Electrified Legs or Restless Leg Syndrome

Lately my legs are feeling electrified.  And as a result, I am not able to fall asleep.

Terrible, I know, but it's really starting to drive me crazy!

I go to bed, and literally my legs feel ENERGIZED like I need to get up and run around, even though I am mentally wiped.  Serious conundrum I have. And Apparently so do many others. Like 7 % of the general population.

I of course, self diagnosed my electric leg problem as Restless Leg Syndrome, or perhaps some mild Peripheral Neuropathy, and shared this brilliant epiphany with my Family Doc. He gave me some samples of Caltrate, a Calcium Vit D multivit supplement and told me to trial it.. I now take it daily, and thought it may be assisting, until the last few week.

As a result of my issue I needed more info and did a brief literature review:

Merlino and company define Restless Leg Syndrome as below:

 Restless legs syndrome (RLS) is a sensorimotor disorder characterised by a complaint of an almost irresistible urge to move the legs.

Yup!  That's me, that's me.  Like even sitting in my office today my legs are vibrating. But is it RLS or some other Neuropathy related to my 29 year history of Type 1 DM.

Well the above article adds;

Furthermore, recent studies show that RLS may be associated also to type 2 diabetes mellitus and to multiple sclerosis.

May be linked?  So I continue my search.

Garcia-Borreguero from the Institution Sleep Research Institute, Madrid, Spain adds:

Recent data from the REST (RLS Epidemiology, Symptoms, and Treatment) general population study show that symptoms of RLS are present in approximately 7% of the general population, and that 2-3% experience moderate or severe symptoms at least twice a week.

and;

RLS is associated with a significant impairment of quality of life, comparable with that seen in chronic medical conditions such as diabetes or depression.

Man, this better not be another diabetes "Problem" to deal with.

One more study done by Gemignani, Franco and colleagues concluded:

Our data show that RLS is a relevant feature of diabetic neuropathy, as a frequent and potentially treatable manifestation of small fiber involvement in the course of DM and IGT/IFG.

Once again supporting a linking of RLS and DM, Wonderful!!!  Now what can I do about it?

Schapira from the UK links not only Diabetes, but also a genetic component to RLS.  Funny my Dad who doesn't have Diabetes, goes to bed at night and vibrates so much Mom frequently kicks him out of bed.  To quote the study directly:

Four essential diagnostic criteria for restless legs syndrome (RLS) have been identified. Patients experience an urge to move the legs, which typically begins or worsens during periods of rest. The symptoms are at least partially relieved by movement, and are typically worse in the evening and night than in the day. All four criteria are necessary to confirm the diagnosis of RLS. In addition, a family history of RLS, the presence of periodic leg movements in sleep, and a positive response to dopaminergic therapy are useful supportive clinical features to confirm the diagnosis. Whilst many cases of RLS are idiopathic, secondary RLS is often observed in pregnant women, patients who have severe renal dysfunction, or in those with iron deficiency.

I then looked into what can be done about my vibrating legs.  Satija add this about treatment and prognosis.

Treatment of RLS is usually rewarding. Most patients respond robustly to dopamine receptor agonists. Over time, response may lessen, or the patients may develop 'augmentation', whereby they have a worsening of symptoms, usually in the form of an earlier onset. Other treatment options include gabapentin, or similar antiepileptic drugs, and opioids.

So my drug options are laid out above. Not to fussy about the options. Basically Parkinson's, Narcotics, and Anti seizure meds.  I'll pass, for now anyway. Not to mention my Doctor is pretty stingy when it comes to handing out pills.


I did find a web site soley devoted to us people with Electrified Legs, AKA RLS. Check it out at http://www.rls.org/

After reading the site suggestions I have a plan to:

Reduce Caffeine, toughie for me, but okay, the website actually recommends eliminating it, Not!!!
Exercise - already in the plan, just need to do it daily
Hot Bath - Try to fit that one in, I have a hard time just using the bathroom in my house
Practice good sleep hygiene - Bed at the same time, Up at the same time
Limit Alcohol - Not hard for this guy
Review Meds that worsen - Apparently Antihistamines worsen it, Benadryll, Gravol, Anti Allergy meds
Diet - Needs to be balanced, hmmm, define balanced, that is a whole topic to itself
Lab Work - Apparently Iron Deficiency Anemia, and RLS are linked.


Trev

Sources:

Merlino, G. ; Valente, M. ; Serafini, A.; Gigli, G. L. Title Restless legs syndrome: diagnosis, epidemiology, classification and consequences.Neurological Sciences. 28(1) (Suppl 1):S37-S46, January 2007.

Garcia-Borreguero, Diego Institution Sleep Research Institute, Madrid, Spain.Tine to REST: epidemiology and burden. Source European Journal of Neurology. 13 (Supplement 3):15-20, October 2006.Gemignani, Franco; Brindani, Francesca; Vitetta, Francesca; Marbini, Adriana; Calzetti, Stefano Institution Department of Neurosciences, University of Parma, Parma, Italy. Restless legs syndrome in diabetic neuropathy: a frequent manifestation of small fiber neuropathy. Journal of the Peripheral Nervous System. 12(1):50-53, March 2007. 

 Schapira, A. H. V. Institution University Department of Clinical Neurosciences, Royal Free & University College Medical School and Institute of Neurology, UCL, London, UK  RLS patients: who are they?. European Journal of Neurology. 13 (Supplement 2):2-7, October 2006.

Satija, Pankaj; Ondo, William G. Institution Department of Neurology, Baylor College of Medicine, Houston, Texas, USA. Restless Legs Syndrome: Pathophysiology, Diagnosis and Treatment.[Review]
Source CNS Drugs. 22(6):497-518, June 01, 2008.

Sunday Summary

Wow, another week has gone by! 

Here are Three 2 Treat`s top 5 posts ranked by popularity:

1.  Exercise Good or Bad?

2.  Pro Carb or Low Carb?

3.  Ring The Bell Already!

4.  Are You Courteously Assertive?

5.  Sleep, Oh How I love Thee!


Have an awesome Sunday!

Trev

Sleep, Oh How I love Thee!

"What I need to avoid at work"

The title was suppose to be:  All You Need Is Love Sleep

If you read my last post, well, lets just say I am ready to go another round or two! Didn't Rocky make like 8 or 9 movies, I can't recall but it was a lot! I am steering away from seriousness to be more in favour of fun, easy, less obsessed. I want to thank you all for reading my blog, and giving me your feedback, it is moocho appreciated.

So back to the topic of sleep.

On my way to work in the cold(fridgid) winter months  I often notice people jogging or walking.  Now, don't get me wrong, I love the idea, or concept of working out, as it is good for you. But....I must identify what I find odd. 

Here are the oddities (to me anyway):

It's freezing!!! Like colder then your freezer. Like freakin cold!!!  I don't get it? If I don't have to be somewhere, like work, then leave me in my warm bed.  Now if I lived near the beach and it was sunny, then I may be inclined to get up early and exercise. But not in the dark, freezing cold Canadian Winter.

The funniest thing is the jogger with the little bags of pet doo-doo; I do thank all the pet owners for picking up the doo-doo drops.  However, I completely LMAO when I drive by and see the steam filled pouch being held my the early morning dog jogger, pinched ever so delicately with their mitted hand. Too funny!

Running on pavement?  Never understood the concept.  I know it kills my knees, and I am young. But running on cold, freezing, icy pavement, just goes contrary to the act of trying to improve one's health. To me it is a risk benefit thing. Run, wreck my knees, slip on ice, break a hip.  I say take a day off, and get some rest.

Okay. Before all you die hard runners, send the "Lynch Mob" style comments.  I do admire your discipline.  I guess to me; sleep, even on the best of days is something I find difficult to squeeze into my 24 hr day. 

Treating late evening highs, checking my little Type 1's  blood glucose through the night, or waiting for her levels to reach  safe range before hitting the pillow. Sleep is my priority.

I guess, I just think, sleep is often last on the list of important "Healthy Activities"  People work, clean, watch prime time TV, and catch the news, and more often then not, sleep is last on the list.

Not for this family.

As for physical activity.  I work out in the evening. Always have, and most likely always will. I know the early bird gets the worm, but who cares, who wants the worm anyways!

I know there are some dazzling studies about how society is getting less and less sleep compared to times past. But I will leave this blog light and fluffy today, so I can save time for some sleep. 

Trev

It's a Love Hate Thing

A colleague asked me yesterday why I work in the diabetes field. "Like, aren't you completely sick of it!"
By the way I am a Nurse who does Chronic Disease management.

I paused... and thought about the question....then responded, "well you'd think I would be, being Type 1 myself, and having to manage my 2 type 1 kids, and then working 40 hrs a week where I generally help others manage their diabetes"

Then I said to her I guess I feel good knowing at the end of the day I am helping others manage their diabetes and hopefully they will feel better and live a better life.

However, the question stuck with me (obviously I am still thinking about it today)

I love helping others, I enjoy doing research and using myself as a "Lab Rat" ,changing regimes, and trying to improve control through self experimentation. I love the feeling of nailing a good A1C, or a good 24 hours worth of normal glucose readings, it empowers me.  Now lets talk about the dark side.

I hate worrying about future complications, I hate how much time it takes for managing diet, tests, doctors, pharmacies, recovering from lows, interrupted sleep at night (from hypos) I hate that my 2 kids(out of 5-Ya I have a whack of offspring) have to struggle with diabetes.  I hate when you get thrown the old hormonal curve ball. I especially hate how it is always there, 24/7-365.   

Diabetes can take you in two main directions.  One of self discovery, learning, and the motivation to meet the challenge that it presents. The other direction is pretty much the opposite; refusal to learn, feeling of hopelessness, poor health and future complications.

However, nothing is that simple, and I think it is more a tug of war between the above two directions.

For me there are days I love diabetes, how its changed me and how I am now able to help others, but other day I absolutely hate it.......Definitely a Love-Hate relationship.

Trev