chatwithketch

Food cravings and aversions: I certainly had loads of aversions with my first pregnancy. I can’t remember any cravings as I couldn’t get any food to stay down. However, some people develop a craving for the oddest, craziest foods when pregnant. Go easy on eating for two though…the healthy living dictum of eating loads of fruits/vegetables and low calories does not change during pregnancy. The more you gorge or give in to the food cravings, the more work you have to do to get it off after the baby. However, if you find yourself craving things like clay, sand etc, please see your doctor as it could be a sign of iron deficiency anaemia.

For more on pregnancy, diet and so much more, get your copy of the book, ‘Just For The Health Of It’

This is a great read and a fabulous gift to loved ones. It is a great gift for anyone who wishes to live and eat healthy, lose weight, get ready for pregnancy and parenting. Buy copies for bridal showers, baby showers, festive seasons etc. It’s a gift that keeps on giving

Here’s what someone said after receiving it as a gift:

‘Good morning, Dr Ketch. I was given your book (Just For The Health Of It) as a Christmas gift by a friend of mine. I’m so happy. God bless you’

Make yourself and someone else happy by getting a copy from any of the following outlets:

1) Laterna Books online shop with nationwide delivery. Just click on this link: https://www.laternabooks.com/laterna_product_details.php?v=15450&c=44

2) Another option for those in Lagos is Laterna Bookshop on 13, Oko-Awo Close, Off Adetokunbo Ademola Street,. Victoria Island. 

3) If you’re outside the country, please visit Amazon through this link http://www.amazon.com/Just-Health-Ketch-Pregnancy-Parenting/dp/9789398026/ref=sr_1_1?s=books&ie=UTF8&qid=1426246647&sr=1-1&keywords=just+for+the+health+of+it+with+dr+ketch+olalere+nkechi

For those in Abuja and environs, please call 07030739403 or pick it up at No 5 Bricks Market, Dawaki 11 Market, Dawaki extension.

4) For those in Awka, please call 08189944090.

Have a great week ahead, y’all

Q: Dr. please help me out. I have issue with hormonal imbalance. What should I do?

A: A collection of tissues called the endocrine system is responsible for the production of hormones, which control various functions in the body like metabolism, sexual reproduction, mood etc. Sometimes, these hormones are produced in excessive or too little amounts throwing the whole body off.

Treatment of hormonal imbalance is dependent on the cause. Excess weight can lead to high estrogen levels. So, exercise and weight loss can be beneficial here. High levels of thyroid hormones can be treated with drugs, radioactive iodine or surgery. The stress hormone, cortisol is produced when one is stressed and so treatment is focused on stress management techniques. The hormone, prolactin which is responsible for lactation in nursing mothers may be produced even when one is not lactating. Focus here is on reducing this hormone levels as will be described below.

Therefore, the first thing that needs to be done now is for your doctor has to investigate to find out the exact cause of the imbalance and then treat accordingly.

All the best!

Q: Good morning ma’am, I do feel severe pains during my period. Please ma’am, what can I use to stop or reduce the pains? Tanks for your care ma’am.

A: Menstrual cramps can take the very joy out of living…at the time you have them.

Cramps usually occur as the uterus tries to get rid of the foreign body, in this case, blood within it. Cramps appear, sometimes, to be more of an issue for some girls than the actual menstruation itself. For most girls, in the first few years of starting their periods, they usually do not have cramps and when these cramps eventually start showing up, they usually last for a few days.

How do we relieve menstrual pain?

Anticipate the pain before it actually arrives by taking some analgesics in the same class as ibuprofen called NSAIDs. These drugs have to be taken with food because they can cause peptic ulcer and so it is important NEVER to start using them without confirming from your doctor that this is fine for you.

Avoid foods that contain caffeine, salty foods, alcohol, smoking and sugary foods. You’ve probably heard the story about alcohol being a great idea during periods…I’m just not sure whether it’s meant to put you in a stupor so you don’t really feel the pain or for some other reason. I can tell you though that it helps you none, during your period Focus on complex carbohydrates during this period (and other times too: whole grains, fruits and vegetables)

Rest up when you need it and you could also use a hot water bottle on your lower abdomen.

Drinking warm fluids and exercising are also very helpful.

Remember to maintain the greatest sense of hygiene during this period (bath at least twice, change sanitary towels and panties often and ensure you smell nice….just don’t pour the whole bottle of perfume over yourself. That makes it smell like you’ve got a secret you’re hiding :D)

Usually after having had a baby, the cramps from period totally disappear or reduce significantly. In other instances though, it may be a good idea to see your doctor as fibroids and some other conditions can make menstrual cramps really painful and heavy.

If self-help remedies do not work, please see your doctor to get checked out and rule out other causes of severe menstrual pain like endometriosis, a situation where some tissue of the womb/uterus grow outside of the uterus or fibroids.

Have a good night y’all 😀

Q: Thanks for this Doc but is it not too early for a 12year old to start menstruating?

Very good question. The post below, which I made a while ago, should answer your question.

Q: Good day sir. Please sir is there anything someone should do for a child of 8 years who has started developing breast. Thanks

A: Okay….first of all, I’m not a sir 😀 And then, what to do? Nothing! Not very helpful, aye?

Before I launch into the gist proper, please don’t also listen to the old school gist of how it may be that some boys are taking undue liberties with her and thus, she’s developing her breast faster than her mates. It has nothing to do with that! By all means, ensure that undue liberties are not being taken but don’t blame the ‘breast buds’ on that 😀

The thing is, there are various shades of normal when it comes to children. Puberty, generally for girls, can occur any time between 8 to 13 years. There are people who experience what is called precocious puberty and would experience the signs of puberty earlier than other children. There may be nothing wrong with these children…they may just be on the very early side of normal 😀 But, if a child starts experiencing puberty before the age of 7, please be sure to see take her in to see the doctor.

The first sign of puberty in girls is what your daughter is experiencing: breast development which starts off as lumps which may be tender around the nipple area. Other signs to follow include growing pubic hairs, widening of the hips, onset of menstruation etc.

Please make this period as trauma-free as possible. Worrying about her breasts ‘coming out too soon’ may make her self-conscious about it and the whole process of shopping for bras with her which ought to be a fun thing, becomes a nightmare! 😀 My experience was actually a nightmare! My mum (very educated medical doctor) would try on the band of the bra on top of whatever dress I happened to be wearing whenever we went shopping for bras….I almost died several times over 😀 (sorry mum!) Why on earth would she want to advertise that I wear bras to the whole world?! As if the world couldn’t see?

And so, with my children, I’m more sensitive. If they don’t want to call it a bra and prefer to call the real bras, bra tops…I’m happy to call it that 😀 When we’re done buying, I have to carry the goodies to the checkout counter…heaven forbid that anyone suspects that they wear such horrible contraptions as bras!!! Same for when we go shopping for sanitary towels 😀 Okay, enough said. They’ll probably not talk to me for a year when they see that I posted about this 😀
So, dear mum, I trust that you have had the talk with your daughter? Before puberty starts would have been a good time. If you failed to do this earlier, now is a good a time as any. Remember to go for facts rather than fiction. That whole gist about getting pregnant when a boy touches you went out with the dark ages. Keep the gist matter of fact and be sure to use real names of body parts 😀 In addition, whatever you do, be available and approachable…your daughter needs you now, more than ever!

I hope this helps.

Like a friend said to me recently, it’s Friday eve! Enjoy!!!

Q: Good day Dr. Ketch, I am in my early month of pregnancy and is finding it difficult to pass stool. Please help.

A: Welcome to the land of pregnancy and raging hormones!!! This is going to be an interesting period in your life and your hormones are going to act up in different ways.

Constipation is common in pregnancy and is due to the hormones of pregnancy, which make the muscles of your digestive tract work in a more leisurely manner. This ensures that food stays longer in the tract, more nutrients are absorbed from it (so that more nutrients can go to baby) but also more water is absorbed from it, leaving the poop hard and constipated. The iron-containing pre-natal drugs may also contribute to this but you do have to take them ;D

Tips to help you deal with the constipation include:

• Adding more fruits and veggies to meals.
• Eating small quantities at a time. You could try to aim for 5 small meals (breakfast, lunch dinner and 2 snacks in between) per day containing fruits, Veggies, complex carbs and proteins. Snacks can be a handful of nuts, etc
• Drink sufficient amounts of water. At least 8 glasses. Remember that this depends on your activity and weather condition. If you find yourself in a hot environment where you’re sweating a lot, by all means drink some more.
• Some activity is also useful in getting things ‘down there’ to move along 😀 Remember to check with your doctor, what activities are safe for you to undertake when pregnant.
• Yoghurt with probiotics is also a great idea and helps the stomach bacteria break down the food and more importantly, keep it moving along.

For more symptoms of pregnancy and the red flags, please click on the link below:

https://chatwithdrketch.com/2013/10/26/baby-in-the-tummy-its-all-up-to-mummy-is-it/

Have a fabulous week, people 😀

Q: Good evening ma’am. Please ma’am,  I want to ask a question. What could be the cause of stooling light blood and it smells so bad? And whenever I use the toilet, I feel pain in my anus. Please, I need an urgent reply ma’am. Thanks

A: Hello! Thanks for writing in.

The first question I have for you is whether the blood is bright red or altered (almost brownish/black)? If it’s bright red, it is likely coming from the anus or somewhere close by. If it’s altered blood, it’s likely coming from higher up in the digestive system eg bleeding from a peptic ulcer. You should see your doctor immediately, if you experience this.

Common causes of bright red bleeding include:

·      Anal fissure

·      Piles (haemorrhoids)

·      Cancer of the rectum or colon

·      Gastro-enteritis: infection of the stomach and intestines

·      Inflammatory bowel diseas

·      Anti-coagulant drugs

You cannot make the diagnosis of what is serious and what is not. So, I suggest you see your doctor to examine you and make a diagnosis.

I will discuss the first two conditions (anal fissure and piles) below;

Constipation can lead to conditions where the stool is so hard that it causes a tear of the skin lining the anus (anal fissure) leading to blood seen with the stool.

Prevention is focused on ensuring that you have enough fibre in your diet (fruits, vegetables, whole grain), getting at least 30 minutes of exercise daily and drinking at least 8 glasses of water daily. When you have the urge to poo, try not to delay it for too long. Go and try to take your time to do your business!

How can you help this?

§  Include some fibre in your diet. Fruits and vegetables, oatmeal, local rice and other whole grain meals are helpful.

§  Drinking at least 8 glasses of water daily. Remember that this number, 8, is not cast in stone. It’s just a helpful guide. If you’re in a hot area, you’ll probably drink more

§  Get at least 30 minutes of exercise/activity per day or on at least 5 days of the week.

§  If these do not help, you may want to see your doctor for a proper examination as some diseases like Diabetes Mellitus may also cause constipation.

Now for piles…

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. For those who love to visit the toilet with their newspapers and spend ages reading them in there, well, you’ve got breaking news!  Sitting on the toilet seat for prolonged periods can also cause haemorrhoids. As people grow older, the support structures for these veins also grow weaker…naturally 😀

Some internal haemorrhoids can be small veins which stay within the rectum. Usually these internal haemorrhoids, stay inside the anus causing no problems. Other internal haemorrhoids can be big veins that sag and protrude out of the anal canal. Straining would cause their delicate surfaces to bruise and bleed. Sometimes, the straining is sufficient to cause the haemorrhoids to protrude out of the anal canal. This is probably what has been described above in the question. When the haemorrhoids are compressed by anal muscles, the pain is made worse and the pressure can lead to cutting off of blood supply to the haemorrhoids.

External haemorrhoids can clot due to irritation forming a hard, painful lump under the skin around the anus.
People with haemorrhoids will complain of streaks of blood in the stool after stooling, blood on the tissue after cleaning up, anal pain, anal itching or a lump around the anus.

Treatment involves the use of ointments to relieve pain, inflammation and itching. There are other minimally invasive and surgical options available that range from rubber band ligation to surgical removal of the haemorrhoids.
You can also limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) to clean up after using the loo, sit on a bowl of plain warm water for about 15 minutes about twice or three times per day and also use some pain relief, if in pain.

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)

Remember though that there are other causes of blood in faeces. That’s why this case has to be checked out in the hospital so that a proper diagnosis can be made.

I hope this helps.

Have a good night y’all 😀

Q: Good morning doctor. I have dark circles round my eyes. It first started to show when I moved to a very sunny environment and sometimes my eyes itch a lot and as a result of scratching it might swell. I don’t know whether to see a doctor. It makes me lose confidence.

A: The skin around the eye is very thin and as a result, any movement of fluid in or out of the area is very visible there. Typical examples are thedramatic sunken eyes when one is dehydrated (maybe from stooling) and the equally ‘gossip-worthy’ swollen eyes after a night of crying 

Usually in the body, fluid would move from an area of low salt concentration to an area of high salt concentration (osmosis). After crying, your salty tears are an attraction for fluids, which move from areas of low salt concentration to accumulate there. On the other hand, going on an alcoholic binge (drinking till you drop) causes dehydration with the accompanying sinking eyeballs.

Now dark circles may be ‘false’ and just look that way when puffy eyelids cast shadows on the area or due to sunken eyeballs as people age. Real dark circles however, may occur due to prolonged bouts of crying, allergy (as may be the case in the question here, with the associated itching), having a cold, drinking a lot of alcohol, rubbing or scratching the eyes often, exposure to sun, ageing, sleeping with make-up on and it also runs in families…I bet you didn’t know that one 

Other causes of dark circles include sleeping positions. If you sleep on your side or on your tummy, thanks to gravity fluid will also accumulate around your eyes. Let’s also not forget the commonest cause…burning the candle on multiple ends!

Treatment will be based on the cause. If it’s due to a cold or allergy or sinus problems, when these are taken care of, then the symptoms will disappear. Modification of lifestyle habits like removing all make-up at night, wearing sunglasses and using sunscreen when out in the sun, changing sleeping positions by sleeping on your back (if possible) or elevating your head with more pillows and leaving alcohol and your eyes well alone (no scratching and rubbing of eyes!)  may also be helpful.

Quick fixes for these bags include using concealer or even foundation to cover it up. Using cucumber slices on your eyes or teabags are also helpful as short term measures. By the time you hit your 30s, you really should invest in a good eye moisturizer because this is the first place to show the sign of aging 

Other solutions include surgery and injection of fillers etc.
Remember that no matter how many concealers, surgeries, moisturizers et al you use, if you don’t rest and avoid fatigue, you’ll just be throwing money down the drain.

If these circles persist, however or seem to be just under one eye, please see your doctor or dermatologist for more advice.

So, as you all start contemplating where to hang out next weekend, be sure not to show up at work with the ‘telling’ bags under your eyes on Monday 

Have a great week ahead, family! 😀

Hugs!

https://www.instagram.com/p/BcMc7e4F2Eq/?taken-by=ddrketch

Q: Hi Doctor, may I ask: is it possible to get HIV from oral sex, whereby the female is HIV positive giving the blow job to a HIV negative guy? Cheers

A: Well, HIV infection through oral sex is not the usual route of HIV infection. However, it is possible. There may be small cuts in the mouth of the female who is HIV-positive from which the virus will gain entrance into the body of the male through the urethra (the opening at the top of the penis from where sperm and urine come out) or anus. In the same way, if an HIV-positive person receives oral sex, the virus can gain entrance into the partner’s body when semen and vaginal fluids get into the mouth.

This risk of contacting HIV through oral sex is increased in the presence of already existing Sexually Transmitted Infections, mouth ulcers, bleeding gums and sores in the genital area.

This risk of HIV infection through oral sex may be reduced by the use of barriers like condoms and avoiding ejaculation in the mouth. Use of pre-exposure drugs (prescribed for people at risk) and ensuring that anti-retroviral drugs (drugs used for the treatment of HIV) are being used correctly by partners who are HIV positive may also reduce risk of HIV infection through oral sex.

Generally for HIV/AIDS, remember the ABCs. Abstain…which is always the best bet if you’re not married, be faithful to one partner (who is hopefully being faithful to you) or use condoms.

For more on HIV prevention, please click on the link below:
https://chatwithdrketch.com/2014/07/02/daily-health-tips-should-i-use-emergency-contraception-as-my-regular-means-of-contraception/

Have a productive week ahead 🙂

Q: Good day Ma’am. Please, at what stage of pregnancy is one required to take Tetanus injection as a first time mum? Thank you.

A: Hallos! Thanks for writing in.

This is a very good question. I will discuss how this should be taken at different stages:

Tetanus Toxoid (TT1) injection is usually given at first contact; then 4 weeks after TT1, the next dose (TT2) is given. 6 months after this, TT3 is due and 1 year after TT3, it’s time for TT4. The final dose is given 1 year after TT4. This is the standard regimen and the five doses protect women throughout child-bearing years.

If you had taken TT1 to 4 before pregnancy, you will receive one dose at least 4 weeks before delivery.

If you had not received any dose of TT before pregnancy, you will receive 2 doses, 1 month apart before putting to bed. The first dose may be given as early as practicable in pregnancy. Thereafter, follow the rest of the standard regimen…with the 6-month dose occurring after pregnancy.

Why is TT injection such a big deal? Well, it is because it kills an estimated 180,000 neonates and up to 30,000 women annually[i]. Tetanus is acquired by exposing broken skin or dead tissue like a wound or cut umbilical cord, to the spores of Clostridium tetani present in soil. Poverty and poor hygiene increase the risk of tetanus. So, protect yourself and your unborn baby with TT injections.

All the best.

Have a good night y’all 😀

[i] http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/immunization_tetanus.pdf