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Ok, medical detectives, I need some assistance... DS, 14, suffers from daily fatigue. He has an adenotonsillectomy scheduled for November 4th that the ENT thinks will help with PANDAS and will help with breathing, sleeping, fatigue, etc. DS, 14, started 8th grade wrestling yesterday. This is his first organized sport ever and he seems very excited about it. That being said, he hates to lose EVER-AT ANYTHING-FOR ANY REASON. I don't know if that is genetic, pandas, or an unhealthy combination of the two. My husband and I are both very competitive. On day 2 of practice, he lost in a drill and he was crying and very upset. He could not be consoled and was nasty the entire trip home. Coach met me at the car to talk about it-JOY. I gave him an apple with peanut butter, he took a shower and is much calmer, but horribly tired. DS was dripping with sweat and said he was starving. A few other times in his life he has been downright ugly and nasty tempered when he has not eaten on a somewhat regular schedule. Usually an apple with some peanut butter will take the edge off until he eats a regular meal. At one time, an endocrinologist said he had Metabolic syndrome and prescribed Metformin. He took for two months and no noticeable results. Dr B, who was immunologist at the time, said he didn't need it, that he did not have metabolic syndrome. His blood sugar always tests in the normal range. DS, is 5'10 and weighs 215; his shoulders are as broad as a linebacker's. He has recently lost 7 pounds on his own by doing elliptical exercise. What am I missing here?? I plan to send a snack for him to eat between school and wrestling practice. Will the adenotonsillectomy help with the fatigue? Again, what else can we do?