Diagnose me.

[ForceField]

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I don't know what the deal is. It's been 2 weeks after our Spring Break (I'm an M1)... and I've been sleeping for so freaking long each day. I sleep 10-12 hours, and then during the day I'm groggy. I've missed tons of class (not the biggest deal), but I've never slept this much. I'm not depressed, I feel fine, but I don't understand why all of a sudden my body wants all this extra sleep. How can I go back to a normal 6-8 hours?!

 

[Olanzapine]

sleep apnea? or maybe hypothyroidism, anemia, etc. Ask your doctor to refer you to a sleep clinic after he checks a TSH and cbc on you.

 

[KyGrlDr2B]

I've done this all year. I've gone through spurts where I sleep all day and don't go to class and then spurts where I can actually get in gear and study. But I think I'm just lazy.

 

[....]

aids









this is not a substitute for the advice of a liscensed physician.

 

[stomper627]

Post-Traumatic Stress Syndrome.....where did you spend your Spring Break? Do you remember ANY of it?

 

[Flack Pinku]

Olanzapine--dagg yo, you might scare the op off.

Anyway, what you're feeling is normal. Do you notice anything BUT sleepiness during the day and long time sleeping during night? If so, go talk to your doctor... they're probably nothing but the fact you're tired.

But as Olanzapine said, anyone of those things could be the case, but hypothyroidism and anemia are rare, unless your diet is bad or you have other conditions...

 

[Stinger86]

Olanzapine's got some good ideas.

To the OP: Do you have a roommate or significant other that you live with? If so, ask them if you snore like a caveman or stop breathing and stuff periodically during the night.

 

[the big wand]

What's your physical exam (HR, RR, BP, heart sound, chest sound)?

Any weight loss (tumor?)
Family history of diabetes?
Many endocrine disorders can produce fatigue.
Drink too much coffee?
Taking any medication?
Any infections? TB?
Do exercise regularly?
What time do you sleep at night and when do you take naps?
How do you feel about your condition?
How is your school? No stress? Or, just don't care?

 

[Vincristine]

so far, most of the differntial here is pretty good. Any chance you're pregnant?

 

[oudoc08]

Try sleeping less, between 7-8 hrs/day. Newest studies show similar presentations between individuals who sleep too little and too long.

Read this:

http://news.yahoo.com/news?tmpl=story&u=/hsn/20040328/hl_hsn/toomuchsleepnotagoodthing

 

[ForceField]

Originally posted by the big wand
What's your physical exam (HR, RR, BP, heart sound, chest sound)?

Any weight loss (tumor?)
Family history of diabetes?
Many endocrine disorders can produce fatigue.
Drink too much coffee?
Taking any medication?
Any infections? TB?
Do exercise regularly?
What time do you sleep at night and when do you take naps?
How do you feel about your condition?
How is your school? No stress? Or, just don't care?

HR: 56
RR: 12
BP: 90/60
Don't know about the heart/chest sounds. (They're normal.)

I've weighed the same since about high school. BMI = approximately 22.
Yes, my father has diabetes.
I rarely drink any caffeine.
No medications.
No infections.
Exercise 3-4x/week.
I sleep whenever I get tired... naps usually when it comes time to study. I also fall asleep after about 15 minutes of studying.
I don't know, I think something is wrong with my liver. If I eat too many carbos (i.e. footlong subs, 2+ plates of pasta, etc) I fall asleep in 10 min, almost uncontrollable.
School is very low stress right now and I don't care much about the workload.

Tell me what's wrong!

 

[Goofyone]

Mono

 

[idq1i]

Originally posted by ForceField
BP: 90/60

You sure about that 90?? that's a map of ~70

 

[Flack Pinku]

Get tested for Epstein-Barr virus... could be Mono like Goofyone said. But then you'd feel infections/vomiting/nausea etc... wouldn't ya?

Of course, go see your Doctor.

 

[Goofyone]

Originally posted by Flack Pinku
Get tested for Epstein-Barr virus... could be Mono like Goofyone said. But then you'd feel infections/vomiting/nausea etc... wouldn't ya?

Of course, go see your Doctor.

"I thought I had mono for a year once. Turned out I was just really bored." - I forget who

Actually I had mono and had the worst 2 months of my life. My primary care doc "diagnosed" me with strep and gave me antibiotics (bastard--I hear it can make the symptoms WORSE and cause a rash), anyway my glands were huge and I had the worst sore throat of my life. Oh yeah, and my spleen was ready to explode too.

Slept 14hrs a day, and layed around for the other 10 without so much as the energy to adjust my pillow.

Anyway I think the symptoms are more subtle for some people.

 

[Kalel]

When mono "causes" fatigue sx that last greater then 3 months, it's usually considered a post-infectious chronic fatigue syndrome rather then some pathologic response to the EBV itself. According to one of my attendings, it's not that uncommon to have patients complain of chronic fatigue for a prolonged period after a mono infection too.

 

[ForceField]

I feel perfectly fine though... wasn't ill since perhaps last year. Today I ran 4 miles, did a regular workout, but ultimately I'll probably sleep again for 10 hours and will miss class. Perhaps I just have to fight the sleepiness and get up and fill myself with caffeine. I don't know.

 

[mrmoran]

I hate to say this, but I'd reconsider depression. Alteration in sleep habits, lack of motivation/initiative, inability to concentrate are classis syptoms. I bet you diet has changed as well, probably eating less (decreased appetite) or if not then the composition of your diet has changes (less carbos so when you have a lot it knocks you out).
For what its worth to you though, I'm also a first year and I'm going through the EXACT same thing. Been to one or two classes, still playing lots of basketball, but sleeping pathologically, even though I'm drinking coffee and diet dr pepper instead of water. maybe we just yet to get over the whole back to school thing.

 

[DarksideAllstar]

I went through the exact same thing after Winter break. I attribute mine to burnout.
Anyway, I have a liver path test tomorrow, and every friggin case presents with someone with fatigue.
Any scleral icterus?
Did we get confirmation that there are no swollen/tender nodes?

 

[ForceField]

Originally posted by mrmoran
I hate to say this, but I'd reconsider depression. Alteration in sleep habits, lack of motivation/initiative, inability to concentrate are classis syptoms. I bet you diet has changed as well, probably eating less (decreased appetite) or if not then the composition of your diet has changes (less carbos so when you have a lot it knocks you out).
For what its worth to you though, I'm also a first year and I'm going through the EXACT same thing. Been to one or two classes, still playing lots of basketball, but sleeping pathologically, even though I'm drinking coffee and diet dr pepper instead of water. maybe we just yet to get over the whole back to school thing.

What is depression though? Specifically, because I'm not sad at all. I hang out with my friends on a regular basis. At my med school, the worst of our classes actually finished just before Spring Break. I'm eating the same stuff I've always eaten. I guess I just want a break, but don't really understand how that correlates with so much sleep. Perhaps I'm just catching up on lost sleep during the past school year.

 

[stork12]

Originally posted by Goofyone
"I thought I had mono for a year once. Turned out I was just really bored." - I forget who

Mike Myers in Wayne's World, right? Party on ...

ForceField - hope you feel better.

 

[Goofyone]

Originally posted by stork12
Mike Myers in Wayne's World, right? Party on ...

ForceField - hope you feel better.

Wayne's World!! Thanks, that was irritating me that I couldn't remember.

Oh, I'm much better, that was a couple of years ago. Thanks for caring.

 

[Mike59]

From what I've learned in med school so far, I can plan your treatment one of two ways based on how you answer this crucial question:

Do you have a sense of impending doom?

 

[dochoot]

The feeling for me comes right from the narcotizing monotony of class....especially histo...it all looks the same to me anyway!

 

[Tazmaniac]

How about "Medical Student Syndrome" added to the DDx?

 

[Andrew_Doan]

I don't know what the deal is. It's been 2 weeks after our Spring Break (I'm an M1)... and I've been sleeping for so freaking long each day. I sleep 10-12 hours, and then during the day I'm groggy. I've missed tons of class (not the biggest deal), but I've never slept this much. I'm not depressed, I feel fine, but I don't understand why all of a sudden my body wants all this extra sleep. How can I go back to a normal 6-8 hours?!

Burnout ?

 

[doc05]

depression?