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