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Disorders of sleep and wakefulness include insomnia or inadequate sleep discount levitra professional 20mg without a prescription, restless leg syndrome purchase 20mg levitra professional, periodic limb movement disorder, narcolepsy (excessive daytime sleepiness), sleep apnea syndromes, sleepwalking, sleep terrors, sleep bruxism (grinding of teeth), sleep enuresis (bedwetting), jet lag, and shift-work sleep disorders. Failure to recognize and treat these conditions appropriately may lead to significant and often disabling exacerbation of existing medical and psy- chiatric conditions, including fibromyalgia, and difficult-to-diagnose dis- eases, including reflex sympathetic dystrophy, chemical sensitivities, and other conditions that involve pain. So when tracking clues as your own med- ical detective, be sure not to overlook the importance of sleep problems. Conclusion If your physician is among those who do not believe that diseases such as fibromyalgia or sleep disorders exist and you believe you have the symptoms, find another physician to consult. Do a thorough Eight Step analysis, mak- ing sure to address these specific questions: • Is your skin painful and tender, or do you feel pain all over your body, even to the point of jumping when touched? Do you hardly ever feel refreshed on wakening after a night’s sleep or even after a nap (although pain will rarely wake you)? If you answered yes to at least five of these questions, ask your doctor to investigate whether you are suffering from fibromyalgia. Also, consider whether a sleep disorder may be the underlying cause of your symptoms even if it is not fibromyalgia. Remember, sleep disorders are one of the most commonly missed causes of mystery maladies. Treatments that are supposed to make us healthier or keep us well sometimes do just the opposite. More often than many of us realize, med- ications or natural remedies recommended for the treatment of certain ail- ments can become the cause of other maladies. Recent statistics show that reactions to medications and other remedies are the fourth leading cause of death in the United States, dwarfing the number of deaths caused by auto- mobile accidents, AIDS, alcohol and illicit drug abuse, infectious diseases, diabetes, and murder. With 46 percent of Americans taking at least one pre- scription drug daily, 25 percent taking multiple prescriptions, and untold percentages ingesting over-the-counter products, there is a lot of potential for close encounters of an adverse kind. There is no formal system for reporting the majority of such reactions because side effects or adverse reactions reportable to health regulatory agen- cies are narrowly defined as clear-cut responses that cause permanent dis- ability, hospitalization, or death. Even the Food and Drug Administration (FDA) admits that serious side effects or medication reactions are grossly underreported and may be reaching epidemic proportions. Just because they are purchased from a health food store or their source is natural, it does not mean they may not be toxic for some people. Nutritional healing is becoming more 103 Copyright © 2005 by Lynn Dannheisser and Jerry Rosenbaum. There is much evi- dence to suggest that increasing numbers of yet unidentified maladies are resulting from nutritional supplements, vitamins and herbs, and many nat- ural remedies. These remedies must be examined because very few controlled studies are performed on them. As a result of all of these factors, it can take years (if ever) for a drug, vaccine, or natural supplement to be removed from the market as unsafe. Consider Propulsid, once the top-selling heartburn medication, which was on the market for seven years before the FDA finally withdrew it based on reports of hundreds of heart arrhythmias and scores of deaths.

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MANAGING YOUR TIME EFFECTIVELY 245 Use various styles of shading to represent different activities 20mg levitra professional free shipping. For in­ stance levitra professional 20 mg low price, you can use solid shading to block out the days you are in work and cross-hatching for Saturday morning when you normally do your shop­ ping. This type of visual display is useful for highlighting any activities that impinge on other areas. Solid shading appearing during the weekend, for example, might indicate that work-related activities were extending beyond normal contractual hours. Other activities, like hobbies or seeing friends, are things that we do out of choice. Find more time Once you have completed your analysis you should have a very clear idea of how you are using your time. For instance, try ordering a home delivery of your groceries on the Internet. Doing a big monthly shop in this way will cut out travel and shopping time. You may have to enlist the help of children, partners or friends in doing some of the tasks that you would normally carry out. Is there something that you can put on hold un­ til you have completed your project? These will need to be further subdivided into subgoals and mini-targets. You may need to re-establish your priorities and organise your time accordingly. Active versus passive Sentences written in the active rather than the passive voice are more direct and give impact to a message. Compare ‘the boy cleaned the car’ (active) with ‘the car was cleaned by the boy’ (passive). An active sentence also gives a livelier tone to a piece of writing and tends to have fewer words. However, the use of some passive constructions is desirable to provide vari­ ety and interest for the reader. Pitfalls: ° the use of an informal writing style in a context that requires a formal approach (and vice-versa) ° writing a piece in a tone that is inappropriate to the context (for example, most women’s magazines like to take an upbeat approach to health issues) ° the use of too many passive constructions. Each piece of writing consists of several hierarchical layers of organisation. These range from how the overall piece is structured down to the arrange­ ment of an individual sentence. The whole is divided into three parts – the introduction, the middle and the end.

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