DESLOGE -- Jeff Jarrells, 58, of Park Hills, passed away January 10, 2018, in Nashville, Tennesse. He was born October 28, 1959, to Russell Dean and Wanda Lee (Conley) Jarrells. Jeff was a 1978 graduate of Central High School and the life of a party. He worked in sales for 30 years and could sale ice to an Eskimo. He was an avid fisherman and founder of Superbass fishing tournament circuit. He attended Crosspoint Church in Nashville, while he was helping his daughter Haley, in the music industry. Jeff was her #1 fan.
He was preceded in death by his father, Russell Dean Jarrells; and father-in-law, Virgil Murray.
Jeff is survived by his wife, Rae Dean (Murray) Jarrells of Park Hills; daughters, Kiley Rigdon and husband Christopher of Park Hills, Haley Jarrells of Nashville, TN; grandsons, Brett and Garrett Ridgon; mother, Wanda “Midge” Jarrell; brothers, Charles (Renae) Jarrell, Barry (Vickie) Jarrell; mother-in-law, Marian Murray; sisters-in-law, Paula (Steve) Tiefenauer, Rhonda (Roland) Hubbard; brother-in-law, Allen Murray; several nieces and nephews, also survive.
Visitation will be held at C.Z. Boyer and Son Funeral Home in Desloge, Saturday, January 13, 2018, from 4 p.m. until 9 p.m. The visitation will resume, Sunday, January 14, 2018, at 10 a.m. until service time at 1 p.m. with Pastor Lennie Fincher officiating. Interment will follow at Woodlawn Cemetery in Leadington. View tribute and share your memories and condolences at czboyer.com.
DEAR HARRIETTE: My daughter is a true teenager. Even when it is freezing outside, she doesn't want to wear a coat. All of the kids these days wear big sweatshirts instead of true outerwear. I see them and know this is their style, but I also know that when it is below freezing outside, they need to be properly dressed. I don't like forcing my daughter to do things at this age, but I don't want her to get sick. How can I get her to understand? -- Putting My Foot Down, Cambridge, Massachusetts
DEAR PUTTING MY FOOT DOWN: Remember that you are the parent here. Make it clear to your daughter that she has no other option in the bitter cold than to wear her coat. These days there are lightweight coats made with new technology that are extremely warm without being bulky. If your daughter does not have a coat like that, you might consider buying her one. They are available in virtually every price range, and a lot of young people wear them. No matter what, let your daughter know that she must wear a coat on cold winter days. If she does not, you should take away privileges like her phone -- something she will truly miss.
DEAR HARRIETTE: My next-door neighbors invited my husband and me to go on a trip with them to Europe this summer. They just asked because they wanted to give us enough time to prepare if we want to go. I love the idea. My husband and I have never taken a vacation out of the country. We love our neighbors, and it would be fun to go with them.
My husband is nervous about the trip. He reminded me of the terrorist attacks in France and Belgium. He cautioned me about other parts of Europe, too. I pointed out that these things happen in the United States as well. I suggested that we take a risk to enjoy this moment with our friends. He is not interested. We have until the end of January to get back to our friends. How can I convince him to go for it? -- Ready for Vacay, Winston-Salem, North Carolina
DEAR READY FOR VACAY: Your husband's concerns about safety are valid. It is true that there have been a number of terrorist activities in European countries -- as they have also occurred stateside. Added to this concern is the fact that your husband is not a traveler. He is probably nervous in general about going overseas.
Show him photos of the places you might visit and talk about the possibilities of what you can do while you are on the trip. Tell him that you really want to go and that you would like him to reconsider the trip. Add that the best way to not give in to terrorism is to live your life to the fullest, without fear.
You may want to invite your neighbors to talk with the two of you about the plans for the trip just to get your husband engaged in the discussion. Talking about it may get him to open up to the idea.
DEAR HARRIETTE: My boyfriend and I have been dating for four years now. We get along great and feel like we will be together forever. We both just finished college and are working hard to get on our feet. Though we talk about the future, we have not specifically talked about marriage.
A few of our friends are engaged now, and I'm feeling a little anxious. I know we need to get good jobs and earn enough money to get a real home and all, but I don't know why we can't do those things together as a married couple. I don't want to push my boyfriend, but I do want to get married. What should I say to him? -- Ready to Tie the Knot, Wilmington, Delaware
DEAR READY TO TIE THE KNOT: Without pressuring your boyfriend, you should talk about the future and how you envision it. If you want to have children, let him know that and give a sense of when you would want to have a child. Go through your list of questions and thoughts about building a life together, and ask him to share his thoughts. You can ask him if he wants to get married, and, if so, when he thinks would be a good time. You deserve to know if the two of you are on the same page as you plan for the future. Talk it out, and you will have a better sense of whether the two of you should remain on this journey together.
DEAR HARRIETTE: My company is taking the leadership team on a retreat soon, and I have been invited. This sounds like a wonderful opportunity. The only thing is, I have never been out of the country, and I don't have a passport. I heard that it takes a long time to get a passport. I don't want to miss out on this trip. I also don't want everybody to know that I have never been anywhere. Most of my co-workers who are on the fast track spent a semester abroad while they were in college. Quite a few of them go to the Caribbean every year. Me, I just work and go home. I work a gazillion hours, which is why I have been promoted. I worry that I'm not going to measure up. -- Going Abroad, Cincinnati
DEAR GOING ABROAD: You are likely not alone. Many people get passports when they are adults. Do not be ashamed about that. Get proactive. You can get an expedited passport -- for a premium price -- in a matter of days. You may need proof of travel, which would be a copy of your airline ticket. Then you should get your passport photos taken and choose an expediter to process your passport. Depending on how much time you have, you can also process it normally. Without extra fees, you need four to six weeks. Expedited is two to three weeks, and expedited through an agency is about eight days. For more information, visit travel.state.gov/content/travel/en/passports/requirements/processing-times.html.
Harriette Cole is a lifestylist and founder of DREAMLEAPERS, an initiative to help people access and activate their dreams. You can send questions to email@example.com or c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106
FARMINGTON – Elizabeth “Betty” May Bieser, of Farmington, passed away surrounded by her family at Missouri Baptist Hospital in St. Louis on January 10, 2018, at the age of 69. She was born in St. Louis, Missouri, on February 17, 1948, to the late John George Korn, Jr. and Stella Ella (Burns) Korn. In addition to her parents she was preceded in death by a brother, Billy Korn; a sister, Judy Thebeau and her grandson, Tyler Bieser.
Betty was a loving and devoted wife, mother and grandmother who was happiest when spending time with her family. She was a professional seamstress having worked for most of her adult life at the Miss Elaine Garment Factory and Eric Scott Manufacturing. In Betty’s earlier years she was very fond of horses and enjoyed horseback riding.
Surviving are her loving husband of 52 years, James “Jim” Bieser, Sr.; four children, Donna Bieser, Wayne (Lisa) Bieser, all of Farmington; James “Jr.” (Jennifer) Bieser of Ste. Genevieve and Dale (Surita) Bieser of Millersville; eleven grandchildren, Lacey (Mike) Copeland, Chelcey Logan, Garret Bieser, Jacob Bieser, Joshua Bieser, Jayce Bieser, Haley Bieser, Jonathan Bieser, Matthew Bieser, Justin Bieser and Cody Bieser; five great-grandchildren, Averi, Chase, Carter, River and Jayce; siblings, Johnnie Korn, Victor Korn, Linda Craig, Donald Korn, Pat Korn, Jimmy Korn, June Neeley and Brenda Cantrell. Also surviving are numerous nieces and nephews.
Friends and family may call at Cozean Memorial Chapel on Sunday, January 14, 2018, from 4 – 7 p.m. Visitation will resume on January 15, beginning at 7 a.m. until the service at 10 a.m. in the Cozean Chapel. Interment will follow at Charter Church Cemetery near Festus. View the tribute video and share your condolences at cozeanfuneralhome.com.
DEAR ABBY: I have an answer for a question from "Excluded in the East" you printed on Sept. 24: "Why do married couples exclude single people?"
As a single mother with three children for 15 years, I made the conscious decision to conduct myself as I always had when I was part of a couple. I hosted backyard parties and holiday dinners and invited my married friends. I initiated invitations for dinner and a movie.
At restaurants, I made sure to pick up my own tab. If a couple insisted on paying for my meal, I insisted on paying the tip and was prepared with cash. Why? Because I was mindful that some men felt uncomfortable about taking money from a single woman.
If I wanted company for the evening, I drove to their house. Sometimes I volunteered to be the designated safe driver. Most important, I never complained about my ex or vented about the difficulties of coping as a single mom.
Needless to say, there was no flirting or inappropriate comments. I also avoided lengthy side conversations with one spouse. In short, I worked hard to make sure my married friends enjoyed my company as much as I enjoyed theirs, and it worked! -- LAURA IN NEW YORK
DEAR LAURA: I'm glad it worked for you. After I asked for readers' input on the topic, I received many interesting responses. Read on for a sample:
DEAR ABBY: I suspect that married couples are afraid divorce is contagious. It could have something to do with the fact that some married people are no longer happily married and they fear if they include a divorcee, it might trigger a divorce. -- HAPPILY UNCOUPLED IN OHIO
DEAR ABBY: I have been married for 10 years. A lot of couples exclude singles because they don't want them to feel like third wheels. I remember when I was single feeling that way in some groups, and it was depressing. Marrieds also have a different mindset than singles, which can lead to awkwardness. It can work, but it has to be the right group. -- MARRIED IN THE MIDWEST
DEAR ABBY: We're a gay male married couple. We have many friends -- singles and couples, gay and straight -- with whom we socialize, usually at restaurants. We often dine with single friends one at a time, because splitting the tab is simply a matter of two credit cards. If we're with another couple, that's two credit cards. Three couples, it's three cards, etc. But with five or seven people at the table, paying for the meal turns into an exercise in high finance. -- KEEPING IT SIMPLE IN PALM SPRINGS
DEAR ABBY: I'm in my early 60s and still single. I actually PREFER to be left out of invitations to eat in restaurants, go on trips, etc. with my many coupled friends. It makes me somewhat depressed to be with those who have found their mates. "Excluded's" friends may be sensitive about this, too. I'm very comfortable at home with my menagerie, and I often invite people over -- married couples included. -- DOG LADY IN BIRMINGHAM, ALA.
DEAR ABBY: Couples who tend to exclude their single friends, for whatever reason, need to remember that one day they, too, may be single and overlooked. My dear mom was left out a lot after her divorce, and I remember how sad it made her feel. -- ANDREA IN DENVER
DEAR ABBY: I play cards with a group of men I have known for more than 20 years. We switch partners after six hands so everyone partners with everyone.
One member of the group has now become unable to remember the rules and constantly asks how he should respond to his partner's bid. He also keeps asking the score and whose deal it is. Because we give small prizes for the high score, I think it's cheating to discuss a hand across the table.
What should we do when he asks the rules or how to bid a hand? I think we should play as we always have, and not discuss the hand or how to bid. Should I find another group to play with, and how can I explain my reason for quitting the group? -- PLAYER IN THE SOUTH
DEAR PLAYER: What a sad dilemma. Before quitting the group, discuss this privately with the other members. Are the small prizes worth the friendship?
Because this man is no longer able to remember how the hands are played, in light of your long friendship, perhaps the group could arrange to do some other activity with him once a week instead of the card game. That way, although he's no longer able to participate in the games as he has before, he won't be completely isolated. In situations like this, relationships and emotional support are very important. I hope you will consider it.
DEAR ABBY: One of my nephews is turning 24 soon. I am reluctant to get him a birthday gift because he's lazy and disrespectful and makes up excuse after excuse for not working. On top of that, he has a 1-year-old daughter and managed to get his family evicted because he felt the mother should do everything -- and I mean EVERYthing.
He's on his cellphone all day texting other women or posting Facebook nonsense. The mother of his child finally woke up and left him, so now he has moved in with his mother.
I am trying to understand why I need to give him a birthday gift. He was dropping hints about his birthday during a family dinner the other day. No one said a word. Everyone ignored him, including his mother.
We're pretty sure he won't be living with her long before he's kicked out. We have all tried to help and support him, but we are tired and no longer want to be bothered.
Must I give him a birthday gift? Or should I use the excuse he gives everyone else: "Oh, I ordered your gift online and they must not have shipped it yet." -- TIRED OF THIS MESS
DEAR TIRED: You are not obligated to send your nephew a gift. A card would be nice, however, if you're inclined to take the high road.
DEAR ABBY: Many years ago, in a "Farmer's Almanac," I read a saying so profound and succinct, I have never forgotten it. I thought one day I should send it to you. Well, with everything that's been happening in Hollywood and beyond, this is the time.
It goes, "If you don't want anyone to know about it, don't DO it!" -- FAITHFUL READER IN CARMEL, N.Y.
DEAR READER: AMEN to that!
DEAR ABBY: I grew up watching my mom being abused by her husband. It was terrible. Unfortunately, he eventually murdered her. She was only 36. I was 16 at the time, and although it has taken almost 30 years, I have finally found peace.
My message is to people who are currently experiencing abuse. No one deserves to be battered physically, mentally or emotionally. When people suffer from addiction (alcohol, drugs, etc.), they can get help only when they are ready. However, with domestic violence, the victims must consider not only themselves, but also their children. If you are a victim of domestic violence, PLEASE get out and get help. -- HEALED IN GEORGIA
DEAR HEALED: Please accept my sympathy for the loss of your mother at such a tender age. In her memory, I will again print the phone number for the National Domestic Violence Hotline. It is (800) 799-7233. There is a separate TTY number for individuals who are deaf or hard of hearing. It's (800) 787-3224. Its website is thehotline.org. Help is available if victims recognize they need it and reach out.
DEAR ABBY: I enjoy weekly massages from a popular self-employed masseuse. I have a standing appointment. If I cancel within 24 hours, I understand that I must pay her. However, if I give her more notice, must I still give her some remuneration? We have never discussed it.
I feel bad about canceling, as she may rely on this income, but it's difficult to pay for the event that requires me to cancel in addition to a massage that didn't happen. What would you do? -- UNSURE IN FLORIDA
DEAR UNSURE: Your masseuse has a 24-hour cancellation policy so when clients can't keep the appointment, she can fill in the time with someone else. Most personal service professionals understand that from time to time appointments must be skipped or changed.
Because you are worried about her, talk with her about it and ask if she can slot you in at a different time if there's a schedule conflict. It would be a win-win. She'll get the money, and you will still have your weekly massage, which, clearly, is important to you or you wouldn't have a standing appointment.
DEAR ABBY: I am worried about my best friend. She never eats at school, and I don't think she's eating at home either. She's beginning to get weak. Yesterday we were playing ball in P.E., and when she caught the ball, I saw her wince. I asked her if she was OK, and she said yes, but I'm still worried. What should I do? -- SCARED FOR HER
DEAR SCARED: Talk to your P.E. teacher about the fact that you are worried about your friend and why. She may not be eating because she thinks she needs to lose weight. Or she may have a serious eating disorder. The teacher will know what to do. Please don't wait.
DEAR ABBY: Recently a friend came over and took me to lunch. She has a small, 50-year-old vintage car that was very popular in the '60s. She had come from Marin County over the Golden Gate Bridge to my house.
As she drove us to the restaurant, her car stalled twice. It was very underpowered and, in my opinion, rickety. After she dropped me home, I sent her an email strongly expressing my concern that she is driving an unsafe car. I was worried for her safety. She took offense, so I apologized.
She has plenty of money to buy a safe used car like anyone else, but she says, "I like driving vintage." I don't want to get into her car again. Was I wrong to tell her I felt her car was unsafe? -- NERVOUS PASSENGER IN SAN FRANCISCO
DEAR PASSENGER: You weren't wrong to warn her. However, you may have been wrong to assume that she has "plenty of money to buy a safe used car." Nobody has as much money as others assume they do. Because you don't want to get into her car again, you should provide the transportation from now on or meet her at the restaurant.
DEAR ABBY: My across-the-street neighbor and I have become friendly. She has a 15-month-old and a newborn. Not only is she not married to the baby's daddy, but they don't even live together.
She has been asking me to help her a lot now that the baby is born. I'm 10 years older and raising three kids, all in their teens.
Abby, I don't want to raise anyone else's kids. How can I politely tell her that I have my own family to care for? She has a tendency to overreact. -- KEEPING DISTANCE
DEAR KEEPING DISTANCE: To tell your neighbor you "don't want to raise anyone else's kids" may be accurate, but it's a bit rough. When she asks you to do things for her, be pleasant and say -- consistently -- that you are busy, you don't have time, you have other plans, etc. If you do, she will soon realize that you are not to be depended upon.
DEAR ABBY: My son has lived overseas on and off for six years. He's being married to a wonderful young woman where they met, which was in Wales. Needless to say, not everyone can attend, so we are having a reception for them here in the States.
My son already has a fully furnished house overseas and doesn't need anything, plus the cost of taking gifts back would be astronomical! Anyway, he is thinking of asking for monetary help with the honeymoon. Would this be all right to do and, if so, how do you ask people for it? -- HELP FOR THE HONEYMOON
DEAR HELP: Many young people today post requests like that on their wedding website. Or, because friends and relatives may ask what they need after receiving invitations or announcements, the message can be conveyed verbally. According to the rules of etiquette, however, requests for gifts or money should NEVER be included WITH the invitations or announcements.
DEAR ABBY: I am president and co-founder of the Wildlife Center of Virginia, one of the leading teaching and research hospitals for wildlife medicine in the world. We have treated more than 70,000 wild patients since our organization was established 35 years ago. Like the reader ("An Apple a Day," Aug. 11) who is under the impression that throwing an apple core out the car window is doing something positive for the Earth, many individuals make "little" decisions without considering the unintended consequences.
The example of the apple core has been at the heart of our education program for more than three decades. Before throwing that apple core out the window believing that some small animal will come finish what's left, people should consider what will happen if the animal coming to eat their scraps happens to be on the other side of the road.
Throwing out that apple core will lure that creature into harm's way. Countless opossums, raccoons, skunks and other small mammals are killed every day because of human food waste on the shoulder of the road. And it doesn't stop there. Predators like owls also suffer. They hunt along the side of the road, not because they eat apple cores, but because they eat the mice, voles and other small animals who are attracted to feed on that apple core. Then, when the opossum, raccoon or owl is killed by a car, scavengers are attracted to the pavement, where their lives, too, are at risk.
If readers want to help the Earth, they should take their waste home and dispose of it or recycle it properly. The small act of throwing an apple core out of a car window can cost the lives of the very creatures they claim to want to help. -- EDWARD CLARK, WAYNESBORO, VA.
DEAR MR. CLARK: When that letter appeared, I received a flurry of mail about it. Many readers touched on some of the points you have expressed. Thank you for writing so eloquently to educate my readers -- and me. Lesson learned.
DEAR ABBY: I'm 29 and I'm having trouble holding down a steady job. I am a college graduate, and it's not because I don't like to work. My problem is I have a strong personality and I tend to butt heads with management. Deep down, I think I'll only be satisfied with a job if I'm the boss or own my own business. Do you have any suggestions about positions for someone who can't handle having a boss? -- MISS INDEPENDENT IN THE BRONX
DEAR MISS INDEPENDENT: No. Unless someone has rich parents or a magic lamp, most people have to work for -- or with -- others until they build enough capital to start a business. Even then, business owners must interact with clients they don't always agree with. Because you tend to butt heads with those in management positions, you would be wise to start working on becoming more patient and less dogmatic. Both qualities will help you in the future if you can develop them.
DEAR ABBY: The winter months are hard for me. They remind me that another year has gone by without my father and my younger sister.
Dad had been a smoker since his teens and died from pancreatic cancer at 39. I was 13, and my siblings were younger. In those days, we didn't know that smoking was a risk factor for pancreatic cancer.
My sister smoked from the time she was 13. She died from lung cancer at 44, leaving behind two young sons.
Neither my father nor my sister got to experience the wonderful family milestones and celebrations we have had. Their grandchildren will never know them. Each year during the holidays, I feel a sadness in my heart.
I urge every smoker to make a vow to quit and carry it through, not only for their own sake but also their family's. Stay determined to quit so you won't cause your loved ones sadness and won't miss out on their futures. With all my heart, I wish smokers the best of luck in quitting. -- MISSING DAD AND SIS IN SACRAMENTO
DEAR MISSING: I'm glad you wrote because the American Cancer Society's annual Great American Smokeout will be held on Nov. 16. It's a day when millions of smokers put down their cigarettes -- just for one day -- with the conviction that if they can go 24 hours without one, then they can do it for 48 hours, 72 hours, and stop smoking for good. The idea grew out of a 1970 event in Randolph, Massachusetts, and became a national event in 1977.
Readers, I'm not going to harangue you with death threats. We are all aware of the grim statistics associated with cancer-related deaths caused by tobacco. If you're interested in quitting, this is a perfect opportunity. Call (800) 227-2345 to be connected with counseling services in your community, provided with self-help materials offering information and strategies on quitting for good, and to receive information about medications available to help you quit. This service is free and provided 24/7. Or go online to cancer.org.
DEAR ABBY: I need your help. Over the past few weeks, I have been vacationing at my mother-in-law's home. The other day I was browsing on her computer and accidentally opened her browsing history. It turns out that she regularly looks at and responds to Craigslist personals.
I was shocked when I read some of the perverted requests she has responded to. The language she used would make a sailor blush. Keep in mind, my mother-in-law is a married woman.
I don't know how to react. Should I tell my wife? Keep it to myself? Make a fake Craigslist post and catch her in the act? -- KINKS IN THE FAMILY
DEAR KINKS: If you disclose this to your wife, it could damage her relationship with her mother. If she tells her mother what you found, it will create a breach in the family. If you trap the woman by creating a fake Craigslist post and she realizes she has been made a fool of, it will not -- to put it mildly -- endear you to her. Let it lie.
DEAR ABBY: I am in a predicament. My therapist is great, but sometimes I think she shares too much. Last time I went, she was running late. When I finally got into her office, she told me the previous patient was nonverbal and had painted her nails during the session. Later in the session, she confided that years ago she had been date raped.
Abby, I am in counseling because my father raped me when I was 15 (I am now 24). Her sharing has me worried because I don't want her telling others what I say or do during counseling. Further, her story of the date rape scared me. She described a situation that is not uncommon for me to be in, and it caused something almost like a flashback in me. I think what she did was insensitive, to say the least.
I have nobody else to ask, so what should I do? I'm getting counseling for free now due to my income, and it took months to get set up with a counselor. Should I report her or accept that this was a mistake and say nothing? If I need to report her, how would I go about doing that? -- CONFLICTED ABOUT IT
DEAR CONFLICTED: You should change therapists because it appears this one has more problems than you do. As to what agency you should report her breach of professional ethics to, contact the state organization that has licensed her to practice.
Dear Abby is written by Abigail Van Buren, also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Contact Dear Abby at www.DearAbby.com or P.O. Box 69440, Los Angeles, CA 90069
BISMARCK -- Wilma F. Wakefield, 91, of Bismarck, passed away January 10, 2018, at St. John Mercy Hospital. She was born December 3, 1926, at Flat River. Wilma was a member of Elvins Assembly of God Church.
She was preceded in death by her parents, Carson Pryor and Emma 'Robinson' Pryor; her husband, Ralph Leroy Wakefield; and great-grandson, Daxton W. Stricklin.
Wilma is survived by two sons, Leroy and wife Patty Wakefield, and Kenneth and wife Pam Wakefield; nine grandchildren; 13 great-grandchildren; one great-great-grandson. Other relatives and friends also survive.
Visitation will be 5 p.m. Sunday, January 14, 2018, at Horton-Wampler Funeral Home in Park Hills. A funeral sevice will be held 11 a.m. Monday, January 15, 2018, at Horton-Wampler Funeral Home with Rev. Elmer Killian officiating. Burial will be at St. Francois Memorial Park Cemetery, Bonne Terre., Arrangements by Horton-Wampler Funeral Home.
DEAR DOCTOR: I am 56 and in menopause. A couple of months ago, I started having severe restless leg syndrome, which even included my arms. I am now taking ropinirole before bed every night -- I also take Pristiq for depression. Although the medication has eliminated my restless leg syndrome, I worry about potential long-term effects. Any idea what could cause restless leg syndrome?
DEAR READER: Restless leg syndrome (RLS) is appropriately named. The syndrome is defined by an uncomfortable urge to move one's legs or arms during periods of inactivity. Because most people are less active in the evening, these symptoms often are first noted at that time. People describe the feeling as a pulling, creeping, cramping, crawling or tingling sensation that makes them feel an urge to move in order to relieve it. The periodic leg movements can also awaken people with the condition -- or those who sleep with them.
Restless leg syndrome occurs more often in people of Northern European ancestry; it's rare in those from East Asia and from Africa. Overall, it affects 2 to 3 percent of the population.
There is no specific cause of RLS, although genetic factors can play a part. Forty to 60 percent of people with RLS report a family history of the condition. Low iron storage can also be a factor, as can alterations in the brain function of the neurotransmitter dopamine.
Certain medications can worsen RLS symptoms, such as the antihistamine diphenhydramine and antidepressants. Thus, the antidepressant Pristiq (desvenlafaxine) could make your symptoms worse, but there are no specific studies of its connection with RLS.
Because poor sleep can aggravate RLS, be sure you are getting good rest. Exercise also appears to decrease symptoms, as can reductions in caffeine. Doing mental activities during a person's evening "down time," such as crossword puzzles, can reduce the focus on symptoms.
Medication that binds dopamine receptors, such as the ropinirole that you're taking, can decrease the symptoms of restless legs. Such medications are started at night and, although they can initially cause drowsiness, this subsides after 10 to 14 days. One problem with such drugs is that they can lead to rebound symptoms -- that is, the restless leg sensations -- in the morning. An even bigger problem is that long-term use can lead to decreased effectiveness, a shorter duration of action, symptoms noted earlier in the day and a spread of symptoms into the arms; these problems can worsen with increased dosages. To reduce the likelihood of this, I'd recommend staying on low doses of the drug and not taking it on a nightly basis, if possible.
You might also want to consider the anti-seizure medications gabapentin or pregabalin. They may not be as effective as ropinirole, but there is less likelihood of rebound or worsening of symptoms. Benzodiazepines, such as clonazepam, can be used for RLS, but can lead to tolerance or even dependency.
In summary, have your doctor check your blood ferritin level, a marker for iron stores. If it's low, consider iron supplementation. Also, be sure to increase your levels of exercise, decrease your caffeine intake and try mental activities at night.
If you feel that your symptoms are worsening on the ropinirole, talk to your doctor further. You have other options.
Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.
Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.