chatwithketch

Q: Good evening Dr. My partner and I are having a baby. She’s 37 on Thursday. For the past 2 weeks or so she’s been having some kind of fluid leaking from her vagina. It’s not urine – it’s watery and she’s been having a lot of pains in her lower abdomen almost like period pains. It’s awful to an extant that she has to flee outa bed a lot or sit up straight. Also there has been some kinda mucus that’s light yellowish that came out. Please shed some light on what could be going on. We have a Dr.’s appointment on Thursday as well .Thank you in advance

A: Thanks for writing in.

Amniotic fluid is the fluid that surrounds and cushions a baby while in the womb. The fluid is contained within a sac called the amniotic sac. Usually just before a woman goes into labour, this sac ruptures and the fluid is released…that’s what is referred to waters breaking. When I had my last baby, my waters broke right in the hospital reception! And so, there was I with water all over my legs and people in the reception area watching 😀 It wasn’t quite funny on that day! But I digress…

Though, you are quite sure the leaking fluid is not urine, here a few things you can do to check:

• If it’s urine, it has the peculiar smell of urine and is usually leaked when one coughs, laughs or sneezes.
• If it’s vaginal discharge, it’s there constantly and may be clear, white or yellowish
• If it’s amniotic fluid, it’s likely to be clear, or slightly mucoid and/or blood stained and it wets panties continuously irrespective of whether one laughs or not

Not sure if the 37 you mean refers to 37 weeks as age of pregnancy or 37 years as age of your partner J I will assume that it refers to age of pregnancy. At 37 weeks, pregnancy is considered to have been carried to term. Therefore, the mucous she saw may be ‘show’.  Show is a mucous plug that may be tinged with blood and is a sign that your cervix (neck of womb) is getting ready for labour.

The abdominal pasins he is having could be Braxton-Hicks contractions (these are ‘fake’ contractions preparing the womb for the main even :D). However, with the other symptoms she is having, the pains could very well be the real deal – real labour has started 😀

So, my advise is….forget your Thursday appointment and go see the obstetrician immediately. It appears your baby is about to make an early appearance 😀

All the best and congratulations in advance.

Have a good night y’all 😀

Want to sleep better? First tip…cut down on caffeine. Perhaps you don’t drink coffee but you take a lot of other drinks that are high in caffeine. Want to know what these are? Energy drinks, teas, chocolates and some sodas, too. Apart from the laxative effect of caffeine, it has other actions on the body:

Inability to sleep – not a good idea if you want a good night rest, right?
Rapid heart beat
Irritability
Nervousness
Irritation of the bladder
High blood pressure etc
The recommended daily amount of caffeine is 400mg which is about the amount of coffee in two 8 ounce cups of coffee. These are the dainty cups of coffee and not the huge mug-like (Who-send-you-come?) cups that a lot of us favour 😀

The energy drinks often contain huge amounts of caffeine and are used by people as a pick-me-up for different reasons. The thing is, if you haven’t slept for 3 days and you’re trying to complete that project by taking more energy drinks that will keep you awake, you will eventually pay for this…one way or the other. It is either the side-effects of caffeine take over or you do fall asleep! You can’t cheat nature (forgive the cliché). Your body needs rest when it needs rest and it will get it one way or another!

So, if you must, one energy drink (about 500mls) once in a blue moon may not hurt you but it may be more constructive to try to pace your activities and not try to get everything done at once. Eat healthy and get some exercise (at least 30 minutes) daily. Mixing these drinks with alcohol and other recreational drugs makes it a more dangerous ‘concoction’.

Please avoid energy drinks if you have been diagnosed with high blood pressure or you have a heart disease or at least speak to your doctor about it. Children and adolescents should stay off this. Pregnant women and breast feeding mothers should be especially careful.

For the other two tips to sleeping better, click on this link: https://www.health.harvard.edu/healthbeat/3-ways-to-get-more-restful-sleep

Having challenges keeping the weight off even though you’re doing all the right things? Here’s help for you!

https://www.health.harvard.edu/staying-healthy/small-tricks-to-help-you-shed-pounds-and-keep-them-off

I got a heart-warming message from someone who is on the road to mending following addiction to Pentazocine. S/he wrote in response to my post on this. Please click here if you haven’t read it: https://chatwithdrketch.com/2014/11/04/daily-health-tips-pentazocine-addiction/

S/he sent in the question below…..

Q: I am also addicted to Pentazocine. And with the help of my family members I have abstained from it for more than a month now. I know it’s not so long but I believe it’s a good sigh because I couldn’t stay without it for 48hrs before. But do you really think I can stop using this method??

A: Hello dear! I am so happy to read from you! Great job! Way to go!

Can you go it alone with just family for support? Yes, you can. There are two options: cold turkey (where you stop completely at once and ride out the withdrawal symptoms) or where you stop gradually and you reduce the dose of drugs from 3 ampoules daily, to 2 and then 1 and then on alternate days until it’s completely tapered off. Please try!

But where you have good centers around, it’s usually best to get into a voluntary program for drug addiction where there will be a combination of clinical psychologists and psychiatrists. A long hard look at one’s life including unhealthy relationships, toxic home/family environment etc will be encouraged. The program will involve detoxification, exercise, counseling and other creative activities like music, art, dance, drama etc. Being enrolled with a help group will also be helpful, if this can be found.

I’m rooting for you all the way and I assure you that there IS light inside this tunnel….not just at the end.

For those who have more questions on drug addiction, I reproduce below, a post I had made on the new face of drug addiction in Nigeria a few weeks back. Enjoy….

Many children hate cough syrup. Scratch that…they hate all medicines. However, there are some teenagers who take ten of bottles of cough syrup daily! Can their coughs be that bad? Could a doctor have prescribed all of that?

If you’re into pop culture, you may know that at parties, sometimes, these cough syrups, especially those containing codeine are added to drinks, to enhance the drinking experience L

And then we have those people who sniff glue. One would wonder if they love the smell that much or perhaps, it reminds them of something/someone pleasant?

Then there are those who inhale the fumes from soak away pits! Now you would consider that downright disgusting! What’s to like in the smell of poop?!

This is the new or perhaps, old face of drug addiction in Nigeria which is just getting a lot of face and air time now.

In the past couple of days and weeks, a lot has been said about drug abuse in Nigeria (codeine, tramadol etc) including bans et al. It is important that this conversation continues with great emphasis on control of ethical and prescription drug prescription. However, that’s one side of the problem – the supply side. However, the supply side exists because there is a demand for this. So, we need to take a look inwards to understand what drives the demand. When did our teenagers move from hating the smell and taste of drugs to ‘downing’ bottles daily? When did it become fashionable to sniff stuff? Who is most likely to be affected by this and what can you do if you discover this? This post will focus on prevention, treatment and enforcement.

First, why do people start taking these drugs? Codeine is an opiate drug which is addictive with potentially dangerous effects used for pain relief and also suppresses cough, which is why it’s found in prescription cough syrups. Pentazocine is another pain killer, originally thought to be non-addictive, but that has since been found to be a drug of addiction that affects mood and behavior. This drug is used for moderate to severe pain. A good number of people start using them first, because they were prescribed by a medical practitioner. Some users report that initially, they just liked how the drug took away the pain they were feeling (I’ve heard this a lot from sickle cell patients with bone crises) but when the pain reduced, they observed some other ‘great’ feelings they were experiencing like ‘euphoria’, ‘feeling good all over’, ‘no worries’, ‘relief for pain and the mind’ etc. Others do not have the excuse of pain. They have heard how good these drugs make one feel. Some conditions make people more at risk of this drug misuse and addiction. They include:

• Poverty
• Youth
• Unemployment
• Personal or family history of substance abuse
• Heavy tobacco use
• Stressful conditions
• History of depression and/or anxiety
• Previous history of alcohol misuse
• Regular contact with high-risk groups or environments

Why do these drugs make people feel this good? They depress the central nervous system leading to feelings of drowsiness and relaxation. They make the users sociable, euphoric and serene. For someone who is dealing with a lot of stress, these are desirable feelings making the users want to re-enact them again and again. The physical dependence that subsequently develop, lead to withdrawal symptoms when the drug is not taken. These symptoms include sweating and chills, irritability, abdominal discomfort etc. So, quite a number of users actually continue to use these drugs subsequently just because they do not want to experience these withdrawal symptoms – they can be quite severe.

Sniffing glue produces the same effect of depressing the central nervous system. For those who inhale fermented human waste, the fumes act as a hallucinogen causing change in perception and hallucinations.

How do we prevent this? When I say we, I mean all of us as a community of people either suffering from this, know people who are suffering from this or know people who are at risk of this. We all need to get involved.

For one, if you or someone you know has a prescription for these drugs, please have a long discussion with your doctor as to how to use, how long it should be used and what signs to look out for that might suggest dependence. I suspect the doctor will do this without prompting but as has always been my take on this page, you all have to be empowered with information about your health so you can make the best decisions for yourselves and your families. If the doctor does not provide the information, please ask. It is your right! While these drugs are still being used according to prescription, keep them out of the reach of children or indeed anyone who could misuse them.

If you’re a parent, are you providing adequate information and a safe home environment where your children can thrive in all ways? Are you comfortable discussing any issue with your children? Are you aware that if you’re not providing this education yourself, you’re probably allowing your teenager to learn from his friends and/or the internet…where he/she may very well be learning all the wrong things! Engage them in activities they are interested in like sports etc and encourage open discussions without judging.

To wean one off this, it’s usually best to get into a voluntary program for drug addiction where there will be a combination of clinical psychologists and psychiatrists. A long hard look at one’s life including unhealthy relationships, toxic home/family environment etc will be encouraged. The program will involve detoxification, exercise, counseling and other creative activities like music, art, dance, drama etc. Getting enrolled with a help group will also be helpful, if this can be found.

If you perhaps live in an area where none of the above can be readily achieved, you may have to go it alone…perhaps with the support of family. There are two options: cold turkey (where you stop completely at once and ride out the withdrawal symptoms) or where you stop gradually and you reduce the dose of drugs from 3 ampoules daily, to 2 and then 1 and then on alternate days until it’s completely tapered off. Please try!

Nothing good in life comes easy. One needs to work at this if one wants to be free and with all of us helping and pitching in to help, we should be able to arrest the demand side of this problem.

Stay drug-free y’all!

Q: Plssss I had an unprotected sex yesterday, though he didn’t release inside me, can I still get pregnant?

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, 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. And 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.

All the best!

Q: I am 9 weeks pregnant, but I don’t have appetite for food. I hate having sex, what can I do?

A: Early pregnancy can be a trying time for a number of women as they go through tiredness, breast tenderness, loss of appetite, nausea etc

Loss of appetite may be due to the nausea of early of early pregnancy where it appears the tummy cannot seem to keep anything down. If you feel nauseous, the following tips may help:

The standard teaching is to try eating some bland foods like Crackers biscuits or dry toast. That personally didn’t work for me. I preferred tart things…which some may want to avoid. I loved lemons during my pregnancies. They were the one thing guaranteed to ‘wake up’ my mouth and chase nausea far away. I also had a particular brand of very tart bubble gum, I indulged in grin emoticon These were key for me because, though I didn’t have the real bad case of morning sickness that sent you to the hospital, brushing my teeth in the morning always sent me into a bout of retching/vomiting. So, I always had a ready supply of the gum or lemon/lime to pop into my mouth once I was done brushing/retching! Not a very pleasant memory ;D

So, if lemons work for you to prevent nausea, go for it. Remember that moderation is key. A few drops (one or two) in a glass of water are enough to provide that tart kick that sends nausea far away. There is a catch here though…remember the heart burn associated with pregnancy. The acid content of lemon might make the heart burn and any pre-existing gastro-esophageal (stomach and esophagus/gullet) problems worse. So, this is all the more reason to be very moderate or stop if it exacerbates an already bad case of heart burn. Wherever and whenever in doubt, please be sure to see your doctor.
Other tips:
• Eat little amounts of food frequently as an empty tummy increases the likelihood of throwing up. Remember this is not an excuse to binge and over eat 😀
• Avoid fatty and greasy foods.
• Avoid smells that trigger nausea
• Cold foods may be preferable to hot as the former does not give off smells that may cause you to feel queasy.
• Get loads of fresh air and rest
• And drink sufficient fluids daily
Talking more generally, here are 5 general 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.
• Be sure to also take foods rich in iron eg and foods rich in folic acid eg green leafy veggies and beans. Folate prevents deformities of the spine.
• 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!

Although sex is considered safe during pregnancy not every woman wants to indulge Some women do experience increased libido, some decreased libido and some are just completely exhausted by their itinerary (wife, worker, sister, daughter, intending mother, worries about the pregnancy or intending birth, care of already existing children, if she has them etc) that sex is the farthest thing on their minds, most times. So, where’s the solution or compromise? Communication lines between couples have to be open. The husband needs to understand what’s going on in the mind and body of his wife. Providing emotional and tangible support by helping her out with some chores/activities, providing a daily evening massage….which becomes something wifey can look forward to, can help create the right mood. Remember that for women, sexual Intercourse starts from the emotional before it gets to the physical 😀 Couples can also explore other means of sexual intimacy apart from sexual intercourse.

For more on this, please click on this link https://chatwithdrketch.com/2018/04/17/hlwdk-daily-health-tips-pregnancy-worries/
Have a good night y’all 😀

Q: What can I eat to have a lovely skin?

A: Hi dear, thanks for writing in.

I will give you general tips for keeping your skin, nice and healthy.

Moisturise, mositurise and moisturise! Long hot showers/baths may sound very tempting but they dry out your skin. Opt for short showers. Immediately after you have a bath/shower (with cold or warm water as opposed to hot water), pat your skin dry…leaving some moisture still on it, and then apply moisturizer at this time. This locks in the moisture. Look for moisturisers that contain ingredients like isopropyl palmitate, propylene glycol linoleate, squalene, and glycerol stearate, jojoba oil, lanolin, glycerin, hyaluronic acid, sorbitol, propylene glycerol, urea, and lactic acid (Long list, aye :D). These ingredients provide the mix of keeping the skin soft, smooth and pliable and then also draw moisture from the atmosphere to the skin’s surface increasing hydration.

If you are prone to having cracks on your feet or hands, thicker moisturisers may be needed. Good old petroleum jelly is great and stops you from looking like the ‘paper white man/woman’:D. Have a good stock at home and also have small packs for your handbags, gym bags etc. Other thick moisturisers include cocoa butter, shea butter and beeswax.

Constant hand washing, especially with hot water could lead to very dry hands so make sure that you have your moisturiser handy so you can slather it on immediately after hand washing. You didn’t think we were going to advocate not washing your hands anymore, did you? 😀

Hydrating from the inside may not be a bad idea too. So drink at least 8 glasses of water and load up on foods like berries, nuts and fish (which are rich in Omega 3 fatty acids) and spinach. Stay off alcohol and caffeine as they lead to more water loss.

I hope this helps

All the best!

Q: Hi doc I have been on the injection for 2 years now. I came off it – main reason being that it made me bleed non-stop for eg when I am bleeding and I take the next injection, it stops and then the next month when it starts, it doesn’t stop until I get the next shot. The thing is I still have on and off periods even though I am not on it anymore. Is this normal? Because even when I came off it in May, I bled straight back until June – not heavy periods but panty liner amount and it’s on and off. It’s not so bad now but is this normal?

A: Family planning injections work by thickening mucous in the cervix, preventing sperm from getting into the womb (uterus) or by preventing the ovaries from releasing eggs every month (ovulation) and so the person taking the injections can’t get pregnant.

Taking these injections affect women differently. In the first few months, there be excessive bleeding during periods, followed by a period of lighter periods. This may yet be followed by a period of irregular or no periods especially in women who have taken these injections for up to a year. Irregular periods should be discussed with your doctor to ascertain the cause. It may be due to the drug or due to an infection which needs to be treated. Prolonged periods can also be treated.

When these injections are stopped, it takes a while for ovulation to be restored because these injections are long lasting. It can be as long as 2 to 3 months. In some other cases, this can last for about a year or even up to 2 years. This has nothing to do with the duration for which the injection was take and whether it is the 2 months’ or 3 months’ injection. In the same vein, because the effects of these injections range from 2 months to 3 months, depending on the one taken, then if there were side effects, one would have to bear them for that same period of time. This may very well be the case with you. If however, you are in doubt, please see your gynaecologist.

All the best!