chatwithketch

Q: Good evening doctor, I gave birth a month ago and my stomach is still as if am five months pregnant… Please what can I do to make my belly look the way it was before pregnancy? Your answer will be of great help, thank you.

A: Honestly, I’ve got no easy answers. It’s diet and exercise….oh and breastfeeding. But breastfeeding is not very helpful if one is not exercising and watching their portions. Again, the dictum of feeding for two here doesn’t also count.

The diet to focus on is the very same one we talk about all the time: fruits, veggies and complex carbs with focus on healthier cooking methods (less frying etc). Exercise should focus, initially on pelvic floor exercises especially if you’re leaking urine when you cough or laugh. To locate your pelvic floor muscles, try holding your urine when you feel pressed. If you are successful, then you have located the muscles you need. Then empty your bladder and lie on the floor. Contract those same muscles and hold the contraction for about 5 seconds and then relax it for about 5 seconds. Gradually build this up to holding the contraction for 10 seconds. Repeat this about 3 times a day. Once you no longer leak, you’re ready for your exercises.

Have you noticed how it is usually easier to lose the baby weight after your first baby and harder afterwards? 😀 Focus on building up your stamina gradually especially if you were not very active in pregnancy or before. Please remember to contact your doctor always, before starting any vigorous exercise program. As you get into the groove, get down with your aerobics, strength training and sit-ups et al.

This is where breast feeding comes in, if you’re exercising and eating right, breastfeeding can help lose weight…as much as 300 calories per day. Does tying a wrapper tightly round your waist help flatten tummy? Honestly, I’ve heard people who swear by that technique. So, what I’ll say is, if it works for you, why not? Just don’t tie so tight as to stop blood flow

How soon to start exercise after having a baby? Well, it depends on how active you were before and during pregnancy. If you were very active, you can start some light stretches as soon as you feel able. However, generally, we advise 6 – 8 weeks after birth to allow for a post-natal check to have been done. Again, start small and allow your body to get into the groove.

And for all those who asked questions about breastfeeding, this should not be a problem as once you position the baby correctly to the breast, milk is ‘produced’ for the baby through a let-down reflex. So, it is almost a misnomer to say one doesn’t produce enough. It is not very common. So, nursing mothers should ensure that they drink copious amounts of water and put their babies to the breast. If beast feeding problems continue, see your doctor with your baby to ensure that the baby is latching on to the breast properly.

Have a great day 😀

Q: Please Dr., what causes eye pain like feeling as if there is smoke?
A: Cloudy vision is a situation in which objects appear milky and ‘veiled’. It is oftentimes used interchangeably with blurry eyes. Blurry, cloudy or even double vision can be seen in disease conditions like:
• Cataract: This is a cloudy area on the lens and can lead to cloudy vision. If not taken care of, they can cause vision loss to the point of blindness. And yes, excessive exposure to sunlight increases your risk of having this condition.
• Near sightedness (myopia) can lead to blurry vision with associated headache and eye strain.
• Far sightedness (hyperopia) can also result in blurred vision when looking at close objects.
• Glaucoma, a condition in which there is increased pressure in the eye
• Diabetes Mellitus in which there is damage to the retina (light sensitive layer) of the eye
• Astigmatism in which there is blurred vision up close and at a distance.
• Pregnancy and migraine headaches are also causes of blurred vision.
This is by no means, an exhaustive list!
Please revisit the hospital and this time, see an ophthalmologist (an eye doctor) who will carry out a detailed eye exam. This should help make a definitive diagnosis. Treatment depends on cause: Cataract requires surgery and replacement of cloudy leans with a clear one; hyperopia, myopia and astigmatism are treated with either contact lens, eyeglasses or refractive surgery etc
Enjoy the rest of your weekend, y’all 🙂

Q: I have headaches. What is the solution?

A: Headaches refer to pain or ache anywhere on the head. They may be primary, in which case they are due to problems with the structures sensitive to pain in the head. Or they may be secondary in which case the pain is due to an underlying disease that causes the pain-sensitive structures in the head to be activated.

Common causes of primary headaches include:
Tension headaches: This is the more common type of headache seen as the everyday sort of headache. It affects both sides of the head as a constant ache. Its causes are not very clear but they can be triggered by stress, hunger, dehydration, etc they can last a couple of minutes to several hours but are not severe enough to stop regular activities. Resting and sleeping well, eating properly and staying hydrated can help prevent this.

Migraines: These are felt as severe throbbing pain at the front or side of the head. Some people may experience other symptoms like nausea, vomiting and being sensitive to light. The pain lasts from a couple of hours or can stretch on for days. Thus, it is more severe than the tension headaches and can stop an individual from carrying out their daily tasks. Some find that they need strong medication prescribed by doctors to get relief but others are relieved by using over the counter medications.

Cluster headaches: These cause severe pain around one eye and are associated with red or watery eyes and a blocked nose or runny one. They tend to occur for one or two months at a time at about the same time of the year. Most times medications do not work for these headaches. Your doctor will prescribe specific treatment courses.

Chronic daily headaches may be due to medication overuse. This would occur in people who use pain medications too often and then end up with rebound headaches…the exact condition they were trying to avoid. Moral of the story: Never abuse your medications J Use only as directed by your doctor.

Sex headaches: Yes, this can occur. It’s also known as post-coital headache, orgasmic headache etc. It could occur during sexual intercourse, during orgasm or after sexual intercourse. And it can also occur at any time of the day and during any type of sexual activity. It is felt at the back of the skull just above the neck and is usually described as throbbing. Or it could build up gradually during sexual intercourse and intensifies as the sexual excitement before an orgasm increases. They can last anything from a few minutes to a few hours; may never recur or may happen a couple more times before gradually fading away.
It is thought to be due to the release of adrenaline and rapid rise in blood pressure which occurs as one approaches orgasm. And so in these cases, the headaches may not be a cause for concern. However, it is also a possibility that these headaches are a sign of a more serious condition like bleeding onto the surface of the brain.
People who usually have migraines, who use recreational drugs like marijuana, use birth control pills etc are more likely to have sex headaches.
Should you swear off sex? Yes, if you’re unmarried And no, if you’re married;) If you have just experienced this, try lying quietly for about an hour or two after taking an analgesic (like paracetamol) to handle the pain. However, it is very important to see your doctor as soon as possible to let him/her know what happened. This is important because, while there may very well not be any underlying issue, you want to be sure to rule out any serious medical condition causing these headaches. Your doctor will also prescribe some drugs on a regular or intermittent basis to deal with your symptoms.
Primary headaches may be triggered by stress, skipped meals and dehydration as noted above. However, they may also be associated with alcohol, foods that contain nitrates like spinach and bad posture.

Secondary headaches may be due to dental problems, hangovers ear infections, blood clot in the brain, wearing tight gear on the head like hats or even wigs (yes, I see you ladies :D) or even eating cold stuff like ice creams etc.

So, what should you do? If you find that tight head gear or eating ice cream is the problem, see if stopping helps.

If you find that these headaches are now more frequent than usual, more severe than usual, stops you from going about your daily activities, is no longer responding to the over the counter medications you used to take etc, please see your doctor. If you have been seeing the same doctor, as it appears to be in this case, with no relief, please seek another opinion or request a review by a neurologist.

All the best.

Good morning, everyone! Happy Id-el-fitri celebrations!

Ever heard of epilepsy? You probably have. You have also most likely heard that it is contagious and so sharing cutleries, hugging and sitting close to epileptics puts you in the direct path of the problem, right? Wrong! Epilepsy is NOT contagious!!! I overhear someone ask a question about epilepsy recently and thought to share this.

What is epilepsy? It is a problem of the nervous system where the cells of the brain ‘fire’ or behave abnormally leading to abnormal sensations, symptoms, behaviour and sometimes loss of consciousness. This is called a seizure but not every seizure is due to epilepsy. Seizures can occur in high fever (especially in children) and also due to dehydration. A seizure needs to have occured at least on two different occasions without provocation for epilepsy to be suspected.

Symptoms of epilepsy would depend on the type of epilepsy (yes, there are different types). So, the person may not lose consciousness at all but may have altered taste, smell etc, there may also be jerky movements of limbs, staring gaze etc.

What are the possible causes of epilepsy? It could be due to genetics (having a relation with epilepsy places one at a higher risk. Also some genes are more likely to be affected by the other risk factors of epilepsy leading to seizures), infections like meningitis, antenatal conditions like poor feeding and infection in the mother, Trauma the head like in head injuries and other brain conditions like stroke. Other risk factors are extremes of age (Early childhood and adults more than 60 years are more likely to have this. However, this is not a hard and fast rule as this has been observed across different age bands) and prior history of seizure in childhood.

Some people may have found out that a seizure is usually provoked by certain things or situations. These triggers include flashing bright lights, stress, sleep deprivation, during monthly menstrual cycle, certain foods, alcohol or certain drug use, poor feeding etc. Sometimes, it is not very easy to recognize these triggers if you are not looking out for them. So, paying attention to the ‘possible’ triggers is important so they can be avoided.

Treatment can range from taking drugs to surgery…or perhaps other forms of treatment. These drugs can either get a person to the point where they never have seizures again or to the point where they have fewer seizures. But please, do not discontinue the drugs. This can be done only with your doctor’s advice as it has to be timed right.

To cope with this long term, ensure that drugs are taken as prescribed and discuss with your doctor if you feel dose needs to be amended. Get enough sleep and generally avoid other triggers of seizures, exercise regularly and make healthy lifestyle choices.

If you are not epileptic or if you don’t know anyone with epilepsy, you probably don’t think you have an action point here. But you do! Epileptics suffer all manners of indignity. They are accused of witchcraft, their feet are burned to get rid of the witchcraft etc. But none of this is true. Help spread the story that epilepsy is NOT witchcraft, is not contagious and epileptics are normal human beings who have suffered enough exclusion and need our love, support and care. We need to teach our children this too as epileptics in schools suffer severe emotional, mental and oftentimes, physical torture/bullying from other kids in school. This could very well be because their parents have told them to steer clear of any child with a seizure. You and I can change this!

If you are an epileptic…it may not look like it right now, but guess what? There is most certainly light at the end of this tunnel!

Have a great day y’all 😀

Q: Happy new month, Drug prescription for amnesia?

A: Amnesia refers to the loss of memories. People with amnesia know who they are but have challenges learning new information or forming new memories.

What are the causes? They are many and diverse because brain function is controlled by many parts of the brain, such than any problem with one area affects memory. There are 3 types of amnesia:

• Neurological amnesia– this is due to damage to the brain and can be caused by conditions such as those listed below:
  • Stroke
  • Inadequate oxygen supply to the brain in conditions like a heart attack
  • Thiamine deficiency from long-term alcohol use
  • Tumors in the areas of the brain associated with memory
  • Seizures
• Permanent amnesia from severe head injuries resulting from incidents like road traffic accidents
• Dissociative amnesia is from emotional shock or trauma. Person involved, may lose personal memories and autobiographical information, but usually only briefly.

People at risk of amnesia are those who are suffering from or had suffered any of the conditions listed for neurological amnesia

Two main features of amnesia are:

• Retrograde amnesia, in which the patient cannot remember previously familiar information
• Anterograde amnesia which the patient cannot absorb new information
• Additional symptoms may include creation of false memories and confusion

To prevent amnesia,

• Avoid excessive alcohol use.
• Wear protective head gear when bicycling and a seat belt when driving.
• Treat infections quickly to prevent spread to the brain.
• Get treated immediately in the event of a stroke

You asked about drugs for treating amnesia. Unfortunately, there are none for now. However, if amnesia is caused by lack of thiamin, then replacement therapy is sufficient treatment.

Generally, treatment focuses on the memory problem and underlying diseases.

• Technology can play a huge role here, sending out messages to remind patients of certain key activities
• Occupational therapy, which could involve memory training

I hope this helps! 😀

Q: Doc, my daughter has been having watery faeces. It’s been five days and not stopping. I also went to clinic but she’s active and she still eats her food. I’m nervous; tell me any home remedies I can give her Doc

A: Hi dear, thanks for writing in. You didn’t tell me how old your baby is, so it was difficult to figure out what age to focus on.

Generally, exclusively breast fed babies may pass stool a couple of times during the day to lots of time (it might even be after every meal :D).  You’re still getting to know your baby and so you should look out for the normal consistency of his stools and the frequency. Diarrhea is usually rare in exclusively breast fed children because you’ve cut off all the middle men like bottles and teats etc that could have been reservoirs of infection. Having said that, watch out for signs like blood or mucous in stool, explosive green stools and foul smelling stools. How can this occur in exclusively breast fed babies? It may be due to an infection (viral and bacterial), food allergy to something the mother ate, it may be due to food poisoning in the mum or perhaps the mother had taken antibiotics. If in doubt as to whether the stools appear normal or as they have been since birth, please see your baby’s doctor. If your baby has diarrhea, he/she should be rehydrated as quickly as possible. The first way is to continue breastfeeding even before going to the hospital. This also provides valuable antibodies that help the baby fight diseases.

Diet affects our breast milk and by extension, baby. These are foods to avoid or limit their consumption while breast feeding:

Caffeine in coffee (try decaffeinated and stick with 2 small tea cups), energy drinks, some soft drinks etc This makes the baby irritable and by extension, makes sleep difficult for the baby. Now, you don’t want that, do you?

Alcohol: This should be avoided at all costs.

Cigarette (yeah, yeah, I know it’s not food) should also be avoided as it reduces the production of breast milk.

If baby reacts to what the mother ate, efforts should be made to pinpoint what the mother ate before the incident started and then eliminating that from the diet to see if the diarrhea or allergy stops.

Make sure that you eat well: lots of fruits and vegetables and complex carbohydrates. Cut out the junk which will not help you achieve your weight loss goals and in addition have empty calories. And drink sufficient fluids daily.

Be careful before taking any drug as most find their way into your baby.

For older children, hygiene may be critical. Did you know that research shows that one out of every five people do not wash their hands after using the toilet. Then, 40% of people wash their hands for less than 10 seconds…and yet, you need at least 20 seconds to get your hands all squeaky clean! Finally, men are twice as likely not to wash their hands with soap or hand wash! Oh dear, just think about all the people we shake hands with, trusting and hoping that their hands are clean!

Diseases like respiratory infections and diarrhea cause up to 20 percent of the burden of disease in children. It has been found that in places where hand washing was instituted, this burden of disease has been cut by about 50%. This is a huge number…from hand washing alone! In hospitals, it was also found that the spread of hospital-acquired infections was encouraged by lack of hand washing and so WHO instituted a global campaign for health workers clearly specifying when hands have to be washed.

So, practical lessons: mums wash your hands before you make your baby’s/family’s food, after you change baby’s diaper, after you blow your nose, after cleaning etc. Ensure that people don’t come in from the market (or wherever) and head straight to pick up your baby and kiss your baby…no matter how well meaning their gestures might be. Encourage them to wash their hands before they do so…or you could buy a hand sanitizer and get them to use it on their hands before picking up your precious bundle of joy. It may be awkward when you start off insisting on these, but pretty soon everyone gets used to it…trust me, I know from personal experience 😀 (I probably got away with more because my in-laws probably just thought I was a weird Okoro girl). Tips: remember that sanitizers are only useful for hands that are not visibly dirty. For visibly dirty hands, you’ve got to wash! Also remember that when choosing the sanitizer, look for products that have up to 60 percent alcohol and ensure that when you use it, you rub until your hands are dry.

We should ensure that we teach children and indeed remind ourselves to wash hands after playing or doing stuff outside the house, before eating, after using the toilet, after playing with pets or disposing of their wastes (in fact children should not be encouraged to play too close to their kennels or sheds), before cooking and even after handling dirty laundry! The list is endless…but that’s also because the possible means of contaminating our hands are endless and the germs find easy routes into the body once we touch our hands, mouths, eyes etc. So we can’t be too careful…and just in case you wondered, ‘no, you don’t have to wear a face mask and/or gloves all the time’ to protect you from the many germs that exist! 😀 That might be…well, for want of a better word, perhaps just a teensy weensy bit extreme! 😀

Finally, remember that hand washing, to be done right, has to be with soap! If you haven’t washed with soap, you haven’t really done much. Tips for effective hand washing: wet your hands with water, apply soap, then scrub thoroughly paying attention to your nail beds, in between fingers, palms and back of hands. Then rinse thoroughly before drying your hands.

Well, if you’re one of those who do not wash your hands after using the bathroom/toilet, let’s encourage you to start washing today.

Sleep tight, y’all J