chatwithketch

Been wanting to write on this, but Harvard Health blog beat me to it! Do you know that the hot air hand dryers in rest rooms may be spreading germs, while drying your hands? Ever wondered where the hot air inside it comes from? No? Oh dear! You should read this!

https://www.health.harvard.edu/blog/the-bacterial-horror-of-the-hot-air-hand-dryer-2018051113823

Q: Good morning doctor, 27weeks gone and I don’t want my baby to be big. Please can I take Lipton tea and zobo without sugar? Thanks Dr.

A: Zobo is a drink made from the Hibiscus flower. This drink is known by many other names depending on where you come from. Some popular names include Karkadi, Karkada, Zenaf, Sour tea, Roselle and of course, Zobo! There are many more names, by the way…but this post is not about the many names of Zobo.

Some people drink Zobo, because there is an assumption that it is a healthier alternative sugary, soft drinks. Well, it depends. If you prepare it with bottles of the sugary soft drinks you were trying to avoid ab initio, then maybe, it may not be so healthy, right? 😀

Again, some of the touted benefits of Hibiscus on hypertension, cholesterol levels, colds etc do not really have significant medical evidence to back them up.

However, it has been shown that taking Zobo with Acetaminophen (our regular Paracetamol) may lead to a situation where your body gets rid of the drug faster than it would have done ordinarily. This implies that in a short while the effect of the Paracetamol would have worn off and the person probably back with the ache.

There is not sufficient evidence to really confirm that zobo and a lot of other herbal drinks are safe in pregnancy. It has been suggested in some quarters that Hibiscus in excessive amounts could lead to menstruation leading to miscarriages in pregnant women. The evidence for or against this is not in great supply but it is probably a great idea to give it a miss during pregnancy. I would do so 😀

Tea contains caffeine. There are conflicting reports as to whether some amount of caffeine is beneficial in pregnancy (less than 200mg) or whether increased amounts are a problem > or more than 500mg). One regular teabag steeped in a small teacup has about 55mg of caffeine. So, it may be a good idea to limit your consumption of tea. Big babies are usually seen in women who

• Are diabetic.
• Have gestational Diabetes (Diabetes that is observed during pregnancy),
• Are obese
• Have had another big baby before
• Have had a lot of babies (from the 5^thpregnancy, the risk of big babies increase)
• Excessive weight gain during pregnancy
• Are older. From age 35 years, the risk of having a big baby increases
• Have pregnancies that are overdue. When a pregnancy is more than 2 weeks overdue, the chances of a big baby are increased

For women with big babies (fetal macrosomia), a vaginal delivery may not be a complete no no! However, your OBGYN will weigh the risk of that against your medical history and other pre-existing medical conditions. Potential complications include having genital tract tears during delivery, prolonged labour and rupture of the uterus. The babies may be born with a higher than normal blood sugar level and be prone to childhood obesity.

However, none of this needs to happen if you eat nutritious foods and watch your portions. You should also register in a good center under the care of a qualified obstetrician.

To prevent having a big baby, remember that feeding for 2 is a fad. You don’t really need to eat like a horse 😀 …you and your baby don’t need that much (an average of 12kg weight gain for 9 months…little over 1kg/month!); include some exercise (gentle stretches and walks, with your doctor’s knowledge and advice) and be sure that Diabetes is controlled, if you have this before pregnancy.

The link to my post on weight gain during pregnancy is included here to provide more information. https://chatwithdrketch.com/2013/12/02/daily-health-tips-eating-for-two/

So, for the remainder of your pregnancy, be sure to follow your doctor’s instruction on weight gain, medications etc. to the letter! Let’s share the good news when the baby is born.

All the best!

Q: I am having a problem with my penis every time I feel like having I always experience a bad pain to my penis and after ejaculates its even failing to get into its normal size not until I deep it into cold water what could be the problem please

A: Hi there! Thanks for writing in.

The condition you describe sounds like 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.

All the best!

Q: Hi doc I gave birth 25 days ago. I saw my menstruation and now it’s some yellowish discharge and it’s so smelly. Am I in trouble or what? And I’m breastfeeding.

A: ‘Bleeding’ after having a baby is normal whether you had an episiotomy or not. As the placenta separates from the uterus when the baby is born, the blood vessels where the placenta was attached start to bleed…understandably, because they are open 😀 They bleed into the uterus (womb). As the womb starts to contract, it seals up the blood vessels such that bleeding stops significantly.

So, the ‘bleeding’ after having a baby is a mixture of blood, bacteria and tissue that has sloughed off the uterus. This discharge is called lochia. In the first couple of days, there’s more blood in lochia giving it a bright red colour which eventually becomes more watery and pikish and eventually becomes yellowish/whitish. This whole process may last 2 to 4 weeks or may come and go, as in the case described above. So, it’s not really a problem 😀

Be sure to check the level of bleeding though and if you feel uncomfortable, please see your doctor. General rules of thumb that suggest there may be a problem are:

• If you’re bleeding heavily…perhaps you’re using a sanitary towel every hour for at least 2 hours or are passing out big clots.
  • If your lochia has a bad smell and you start having fever and chills
  • If your lochia is still bright red after 4 days of delivery.
  In your case with the bad smell, I strongly suggest that you go and see your doctor for a proper review. Better safe than sorry!

All the best!

What is heart failure? Want to know? Read this!

https://www.health.harvard.edu/healthbeat/what-are-the-symptoms-of-heart-failure

Some people crack their knuckles when they are nervous. Some others do it when they are angry. Others have no reason – they just do it! 🙂 Question is, ‘should you be doing it for any reason at all?’

Read!

https://www.health.harvard.edu/blog/knuckle-cracking-annoying-and-harmful-or-just-annoying-2018051413797

It’s yet another Mothers’ Day! Yep! The world can’t get enough of us….and you know what?! We absolutely deserve it 😀

And now, to a question that concerns mothers…..

Q: Is bleeding in early pregnancy normal?

A:  Bleeding during pregnancy can be worrying whether it’s a little or a lot. But, 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 🙂

Have a great week ahead y’all 😀

Q: Please I need help. I used Minoxidil for hair growth but has been having unbearable side effects such head pain, change of body color, etc. I have gone to different hospitals but still no solution. Please, I want to know whether I can get assistance from you in order to have a lasting solution, thanks

A: Hi dear. Thanks for writing in. Sorry to hear about the problems you are facing with your medication. For those who do not know, this medication is used for the treatment of hair loss like baldness. A quick refresher course before we go into the remedies for the side effects of the medication.

Baldness is excessive hair loss from the scalp. It usually starts from thinning hair before it involves wider areas of hair loss.

How does this happen? Usually, a hair follicle produces hair and each hair grows from a follicle for as long as three years before it is shed and a new one produced. Testosterone is produced normally by the hair follicle and these follicles now convert testosterone to Dihydrotestosterone (DHT). In baldness, the hair follicles are overly sensitive to the effects of DHT causing the hair to thin out and also last less than the usual 3 years.

Now it is usually assumed that being bald is a sign of great virility but studies have shown that this is not true. Bald people do not have more than normal amounts of male sex hormones, their hair follicles are just more sensitive to the effects of the hormones.

Baldness runs in families and may start as early as late teens in some people with most men at 6o years of age having experienced some level of hair loss. It is, of course, more traumatic when it happens at an early age.

Treatment runs from doing nothing (always an option :D), wearing wigs or styling hair in such a way as to cover the bald patch if possible to surgery where individual hair strands are transplanted. Other treatment options include the use of medications like Finasteride (which prevents conversion of testosterone to DHT thus allow the hair follicles to enlarge back to normal) and Minoxidil. It usually take about 4 months for any effect to be noticed, though. There are still issues surrounding the effects of these drugs on fertility. The drugs do not work for everyone and work for only as long as one keeps taking them.

Common side effects of Minoxidil include palpitations, headaches and chest pain, skin irritation, dryness and itchiness. Less common side effects include fatigue, dizziness, acne (pimples), dark spots around the eye and excessive hair growth. Rare side effects (which require an immediate and emergency doctor’s visit) include severe chest pain, dizziness and rashes, changes in vision, weight gain, swelling of face, feet, hands etc. Scary as all of these side effects sound, not everyone experiences them and that is why it is always best to be guided by your medical doctor in using medications.

For the colour changes, your doctor may reduce the strength of the formulation (%) or the frequency of use and s/he may stop the use of the drug completely if this continues. Analgesics may be prescribed for the headaches but for symptoms like dizziness, chest pain and allergies (itching, redness, dry skin), the drug may be completely stopped.

So, I suggest you visit a specialist/teaching hospital with your medication so that a doctor will review you and advise on the best course of action.

All the best J

To conclude our discourse of yesterday, I decided to take this question today.

Q: Thanks Doctor. Please what can I do to boost my blood pressure?

A: Your question is not clear. I’m not sure , if you’re inquiring about high poor low blood pressure 🙂

We’ll discuss both.

BP is the pressure with which blood pushes against your vessels as it passes through your body. A normal blood pressure allows blood to flow and deliver oxygen and food to different parts of the body.

We measure blood pressure with two numbers (ie, 124/84 mmHg). The first number is called the systolic blood pressure and the second is called the diastolic blood pressure. These two numbers are written as ‘systolic/diastolic’ followed by the unit of measurement.

Systolic blood pressure is your highest blood pressure measurement and is recorded when your heart contracts.

Diastolic blood pressure is your lowest blood pressure measurement and is recorded when your heart relaxes and fills with blood.

Low blood pressure is a blood pressure reading below 90/60mmHg. Though this is low, if it does not cause any problems, then it is not something to worry about. If, however, it is accompanied by symptoms like dizziness, light headedness, confusion, fainting etc then the low blood pressure becomes a cause for concern.

The ideal blood pressure is 120/70mmHg. Any figure between this and 140/90 is pre-hypertension and a call to action and lifestyle modifications.

• Reduce your risk generally by imbibing lifestyle modifications:

• Be physically active for 30 to 60 minutes on most days of the week. Try walking, biking, swimming, dancing or any other physical activity that you enjoy. Remember that even a little bit of physical activity is better than no activity at all.

• Eat a lot of fresh fruits and vegetables, low-fat dairy products and other foods low in fat and salt. Avoid fast foods, canned foods or foods that are bought prepared, as well as any foods where you can see the fat in them.

• If you drink more than two alcoholic drinks each day, drinking less will help to lower your blood pressure. A regular-sized bottle or can of beer or a regular-sized glass of wine are each equal to a single alcoholic drink.

• Keeping your body weight within a healthy range also prevents high blood pressure. If you are overweight, losing about 10 lbs (5 kg) will lower your blood pressure, and reducing your weight to within a healthy range will lower your blood pressure even more.

• It is important to stop smoking if you have high blood pressure. Smoking increases the risk of developing heart problems and other diseases. Ensuring that you live and work in places that are smoke-free is also important.

• Other lifestyle modifications include weight control, diet watch (portion control, use of less salt, using less oil in our foods and when we do use oil to focus on the heart healthy oils) etc

I hope this helps. Have a great weekend 🙂