chatwithketch

‘Stress, exercise, and even a few drinks the night before your doctor’s appointment can push your blood pressure up.’

For more, read! https://www.health.harvard.edu/healthbeat/monitoring-blood-pressure-at-home

Q: Dr. Ketch your friend is suffering pains from penis for almost thirty years – no cure. I want you to help me please.

A: Dear friend, sorry to hear that you are in pain. Where exactly is this pain? The tip, shaft or base? There are different causes of penile pain and it could affect any of these areas. Penile pain should always be checked out in the hospital. Better safe than sorry.

Some causes of penile pain include:

• Priapism: Priapism is a condition, in which there is a sustained and oftentimes, painful erection of the penis, continues for hours beyond sexual stimulation or even when there is no sexual stimulation. It is more common in men in their 30s.

There are three types of priapism (ischaemic, non-ischaemic and recurrent) but to understand this, we’ll take a look at the mechanism of erection. An erection occurs in response to stimulation, physical or psychological. As a result of this stimulation, the blood vessels and smooth muscles of the penis relax, allowing increased blood flow to the penis. This is what causes erection. When the stimulation is over, the vessels and smooth muscles constrict causing the blood to flow out of the penis and become flaccid. In priapism, the order of events causing the blood to flow out of the penis is changed such that the blood does not flow out of the penis

In ischaemic priapism, which is the more common type due to inability of blood to leave the penis, there is pain, rigid penile shaft but flaccid glans (penile tip) and the erection lasts more than 4 hours! Causes include blood disorders like sickle cell anaemia and injuries to the penis and/or pelvis, alcohol, cocaine and other illicit drug use, some medications like blood thinners and antidepressants, cancer of the penis etc.

Non-ischaemic priapism is usually due to an injury to the perineum or genitals that results in poor regulation of penile blood flow. It is not usually painful and manifests as erection that lasts for more than 4 hours but the penile shaft is not fully rigid.

In recurrent priapism, situation is similar to ischaemic priapism with erections that are painful, recurrent but ease after 2 to 3 hours. These erections may subsequently progress to become more frequent and more prolonged. It is common in males with sickle cell anaemia

Any sort of priapism should be checked out with a medical doctor (urologist) to determine type, cause and management. Erection lasting more than 4 hours is an emergency and may led to damage of the penis and subsequent erectile dysfunction. Treatment depends on cause and should be started as soon as possible.

Options include aspiration (in which blood is drained out of the penis with a syringe), use of medications to constrict the penile blood vessels, treatment of underlying medical condition like sickle cell anaemia and surgery in some cases. Note of warning, though it sounds very simple to use a syringe to drain out the blood in the penis, you must never attempt it on your own. You must visit a hospital and let a doctor work out the best treatment option(s) for you. Patients who do not get treated early enough and some that went through surgery eventually end up with poor erectile functions despite the successful treatment.

• Balanitis: Skin irritation of the head of the penis, known as balanitis, could present with itching as you described. Causes include:
  Irritation under the foreskin caused by urine
  • Candidiasis
  • Use of shower gels, soaps and other skin irritants
  • Skin conditions like eczema
  • STI
  • Poor hygiene

Your doctor will work with you to determine the cause and treatment is dependent on that.

• Urinary tract infections: In men, UTIs are not so common and would happen more in people who have an enlarged prostate, people who have a poor immune system and people who have kidney and bladder infections. Symptoms include frequent urination, difficulty with urination, pain during urination, fever etc. Involvement if the kidney leads to loin pain in addition to worsening of feelings if illness.
  The doctor will usually send a urine sample to the laboratory to check for bacteria present in the urine and what antibiotic(s) are effective against them. Be sure to take the antibiotics for the prescribed period of time, even if you feel better before you finish the course to prevent backtracking of infection into the kidneys. Drink a lot of water and take analgesics for pain, if needed.In summary, your specific treatment depends on the organism that is found in your urine at the laboratory. Be sure not to prescribe antibiotics for yourself!

For more on urinary tract infections, please click on the link below:
https://chatwithdrketch.com/2014/05/16/daily-health-tips-urinary-tract-infections/

• Sexually transmitted infections like syphilis, gonorrhea and chlamydia, injuries to the penis, penile cancer, phimosis in which the foreskin of the penis is stretched too tight and cannot be pulled away from the head of the penis, can cause penile pain.

Treatment depends on cause and some have been described above. Antibiotics can be used to treat UTIs and some STIs, including chlamydia, gonorrhea, and syphilis. Stretching the foreskin with fingers may make it looser in phimosis. Steroid creams rubbed on the penis can also help. In some cases, surgery is necessary in phimosis and/or cancer. In the latter, radiation treatment or chemotherapy could be included.

So, your first step is to see your doctor for a proper diagnosis and treatment.

All the best!

Have a goodnight, y’all 😀

Q: Hello Doctor my dad is having hiccups and it’s really irritating because he can’t eat even if he drinks water it doesn’t stop. We went to different hospitals, no help. What can be the cause and its treatment?

A: Hiccups refer to involuntary contractions of the diaphragm. The diaphragm is the thin muscle that separates the chest from the abdomen. This is followed by sudden closure of the vocal chords with the resulting hiccup sound at the top of the windpipe.

Hiccups are quite common and can affect any age group. They usually occur without provocation and last for a few minutes before disappearing. These episodes may be linked to:

• Bloating…which may be a factor in your case, given your belching.
• Eating or drinking too quickly (in which case a lot of gas/air is taken in. Again, this could be a factor in your case)
• Smoking
• Drinking alcohol
• Drinking fizzy or hot drinks
• Sucking on candy

However, sometimes hiccups may last for prolonged periods and in these cases are associated with underlying medical conditions:

• Meningitis
• Diabetes
• Alcoholism
• Stroke
• Neck tumours

Most cases of hiccups do not require treatment. However, some may persist requiring treatments with drugs, injection of medications and/or surgery depending on the underlying condition.

I am sure most of you may have tried many home remedies like

• Putting a thread on your head! This one is laughable and I do not know anyone it has helped.
• Sipping on cold water. Well, if it helps, why not?!
• Holding your breath for a bit. Again, if it helps, go for it.

So, I suggest that you note the triggers noted here (generally, things that make you gassy), stay away from them and see if that helps. The triggers for belching and hiccups are basically same…factors that cause you to swallow a lot of air. Don’t stay away from food completely….we need you alive  I believe this will help. Be sure to also check in with your doctor for a proper diagnosis to be made, if this continues.

Have a good night, people 😀

Q: Hello Doc, what is a whitlow and what’s the treatment?

A: Whitlow usually refers to Herpetic whitlow caused by Herpes Simplex Virus. It usually affects the tip of the index finger or thumb. It happens when the finger skin, especially the cuticle, is broken and invaded by virus causing infection of the soft tissue around the nail. This can happen through skin to skin contact or when infected fluid touches the breach/cut in the finger skin. In children, this can happen when a child with cold sore (what we usually term fever blister), sucks on a finger with a cut on the thumb or also through contact with someone who has genital Herpes.

The virus may remain inactive in the skin for up to 3 weeks before symptoms manifest. This condition is intensely painful and patients would complain of swelling and blisters in the affected area, tenderness over the area and, of course, pain. As is usual with viral infections, whitlow is self-limiting. This means that the infection will run its course and disappear. They usually clear up within 3 to 4 weeks without treatment. However, your doctor may prescribe an anti-viral agent to prevent recurrence of the infection.
If you already have a whitlow, prevent its spread by covering it up with a plaster (it could spread to another finger, you know :D), wearing glasses to prevent passing on the virus to your eyes, ensuring that your baby does not suck his ‘whitlow finger’ (Eeew! :D) and washing your hands often.

Have a great day!

Q: I am 8 weeks pregnant. Now I am bleeding…is this miscarriage?

A:  Bleeding during pregnancy can be worrying whether it is a little or a lot. However, it may not necessarily be the sign of a problem.

Bleeding can occur in early pregnancy, close to or about the same time as the menstruation would and thus be mistaken for a period. This bleeding could be due to implantation as the fertilized egg implants itself in the uterus (womb). Other causes of bleeding in early pregnancy include ectopic pregnancy, miscarriage and infections.

For more information on ectopic pregnancy and miscarriage please click on these links:

https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/

https://chatwithdrketch.com/2014/12/14/daily-health-tips-miscarriage-and-infertility-re-visited/

Bleeding in pregnancy may not necessarily be an emergency but because there are other causes of these episodes of bleeding, which are potentially life threatening like ectopic pregnancy, bleeding in pregnancy should always be checked out in the hospital. Better safe than sorry 😀

All the best!

Q: My 8 months baby is purging and I don’t know why whether it’s because of teething

A: Two key symptoms that are often associated with teething are fever and stooling.

It is thought that the inflammation of the gum around the area where the tooth will erupt from may cause low grade fever which is why the babies may experience some fever.

There’s no conclusive research that has shown any link between the process of erupting a tooth and diarrhoea. If anything, it has been found that this is the same period when children start picking up things and of course the natural ‘tourist’ destination for anything they pick up, is their mouths! 😀 What happens? When they pick up dirty stuff and suck on it, it would ultimately lead to diarrhoea. Others think that the excessive saliva produced at this time, end up in the intestines and lead to loose stools. Whatever the cause, more than ever, this is a time to be watchful and ensure that the children are not stuff their mouths with rubbish and ensure their toys are cleaned.

Having said that, how can I help my baby through teething what with the itch and discomfort they feel around the ‘erupting tooth’ area? Even the drooling? Well, here are a few things you could do:

Rub over the teething area with your finger (thoroughly scrubbed and clean, of course :D) or use a finger covered with clean gauze or even the baby’s wash cloth. If this is cool to touch, this is even better. Massage the teething area with this…it helps to soothe the discomfort.

Teething rings are great ideas too and you could also refrigerate these to provide more comfort. Please do not freeze them.
Clean off the drooling saliva as this could cause irritation around the baby’s mouth, worsening his crankiness.

Over the counter analgesics like paracetamol could also be helpful provided it’s given in the appropriate dose for the baby’s age. This will also help with the fever. Please avoid Aspirin as it causes a disease called Reye’s syndrome.

Several studies have been conducted on the efficacy of gripe water though it is liberally used by parents and doctors alike, and it has not really been found to be particularly useful in teething. Older formulae contained alcohol, which were thought to be perhaps, responsible for the soothing effect it had. Other components like the herbs etc may not go down well with all children.

If fever continues, please take the baby to see the doctor to rule out other causes of fever. Dehydration is the more critical issue. If your baby is still stooling, fluid needs to be replaced. Please take him in to see his doctor to determine if the fluid loss is serious enough to warrant replacement. In the meantime, keep breastfeeding.

So, there you go!

Do you find yourself starting out the day feeling super excited and energized and towards the end of the day, you feel down in the dumps, as you struggle to end your day on the same high on which you started? Do you know that your diet could help? Are you eating the right or wrong carbs? You should read this! https://www.health.harvard.edu/healthbeat/want-more-energy-heres-what-really-helps

Q: Good morning ma’am. I want to ask what to do if a month-old baby couldn’t excrete for 3-4 days. The baby only sighing, you know when a baby is making uncomfortable sound,”hmmmnnnn”. The baby is sucking as usual. He sweats normally as well. Someone suggests I parboil waterleaf and give the baby. Please, what do I do? Reply please ma’am.

A: You didn’t note whether your baby is being exclusively breastfed or not. If your baby is exclusively breast fed (as he should be from birth to 6 months of age), the baby can sometimes go days without defaecation and is due to the fact that practically all the nutrients in breast milk are completely absorbed during each feed, such that there is little or nothing to excrete. However, it is expected that when baby does poop, the faeces should still be soft in consistency as opposed to hard, dry, pellet-like stool as occurs in constipation. If the stool is hard with exclusive breast feeding (?), please visit your baby’s paediatrician. On no account, should you give your baby parboiled waterleaf fluid or any other concoction! Please don’t! Where in doubt, always consult your doctor when in doubt.

Formula fed babies, on the other hand, suffer from constipation because it is more difficult for a baby to digest formula than breast milk.

If your baby is dehydrated, perhaps from not taking enough fluids as may occur if she has a cold and is refusing feeds due to difficulty with breathing when feeding, ‘constipation’ may also occur. Other causes include food allergies and/or introduction of complementary fees as the body learns to handle these foods.

If your baby is on exclusive breast-feeding, passing out dry, hard stools is unlikely. For formula feeds, try to give your baby more water and be sure that you are adding the right amount of formula to make the baby’s meals. If this continues, please see your baby’s doctor.

For more on this subject, please click on https://chatwithdrketch.com/2014/05/20/daily-health-tips-can-my-diet-cause-my-baby-to-have-diarrhea-while-breastfeeding/

Have a great day, y’all  😀

Q: Good afternoon Dr, I give you all the accolades. God will continue to bless you with wisdom and you will live to declare his Goodness. Amen🙏
Dr please, I tested positive to pregnancy after missing my period on 12th so I decided to have a home test which came out positive. Dr. I really do not want to visit the hospital now I still want to observe myself for the next one month. Dr. please what food should I eat and avoid and also can I take folic acid or wait till I see the Doc?
Thanks so much Dr. God bless you big. N.B no symptoms at all only my breast been a bit slightly painful. I am AA and B+.

A: Hallos! Thanks for writing in and Amen to all your prayers! 😀

Pregnancy is such an awesome time. Okay, I know those of you who have a hard time with pregnancy are wondering whether to throw rotten tomatoes at me 😀 Hold your peace! But the truth is, when you’re not feeling absolutely horrible, you’re elated at the thought of the life growing in you, aren’t you. It’s such an awesome responsibility to be given…the nurturing and birthing of this child. Don’t get me started on this….

Okay, with this huge responsibility comes even more responsibilities 😀 There is the need to eat right to nurture the growing life inside that huge tummy. Eating right is not necessarily eating for two…I know we’ve all heard the feeding for two fable. Trust me, in pregnancy, your calorie requirement doesn’t increase in first trimester, increases by just 300 calories in second trimester and about 400 calories in the 3rd trimester …if you’re carrying just one baby. For multiple pregnancies this increases slightly.

Here are 5 nutrition tips for a pregnant woman:

• Eat a balanced diet with a variety of foods from different food groups.
• Be sure to include a lot of high fibre foods like vegetables, whole grain cereals etc to deal with the constipation associated with pregnancy.
• Ensure you take your antenatal medications (prenatal vitamins) in addition to eating well.
• Drink at least 4 servings of milk, other dairy products or calcium rich foods. If you don’t eat enough, your baby will start drawing on your own stock from your bones. So, drink up your milk!
• Be sure to also take foods rich in iron eg and foods rich in folic acid eg green leafy veggies and beans. World Health Organization recommends that pregnant women receive folic acid and iron tablets daily. Folic acid prevents neural tube defects which may occur during the first 28days of pregnancy. This is usually the period when quite a number of women do not even know they are pregnant. Thus, women who plan on getting pregnant should start on folic acid supplements at least 3 months before their planned date to safeguard against neural tube defects. If you haven’t started this earlier and realize you’re pregnant, start taking them as soon as possible.

Pregnancy provides an opportunity for a mother to adequately prepare her baby for life in 9 months. Make sure that you get all the nutrients that give your child a great health boost.

Have a great evening y’all 😀

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