16F Sleep Rhythms PaJR

This is an online E-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's consent. Here we discuss our individual patient's problems through a series of inputs from the available global online community of experts with the aim to solve those patients' clinical problems with the collective current best evidence-based input. 

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22/01/2023, 7:00 pm - Dr. Rakesh: Can the patient advocate share the patient's history, sequence of events, and the clinical images of her throat here?

22/01/2023, 7:33 pm - Patient Advocate: I went to marriage on 6jan. There I didn’t take any cold food. On 7jan I drank a cold soft drink after eating oily food in the evening. At night, at 3am I got a fever of 101 temperature, extreme body aches, and throat pain. I started paracetamol (taken 4 times) but the fever got down after 24 hours. My throat pain didn't go away. The body ache and the feverish-like condition got resolved after 3 days. I started amoxicillin and clavulanic acid tablet after 2 days and took them for 6 days (2 tablets a day), and then stopped taking them meanwhile severe cough started. Taking paracetamol for pain as required.

This antibiotic doesn’t work and the throat pain continues, only paracetamol works for pain. The pain is so much that I cannot speak without taking paracetamol. It’s been more than 15 days. Pain seems moderate and becomes severe again in the morning. I went to the doctor on 20 Jan. He gave me some meds and I started doing warm salt water gargle, steam, and honey water. Seems like the cough becomes worse due to irritation in the throat.

It is not getting any better. It feels like It is going away but it came back again today morning. Too much that I cannot speak again, right ear and right neck side, and right jaw seem heavy and painful. Ate two biscuits only as cannot open my mouth and took paracetamol which reduces the pain to a degree of mildness then took the doctor's prescribed medications. I am drinking warm water for more than 15 days. Yes, I was sleeping under the fan on and off until 3days ago. Not taking any cold food, drink, oily food, or rice since 8jan. I have an acid reflux issue so take omeprazole as needed.

22/01/2023, 7:33 pm - Patient Advocate: (file attached)

20 Jan prescription

22/01/2023, 7:34 pm - Patient Advocate: (file attached)

Throat pictures were taken today

22/01/2023, 7:40 pm - Patient Advocate: After taking paracetamol and meds at 11am, there is only mild pain in the throat, no cough, no jaw ear n neck pain, no problem in speaking, and movement of the tongue. Everything seems mild and normal. Taking warm soup, steam, warm water, and warm salt water and gargling the whole day with a little gap which is also maintaining the pain.

22/01/2023, 8:15 pm - Dr. Rakesh: Good. This appears to be a self-limiting viral pharyngitis. You should recover soon. Antibiotics may not be indicated and their side effects can troublesome. Do continue to share your hourly activities and daily food plates here if possible.

23/01/2023, 7:32 am - Patient Advocate:

 8pm: Had chicken soup with a boiled egg.

9:30pm: After half an hour had 2 little bowls of oatmeal with no masala chicken.

Have meds.

Nasal spray with Steam.

Read a book.

Slept again.

1:30am: Had a bowl of oatmeal with chicken again. 

Have meds.

Honey water.

Read book.

Tried to sleep from 3am-6am

(I Slept all day so wasn't able to go into a deep sleep)

23/01/2023, 7:33 am - Patient Advocate: (file attached)

Bowl of oatmeal with chicken

23/01/2023, 7:34 am - Patient Advocate: 

7am: Had a nasal spray with Steam.

Ate custard.

Took paracetamol as the pain is increasing.

23/01/2023, 7:35 am - Dr Rakesh: Dose of Paracetamol?

23/01/2023, 7:44 am - Patient Advocate: 500mg

23/01/2023, 7:44 am - Patient Advocate: (file attached)

A single bowl of mango custard

23/01/2023, 7:45 am - Patient Advocate: Yesterday I took the restricted diet (soft diet) so the pain is not too much severe in the morning.

23/01/2023, 7:53 am - Patient Advocate: And also no cough.

24/01/2023, 7:46 am - Patient Advocate: 

8:30am: Salt water gargle.

Slept around this time and woke up around 12pm. 

1:30pm: 1 small Bowl of soup with the bun in it.

Meds (course completed, only antibiotic and sprays left)

Spray with Steam.

10-15mins Sunlight.

Slept again around 3:30pm.

5pm: 2 small bowls of Oatmeal with minced meat in it.

Spray with Steam.

Salt water gargle.

Talked on call for a little while after 3 days. Didn't feel uncomfortable afterward.

6:30pm: One small bowl of soup with a boiled egg.

Slept again.

8:30 pm: 2 small bowls of oatmeal with minced meat and the bun in it. 

Talked for a little while on a call.

Spray with Steam.

Salt water gargle.

Book reading.

Slept again.

1am: one small bowl of oatmeal with minced meat n bun in it.

Med.

Warm honey water.

Spray with Steam.

Salt water gargle.

Book reading.

Rest.

(Whole day was spent resting/sleeping and eating. Nothing much more.)

24/01/2023, 7:51 am - Patient Advocate: (file attached)

A small bowl of oatmeal with minced meat in it

24/01/2023, 7:51 am - Patient Advocate: (file attached)

A small bowl of soup with a boiled egg

24/01/2023, 7:51 am - Patient Advocate: (file attached)

A small bowl of soup with a bun in it

24/01/2023, 9:06 am - Dr. Rakesh: Feel this patient is recovering well 👍

24/01/2023, 5:14 pm - Patient Advocate: Yes. Condition not severe for 3 days.

24/01/2023, 5:17 pm - Patient Advocate: Thank you so much ☺️☺️

26/01/2023, 12:34 am - Patient Advocate: (file attached)

Oatmeal with vegetables in it

26/01/2023, 12:34 am - Patient Advocate: (file attached)

Soup with a boiled egg in it

26/01/2023, 12:35 am - Patient Advocate: Had vegetable rice also.

26/01/2023, 12:37 am - Patient Advocate: This was yesterday's meal. Repeated the same today. There is no discomfort or pain in the throat today for the whole day. Seems like the virus is cured.

26/01/2023, 12:37 am - Patient Advocate: Wasn't on any medication except the nasal spray. Steam, gargle, and honey water continues.

26/01/2023, 12:39 am - Patient Advocate: Thank you so much for the great support and monitoring. Grateful to have you. 🙏

Be Blessed Always 😇

26/01/2023, 8:32 am - Dr. Rakesh: Please continue to share your patient's daily diary with food plates (energy inputs) and daily energy expenditure narratives which would be therapeutic for all the members in this PaJR group 🙂

26/01/2023, 11:34 pm - Patient Advocate: Ok. I will start doing that. 😊🙏

02/02/2023, 2:31 pm - Patient Advocate: 

1:30pm-3pm

Woke up at 1:30pm

Got fresh

Organized room

Sunlight (15mins)

Had breakfast (onion paratha with one scrambled egg)

Took Vitamin D3 Med

Namaz

Skincare routine

3pm-5:30pm

Study (video lecture)

5:30pm-7:30pm

Daily have a Group call with sis & a friend.

Meanwhile 

{

Namaz

Lunch (one plate of chicken n veg rice)

Namaz

Exercise 30mins (Treadmill)

}

7:30pm-9:15pm

Study (video lecture + Book Reading)

Had 1 small packet of chips

Had 2 pieces of Bakarkhani

9:15pm-11pm

Break

Nap for an hour

11pm-2am

Dinner (One plate of Chicken n veg rice)

Music/entertainment

4 small piece non-veg samosa

2am-4:30am

Study (Recommendation by others)

Slept around 6am

Water Intake = 1.5L

1st Feb Wednesday

02/02/2023, 2:34 pm - Patient Advocate: (file attached)

02/02/2023, 9:14 pm - Patient Advocate: I usually start it from 2 and make it up to 3.5 gradually.

03/02/2023, 3:07 pm - Patient Advocate: 

2pm-3:30pm

Woke up at 2pm

Got fresh

Organized room

Sunlight (15mins)

Skincare routine

Namaz

3:30pm-5:30pm

Study (video lecture + Book Reading)

5:30pm-7:30pm

Daily have a Group call with sis & a friend.

Meanwhile 

{

Namaz

Exercise 30mins (Treadmill)

Namaz

Lunch (one plate of rice with minced meat n aloo)

}

7:30pm-9:30pm

Rest n nap

9:30pm-4am

Nothing (Random stuff)

4am-5am

Study

Slept around 6:30am

Water Intake 1.5L

2nd Feb Thursday

03/02/2023, 3:08 pm - Patient Advocate: (file attached)

03/02/2023, 3:54 pm - Dr. Rakesh: Isn't this unusual sleep timings!!?

03/02/2023, 5:20 pm - Patient Advocate: Yes Doctor. I will try to improve it. As a late sleeper since always it's difficult to maintain that early rhythm.

03/02/2023, 7:57 pm - Dr. Rakesh: Late sleeper? How much late? 6:30 AM!

03/02/2023, 11:09 pm - Patient Advocate: Yes Doctor. My mistake. I will try to sleep early today and avoid napping before that.

04/02/2023, 1:13 pm - Patient Advocate: 

2pm-3:30pm

Woke up at 2pm

Got fresh

Sunlight (20mins)

Breakfast (Paratha with scrambled egg)

Namaz

3:30pm-7pm

Birthday celebration of a friend

Namaz

Skincare routine

Namaz

7:30pm-9pm

Study

9pm-10pm

Meal (Rice with aaloo palak)

10pm-12am

Study

12am-2:30am

Random work

Break

2:30am-4am

Study 

Slept around 4:30am

Water Intake = 1.5L

4rth Feb Friday

04/02/2023, 1:56 pm - Dr. Rakesh: What is the study that your patient does?

04/02/2023, 3:39 pm - Patient Advocate: Study regarding the world of psychology, neurology, religion, and philosophy. It includes video lectures, short courses, articles, research papers recommended by others, books, talking with other patients, and wherever stuff I can find on the internet to clear my concepts.

04/02/2023, 4:07 pm - Dr. Rakesh: 👏👏

06/02/2023, 3:15 pm - Patient Advocate: Unable to update about Saturday as there was a severe body ache coz I slept under the fan. The whole day I rested and just read a book and took a work call.

06/02/2023, 3:19 pm - Patient Advocate:

Woke up at 1pm

2pm-3pm

Got fresh

Room organize

Had Breakfast (1 Paratha with scrambled egg)

Took Calcium med

Namaz 

Self-care

3pm-4pm

Study

Had 1 Orange

5pm-11:30pm

Went to Super Mart

Had Russian salad at 7:30pm

Went to Relative's home

{

Had a Meal around 9pm (1 plate of chicken biryani)

Had 2pieces of pizza at 10:30pm

Had Half a cup of tea

}

12am-1am

Did Housework

Had Chocolate (32g)

Water Intake = 700ml

6th Feb Sunday

06/02/2023, 3:49 pm - Dr. Rakesh: What work call for a 16F?

07/02/2023, 2:39 pm - Patient Advocate: Study call. 🙂

07/02/2023, 2:37 pm - Patient Advocate:

Woke up at 2pm 

2pm-4pm

Got fresh

Room organized 

Had Chocolate 32gm

Namaz

Self-care

4pm-5:30pm

Study

5:30pm-7:30pm

Namaz

Call

{

Lunch (Chicken biryani)

Calcium med

Namaz

}

7:30pm-8:30pm

Study

9pm-12:30am

Too drowsy the whole day- Tried to study by taking frequent breaks coz slept at 8:30am last night. 

1piece veg roll

1piece non-veg samosa

1packet chips (45gm)

Slept at 12:30am

Water Intake = 1.3L

5th Feb Monday

09/02/2023, 4:23 pm - Patient Advocate: 

Woke up at 2pm

2pm-5pm

Got fresh

Room organized 

Self-care

Breakfast (1 paratha with scrambled egg)

Vitamin D3 med

Random work

Call

Had 1 piece of chocolate nut cake

5pm-9pm

Study

9pm-10pm

Lunch (1paratha with mutton stew)

Calcium med

10pm-1am

Break/Random stuff

Had half a chicken roll and 1 piece peri bites

1am-3:30am

Study

Water Intake = 1.3L

Slept around 4:30 am

8th Feb Wednesday

10/02/2023, 9:48 pm - Patient Advocate: 

Woke up at 2pm

2pm-4:30pm

Got fresh

Room organized 

Breakfast (1paratha with scrambled egg with mixed veggies)

Took Calcium med

Housework

Had 1 Orange

Self-care

4:30pm-5:15pm

Study

Took nap

5:15pm-8pm

Call

{

Exercise (15mins)

Random work

Meal (2 packets noodles with minced meat in it)

}

8pm-11:30pm

Slept

Random work

1 mayo garlic roll

11:30pm-4:30am

Study

1 piece chocolate cake

Half chicken burger

Slept around 5am

Water Intake 1.8L

9th Feb Thursday

10/02/2023, 9:48 pm - Patient Advocate: (file attached)

11/02/2023, 7:22 am - Dr. Rakesh: Very interesting routine especially with regard to the timeline. 

We have one 29M admitted with us right now who has the exact same routine.

11/02/2023, 7:26 am - Patient Advocate: Admitted for which problem?

11/02/2023, 8:04 am - Dr. Rakesh: There is a separate PaJR group and case report on him

12/02/2023, 2:55 pm - Patient Advocate: Ok ok.

25/02/2023, 10:22 am - Patient Advocate: 

Woke up at 5:30am 

6am-7am

Prayer

Got fresh

Self-care

Exercise (Treadmill 15mins)

Had one biscuit

7am-2pm

Study

2pm-3:30pm

Nap

Meal (1paratha with tea)

Prayer

3:30pm-9:30pm

Calls

Music

Ate 2 samosas

Housework

Meal (Rice with kabab)

9:30-12:00

Study

Slept around 12:30am

23rd Feb

25/02/2023, 10:25 am - Patient Advocate:

Woke up at 5:30am

6am-7am

Got fresh

Self-care

Exercise (15mins)

Ate a biscuit 

7am-8am

Study

8am-9am

Slept

9am-1:30pm

Study

1:30pm-3:30pm

Slept

3:30pm-10:30pm

Meal (1paratha with potato sabzi)

Calls

Meal (Noodles at 6pm)

Housework

Did some Writing

Slept around 10:30pm while meditating

24th Feb

26/02/2023, 4:30 pm - Patient Advocate: 

Woke up at 6:30am

6:30am-7am

Got fresh

Ate biscuit

Self-care

7am-8am

Study

8am-9:30am

Writing

9:30am-10:30am

Break

10:30am-12:30pm 

Study

Breakfast (1paratha with potato sabzi around 11:30am)

1pm-3:30pm

Slept

4pm-8:30pm

Had two kharboza

Lil bit fried chicken

Calls

Housework

Meal (Rice with meat daal gravy)

8:30pm-9:30pm

Study

9:30pm-12am

2piece non-veg pizza

Music

Housework

12am-3am

Tried to sleep but can’t 

3am-4am

Random work

Ate 1 piece of non-veg pizza + drink

4am-7am

Study

7am-8am

Exercise (30mins)

Got fresh

Self-care

Had one omeprazole med

8am-9am

Study

Slept around 9:30am

26/02/2023, 4:57 pm - Dr. Rakesh: Biscuits, pizza, drink sugary? All red flag bearers for metabolic syndrome

27/02/2023, 8:38 am - Patient Advocate: Dara dya 😭😭😭😭😭😭

27/02/2023, 8:40 am - Patient Advocate: 

Continue

Woke up at 2pm

2:30pm-5pm

Meal(1 Paratha n potato sabzi)

Random stuff

5:30pm-10pm

Housework

Meal (Half plate Chicken biryani around 6pm)

Calls

Rest

Housework

Study an hour

Slept until around 10:30pm

01/03/2023, 5:49 pm - Patient Advocate: 

Woke up at 6am

6am-7am

Got fresh

Prayer

Exercise (15mins)

Self-care

1 biscuit (only 3 pieces)

7am-8am

Study

8am-12:30pm

Slept

12:30pm-5pm

Study

Meal (1 paratha with veg at 3pm)

Prayer

Study

5pm-12:30am

Prayer

Calls

Meal (non veg biryani)

Prayer

Housework

Had chocolate shake

Had a piece of sandwich

Watched a web series for an hour.

Slept around 1:30am

01/03/2023, 7:04 pm - Dr. Rakesh: Wow! Your patient appears to have turned over a new leaf! 

Was thinking of changing this group title to Altered sleep rhythm but now I am wondering what else would be better.

01/03/2023, 7:19 pm - Dr. Rakesh: Just as you have been a successful patient advocate for this patient with throat pain that recovered, would you like to help this 14F with currently similar symptoms 👇

01/03/2023, 9:26 pm - Patient Advocate: Yeyeyeyeyeye thank you 🙈🙈🙈

01/03/2023, 9:28 pm - Patient Advocate: Yes Doctor I would love to help. I joined 👍

[02/03/2023, 3:56:32 PM] - Patient Advocate: 

Woke up at 6am

6am-7am

Got fresh

Prayer 

Self-care

Exercise (15mins)

Ate a piece of sandwich

7am-12:30pm

Study

Had half plate of biryani

12:30pm-3:30pm

Slept

3:30pm-10:30pm

Prayer

Calls

Prayer 

Housework

Prayer

Housework

Ate 4 chocolate pancakes (cooked by me) around 7:30pm.

Few sips of a cold soft drink

Music

Random stuff

Slept around 12am

[02/03/2023, 3:57:03 PM] - Patient Advocate: Ok 🙃🙃

[02/03/2023, 4:00:11 PM] - Dr. Rakesh: Great 👍

Managing to wake up at the right time. Why not ask your patient to convert her 2-hour afternoon nap into a 15-minute power nap and then have an early dinner and retire at 10: 00 PM?

[02/03/2023, 4:12:46 PM] - Patient Advocate: Ok I will ask my patient to do that. Might be possible some of the issues a patient is facing regarding tiredness will eventually sort out.

[04/03/2023, 3:12:14 PM] - Patient Advocate: 

Yesterday woke up at 6am

6am-7am

Got fresh

Prayer

Self-care stuff

Exercise (15mins)

After 7am

Actually did random house stuff yesterday, calls and prayers, nothing much. 

Meal 1: Onion paratha at 1pm

Meal 2: non-veg Biryani and a few sips of cold soft drink at 4:30pm

Meal 3: 2 chocolate pancakes around 8pm

Went to bed at 10:30pm but cannot sleep till 1am so watched youtube videos.

Woke up again at 2am due to acid reflux in my throat.

Cannot sleep till 4am so did some online shopping. 

Again woke up at 6am due to acid reflux in my throat and Took omeprazole.

6am-7am

Got fresh

Prayer

Self-care

Exercise (15mins)

7am-8am

Study 

8am-1pm

Slept

1pm-3pm

Room organized 

Prayer

Meal (1 paratha and non-veg stue)