok
Doctor :  
usually it presents late in some people
Doctor :  
in the age 20-25
Doctor :  
but you are already 26 and do not have other symptoms
Doctor :  
So I dont think it is worrisome
Doctor :  
However do get a Neurologist opinion on that
User :   the balance and gait can be attributed to the hips correct?
Doctor :   Yes, it is quite evdient

Doctor :  
Hip surgery does affect it
Doctor :  
and your symptoms are mainly pointed out there only
Doctor :  
and not Fredreich's
User :   hammer toe too?
Doctor :  
Hammer toe is not a manifestation of Friedreich's
Doctor :   Instead there could be deformity in plantar arches in Friedreich's
User :   they would have found something during the bloodwork, ekg, stress test if i had ataxia?
User :   before my operation
Doctor :   It cannot be found out in those investigations

Doctor :  
and is a clinical finding

User :   you still there?
Doctor :   Yes
Doctor :  
Proceed with your query
User :   but i thought people with friedreichs have bad hearts
User :   and mine checked out ok
Doctor :  
Ok
Doctor :  
thats true
User :   or does that happpen after onset
Doctor :  
that cardiac problems are there in that condition
Doctor :  
but not a mandatory one
User :   so you say unlikely but worth it to see a neurologist but in the meantime go back to pt
Doctor :  
Yes, for a reconfirmation
Doctor :  
it is better to get a Neurologist possiblity
User :   i bought some more time so i have some more questions
Doctor :   and the possibility is very remote
Doctor :  
Sure
Doctor :  
Go on
User :   i always remember having this but never bothered me much
User :   when i lay on my back my stomach muscles get real tight and there is a twitching or pulsating from the stomach
User :   if i put a hand on the stomach even lighlty the feeling goes away
Doctor :   Ok

Doctor :  
this is mainly due to muscular spasms
Doctor :  
and the presentation looks like that
User :   what is the cause? is it related to friedreich's?
Doctor :  
In Friedreich's the muscular weakness is seen
Doctor :   that too in the limbs
Doctor :  
rather than abdominal muscles
User :   so what could this be? it really only bothers me in that position
Doctor :  
Ok
Doctor :  
It is a abdominal rigidity
Doctor :  
and could be due to an underlying abdominal disease
Doctor :  
like in the intestines, etc
Doctor :  
Hernia problems
Doctor :  
these will lead to such spasms
Doctor :   Are you aware of such issues if any?

User :   none
Doctor :  
and one more is electrolyte imbalance and low calcium levels also cause such problems
User :   i have no pain
Doctor :   Ok

User :   i had a vitamen k deficiency
User :   i think it was k
User :   potassium?
Doctor :  
They are different
Doctor :  
Yes potassium is a relaxant
User :   i've had this for 5+ yrs
Doctor :  
and the defeciency can cause such muscle issues
Doctor :  
Are you taking supplementation?
User :   no
Doctor :  
Ok
User :   i tok some before my surgery and they gave me plasma
Doctor :  
You should take supplements
Doctor :  
and banana is a very good source
User :   vitamin k supplements?
Doctor :   Vitamin K, have you got it tested?
User :   no. i dont know. before my surgery they ran blood and said i was deficient in vitamin k i think. they were worried my blood was too thin so they gave me plasma
Doctor :   Ok

Doctor :  
It is potassium which is termed as K
User :   my mom is a hematologist and said my numbers were close to ok
Doctor :  
and vitamin K defeciency is very rare to see
Doctor :  
in individuals taking normal foods
User :   i dont eat great
Doctor :   Ok

Doctor :  
but Vit K defeciency is unlikely
User :   so i have a potassium deficiency?
Doctor :   that is most likely

Doctor :  
and calcium is the significant of all
Doctor :   If you get a S.Electrolytes and calcium done

Doctor :  
you will know the picture
User :   is that related to the abdomianal guaring?
Doctor :   Yes, quite possible

User :   S. Electrolites?
Doctor :   Yes, it tests for the electrolytes in the body
Doctor :  
lie sodium, potassium, chlorides, etc
User :   so you are saying get some tests?
Doctor :   exactly

User :   who do i see for that?
Doctor :   General Physician
Doctor :  
and one more possibility of your condition is anxiety related
User :   yea, my eye lash twitches sometimes too
Doctor :   Ok

User :   i know that stress/anxiety related
Doctor :  
eye lash twitches are common
Doctor :  
and is not of concern
User :   final question
Doctor :  
Ok
User :   im glad this is over chat
User :   my anus itches
Doctor :  
Ok
User :   not all the time
User :   but at night mostly, buy sometimes during the day
Doctor :  
Is it seen daily?
User :   not daily
User :   but multiple time per week
Doctor :   Ok
User :   once i start itching is gets worse, i dont want to destroy my anus
Doctor :   the causes could be like lack of hygiene, use of soaps to clean the anus and Pinworm infestation
User :   i've itched for a few years now. my doc told me to wash with no soap and warm water
User :   but it still itches
Doctor :   Ok

User :   then he gave me some cream and that didnt stop it. im too embarassed now to go back again
Doctor :   Ok

Doctor :   Are you sexually active?
User :   not in 2.5 yrs lol
Doctor :   Ok

Doctor :   So you will need to talk about the Pinworm infestation with your doc
User :   is that what you think it is?
Doctor :  
as it causes mainly in the early morning like around 4 am like that
Doctor :  
and also in the night
User :   he dismissed it saying its rare and he didnt see anything
Doctor :  
while at sleep it happens mainly
Doctor :  
in case of Pinworm infestation
User :   i scratch at night
User :   while sleep
Doctor :  
Yes
Doctor :  
that is common in Pinworm
User :   is it serious?
Doctor :   No

Doctor :  
it is not
Doctor :  
just needs to be treated to avoid the discomfort
User :   is the abdomen pulsating a symptom?
Doctor :   No

Doctor :  
such pulsations are usually seen when there are anxiety attacks
User :   one more minor thing. my mouth is always dry especially in the morning. this means bad breath and a dry whitish tongue
User :   what can i do about this
Doctor :   Ok

Doctor :  
You should increase your water intake
Doctor :  
and you shall improve
Doctor :  
Avoid dairy products before going to bed
Doctor :  
or clean your tongue
Doctor :  
and that shall help you
Doctor :  
clean your tongue before going to bed
Doctor :  
with a tongue cleaner
User :   so other than the 15 problem i seem quite healthy
User :   im only 26
User :   its hard not to be depressed
Doctor :  
Ok
Doctor :  
k
User :   do you recommend anti-depressant?
User :   im not on any but have though about it
Doctor :   better than hypnotics
Doctor :  
for long term use
Doctor :   Is there any thing else I can help you with?

User :   nope. thank you
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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