chatwithketch

‘Relaxation, meditation, positive thinking, and other mind-body techniques can help reduce your need for pain medication.‘

Want to know how? You should read this! https://www.health.harvard.edu/pain/6-ways-to-use-your-mind-to-control-pain?utm_source=delivra&utm_medium=email&utm_campaign=GB20171108-Pain&utm_id=698735&dlv-ga-memberid=11052531&mid=11052531&ml=698735

Q: Thanks doc, please I want to ask about releasing of semen while in sleep is it always a spiritual something or it’s a medical issue or its normal. Thanks

A: Thanks for writing in.

Well, in very few words, ‘this is not a spiritual somtin!’ 😀 Trust me it’s not.

I’m not sure how old you are but in young men going through puberty, especially, wet dreams (also called nocturnal emissions) may occur as the body starts producing testosterone. There is ejaculation during sleep leading to wet PJs and embarrassment when the gentlemen wake up. Note that not every teenage boy goes through this experience.

Q: Good evening Doc. Please I’d like to know if a woman can go through pregnancy without taking routine drugs (I mean folic acid and the likes) and still have a healthy baby. If no, what are the possible side effects? Thank you!

A: I actually laughed when I read this! The first thought that came to mind was a bible verse: ‘all things are lawful; but not all things are helpful’. So, you can go through pregnancy without taking routine drugs, but it is not advisable. Some people say that once you eat well, you don’t need the medications. But remember that pregnancy is a period of increased need for nutrients as your body grapples with the idea of feeding itself and another young, growing lufe within it. Indeed, you are advised to take your antenatal medications (prenatal vitamins) in addition to eating well. Foods rich in iron and foods rich in folic acid like green leafy veggies and beans are especially recommended. Folic acid prevents deformities of the spine. Dairy is also a great idea. Take, at least, 4 servings of milk, other dairy products or calcium rich foods. If you don’t eat enough, your baby will start drawing on your own stock from your bones. So, drink up your milk! The veggies you are taking have fibre but be sure to include other high fibre foods like whole grain cereals to deal with the constipation associated with pregnancy.

I hope this helps.

Have a great evening, everyone 😀

Q: Hello good evening ma’am. I’m a medical student. I have an issue that’s been bothering me for a while now. 2 years ago when I was 20 I noticed a discharge from my breasts, I complained to my brother-in-law who is an endocrinologist. He did some examinations and that was it….recently I started to have migraine during my period and he said I had menstruation-induced migraine. He gave some medications for it. Until recently, I forgot about the discharge from my breasts so, I checked and noticed it was still there. …I did some research and realized it might be a result of hyperprolactinaemia. So my fear is…I learnt it could cause infertility. I’m not married though and not sexually active but I’m worried….I don’t want to have issues when I do get married….and I forgot to add….The discharge is colorless and bloodless….Thank you

A: Hi dear. Thanks for writing in. The greatest problem(s) that doctors and other medical professionals have is that of over-diagnosing themselves! So, I suggest that instead of doing more self-diagnosis, you actually make an appointment to see the endocrinologist in the teaching hospital where you are studying.

Having said that, I’ll attempt to unpack some of the symptoms you describe.

Headaches during menstrual periods are referred to as menstrual or hormonal migraines and are due to a drop in the level of estrogen, a hormone. For a headache to be classified as this, it would happen anytime between about 2 days before a menstrual period to about 3 days after the first day of menstrual period. Some of these women find relief during pregnancy as the level of estrogen rises.

To pre-empt this, you can take pain relievers that are also anti-inflammatory like ibuprofen at the start of the period or even about a few days before the start of an expected period until the bleeding stops. If you’re asthmatic or have peptic ulcer disease, this drug is not a safe choice for you.

It is possible that the breast discharge is associated with the headache as can happen in prolactinomas, but they could be separate issues.

Causes of breast discharge include:

• Pregnancy
• Breastfeeding
• Stimulation of the nipples during sexual foreplay or even pressing the nipple by people who are worried about the nipple discharge or friction between fabric and nipple can lead to nipple discharge.
• Breast abscess/infection
• Injury to the breast
• Cancer of the breast
• Use of some medications
• Hormone imbalance which can lead to production of prolactin even when one is not lactating. This results in women who are not pregnant having milky fluid come out of their breasts when they are not breastfeeding or even in women who have never been pregnant. This is called galactorrhea (pronounced gulactoria). This is not a disease on its own but a symptom of a problem. The hormone, prolactin is usually produced in these cases.

This milky fluid can be expressed by pressing or it can spontaneously come out on its own. It can affect one or both breasts and usually there are no blood stains involved. Sometimes, the cause of this discharge may not be known but some causes could be some medications, some drugs like cocaine, spinal cord injuries, some birth control pills, stress and even excessive stimulation during sexual intercourse. Galactorrhea can also happen in men and new born babies! In new born babies this can happen if the mother has a high level of estrogen which crosses over into the baby and stimulates the formation of breast tissue and sometimes, some milky white discharge.

If you notice this, please visit your doctor who may try to express this discharge to study. The discharge may also be clear, bloody or even tinged yellow. These need further evaluation and the presence of lumps should also be checked for. The level of prolactin will also be assessed. This may, however, be normal in people who are overly sensitive to prolactin. In this class of people, prolactin level is normal but there is still milky discharge from the nipples.

To determine cause, the doctor may do a scan, take tissue sample to examine (biopsy) etc. Treatment depends on cause. If due to pregnancy or breastfeeding, it will eventually stop. If due to stimulation, the discharge will continue as long as the stimulation is present. If due to injury, it will also stop with healing. If the discharge is due to medication, stopping the medication is sufficient to bring this to a stop or switch to something else under the supervision of your physician (doctor). If there is a tumour producing prolactin (this condition is associated with complaints of headache when they are large), drugs can be taken to shrink it or surgery can be done.  If no cause is found, drugs that reduce prolactin level are prescribed. Remember, that you could be pregnant and so a pregnancy test may not be out of place.

In the meantime, breast pads can be worn to prevent the embarrassing leaks from staining clothes, limit manipulation of breasts either by self-breast examination or during sexual activity and try not to wear clothes in which there would be friction between the nipples and the material.

The first challenge is confirming a diagnosis and then dealing with the cause. I suggest that you deal with that first and then sort out other issues, if need be, afterwards.

All the best!

Have a good weekend 😀

‘Many natural therapies promise to help with erectile dysfunction (ED), but there are reasons to be cautious.’

Want to learn more? Click on this link: https://www.health.harvard.edu/mens-sexual-health/beware-of-erectile-dysfunction-scams

Q: Good morning Doc, please I have a question. If sperm is mixed with blood, what is the cause?

A: Hi dear, thanks for writing in. It is certainly very disturbing to see blood in semen! This phenomenon, known as haematospermia or haemospermia in men under 40 years with no other symptoms related to more serious issues (which I shall discuss below) is usually not a major medical problem. Causes include:

·       Inflammation of the prostate gland (where semen is produced)

·       Inflammation of the seminal vesicles (where most of the fluid in the semen is produced)

·       Cysts in the seminal vesicles

·       Sexually Transmitted Infections like gonorrhea, chlamydia etc

·       Following recent instrumentation eg after prostatic biopsy

These conditions would usually resolve on their own or require a course of antibiotics. Please be guided by your doctor.

However, if you develop the under-listed symptoms, especially if you’re older than 40 years, it may be a sign of more serious conditions and you should see your doctor immediately.

·       Blood in semen which persists for longer than 3 to 4 weeks

·       Presence of other symptoms like pain during urination

·       Recurrence of blood in semen

·       Presence of other risk factors for bleeding disorders, cancer etc

These more serious problems could be due to bleeding disorders, severe high blood pressure, cancer etc

So, please see your doctor and let him make a proper diagnosis.

All the best.

Good night y’all 😀

Q: Good evening Doctor, I am 30 weeks pregnant and unfortunately my house help left for school about 3 week ago. Now all the house chores such as sweeping, washing, mopping etc. are on me now. Please, will this have any negative effect on the baby? I am very worried.

A: Hi dear. Thanks for writing in and congratulations on your pregnancy. I assume that it’s your first from your question 😀

So, pregnancy is not a death sentence or an illness, really. It is a natural condition and so, potentially, you can do a lot of things without any problem. Now there are caveats…if you have threatened abortion (miscarriage), your doctor will advise you to be on strict bed rest and not to lift a finger, literally 😀 There are a few other conditions that may limit what you can do, but your doctor will definitely be the one to issue those orders. In any case, whenever in doubt, please consult your doctor.

Having said that, bending to sweep or mop is okay in pregnancy but it has to be done the proper way…bending at the knees and not twisting your body while at it 😀 I suggest that you use the long-handled brushes/mops for sweeping/mopping as opposed to the local/native brooms/scrubbing brushes that require bending…in probably uncomfortable ways.

Pregnant women get lots of advice: from friends, mothers, mothers-in-law, colleagues, husbands etc. Sometimes it’s confusing to know what’s true and what’s not.

Here’s our take on some of them:

Advice

The first breast milk, colostrum, should be discarded as it is dirty and causes rashes in children

Fiction (False)

Colostrum is the first milk produced by the mother and is loaded with antibodies and nutrients needed by the baby. Babies should not be deprived of this milk.

Advice

Women should not take the prenatal vitamins (antenatal drugs) given at the hospitals because it makes babies grow unnecessarily big.

Fiction:

The iron tablets are important to prevent anaemia (blood shortage) in pregnant women and the folic acid ensures that baby’s spine develops well with no defects. In fact, it is advised that women who wish to get pregnant should start taking folic acid about 3 months before they conceive.

Want to know more? Get details from the book, Just For The Health Of It. We have a limited stock of copies left. You can get a copy via the shop now link on our facebook page. Or you can get it through:

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

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

5) For those in Awka, please call 08189944090.

It’s almost Christmas and this is the perfect gift for anyone!

Have a good night, y’all 😀

Q: Hello Doc, thanks for your good work. Please, how do I control my fat after birth? I am increasing in size every day. It’s 6wks since I put to birth. Thanks Doc

A: How to lose the pregnancy belly? Honestly, I’ve got no easy answers. It’s diet and exercise….oh and breastfeeding. But breastfeeding is not very helpful if one is not exercising and watching their portions. Again, the dictum of feeding for two here doesn’t also count.

The diet to focus on is the very same one we talk about all the time: fruits, veggies and complex carbs with focus on healthier cooking methods (less frying etc). Exercise should focus, initially on pelvic floor exercises especially if you’re leaking urine when you cough or laugh. To locate your pelvic floor muscles, try holding your urine when you feel pressed. If you are successful, then you have located the muscles you need. Then empty your bladder and lie on the floor. Contract those same muscles and hold the contraction for about 5 seconds and then relax it for about 5 seconds. Gradually build this up to holding the contraction for 10 seconds. Repeat this about 3 times a day. Once you no longer leak, you’re ready for your exercises.

Have you noticed how it is usually easier to lose the baby weight after your first baby and harder afterwards? 😀 Focus on building up your stamina gradually especially if you were not very active in pregnancy or before. Please remember to always contact your doctor before starting any vigorous exercise program. As you get into the groove, get down with your aerobics, strength training and sit-ups et al.

This is where breast feeding comes in, if you’re exercising and eating right, breastfeeding can help lose weight…as much as 300 calories per day. Does tying a wrapper tightly round your waist help flatten tummy? Honestly, I’ve heard people who swear by that technique. So, what I’ll say is, if it works for you, why not? Just don’t tie so tight as to stop blood flow 😀

How soon to start exercise after having a baby? Well, it depends on how active you were before and during pregnancy. If you were very active, you can start some light stretches as soon as you feel able. However, generally, we advise 6 – 8 weeks after birth to allow for a post-natal check to have been done. Again, start small and allow your body to get into the groove.

I hope this helps.

Good night 😀

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