chatwithketch

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Q: Good evening, Doctor. Please I have been noticing some string (something?) on my foot nails – some said it’s fungi. How can I treat it both medical and herbal or let me say, home remedies?

A: Fungal infections of the nails occur when nails are infected by fungi (as if you didn’t know that! :D), yeasts or mold. These infections can happen when there is a cut on a finger or when your nails are constantly in moist and warm environments. These nails are colonized by the fungi and result in nails that are discoloured, brittle, distorted in shape, dull or even hardened. The nails could even separate from the nail bed and then, there’s that smell, that signifies that something is not quite right ether 😀 The infection would usually start off with a white or yellow speck under the nail tip which spreads and may involve the whole nail. So, if you see a white or yellow spot under your nail tip, race to see your doctor and start treatment early!

Fungi love warm, moist places. So, toe nails are more easily infected by fungi because they are oftentimes hidden away in shoes that really don’t allow them to ‘breathe’ and are not as rich in blood supply as finger nails. Walking around barefoot in wet areas, sweating heavily and working in wet and humid conditions are also pre-disposing factors. People who have had athlete’s foot and are diabetic are more prone to these infections for reasons I have already mentioned.

How to prevent this? For finger nails, wear rubber gloves if you’re going to be working with water for extended periods, keep your nails short and trim; And yes, just in case you wondered…that means that wearing those artificial nails may be doing more damage than we know as it provides the warm, moist environment needed for fungi to grow. If you like DIY manicure and pedicure, try not to cut too close to the skin around nails to avoid injuries that could be good places for fungi to breed. Opt for reputable nail salons that have the right tools and man power and indeed buy your own manicure set.

Treatment could be with oral medications (that is drugs taken by mouth). This could be taken for up to 3 months and essentially, the infection is over when a new healthy nail grows out. Other times, your doctor could prescribe a nail polish (which contains anti-fungal ingredients) or advice a mixture of cream and lotion to be applied on the nail bed. Another option is surgery, especially if the nail is painful

As with most fungal infections, the watchword is ‘patience’. Don’t be in a hurry to conclude the medications; it may take a while. Take solace in the fact that, ‘this too shall pass’ 😀

This Harvard post reminded me of a question I had received a while ago…2 questions, actually. Here goes the first one

Q: Hello Dr, I have been having swollen legs since I traveled almost 17hrs by air. All tests been done, no fault discovered. What shall I do?

A: Hello dear, thanks for writing in.

Swelling of the legs and feet during flights is common and usually not suggestive of a more serious problem. It happens when blood pools in the leg veins due to long periods of inactivity as can occur during a long-haul flight. This swelling usually lasts for a few hours. If the swelling persists, occurs more in one leg and is associated with leg pain, please see your doctor immediately as it may be suggestive of a more serious problem, like a blood clot in the leg.

I repeat a post I made some years back on preparing for flights. It focuses on preventing the condition you already have. However, if you already have swollen legs due to pooling of blood as described above, rest, elevate and exercise your legs to reduce swelling. Exercise tips are given in the post below.

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Dear Diary, you’re probably the only one who really understands how very busy the past few days have been. So, as I race through Lagos traffic towards the airport, I’m actually looking forward to catching up on some much-needed sleep on the plane…

I know quite a number of people who tell me they can’t sleep when they are in a bus, on the plane or in a car. They can’t sleep when there is even a bit of noise, when the curtains are not drawn, when the lights are on or the lights are off! Different variations! Well none of these define me! Once I’m tired, I can sleep anywhere…in the middle of a room filled with noisy children, in a squashed cramped car on a long trip, in the squashed space of a bus, in the tiny economy space of local and international flights and I daresay I can sleep on top of a trailer filled with sacks (I haven’t had this dubious pleasure yet!). In fact, I rather look forward to these trips sometimes because it presents an opportunity to sleep undisturbed. Provided I am travelling alone and not with my family, I am sure that I am unlikely to be disturbed for bathroom breaks, hunger, any sort of telephone call or work emergency. Oh bliss! (Just in case you wondered, I totally, absolutely and completely love my family :D).

So that’s my story. If you’re like me, you would stock up on some good novels to read at some point (when you open your eyes briefly) but if not, you are dreading the 6 or 12 hours (or perhaps even more) flight.

So, plan for it. Whether you’re travelling first, business or economy class, you don’t have to be worn out when you arrive at your destination. If you’re travelling economy, enquire at the booking desk if the flight is full. If it’s not, you could get a seat with empty seats beside you. Almost like flying in business class….albeit devoid of the personal touch, but who cares, right 😉

Wear comfortable and loose-fitting clothes. I’m consistently amazed by slay-queens who dress to the nines complete with high heels when travelling! I’m in awe! 😀

Get comfortable…take off your shoes and….nothing else, please :). This should help minimise discomfort especially if foot swelling occurs. Pressure stockings are also a good idea to help prevent this swelling.

Get a travel pillow…those U-shaped pillows they sell at the airports. They are pretty comfy and prevent you from getting a crick in your neck during that long flight.

Take walks round the cabin every hour or so to help circulation and stop you arriving at your destination with swollen legs/feet. You could use these walks to network and/or catch up with friends/colleagues/business associates who happen to be on the same flight.

For the sleepy heads like me, try some ankle rotation exercises during those small intervals when you are conscious 🙂

Lay off the coffee and alcohol. And drink a lot of water. Yes this may increase your visits to the bathrooms which you really don’t want, what with the long queues of people waiting to use them; but it is much better than getting dehydrated as the air in the cabin is pretty dry and could dehydrate you.

As for the food…perhaps you’re one of those who hate the ‘plastic’ food and laugh at the oyibo’s attempt at jollof rice (I’ve tried explaining to them that the art to cooking jollof rice is only in the gene of Nigerians and jambalaya is not even a close substitute! Please note that the study about the jollof rice-gene interaction has only been carried out in my head…so this is clearly proprietary material right here! :)), then you have no problem because you probably ignore the food. But you could stock up on some nuts (almonds, cashew nuts etc), granola bars, fruits and water to take with you. They are useful during those long lonely hours when you’re waiting for the flight to board and to take onto the plane if you’re going to ‘dis’ (code for disrespect, my son tells me) the food! It’s also most certainly cheaper and healthier than the over-priced airport food which you may be tempted to indulge in. However, if you’re going to indulge, you might want to book online and order the lower calorie options.

Pack some breath mints in your bag. There’s nothing as thoroughly embarrassing…no scratch that! There’s nothing as humiliating as trying to discuss with a business associate who you happened to meet on disembarking from the plane, while trying not to come too close because you know you’ve got morning breath! So be a boy scout! Be prepared!

If you’re, perhaps going for a conference, resist the urge to indulge in all that free food (close your eyes and visualise banquet tables groaning under the weight of all types of food: chocolate fountains, pasta, all kinds of gravy, pastries of different shades and colours, fish, chicken and beef dishes of all kinds!) and look for those healthier alternatives (fruits, salads…not soaked in dressing, quinoa, grilled fish, vegetables etc). Load up on all these…loads of beautiful colours on your plate!

You know all those free books they give you at the conference? Take only the ones you really mean to read. This way you’re not tempted to trash them at the airport when ‘they’ tell you, you’ve got excess luggage! This is becoming a huge ‘international’ joke!

I am actually on my way to a conference and so this advice is as much for you as it is for me! 😀

And the second…
Q: Hello Doc, I want to find out if swollen feet are associated with pregnancy?

A: Good question…and yes, it is normal for the body to tend to retain more fluid during pregnancy apart from the fact that the uterus (womb) as it grows, puts pressure on the veins preventing the proper return of blood to the heart. Increased blood flow and hormonal changes (causing foot ligaments to relax and therefore bones to spread out) may also play roles in this.

To prevent this …or significantly reduce it, try the following:
• Wear comfortable shoes and try not to stay on your feet for too long.
• Kick up your feet and relax as often as you can.
• Exercise helps…gentle stretching and other exercises safe in pregnancy (speak with your doctor where in doubt as to what is safe) help to move the fluid along. In addition, foot exercises, are also great and would include gentle rotation of the ankles.
• Sleep on your side, drink sufficient fluids during the day and limit your salt intake….remember that for salt, if you can taste it, it’s definitely too much

Having said this, some swelling in pregnancy is due to a condition called pre-eclampsia. So, be sure to check with your obstetrician if the swelling observed appears to be sudden or indeed, worrying.

Have a good night, everyone 😀

Q: Dear Dr I went for a Lab text last month and The result showed that am having pelvic inflammatory disease (PID). My question is this: could it be that my fallopian tube might have been blocked or what?

A: PID known as Pelvic Inflammatory Disease is an infection of the reproductive organs of a woman (uterus, fallopian tubes, ovaries and surrounding tissues) and it’s usually due to infections which may or may not be sexually transmitted (more likely to be the latter, though). The two most common causes of PID are 2 bacteria: Chlamydia and gonorrhea. Other bacteria found in the vagina and cervix (not associated with STIs) can also travel up the vagina and cause a PID.
People more at risk of this condition include people with multiple sex partners, people who use Intra Uterine Device as contraceptive, people who douche ( douching involves injecting fluid up the vagina to cleanse it. This process can carry bacteria up the vagina), people who have had an STI, young women less than 25yeras who are sexually active.
How do you know if you have this infection? Sometimes this is difficult as it may not give any symptoms. However, in other cases, patient could complain of vaginal discharge, painful urination and sex, fever, lower abdominal pain and irregular bleeds.
If this is left untreated, it may lead to ectopic pregnancy (pregnancy that implant outside the womb), fallopian tube damage and blockage with subsequent infertility and long term abdominal pain.
To diagnose the condition, your doctor may take samples from the vagina and cervix (mouth of the womb), carry out blood tests and he may also want to look-see using laparoscopy.
Based on the results, he will prescribe a course of antibiotics which has to be adhered to and the dose completely finished even if one feels better before the complete dose is finished. It is important that there is no sexual intercourse until infection is treated and indeed, sexual partner should also be treated as well. Remember the ABCs of sex.
So, I suggest that you go see a gynaecologist. You can check the Teaching or Specialist Hospital closest to you. As noted here, the treatment is based on the result of your tests. Please schedule this specialist appointment as quickly as possible…the consequences of untreated PID are severe. If any damage to the reproductive organ has already occurred, starting treatment may not reverse them. So the earlier you deal with this, the better.
For related articles:
https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/
https://chatwithdrketch.com/2014/07/02/daily-health-tips-should-i-use-emergency-contraception-as-my-regular-means-of-contraception/
I wish you the best!

Have a good night, y’all 

It’s just about one week to Christmas! How do you plan to eat healthy this holiday? well, here are a few tips!

https://www.health.harvard.edu/blog/healthy-eating-through-the-holidays-2018112015386

Q: Dear doctor I haven’t seen my period for October and November; then on the 6th of December I broke my virginity using the withdrawal method and on the 8th again I had unprotected sex. Then on the 10th I had a pinkish discharges that turned in to red. I went jogging that day then it stopped on the 11th could I be pregnant??? My periods are always irregular

A: Withdrawal method involves pulling the male organ out of the vagina just before ejaculation. This method may protect against pregnancy if used well but does not protect against STIs. It has been argued in some quarters that the pre-ejaculate (a lubricating fluid) may contain some sperm cells and so even if your partner is able to withdraw before ejaculation, the harm would have been done. However, the sperm in the pre-ejaculate is not there at the time the fluid is produced, but is sperm from previous ejaculations that was probably left in the urethra. It is believed that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations.

So, given the recent history of unprotected intercourse, it could very well be that you are pregnant – this is your most usual ‘go to’ question when a period is ‘missing’ and is a key reason for delay of menstrual periods for 9 months J In your case, it’s a little too early to tell.

On the regularity of your period…

A ‘regular’ menstrual cycle is supposedly one in which the cycle (the length of time from the 1st day of a menstrual period to the first day of the next menstrual period) is about 28 days but there is nothing abnormal about cycles that fall outside of this range. It could range from about 24 days to 34 days with ovulation happening at mid cycle. Indeed, in some women each period appears to have a different cycle. For young girls who have just started menstruating, skipped or irregular periods may occur.

What do people refer to as irregular periods? Well, if the time between each period changes, or the length of days of the period changes or indeed when the quantity of blood lost during each period changes, the period is termed irregular. What can cause these changes? They include:

§ Changes in hormone levels, as is common in the puberty period or menopausal period (not an issue here)

§ Stress

§ Excessive weight loss or excessive weight gain

§ Fibroids

§ Problems with the thyroid (hyperthyroidism)

§ Polycystic Ovary Disease (PCOD)

§ Scarring from previous surgery in the uterus

§ Breast feeding mothers may also experience irregular periods as the hormones released may delay return of menstruation. Remember, however, that this is not an effective means of contraception.

So, it’s always a good idea to keep a record of your periods: length of cycles, number of days the period lasts, presence of pain etc. If you keep a chart of this over time, you would be able to know what is normal for you.

Treatment of irregular periods depends on cause: fibroids, PCOD, hyperthyroidism all have to be treated. If irregularity is due to stress, learning coping mechanisms or relaxation techniques may help. Reduce weight or go easy on your exercise routine, if weight issues are a problem.

So, you might want to go and see your doctor to check you out.

All the best.

Q: Good Day Doc, please kindly instruct me on how to improve the quality of egg for a 39 year old woman for conception.
A: Every woman is born with about 1 million eggs. These eggs in the ovary die steadily such that by the time she gets to puberty, she has just about 300,000 left. These eggs are released every month in sync with the menstrual cycle. A woman will release about 300 to 400 eggs in her lifetime. As a woman ages, the quantity and the quality of the eggs reduce. Indeed the ovary’s ability to release eggs reduces until it can no longer release any eggs (menopause). The quality also reduces such that as one ages the eggs are more prone to having problems leading to miscarriage, birth defects etc
How can you improve the quality of your eggs? A study by some scholars at medical school shows that calorie restriction, which has been shown to reduce age-related problems and diseases, is also useful in improving quality of eggs even in old age. Calorie restriction involves limiting one’s normal calorie or food intake with the primary aim of slowing ageing and indeed, improving health. So this is an option. You will be losing weight or keeping trim while improving the quality of your eggs 

Egg freezing is also an option to preserve the quality of the eggs you have now, if conception is not yet on the cards.
Other lifestyle factors that may help give you a better shot at pregnancy include:
Eat healthy.
Keep your weight healthy. Avoid the extremes of weight: underweight or overweight
Exercise. Ensure that you are active at least 30 minutes every day. Goal is at least 150 minutes every week
Stay away from tobacco, alcohol and other drugs of addiction.
You can have more of an in-depth discussion on this with your obstetrician who can also let you know other procedures available to you based on your specific history.
Have a positive attitude too and keep those fingers crossed