There Are Alternatives to Treat Daytime Restless Leg Syndrome
Dear Dr. Roach: Among my problems is restless leg syndrome. I take generic Requip (ropinirole) in order to sleep at night. Recently, I find I must take it earlier and earlier before bedtime (i.e., now an hour to an hour and 30 minutes before I expect to go to bed). Without this medication, I would have to take sleeping pills every night. But because Requip puts me to sleep, I cannot use it when I do not want to go to sleep. And increasingly, my legs give me so much trouble whenever I want to watch a movie, go to a play, do any traveling, etc. My doctor prescribed gabapentin for daytime use. However, I do not feel that medication is doing any good. There are early evenings when I think I’m going to go nuts because my legs bother me so much. I have it in both legs, but usually only one is bothersome at a time. My question is whether there is anything I can do or take to relieve these annoying RLS symptoms when I am not ready to retire? — L.M.
Answer: Restless legs syndrome, also called Willis-Ekbom Disease, causes symptoms of spontaneous leg (and sometimes arm) movements during rest, often associated with unpleasant sensations in the limb. It is common, and can be associated with iron-deficiency anemia and other medical conditions. Symptoms are usually worse at nighttime.
Ropinirole (Requip) and pramipexole (Mirapex) often are the first medications used in this condition, and they can be very effective. They start working in about 90-120 minutes. Some people do experience fatigue with these medications.For daytime symptoms, I have had good success with carbidopa-levodopa (Sinemet and others). You might ask your doctor about it.
Dear Dr. Roach: My wife read that oral sex is the chief cause of throat and lung cancer. Can this be true? — Anon.
Answer: Recently, it has been found that human papillomavirus is a risk factor for cancer of the throat and mouth (but not lung). The presence of HPV increases the risk of cancer two to three times. Smoking remains a more powerful risk factor, and increases the risk five to 25 times. HPV can be transmitted through sex, including oral sex, from someone infected with HPV. HPV can’t be transmitted through sex, oral or otherwise, in someone who doesn’t have the virus, but many or even most people infected with HPV are infected without realizing it.
HPV is the cause for all or nearly all cases of cervical cancer. The vaccine for HPV dramatically reduces the risk of cervical cancer. It is hoped that it will reduce the risk of head and neck cancers as well. All males and females ages 13 to 26 are recommended to have the HPV vaccine.
Dear Dr. Roach: I’m wondering about the commercials regarding eating ice cream. The way they sound, it’s OK to eat it without fear of fat. I’m a male in his 70s, in fine health, and I am wondering if eating it is fine, but just once in a while. Thank you. — A.A.
Answer: Ice cream has more saturated fat and sugar than is good for you. People who want to be super-healthy don’t eat ice cream at all. However, I am a believer that it’s OK to indulge yourself once in a while in something that might not be the healthiest for you.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.