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Family Medicine (Expert Forum)
Restless Legs
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Restless Legs
by Ketta, Apr 08, 2002 12:00AM
Help, I need the advice of a doctor.
A year ago I was seeing many doctors for many pains and problems: headaches, pelvic pain, breakthrough bleeding, insomnia, backaches, anxiety, INSOMNIA, etc. I was perscribed many meds. and many were controlled. I had a general practioner confront me about "doc. hopping," he had received a letter from my insurance saying I'd been given too many Rxs. He felt I was taking too much, and I guess I agreed and said I'd get "help." I didn't think I was doc. hopping, and no one helped me in the year I'd seen 8 different doc.s, and there is a history of addiction in the family and I could see the meds as out of control. So, I went to an addiction specialist and he tried to sell me his brand of herbal tea?? It was not applicable to me and I didn't pursue "help." AFter I was confronted, I refused to go to the doc. even though I suffered still from the headaches, backaches, anxiety, etc. I just stopped taking any pills and did not seek them in any way. I just worked out more and kept. busy.
My husband made me go when I would writh in pain unable to go to work or have sex. Finally, after nine months of not going to any doctors, and not taking any meds, I saw my fourth OBGYN and she ordered a sonogram. Turns out I had softball size tumors on my ovaries. Further investigation revealed an elevated CA-125(REALLY ELEVATED) >1300. Surgery discovered stage four ovarian cancer. Cancer was resected from uterus, lost one ovary, removed cancer from the other, the umodendum(fat layer over stomach/pelvis)removed and six days in the hospital.
My prognosis is amazingly good. My oncologist doesn't know about the "letter" that my insurance sent to my gen. practioner over a year ago. I only took the pain meds post surgery and as little as I could and often went without for fear he would find out about this letter and yell at me or refuse to treat me. My cancer is under control, however, I have HORRIBLE restless legs and often go 4-5 days without sleeping and have terrible pain. They had me in some contraption that did lead to nerve pressure during surgery 8wks ago. The discomfort has not gone away, it's gotten worse. I am scared to tell my doc. I don't want him thinking I'm "seeking" but these restless legs are torture.
You'll say to tell him everything, fine, but what happens when he kicks me out for allegedly doc. hopping a year and a half ago? I'm scared because there are only two specialists in gynocological oncology and my doc. is really terrific. I still am not sure I think I was doing anything wrong- and no one ever found my cancer- my pain was REAL. I have taken buckets of calcium, potassium, unisom, valerian root, and tylenol to deal with these restless legs at home, but I still suffer with this!
A year ago I was seeing many doctors for many pains and problems: headaches, pelvic pain, breakthrough bleeding, insomnia, backaches, anxiety, INSOMNIA, etc. I was perscribed many meds. and many were controlled. I had a general practioner confront me about "doc. hopping," he had received a letter from my insurance saying I'd been given too many Rxs. He felt I was taking too much, and I guess I agreed and said I'd get "help." I didn't think I was doc. hopping, and no one helped me in the year I'd seen 8 different doc.s, and there is a history of addiction in the family and I could see the meds as out of control. So, I went to an addiction specialist and he tried to sell me his brand of herbal tea?? It was not applicable to me and I didn't pursue "help." AFter I was confronted, I refused to go to the doc. even though I suffered still from the headaches, backaches, anxiety, etc. I just stopped taking any pills and did not seek them in any way. I just worked out more and kept. busy.
My husband made me go when I would writh in pain unable to go to work or have sex. Finally, after nine months of not going to any doctors, and not taking any meds, I saw my fourth OBGYN and she ordered a sonogram. Turns out I had softball size tumors on my ovaries. Further investigation revealed an elevated CA-125(REALLY ELEVATED) >1300. Surgery discovered stage four ovarian cancer. Cancer was resected from uterus, lost one ovary, removed cancer from the other, the umodendum(fat layer over stomach/pelvis)removed and six days in the hospital.
My prognosis is amazingly good. My oncologist doesn't know about the "letter" that my insurance sent to my gen. practioner over a year ago. I only took the pain meds post surgery and as little as I could and often went without for fear he would find out about this letter and yell at me or refuse to treat me. My cancer is under control, however, I have HORRIBLE restless legs and often go 4-5 days without sleeping and have terrible pain. They had me in some contraption that did lead to nerve pressure during surgery 8wks ago. The discomfort has not gone away, it's gotten worse. I am scared to tell my doc. I don't want him thinking I'm "seeking" but these restless legs are torture.
You'll say to tell him everything, fine, but what happens when he kicks me out for allegedly doc. hopping a year and a half ago? I'm scared because there are only two specialists in gynocological oncology and my doc. is really terrific. I still am not sure I think I was doing anything wrong- and no one ever found my cancer- my pain was REAL. I have taken buckets of calcium, potassium, unisom, valerian root, and tylenol to deal with these restless legs at home, but I still suffer with this!
Doctor's Answer
by Forum-M.D.-DT, Apr 09, 2002 12:00AM
Thanks for visiting the family practice forum.
I think it may be a good idea to consider another primary care practicioner (GP or FP). Sometimes, once a doc has it in their mind that you are "doc hopping" or "drug seeking", it is difficult to change their mind. I am not saying that you are doing any of these things, rather ... letting you know how doctors "are". Restless legs syndrome is a "REAL" phenomoneon and you may get further by starting over with another doc.
Restless legs syndrome is an unpleasant sensation in the legs (and occasionally the arms) which occurs at rest and is relieved by movement. The discomfort associated with this syndrome will cause significant insomnia in most patients. There are certain symptoms associated with Restless Legs Syndrome as well as several effective treatment options to consider.
Symptoms
Restless legs syndrome is present in approximately 5-8 % of the general population. Sensations are described as having one or more of the following qualities in the extremity affected:
1. Crawling
2. Creeping
3. Aching
4. Jittery
5. Fidgety
6. Burning
Symptoms may occur at any time during the day but are much more common at night.
Causes
Most commonly there is no exact "cause" identified for the syndrome and it is termed "idiopathic".
However, the doctor examining the patient with restless legs syndrome must be certain to rule out certain medical causes for the symptoms:
1. Iron Deficiency
2. Vitamin B12 Deficiency
3. Diabetes
4. Uremia / Kidney disorders
5. Polyneuropathy
6. Peripheral Vascular Disease (blood vessel disease)
Diagnosis
The doctor examining the patient with restless legs syndrome will pay particular attention to the nerves and blood supply to the affected limb. Blood tests for kidney function, anemia and iron or B12 deficiency may be ordered as well. In some cases, a sleep study may prove helpful as well and may diagnose other concomitant sleeping problems.
Treatment
Treatment for restless legs syndrome is through 3 main avenues.
1. General measures include avoidance of caffeine, alcohol and smoking.
2. Treatment of any underlying disorder (such as diabetes)
3. Medication: Several medications have been used to treat this problem. These include Klonopin, Tegretol, Clonidine and Sinemet.
My experience has been that overall the best results are obtained by both avoidance of caffeine, alcohol and smoking and the use of Klonopin 2-4 mg at bedtime.
I hope this proves helpful!
Dean M. Tomasello, M.D.
I think it may be a good idea to consider another primary care practicioner (GP or FP). Sometimes, once a doc has it in their mind that you are "doc hopping" or "drug seeking", it is difficult to change their mind. I am not saying that you are doing any of these things, rather ... letting you know how doctors "are". Restless legs syndrome is a "REAL" phenomoneon and you may get further by starting over with another doc.
Restless legs syndrome is an unpleasant sensation in the legs (and occasionally the arms) which occurs at rest and is relieved by movement. The discomfort associated with this syndrome will cause significant insomnia in most patients. There are certain symptoms associated with Restless Legs Syndrome as well as several effective treatment options to consider.
Symptoms
Restless legs syndrome is present in approximately 5-8 % of the general population. Sensations are described as having one or more of the following qualities in the extremity affected:
1. Crawling
2. Creeping
3. Aching
4. Jittery
5. Fidgety
6. Burning
Symptoms may occur at any time during the day but are much more common at night.
Causes
Most commonly there is no exact "cause" identified for the syndrome and it is termed "idiopathic".
However, the doctor examining the patient with restless legs syndrome must be certain to rule out certain medical causes for the symptoms:
1. Iron Deficiency
2. Vitamin B12 Deficiency
3. Diabetes
4. Uremia / Kidney disorders
5. Polyneuropathy
6. Peripheral Vascular Disease (blood vessel disease)
Diagnosis
The doctor examining the patient with restless legs syndrome will pay particular attention to the nerves and blood supply to the affected limb. Blood tests for kidney function, anemia and iron or B12 deficiency may be ordered as well. In some cases, a sleep study may prove helpful as well and may diagnose other concomitant sleeping problems.
Treatment
Treatment for restless legs syndrome is through 3 main avenues.
1. General measures include avoidance of caffeine, alcohol and smoking.
2. Treatment of any underlying disorder (such as diabetes)
3. Medication: Several medications have been used to treat this problem. These include Klonopin, Tegretol, Clonidine and Sinemet.
My experience has been that overall the best results are obtained by both avoidance of caffeine, alcohol and smoking and the use of Klonopin 2-4 mg at bedtime.
I hope this proves helpful!
Dean M. Tomasello, M.D.
