chatwithketch

Q: Hello Dr, I have been having swollen legs since I traveled almost 17hrs by air. All tests been done, no fault discovered. What shall I do?

A: Hello dear, thanks for writing in.

Swelling of the legs and feet during flights is common and usually not suggestive of a more serious problem. It happens when blood pools in the leg veins due to long periods of inactivity as can occur during a long-haul flight. This swelling usually lasts for a few hours. If the swelling persists, occurs more in one leg and is associated with leg pain, please see your doctor immediately as it may be suggestive of a more serious problem, like a blood clot in the leg.

I repeat a post I made some years back on preparing for flights. It focuses on preventing the condition you already have. However, if you already have swollen legs due to pooling of blood as described above, rest, elevate and exercise your legs to reduce swelling. Exercise tips are given in the post below.

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Dear Diary, you’re probably the only one who really understands how very busy the past few days have been. So, as I race through Lagos traffic towards the airport, I’m actually looking forward to catching up on some much-needed sleep on the plane…

I know quite a number of people who tell me they can’t sleep when they are in a bus, on the plane or in a car. They can’t sleep when there is even a bit of noise, when the curtains are not drawn, when the lights are on or the lights are off! Different variations! Well none of these define me! Once I’m tired, I can sleep anywhere…in the middle of a room filled with noisy children, in a squashed cramped car on a long trip, in the squashed space of a bus, in the tiny economy space of local and international flights and I daresay I can sleep on top of a trailer filled with sacks (I haven’t had this dubious pleasure yet!). In fact, I rather look forward to these trips sometimes because it presents an opportunity to sleep undisturbed. Provided I am travelling alone and not with my family, I am sure that I am unlikely to be disturbed for bathroom breaks, hunger, any sort of telephone call or work emergency. Oh bliss! (Just in case you wondered, I totally, absolutely and completely love my family :D).

So that’s my story. If you’re like me, you would stock up on some good novels to read at some point (when you open your eyes briefly) but if not, you are dreading the 6 or 12 hours (or perhaps even more) flight.

So, plan for it. Whether you’re travelling first, business or economy class, you don’t have to be worn out when you arrive at your destination. If you’re travelling economy, enquire at the booking desk if the flight is full. If it’s not, you could get a seat with empty seats beside you. Almost like flying in business class….albeit devoid of the personal touch, but who cares, right 😉

Wear comfortable and loose-fitting clothes.  I’m consistently amazed by slay-queens who dress to the nines complete with high heels when travelling! I’m in awe! 😀

Get comfortable…take off your shoes and….nothing else, please :). This should help minimise discomfort especially if foot swelling occurs. Pressure stockings are also a good idea to help prevent this swelling.

Get a travel pillow…those U-shaped pillows they sell at the airports. They are pretty comfy and prevent you from getting a crick in your neck during that long flight.

Take walks round the cabin every hour or so to help circulation and stop you arriving at your destination with swollen legs/feet. You could use these walks to network and/or catch up with friends/colleagues/business associates who happen to be on the same flight.

For the sleepy heads like me, try some ankle rotation exercises during those small intervals when you are conscious 🙂

Lay off the coffee and alcohol. And drink a lot of water. Yes this may increase your visits to the bathrooms which you really don’t want, what with the long queues of people waiting to use them; but it is much better than getting dehydrated as the air in the cabin is pretty dry and could dehydrate you.

As for the food…perhaps you’re one of those who hate the ‘plastic’ food and laugh at the oyibo’s attempt at jollof rice (I’ve tried explaining to them that the art to cooking jollof rice is only in the gene of Nigerians and jambalaya is not even a close substitute! Please note that the study about the jollof rice-gene interaction has only been carried out in my head…so this is clearly proprietary material right here! :)), then you have no problem because you probably ignore the food. But you could stock up on some nuts (almonds, cashew nuts etc), granola bars, fruits and water to take with you. They are useful during those long lonely hours when you’re waiting for the flight to board and to take onto the plane if you’re going to ‘dis’ (code for disrespect, my son tells me) the food! It’s also most certainly cheaper and healthier than the over-priced airport food which you may be tempted to indulge in. However, if you’re going to indulge, you might want to book online and order the lower calorie options.

Pack some breath mints in your bag. There’s nothing as thoroughly embarrassing…no scratch that! There’s nothing as humiliating as trying to discuss with a business associate who you happened to meet on disembarking from the plane, while trying not to come too close because you know you’ve got morning breath! So be a boy scout! Be prepared!

If you’re, perhaps going for a conference, resist the urge to indulge in all that free food (close your eyes and visualise banquet tables groaning under the weight of all types of food: chocolate fountains, pasta, all kinds of gravy, pastries of different shades and colours, fish, chicken and beef dishes of all kinds!) and look for those healthier alternatives (fruits, salads…not soaked in dressing, quinoa, grilled fish, vegetables etc). Load up on all these…loads of beautiful colours on your plate!

You know all those free books they give you at the conference? Take only the ones you really mean to read. This way you’re not tempted to trash them at the airport when ‘they’ tell you, you’ve got excess luggage! This is becoming a huge ‘international’ joke!

I am actually on my way to a conference and so this advice is as much for you as it is for me! 😀

Have a good night, everyone 😀

Q: Good day Doc. please I put to bed 3 weeks ago. Just today I just find out that there is a fresh like boil coming out of my anus. If I push it in after using the toilet it will still come out. Please help me. I am so scared right now.

A: Thanks for writing in and congratulations on your baby! It does sound like you may have haemorrhoids. Piles, known as haemorrhoids in medical lingo are swollen veins in the anal canal. They can be internal, external or both internal and external can co-exist. Internal haemorrhoids occur when veins swell within the rectum and external haemorrhoids are found under the skin around the anus.

These haemorrhoids develop when there is undue pressure in the pelvic and anal area as can occur when people strain to pass faeces (if they have diarrhoea or are constipated), in pregnancy (especially the last 6 months), in obese people, people who eat diets low in fibre and people who practice anal intercourse. When women strain in labour, haemorrhoids can also be made worse.

It is important to consult your doctor to make a proper diagnosis.

In the meantime, limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) or washing with unscented soap to clean up after using the loo, sitting on a bowl of plain warm water for about 15 minutes about twice or three times per day, applying cold compress and not standing or sitting for too long. Some believe sprinkling some powder there helps…it doesn’t! Avoid it J

To prevent this, ensure that your diet has sufficient amounts of fruits and vegetables. Remember that if you take a regular flat plate, half of this should be filled with fruits and vegetables, half of the plate with complex carbohydrates and the last half with proteins.

Limit the time you spend sitting on the toilet seat (read your newspapers elsewhere :D), use the toilet as soon as you feel pressed (that way the fluid in the stool is not absorbed making the stool hard) and then don’t strain when you do go. Drink sufficient quantities of water daily, exercise (to keep everything moving along nicely :D). Use pain relief only under the supervision of your doctor, especially if you’re breastfeeding.

I hope this helps you.

Have a fab weekend, everyone 😀

‘Q. I get headaches after drinking red wine. Why?’    Want to know why? Then, click on this link:  http://www.health.harvard.edu/healthbeat/what-causes-red-wine-headaches

This article says,”If lack of energy has drained your sex life, there are ways to reignite the passion.”

Read: https://www.health.harvard.edu/mens-health/recharge-your-sexual-energy

Q: Good evening ma’am, God bless you for the job well done. Please I urgently need your help. I did IUD contraceptive method of family planning for about ten months now. Lately I started noticing overflowing and long days in my period and bloating in my stomach – looks as if I am pregnant. Please advise if to remove it or not. Thanks ma’am

A: There are two types of IUDs: the Paragard IUD and the Mirena IUD.

The Paragard IUD is a copper-containing IUD. 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. If your bleeding is this much, please see your doctor immediately
• 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’re not sure of the IUD you had inserted, please visit your healthcare provider to confirm. If your side effects are determined to be in the danger zone, the medical personnel at your family planning clinic will take urgent steps to remove the IUD if necessary.

Have a great evening, everyone 😀

Today is World Cancer Day with the theme, ‘We can. I can.’ The question being posed today is how everyone – as a collective or as individuals – can do their part to reduce the global burden of cancer.

I have heard people say that they don’t need to be screened. They feel if they get screened, the doctors must find something wrong with them! 😀 Honestly, much as we (doctors) would like to feel we’ve got a lot of powers, trust me, we do not manufacture cancer in people to amuse ourselves. There’s nothing remotely amusing about cancer, right? L

Then, I’ve heard others say, that if you know you’ve got cancer, then worrying about it will send one to an early grave even before the disease! Okay, this is one place where ignorance is not bliss! If one screens for cancer and this is caught early, treatment is possible and the person could live a long and healthy life. Our problem, especially in third world countries is that we do not screen early and so the disease is usually caught in the late stages when they would have spread to other organs.

A couple of years ago, we talked about the myths surrounding cancer and I repeat part of that post here because the issues raised are still very relevant.

We don’t need to talk about cancer: Some people think talking about cancer is like going around with a death wish. Not true. Not talking about it doesn’t make it disappear. We need to talk about super foods that can prevent cancer, screenings that can help detect it on time and of course, risky behaviours that lead to cancer (like the multiple sexual partners in cervical cancer)

There are no signs and symptoms of cancer: For many cancers there are noticeable signs…a lump here, change in the contour of the breast there etc. Early screening can certainly help detect these cancers early. There are people who have Health Insurance plans that cover annual medical checks with cancer screening and yet, never take advantage of these screenings. Are you one of those? L

There is nothing I can do about cancer: Absolutely not true! There’s a lot you can do! You can help spread the news of things that can help prevent it eg eating healthy, not using oil that has smoked etc. Then getting screened and advising others to do same, knowing our bodies and being quick to spot changes in colour, shape or contour of any part…which may or may not signify a cancer.

I don’t have the right to cancer care: You do have the right. In the third world countries, access to care is an issue but if we are careful to catch the cancer early, treatment may not be too extensive or expensive.

You can do something to reduce the burden of cancer. I can do something to reduce the burden of cancer. We all can do something to reduce the burden of cancer. So, let’s do something…today!

Have a great week ahead, people 😀

Tomorrow is World Cancer Day. So, I will dedicate this weekend to cancers.

Can your lifestyle contribute to cancer? Yes it can! Here are some tips to help you make the right choices.

Dos

• Eat healthy. More fruits and vegetables which are full of anti-oxidants which help protect the body against free radicals that lead to cancer. Eat less animal fats. Green leafy vegetables are rich in substances that are thought to protect against cancer of the mouth, esophagus, and stomach. These vegetables are also rich in folic acid which helps your body produce new cells and repair DNA, and is especially important for women of childbearing age because it can prevent neural tube (spinal cord) defects in a developing fetus . You get the most of these nutrients when the leaves are eaten raw or slightly cooked. So please don’t smother them in oil!!!

• Exercise as this helps you lose weight and reduces your risk of certain cancers like those of the breast, kidney and oesophagus.

• Garlic: Funny…but it could very well be the sulfur compounds causing that odor that also stop cancer-causing substances from forming in your body, speed DNA repair, and kill cancer cells :D…..talk about a stinky idea!! Garlic also battles bacteria, including H. pylori (the one connected to some ulcers and stomach cancer), and it reduces the risk of colon cancer. To get the most benefit, peel and chop the cloves and let them sit 15 to 20 minutes before cooking. That activates enzymes and releases the sulfur-containing compounds that have the most protective effect
  And…by the way, stick with the cloves, not the dietary supplement.

• Carrots: They contain beta-carotene, an antioxidant believed to protect cell membranes from toxin damage and slow the growth of cancer cells. They also deliver other vitamins and phytochemicals that might guard against cancers of the mouth, esophagus, and stomach. Some studies have suggested that cooked carrots supply more antioxidants than raw. If you’re cooking carrots, leave them whole while steaming or boiling, and cut them after they’re done. That reduces the loss of nutrients and gives them a sweeter taste as well.
• Whole Grains: They have a lot of fiber and contain other substances that might battle cancer. So stock up on 100% whole wheat bread (not white bread), ofada or brown rice as opposed to polished white rice and oats instead of sugary cereals.
• Strawberries: Berries are thought to protect against heart disease, memory decline and cancer. Strawberries are rich in antioxidants which are thought to destroy cancer-causing substances and slow the growth of tumors. Other types of berries like raspberries, blackberries, blueberries, and cranberries are also good sources of these anti-oxidants. They can be found fresh or frozen at big supermarkets in major cities. Studies have shown that eating fruit, including berries, probably decreases the risk of lung cancer and could prevent cancers of the mouth, esophagus, and stomach.
• And guess what? Breastfeeding is protective against cancers…one more reason to ensure that your baby gets this all important goodness 😀

Don’ts

• S Smoking is one avoidable lifestyle habit that increases your chances of a lot of diseases like cancer) of the mouth, throat, stomach and cervix high blood pressure etc. Even second-hand smoke (inhaling smoke from someone else who is smoking) has been implicated in lung cancer.

• Alcohol intake: Limit alcohol consumption to 2 drinks a day for men and 1 drink a day for women with at least 2 alcohol-free days per week. However, even these recommended amounts are still associated with significant health risks include cancer

• Red Meat and Animal Fat: Studies have shown that a diet high in animal fat increases the risk for several types of cancer, particularly colon cancer. Poultry and fish contain less fat than red meat, thus reducing the red meat in your diet may help to prevent cancer. A diet high in fat also is major cause of obesity, which is a risk factor for many types of cancer.

• Unsafe Sex: This has been implicated in cervical cancer. Unsafe sex can cause infection with the human papillomavirus (HPV), which can cause cancer of the cervix and is a risk factor for other types of cancer. HPV is a common sexually transmitted infection that is spread through sexual, skin-to-skin contact. There is a vaccine to prevent this cancer now. Please ask your doctor. HIV/AIDS is also associated with some types of cancers. Get screened regularly

There are vaccines to prevent some cancers like those of the cervix. You could also take the Hepatitis B vaccine to prevent long term damage to the liver and cancer.

More importantly, study, know and understand your body and be sure to notice any change(s) like change in skin colour, development of a lump etc.

Have a lovely day, folks 😀

Q: Good day Dr. Ketch, please my question is…what supplements can a nursing mother take to enable free flow of breast milk? Thanks

A: How can we help mum to establish or re-establish breastfeeding? To answer that I’ll reproduce part of a post I had made on this subject.

Mum needs loads of support from her medical team (be that the nurses that provide support for lactation or the doctor who does same). This support can range from teaching her how to latch baby on properly to the doctor prescribing medications that encourage milk production. Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

Effective breastfeeding requires loads of patience. You have to put baby to the breast as often as possible (at least every 3 hours) or failing that, use a breast pump to extract as much milk as possible. It is thought that some of the galactogogues ‘improve’ the taste of breast milk making the baby spend more time on the breast.

Remember that the sucking process/nipple stimulation encourages milk let-down. Being relaxed and thinking about you and your baby in a nice cozy environment, breastfeeding and bonding may also help this process along.

You may want to assume the regular position you used to adopt when baby was breastfeeding and ensure that baby gets skin to skin time with you. It may be easy for baby to immediately go back to breastfeeding, other times, it may take a while. You need to know when the baby is sucking and indeed whether he’s getting enough. Your baby should make at least six (6) wet nappies per day. If baby is not getting enough breast milk at the beginning of this process, you may have to supplement with formula. Use a cup and spoon to avoid nipple confusion.

Be sure that you are getting enough fluids yourself and eating nourishing foods.

For more on breastfeeding, please click on the links:

https://chatwithdrketch.com/2014/07/13/daily-health-tips-can-my-breast-milk-get-sour-if-i-dont-express-it-and-my-baby-refuses-to-feed/

https://chatwithdrketch.com/2014/09/12/daily-health-tips-im-a-breastfeeding-mother-who-just-developed-a-painful-lump-in-my-breast-could-it-be-cancer/

https://chatwithdrketch.com/2014/09/01/daily-health-tips-breastfeeding-challenges/

https://chatwithdrketch.com/2014/04/22/daily-health-tips-please-help-my-breasts-still-feel-engorged-though-i-stopped-breastfeeding-some-days-ago/

https://chatwithdrketch.com/2014/05/27/daily-health-tips-what-should-i-do-after-having-my-baby-if-my-breast-milk-doesnt-come-in-immediately/

All the best!

Have a good night and a fabulous weekend y’all 😀