Post-op insomnia

Thank you. One pain is from an embolised blood vessel in the ankle, a blood clot, which had travelled down from the occluded aneurysm behind the knee cap. The other pain is from behind the knee cap. During surgery, the knee aneurysm was tied off. The pain is post op pain, as the pain I had pre-op was in the calf on walking and was much worse.

I have asked my wife to add ginger to my tea and a spoonful of cod liver oil to my porridge. 2 months ago the GP said I was vitamin D deficient and had an excess of iron in my blood. I am on Vitamin D tablets. Excess iron not dangerously high. Following your reply, my wife has added fish oil capsules to my medication.We do not know about lecithin. Thank you

Flax/linseed when good quality cold-pressed might also be useful, and if as stated quite tasty (if it isn't, it's off). Also the seed itself, after it has been soaked for a few hours, makes a good addition to porridge and the like.

Garlic is very effective at making the blood less sticky: a shaving nick that takes about 10 minutes to stop bleeding may take 45 minutes or longer when garlic is consumed in any quantity. Of course, it's raw garlic that's best. A good pilchard or mackerel salad with loads of raw garlic, onions and all the usual things. I've just noted though that garlic can increase the effect of clopidogrel "increasing the risk of bleeding", so you might want to check that out with your doctor.

Lecithin is found in abundance in eggs, but which, though also providing excellent protein, also contain quite a lot of fat. The soya lecithin capsules that you can buy are generally easier to swallow than they look, easier than some small hard tablets, I find. You can also get lecithin granules to sprinkle over food. Decades ago I read that in vitro studies showed that lecithin and omega-6 fatty acids (found in many vegetable oils) "dissolved" cholesterol. You might want to be more worried about cholesterol coming free and causing problems in the blood stream that way than the combination not doing anything.

Sorry, not sure what might help the knee aneurysm.

We have ginger and added it to my tea yesterday, thank you. I will check with my GP about the garlic before adding it into my diet. Lecithin and linseed noted, thank you.

The knee aneurysm was tied off during the bypass and the surgeon has told me: no kneeling, no crossing of legs. I am waiting for a special scan of the leg. The scanner is one of only 2 machines of its type in London. It will see if the graft is working or not.

4 years ago, I had steatohepatitis and was cured by going down the homeopathic route and a change of diet/lifestyle. As a result of this I dislike taking any medication which damages the liver or kidneys. Another result is that my GP says my cholesterol levels would be the envy of many.

My wife adds lactulose, live yoghurt and sometimes honey. Now she is going to add a spoonful of cod liver oil for the omega. To be honest, it tastes ghastly but if it works and helps to improve my insomnia, it will be worth it ....I eat it quick.

Thank you

I suggested the linseed in respect of the taste of the cod liver oil. I take all my cod liver oil in capsule form. Linseed contains a lot of omega-3, but it's not known too well how well humans can make use of it, especially if their digestion is poor. The B vitamins (B1, B2 and B6 particularly) are needed in the conversion process to make it useful. In fact the B vitamins are needed for the digestion of fat generally, so a one-a-day vitamin B supplement, I believe, helps in getting a "lean burn" from fat consumed. (If your water is at all brackish, do take some, you will see a difference.) Vitamin C, again at just the RDA level, also helps digestion – it's not only needed for boosting immunity.

Don't expect too much from the ginger, it's just a useful adjunct. I tend to sprinkle it on fish: it tends to balance the taste of the fish – an idea essentially from Caribbean cuisine, I think.

Thank you for taking the time to write.

3 years ago I suddenly developed burning feet and was treated with gabapentin. I have been fully tested except for nerve conduction tests. I was put on high doses of Vitamin B. This was stopped 2 months ago as my levels of Vitamin B were excessively high. Then back early July, more problems with my leg after doing 4 long haul flights within a week between London and Nairobi.

The GP gave me a form to recheck bloods for Iron, Vitamin B, Vitamin D, etc in March.

Last night, my sleep was better. Sleeping from 2am-4 and 4:30 am to 8:45 a.m, the best sleep I have had in months.

Do you suffer from insomnia, if I may ask?

Yes, I've taken zopiclone for over 10 years now, apart from a few relatively short breaks, to get the sleep I need. The insomnia is not caused by pain though. It may be just one of the facets of the insomnia, RLS, night cramps (if I skimp on protein – consume less than about 80g a day) and general anxiety problem I have – I think these four are often found together.

My cholesterol level was a little high, about 5.7 I think, the last time it was measured (over 10 years ago), though my triglycerides couldn't healthily be much lower at 1.2. Looking at the blood test report it looked as if I was also somewhat hyperkalaemic, doubtless the lo-salt product I use (if not my rather greedy banana consumption), but my doctor at the time made no comment on that.

With the zopiclone I usually sleep for about 3 hours, wake up, go back to sleep for another 2 or 3 hours and then sometimes I go back to sleep again for another hour or so before I get up.

You were also tested for diabetes when you had the sensation of burning feet?

I was cleared for diabetes and periodically get tested. Whilst I was in hospital I was given temazepam for 2 nights. Pain control post op was not very good. On the 4th night, it had been reduced to only 2 paracetamol at night, which left me in tears begging something stronger. It wasn't until I made a formal complaint that I received an apology from the consultant and was put onto Oramorph + Codeine. At that point, the temazepam was stopped for drug safety reasons.

10 years experience of Zopiclone, makes me wonder if this is because nothing else works for you better?

You mentioned anxiety. A contributing factor to your insomnia? I am sorry you are having to endure this. How very unpleasant.

I don't think there is anything better than zopiclone for getting through the night if both getting to sleep and staying asleep are your problems solvable only with medication. In America they have eszopiclone which is essentially the active part of zopiclone. There they also have Belsomra (suvorexant) which acts differently but may not always be effective. Essentially, I think zopiclone works on the on/off switch and the only hope may be for drugs that do it more safely.

None of the sleeping pills to my knowledge help with pain, it might be that they make it worse. The tricyclic antidepressants do help with pain, but possibly only pain that is directly related to a nerve. They are not licensed for the purpose.

Usually I can cope if I get enough sleep and keep away from situations that cause anxiety. Originally I only needed a pill to sleep if there was something important (or worrying or irksome) to do the following day. Now I may need two and a tranquilizer.