June 23, 2014

Ask the Doctors

I’ve had a stressful and overpacked schedule with very little sleep. I find I am forgetful and my thinking a little “fuzzy.” Do I have early dementia?

It sounds like a case of sleep deprivation. When we don’t sleep enough, we don’t think clearly and sometimes struggle with memory. It’s a sad but true fact that many people throughout the world are sleep-deprived. We have adopted amazing technologies that surround us and allow communication with friends and colleagues 24/7. We’re expected to be at the end of our cell phones, guarding our e-mail in-box, standing at the ready with Skype whenever needed. Many hours are spent surfing the Internet, visiting social networks, playing video games, and watching video clips on the Web. As a result, many are sleepless and restless.

The parts of our brain most affected by insufficient sleep and rest are the frontal lobes. Sleep deprivation impairs our cognitive performance. This in turn influences the quality of our decisions, emotional control, efficiency and productivity, and safety. We become less effective at recognizing the choices that are available to us and less capable of deciding which of the choices is best. Even if we can clearly discern the choices, we may not be able to act on what we know we ought to do. We may have reduced awareness of the surroundings, reduced ability to process the information, a decrease in our memory, and difficulty in learning new information. Because success in almost all of life’s endeavors is determined by the quality of the decisions we make, we can see that it’s vitally important to sleep well. When we miss out on sleep, we accumulate what is known as “sleep debt.” As this accumulates, we become less productive.

How Much Sleep Do We Need?

Sleep needs vary from individual to individual. Nearly all sleep experts agree, however, that seven hours of sleep per night is enough to manage adequately, but that most people need about eight hours for optimal function. Adequate nighttime sleep should remove most daytime sleepiness and provide a sense of calm well-being and alertness. Individuals with sleep disorders, whether from obstructive sleep apnea or significant mental health disorders, all complain of daytime sleepiness and tiredness. Sleep prepares our bodies and minds for peak performance. Most sleep-deprived people are totally unaware of their own reduced capabilities because they’ve been sleepy for so long that they don’t know what it’s like to feel wide awake! A rested person will accomplish more in less time and do it better, more effectively, and safely.

Most sleep-deprived people are totally unaware of their own reduced capabilities.

Practical Tips

Here are a few steps to getting a good night’s sleep:

Learn to value sleep. We never accomplish what we don’t value.

Establish a regular bedtime ritual to let your mind and body know that you’re preparing to sleep.

Exercise appropriately every day, at least four to five hours prior to retiring.

Establish regular times for rising and retiring, and stick to them even on weekends.

Use a comfortable, firm bed located in a quiet, cool bedroom not cluttered with TVs, computers, and exercise equipment.

Eat lightly in the evening, several hours prior to bedtime.

Avoid watching exciting or depressing TV programs or movies, engaging in arguments, or making momentous decisions shortly before bedtime.

Avoid the use of sleeping medications, caffeine, and alcohol, which disrupt normal sleep architecture.

See your personal physician if you suspect a sleep disorder or other medical condition.

Relinquish your problems and anxieties to God as you go to bed—He cares for you.

Back to your question. Get into the routine of regular sleeping. If your thinking remains fuzzy and memory does not improve even though you are well rested, seek medical advice.

Remember: tonight’s sleep builds tomorrow’s energy! Sleep is as important as diet and exercise, only easier!

I recently married, and my husband has been found to have a cancer in his thyroid. He is 29 years old, and I’m extremely worried about his condition. Could you give me some information about thyroid cancer?

The thyroid is a small, shield-shaped gland that straddles the voice box and usually isn’t visible. The cells of the thyroid produce thyroxin, a hormone that stimulates metabolic activity in all other cells of the body. The absence of thyroxin is not compatible with life, and low levels may manifest with fatigue, lethargy, dry skin and hair, a low heart rate, and thickening of the skin of the face and tongue. Constipation and cold intolerance may be other features.

The thyroid cells trap iodine from the blood and bind it to an amino acid called tyrosine to build up the four molecules of thyroxin. The thyroid is stimulated to perform its functions by a pituitary hormone called thyroid stimulating hormone (TSH), and when the levels of thyroxin rise, TSH is suppressed—and vice versa.

The thyroid gland may develop nests of cells that grow into nodules; about 4 to 7 percent of the population has such nodules. Women are typically affected more than men. Of this small group of people with thyroid nodules, possibly 10 to 20 percent will develop cancer in the nodule.

In Japan autopsy has identified “hidden,” or “occult,” thyroid cancer in 28 percent; whereas, for the rest of the world, it’s about a 5 to 10 percent finding.

Thyroid cancer is classified into four types: papillary, follicular, medullary, and anaplastic.

Papillary thyroid cancer is the most common of these. In about 40 percent of cases it spreads to lymph nodes on the same side of the neck. Older patients have a greater risk of distant spread, though children and youth may also have spread.

Follicular thyroid cancer is less common but has a slightly worse prognosis than papillary carcinoma. It occurs more in the older age groups. This cancer is usually “well differentiated,” which means its cells retain many of the characteristics of normal cells.

The third type is the medullary thyroid cancer. This cancer grows from what are called C cells, which normally produce a hormone called calcitonin that pushes calcium into the bone. This cancer may cause secretory diarrhea, flushing, and vasomotor effects related to calcitonin secretion. It can be hereditary, and can be associated with other types of tumor such as pheochromocytomas, which produce adrenaline-like hormones.

Anaplastic carcinomas are usually aggressive and metastasize early.

Surgery will offer the first line of treatment. This may be accompanied by lymph node dissection, both to treat and to define the stage of the disease.

For follicular and papillary types, which can be expected to trap iodine, radioactive iodine is often injected. The tumor will trap the iodine, and the radioactivity will then kill the cells from within.

Sometimes the neck will be irradiated in an attempt to blast away the cancer cells.

Your physician will diagnose the exact form of thyroid cancer your husband has and recommend the best treatment. And remember: We are always in the hands of the Great Healer—our Lord and Savior, Jesus Christ. Put your trust in Him.

Send your questions to Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or e-mail them to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend you consult with your personal physician on all matters of your health.