chatwithketch

Q: Good day ma’am. Please can you talk about pile in children?

A: Hey! Thanks for writing in and yes I can 😀

Piles known as haemorrhoids in children is not very common. Indeed, my first suggestion would be to get your baby checked out by a paediatrician to confirm that this is not due to problems like Crohns Disease (a problem-inflammation of the bowel) or even portal hypertension in which there is backwards pressure in the vein (blood vessel) that carries blood from the digestive tract to the liver.

Once these have been ruled out, we can focus on the more common cause of haemorrhoids in children which is constipation. The causes of constipation in children could be dehydration or even a lack of fibre in their diet. So, if you’re fond of feeding your baby highly processed foods without including fruits, vegetables, complex carbohydrates like local rice, beans, oatmeal etc, your baby could be at risk. If your child, also, does not get enough activity daily and spends more time in front of the television, computer or playing handheld/video games, this is a potential problem. Children who drink a lot of soda or soft drinks/minerals, as we call them in Nigeria, tea/coffee are prone to this. The caffeine found in these drinks causes the body to lose water and thus can cause constipation.

What can you do to help relieve the pain that your baby is feeling? Sitz bath is helpful. Help your child sit in a basin or bath tub of warm water several times a day (2 to 3 times). This helps to relieve the pain. When she uses the toilet, using regular tissue paper is out of the question as this will cause more irritation and itching. Unscented baby wipes or even wet tissue is a good way to go.

Pain relief can be with over the counter pain relievers (analgesics) like ibuprofen. You can also wrap some ice in a towel and have your child sit on this intermittently.
Childhood haemorrhoids usually go away with a fibre-rich diet, exercise, sufficient fluid intake in a day and loads of love 😀 If the symptoms persist after about two weeks, please check with the paediatrician again.

For related topic, please click on this link: https://chatwithdrketch.com/2014/03/12/daily-health-tips-help-please-i-have-chronic-piles-haemorrhoids/
Have a great evening, y’all 😀

Q: How to deal with stomach ulcers?  Especially food wise..

A: Thanks for writing in.

There are two conditions that may often be confused, one for the other: Peptic ulcer and Gastro-Esophageal Reflux Disease (GERD).

Gastric acid is secreted normally in the stomach to help the process of digestion. Peptic ulcer is a sore in the stomach, esophagus or duodenum and occurs when there is either over-production of this gastric acid in the stomach or reduction in the quantity of mucous that protects the stomach from the acid. Infection with an organism, Helicobacter pylori (H. pylori) has been found to be a cause of peptic ulcer.

GERD, on the other hand occurs when stomach acid backtracks into the esophagus causing heart burn.

In the past, it was thought that spicy foods caused peptic ulcers. However, there’s no evidence to support this, though spicy foods can certainly make the symptoms of ulcer worse  Smoking, stress and drinking alcohol are also likely to worsen the symptoms of peptic ulcer. Caffeinated and carbonated beverages may also be culprit.

Ulcers are also common in people who take certain pain relieving drugs known as Non- Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen.

People with peptic ulcer usually complain of abdominal pain or even sometimes, chest pain as the pain can be anywhere from the breast bone to the navel…giving room for a wide range of descriptions  The pain is usually worse at night or when the stomach is empty.

People with ulcers may vomit blood or pass out fresh or altered blood in stool. For the latter, the stool looks tarry black. Complications of peptic ulcers include internal bleeding, leakage of the acid into the abdominal cavity etc

Treatment is targeted at reduction in acid production, neutralization of acid, treatment of Helicobacter infection, promotion of healing or protection of stomach lining. Your doctor will determine the best option or combination(s) with your active participation, of course

Thus, prevention is targeted at switching pain relieving drugs (if you have an ulcer, please stay away from NSAIDs, reducing your level of stress, stopping smoking and reducing your alcohol intake. Maintaining a healthy diet filled with loads of fruits and veggies, which provide sufficient vitamins to aid healing, is also a good way to go. It is still not very clear how H. pylori infections spread but it is thought to be probably from person to person or from food and water. So, judicious and very frequent, hand washing will certainly help

Does milk help? Well, temporarily but it quickly makes it worse. Milk coats the surface of the stomach, reducing the pain but then stimulates more acid production. Sounds like you can’t win, aye?! ;D

For GERD, there are also conditions like pregnancy and obesity that make this condition worse and there are also foods that encourage this. Examples of these ‘foods’ are fatty foods, alcohol, orange juice, chocolate and coffee, onions, tomatoes, peppermint and spicy foods.

So for the person in the question, I suggest you keep a food diary over a period of time and try to figure out the trigger foods. If you suspect tomatoes, try to confirm this by having a ‘tomato meal’ and watching for heartburn and an unpleasant taste at the back of the mouth. If this is not the issue, perhaps it’s a weight issue or even over-eating.

Treatment is targeted at the acid and healing the esophagus. Remember that occasional heartburn is not regarded a problem but if it happens frequently, like two or more times every week, then it becomes a problem and is now referred to as Gastro-Esophageal Reflux Disease (GERD). So, drugs used can stop acid production, reduce acid production and cause healing of the esophagus or neutralize the effect of the acid.

Prevention involves trying to avoid your trigger foods (quite a number are actually healthy maintaining a healthy weight, avoiding heavy meals just before bedtime, try eating smaller meals and avoid tight clothes that may also put pressure on your abdomen.

So, see a doctor first to confirm the diagnosis….peptic ulcer or GERD and then he’ll advice on treatment.

Have a fabulous evening and remember…no heavy meals before bedtime 😀

Stroke as the name implies refers to an incident that happens suddenly…without warning. It usually occurs when the brain is deprived of some of its blood supply and consequently oxygen supply. This can happen when there is a blood clot in a vessel in the brain or due to a burst blood vessel leaking blood onto the substance of the brain or around the brain. This blood leakage can lead to undesired pressure on the brain.

Oftentimes, people refer to a Transient Ischaemic Attack (TIA), as a partial stroke. This condition occurs when a blood vessel is partially blocked. This would usually be resolved within 15 minutes and is a sign that a major event (a stroke, proper) may not be far off. This is a warning that should be taken seriously.
It is important to know the signs of a stroke because if action is taken immediately, it can prevent permanent damage from being done. If the brain is deprived of its blood supply for about 4 minutes, irreversible changes begin to occur in the brain. If this deprivation continues beyond this time, permanent changes would have occurred that may affect different facets of the individual’s functions.

The signs of stroke to look out for are known by the acronym FAST.
• F stands for drooping of a side of the face. Ask the patient to smile and you will observe that the smile looks lopsided.
• A stands for weakness of one side of the body. Ask patient to lift both arms and it will be seen that one side is being ‘dragged’ or lagging
• S stands for speech difficulty like slurring. Patient cannot enunciate words properly again
• T stands for time. Once these symptoms are noticed, it’s time to call for help. In climes where there are emergency numbers like 911 or 999, please call these. Otherwise, efforts should be made to take the person involved to the hospital immediately.
Patients may also complain of sudden inability to move legs, feel confused, have blurred vision etc

There are risk factors for stroke and they include:
• Age: The older you are the more prone to stroke. People from age 55 years are more likely to have a stroke, though this can also happen in children eg those born with heart defects and those with Sickle Cell Anaemia etc
• Race: Africans and Asians are more at risk
• Sex: Females are more at risk…as if we don’t have enough problems
• Family history of stroke: The presence of this increases risk
• Previous history of a stroke.

Other risk factors:
• Hypertension
• Diabetes Mellitus
• Overweight
• Sedentary lifestyles
• Not eating healthy
• Smoking
• Drinking Alcohol

The rate at which one recovers from stroke and indeed the degree of symptoms experienced, depends on the area of the brain affected, how serious the damage to the brain is etc and so recovery will be different for different people.

Patience is key. Speech therapists may be needed to help the person re-learn the art of speaking. Physiotherapists will help improve motion on the affected side and indeed, mobility. Other therapists may help with eating…if swallowing is a problem, relearning the art of reading and reasoning etc

Usually, people who visit find it difficult to understand their speech during recovery and this can put even more pressure on the patients. Speak slowly and listen carefully so you can understand what they are saying.

Generally eating healthy with lots of fruits and vegetables, cutting out the white carbs (pastries etc), exercising (at least 150 minutes weekly), ensuring you are not overweight and quitting smoking help with reducing bad cholesterol and also preventing strokes.

One may need to walk with a stick as they re-learn the art of walking. Recovery may be long and tedious but the person has got to keep at it.

For more tips on preventing stroke, read!

https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke

Q: Good morning ma’am, my sister was raped last month, and we just found out yesterday that she is pregnant and she cannot keep the child because she will be getting married by December. She has been struggling to deal with the memory of being raped and finding out that she is pregnant is something she cannot handle. Please ma’am, is there any pills she could take that will help her get rid of the baby? Thanks

A: Hello dear, my heart goes out to your sister for what happened. This is just horrific!!!

There are two things every rape victim must always do…report the rapist to the police and get herself/himself checked out in a hospital. Usually when people are raped, they experience a deep sense of shame making it difficult for them to seek help and indeed prosecution for the person accused. This should not be. Please get her to seek help… to ensure that she does not end up with any STI. If she had also sought help early, she would have been given emergency contraception and been checked out by a doctor especially if there is suspicion of a genital tear etc. Further, raising the alarm ensures that the predator is not emboldened to do this to another person, ever again. Going to law enforcement as soon as possible would help as the clothes may contain some forensic evidence.Now in this case, it would appear none of this was done.

Before I start my comments on what I perceive as next steps, I would like to issue my regular disclaimer: On this page, I do not pass judgement or tell people what to do. I just try to provide enough information to get you to take the right decisions.

I absolutely sympathize with your sister. It is harrowing enough to deal with the issue of rape and then add to that the issue of pregnancy resulting from that. The psychological ‘wounds’ from rape are deep-seated and will find an outlet one way or the other, if not today, it will be tomorrow or next year…but it will come out sometime. I would recommend that she tells her fiancé. All things being equal, he would still want to hang around to help her deal with this…after all, your sister is the real victim here L Having said that, there is no guarantee that he will stick around and so if your sister decides to tell him, there is the possibility that her fiancé may head for the nearest exit. I know that having wedding close at hand makes it look like there’s only one option here, but that may not necessarily be so! Please get her to seek help and counseling.

For the pregnancy, termination is illegal in Nigeria. Beyond the legality of this, I suggest that she figures out how she wants to handle this with her fiancé and then, dealing with the pregnancy becomes more straightforward.

I wish she were close by so I could give her a hug and tell her that everything will be okay…and they will. It may look like all is wrong with her world now, but trust me, she will come through this stronger than before. There are really no easy answers here. I wish this was one of those questions where the path to take is clear and easy. This is not one of those, but it is in the dark and difficult times that we stretch and discover purpose. Get your sister to seek counseling. If she decides to tell her fiancé, I hope that he sticks around for the long haul; but if he doesn’t, it’s his loss. She needs to focus on her now. She has to let go of the experience she had in order to begin her life afresh without fear and hang-ups.

To help prevent other incidents of rape, practice personal safety and trust your instincts. If the situation looks or feels fishy, it probably is. Try to ensure you go with company if you must visit any friend of the opposite sex or better still, meet in a public place etc.

If you’re in Nigeria, Project Alert (http://www.projectalertnig.org/) and the Lagos Domestic Violence centers  (http://domesticviolence.com.ng/help-for-domestic-violence/) will also be able to provide some more practical support in terms of counselling and probably legal help, if required.

Remember that she needs to get herself checked for STIs and/or other infections while the discussion on the pregnancy and upcoming wedding continues.

Please tell her to stay strong, okay?!

Loads of love and hugs coming her way…

Have a great night, people 😀

Heart burn really has nothing to do with the heart. It is usually felt as a burning sensation in the chest which feels worse on bending down or lying down. Okay, why and how does this happen? You know that the stomach produces acid to help with food digestion, right? Have you ever wondered, how come this acid isn’t all up in your mouth all the time? Well, that’s because there’s a ‘lock’ or control at the junction of the esophagus and the stomach which prevents the acid in the stomach from coming back up into the esophagus. This ‘lock’ is called the Lower Esophageal Sphincter. This lock can get strained if the esophagus opens too often or if there is too much food in the stomach…so, if you regularly over-eat, you might want to re-think that 😀 A major no-no is a very heavy meal just before you lie down. It’s almost certain you may have a heart burn 😀

If despite your best efforts you still have a heart burn, here are tips to help you! https://www.health.harvard.edu/diseases-and-conditions/the-best-ways-to-manage-heartburn

Q: Please ma’am, I had unprotected sex, but he didn’t release; but I am just scared. What will I do to clear my fear??

A: Well, the first step towards never experiencing this kind of fear is to remember your ABCs. A is for abstinence. Honestly, this is your safest bet. If you’re not ready to deal with the responsibilities of having a baby, please leave well alone. You can’t have an STI, HIV/AIDS, or otherwise if you don’t have sex. In addition, you can’t get pregnant. Now, if abstinence is a problem, be faithful to one partner…who, hopefully, is being faithful to you too. If you can’t swear on this, revert to plan A. Finally, if all else fails, ensure that you use a condom to prevent STIs and pregnancy.

‘Not releasing’ implies that you used the withdrawal method of contraception. 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, is it possible that you could get pregnant with this method of contraception? The answer is yes. You should also worry about the potential for STIs. I suggest that you visit your doctor for confirmation of pregnancy – though most GPs would ask that you wait until you actually miss your period. Then, if you are not pregnant, I suggest that you visit a family planning clinic for help with choosing a means of contraception.

All the best!

Best,

Nkechi

Q: Good evening Doctor, please is ketogenic diet safe for everyone. I am confused about the high fat about the diet. Please kindly help me understand the diet since I really want to lose weight after child birth.

A: The keto diet is mainly used to reduce the frequency of epileptic seizures in children. it has been used for weight loss and achieves results short-term, in some cases. The long-term effects and safety are not really clear. So, if you want to lose weight after your baby, 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 always contact your doctor 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.

That’s it. And to learn more about the keto diet and side effects, click on the link below https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet

Q: Doctor please help me; I am not ovulating

A: Hey! Thanks for writing in.

How do you know this? Typically, the ovaries in females release an egg every month. If this does not get fertilized, the womb which had been getting ready to receive a fertilized egg, sheds its thickened lining. The release of an egg stimulates the production of the hormone, progesterone. This hormone is mostly responsible for keeping periods regular. But in some instances, a mature egg is not released regularly on a monthly basis and sometimes, no egg is released at all…meaning no ovulation. In this case, progesterone is not produced and the cycle is either erratic or bleeding, heavy.

This kind of cycle, known as anovular cycle, is quite common in adolescent girls especially in the first year after they start menstruating. Other causes of anovular cycle include hormonal disorders, obesity, weight loss, thyroid problems, polycystic ovarian syndrome, hirsutism and pituitary problems. So, if you believe you are not ovulating, please see your gynaecologist for a thorough check.

If you do have an anovular cycle, treatment options include lifestyle changes (focused on eating healthy, weight loss, exercise, stress management etc), medications to induce ovulation or to regulate menstruation and surgical (to remove part of the ovaries and restore hormonal balance)

For more related topics, please click on the following links:

https://chatwithdrketch.com/2016/12/22/daily-health-tipswill-i-need-to-take-pills-forever-for-pcos/

https://chatwithdrketch.com/2017/12/09/hlwdk-daily-health-tips-hormonal-imbalance/

https://chatwithdrketch.com/2016/09/29/daily-health-tips-thyroid-problems/

https://chatwithdrketch.com/2016/11/07/daily-health-tips-what-do-i-do-about-the-hair-growing-on-my-chin/

All the best!

Q: Hey Doc, please I need help. I wanna remove my IUD

A: Hey! Thanks for writing in.

What’s the problem? Your IUD can be easily removed by a qualified nurse or doctor. Have you visited one of them? Or you don’t know if it’s time to remove the IUD? Well, it depends on the time you had inserted.

There are two types: the Paragard IUD and the Mirena IUD.

The Paragard IUD is a copper-containing IUD. This is probably the one your wife had inserted. The copper is poisonous/toxic to sperm and the IUD also prevents implantation of the fertilized egg into the uterus, should fertilization still occur. Paragard can be used during breastfeeding and its removal leads to a quick return of fertility, generally. It usually prevents pregnancy for about 10 years after insertion.

The Mirena IUD contains hormones which make the cervical mucous extra thick preventing the sperm from getting to the womb and it also makes the lining of the womb thin such that even if a fertilized egg were to get there, it would not be able to implant on the thin lining of the womb. It also prevents ovulation. Mirena helps reduce the cramping pain of a menstrual period and also reduces bleeding. It prevents pregnancy for up to 5 years after insertion.

Side effects of Paragard include back ache, cramps, severe pain during menstrual period and heavy bleeding etc while Mirena can cause breast tenderness, weight gain, irregular menstrual cycles etc Both IUDs can also be expelled, spontaneously, that is for no reason.
There are warning signs to look out for when you have the IUD on. If you experience any of these under-listed symptoms, please see your doctor immediately.

• Severe vaginal bleeding with at least 2 sanitary towels soaked every hour for 2 or more hours.
• Smelly vaginal discharge. This could be associated with fever and chills
• Severe pain in abdomen or pelvis

General information about IUDs:
• They are more than 99% effective
• You and your partner cannot feel the IUD either during sexual intercourse or while checking for it
• Your partner may however be able to feel the string during sexual intercourse and the string can also be felt if a finger is into the vagina.
• People who have inserted IUDs may feel abdominal cramps or lower back ache for a few weeks after insertion
• Bleeding in between periods may also happen.
• There is a risk of infection if the user of IUD or her sexual partner have other sexual partners.

If you are not sure of the IUD you inserted, please visit your healthcare provider to confirm. The IUD is usually quickly reversible and so if you’re planning for pregnancy, you should be able to achieve that without much stress.

All the best!