Daily Express - 30.07.2019

38 Daily Express Tuesday, July 30, 2019

DX1ST

CALL US ON0871 664 1466

OR VISITEXPRIVIERA.CO.UK

THE SERVICES OF OUR EXPERIENCED AND

INSIGHTFUL TOUR MANAGER THROUGHOUT

ESCORTED TOUR OF

South Africa

TERMS AND CONDITIONS:Calls cost 13p p/min from a BT landline. Mobile and other providers’ costs may vary. Prices are based on two people

sharing and are correct at time of print. Single supplements may apply. This holiday is operated by and subject to booking conditions of Riviera

Travel, ABTA V4744 ATOL 3430 protected. Subject to availability. Additional entrance costs may apply. Images used in conjunction with Riviera

Travel. For further information please write to Riviera Travel, New Manor, 328 Wetmore Road, Burton upon Trent, Staffs, DE14 1SP. For any

queries regarding placed orders call: 01283 742389. **Selected departures from October 2019 to November 2020.

16 DAYS*

FROM

£2,299

PER PERSON

DATES UP TO

NOV 2020**

South Africans call their homeland ‘a

world in one country’. It covers an area

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world-class destination.

PRICE INCLUDES

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Tour the legendary Zulu War

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Drift with a specialist guide

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Full-day guided safari in Kruger

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Stay in the heart of the gorgeous

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a cellar tour and tasting at a

300-year-old wine estate

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Stay three nights in cosmopolitan

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by the instantly recognisable Table Mountain

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Explore legendary Cape of Good Hope and Cape

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Visit Johannesburg’s Apartheid Museum

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dinners

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The services of our experienced and insightful

tour manager throughout

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Departures available exclusively for solo travellers

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February and September 2020

TRAVEL

yourhealth

Dr Rosemary

Leonard

My painful struggle to

get to grips with the

side effects of cycling

CONCERN: Doctor wants patient to take Duloxetine

Q

I’M 63, and have early arthritis

in my knees, which means I

can’t go jogging any more. I’ve

taken up road cycling instead to

keep fit and really enjoy it.

However, whenever I do a long

ride I find I can’t use my hands

properly afterwards. My little and

ring fingers splay out and it’s

difficult to hold a knife and fork. It

usually gets better in a week or so

but why is this happening?

A

AS you have discovered,

cycling can be a very good way

of exercising when you have slightly

dodgy knees, and it’s a sport that

many older people can enjoy safely.

However, cycling for several

hours can put a strain on the wrists,

and lead to what is called “cyclist’s

palsy” which is what I suspect you

have. It is caused by pressure on the

ulnar nerve which runs from the

elbow to the little finger and

supplies the small muscles that

help to control finger movement,

especially the little and ring fingers.

The pressure occurs at the wrist

and is usually caused by the

position of the hands on the

handlebars, particularly when they

are in the drop-down position.

I suggest you go to your local

bike shop and ask them to check

that both your handlebars and

saddle are in the right position, as

just a minor adjustment can make

a big difference to the pressure on

your wrists. You should also change

the position of your hands when

riding and also keep your bottom

far back on the saddle. Support

your body as much as you can by

engaging your core tummy muscles.

Q

I HAD my prostate removed 18

months ago and I’m still quite

incontinent. My doctor keeps

pushing me to take duloxetine but I

am reluctant because on the leaflet

that accompanies the pills, it says it

alters the chemicals in the brain.

I would like to know what that

means. I’ve asked my doctor but

she has given no proper

explanation. Please can you help?

A

DULOXETINE is one of an

increasing number of drugs

that can be used to treat more than

one medical condition. It can

increase the levels of the brain

chemical serotonin and

noradrenalin, and this means it has

an antidepressant action. However,

it is also very effective at reducing

spasm of the muscle of the bladder.

This means it can be helpful for

people who have episodes of

incontinence.

Generally the doses used for

bladder problems are lower than

those used for depression and as

with many drugs, it is best to start

with a small dose and increase this

slowly. However, if you would

prefer to have a drug that does not

affect your brain chemicals, then

there are others available for

bladder spasm, including solifenacin

and tolterodine. These are available

GETTING

TO THE

HEART OF

MEDICAL

MATTERS

Pictures: GETTY; ALAMY