I’ve had back aches for ages – I can only stand for a few minutes before it’s unbearable

FIDGETY, disruptive, forgetful – these are symptoms of ADHD that you may be aware of.

But it can affect people in many ways, and as October is ADHD Awareness month, this a great time to discuss them.

The rise in the awareness of ADHD is reflected in the huge pressure on NHS diagnosis services.

ADHD doesn’t come and go or cause the odd behaviour change, such as an inability to put laundry away or pay a bill. It affects daily life. It’s also not just about being hyper or naughty.

People with ADHD tend to have trouble with executive function, aka the “management system” of the brain.

This makes managing time and emotions difficult.

An individual’s experience of ADHD can vary greatly. But neurodiversity – the range of differences in how brains work – can also be celebrated.

With more awareness, the world can hopefully better support those with conditions such as ADHD, autism and dyslexia to thrive.

Here’s a selection of what readers have asked me this week.

Q) I AM a man of 75 and although I have had back aches for a long time, just lately it’s been really bad.

I only have to stand for a few minutes and the pain across the bottom of my back is unbearable. Could this have anything to do with having two false hips?

A) It’s not common to get back pain severely after having false hips – around one in ten patients experience back pain post surgery that haven’t had it before.

It can occur post surgery temporarily as you recover but it should alleviate and get better with motion and mobility during recovery.

If you’re still under any type of care for your hip replacements, speak to your consultant or surgeon or physiotherapist about it as they should be able to advise you on what to do.

If you’re no longer under their care, speak to your GP and see what physiotherapy services are available in your area.

In some parts of the country you can self refer for physiotherapy.

There is a good chance that if you had degeneration of the hip joints sufficient to require surgery, then you may have degenerative changes in the bones and discs of the lower back too.

It’s worth having a look at your own posture generally too.

When you sit, is your chair or sofa supportive?

Are you slouching, when you stand up straight, are you hunched over or leaning on something?

A quick Google search will show you a lot of good posture guides where you can see how you compare to an ideal posture.

Whilst you have pain when standing it is important to try to maintain as much flexibility and strength as possible.

Chair based exercise, pilates or swimming may be some good options for you to try.

Struggle to manage wife’s skin issues

Q: MY wife has Alzheimer’s and has got a very sore area of skin around her anus.

This problem started in January and after using over-the-counter creams like Germolene, we were referred to a dermatologist and prescribed both fungal and bacterial creams, which have had no effect.

The problem is made worse as my wife is not able to maintain normal hygiene procedures after going to the toilet.

I was wondering what cream I can buy over the counter to numb the area.

A: You sound like an incredibly patient and kind carer for your wife, so thank you for writing in and advocating so well for someone you love who might struggle to advocate for themselves.

Has the area been assessed for infection?

If you’ve been referred then I’m assuming it has been assessed by a doctor or nurse and skin infection ruled out with a swab?

If not I would recommend this.

If your wife is confined to the house, then a district nurse could help, which your GP can arrange.

Lidocaine is a local anaesthetic that numbs the area where you use it. It comes in a cream or a gel preparation that can be applied to the perianal skin.

It would be best to speak with the doctor or nurse who saw her first to see if they recommend this.

The other option would be a haemorrhoid treatment, which can be bought over-the-counter.

Some contain lidocaine mixed with hydrocortisone, a mild steroid.

They come as creams, ointments, sprays and suppositories.

Finally, it’s worth contacting people like the Alzheimer’s Society if you haven’t already.

You can find them at alzheimers.org.uk and the charity also has a Dementia Support Line that you can call if you’d prefer – 0333 150 3456.

They will have nurses who will have experience of what your wife is going through and they can advise you both accordingly.

He likes sweet not savoury after stroke

Q: MY 80-year-old husband had a stroke four years ago. He recovered quite well but he lost his taste for savoury foods.

He’s only eating sweet foods, such as cakes, sweets and puddings. He can’t enjoy a roast or a steak any more because he just can’t taste them, so he’s not getting the nutrition he needs.

He’s had tests and an MRI scan but they couldn’t find anything wrong. He is so frustrated by this.

A: While it’s not a terribly common disability, if a stroke damages the parts of the brain that are responsible for interpreting signals about taste and smell you can end up with no smell or taste at all.

But it also means you can end up with a taste for certain foods and an aversion to ones you may once have enjoyed.

The issue, as you rightly point out, is that nutrition with only sweet foods isn’t ideal.

Eating high-sugar foods constantly can affect mood because you deal with sugar highs and lows. It can also result in weight gain and dental issues if the teeth are constantly under attack from sugar.

It might be worth getting in touch with your husband’s stroke nurse to see if they can offer any advice and a dietician may be able to make some suggestions, perhaps about ways to sweeten some savoury foods.

There’s also the Stroke Association (stroke.org.uk) who can help with advice related to taste and smell. Your GP is obviously aware of the issue as you say your husband has had MRIs, but there are other conditions that need to be ruled out that could be causing the change in taste including diabetes, medications, infections and conditions like dementia and Parkinson’s.

In the meantime while you await further investigations, there are naturally sweet foods he can eat that are of nutritional value.

Things like sweet potatoes, bananas, porridge with cinnamon and honey, flapjacks, granola and yoghurt will all appeal to a sweet palate but they’re slow release energy and will be better nutritionally for him than highly processed packaged foods.