The mission - sleep: The shingles virus lies dormant in the body - and then breaks out | Prof. Rafi Carasso
What is the reason for the continuous lack of sleep, how to overcome migraine pain, and why is there sometimes a blurriness in the period after cataract surgery?
I am 50 years old and have suffered for years from high cortisol levels, excessive facial hair, and severe sleep disturbances — the feeling is one of complete lack of sleep for two months. Various pharmacological treatments for sleep and sedation have not helped. What is the reason for the condition and how should one act?
«High levels of cortisol in the blood, which do not stem from an external cause (such as taking steroids), raise suspicion of Cushing's syndrome. This syndrome usually stems from a benign tumor in the pituitary gland or the adrenal gland, and requires an in-depth endocrinological investigation.
Medically, there is no state of complete lack of sleep for two consecutive months. It is a matter of very fragmented sleep, or unconscious sleep (micro-sleeps), in which the patient does not experience a feeling of freshness and feels as if they have not slept at all. I recommend turning to the attending physician and requesting a home sleep monitoring test (actigraphy) to evaluate the true quality of sleep. In addition, ask the doctor to perform a re-evaluation of the medication treatment while considering adjusting dosages or switching to drugs with different mechanisms of action.»
My 45-year-old son suffers from severe pain and intense burning due to shingles. The medication treatment does not prevent his suffering and he cannot sleep. How can it be relieved, and is there a fear of contagion?
«The shingles virus lies dormant in the body after chickenpox, and tends to break out in situations of mental stress or during a decrease in immune system function. Nerve pain in shingles can be very powerful. To relieve the pain, it is recommended to combine treatment intended for calming nerve (neuropathic) pain and general painkillers, according to a doctor's instructions.
It is important to understand: the disease is not contagious as shingles to adults, but visible blisters can infect children or people who have not had and have not been vaccinated in the past against chickenpox. I suggest adhering to a balanced Mediterranean diet, adapted physical activity, and sufficient sleep. In addition, in consultation with the attending physician, a few months after recovery from an acute outbreak, it is recommended to receive a dedicated vaccine against shingles to prevent recurrence of the disease.»
I am 29 years old, suffering for three years from migraines accompanied by tension in the neck area, with a frequency of once or twice a week. Basic painkillers help, but are there other treatments? And also, is there a connection to diet and sleep?
«Migraine is a chronic disease. If painkillers from the non-steroidal anti-inflammatory series provide a good response, they can be continued. In case the attacks worsen, one can be assisted by dedicated migraine drugs (from the triptan family) by medical prescription.
It is recommended to keep a tracking diary and avoid foods known as attack triggers: foods containing nitrites (such as sausages and processed meat), chocolate, red wine, and monosodium glutamate. Also, a sudden change in sleep patterns, such as sleeping a lot on weekends, is a common trigger for an attack outbreak. To relieve neck tension, I suggest a combination of relaxation techniques, meditation, and ergonomic adjustment of the work environment (screen, chair, and sitting angle) that will help reduce muscle load in the neck and head area.»
How can food sensitivities that cause gas and bloating be diagnosed, and is it allowed to stop cholesterol treatment after the values have stabilized?
«When imaging tests are normal, it is recommended to take the elimination method (gradual reduction): complete cessation of dairy products for three weeks to examine for improvement. If there is no improvement, one should try switching to a gluten-free diet or separating carbohydrates and proteins in meals.
Regarding the treatment for high cholesterol, it is important to understand that this is a chronic condition. The drugs do not 'cure' permanently but balance the condition as long as they are taken. Stopping the treatment will lead to a renewed rise in cholesterol levels, similar to sugar levels that climb again without treatment. Therefore, it is recommended to adopt the 'golden mean' principle — avoiding exaggerations, maintaining a varied diet, and eating sweets in a controlled manner.»
I am 62 years old, and I underwent cataract surgery about two months ago. Since the surgery, I feel a sense of blurriness and instability, mainly when going out to the street or to closed and crowded complexes like malls. Eye exams and ENT exams were found to be completely normal.
«This is a known phenomenon. After the surgery, the brain requires adaptation time to re-process the update in visual focus and the sharpness of the image received. Sometimes a slight component of anxiety about open or crowded spaces accompanies the process, stemming from the gap between the new sense of vision and the surrounding space. It is recommended to use dark sunglasses when leaving the house, as strong light and glare can increase the feeling of discomfort and blurriness. In the vast majority of cases, the phenomenon passes by itself when the brain's adaptation is completed. In case the feeling persists and interferes with functioning, one can consult with the doctor regarding short-term anti-anxiety treatment.»
