TAKING CARE
By Leslie Girmscheid
October 2009
If you can't sleep, then get up and do something instead of
lying there and worrying. It's the worry that gets you, not the
loss of sleep. Dale Carnegie
It is better to sleep on things beforehand than lie awake about them
afterward. Baltasar Gracian
SLEEP: PART II
Simple insomnia can often respond to improvement in “sleep hygiene”. I have
listed a number of suggestions below. If you missed the first installment of SLEEP,
email me for a copy.
→ Consistency in bedtime hours. Routine helps.
→ Limit your daily intake of caffeine in coffee, black and green teas, colas and some
other soft drinks. People metabolize caffeine at a wide range of rates so stop your intake
by early afternoon to be on the safe side.
→ Chocolate can also be a stimulant; darker chocolate means there is more active
ingredient.
→ Moderate your alcohol intake as the breakdown product of alcohol can be a stimulant.
→ Avoid these foods which can cause reflux at least 3 hours before going to bed: coffee
(even decaf), chocolate, peppermint, alcohol, carbonated drinks, citrus juice, tomatoes,
large snacks, and foods or beverages that might cause belching.
→ Limit water intake after supper to decrease those nighttime trips to the bathroom.
→ Quit smoking well before bedtime as nicotine can be stimulating—better yet, just quit.
→ Avoid working on plans (even if you enjoy the project) right before you go to bed as
this revs the brain, making it difficult to shut down.
→ Turn off that TV or computer at a set time so that you have enough time to get ready
for bed. Doing email until you go to bed (you know who you are) is a guarantee that
your brain will not shut down for the night. Leave enough time to thumb through a
magazine, listen to calming music, or watch a little bit of TV like the Weather Channel,
TV Land or Nickelodeon. Is Sponge Bob on at night? That’ll hit the brain’s off switch.
Just make sure that the topics are light.
→ Avoid watching the news at night. Only read the news in the morning.
→ Get ready for bed before that show or video that you really want to see.
→ A 10-20 minute warm bath can be relaxing, and those with chronically cold feet
should have microwaveable foot warmers, which I happen to sell.
→ Turn the clock around.
→ Reading while in bed is not supposed to be ideal, but you should experiment with this.
Some beds do not provide support for sitting up and reading, but then again, is it better to
fall asleep in the recliner? You decide this one.
→ Some insomniacs are light sleepers and would benefit from a “white noise” machine, a
fan, air purifier, or a radio left on between stations to block noise.
→ Light to moderate exercise during the day seems to help with sleep, but if it is
performed in the evening, it may be stimulating.
→ Napping during the day can help dispel the anxiety about falling asleep in a select few,
but in others, it just contributes to the lack of sleepiness later.
→ Play with the thermostat to find a good sleeping temperature that is acceptable to you
and your housemates. Since a cool temp at night usually aids sleep, programmable
thermostats are great to allow for warming up the house before the alarm goes off.
→ Those of you with Seasonal Affective Disorder and a light box should your dose of
bright light in the morning.
→ Patients with low level aches and pains that just can’t get comfortable often respond to
acetaminophen at bedtime. Do not take ibuprofen on an empty stomach if this works
better for you. Take it after supper.
→ Over the counter sleep meds usually contain an antihistamine with or without a pain
medication. Side effects can include worsening of prostate troubles, dry mouth and eyes,
and morning grogginess. Be aware that the nondrowsy allergy pills may actually be a bit
stimulating in some and should not be taken at bedtime.
→ If you are interested in L-tryptophan, I would obtain it from food sources rather than
pills. Sources include meats, especially turkey, milk and cheese, tuna, soybeans, eggs,
almonds, lima and kidney beans, and chocolate.
OFFICE NOTES:
*****Receive $10 off your next massage for every new patient that joins my
practice because of a referral from you. Make sure they mention your name
when they make the appointment so that I put a credit in your chart.
***** GIFT CERTIFICATES are available. They are perfect for holidays,
birthdays, anniversaries, and as a thank-you for a job well done.
***** If you wake up sick, please call (after 7:30 a.m.) or email me at anytime in
the morning. I do not charge the cancellation fee if you are ill.
LAUGH OF THE MONTH
Sleeping at Your Desk (More)
TEN BEST THINGS TO SAY IF YOU GET CAUGHT SLEEPING AT YOUR DESK:
10. "They told me at the blood bank this might happen."
9. "This is just a 15 minute power-nap like they raved about in
that time management course you sent me to."
8. "Whew! Guess I left the top off the white-out. You probably
got here just in time!"
7. "I wasn't sleeping! I was meditating on the mission statement
and envisioning a new paradigm."
6. "I was testing my keyboard for drool resistance."
5. "I was doing a highly specific Yoga exercise to relieve
work-related stress. Are you discriminatory toward people who
practice Yoga?"
4. "Why did you interrupt me? I had almost figured out a solution
to our biggest problem."
3. "The coffee machine is broken..."
2. "Someone must've put decaf in the wrong pot...
"And the #1 best thing to say if you get caught sleeping at your desk.
1. " ...... Amen."
Skeleton
The orthopedic surgeon I work for was moving to a new office, and his staff was
helping transport many of the items.
I sat the display skeleton in the front of my car, his bony arm across the back of my
seat. I hadn't considered the drive across town. At one traffic light, the stares of the
people in the car beside me became obvious, and I looked across and explained,
"I'm delivering him to my doctor's office."
The other driver leaned out of his window. "I hate to tell you, lady," he said, "but I
think it's too late!"
CONTEMPLATION
Lessons to make you think about the way we treat people.
The Cleaning Lady
During my second month of college, our professor
gave us a pop quiz. I was a conscientious student
and had breezed through the questions until I read
the last one:
"What is the name of the woman who cleans the school?"
Surely this was some kind of joke. I had seen the
cleaning woman several times. She was tall,
dark-haired and in her 50s, but how would I know her name?
I handed in my paper, leaving the last question
blank. Just before class ended, one student asked if
the last question would count toward our quiz grade.
"Absolutely," said the professor. "In your careers,
you will meet many people. All are significant. They
deserve your attention and care, even if all you do
is smile and say "hello."
I've never forgotten that lesson. I also learned her
name was Dorothy.
Happy Halloween!
Leslie
Leslie Girmscheid, MD, NCTMB
3 Apple Tree Lane
Cape Elizabeth, ME 04107
207-899-3337
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