chatwithketch

Q: Ma’am good evening. Please I need your help concerning my sister she as been in the hospital for a week now. Her complain is headache

A: Headaches refer to pain or ache anywhere on the head. They may be primary, in which case they are due to problems with the structures sensitive to pain in the head. Or they may be secondary in which case the pain is due to an underlying disease that causes the pain-sensitive structures in the head to be activated.

Common causes of primary headaches 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. 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.

Chronic daily headaches may be due to medication overuse. This would occur in people who use pain medications too often and then end up with rebound headaches…the exact condition they were trying to avoid. Moral of the story: Never abuse your medications J Use only as directed by your doctor.

Sex headaches: Yes, this can occur. It’s also known as post-coital headache, orgasmic headache etc. It could occur during sexual intercourse, during orgasm or after sexual intercourse. And it can also occur at any time of the day and during any type of sexual activity. It is felt at the back of the skull just above the neck and is usually described as throbbing. Or it could build up gradually during sexual intercourse and intensifies as the sexual excitement before an orgasm increases. They can last anything from a few minutes to a few hours; may never recur or may happen a couple more times before gradually fading away.

It is thought to be due to the release of adrenaline and rapid rise in blood pressure which occurs as one approaches orgasm. And so in these cases, the headaches may not be a cause for concern. However, it is also a possibility that these headaches are a sign of a more serious condition like bleeding onto the surface of the brain.
People who usually have migraines, who use recreational drugs like marijuana, use birth control pills etc are more likely to have sex headaches.

Should you swear off sex? Yes, if you’re unmarried  And no, if you’re married;) If you have just experienced this, try lying quietly for about an hour or two after taking an analgesic (like paracetamol) to handle the pain. However, it is very important to see your doctor as soon as possible to let him/her know what happened. This is important because, while there may very well not be any underlying issue, you want to be sure to rule out any serious medical condition causing these headaches. Your doctor will also prescribe some drugs on a regular or intermittent basis to deal with your symptoms.

Primary headaches may be triggered by stress, skipped meals and dehydration as noted above. However, they may also be associated with alcohol, foods that contain nitrates like spinach and bad posture.

Secondary headaches may be due to dental problems, hangovers  ear infections, blood clot in the brain, wearing tight gear on the head like hats or even wigs (yes, I see you ladies :D) or even eating cold stuff like ice creams etc.

So, what should you do? If you find that tight head gear or eating ice cream is the problem, see if stopping helps.

If you find that these headaches are now more frequent than usual, more severe than usual, stops you from going about your daily activities, is no longer responding to the over the counter medications you used to take etc, please see your doctor. If you have been seeing the same doctor, as it appears to be in this case, with no relief, please seek another opinion or request a review by a neurologist.

All the best.

Merry Christmas everyone! It’s Christmas morning. Just imagine…thousands of years ago, God made the decision to send His son down to earth just because of you and me. So today (and hopefully, hereafter), let’s celebrate the love, joy and peace that comes with knowing this. Let’s share this same love with our families and people all over the world.

And because I know we tend to over-indulge when celebrating this season, I reproduce a post that I think y’all will find helpful! 😀

Q: I want to stop sugar because I’m addicted. What can I do doctor?

A: Thanks for writing in. Don’t we all struggle with this???
I’ll reproduce here a post I had made on healthier alternatives/substitutes to foods we generally love which may not be so healthy. This includes sugary foods and those loaded with bad fats. Enjoy…

First, commit to reading labels in supermarkets. For all the foods that you will buy from shops, read the labels and be sure that they contain wholesome nutrients. Look out especially for trans fats, sugars, salt and lack of fiber. Avoid foods that have them…as much as you can!

Try these substitutions:
Substitute white rice with local rice like Ofada, Abakaliki rice or brown rice etc

While shopping for pasta (eg spaghetti, macaroni or the like), look out for whole grain pasta. It will be written on the pack.

Instead of buying white bread, go for whole wheat bread.,,noting that even wheat bread has a significant amount of salt. So, if you can lay off bread once in a while, please do 😀

Remember that just because it’s brown, it doesn’t necessarily mean it’s whole wheat. Ask the grocer/baker/whoever you’re buying from.

If you need a sugar fix, don’t get it from a pack of sugar-filled fruit juice, juice your own fruits or opt for fruit slices

You know those sugar filled cereals that tell you that it’s just honey and whatever else, read the pack, you’ll see how much sugar is in them…plus of course, the honey. Substitute with oatmeal or other whole grain cereals. If you hate oats, try this recipe for overnight oats I learnt while shooting my half hour show.

Overnight oats
Put some oats in a bowl, add some milk and unsweetened yoghurt. Cover with cling film and leave in the fridge overnight. In the morning, add some fruit slices (I like apple and banana slices), add a sprinkle of cinnamon and if you want a little bit more ‘sugar’, add a couple of raisins/currants/dried fruit. Mix it all up…tastes fabulous! 😀 Or you could just make your oats the way you make other cereals. Just pour on the milk (warm or cold, as you like it) in your bowl of oats and enjoy.

Stay off soft drinks/soda as much as you can. Substitute with water 😀 or sparkling water which has some drops of lemon in it or you can do same with still (regular) water.

Instead of red meat, go for chicken and fish.

Substitute butter for cooking with healthier oils like Olive oil.

Substitute butter on bread slices with healthier spreads like peanut butter or even mashed avocado pear.

Try shopping for reduced fat mayonnaise and salad dressings to take the place of the regular goods. You could also try balsamic vinegar as a dressing for salad.

In recipes that need sugar, you can significantly reduce sugar to be used by using some cinnamon, nutmeg or vanilla.

Blend up some fruits and add them to low fat, sugar-free yoghurt…and dare I say, use that as a substitute for ice cream??? 😀

Reduce salt intake by using other herbs and spices like ginger, garlic etc

Replace pounded yam with oatmeal and serve up different varieties of vegetable soups.

Remember that while making your stew, the oil should not be visible on top of the stew when you’re done cooking. If we can see it, it’s too much!

Okay! Now that I’ve done my good deed for the day, I’m off to enjoy to enjoy Christmas with my family! 😀

Merry Christmas to all of you! Love you to bits 😀

Q: Good evening Doc. Thanks for your advice etc. I gave birth at 38weeks through C -S because the water was flowing and there was no labour. The doctor refused to induce me. Thank God we are both okay. The first day, her eyes were bright but after a few days, her eyes became a little yellowish. I took her back to the hospital, they
ran full blood test on her and her blood was okay they also tested for jaundice,
which they said that they really didn’t detect, and her face and body
complexion is still normal. What could be the problem? She suckles well, she
cries well unless when she cries a long time, she tends to be weak. Please I
need your advice. God bless you ma’am

A: Hello dear. Congratulations on your new bundle of joy!

What could be the problem? It would appear that there is none…from what your baby’s doctors have told you 😀 Let me break it down for you though.

Jaundice is a condition in which there is yellowing of the eyes or the skin. It can happen in both children and adults. Usually, when old red blood cells are broken down, a yellow pigment, bilirubin is released as part of that process. The bilirubin is removed from the body through urine and stool. It is the bilirubin that gives rise to that yellow colour seen in jaundice.

Other symptoms of jaundice include deep yellow urine and pale stools.

In new born babies, there are two types of jaundice (neonatal jaundice) that can occur: Physiological jaundice and pathological jaundice.

Physiological jaundice occurs as a natural process of life. While in the uterus, the baby’s bilirubin is removed through the placenta. Once the baby is born, he/she has to handle this bilirubin business by himself/herself J (talk about responsibility immediately after touching down in planet earth!) because his organs are unable to deal with all the bilirubin released from breakdown of red blood cells. As the bilirubin accumulates in blood, jaundice results. Typically, this jaundice appears about 24hours after birth, actually gets worse until the 3^rd or 4^th day. It would usually have disappeared by the end of one or two weeks.

Pathological jaundice is due to a disease condition like infection, mother and baby’s blood groups not being compatible etc. This is typically present before 24 hours of birth.  Indeed, this is the main difference between the two types of jaundice. The one that occurs naturally is seen after 24 hours while the one due to disease is seen before 24 hours…rule of thumb 

Jaundice may be mild, disappearing on its own, especially physiologic jaundice. However, sometimes, the yellowness deepens, the baby may develop a high-pitched cry and/or develop arched back. These are dangerous signs and this child should be in a hospital. Indeed, if you observe jaundice in your baby after you have left the hospital, please get it checked out in the hospital just to be sure.  Most babies are able to deal with this excess bilirubin on their own without needing treatment. However, some other babies may be put under special lights called phototherapy or in more serious conditions, an exchange blood transfusion may be done (literally, this involves practically exchanging the baby’s bilirubin-filled blood with ‘new’ blood).

The main focus in jaundice is to bring down the level of the bilirubin. If this is not done, it could cross the blood/brain barrier and stain the brain leading to brain damage, a condition called Kernicterus.  More frequent feeding is usually suggested as this helps the baby get rid of more bilirubin.

So, from your description, it would appear your baby had physiological jaundice but is right as rain now! 😀 As I always say, whenever in doubt, please see your baby’s doctor for another consultation.

All the best.

Merry Christmas everyone 😀

‘If you snore at night, you’re in good company’.Perhaps not exactly what you wanted to hear, right? Want to know what it means? Click on this link: https://www.health.harvard.edu/diseases-and-conditions/is-snoring-always-a-sign-of-sleep-apnea

Q: During my first and second trimester, I used to have active sex, but not now anymore, since 8 months upward. During the earlier stage, I do use missionary position, and my hubby do sleep on me sometimes, hope it can have caused any issue for the baby ma’am? However, I don’t feel anything of such, but I am just thinking about the baby’s condition inside me. So that it won’t cause any deformity whatsoever. I’m disturbed whenever I think about those early active sex activities.

In addition, I have not used any folic acid since inception of the
pregnancy, may God forgive me. If at the
nine months now, that I am even expecting that I should have deliver, and have
not yet. Can I go for folic acid? Does it have any contribution anymore?

Thank you ma’am

A: Sex is generally considered safe during pregnancy. Except the doctor has noted some medical issues that may cause some restrictions on sexual intercourse, couples can generally continue to have sexual intercourse during pregnancy.

Having said that, it doesn’t mean that every woman wants to indulge 😀 Unfortunately, no. Some women 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 different positions or other means of sexual intimacy apart from sexual intercourse.

Some issues that may cause a doctor to issue some restrictions on sexual activity include:

·       Threat of a miscarriage

·       History of pre-term labour

·       Unexplained bleeding in pregnancy

·       Cervical incompetence (where the mouth of the womb is open leading to a risk of miscarriage) etc

If you’re not sure whether you belong to any of these groups or not, please ask your obstetrician.

Now, there also some risky activities during sexual intercourse in pregnancy:

·       If you indulge in oral sex, hubby please do not blow into your wife’s vagina as this can lead to an air bubble being lodged in a blood vessel causing problems in mother and/or baby

·       Having STI with an infected partner can lead to STI in pregnant mum. This infection can be transmitted to the baby. So, hubbies be sure that you stay faithful

·       Anal sex is also discouraged.

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, start taking them as soon as possible. Where in doubt, speak to your doctor.

All the best 😀

Q: Good morning Doctor. I have been a keen fan of your page, and I must confess, you are doing a great job. May God replenish you.

I want to ask medically, reason why I am yet to deliver my baby, which the
scan gave me EDD of first week of December. We are now running to the third week. Delivery had not taken
place. I only feel pressed sometimes, feeling that the baby is preparing to
come. (Amusile in yoruba). However, I am yet to see coming of water (omira).
When I was dissatisfied with this condition, I try to think back to when last I
saw my period. I was able to remember its April, meaning that December is possibly my 9th month not November as said by the test and scan.

I also want to know, can the scan be questionable as regard the month of a
pregnancy?

Can my own counting, since I saw my period last, be relied on and dispose
that of the scan result?

Lastly, what can be medically wrong Ma? Or is it normal to use up to
two-three weeks after the EDD given by the scan test, without delivery.

Please kindly give me detailed knowledge about this Ma. I will appreciate
it, and it would reduce my worries.

Thank you ma’am

A: Dating pregnancy is best done with the use of the last menstrual period. That is the first day of the woman’s last normal menstrual flow. However, if she is not sure of her dates, then a scan can be used. To date pregnancy, a first trimester scan gives the most appropriate approximation. The earlier it is, the more accurate it is likely to be.

In our part of the world, Nigeria, especially, people tend to think that pregnancy going beyond its due date is related to witchcraft or having run-ins with ‘bad’ people. I’d like to state unequivocally that this is not witchcraft 😀

Usually pregnancy lasts for 40 completed weeks plus or minus 2 weeks. This is usually through pregnancy dating using ultrasound scan in the first trimester. Generally though, from 37 weeks, your baby is good to be born…all things being equal. Therefore,, if a woman gets to 40 weeks without any sign of labour, she is tentatively given 2 more weeks, especially if there are no other risk factors present in the pregnancy. This is called watchful waiting and during this period, the baby’s kicks are counted, baby’s heartbeat is monitored and indeed, baby’s growth and other parameters are monitored. From the 41st week, if she does not spontaneously go into labour (without help), then there is a plan made for induction, having fully informed the woman of all possible scenarios. Some women do not like the idea of induction and so, having discussed with the medical team, may opt for a sweep of the membranes. This involves the separation of the membranes (the ‘bag’ in which the baby lies) from the lower part of the womb (uterus). This releases prostaglandins, which help stimulate labour.

When a pregnancy goes beyond the Expected Date of Delivery (EDD) which is 40 weeks, it is called a post-dated pregnancy. If the pregnancy lasts beyond 42 weeks, it is called post term.

It is not really clear why some pregnancies become post-dated but some associated risk factors include previous post dated pregnancy, first pregnancies, mothers with high BMI and advanced age.

The main challenge with allowing a baby to remain in the womb beyond the 42nd week is that of the placenta no longer being able to supply sufficient amounts of oxygen to the baby. This can lead to brain damage or even death of the baby. The second issue is the threat of the baby having its first poop inside the womb and then aspirating (breathing in) same.

So, have a long chat with your medical team and discuss options available and the ones you are comfortable with.

All the best! Let’s know when the baby is born! Lots of love and hugs.

Have a good night, people 😀

Do you need a special diet while on thyroid hormone medication? This Harvard article says, ‘Limit foods high in soy protein, because large amounts of soy might interfere with the absorption of thyroid hormone’. Want to know more? Please click on this link: https://www.health.harvard.edu/healthbeat/healthy-eating-for-a-healty-thyroid

Q: Good day doc, how long does one need to wait after a CS before trying for another baby? Thank you sir.

A: Thanks for writing in. This is a common question amongst women who have had a Caesarian Section. How soon can I get pregnant again? This is an especially important question as the argument about how much time the body needs to heal rages. It only makes sense that the longer the body is allowed to heal, the better the wound healing. Different schools of opinion exist from 6 months to 1 year to at least 2 years. However, generally, a gap of 6 months is considered fair to have given the body sufficient time to heal.

Can you deliver normally? I prefer to ask, ‘can you deliver vaginally? There is nothing abnormal about having a baby through Caesarian Section. You’re as normal as the woman next door and you feel the same maternal urge as she does…maybe, even more 😀 It’s because we think C-section is abnormal that women who would benefit from this procedure turn it down and then end up dying because they wanted to do it ‘normally’! We need to change this mind set! For women who think ladies who had C-section are lesser mortals than them because they had a vaginal delivery, try cutting up yourself with a knife and then sewing it back up and you would know who’s more super-human! By the way, just in case you wondered, I’m not taking it personal because I had a C-section. I had all three of my children vaginally but would most certainly have opted for a C-section if I was advised to do so. But I digress….

So, can you deliver vaginally? This is possible. Your chances of a successful VBAC increase if:

• You’ve had a previous successful vaginal delivery
• You and baby are healthy with pregnancy progressing normally
• You’ve had only previous Caesarian Section with a low transverse incision on the uterus (womb)
• Spontaneous onset of labour on or before the your EDD

Now, these are general rules of thumb. Your specific medical history may be different, requiring a different approach. So, be sure to discuss the options open to you with your doctor.

And please, remember to discuss contraception/family planning options with your doctor during your 6 weeks appointment if you’ve had a baby. I’ve had quite a number of people writing in to ask if breast feeding protects against pregnancy and if it was possible for them to get pregnant even before their periods return or if it was safe to breastfeed a baby while pregnant (The answers by the way, are yes to getting pregnant while breastfeeding, yes to possibility of getting pregnant before periods return and yes to breastfeeding while pregnant); this means that there are probably a couple of people getting pregnant earlier than they had planned. Let’s take the right decisions.
Don’t forget to visit my blog, http://www.chatwithdrketch.com to search for any health/wellness topic you want information on. If you can’t find the answer you need, bring it here 😀

Have a great week ahead, y’all 😀

Q: Hello Doc, how are you doing? Kudos to you for the way you help people with various issues. Please Doc I would need your help in tackling my issue. I gave birth to my 1st child 3 weeks ago and unfortunately we lost her the next day. it was a natural birth…..it was really devastating but I am strong
now. My hubby and I would like to try again and I don’t know how soon we can
begin the process. Thank you ma’am and looking forward to hearing from you. God
bless

A: Condolences on the loss of your baby! I can’t imagine what it must have felt like going through this experience! I’m glad you feel much better and I’m rooting for you! By His grace, you will soon have a precious bundle of joy in your arms J

There are no standard answers really, as to when to start. Some doctors still advice people to wait 3 to 6 months before trying again so that it’s easier to date the pregnancy etc. Others will just ask you to wait until you’ve had one menstrual period. Be sure to ask your doctor to explain the reason for any recommendation he eventually comes up with so that you understand every step of the process.

What to do before you start trying again? Be sure to eat healthy…lots of fruits and vegetables and exercise. Limit caffeine and keep your weight within normal limits. You can start taking folic acid supplements now, even before you get pregnant.

The basic rules of trying to get pregnant also apply: make sure you have sexual intercourse at least 3 times a week (with ejaculation of a significant quantity of semen).

It is normal to feel worried and a bit scared going into another pregnancy, but you have to trust that all will work out well this time. Surround yourself with good professionals (OBGYN) and loving family/friends. Then relax and enjoy the ride J

Please write in anytime and let me know if there are other questions you have.

Have a great night y’all 😀