chatwithketch

Q: Good evening doctor. I’m having headache with pains on the side of my face, ears sometimes with  my neck. I feel like heat on my face. Went to a doctor and ‘he’ said it’s allergy. He gave me antibiotic – at that I got relief but it started again. Please, I need your advice

A: Headaches with facial pain can be due to an infection of the neck, teeth or jaw coinciding with a headache or due to some chronic conditions or nerve disorders. Common causes 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 and sometimes feels like pressure is being applied to the head or neck. 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.

Neuralgia: Typically, the term neuralgia refers to peripheral neuralgia which is a painful condition due to damage of peripheral nerves by injury or disease. Symptoms of this condition include burning, prickling, or stabbing sensation felt anywhere in the body, and most commonly in the neck or the face.

Occipital and trigeminal neuralgia typically affect the head and face.

In occipital neuralgia, pain is felt on one or both sides of the head, the back of the head or at the base of the skull mimicking the symptoms of a migraine, complete with light sensitivity and pain with movement of the head. This happens when the occipital nerves, which run from the top of the spinal cord upward to the scalp, become injured or inflamed, resulting in a constant aching throb. Causes include injury, inflammation, or tight muscles that put pressure on the occipital nerves.

In trigeminal neuralgia, facial pain described as similar to an electric shock can be felt on any part of the face including the lips, jaw, eyelids, cheeks, nostrils, or forehead. It is caused by injury to the trigeminal nerves that control sensations in different parts of the face. The pain can be triggered by shaving, brushing the teeth, washing the face, or even applying makeup.

Problems of the temporomandibular joint (TMJ): The TMJ is found in front of the ears on both sides of the head, connecting the lower jaw to the skull. This joint enables eating and speaking by opening and closing the jaw. Disorders of this joint lead to stiffness and pain in the face, jaw, and neck, along with clicking and locking of the jaw. The latter symptom leads to difficulty with opening the mouth to eat or speak. Causes include teeth grinding, arthritis, congenital structural problems within the jaw.

Myofascial pain syndrome: This is associated with a dull ache radiating to the teeth, jaw, or ears, with difficulty in opening the mouth widely and chewing. Causes include jaw trauma, teeth grinding, infection, jaw clenching, stress and anxiety

I am a sucker for second opinions. Please seek a second opinion and make sure you are getting the help you need.

All the best!

Is intermittent fasting good for you? Apart from the spiritual impact, it does appear it is good for your weight! The Harvard Health blog post below tells you how. Before then, I repeat below I post I had made a while back on fasting.

Q: Hello Dr Ketch, what can I do to be healthy especially as we are preparing for our fast?

A: Thanks for writing in.

What to do? Keep eating healthy and focus on gentle exercises.
Breaking a fast is usually not as easy as it should be. You haven’t been eating and now it’s time to eat, so you pick anything you like to eat. Pretty open and shut, isn’t it? But actually, it’s not that easy.
Eating and drinking during a fast (religious or otherwise) should be easy…but is not always so. First, when a lot of people break fasts, they go on a binge. They eat the equivalent of what should have comfortably been taken over two or three meals! 😀 And then they break the fasts with the wrong meals: refined and processed foods (eg cakes, pies etc) which lead to blood sugar spikes. Complex carbohydrates are better options. Foods like local rice, beans, whole wheat grains, oatmeal etc belong to this group. These absorb water and are digested slowly. Remember that during a fast, your digestive system took a break. So, it only makes sense to re-introduce your body to food gradually with easy to digest foods. If you have ever tried to load your body with food immediately after a fast, you will recall the horrible cramps that followed as a result of trying to waken a sleeping digestive system too quickly

As for drinks, water is always a great choice. Drinks that contain caffeine may lead to dehydration as they cause one to urinate a lot.

Remember that meals should be balanced, containing all food groups: proteins (fish, chicken etc), carbohydrates, fats and oil ( eg olive oil used for cooking), minerals and vitamins in the veggies used to cook etc Healthy methods of cooking like boiling, steaming, grilling should be used as opposed to frying.

Easy to digest fruits like grapes, watermelons and apples are great options. They are easy to digest and absorb while providing the body with needed energy and nutrients. Juicing or eating slices of them…it doesn’t matter. Most people would break with citrus fruits like oranges but their acidic content may be too much for your stomach to handle.

Remember that during your fast, given that you’re on a calorie restrictive diet, go easy on the exercises and focus on stretching and gentle walks.

For additional resources, click on this link: https://chatwithdrketch.com/2016/07/05/daily-health-tips-should-a-pregnant-woman-fast/ and the Harvard Health blog post below:

https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156

Q: Hey Doctor, I hope you are fine. I went to visit my hubby in November, then we had unprotected sex for 2 months. In February, I started to feel something funny about my body. When I get up, my pressure goes up and I have back pain. I thought it was nothing. In my tummy I could feel something beating fast. In March, I started vomiting whenever I ate chicken. In addition, I have green lines on my chest and my hands. My boobs got big and hurt. My periods didn’t stop but only going for 3 days now – weak blood. Now I am ugly. I have pimples and my tummy is too big. Yesterday, I went to a doctor. He touched my tummy and he said he can ‘hear’ the baby’s head but the time he touched it, it hurt. So, he sent me to scan and  there was nothing. The person who did the scan did not see anything. He told me that I could not be pregnant if I was having periods. I just left. I was confused. What’s the problem because I can hear the movements and the kicks. Please help me. What’s happening to me?

A: Hi dear, thanks for writing in.

There are usually 5 Fs that can cause a swollen tummy. They include fat, faeces, flatus, fetus and fluids. If an ultrasound has been done to confirm the presence of a fetus (baby) and it’s negative, we may need to start looking for other sources of this swelling.

How long have you been married? Are you under pressure to have a baby? There are instances where a woman (and in some instances, a man) truly believes she’s pregnant but she’s not. This is called a false pregnancy and the person in question has a lot, if not all, the symptoms of pregnancy!

The exact cause of this false pregnancy, also known as pseudo-cyesis (pronounced siu-do sa-ye-sis) is not really known but it does appear that psychological issues (perhaps from being pressured to get pregnant, having had repeated miscarriages, worry about ever getting pregnant as menopause approaches) may lead to a situation where the body of a woman in this situation begins to produce pregnancy signs like swollen abdomen, swollen breasts etc. The brain then swings into action, erroneously interprets these signs as those of pregnancy, and begins to produce pregnancy hormones which lead to pregnancy symptoms like nausea and vomiting, absence of menstruation, weight gain etc. These symptoms could last for weeks, months or sometimes, even up to years. Sounds stranger than fiction, right?!

I suggest that you seek a second opinion. Have another doctor evaluate you to confirm the presence or absence of a pregnancy. If it is confirmed that pregnancy is absent and there is objective abdominal swelling, then the doctor will examine you and order investigations to find out the cause(s). Definitive treatment may also involve psychological therapy if indeed you are not pregnant but genuinely believed that you were.

All the best, dear. Let me know how it goes.

Loads of hugs coming your way…..

Q: Good evening doc . Please i need your advice, i went for scan and i was told my liver is accumulating some fat. I am confused because I don’t even taste alcohol. So doctor what do I do?

A: Hello! Thanks for writing in.

Unfortunately, fatty liver can occur in people who do not take alcohol. It’s actually also referred to as non-alcoholic fatty liver. In this condition, there is inflammation of the liver. As the liver tries to stop the inflammation, scarring of the liver tissue occurs. With more inflammation, more scarring occurs and fibrous tissue spreads to take up more and more space in the liver. If this continues uninterrupted, the abdomen starts to swell as fluid builds up in the abdomen, the veins in the esophagus, swell, rupture and bleed, confusion, drowsiness and slurred speech may also occur. Yellowness of the eyes and enlarged breasts in men could also occur. Ultimately, the person may end up with liver cancer and end-stage liver failure. Having said all this, it is important to note that not everyone with non-alcoholic liver disease progresses to cirrhosis.

This condition usually does not present with symptoms. Where they exist, the patient may complain of upper right abdominal pain and perhaps, tiredness. This condition is common in people around the ages of 40 to 50 years with risk factors for obesity and type 2 diabetes mellitus. Although the exact cause of this condition is not known, it is thought to be associated with being overweight, high blood sugar and high blood fat (triglycerides) in the blood. The risk factors to developing this condition include:

• High cholesterol. For more click on the link: https://chatwithdrketch.com/2015/12/31/daily-health-tips-how-can-i-remove-bad-cholesterol-from-the-body/;
• High triglycerides in blood
• Obesity
• Type 2 diabetes mellitus. For more click on the link: https://chatwithdrketch.com/2016/11/14/daily-health-tips-world-diabetes-day/
• Polycystic ovary disease. For more click on the link: https://chatwithdrketch.com/2016/12/22/daily-health-tipswill-i-need-to-take-pills-forever-for-pcos/
• For more click on the link: https://chatwithdrketch.com/2016/09/29/daily-health-tips-thyroid-problems/

To prevent this ab initio, it’s the 3 things we talk about often:

• Diet: eat healthier. More fruits, veggies, healthy fats, whole grains.
• Exercise: At least 150 minutes every week.
• Maintain a normal body weight. Be guided by your BMI and try to lose some calories daily as you also reduce your intake

If you already have the disease, the steps above can help you control the disease. In addition:

• If you’re diabetic, get it under control. For more tips, read https://chatwithdrketch.com/2018/01/25/hlwdk-daily-health-tips-family-history-of-diabetes/
• If you have high cholesterol, make changes to your diet and reduce this. Read https://chatwithdrketch.com/2014/04/23/daily-health-tips-can-my-diet-help-reduce-my-cholesterol-level/

• Avoid alcohol or any other toxin that could cause further damage to your liver eg herbal medicines etc

So, I suggest you have a long chat with your doctor about treatment options available to you – this would typically start with lifestyle modifications focused on weight, diet and exercise. If cirrhosis occurs, liver transplantation is an option.

All the best!

Have a good evening, y’all 😀

Do you find yourself getting bored with your menu? Eating the same thing all the time? If you have a set menu for meals at home, when was the last time you changed it? Are you and your family stuck with the same food choices?

In Africa, we talk about the fact that our foods are heavy on starch but you can combine them in such a way that you make the best of the nutrients available. For tips on how to spice up your menu read thishttps://chatwithdrketch.com/…/hlwdk-daily-health-tips-heal…/ and the Harvard Health post below.

https://www.health.harvard.edu/blog/dietary-rut-5-ways-to-snap-out-of-it-2018062014079

Q: Good morning doc. I have been having this body itching for the past two months and I have taken drugs but it would go and come back again. The itching occur mostly in the evening, what could be the cause and what should I take to stop it?

A: Body itching can be caused by different conditions including:

• Skin reactions to heat or allergies
• Skin conditions like eczema, dandruff or psoriasis. For more on eczema and dandruff, please click on these links https://chatwithdrketch.com/2014/03/01/daily-health-tips-what-can-i-do-about-the-eczema-on-my-skin/; https://chatwithdrketch.com/2017/05/18/hlwdk-daily-health-tips-help-with-dandruff/
• Parasitic infestations like scabies. For more on scabies, please click on this link: https://chatwithdrketch.com/2017/07/22/hlwdk-daily-health-tips-scabies/
• Fungal infections like jock itch or athlete’s foot. For more on scabies, please click on this link: https://chatwithdrketch.com/2018/03/31/hlwdk-daily-health-tips-athletes-foot/
• Hormonal changes during pregnancy or menopause
• Other medical conditions like thyroid, liver or kidney problems
• Dry, cracked or irritated skin. For more on eczema and dandruff, please click on this link: https://chatwithdrketch.com/2017/12/29/hlwdk-daily-health-tips-i-itch-after-every-bath/
• Nerve dysfunction
• Medications

Treatment of skin rashes is, of course dependent on the cause. It may include any or a combination of medications (anti-histamines), wet dressings on affected areas and phototherapy. If the itch is severe enough to affect your daily life, lasts more than 2 weeks, keeps coming back, is all over your body, is associated with other symptoms like yellowness of the eyes, please see your doctor immediately.

What can you do at home to provide relief and minimize harm to yourself? I’ll split them into dos and don’ts

Dos

• Keep your nails short so that you don’t do mortal damage if you do scratch J
• Or if you don’t want to do that, you could wear gloves to sleep at night – that way, even when you scratch unconsciously, no harm done
• Try patting the itchy part instead of scratching
• A cold compress held against the itchy part can also help reduce itching
• Wear more cotton fabrics to allow your skin breathe and not chaff your skin
• Use cotton beddings for the same reason

Don’ts

• Avoid hot baths. Keep bath water cool or lukewarm. Want to know why? Read this!
• Avoid vigorous drying off after a bath. Dab your skin dry
• Avoid perfumed products – soap, deodorants, shower gels, lotions etc
• Avoid tight-fitting clothes. They make a bad matter (itch) worse 😀
• Avoid harsh detergents for laundry
• Avoid spicy foods – they increase blood flow to the skin and make itching worse

Have a good evening 😀

https://www.instagram.com/p/Bkse2EDA7WF/?taken-by=ddrketch

Q: Hello Dr, how are you doing, thanks for all the educative advice. Please I want to know if HAIR REMOVAL CREAM is advisable for removing hair on my chest.?

A: Hair removal cream also known as depilatory creams contain chemicals like thioglycolic acid (responsible for that strong and pungent odour associated with these creams) that break down the protein (Keratin) in hair. This leads to weakening and dissolution of the hair making it easy to be scraped away from the skin’s surface.

This product is usually used with great caution as keratin is also found in the top layer of the skin and if the cream is left on for too long, the chemical in it starts working on the skin leading to chemical burns and blisters. So be sure to follow the manufacturer’s instructions, strictly and test the cream on a small patch of skin on the arm or leg before using it on a large area. If you have any sort of reaction like blisters, burning, redness etc, wipe off immediately and do not use that same brand again. If you’re still up for it, you could try a different brand.

​Depilatory creams are generally safe to use on the chest (though they were originally developed for the arm and legs). There are special products for people who have sensitive skin too.

Please do not use depilatory creams on the following areas:

• Groin – use only around the bikini line. How? Wear a pair of old panties and then apply the cream on the hair that is exposed. Do not apply on the area covered by the panties
• Around the anus or nipples
• Eyebrows or around the eye area
• Nose – not for nose hair
• Scalp
• Ear – not ideal for ear hair

Avoid using this cream:

• If you have broken or irritated skin
• If you have a sunburn
• If you have had any other form of hair removal within 24 hours
• If you are undergoing medical treatment for skin conditions, diabetes or circulatory disorders. In these cases, speak with your doctor first
• If you are allergic to any of the components of the cream

Where in doubt, always speak with your doctor!

To round off this discourse, here are some tips for avoiding razor bumps after hair removal:

Razor bumps are also known as ingrown hairs. Ingrown hairs occur when hair curls back and brow back into the skin. This is particularly easy with hair that had been cut (as in shaving) as the hair that grows back usually has a sharp edge and finds it easy to ‘pierce’ into the skin.

For under arm bumps, a solution to this is to stop shaving and leave the hair well alone 😀 Another option is to use depilatory cream. This may, however, cause irritation and so should not be used more than once or twice a week.

Try to resist the urge to press these bumps but if the temptation proves too great, use a sterile needle to tease out the hair, if it appears to lie close to the surface. If it appears deep, please leave well alone…let’s not give you scars you’d rather not have 😀

Preventive measures you can practice include:
• Using a single blade shave stick
• Wet the area to be shaved with warm water and use a shave gel
• Try not to shave too close…you know how you like to pull the skin taut to achieve a better shave? Well, stop doing that as this encourages hair to curl back into the skin
• Shave in the direction of growth of the hair.
If infections occur, the bumps become filled with pus and you may be prescribed antibiotics for this. Your doctor may also prescribe some drugs to help calm down the inflammation.

For razor bumps in the groin….

In Africans, the hair in the groin area is very curly and so it is pretty easy for the hair to curl and grow down instead of growing up and out. These lead to red, raised spots/bumps which could get infected and become pus-filled.

More often than not, an ingrown hair does not require special treatment. They just leave quietly on their own…much like how they came. This of course, presupposes that there is no shaving done during this period to aggravate the situation. In the meantime, do not squeeze the bumps as this may push the bacteria further inside. You could use a soft bristled brush to loosen the hair before shaving or use a sterile needle or tweezers to tease out the ingrown hair(s) if it lies close to the surface.

How to prevent ingrown hairs? Simple! Stop shaving…at least for a while. That’s always an option. There’s always a huge debate about whether things should be kept natural down there! 😀 However, if you choose to shave, try using a scissors to trim, before using a single blade shave stick to shave. Make the hair as wet as possible using shave foam and then shave in the direction of the growth of the hair. And while you may think it’s fun to be completely clean shaven there, try not to shave too close to the skin and rinse the shaver after each stroke:D Pat the area gently afterwards…don’t rub vigorously. Remember that re-using razors you have used on the infected parts may lead to further re-infection with bacteria that are on the surface of the razor.

Your doctor will make a definitive diagnosis. He/she may prescribe some anti-biotic ointment or oral antibiotics (taken by mouth) and some other ointments to stop the inflammation. Remember that antibiotics should be taken for the full period prescribed by the doctor and not stopped as soon as you feel better.

Have a fun-filled weekend 😀

Q: Hello Doctor. ..is it safer for a pregnant women to sleep on her tummy?

A: Congratulations on your pregnancy! In early pregnancy, there’s nothing really wrong with lying on your tummy….that’s if you feel comfortable. As your pregnancy progresses, you will definitely not be able to do so again. So, if this is your guilty pleasure, enjoy it while it lasts. Generally, in the first trimester, if you’re used to sleeping on your back or tummy, you can continue. However, as you get into your second trimester, it is fact that pregnant women should not sleep on their backs especially close to term. This is because the woman may feel dizzy as the growing uterus puts pressure on the vein that returns blood from the body making the woman feel dizzy on getting up and the baby may also not get enough nutrients from the placenta in that position.

As pregnancy proceeds, you may start to experience more backaches as the weight you have put on starts to take its toll. Be sure to sit up straight on chairs with proper back support to help with this. Sleeping on your side with a pillow between your legs will also help. This may be the cause of your backaches but if they are very discomforting, please see your doctor. Better safe than sorry.

Have a good night, everyone 😀

How stressed are you? How do you handle stress? Does this have an impact on your health? You should read this!

https://www.health.harvard.edu/newsletter_article/holding-on-to-stress-could-affect-health

For additional resources, please read this: https://chatwithdrketch.com/2015/03/02/daily-health-tips-i-am-stressed-out/