Monday, June 20, 2016

Effects of Snacking Late at Night

Although clinical studies vary on if late-night snacking causes people to gain weight, it can certainly interrupt your sleeping patterns. Not getting enough sleep can lead to weight gain.

My favorite time for snacking is late in the evening. Although I know I shouldn't do it, I eat late in the evening anyway. Why? Perhaps because I associate eating with relaxation.  Perhaps I got into the habit of eating a meal before going to bed when I worked the graveyard shift.  Or perhaps I have bad eating habits. 

Because I have never been able to break this habit, I have curtailed it a bit. I generally don't snack in the daytime (usually because I'm not hungry). Instead of having something high calorie and high protein, I usually limit it to a few cookies or a bowl of cereal. And I string out the time it takes me to eat my snack by reading, writing or watching my goldfish in order to distract me from my belly.

Do You Gain Weight Or Not?

One of the reasons that eating late at night is discouraged is because it it generally believed that you gain weight faster when you eat and immediately sleep rather than eat and go throughout your day, burning those calories. However, this might not necessarily be true. (But if believing eating right before bed will make you fat is enough to stop you eating before bed, skip the next paragraph!)

A 2006 study done by the Oregon Health & Science University studied the weight gain of 47 female monkeys. Eating at night didn't cause any significant weight gain over eating during the day. Giving hysterectomies to 19 of the monkeys didn't make a difference, either. Apparently, you need more than just a day to burn off calories consumed.

Contrast this with a 2005 study done on college students who regularly snacked from 8pm to 4am. Conducted by The American College of Sports medicine, 212 college students described as "sedentary" gained at least 1.1 pounds when they snacked at night.  And another study released in 2009 also linked eating before sleep to weight gain – well, for mice, at least.

Your Sleep Is Disrupted

But the big reason not to snack right before bed is that the digestion often interrupts your sleep. This can be because you have to go to the bathroom, or that you get heartburn after lying down too soon after eating, or you are snacking with caffeine and sugar that can keep you awake.
You also want to avoid alcohol a few hours before bed, because not only does that pack on the pounds (no matter what time of day you drink it) but it can also make you have irregular sleep patterns.

When you don't get enough sleep, you get stressed. And when you get stressed, your body puts out a chemical called cortisol that gets your body ready to run for its life or fight for survival. When cortisol is released, it tells the body to stop certain functions so you can have the most energy diverted to fighting or fleeing. One of these is digestion.

So, you can't digest your food as thoroughly when you're chronically stressed with sleepiness as when you have enough sleep. Because stress can make you fat, it can be extrapolated that eating a lot right before bed can make you not only tired and stressed, but fat.


Mayo Clinic. “Insomnia: Causes.” 

Monday, June 13, 2016

Cymbalta Side Effects and Withdrawal Symptoms

The body needs about 2 to 4 weeks to adjust to Cymbalta (duloxetine hydrochloride.) It often causes sleep problems. Here’s how to know when to call the doctor.

Cymbalta is the brand name for duloxetine hydrochloride, which in the family of antidepressants called SSRIs (selective serotonin reuptake inhibitors). More familiar drugs like Prozac (fluoxetine) and Paxil (peroxetine) are also in the family. Although many people with depression, fibromyalgia and/or general anxiety disorder (GAD) have been helped with Cymbalta, side effects are common and to be expected.

Normal Side Effects

It can take up to a month for the body to adjust to life with Cymbalta. This means that some normal side effects can last for a month. Some people adjust as soon as ten days. The normal side effects of Cymbalta for new users are:

  • Fatigue
  • Increase in appetite (although some people have a decrease in appetite)
  • Dry mouth
  • Constipation or diarrhea (but not both)
  • Increase or decrease in sleep
  • Loss of sex drive
  • Mild nausea that goes away after a couple weeks.

Serious Side Effects

Like any other drug, some people can be allergic to Cymbalta. These serious side effects will show up within the first week of taking it, maybe even after just a couple of days. Contact your doctor immediately if you get any or a combination of these symptoms: 

  • Suicidal thoughts
  • Sudden nosebleeds
  • Sudden, unexplained bruising
  • Black, grey or tar-like stools, which usually indicate blood in the stool
  • Loss of coordination or inability to stand up
  • Vomiting (although some nausea is common, vomiting isn't)
  • Hallucinations or mania
  • Intensification of anxious symptoms (if you are taking Cymbalta for GAD)
  • Seizures
  • Shallow breathing or problems breathing

Since you may not be aware if you are hallucinating, it's good to let a trusted person like a parent or friend know that you have started taking Cymbalta. Sometimes the doctor's office will act in this capacity. All they need to do is check up on you once a week to see how you are doing. If you start talking about demons out of the wall, then they can let you know that you are hallucinating and you need to get in contact with your doctor.

Don't Just Stop

You shouldn't stop taking Cymbalta cold turkey, unless you've only been taking it for a week. But over a week, the body starts getting used to Cymbalta and can give you painful withdrawal symptoms if you suddenly quit. You may just need a reduction in dose. Eventually, years down the road when your doctor says the time is right, you can wean yourself off of Cymbalta by gradually reducing your dose. But that's a subject for another article.

Withdrawal symptoms include, but are not limited to:

  • Migraines or headaches
  • Vomiting
  • A strange tingling or burning sensation
  • Sweating
  • A return of all the symptoms you had before you started taking Cymbalta
  • Changes in sleep patterns (too much or too little)
  • A marked increase in irritability
  • Trembling or shakiness
  • Nightmares

These can last from three days to three weeks. Being dependent on Cymbalta or any medicine that helps better your quality of life is not a sign of moral weakness.


The Family Intervention Guide to Mental Illness: Recognizing Symptoms & Getting Treatment. Bodie Morey & Kim T. Mueser, Ph.D. New Harbinger Publications; 2007.

US Food & Drug Administration. "Cymbalta (Duloxetine Delayed-Release Capsules) Medicine Guide."

Wikipedia. “SSRI Discontinuation Syndrome.” 

My Mom has also been taking Cymbalta for yonks.

Causes of Charley Horses or Nocturnal Cramps

Charlie (or charley) horses are also known as nocturnal cramps or simply muscle cramps.  They are mostly located in the arch of the foot, the calf and up the leg.   Medical science doesn't agree as to their causes but they do agree that charlie horses can be prevented.  

The main triggers for charlie horses include too much exercise and certain drugs.  The most serious cause is increasingly poor blood circulation (or intermittent claudication), so muscle cramps in the legs and feet should be checked out by a doctor.


Since the cramps are commonly associated with vigorous or prolonged exercise, it's thought that there may be a chemical imbalance that causes muscles to contract and then refuse to relax.  Various theories have been batted about that the muscles loose too much electrolytes or that circulation has been somehow damaged during dehydration or muscle strain which then causes the body to be unable to properly flush away toxins.

Whatever the true reason, fear of intensely painful nocturnal cramps may keep some people from engaging in regular exercise.  They may begin an exercise program and do too much at once, causing not only  charley horses but other pains.  This is why it is important to talk to your doctor before you start on an exercise program and to begin slowly.

Adventure Vacations

Although charley horses may be seen most often in children, the elderly and athletes at the beginning of their sports' seasons, there is another section of the population very prone – the vacationer.  This person has sat at a desk job for 50 weeks of the year and wants to have an active, sports-filled vacation, such as riding at a dude ranch.

However, his muscles are not used to the sudden burst of activity.  A few hours in the saddle leads to charley horses and a miserable rest of the vacation.  If planning an adventure vacation, it is best to begin regular exercise at least three months before the vacation starts.  During exercise, be sure to drink plenty of quality fluids like water.  This at least gets the muscles used to activity.  It may not prevent all charley horses, but it may lead to less painful charley horses.


But this does not explain all causes of severe leg and feet muscle cramping. Certain medications can also trigger charlie horses.  These include antipsychotic drugs like amytriptaline; blood pressure medications like statins; drugs for diabetics and corticosteroids like prednisone.  Addicts of drugs such as heroin may also suffer from charley horses and not do any exercise, according to the American Academy of Orthopedic Surgeons.

One theory is that these medications (as well as illegal drugs) take out fluids that the body needs to properly maintain the endocrine and circulation systems.  But just exactly why these drugs cause cramps and not others is unknown.


Women’s Health & Wellness 2003. The Editors of “Health” Magazine. Oxmoor House; 2002.

The American Academy of Orthopedic Surgeons. “Your Orthopedic Connection: Muscle Cramp.” 

ABC News. “The Mysterious Pain of ‘Charley Horse’.” Lauren Cahoon. April 1, 2008 (no joke).

Saturday, June 4, 2016

Killing Bed Bugs in Electronics

Yes – they can hide in electronics.

Your home has bed bugs. Your home will need at least two treatments from professional pest managers in order to kill the bed bugs. 

Unfortunately, adult bed bugs can last up to one year between meals.  What do they do all of this time when they are fasting?  Hiding.  The nearly flat bodies of bed bugs make them insect Houdinis, escaping from insecticides into the narrowest of cracks – including those in your electronics.

How Valuable is the Electronic?

Bed bugs tend to stay in rooms where ever a person sleeps, so unless you sleep in the kitchen, the kitchen electronics should be fine.  A professional exterminator may concentrate his or her energies on checking for infestations in places where people sleep or nap.

Is this a clock radio or a laptop?  When your home or business is infested with bed bugs, assume that everywhere that a bed bug can fit into is home to adults, larvae (called nymphs) and eggs.  If the item can be easily replaced, place it in a resealable plastic bag and throw it out.

Outside Electronics

More valuable items like televisions or personal computers cannot be easily replaced unless you are really rich.  Exterminators will check these items, but you can, too, if you have a magnifying glass, a knife and a vacuum.  Always wrap up an electronic item in plastic before moving it out of a room, or you may wind up giving bed bugs a free taxi ride to infesting yet another part of your home.

The object is to sweep the bugs out of the cracks and vacuum them up immediately.  This works best on light-colored floors, although nymphs are mostly transparent unless they have recently fed.  With the magnifying glass, check screws, seams and ridges for adults or for fecal deposits, which look like rusty-brown or black spots.  If you see them, pass the knife in the crack and force the bugs out.  Zap them up with the vacuum. Immediately empty the bag into an outside garbage container.

Fumigating Electronics

Exterminators use cans of compressed air to blast bugs out of electronics, notes board certified entomologist and author of The Bed Bug Book (Skyhorse; 2011) Ralph H. Maestre.  Compressed air cans are sold in computer stores, often labeled as a safe way to remove dust from sensitive screens.

If the bugs have gotten into the electronic, things get more complicated.  The item needs to be fumigated by deep-freezing.  The only safe method so far is pressurized carbon snow, best known under the brand name Cryonite.  Not all exterminators will be able to use pressurized carbon snow, so ask beforehand.  


Never spray over the counter insecticide aerosols into electric outlets or electronics! This can cause fires.  Never use total release aerosols or “bug bombs.”  Bug bombs do not penetrate into bed bug hiding places.  Over-the-counter insecticides will NOT kill bed bugs, even if they are labeled as killing bed bugs, warns Cornell University’s New York State Integrated Pest Management department.

Pesticide sprays and dusts that do kill bed bugs are regulated, but still may not kill bed bug eggs.  You will need a second or third treatment in order to kill newly hatched bugs.


The Bed Bug Book.  Ralph H. Maestre.  Skyhorse Publishing; 2011.

Cornell University New York State Integrated Pest Management. “How to Deal with BedBugs.” 

University of Minnesota Extension. “Prevention and Control of Bed Bugs in Residences.” Dr. Stephen A. Kells & Jeff Hahn.  2011.  

Bulimia: Symptoms, Types and Treatments

NOTE: Many people with bulimia also suffer from sleep problems. The best way to treat the sleep problems is to treat the bulimia. Talk to your doctor in the meantime about treating sleep problems caused by the eating disorder as you work on managing your bulimia.

When you discover that someone you know has bulimia, it can be hard to believe. Often, bulimics seem to be the envy of everyone they know. That is one reason why bulimia is so hard to recognize and treat in others.

Dangerous Symptoms

Although bulimia is often considered a teenage girl's affliction, baby boomers, young boys and grown men turn to bulimia to help them with their self-image. Symptoms of bulimia in either sex include:
·         Mood swings
·         Problems with teeth, cheek glands, and/or heartburn (see image)
·         Preoccupation with food, even if you never see them eat
·         Fears of getting fat
·         Use of the bathroom soon after meals
·         Irregular to no periods in women.

Types of Bulimia

We tend to think of bulimia as someone stuffing themselves with a refrigerator full of food and then throwing it all back up. There are actually different types of bulimia eating disorders which all showcase a person's self-hatred by their unhealthy relationship with food. Here are the three types of bulimia:

·         Anorexia bulimia: This is when someone alternates between anorexia (not eating) and bulimia.
·         Bulimia nervosa: This is the "usual", where the victim is obsessed about their looks and usually does not eat in public. They then binge eat and purge through vomiting or taking a lot of laxatives. This can go on for years until physical affects are eventually seen.
·         Pro Bulimia, Pro Ana or Pro-Mia: This is when a bulimic is in a state of denial about the damage they are doing to their health. They refuse to see bulimia as a problem, but instead call it a "lifestyle choice." As a consequence, they refuse treatment and resent being told they have a problem which could eventually kill them.

Treatment Options

You don't really need a doctor or therapist to diagnose bulimia (especially if you catch the bulimic in the acts of binging and purging), but a professional diagnosis can greatly help the patient face the problem. Any doctor or therapist should be able to diagnose bulimia.

There are many treatment options available, especially if there are any other issues like addiction or depression in addition to bulimia. The patient might not need to do all of them or do a combination in order to feel better about themselves and about food. Bulimia treatments include:

·         Therapy: This could be for the patient or for the whole family as ongoing treatment or an intense rehabilitation retreat.
·         Medication: Bulimia brings on secondary symptoms that need medical attention, such as loss of menstruation or getting tooth damage. The triyclic antidepressant Elavil (amitripyline) is often prescribed for bulimia. Other antidepressants are used when a patient cannot take amitripyline. Another promising drug is Topamax (topiramate.)
·         Support groups: This is essential for ongoing treatment, just to let the patient know they are not alone and don't have to fight alone. Social interaction is also helpful in breaking self-destructive thoughts and to think about something else other than when to binge and purge. You can find anorexia and bulimia support groups online as well as through your doctor or your Yellow Pages.
·         Hospitalization: This is for emergencies, such as collapse or a suicide attempt. Although it might seem drastic, it may serve as a needed wake-up call.


eMedicine. “Bulimia.” Rebecca Barth, MD, et al. Oct. 8, 2010

Mayo Clinic. “Bulimia Nervosa.” 

National Alliance on Mental Illness. “Eating Disorders.” 

Sunday, May 22, 2016

What are the Causes of Cluster Headaches?

Women that have both given birth normally and experienced cluster headaches claim that giving birth hurt less.  But unfortunately, the exact cause of these crippling attacks remains unknown. However, attacks often begin during sleep.

Image: "The Headache" by George Cruikshank (1819)

Cluster or suicide headaches are one of the most painful types of neurological conditions that can happen to a human being.  Women that have both given birth normally and experienced cluster headaches claim that giving birth hurt less.  But unfortunately, the exact cause of these crippling attacks remains unknown.  More research needs to be done in order to determine why some people get cluster headaches and not others.


For an unknown reason, men are far more likely to get cluster headaches than women.  Women aren’t completely lucky because they are three times more likely to suffer from migraines than men.  This may have something to do with hormones, but just how they play a part is still unknown. 

Being a black man over the age of twenty that smokes, drinks and has someone else in the family that also suffers from cluster headaches is the most likely person to develop cluster headaches.  Just why is still unknown. 

Theories For Causes

One theory is that people are born with a genetic predisposition for headache problems, including migraines and cluster headaches.  A variety of conditions have to come about in order to trigger a cluster headache attack.  One of these conditions is the brain not being able to properly absorb the neurotransmitter serotonin.  Perhaps not coincidentally, serotonin problems are also thought to be the blame for migraines, major depression and epilepsy.

One major trigger seems to be a lack of oxygen caused by sleep apnea.  Breathing high-flow oxygen has shown to help many patients that suffer from either migraines or cluster headaches. Lack of oxygen may also explain why many attacks begin one or two hours after a patient falls asleep.  The pain becomes so bad it wakes him or her up.

What About Brain Activity?

The Mayo Clinic reports that MRI scans of cluster headache sufferers had significant activity in the parts of their brains known as the hypothalamus.  Just why is, again, unknown.  Could it be the hypothalamus is malformed or have become damaged in some way?  According to Lori K. Sergeant, MD and Michelle Blanda, MD, sometimes people suffering from cluster headaches did have a head injury in their past.  But not all cluster headache sufferers have had head injuries.

Could the rise or drops in natural hormones produced by the body such as melatonin or cortisol?  Again, we just don’t know.


Migraines For Dummies. Diane Stafford and Jennifer Shoquist, MD. For Dummies; 2003.

ABC News. “Oxygen Therapy Can Help Cluster Headaches.” Lauren Cox. December 9, 2009

eMedicine. “Headache, Cluster.” Lori K. Sergeant, MD and Michelle Blanda, MD. May 20, 2010.  

Bed Bugs and Insect Growth Regulators

I wrote this article a few years ago, but the information is still valid. I see that some folks have reprinted it for their blogs without my permission. May you get bed bugs, Scrapers.

The only known IGR for bedbugs is hydroprene

Bedbug infestations are not only creepy, they are expensive to treat. One type of chemical used to kill bedbugs is the insect growth regulator or IGR called hydroprene.

What Is An IGR?

Insect growth regulators or IGRs do not kill insects.  But they can help prevent insect larvae from maturing.  Remember that only the adult phase of many insects such as bedbugs can breed.  If a population stops breeding and no new breeding insects are introduced, eventually the insect population dies out.

IGRs can be used separately, but more often they are combined with pesticides.  But you cannot find IGRs on the store shelf.  These are regulated chemicals, which means that only a licensed exterminator can (or should) get a hold of them and use them. 

Which IGR Is Which?

IGRs can be easily confused.  The same company that manufactures Precor with methoprene, Zo√ęcon, does make an IGR product for bedbugs called Gentrol.  Its IGR ingredient is hydroprene, the only IGR affective against bedbugs, according to Virginia Tech entomologist Dini M. Miller, PhD.  But unfortunately, some exterminators have been reported using methoprene in the belief that it worked like hydroprene.  Also, some people may have done a quick Internet search and picked up information about IGRs and bedbugs from dubious sources.

For example, one major typo on the otherwise highly respected articles by University of Nebraska-Lincoln entomologist Barb Ogg, PhD accidentally states that the brand name Precor is recommended for bedbugs.  Later on in the article, hydroprene is identified as the brand name Gentrol.  However, anyone skimming the article and not taking the time to read the entire thing may mistakenly think Precor is the product they need.  If they have bedbugs, then chances are high that they haven’t had much sleep lately. 

What Does Precor Kill?

Methoprene helps to stop severe flea infestations, not bedbug infestations.  But it cannot be used alone to manage a flea infestation because it cannot infect adult fleas or fleas that are already breeding, only flea larvae and flea eggs.  Since Precor is a combination of methoprene and two pyrethroid insecticides, it should be able to kill the adults, but not before they’ve bred.

Regular vacuuming, laundry and housecleaning can help to reduce both the populations of bedbugs and fleas, but housecleaning does not do the job all by itself.  It needs to be combined with a chemical assault in order to eliminate these two blood-sucking pests.

How Effective Are IGRs against Bedbugs?

IGRs like hydroprene work much better under laboratory conditions than in real world conditions.  As explained by Dini M. Miller, bedbugs are constantly exposed to hydroprene and therefore die in larger numbers.  But how can you guarantee a constant exposure in the home environment?  This can be a problem. 

Miller also notes that some bedbug larvae exposed to hydroprene did survive to adulthood and mated once before they died.  Although they died before their normal lifespan expired, they still were able to breed.  So, do not expect miracles using hydroprene against bedbugs.  It may take more than one application before the bedbugs are gone.


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