Daily Health Tips: Persistent Cold And…How Do I Add Weight?

Q: Please Doc, I need to add some weight and at least have appetite for food. What can I use? Secondly I’m prone to cold. Sometimes, I take Procold…I don’t know if that’s advisable.

A: With the adoption of western lifestyle, obesity and other chronic non-communicable diseases like Diabetes and Hypertension are on the increase. Many people are now looking for ways to reduce weight and live healthier. Both actual and virtual forms of exercise or weight reduction programs abound.

Ironically, here you are asking for how to add some weight. I can almost say, you are so lucky! However I had to caution myself, considering there may be other circumstances surrounding your request.

First, your weight or how you see it may not be a true reflection of your health status. A slim, tall man, may be healthier than a thick, stocky counterpart. Also, a fat, rounded person, who is tall and exercising regularly, with no other risk factors, may be healthier than an average height, full-bodied individual. A more objective measurement is the body mass index, which makes use of your height and weight and categories if you are underweight, normal, overweight or obese.

So, I would advice before you start adding on the weight, do check your BMI and see a doctor who can help rule out other health issues that may be contributing to ‘low weight’. For your appetite, I would advise you eat only when you are hungry, eat an appetizer like carrots, or fruit salad before meals, avoid drinking water or fluids before meals, this will fill up your stomach and reduce the quantity of food you can consume. I wouldn’t really encourage that you take medications to boost your appetite, as these could have effects on the brain and general functioning of the body. Let your doctor advice you as to whether you need to take these or not.
To add on weight, eat foods that are balanced in carbohydrates, proteins, fats, vitamins and minerals. Proteins are excellent for body building and help in cell growth and repair. Meat, chicken, fish, eggs, beans, legumes, milk, and other diary produce are excellent examples. Focus on quality and not quantity. The rule is divide your plate into 3 parts, ½ of it should be a protein diet, ¼ carbohydrate or fats (unsaturated), and the remaining ¼ should be vegetables and fruits. Eat more frequently, and never skip meals. If you must snack, choose snacks like nuts, dried fruits, crackers or crunchy vegetables and fruits. Eat before bed time, never go to bed on an empty stomach.

It’s important to monitor your weight from time to time and also exercise (note, exercise is not just for weight reduction, it’s for physical fitness too). As much as you can, avoid physical and emotional stress.

Being prone to recurrent colds, may be due to an allergic condition in which you are highly sensitive to certain substances like cold environment, dust, smoke, perfumes, strong smells etc. It usually starts as an episode of sneezing and later a blocked/ dripping nose. It may be a problem with the immune system, where the body isn’t strong enough to fight against infections. It could also be that there is an infection of the nose and adjacent structures which may require antibiotics. There could be a small growth in the nostril called a polyp which could make you more prone to this, or an obstruction along the tract.

It may not be a good idea to keep taking the medication you mentioned. I would advise you see a doctor who would be able to evaluate you properly, find the cause of your colds and treat appropriately. Meanwhile, I would advise you avoid cold environments and cold drinks for now. Keep warm, take a lot of fluids, get adequate rest, and eat healthy. Steam inhalation(covering yourself up in front of a bowl of hot water in which eucalyptus oil has been added, for about 15-20minutes twice or thrice a day, with the aim of inhaling the stream)is also very helpful.

I hope you are able to get the desired weight you desire :D and not overweight. Remember, it’s a lot easy to gain weight but very hard work to lose it!

****The answer to this question was contributed by a guest doctor blogger.

For more on this question, please click on this link http://chatwithdrketch.com/2015/03/13/daily-health-tips-adding-weight-re-visited/

Have a great night, everyone :D

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Daily Health Tips: Genital Tract Tear And Uterine Rupture

Q: Please throw more light on genital tract tears and uterine ruptures, its effect on a woman who had a big baby through vaginal birth. Thanks and God bless

A: Genital tract tears or perineal tears during childbirth (vaginal delivery) as well as uterine ruptures are quite common especially in the resource poor nations where most pregnancies/deliveries do not receive adequate care or supervision.

Genital tract tears, in most cases occur when the baby’s head passes through the birth canal, or for a number of other reasons, and to differing degrees. The tear can range from a first degree tear involving the skin around the vagina alone, and no muscles involved to a fourth degree involving the perineal muscles, and extending up the anus and rectum. The risk factors include, a big baby(as you have mentioned) or if the baby’s head is big, having a previous perineal tear, an episiotomy(a cut given by a midwife to enlarge the birth canal, may get extended resulting in a tear), excessive bearing down between contractions (when the cervix is not fully dilated),when a certain instrument called a forceps is used to assist in bringing out the baby, prolonged labor (labor lasting more than 20hours in a ‘first-timer’ and 14hours in a woman who has previously given birth) and very fast labor (precipitate labor) are also risk factors.

Genital tract tears are repaired by the health worker, as soon as they are identified, to prevent bleeding. Following the repair, ice packs may be applied to the area for a few hours. Painkillers, antibiotics and vitamins prescribed by your doctor, may help to relieve the pain and aid healing. Sitz bath (sitting in a bowl of warm water which has been mixed with a handful of salt for 10 -15 minutes twice or thrice a day) is also recommended for pain relief and to prevent infection.

Uterine rupture on the other hand is not as common, but most often the major risk factor is a scar from a previous caesarean section. Attempting a vaginal delivery after one or more previous caesarean sections is a controversial issue for both women and their doctors. In the typical African setting, the woman is seen as weak if she does not experience labor pains and have a vaginal delivery. With this pressure, most women would want to give it a try, even when strongly discouraged by their care giver. Following a caesarean section, the lower uterine segment, this is the part of the uterus which was cut open to deliver the baby, is not that strong. So, during labor, with regular strong contractions that area which is already weak undergoes further stretching, and may tear/rupture. It is advisable to have a vaginal birth after a caesarean section (VBAC), supervised by a trained healthcare worker and in tertiary hospital. The labor is made as short as possible and closely monitored to prevent a uterine rupture.
Other risk factors for rupture of the uterus include, previous uterine surgeries like fibroid surgery, excessive stimulation (hyper-stimulation) of the uterus during labor with the use of oxytocin or prostaglandins, high parity (having 5 or more deliveries), over-distension of the uterus (either from amniotic fluid or carrying more than one baby), trauma to the uterus from maybe a car accident, a difficult manual removal of the placenta and a prolonged labor in a woman with a big baby.

Prevention of both genital tract tears and uterine rupture lies primarily in receiving qualitative and efficient antenatal care, peripartum (around the time of birth) care and postnatal care. Risk factors like being overweight or being diabetic (which are risk factors for having a big baby) should be identified and managed proactively (focus on dietary modifications, weight management, and exercise). Women should be given adequate support and care through pregnancy and more especially during labor.

Thanks for your question and God bless you too.

******This answer was provided by a guest doctor blogger.

For related posts, please click on http://chatwithdrketch.com/2014/07/22/daily-health-tips-can-i-have-a-baby-normally-after-a-cervical-tear/

Have a great weekend y’all :D

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Daily Health Tips: Why Do I Have Boils?

Q: Please Dr, I have a boil in my pubic region and after bursting it this evening, a smelly and disgusting stuff came out of it. What is the cause of this sir?

A: A boil, also called a skin abscess, is an infection of a hair follicle deep in the skin. Boils can occur in any part of the body, but most frequently in the armpits, groin, around the vagina/anus areas, around a tooth and at the back. They are often swollen, painful, and after a few days collect as a head of pus and debris (this explains what you noticed) which can rupture on their own when soft or ‘ripe’ or may require a health expert to cut it open and drain it (if it’s quite large).

Boils in the pubic region, can be caused by an ingrown hair (the hair instead of growing upwards, grows inwards into the skin, this may occur following shaving), blocked hair follicles (from sweat, or a damp unclean environment), a sexually transmitted infection (herpes, when it’s just starting) a sign of some other disease like diabetes, or problems with the immune system, poor hygiene (especially during menses for women) and poor nutrition.

As much as you may want to, avoid squeezing or scratching it, allow it rupture on its own. This would help prevent further infection of deeper structures and skin, and also prevent spread to other areas. Apply warm water with a cloth on the boil for about 10-15 minutes, 2-3 times a day. Avoid sharing towels and washcloths with other people and keep the area clean and dry as much as you can. An antibiotic cream or mupirocin cream can also be applied (ask for this in a pharmacy shop). You may require antibiotics, which would be prescribed by your doctor, if he thinks you need them. Further evaluation may be necessary if you have boils in multiple areas, recurrent boils over several months, a very large boil, or boils on your face and anus.

Hope this helps.

*****This post was contributed by a guest doctor blogger

Have a good evening, y’all :D

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Daily Health Tips: Why Can’t I Get Pregnant After Having My First Baby?

Q: Dr. I am a lady of 28 years. After my 1st child I began to experience irregular flow. My baby will be 3 years old by March 27 this year I can’t get pregnant

A: Madam, I empathize with you. I had a similar experience following the birth of my first child. It took 3 years too, before I got pregnant again. So, I truly understand your fears and concerns.
Secondary infertility is very common, but not often talked about. Even when women present themselves to the hospital, they don’t come out straight to let the doctor know what actually brought them to hospital, and rather list a series of symptoms most often, unconnected to their primary (main) concerns. Secondary infertility is the inability to become pregnant, or carry a pregnancy to term following the birth of one or more children. There however has to be frequent (at least three times a week), unprotected intercourse for a period of at least one year (six months for women older than 35), for this definition to be complete.

The causes include impaired sperm production (quantity and/or quality), erectile dysfunction, or new disease conditions in males. In females the causes include tubal damage (that is damage to the tubes from infections or adhesions in which case certain body surfaces stick together following surgery), ovulation problems (menstrual abnormalities), uterine conditions (infections from complications during a prior delivery, retained placenta, or a miscarriage which wasn’t properly cared for), complications from previous pregnancy(excessive bleeding following delivery) and changes in you or your partners’ risk factors; like changes in age (increasing age), weight, smoking and use of certain medications or disease conditions.

Irregular menses may be as a result of a hormonal imbalance, endocrine abnormality (diabetes, thyroid dysfunction, or pituitary abnormalities), certain medications, eating disorders (too much, too little, or too poor), polycystic ovarian syndrome (asides the irregular menses, there is also male pattern hair growth, facial hair, acne/pimples, cysts in the ovaries, obesity and sometimes diabetes), may be stress induced or a sign that you may be approaching menopause.
I would advise you visit a gynecologist, who would be able to evaluate you properly, possibly identify the cause of the infertility as well as the irregular menses and then treat you appropriately. Apparently, the irregular menses may not be entirely responsible for the problem you are having with getting pregnant.

Also try to identify any of the other risk factors I have mentioned above and work on them .i.e. exercise to reduce weight, a well balanced and nutritious diet most times, lots of water, smoking cessation, treatment of other possible health conditions and avoid the use of medications, (except those prescribed by your doctor).
More importantly, get support for your emotional health, by joining groups of women who have / have had similar challenges and share their stories to inspire others, become an active member of your religious group, attend counseling sessions with a therapist/spiritual counselor, and keep yourself busy or occupied with other activities asides house chores. All these would help you pass through this phase easily and am sure you too will be sharing your story pretty soon…God willing:) Cheers!

****This post was contributed by a doctor guest blogger

Have a great night y’all :D

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Daily Health Tips: Am I Leaking Amniotic Fluid (Liquor Amnii)?

Q: Good day Ma’am. I’m 27weeks pregnant with my first. For the past 1week, I’ve been noticing a white/milky watery discharge with no smell. I’m confused because I’ve heard many stories of leaking amniotic fluid (which I learnt is dangerous). Is this normal & please what can I do about it? I’m anxiously waiting for your reply. Thanks

A: Thanks for writing in dear.

Amniotic fluid is the fluid that surrounds and cushions a baby while in the womb. The fluid is contained within a sac called the amniotic sac. Usually just before a woman goes into labour, this sac ruptures and the fluid is released…that’s what is referred to waters breaking. When I had my last baby, my waters broke right in the hospital reception! And so, there was I with water all over my legs and people in the reception area watching :D It wasn’t quite funny on that day! But I digress…

Sometimes, this sac of fluid bursts or it could start leaking very gradually before the pregnancy is 37 weeks. This is called Pre-term Pre-labour Rupture Of Membranes (PPROM)

Question is whether what is leaking is urine, amniotic fluid or vaginal discharge.

Here are some tips to help you know:

If it’s urine, it has the peculiar smell of urine and is usually leaked when one coughs, laughs or sneezes.

If it’s vaginal discharge, it’s there constantly and may be clear, white or yellowish

If it’s amniotic fluid, it’s likely to be clear, or slightly mucoid and/or blood stained and it wets panties continuously irrespective of whether one laughs or not

The most significant issues with PPROM is the danger of infection, premature birth and the dangers associated with it.

Thus, if you develop a fever, the discharge changes to green, develops a foul smell, you experience vaginal bleeding, contractions, abdominal pain or baby appears not to be moving as normal, be sure to see a doctor immediately.

So, my advice would be to see your doctor immediately so he can examine you and make a diagnosis. He will confirm whether indeed it is amniotic fluid and then take a decision as to what step to take next. If the leakage is little, you may be asked to stay in hospital for a few hours while wearing a sanitary pad to check for whether it becomes soaked. An ultra sound scan, vaginal exam etc are also useful in making a diagnosis.

Have a good night y’all :D

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Daily Health Tips: All About Breastfeeding

Q: Hello Dr. How many years/months should a mother breast her baby? Thanks

A: A mother should breastfeed her baby with breast milk ONLY for the first six months. After that, she can add other foods while still breastfeeding her baby. She should actually continue breastfeeding until the baby is 2 years old.

Q: Hello Doctor Ketch please I need your help! I have a 3 months old baby. I stopped breast feeding her because I had a very big boil on my breast! After the boil was treated I wanted to try breast feeding her again but it just was not flowing. At the moment it’s dried up! I’m worried! What can I do for my breast milk to flow well so I can continue breast feeding her?! I feel so bad knowing that I can’t breast feed her! Please reply me soonest!

To respond to this question, I reproduce the contents of a post I had made on this same subject.

A: My dear, even if you’re exclusively breastfeeding, you still stand a chance of getting pregnant. Please use some method of contraception if you do not wish to get pregnant again, now.

For more on this, please click on this link: http://chatwithdrketch.com/2015/01/08/daily-health-tips-contraception/

Q: Good ma’am. Thanks for being there for us. Please help me out, this is my first child. I planned to breast feed him for 6 months but sickness did not allow me for one month. I am ok now and I want to feed my baby with breast milk but it is not coming out. Please, what will I do? Can I still feed him with breast milk? If I see him sucking his finger, it makes me shed tears. Please, help me.
A: Hello dear, thanks for writing in. Being a first time mother can be overwhelming especially when we cannot fulfill all the dreams we had dreamed for our babies. I’m sorry you could not breastfeed your baby earlier. But all hope is not lost. Re-lactation (re-establishing the process of breastfeeding after it had been stopped) may not be the easiest process but can still happen.
First, you have to let go of all feelings of guilt. Breast milk is the best food for baby, but if you couldn’t breastfeed because you were ill, then there’s really nothing that could have been done. Trust me, you’re better off to your baby alive than incapacitated in any way! So, chin up :D Smile…

Now, you will need loads of support from your medical team (be that the nurses that provide support for lactation or the doctor who does same). This support can range from teaching you how to latch baby on properly to your doctor prescribing a medication that encourages milk production. Drugs and foods that encourage milk production are called galactogogues and for the foods, a number of local foods have been touted to help eg Pap (akamu, ogi)
This process requires loads of patience. You have to put baby to the breast as often as possible (at least every 3 hours) or failing that, use a breast pump to extract as much milk as possible. Remember that the sucking process/nipple stimulation encourages milk let-down. Being relaxed and thinking about you and your baby in a nice cozy environment, breastfeeding and bonding may also help this process along.

You may want to assume the regular position you used to adopt when baby was breastfeeding and ensure that baby gets skin to skin time with you. It may be easy for baby to immediately go back to breastfeeding, other times, it may take a while. You need to know when the baby is sucking and indeed whether he’s getting enough. Your baby should make at least 6 wet nappies per day. If baby is not getting enough breast milk at the beginning of this process, you may have to supplement with formula. Use a cup and spoon to avoid nipple confusion.

Be sure that you are getting enough fluids yourself and eating nourishing foods.

For more on breastfeeding, please click on the links:
http://chatwithdrketch.com/2014/07/13/daily-health-tips-can-my-breast-milk-get-sour-if-i-dont-express-it-and-my-baby-refuses-to-feed/

http://chatwithdrketch.com/2014/09/12/daily-health-tips-im-a-breastfeeding-mother-who-just-developed-a-painful-lump-in-my-breast-could-it-be-cancer/

http://chatwithdrketch.com/2014/09/01/daily-health-tips-breastfeeding-challenges/

http://chatwithdrketch.com/2014/04/22/daily-health-tips-please-help-my-breasts-still-feel-engorged-though-i-stopped-breastfeeding-some-days-ago/

http://chatwithdrketch.com/2014/05/27/daily-health-tips-what-should-i-do-after-having-my-baby-if-my-breast-milk-doesnt-come-in-immediately/

Have a great night y’all and an awesome week ahead :D

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Is A Diet Of Carbohydrates Only, Dangerous?

Q: When you eat only eba, beans, rice and bread is it dangerous?

A: Hello healthy people, I came across a report from a Harvard review and it gives 8 principles to low glycemic eating…a principle that will help answer the question asked. Glycemic index, by the way, is a measure that ranks foods that contain carbohydrates on a scale of 0 to 100. The higher the number, the faster the food is digested, causing fluctuations in the blood sugar level and the lower the number, the slower the food is digested causing less fluctuations in the blood sugar level. So the focus should be on foods with low glycemic index. If you reduce your portion sizes and are exercising and generally doing the right things, you may sill be adding weight or not losing weight if you’re eating a lot of food with high glycemic index.

So here goes: principles of low glycemic eating:

Eat a lot of beans (any and every type), non starchy veggies (garlic, onions, leeks, chives, cabbage, broccoli, lettuce, tomatoes, peppers etc) and fruits like apples, berries, peaches and pears.

Eat a lot of grains in their natural state like natural granola, brown or local rice and muesli cereal

Reduce your intake of concentrated sweets like fruit juices (no more than half a cup daily…if you must) and other sugar loaded or sweetened drinks.

For more of these principles, get details from the book, Just For The Health Of It. You can get a copy via the shop now link on our facebook page. Or you can get it through:

1) Jumia.com. Just click on this link http://www.jumia.com.ng/jumia-books-just-for-the-health-of-it-with-dr-ketch-179486.html and get a copy. You have the option of paying when the book is delivered to you or paying online. This service is available all over Nigeria.

2) Another option for those in Lagos is Laterna Bookshop on 13, Oko-Awo Close, Off Adetokunbo Ademola Street,. Victoria Island.

3) If you’re outside the country, please visit Amazon through this link http://www.amazon.com/Just-Health-Ketch-Pregnancy-Parenting/dp/9789398026/ref=sr_1_1?s=books&ie=UTF8&qid=1426246647&sr=1-1&keywords=just+for+the+health+of+it+with+dr+ketch+olalere+nkechi

Here’s to a healthier you!

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