chatwithketch

Q: Greetings Dr. Ketch, I am 31 years old – in the journey of trying to get pregnant. I had a miscarriage in March 2017; before then, earlier in 2016, I was diagnosed with fibroids. I had a myomectomy to take out the fibroids and eventually the following year that’s 2017 I conceived but had a miscarriage. Since then, over 6months now I have been unable to conceive again. Please doctor advise me on tips and what am supposed to do
A: Not being able to have a child at the time that we expect it can be a harrowing experience…especially in Africa where a couple of months into your marriage, family members and even outsiders are beginning to look at you in suggestive ways. Some actually ask outright, ‘when are you guys planning to start having babies?’
However, in the medical world, we can only agree that perhaps there might be an issue after one full year of trying to have babies with no luck. This, however, implies that there is frequent and unprotected sexual intercourse. Frequency in this respect means that sexual intercourse should be at least 3 times in a week. Unprotected means that there should be no barrier protection like a condom. Don’t laugh…this has been known to happen. People use a condom and then expect to get pregnant J The ejaculate (semen) should also be of significant volume.

Therefore, if this has been established to have been happening for one year, the next thing is to run tests. The less ‘invasive’ tests are usually done first. This usually involves the husband who provides his semen for analysis. Other tests will now be run on the wife, which presumably has already happened in the case above.

Some causes of infertility in men include problems with the production of sperm, problems with the delivery of sperm, being exposed to environmental toxins (like sitting in hot tubs) and cancer.

Some causes of infertility in women include problems with ovulation, problems with the uterus and cervix, blockage or damage of the fallopian tube, thyroid problems, cancer etc. Fibroids may or may not cause inability to have a pregnancy. It depends on size and position. Big fibroids in the area of the womb where a baby is meant to implant may cause a miscarriage or indeed, failure of the fertilized embryo to implant. Your doctor will take a decision on what to do with the fibroids based on size, symptoms etc., if this is still a problem.

Other risk factors for both sexes include use of alcohol and tobacco, being overweight or even underweight and age (the older people get, the more difficult it is to get pregnant).
Where a problem is identified, this is taken care of through various options like the use of drugs or surgery.

Oftentimes, no reason can be found for infertility. In these instances, the couple may want to consider assisted reproduction. Your doctor will discuss the different options available in your area and if you can afford it, he will suggest other centers where better facilities exist.

Prevention of infertility is targeted at the risk factors. Quit smoking, reduce alcohol consumption, exercise moderately and keep your weight within normal limits.
Infertility is really nerve wracking, because nobody has an idea how long it’s going to last or what treatments are going to work best. Joining support groups and/or counseling sessions may be helpful during this period of waiting, patiently and prayerfully J

On your miscarriage….condolences on the loss of your baby. It is never an easy experience for anyone to go through.

Unfortunately, often times, the cause of a miscarriage is not identified. You need to understand this so that you don’t blame yourself unduly. Having said that though, first trimester miscarriages are mainly due to problems with the baby/fetus. These problems could be due to problems with the placenta. This is how the baby receives its nutrients in the womb and so, if this organ cannot deliver, a miscarriage might occur. There may also be a problem with the baby’s chromosomes, such that a baby may receive too many or too few genetic materials or there may be a damaged egg/sperm. Other associated risk factors include smoking and drinking alcohol, being overweight, malnutrition, increased maternal age, trauma and drug abuse. By the way, trimester is 3 months of pregnancy. Therefore, first trimester refers to the 1st three months, 2nd trimester, the 2nd three months and 3rd trimester, the last three months

To try for a pregnancy again, remember to ensure there is unprotected sexual intercourse at least three times a week with ejaculation of sufficient amounts of semen. You should start on folic acid supplements as soon as you can, to prepare you and baby for the journey ahead.

To prevent a recurrence, focus on ensuring that you stay healthy and do not indulge in harmful habits like smoking and excessive alcohol drinking. Other helpful tips include eating healthy, keeping weight within normal parameters, avoiding trauma and not abusing drugs.

In addition, as soon as you get pregnant again, you should register for antenatal as soon as possible and keep to your appointments religiously.

For more on this topic, please click on the link below:
https://chatwithdrketch.com/2014/06/02/daily-health-tips-what-should-i-do-to-conceive-again-after-a-miscarriage/

All the best!

Q: Hello Doc I want to know why there is hole in my tooth I can(not) drink water with eas(e)y on that side of my tooth (be)cause of the coldness I will receive.

A: Tooth aches are mainly due to tooth decay, which may give rise to a hole in the tooth.

How does a tooth get to the point of a cavity/hole? There are bacteria that live naturally in the mouth. When we eat foods rich in sugar and starch, the bacteria act on these foods and produce acids. These acids can eat away at the enamel covering of teeth. If these foods are eaten often, serious damage can be done to the teeth leading to the formation of cavities and subsequent decay as the acid eats its way through the enamel and may even get to the nerve ending! Imagine the quantum of pain, this person will experience!

What to do? You need to see your dentist asap. In the meantime, gargle with warm water and take some analgesics. Remember not to go over the recommended dosage. Use dental floss to remove food debris in between teeth.

To prevent this, be sure to remember and follow the rule of twos: brush your teeth twice a day, brush your teeth for at least 2 minutes (brushing up and down in circular motions) and see your dentist at least twice a year. Use fluoride-containing toothpaste. How do you find this? Walk into any shop or supermarket and read the ingredients on the pack. If it states that it has fluoride in it, you’re on the right path 😀 Limit your intake of sugary substances…make them occasional treats and if you do take them, please rinse out your mouth or better still, brush your teeth. Be sure to brush your teeth last thing before you go to bed. If you eat afterwards and take in sugary stuff, the acid produced really has time to eat away at your teeth while you’re sleeping as a result of the fact that less saliva is produced.

I hope y’all had a great day 😀

Worried about eczema in you or your baby? If your baby has eczema, you should find helpful tips in the post below https://www.health.harvard.edu/blog/3-things-you-can-do-when-your-childs-eczema-gets-bad-2017011010996

If you (an adult) have eczema, follow this other link for helpful tips https://chatwithdrketch.com/2014/03/01/daily-health-tips-what-can-i-do-about-the-eczema-on-my-skin/

https://www.instagram.com/p/Bd7fHvXlHc4/?taken-by=ddrketch

Q: Doc, I have been struggling with breast milk discharge after a miscarriage. I have possibly tried the cabbage, ice pack etc methods but is not working for almost a year now. What will I do please… I need help

A: Condolences on your loss! I cannot imagine what you are going through. Please make out time to mourn your baby and then as soon as you can, open up your heart to the possibilities in your future. I hope loving supportive family and friends surround you. Hugs 😀

Sometimes after a miscarriage, the body does not quite recognize that there is no longer a need to feed a baby. And so, it just continues to produce milk.

Now, for stopping milk production, you appear to have taken some of the usually advised actions eg use of ice packs. But I repeat them in this post, just in case you did not use correctly.

In the good old days, mothers would tell their daughters to tie a wrapper tightly across their breasts. This helps. In fact, I believe that this is still being done by lots of people. If you’re more jet age, though wear a firm supportive bra, night and day.

For the pain, take analgesics and also apply cold packs to your breasts. These cold packs can be packs of frozen veggies or even cold cabbage leaves. For the latter, wash the cabbage leaves and put them in the fridge. Remove the areas that have big veins as they may hurt your tender breasts. Put this cold cabbage leaves in your bra and change to another set of cold ones every 2 hours or when the cabbage leaves feel limp.

Try not to stimulate the nipples during this period. Use a breast pad to prevent leakages.

If you find that your breasts still fill up, then express some breast milk. Express until you fill comfortable…not until you empty out the breast.

Keep hydrated and try to lie on your back or your side when sleeping.

I suggest you see your doctor, if this condition continues and you need reassurance. It’s also important to rule out other causes.

Your baby will always have a special place in your heart. And you will yet smile….very soon.

Loads of hugs…

Dear Healthy Living with Dr. Ketch family,

Happy New Year! I hope you have started the year with a determination to live your best life yet. I have!

I have made a couple of improvements to this platform to ensure that I meet the different and diverse needs of y’all 🙂

From now on, if you send a message to my inbox, you will be presented with 3 options:

·       Ask your question – Just go ahead and type your question in there and I will revert

·       Visit my blog – Clicking on the link takes you to my blog to search for the answer

·       Schedule a meeting – Clicking on this link takes you to a booking page where you can schedule a one-on-one live chat with me. You can choose from any of two options: 15 minutes or 30 minutes. So, if your question is urgent or you have a lot of follow-on questions, this option will work for you!

Remember that you can still send in your questions as posts on the page. The options above will only be presented if you send a message to the inbox.

I hope this makes your interaction with this page easier and faster. Please let me know if there are other ways, we can serve you better!

Have a great weekend! 😀

Q: What causes burning sensation under the feet in the elderly?

A: People 45 years or older may be more likely to have this and it shows up during activity or even at night making sleep difficult. It may be temporary or permanent depending on the cause.

Some causes of this sensation include:
Peripheral neuropathy: This is a situation where peripheral nerves (a network of nerves which connect the brain and spinal cord to the rest of the body) are damaged with resultant symptoms like tingling or burning sensations. Diabetes Mellitus is a common cause of this problem

Menopause: The hormonal changes in menopause may lead to the feeling of ‘heat’ in the feet etc

Other conditions that could cause this include vitamin deficiency, alcohol abuse, kidney or liver problems, HIV/AIDS, low thyroid hormone levels, heavy metal posioning etc.

The treatment, of course, would depend on the cause. So, please take the person concerned in to see the doctor. He will make a diagnosis and advice on treatment.

Have a great evening, y’all 😀

Q: Good pm doc, please I am 3 months pregnant and I am having itching and a lot of discharge in my vaginal, what is the remedy to it? Thanks ma’am

A: In pregnancy, the decrease in tolerance to glucose which may occur, means that the vagina has a rich supply of sugar which encourages the fungi to grow and multiply as they love the dark, warm, moist and rich environment 😀

Usually, there is yeast (fungi) in the vagina and they generally mind their own business until something comes along to disturb the peace of the environment. This disturbance can be in the form of abuse of antibiotics (which kills off the good bacteria that hold the fungi at bay causing them to take over and overgrow the environment) or even in pregnancy (where the estrogen hormone produced in pregnancy messes with the normal order of co-existence of fungi and bacteria, again, allowing the fungi to take over). Other conditions associated candidiasis include Diabetes Mellitus, disorders of the immune system, use of oral contraceptives, the hormonal changes associated with menstrual cycle etc.

How can this be prevented? Trust me, I’m not going to suggest not getting pregnant 😀 There are things you can do to reduce your risk of this infection. They include:
• Wear cotton panties instead of tight fitting nylon panties.
• Always wipe from the front to the back, after using the bathroom
• Do not use perfumed personal care products like sanitary towels, tissue etc
• Do not spray perfumes in your genitals and avoid perfumed soaps
• Change out of wet swimming gear as soon as possible

Now, this infection can be treated using oral drugs (tablets to be taken by mouth) but these are not recommended during pregnancy and breastfeeding. Vaginal pessaries and creams are better bets in pregnancy. However, because of the very small possibility of hurting your cervix (the neck of the womb), it is advisable not to use the applicator to administer the pessary. Instead, use your finger to insert the pessary. It may be necessary to continue the drug application for about 6 days as opposed to the shorter 3-day course. Your doctor will confirm diagnosis and advice on medication duration.

For more on candidiasis, please click on the following links:
https://chatwithdrketch.com/2014/06/26/daily-health-tips-why-do-i-have-recurrent-candidiasis/
https://chatwithdrketch.com/2014/03/07/daily-health-tips-toilet-infection-seriously/
https://chatwithdrketch.com/2014/04/27/daily-health-tips-is-vaginal-discharge-normal/

Have a great weekend, y’all 😀

Q: Hi doctor, I’m short of iron in my body so what must I eat?

A: Shortage of iron can lead to iron-deficiency anaemia because iron is needed to produce new red blood cells. Folic acid and Vitamin B-12 are also important in the process. Anaemia occurs when the amount of red blood cells in the blood is not enough. Simply put, a shortage (deficiency of red blood cells). To confirm this diagnosis, a Full Blood Count (FBC) or Packed Cell Volume (PCV) test is done.

To make up deficiency of red blood cells, iron and vitamin intake should be increased. Supplements are an option, however, as I always say, supplements are meant to plug holes that exist in the diet and not be the main stay of the diet itself. So, it’s much better to eat iron rich food like: eggs, shellfish, beans and other legumes, green leafy vegetables, lean red meat, iron-enriched wheat bread and cereals.

People particularly at risk are pregnant women and menstruating women. For some ladies, during menstruation, the bleeding is heavy with lots of clots. It may lead to a situation where the body is unable to keep up by manufacturing new blood cells to replace those being lost. These women need to increase their intake of iron.

Iron, however, can lead to constipation and so, for people who use the supplement, be sure you are taking enough fruits and vegetables and drinking sufficient water.

Be sure that you are also being guided by your doctor as some levels of anaemia will require a blood transfusion.

Have a good night, everyone 😀