Ask the ex­pert

Good Health (Australia) - - Be Informed -

For the past year, I have turned into a ‘night owl’. I can’t get to sleep un­til af­ter mid­night, then have trou­ble wak­ing up in the morn­ing. How can I get back to a nor­mal pat­tern?

A It sounds like you have cir­ca­dian rhythm disor­der where you have a de­lay in your nor­mal sleep pat­tern. (This pat­tern is ac­tu­ally nor­mal for teenagers.) This can be treated by avoid­ing ‘blue light’ at night from elec­tronic de­vices and in­stalling ‘warm light globes’. Get­ting plenty of nat­u­ral light in the morn­ing helps us to wake up. Try to do morn­ing ex­er­cise out­side and set reg­u­lar meals times, with din­ner sev­eral hours be­fore bed time. A mela­tonin sup­ple­ment taken two hours af­ter sun­set can also help. If these changes don’t re­solve the prob­lem, see your GP for re­fer­ral to a sleep spe­cial­ist.

My teenage son seems ob­sessed with be­com­ing mus­cled. He only wants to eat high-protein foods, take protein pow­der sup­ple­ments and be­comes ex­tremely ag­i­tated if he misses a gym ses­sion. Is this nor­mal?

A Your son may have a form of body dys­mor­phic disor­der known by the term ‘mus­cle dys­mopho­ria’. With this, men be­come ob­sessed with the size of their mus­cles and have ex­ces­sive con­cerns about ap­pear­ing phys­i­cally weak. They can ex­pe­ri­ence great dis­tress, some­times ex­ac­er­bated by non-med­i­cal steroid use. It is im­por­tant to seek help – take him to your doc­tor for re­fer­ral to a psy­chol­o­gist.

How do you know if you need an x-ray when you sprain your an­kle?

A There are a set of rules called the Ot­tawa An­kle Rules that are de­signed to help doc­tors de­ter­mine whether or not a pa­tient needs an x-ray when they have a sprained an­kle. Ac­cord­ing to these rules, an an­kle x-ray is only needed if there is ten­der­ness when you press on the malle­o­lar bones (the bones that jut out on each side of the an­kle); if there is ten­der­ness when you press on the bones above the malle­o­lar bones; or if you can­not weight bear for four steps right af­ter the in­jury.

My hus­band has a lump in his left groin that gets big­ger af­ter ex­er­cise and goes away when he lies down. It’s not painful. Could it be a her­nia?

A This cer­tainly sounds like a her­nia. All her­nias should be ini­tially as­sessed by a sur­geon. While ‘watch­ful wait­ing’ is rea­son­able for her­nias not caus­ing symp­toms, 75 per cent will re­quire surgery within 10 years. If the her­nia ever be­comes painful or can­not be re­duced by ly­ing down, it re­quires ur­gent med­i­cal re­view.

‘This can be treated by avoid­ing ‘blue light’ at night’

If you’d like one of our ex­perts to an­swer your ques­tion, email it to health@bauer-me­dia.com.au. No per­sonal cor­re­spon­dence will be en­tered into.

DR PENNY ADAMS OF­FERS HER AD­VICE ON RE­SET­TING SLEEP CY­CLES, MAN­AG­ING DYSMORPHIA IN YOUNG MEN, AND WHEN TO TREAT A HER­NIA

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