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Q. When compared to night shift, how is working in daytime better?

Answered by
Dr. Hariharan V
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 06, 2015 and last reviewed on: Oct 09, 2018

Hi doctor,

I am a 38 year old male. I am overweight. For past 10 days, I feel tiresome. I am taking tablet Nurokind-LC 1-0-0 and capsule Adliv Forte 1-0-1 for the past four days. Now, I am feeling better but not 100%. I suspect UTI, but not tested yet. I have asthma from childhood. Initially, I used Foracort 200 inhaler and now I am using nebulizer with Asthalin respirator solution. My wheezing is in control now. My lifestyle over last few years was not good. I missed sleep and slept whenever I had to. Please suggest ways to get better with or without tablets.

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome to icliniq.com.

God created us in manner that we should work for 8 hours, rest for 8 hours and sleep for 8 hours. When we change this pattern it may lead to many diseases like migraine, hypertension, diabetes, obesity, etc.

  • Why you are not getting sleep on time? Are you doing night duties or sleep in daytime? How many hours you sleep at night? Are you the person who thinks much before sleep? Is there loads of stress at work?
  • Please answer my above questions. It will help me find out why you are not sleeping well. Kindly refer relaxation exercises and breathing exercises. Do it for 20 minutes before going to bed.
  • If your sleep does not become regular we can start with sleeping pills, which will greatly improve your sleep. My opinion is, when you sleep well, your increased weight and tiredness will go away. Anyway you are just 3 kg overweight. You can reduce it easily by going fast walking 40 minutes a day in the morning.
  • Nurokind-LC (Methylcobalamine) is usually given for cramps occurring at night. If you have that you can continue with Nurokind LC. Better health tablet is Zincovit. I have tried that with many patients and found it is one of the best drugs for tiredness.
  • What is the purpose of taking Adliv Forte? Is it like Liv 52 given for people with liver problems? Why your doctor has given that? Do you take alcohol regularly? Do you have indigestion or recent jaundice or any pain in right side of abdomen? If there is no need for taking Adliv, Zincovit is more than enough.
  • Eating a fruit as a whole everyday gives you all the vitamins you need and good amount of fiber. Eat one fruit everyday.
  • What about UTI? How long you suffer with pain during urination? Please explain the symptoms, so that we can analyze and prescribe any test (if needed) and treatment.

Revert back with the answers for the above questions to a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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Hi doctor,

Thank you for your thoughtful approach. Yes, I used to work various shifts and mostly night shift in the past three years. I was working for more projects and more clients and so I compromised with my sleeping hours. Yes, I used to think too much day and night and it disturbs my sleep pattern. I am in rest for past three weeks. I recovered 90% now, except for a mild tiredness when I try to concentrate heavily about any single issue. I took routine urine test and attached the report. I did not have any symptoms of UTI now. I just stopped both tablets Nurokind-LC and Adliv Forte after your reply. Now I feel that my recovery is getting faster. I do not drink or smoke. I do not have any digestive problem or pain in my right lower rib area. I am suffering with wheezing from age 1 till now. I would like to know any advice for long-term prevention.

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome back to icliniq.com.

  • According to your urine test (attachment removed to protect patient identity), only few extra pus cells are present which poses no problem at all.
  • Night duty will spoil our health. We will get accustomed to one shift for some time and get some sleep after duty. But they will change the shift before we get adjusted to it. It gives a big trouble. So, if you are going to do shifts again, please ask them to give you monthly shifts (regular night duty for a month and day duty the next month), so that the shifts will not cause any health problem.
  • You can take Zincovit tablets at morning everyday for a month for your tiredness.
  • Regarding wheezing, start with tablet Montair-LC (Montelukast Sodium). One tablet before sleeping for two months. It will prevent further episode of asthma. If your symptoms occur like once a month or rarely, then this tablet is not necessary.
  • In that rare case, you can take tablet Septilin which is an ayurveda tablet. Take one tablet at night daily. It will increase your immunity and will prevent asthma.

For further information consult a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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Thank you doctor,

I will follow your advice and will let you know how things go. I stopped working in night shifts after this health disaster. As of now, I am self-employed and have the freedom to choose my work hours. Did you say working in daytime is best compared to night-time? Please let me know.

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome back to icliniq.com.

  • There is no doubt that day duty is the best. We are made up for that only. Since you have started your own setup, it is very good.
  • There are two kinds of people. One wakes up early in morning like 6 or 7 AM and goes to sleep by 10 PM. Another type person who is comfortable waking up by morning 11 AM and goes to sleep by 2-3 AM. Both are normal only.
  • I think you are type 1. So, day time work is better. Night duty is always harmful. Please find some relaxation exercise and do it at night. You will get good sleep. Once you start sleeping well, all your problems will fade away.
  • Also start doing pranayama. Close right side of the nose and take deep breath using the left nostril. Hold breath for few seconds. Now open the right side and close left. Exhale via right side. Again start inhaling by right side. Proper practice will make you do that easily. Do pranayama for 5 minutes three times a day and before sleep.
  • Again there are different timings of sleep. Some people feel better if they sleep for 8 hours a day. Some needs only 5 hours. You have to find out the timing which works for you and follow the same timing. For example, if you sleep for 6 hours and feel fresh the next morning then it is the correct time. But if you feel tired you may need more time.
  • Never have hot drinks like coffee or tea at night. Similarly please avoid spicy masala food at night. Both will impair sleep.

For further query consult a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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Hi doctor,

With regards to pranayama effort, sometimes either one side of the nose is partially or fully blocked. So, I get little bit discouraged whenever I try to do this exercise as suggested by some of my college seniors when I was an UG Student. Please let me know if there is anything I can do about it to rectify that issue. Often my sleep used to get disturbed either due to wheezing or due to other issues such as phone. Now I have learned to switch off all those gadgets three hours before sleeping time. After using Montair-LC I am not getting disturbed much except for a slight discomfort of breathing when I wake up. I was using Asthalin respiratory solution in nebulizer from my age of 28 to 37 and moved to Foracort inhaler 200 for almost a year back. At present, I am using only Montair-LC every night before sleep and Asthalin respiratory solution without diluting for a few seconds whenever I feel difficulty in breathing. I took blood test just to see how things are with my general health. I am attaching my CBC (complete blood count), LFT (liver function test) and urine routine test reports here for your review. I am 99% alright now and my weight is 74 kg now. I am not feeling energetic to go for a morning tennis which I have started recently for having some fun out of work.

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome back to icliniq.com.

  • Your blood and urine reports (attachment removed to protect patient identity) are normal. Even eosinophil count is normal.
  • Regarding pranayama, do it whenever your nose is not congested. If nose blockage is present, you cannot do it.
  • Also I suggest lung exercises to increase your tidal volume. This will increase exercise tolerance. So, you will not feel breathless or tired when playing tennis. Just buy some balloons and blow 10 balloons a day. How much ever you do is fine.
  • You can start tablet Roflair (Roflumilast) 500 mcg at night. It works for 24 hours and reduces wheezing. It is like Deriphylline (Theophylline) which dilates air passages. Slowly you can stop Foracort when you use Montair and Roflair.
  • Tennis is a game which requires lot of energy and stamina. So start playing lightly for a month and gradually increase speed.

For further information consult a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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Hi doctor, Yesterday, I had a wheezing attack after longtime. It was a gradual discomfort started from evening. I stopped taking Montair for few days. Also for the past ten days, I am coughing regularly in the morning. I am getting light yellowish color phlegm regularly but no difficulty other than that. The chest congestion is a bit high now and I feel there is a lot of phlegm around my chest. I am a bit concerned about using Montair regularly. Yesterday night, I took Betamethasone 0.5 mg one at 8 PM and one at 2 PM with Asthalin respirator solution in nebulizer and my wheezing was controlled. Please advice.

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome to icliniq.com.

  • Stopping Montair is fine. Usually I prescribe it when a patient had wheezing episodes once to thrice a week. It is an on and off tablet. If wheezing comes, we can take for a week and stop. If the wheezing happens occasionally like once a month, then regular use is not recommended.
  • Are you still using Foracort? If so, you please take up to four puffs per day for next two to three days.
  • Please take the following tablets for severe phlegm. Tablet Azee (Azithromycin) 500 1-0-0, tablet Deriphylline (Theophylline 300 mg) 1-0-1, tablet Cetirizine 0-0-1 and syrup Tusq-X (combination of Terbutaline Sulphate, Bromhexine Hydrochloride and Guiafenessin) 10 ml-10 ml-10 ml.
  • It is good to have black coffee without sugar two times a day for asthmaDrink hot water for few days.
  • Betamethasone is a steroid. It is fine to take one or two times. Please stop that and take above drugs. Also take Montair-LC for 10 days and stop.

For further information consult a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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Thank you doctor, I am not using Foracort now. Because I do not feel good with the medicine like earlier. I just keep Asthalin inhaler in my car and a few Montair tablets for emergency when I go out in two wheeler or car. When I feel slight breathing difficulty, I am just inhaling one or two breaths of Asthalin respirator solution without dilution.

I am not going for any sporting activity yet as I feel little weak when I do something physically. Thought of continuing sports after two months. I am just taking rest at home now for past two months doing mild stuff at home and engaging in mental work for about three to four hours per day. Once I stopped Montair after a day or two, I am getting discomfort. So I got scared whether my body is going to get addicted to this medicine. Your response makes me feel better.

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome back to icliniq.com.

The main thing is that the wheezing is usually seasonal in many patients. Like autumn or in rainy seasons. So during that time Montair-LC is good.

  • When a person takes Montair for two months, that whole two months he will not have any wheezing episode. Even after stopping the tablet, he will not get symptom for another two months. In few patients it may prolong up to six months. So most of my patients take Montair for two months continuously per six months.
  • Another set of patients respond well to Montair-LC but after stopping it they may have wheezing. We do not know why this tablet works differently for different sets of patients. I think when there is severe asthma Montair works only when it is being taken and wheezing comes back after stopping it. It will be better if you try two months per six months of Montair LC. I guess you already had this tablet for 50-60 days.
  • As I have already mentioned, tennis is a rough sport. Constant running triggers asthma. Walking, yoga, cycling, volleyball, cricket are best. Since they are light, we can take rest at times.
  • Swimming is the best, since it gives workout to all your muscles and being in water every day may make you resistant to cold and may reduce episodes.

For further information consult a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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Hi doctor, Thank you for the good explanation and right reasoning about Montair. I understand your point here. I took Montair about 30 tablets till now in the past two months. Will continue Montair for one more month and then will review from there as per your advice.

Earlier, I was playing badminton (shuttlecock) in the night-time around 8 to 10 PM for few months. It was too tough for me as we played only doubles and it requires swift movements consistently. I use to get one episode of wheezing almost every day which gets controlled when I take two puffs of Foracort 200 with around few breaths break. If I play for another 2 to 3 hours even I do not get any wheezing the rest of the day. 

That was my routine for about 3 months and in general most things were in control that time, then my health became so weak. So, I stopped playing badminton and tried tennis once or twice a week for about one month. After a month, I was bedridden with tiredness for almost 10 to 20 days and that is where I started to interact with you. Now I stopped all these and will try other things like cricket at home/walking/swimming etc as you suggested .Till I get a good health I will not go to racquet sports again. I had fits once when I was around 20 years old and took Tablet Neptoin for two years and it got cured and never had fits again. Will it get triggered from my medication?

Dr. Hariharan V

Diabetology General Medicine Internal Medicine Nutritionist
#

Hi,

Welcome back to icliniq.com.

  • Having one episode of epilepsy can be due to many causes. Let us not go deep into that, but taking Montelukast when you had one episode of seizure is not a worrisome issue. It will never cause or aggravate fits.
  • Swimming is also good for backbone. I had a friend who was diagnosed with lumbar disc prolapse and doctors advised him to go for surgery. He was 35 at that time. By swimming three to four days a week, he made all the symptoms disappear and is fit now. So, swimming is good for health.
  • Around 10% of olympic athletes have asthma. How about that? So, playing soft games are good entertainment and also it will increase your exercise tolerance which will reduce episode of asthma.

Revert back after a month for review to a family physician online -->  https://www.icliniq.com/ask-a-doctor-online/family-physician


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