Brief Answer:
Workup for constant fatigue can be EXHAUSTING

Detailed Answer:
Good afternoon. Your question is a common one asked by many. Unfortunately, isolating the sole cause of fatigue, tiredness, or sleepiness is one of the most challenging diagnostic dilemmas in medicine.

You've not provided very much information for me to go on, however, just by telling me that you are 81 years old and have a pain medication pump which is installed is a RED FLAG right away. "Not supposed to......" with you filling in the DOT, DOT, DOT with anything you like are the most famous last words in medicine. Neither medications, nor diseases read medical text books and so the notion that a continuous infusion of some type of PAIN MEDICATION is as big a risk for sleepiness and tiredness you'll see above all else assuming that you're otherwise healthy.

Trust me when I tell you that medications leak out of all sorts of places they're supposed to stay put and that's natural...especially in someone whose muscle/fat mass in decreasing. The medication doesn't have very many places to stay put and if it's being pumped into spinal cavity then, that means there is direct access to the brain because the fluid into which the medicine is being pumped circulates about the brain. You DEFINITELY CAN get side effects from that medication having to do with mental blunting, cognitive dysfunction, memory/attention/concentration difficulties (especially when the pump is working to release medication...or whenever you push the button), and then, comes fatigue, sleepiness, weakness, and tiredness....despite getting LOTS OF SLEEP.

But aside from that most "out front" risk factor has your doctor checked your CBC to be sure you're not anemic? Even though the numbers may not be that low....again, if we are talking relative impact.....a 1-2% decrease in the total hemoglobin or hematocrit from normal of a 20 year old active young man will have almost zero impact on their ability to perform compared to the same 1-2% decrease in an 81 year old which is the equivalent of nearly a 10 point drop in a 20 year old...and that IS SIGNIFICANT. So, what are your BLOOD COUNTS as people like to call them. And if your blood counts are low....could your bone marrow be suppressed in any way and maybe not producing sufficient quantities

How about the thyroid gland and even the parathyroid, serum calcium and ionized calcium?

And if all the above parameters are normal or unremarkable then, how about looking at sleep disorders? Could you possibly have sleep apnea which is a HUGE risk factor for excessive daytime sleepiness despite the amount of sleep you may think you get because in fact, you would be CONSTANTLY waking up but not enough to know it or sense that anything were wrong.

My advice is to talk to your doctors and have them turn down the dispersion rate of the pain medication. Otherwise, if your doctor truly believes that the medication could not possibly be causing this problem you then, need a full workup with either a neurologist or sleep specialist.

If I've satisfactorily addressed your question could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback as to our transaction? Again, many thanks for posing your question.

Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 29 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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