chatwithketch

Q: Good evening doctor. Please I want to ask, can a breastfeeding (exclusive) mother take emergency contraceptive ?

A: Well, a breastfeeding mother should definitely not be taking any medication without speaking to her doctor. That’s for sure! 😀 This is because drugs that you take will also end up in breast milk. Most times, the concentration of these drugs in breast milk is so small that it hardly causes any problems in the baby but in some instances, the drug could get very concentrated in breast milk, putting the baby at risk. So, all drug choices, be they contraceptives or otherwise, must pass through your doctor.

A very common question I get asked is if breastfeeding mums can get pregnant. The answer is yes. If you’re exclusively breastfeeding, feeding your baby on demand (every 4 hours), you’re within 6 months of your baby’s birth and your menstrual period has not returned after the birth of your baby, you stand a better chance of not getting pregnant during this period. However, this is not a reliable method.

Birth control pills can help prevent pregnancy at this time. Pills that contain estrogen can lead to reduction in breast milk supply (and yes, combination pills contain estrogen). So, it’s a good idea to avoid such pills at this time. Pills that contain only progestin (like the minipill or progestin-only emergency contraceptive pills) are better options, as they do not affect breast milk supply. It’s usually taken at the same time daily. It’s best to start this discussion before you have your baby or immediately after so that your doctor can advise as to when you should start taking the pills, if at all.

Barrier contraceptives like condoms, diaphragms etc can also serve the purpose of preventing pregnancy at this time.

There are, of course, other methods of birth control available eg Intra Uterine Device (IUD), implants, patches etc also exist and you may want to discuss these other options with your doctor as you conclude breastfeeding.

Have a great evening 😀

https://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol

Q: My seven years daughter has multiple teeth. Is there any solution? I can’t help it

A: Children start losing their baby teeth from 5 to 7 years, but some could start the process earlier and some later 😀 In some cases, as appears to be happening here, the baby teeth have not gone before the permanent teeth come out. Oftentimes, these permanent teeth would grow in behind the temporary teeth (shark teeth). What’s the solution? The temporary teeth may eventually fall out on their own (as happened in my son’s and daughter’s case) or may need to be extracted by the dentist if they ‘refuse’ to fall off. So, there are no drugs for this 😀 Indeed, you don’t want to stop that tooth from growing…it is one of the permanent teeth which your baby needs. Remember that your baby should visit the dentist at least twice a year…it is never too early to start 😀

Have a great week ahead!

Did you know that research shows that one out of every five people do not wash their hands after using the toilet. Then, 40% of people wash their hands for less than 10 seconds…and yet, you need at least 20 seconds to get your hands all squeaky clean! Finally, men are twice as likely not to wash their hands with soap or hand wash! Oh dear, just think about all the people we shake hands with, trusting and hoping that their hands are clean!

Diseases like respiratory infections and diarrhea cause up to 20 percent of the burden of disease in children. It has been found that in places where hand washing was instituted, this burden of disease has been cut by about 50%. This is a huge number…from hand washing alone! In hospitals, it was also found that the spread of hospital-acquired infections was encouraged by lack of hand washing and so WHO instituted a global campaign for health workers clearly specifying when hands have to be washed.

So, practical lessons: mums wash your hands before you make your baby’s/family’s food, after you change baby’s diaper, after you blow your nose, after cleaning etc. Ensure that people don’t come in from the market (or wherever) and head straight to pick up your baby and kiss your baby…no matter how well meaning their gestures might be. Encourage them to wash their hands before they do so…or you could buy a hand sanitizer and get them to use it on their hands before picking up your precious bundle of joy. It may be awkward when you start off insisting on these, but pretty soon everyone gets used to it…trust me, I know from personal experience 😀 (I probably got away with more because my in-laws probably just thought I was a weird Okoro girl). Tips: remember that sanitizers are only useful for hands that are not visibly dirty. For visibly dirty hands, you’ve got to wash! Also remember that when choosing the sanitizer, look for products that have up to 60 percent alcohol and ensure that when you use it, you rub until your hands are dry.

We should ensure that we teach children and indeed remind ourselves to wash hands after playing or doing stuff outside the house, before eating, after using the toilet, after playing with pets or disposing of their wastes (in fact children should not be encouraged to play too close to their kennels or sheds), before cooking and even after handling dirty laundry! The list is endless…but that’s also because the possible means of contaminating our hands are endless and the germs find easy routes into the body once we touch our hands, mouths, eyes etc. So we can’t be too careful…and just in case you wondered, ‘no, you don’t have to wear a face mask like dear Michael Jackson and/or gloves all the time’ to protect you from the many germs that exist! 😀 That might be…well, for want of a better word, perhaps just a teensy weensy bit extreme! 😀

Finally, remember that hand washing, to be done right, has to be with soap! If you haven’t washed with soap, you haven’t really done much. Tips for effective hand washing: wet your hands with water, apply soap, then scrub thoroughly paying attention to your nail beds, in between fingers, palms and back of hands. Then rinse thoroughly before drying your hands.

Well, if you’re one of those who do not wash your hands after using the bathroom/toilet, let’s encourage you to start washing today.

Enjoy the rest of your day, y’all 😀

Q1: Can Postinor stop an occurrence of pregnancy if taken within two hours of the sperm entering one’s vagina?

Q2: Please I need advice on how Postinor should be taken to avoid pregnancy? Also any other anti pregnancy drug you can recommend will be highly appreciated.

The morning after pill which can be taken within 72 hours (some can be taken within 5 days) of unprotected intercourse, can help prevent pregnancy.

Remember though, the simple ABC that guides these affairs. The first is 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. And of course, 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.

Contraception is a good option but the answer to proper contraception is not popping a pill in panic whenever you happen to have sexual intercourse. Emergency contraceptives have their place but they are not meant to take the place of regular contraceptives, as they are less effective than the regular ones. Regular use of these emergency contraceptives may cause your periods to become irregular and unpredictable. I’m sure you don’t want to have this problem J You might want to visit your nearest family planning clinic for options which can work for you.

Have a great weekend, everyone 😀

Q: Dr. please what’s the cause of blood coming out of a female vaginal as a discharge when she is not menstruating?

A: Hi dear, thanks for writing in.

My first question would be, ‘how do you know it’s not a period?’ Irregular periods may be hard to track.

A ‘regular’ menstrual cycle is supposedly one in which the cycle (the length of time from the 1st day of a menstrual period to the first day of the next menstrual period) is about 28 days but there is nothing abnormal about cycles that fall outside of this range. It could range from about 24 days to 34 days with ovulation happening at mid cycle. Indeed, in some women each period appears to have a different cycle. For young girls who have just started menstruating, skipped or irregular periods may occur.
What do people refer to as irregular periods? Well, if the time between each period changes, or the length of days of the period changes or indeed when the quantity of blood lost during each period changes, the period is termed irregular. What can cause these changes? They include:

• Changes in hormone levels, as is common in the puberty period or menopausal period.
• Stress
• Excessive weight loss or excessive weight gain
• Fibroids
• Problems with the thyroid (hyperthyroidism)
• Polycystic Ovary Disease (PCOD)
• Scarring from previous surgery in the uterus
• Pregnancy cannot be overlooked as a cause of irregular bleeding and has to be checked out.
• Breast-feeding mothers may also experience irregular periods as the hormones released may delay return of menstruation. Remember, however, that this is not an effective means of contraception.
• Cancer of the cervix or uterus.
• Sexually Transmitted infections
• Recent instrumentation like a Dilatation and Curettage (D and C)
• Injury to the vagina eg through rough sex

So, it’s always a good idea to keep a record of your periods: length of cycles, number of days the period lasts, presence of pain etc. If you keep a chart of this over time, you would be able to know what is normal for you.

Treatment of irregular periods depends on cause: fibroids, PCOD, hyperthyroidism all have to be treated. If irregularity is due to stress, learning coping mechanisms or relaxation techniques may help. Reduce weight or go easy on your exercise routine, if weight issues are a problem.

However, be sure to see your doctor if your period is consistently below 21 days or more than 35 days, if you menstruate for longer than one week, still believe that the bleeding is between periods or experience severe cramps.

For related topics, please click on https://chatwithdrketch.com/2014/06/27/daily-health-tips-why-do-i-have-scanty-periods/

https://chatwithdrketch.com/2014/05/29/daily-health-tips-are-there-other-treatment-methods-for-fibroids-other-than-surgery/

Have a good evening, y’all 😀

Q: Good evening Dr. Please I have been having constant boil in my armpit. Please can I know the reasons? A: Hi dear, thanks for writing in. Sorry to hear about your challenge.

Pain and swelling in the underarm (which is how a boil would appear) can be very uncomfortable.

There are a couple of things that can trigger these:

• Deodorants: These can cause skin irritation which can lead to boils. The delicate and sensitive skin of the underarms and the sweat that can accumulate there making it a rich culture medium for germs are factors that have been implicated. Solution: You may have to try another one…find one without fragrance or perhaps, formulated for sensitive skin. Reading the labels will provide this information

• Shaving: A lot of people can identify with this…bumps in the underarm after shaving. This can happen if you do not shave properly. Try shaving after taking a bath when the hair is moist and the skin hydrated. If this does not suffice, you may have to find alternative means of removing underarm hair eg depilatory cream.

• Infection of the hair follicles from cuts or injuries to the underarm, or from friction caused by wearing tight clothing. So, be careful while shaving and try to wear clothes that are more loose fitting (especially under the arms) and/or focus on fabrics that can ‘breathe’ like cotton

• Dirt or debris from excessive sweating can clog up hair follicles leading to painful lumps. Personal hygiene is key. Don’t be miserly with bathing and be sure to ‘take care’ of the underarms and other areas like the groin that tend to accumulate sweat and raise a stink • Infections due to viruses or bacteria.

• Cancer of the breast may also present like this. I hope this helps. If none of these solutions help, please see your doctor.

Fingers crossed, it’s nothing more serious 😀

For related posts, please click on https://chatwithdrketch.com/2015/02/06/daily-health-tips-how-can-i-prevent-rashes-after-a-shave/ https://chatwithdrketch.com/2014/07/14/daily-health-tips-how-do-i-get-rid-of-excessive-facial-hair/

Daily Health Tip: Dark under arms

Have a great night, y’all 😀

Q: Good day Dr, please this my room mate is having stomach problem and we went for a test and they said he’s having hernia and we are still in school now without any cash. Please, madam is there any tablet or injections for him before we will be travelling home?

A: Hernia is the protrusion of an organ through a defect (like a hole or opening) in the wall of the muscle or cavity which usually holds it in place. There are different types hernias (or herniae) and they include:

Inguinal hernia: The most common type of hernia. It usually happens in situations where the pressure inside the abdomen is increased.

Other hernias include incisional hernia (where a protrusion develops from the site of a previous surgery, especially abdominal surgery), femoral hernia (which has the same risk factors as inguinal), umbilical hernia (common in black children where the umbilicus, aka navel does not form a small ‘button’ on the abdominal wall but protrudes) and hiatal hernia (where the stomach squeezes through a hole meant for the oesophagus (the pipe through which food gets to the stomach).

Typically, all hernias are caused by a weakness in the wall of muscles or containing cavities and an increase in pressure. Examples of activities that increase pressure in the abdomen are long-standing cough or frequent sneezing, carrying heavy loads regularly, straining at stool whether due to constipation or diarrhea etc. The walls of muscles are usually weakened in people who are obese, pregnant women, smokers and malnourished people. It is also more common in men and as people grow older.

What are the symptoms? People with hernia would usually notice a protrusion after a strain eg lifting something heavy or coughing. Sometimes, they are able to push it back. Other times they are not. The worry about hernia and the reason why they have to be treated quickly is that they may strangulate. Yes, just think about the word strangle and you understand what strangulate means J The protrusion may become squeezed by the opening through which it passes blocking off blood supply to the area protruding. Once a part of the body is deprived of blood, it dies. We don’t want that to happen!

The decision as to whether to go for surgery or not depends on where the hernia is located (inguinal and femoral hernias usually need surgery), the contents of the hernia sac and the symptoms. A truss (a supportive device that prevents enlargement of a hernia) may be prescribed by your doctor to help for a short period of time. Typically a doctor will schedule a surgery to repair a hernia. Complaints of pain in a hernia patient may mean strangulation, which need to be dealt with immediately. Umbilical hernia does not usually require surgery as the protrusions usually ‘return’ on their own. If this persists beyond 5 years, then surgery may be needed.

If you do require surgery, you don’t need to fret about it…really. This is not major surgery…it’s intermediate (sort of like half way between minor and major :D). Your doctor will provide answers to all the questions you have and of course, counseling. There are options for laparoscopic surgery which is surgery done through small incisions guided by a camera.

Preventive measures include having a healthy weight, giving up smoking, treating conditions that may lead to long standing coughs, eating healthy to prevent straining at stool etc. These are the self-help options available to you now. I am worried though, about the possibility of strangulation. I suggest that you go to a Government hospital. Consultation fee will be moderate and a doctor will give you a proper diagnosis after examining you.

All the best!

Have a good evening, everyone 😀