Each week our panel of healthcare experts tackle all your most pressing troubles from a lack a lack of tears to how to use an inhaler...

THE CHILD BEHAVIIOUR EXPERT

Child behavioural specialist Amanda Clarkson of The Cactus Clinic at the University of Teesside

Q: Is medication suitable for ADHD and are there any side effects?

Amanda says: This is a particularly contentious area of clinical practice in ADHD.

Many people have very differing views on this. The main medication used to treat ADHD in the UK is methylphenidate, or more commonly referred to as Ritalin.

Also used is Straterra, Concertta and others. Recent prescription rates suggest 526,600 prescriptions have been written in 2005, an increase from 369,000 last year.

In some cases medication is suitable for individuals, however it should not be used as a first base management.

It is not sure how the medication works in ADHD although it is generally believed that it is used to regulate dopamine and/or noradrenalin which are necessary for increased attention and reducing hyperactivity and impulsivity.

Worry

Research of such medications has not necessarily been tested for efficacy and safety over a long period so should be considered with caution.

In terms of side effects many have been reported the main being loss of appetite, growth suppression, adverse effects on cognitive function, weight loss, tics, tourettes syndrome and psychotic effects.

There are also many other problems that may not have had time to manifest themselves, or have not yet been researched, such as the effect on aging, reproduction and adverse effects on the central nervous system.

For more information Contact ADDEPT - supports & advocates for individuals/ families who have ADHD & hidden disabilities.– 01904 782556 or The Cactus Clinic 01642 384433

THE GP

DR Jeremy Tankel has been a GP in Salford for 19 years. He is married with four children.

Q: My asthma inhalers don't seem to be working very well?

Jeremy says: Inhalers don't work if you do not use them properly and they don't work very well if thet are not used properly.

Many people find it is very difficult to use some inhalers. It needs co ordination and a big breath in.

Fortunately these inhalers come in different packages. There are powders and sprays. Some need a push down on the canister, others are activated by a breath in and so need no coordination, some have a twist and breath in type of mechanism.

Others who can't muster enough puff at all need to use a spacer device which is a clear plastic expanded tube that acts as a reservoir.

There are two main types of inhaler. A reliever (salbutamol, terbutaline or the long acting salmeterol which must be used with one of the other two) and a preventer which is a very low dose steroid.

Monitored

Essentially this preventer reduces the inflamation in the airways, reduces the thickening of the airways and stops them being so irritable helping to prevent them going into spasm.

That is why they are important. Generally if you need the reliever once a day or more then you should take the preventer.

Please note that if you have a sudden worsening of your symptoms then you may be having an asthma attack.

Contact NHS direct or your GP before your symptoms get too severe.

THE OPTICIAN

Optician Martyn Allen is clincial director at Stuart Jones Styling Opticians in Manchester

Q. I am a 79 year old woman and I cannot cry! I know I could in the past, but not any more. My sight never changes and I have regular check ups.

Martyn says: “Very interesting. If you are struggling with the emotional side of crying, this is possibly more a psychological issue, which you may want to speak to your GP about if you are concerned.

If you are able to be emotional, but do not produce tears, then the problem is much more likely to be related to the eyes, and more importantly, the lacrimal gland around the eye.

“Nearly all your tears are produced in the lacrimal gland, so any reduction in the tears may be caused by a blockage in the gland or by the nerves that send the messages to the gland to secrete the tears.

Emotion

If the gland is blocked, I would expect that your eyes are always very dry and uncomfortable, and your vision could be effected as a result of a dry eye.

To assess the quantity and quality of your tears I suggest speaking with your own optician, who may refer you for further tests with an Ophthalmologist.

“Whilst the daily production of tears for the eye and the tears that you cry when emotional do come from the same glands, the way those tears are secreted depends on the messages from the brain.

THE PERSONAL TRAINER

Steve Findlater specialises in nutrition and weight management.

Q: Is it better to do cardiovascular exercise before or after lifting weights?
 
Steve says: “You should always perform a warm-up before any exercise routine, but whether you should complete your full cardio workout first depends entirely on your goals long term.

“If weight loss is your main goal then I would suggest you complete your cardio first. This is so you don't sap much needed energy performing your weights routine first.

“If, however, you are wanting to increase muscle mass, I would either complete your cardio session at the end of your workout or limit it to a 20 minute session before.

“This is due to the body starting to burn muscle as an energy source as opposed to body fat after this period of time.

Routine

“I would also look at the type of cardio exercise you are are doing, for example, if you break your training days up, legs one day, arms another, it would make sense to cycle on your leg days and row on the arm days.

“Think about your routine and seek advice from a fitness professional if you are unsure.

“Also, remember to incorporate a good healthy balanced diet and stretch routine to your programme.”

If you've got a question for one of our experts write to them c/o Carmel Thomason, Features, Manchester Evening News, 1 Scott Place, Manchester, M3 3RN.