DEAR DR. DONOHUE: I am 71 years old, and the doctors tell me I have narcolepsy. Can you explain it? Do you know anything that can control it? Sometimes it causes me to jerk, and I lose control over my body. I fall to the floor wherever I am. — Anon.

ANSWER: Narcolepsy is an irresistible urge to fall asleep at inappropriate times and in inappropriate places. It occurs at any age, but it most often makes its debut between the ages of 15 and 25. The sleep attacks last for as little as a few minutes or as long as half an hour. Another symptom that is all but a conjoined twin of narcolepsy is catapexy. It’s a temporary loss of muscle control. It shows itself from something as inconspicuous as drooping eyelids to something as obvious as buckling knees and dropping to the floor. The person is awake but unable to move for several minutes. Emotionally charged situations trigger catapexy — things that provoke laughter, anger or anxiety. You can see how the two constitute a danger to a driver and to the public.

Two other signs of narcolepsy are sleep paralysis and hypnogogic hallucinations. The first is an inability to move when just about to fall asleep or upon wakening. The second is dreamlike experiences occurring near the onset of sleep.

Brief daytime naps can lessen the number of narcoleptic attacks. Medicines also are available. Methylphenidate, Provigil (modafinil) and Nuvigil (armodafinil) are some examples. Venlafaxine (Effexor) helps control catapexy. So does Xyrem, which has to be taken in two nighttime doses — one when the person first gets into bed and a second two and a half to four hours later. It has to be obtained through a special program, the Xyrem Success Program. It’s for those whose catapexy isn’t controlled by any other medicine.

DEAR DR. DONOHUE: Please comment on the CA-125 lab test. Mine has fluctuated off and on. I understand you should take a series of these tests in order to ascertain whether the results are valid. Once, mine was high, but it went down to near normal. Transvaginal ultrasound tests were normal. It looked like I did not have ovarian cancer.

What else can the test indicate? One of my doctors says to forget it. What is your advice? — C.P.

ANSWER: The CA-125 blood test should not be used as a screening test for ovarian cancer. It is too unreliable. Many women have been led to think that a high test result indicated that they had ovarian cancer. They had to go through a battery of other tests in order to prove they did not. It is a useful test for monitoring the success of treating ovarian cancer. It is a good screening test for women whose family history is riddled with examples of ovarian cancer or who are at high risk for developing it.

Smoking, cirrhosis, pancreatitis, peritonitis, fibroids, endometriosis, pelvic inflammatory disease and cancers of the colon, lung, uterus and breast all can raise the CA-125 level. A normal reading is 0 to 35. One percent to 2 percent of normal, healthy women will have a CA-125 level greater than 3,500.

I think you are justified in ignoring the test. With cancer, the values do not fluctuate the way yours have.

DEAR DR. DONOHUE: I have a 47-year-old son who has migraines. Orange Slices, a Brach’s candy, can bring one on. (I know; so don’t eat them.) I wrote for a list of ingredients but couldn’t obtain one. Perhaps you will elaborate on foods that cause these headaches. — J.E.

ANSWER: I love those candies. Three pieces have 150 calories and 30 grams of sugar, 10 mg of sodium and 60 mg of vitamin C. They also contain some corn syrup and juices made from grape and orange concentrates. Artificial color yellow No. 6 and red No. 40 are added. The best test of a food cause of migraine is not to eat it and see if headaches stop. If your son is scientifically inclined and can put up with a headache, the ultimate test is eating the suspect food and waiting for the headache. Foods often implicated as causes of migraines are: aged cheeses, sour cream, sourdough bread, bananas, raisins, figs, avocado, citrus fruits, fava beans, onions, snow peas, chocolate, nuts, monosodium glutamate, wine (especially red), beer, champagne, sulfites, aspartame, garlic and caffeine.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

Copy the Story Link