Mr M, a 60 year old male, was brought to the office , quite reluctantly, by his concerned wife. “I am being dragged in kicking and screaming.” Though not really. She was concerned because he had long term fatigue, would go to his car during the workday to rest from his “sinus headaches”, he has a long history of snoring so bad that he sleeps in the other room, blood pressure “used to be high” and he “used to take prostate medicine” but I’m having trouble again.
Mr M used to have a primary care provider and has a family member in the health profession. He had not seen a provider nor listened to his family member since the primary care provider he had stopped practicing because of of his own unexpected health problems. I really don’t want to take a lot of medication or being told what I have to do. I sat down with him and asked what he wants from me and out of our entire interaction today. We spent the better part of an hour discussing what was going on, doing a complete physical, discussing the immediate findings like dangerously high blood pressure, probability of sleep apnea, his prostate concern, because of lack of sunshine exposure the likelihood of significant vitamin D deficiency, and nasal problems preventing him from breathing through his nose even in the daytime.
In short he was miserable, forgot how to laugh and have fun because he was “walking in molasses in January in Pennsylvania.” If you have never tried it that walk is difficult.
We started with he most pressing problem - his prostate function - and he was willing to take medications to allow better function.
Blood works was obtained and did show significant vitamin D problems. We started a supplement of vitamin D; a sleep study showed he was really not sleeping more than a few minutes at a time because he kept waking up in order to breathe. He was willing to try CPAP; and finally when he understood the reason he got the headaches requiring he go sit in the truck and rest were in fact caused by his high blood pressure he began taking blood pressure medications, reluctantly.
These changes in his life, changes in habits, improved sleep, normalized blood pressure, a working prostate, regular supplements, and raising his “sunshine vitamin” vitamin D has turned around his life path.
The headaches are gone. He sleeps all night then wakes up refreshed. His mood is improved - he found his laugh. And his wife is happy.