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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11096
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Dear dr. Rick. I have, during neck operation C5/6, acquired

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Dear dr. Rick. I have, during neck operation C5/6, acquired Horners syndrome. Due to severe sleep difficulties after the op. melatonine level was examined. It was constant low both days and nights (below 10). So far neuroopht. have only been able to diagnose a unilateral Horners syndrome. Neurophys. have concluded that only bilateral/destroyed upper neck ganglion/spinal cord injury can explain ceased mel.prod. Can people have ceased Mel. without sleeping difficulties ? What to do?
Pls. help.

Dr. Rick : Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
Dr. Rick : I must confess that I, too, do not understand how a unilateral problem can account for your notably systemic melatonine level.
Dr. Rick : An excellent article that you might find helpful discuses melatonin levels, replacement and sleep problmes:
Dr. Rick : http://www.sleepfoundation.org/article/sleep-topics/melatonin-and-sleep
Dr. Rick : A very interesting point this article makes, which I would like to highlight here, is:
Dr. Rick : "For melatonin to be helpful, the correct dosage, method and time of day it is taken must be appropriate to the sleep problem. Taking it at the "wrong" time of day may reset your biological clock in an undesirable direction. How much to take, when to take it, and melatonin's effectiveness, if any, for particular sleep disorders is only beginning to be understood."
Dr. Rick : So, if melatonin, exposure to a constant light/dark cycle, etc have not worked, what should you do?
Dr. Rick : Well, the first step you have already done: Consult with your neurologist. The next thing to do would be to have a complete sleep study, including review of your wake cycle.
Dr. Rick : The best place to get this sort of complex workup would be at a university medical center. Why a university center? Because at an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this in the USA. That being said there are many excellent teaching hospitals all across the world and I am sure that there is one in Denmark near you.
Dr. Rick : Does this make sense to you?
Dr. Rick : I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.Thanks in advance,Dr. Rick MD FACS
Dr. Rick says:
2:17 PM
Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
2:18 PM Customerhas entered this chat!
Dr. Rick says:
2:18 PM
I must confess that I, too, do not understand how a unilateral problem can account for your notably systemic melatonine level.
2:20 PM
An excellent article that you might find helpful discuses melatonin levels, replacement and sleep problems:
2:21 PM
http://www.sleepfoundation.org/article/sleep-topics/melatonin-and-sleep
2:22 PM
A very interesting point this article makes, which I would like to highlight here, is:
2:22 PM
"For melatonin to be helpful, the correct dosage, method and time of day it is taken must be appropriate to the sleep problem. Taking it at the "wrong" time of day may reset your biological clock in an undesirable direction. How much to take, when to take it, and melatonin's effectiveness, if any, for particular sleep disorders is only beginning to be understood."
2:23 PM
So, if melatonin, exposure to a constant light/dark cycle, etc have not worked, what should you do?
2:24 PM
Well, the first step you have already done: Consult with your neurologist. The next thing to do would be to have a complete sleep study, including review of your wake cycle.
2:26 PM
The best place to get this sort of complex workup would be at a university medical center. Why a university center? Because at an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this in the USA. That being said there are many excellent teaching hospitals all across the world and I am sure that there is one in Denmark near you.
2:26 PM
Does this make sense to you?
2:26 PM
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.Thanks in advance,Dr. Rick MD FACS
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