DR. HELENE EMSELLEM: Good to seeyou too.How have you been doing?
ANNIE EMBERTSON: A lotof changes this year.I got married last fall,and I started a new jobthis March.
DR. HELENE EMSELLEM: A lotof changes.How have you been coping,in terms of the narcolepsyand life?
ANNIE EMBERTSON: Pretty good.My new job is workingin an inpatient unitat the hospital.So, that's been a little bitof a hard change,trying to get my sleep schedulein order.
DR. HELENE EMSELLEM: Areyour medications keeping youadequatelyalert during that entire time?
ANNIE EMBERTSON: Yeah I takemy daytime stimulantsin the morning.And then usually, I take oneof them when I eat lunch.And then I'm usuallyable to make it the whole day.I'm able to take a 20 minutebreak in the afternoon.
DR. HELENE EMSELLEM:So a short nap is refreshingand sort of resets.
ANNIE EMBERTSON: Yes.In fact, even after my nighttimesleep, oftentimes I wake up notfeeling refreshed.But a 20 minute nap will feellike I've slept all night.
DR. HELENE EMSELLEM: Medicinesthat you're taking that aredirected towards the cataplexygenerally help?
ANNIE EMBERTSON: I takethe nighttime medicine thatdeals with the cataplexyand daytime sleepiness.And since I've been on it,I definitely feel morecontrolled.
DR. HELENE EMSELLEM: Do you everget cataplexy with sadness,or if you get upset?
ANNIE EMBERTSON: When I getangry at my husband, my kneeswill buckle.And usually, with mirth or kindof joy, and anything that's verytouching to me,like emotionally, I'llhave a slight bend in my knees.I have heard that whensome women get pregnant,that their symptoms either getworse, or sometimesthey go away.Have you had any patients whohave been pregnant dealwith those symptoms?
DR. HELENE EMSELLEM: So,a pregnancy is a little morecomplicated with narcolepsy.I've had patients workthrough their pregnancies,but the medication's generallynot considered to bea healthy thing to be on.The biggest challengeis learning to usethe timed naps, as well asexercise, to get youthrough the day,having a job that will beaccommodating.
ANNIE EMBERTSON:Another question, I guess,is as you age, do people'ssymptoms get worse, or do theyget better?Have you seen any changesin your other patients?
DR. HELENE EMSELLEM: Mostly,symptoms seem to be quitestatic over time.With normal aging, we just don'tsee the disorder disappear,unfortunately.But we also don't usually see itworsen either.
ANNIE EMBERTSON: I feellike as a health care provider,I'm starting to be moreopen with colleaguesabout my sleeping disorder.That's one of my goals,is to try to be more open,and to do more awareness.Because there is a lackof knowledgeout there in the general public,for sure.
DR. HELENE EMSELLEM: Good, goodfor you to try to come outof that box a little bitand help people understand.In terms of new researchand where we're going--looking at stabilizingnighttime sleep, finding waysto treat the cataplexy,looking at the overall impacton lifeand social circumstances--and encouraging peopleto get the exercise that theyneed to stay healthy.And try to keep this in its box,manage it, and not let it runyour life.
ANNIE EMBERTSON: Well, that'sall the questions I had for you.Thank you so much.
DR. HELENE EMSELLEM: You'revery, very welcome.And I always do tell my patientsyou have to talk to meabout the pregnancybefore you talk to your husband,so we can clear the deckswith beds.