chatwithketch

Representative of our winner, Opeyemi Morakinyo, picking up her prize from the Samsung office.

Be sure to participate in our quizzes and challenges 

Q: Good evening Doctor. Please, I have been having a stomach problem for 4 weeks now. Running stomach, heartburn and discomfort. Please, what might be the problem. I am planning to go and do test but I don’t know if I should go I see doctor first. Please, help me

A: Running stomach, the runs or diarrhea can be due to several causes which include infections (viruses, bacteria etc), lactose intolerance, some medications, fructose (the sugar found in fruits) in people who cannot digest this, surgery, artificial sweeteners etc. In excessive amounts, coffee (which is implicated in heart burn) can cause diarrhea. The symptoms are loose watery stools which are accompanied by abdominal cramps/pain, urgent need to defecate etc.

The major issue with diarrhea is dehydration. This condition is evidenced by dry mouth/skin, excessive thirst, tiredness/fatigue, reduced urination etc. So, be sure to see your doctor immediately if you observe any of the symptoms of dehydration, loose stools continue for more than 2 days, if you have severe abdominal pain, high fever and/or bloody stools. For dehydration, you can mix up a batch of oral rehydration salts and start on this before going to the hospital.

To prevent diarrhea, be sure to wash your hands often, especially before you eat.

Heart burn really has nothing to do with the heart…I bet all of you knew that, aye? It is usually felt as a burning sensation in the chest which feels worse on bending down or lying down. Okay, why and how does this happen? You know that the stomach produces acid to help with food digestion, right? Have you ever wondered, how come this acid isn’t all up in your mouth all the time? Well, that’s because there’s a ‘lock’ or control at the junction of the esophagus and the stomach, which prevents the acid in the stomach from coming back up into the esophagus. This ‘lock’ is called the Lower Esophageal Sphincter. This lock can get strained if the esophagus opens too often or if there is too much food in the stomach…so, if you regularly over-eat, you might want to re-think that 😀 A major no-no is a very heavy meal just before you lie down. It’s almost certain you may have a heart burn 😀

There are also conditions like pregnancy and obesity that make this sphincter stay open for prolonged periods as a result of pressure on the abdomen and there are also foods that encourage this. Examples of these ‘foods’ are fatty foods, alcohol, orange juice, chocolate and coffee, onions, tomatoes, peppermint and spicy foods.

So for the person in the question, I suggest you keep a food diary over a period of time and try to figure out the trigger foods. If this is not the issue, perhaps it’s a weight issue or even over-eating.

Treatment is targeted at the acid and healing the esophagus. Remember that occasional heart burn is not regarded a problem but if it happens frequently, like two or more times every week, then it becomes a problem and is now referred to as Gastro-Esophageal Reflux Disease (GERD). So, drugs used can stop acid production, reduce acid production and cause healing of the esophagus or neutralize the effect of the acid.

Prevention involves trying to avoid your trigger foods (quite a number are actually healthy 😀 maintaining a healthy weight, avoiding heavy meals just before bedtime, try eating smaller meals and avoid tight clothes that may also put pressure on your abdomen.

So, the first and best thing to do now is to go see your doctor to get a diagnosis made. If you drink a lot of coffee, you may have to reduce or stop as this can actually be responsible for both diarrhea and heart burn.

Have a fabulous evening and remember…no heavy meals before bedtime 😀

We typically advise people to measure their blood pressures at home but sometimes, this makes people to report some false high blood pressure readings! Do you know what could be responsible? Make you just took a cup of coffee before taking the reading. Or perhaps, you were talking and/or gisting with a friend before taking the measurement? Well, read the post below to find out what you could be doing wrong when measuring your BP and get it right! 😀

http://www.health.harvard.edu/healthbeat/tips-to-measure-your-blood-pressure-correctly

Q: Please Ma’am what are the remedy for low & Immotile sperm?

A: Several factors could affect the results of a semen analysis.  The results also vary from man to man such that results outside of the ‘normal’ do not necessarily mean fertility or having a baby is out of the question. Your doctor will work with you according to your specific context.

You have to be sure to follow all instructions given before the test. This includes abstaining from sexual intercourse for at least 3-5 days before sexual intercourse.

Using WHO reference values, a normal semen sample should fulfill the following:

• Volume amount of sperm produced in one ejaculation): Greater than or equal to 1.5 ml
• pH (whether acidic or alkaline. If less than 7, it’s acidic and greater than 7 is alkaline): Greater than equal to 7.2
• Viscosity (being semi-fluid):  viscous
• Transparency: opaque
• Motility (percentage of sperm that move forward normally):  This should be more than 40%
• Morphology (percentage of sperm that have normal shape): This should be greater than or equal to 15% normal, oval sperm heads
• Liquefaction (time taken for the semen to become ‘liquid’): This should be complete within one hour
• Total sperm count: This should be greater than or equal to 15 million.
• Pus cells should be less than 1 million/ml or less than 5/hpf

The causes of low sperm count could be medical, environmental or due to lifestyle issues. Sometimes, the cause(s) can, also not be identified.

Medical causes include infections like gonorrhea and chlamydia, certain drugs used for cancer and fungal infections, hormone imbalance, undescended testes, varicocele (swelling of veins that drain the testicle) and cancer.

Environmental causes include over-exposure to industrial chemicals, heavy metals and X-rays; over-heating the testicles by frequently using the sauna and hot tubs; prolonged bicycling

Lifestyle causes include alcohol use, tobacco smoking, illegal drug use, obesity and emotional stress.

To get a woman pregnant, a man has to have at least 40 million sperm per ejaculate. People with low sperm count usually have less than this.
If you have been diagnosed with low sperm count, then do something about it. Here are some tips that could help to improve your sperm count. Treatment is generally based on the cause:
Stress has been found to contribute to infertility problems such as hormonal issues. So, prevent excessive stress and perform relaxation exercises. Remember that infertility and life in general can be stressful, learn to relax.

Stop smoking because smoking significantly reduces both sperm count and the movement of sperm-cells.

Prevent overheating of the scrotum: When scrotal temperature rises (caused by tight underwear, long stays in a sauna or Jacuzzi, for example) sperm production can be impaired.

Maintain a healthy weight: Not too under or overweight since weight influences estrogen and testosterone levels.

Stop using drugs: Prolonged use of recreational drugs (for example, alcohol, marijuana, cocaine)

If you have infections like gonorrhea and chlamydia, these need to be treated.

Surgeries can be done for varicocele and cancers. Radio and chemotherapy are also treatment options for cancer.

Medications or hormone replacements can be used for hormonal problems.

The major challenge with low sperm count is infertility. Sometimes, the treatments listed above do not work, especially when the cause is not known. But IVF is an option that exists for this group of people.

So, first thing is to confirm from the doctor what exactly the cause of the low sperm count is (if known) and then review your options from there.

All the best.

Have a good night, everyone 😀

Q: Good morning…… I weaned my son when he was 1yr and 2 months and I did not feel any pain or engorgement on my breast….is it normal?

A: Hi! Thanks for writing in and congratulations on your new baby.

I would have thought you’d be excited by the lack of pain you felt…rather than wondering if it is normal 😀

People usually stop breastfeeding in one of two ways:

You can stop gradually over a period of time. Replace some feeds during the day with other foods or even milk (just not from you). Usually the first and last feeds of the day are the most difficult to replace or give up as they are your baby’s sorta emotional anchors 😀 But keep at it over a period of weeks and the breast milk production will gradually ‘dry up’. This method is more likely to produce the result you had…pain-free and no engorgement. So, this is normal. Enjoy!

The other option is to just stop putting baby to the breast. If your baby feels it’s also a good idea to stop, then you’re good. If not, you may have to be very creative with means and ways of distracting him/her. In this second situation, you are more likely to find your breasts engorged. Please ensure that you get the right support for your breasts. In the good old days, mothers would tell their daughters to tie a wrapper tightly across their breasts. A lot of people swear by it…I don’t 😀 If you’re more jet age, though wear a tight supportive bra. For the pain, take analgesics and also apply cold packs to your breasts.
Try not to stimulate the nipples during this period. This encourages milk production. Hubby should kindly take note too J

All the best as you move to a new phase of parenting!

Have a good night y’all 😀

Q: Good Day Dr, Please, I need your advice. I’ve been experiencing pains and an urge to wee again each time I finish urinating for the past 6 days now. Rashes all over my neck and shoulders, though we’ve been battling scabies my son brought home from boarding school since 3 months now. These rashes are itching me badly. The vaginal pains started 2 days after unprotected sex with my hubby. We’ve using condom since after my fourth baby.

A: Urinary Tract Infections occur anywhere in the urinary tract (Genius me, right? :D) and include infections of the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder (the reservoir or store house for the urine) and the urethra (the tube that transports the urine from the bladder to the outside).

So, who is more likely to have an infection and why? Women are more likely to have infections and this is because they have short urethrae (those tubes that transport the urine outside) and because the opening of this tube is very close to the opening of the anus. And so, if a woman urinates and has not quite mastered the art of cleaning from the front to the back, she could transfer bacteria from her anus to her urethra and this in turn travels up and infects the bladder. Women who also use the birth control method, diaphragm appear to also be at risk as it may cause the bladder not to empty completely when they urinate. Indeed, not urinating immediately after sexual intercourse in women may also predispose to this as the urethra may have may have become irritated, making it easier for germs to move in. People with depressed immune systems, frequent constipation and some people born with some disorders of their uro-genital system are also prone to UTIs.

In men, narrowing of the urethra which may happen in men who have had straddle injuries (eg falling astride {with legs apart} on a pole…ouch!), history of STIs or prostrate problems may make a man open to UTIs. Recurrent and chronic urinary tract infections (UTI that keeps recurring) may be due to changes in hormone (estrogen) level as one gets to menopause, problems with the urinary tract in terms of function or shape, kidney or bladder stones, bacteria getting into the urinary tract during sexual intercourse etc What symptoms does a person with UTI have? They would complain of feeling they have to urgently urinate often and then when they do get to the toilet, they can only pass out very little urine, pain or burning sensation during urination, pain in the flank (just under the ribs at the back), the urine may be cloudy or reddish or coke coloured, fever with chills and rigours etc. UTIs have to be treated because these infections could keep back tracking from the urethra to the bladder to the ureters and then to the kidneys…we don’t want that do we?! 😀

Treatment is focused on eradicating the infection…of course 😀 Usually a urine sample is taken to the lab. Part of the lab work is a culture and sensitivity test to find out the organisms causing the infection and the specific antibiotic that is active against it. Your doctor may also order other tests as he sees fit eg checking out for congenital defects etc. Apart from the preventive tips above, be sure to drink lots of water which help dilute your urine and help flush out the bacteria.

If placed on antibiotics, please take your prescription for the right period of time even if your symptoms disappear before you finish. And don’t go taking antibiotics without prescription. If you do, you could come down with a yeast infection (candidiasis), which may have symptoms similar to UTI but is a different entity.

Candidiasis is caused by an organism called Candida, a fungus (yeast). This infection can result in cheesy white (like ground melon/egusi seeds) vaginal discharge and vaginal itching. This itching can lead to irritation/pain in the vagina, which can become further infected, by bacteria. Candidiasis is very common in diabetics (the sugar in their urine makes the vagina a rich culture medium for them) and pregnant women who have altered glucose tolerance. This infection is also common in people whose immune systems are compromised and people who wear tight panties that do not allow their delicate inner selves to ‘breath’. Preferred materials for undies would be cotton and should be loose (I see my fashionistas frowning :D). It also happens in people who take a lot of antibiotics. Normally, some bacteria and fungi (yeast) co-exist peacefully 😀 in the vagina. To encourage this peaceful co-existence, the bacteria produce some acid that hold the yeast in check and prevent their over-growth. When antibiotics are abused, this leads to a situation where the yeast takes over 😀 (almost like a coup, right?). Though this infection can be passed on through sexual intercourse…especially oral-genital contact, it’s not really called an STI because women who are not sexually active can be infected with this.

Treatment is with anti-fungal vaginal tablets and/or anti-fungal cream which can be used for between 1-3 days depending on drug of choice. A single course dose of Fluconazole can also be taken orally. Any of these regimen may be extended if the infection is complicated…let your doctor be the best judge of that 😀 Prevention is targeted at causes:

• Wear loose fitting cotton undies
• Stay away from or limit time spent in hot tubs or saunas
• Stick strictly with the prescription for antibiotics in terms of quantity and duration
• Change out of wet clothes eg swim suits as soon as possible

If these measures do not help, please see your doctor.

The rashes and itching may very well be due to scabies as you noted. It is not called the 7-year itch for nothing! Scabies is contagious (spread by person to person contact but also through beddings, towels or infested upholstery) until treatment is started. It is possible to keep re-infecting oneself if all beddings and towels etc are not thoroughly washed at the time of starting treatment.

So, make sure you and everyone exposed to this has been commenced on appropriate treatment (after diagnosis by a doctor), ensure you have prevented re-infection by washing any article that may have been infested. More on scabies over the weekend…

I hope this helps.

Have a good night, everyone 😀

It’s that season when people are sniffling all over the place! 🙂 When you have a cold, it’s easy for the virus to go round everyone at home and even work. Let’s help you prevent this from happening again.

Here are our 5 top tips to prevent spread of germs when you have a cold
• Wash your hands frequently and avoid touching your face.
This is a no-brainer, right? If you sneeze into your hands and then touch your face or nose, you are constantly re-infecting yourself and so you may remain a major source of infection for a while. If you leave your face, well alone, then you are more likely to kick the bugs faster.
• Keep your drinking glasses and towels separate from other people.
Again, this appears to be common sense. Don’t drink from the same glasses as other people and please keep your towels separate from other people. Be sure to remember that these ‘other people’ include our significant others. Mhmmm! So find other ways of showing love at this time 😉
• If possible, avoid being close to other people
As much as possible, avoid invading other people’s private spaces and stop people from invading yours. That way you don’t expel your droplet infections right into their faces and bodies. In fact, if you have a baby, you may have to use a face mask.
• The best way to cough is into the crook of your arm.
Please sneeze into the crook of your arm. If you are wearing a long sleeved shirt or a jacket, remember that you would have increased the population of germs on this jacket by coughing into it. So be sure to wash these clothes at the end of the day. If you are wearing a short sleeved shirt, you are unlikely to be shaking anyone with that part of your body but be sure to take a bath at the end of the day.
• Do not shake people if you have just coughed or sneezed into your hands.
Just in case, in spite of your best efforts, you still find that you have just sneezed or coughed into your hands, be sure not to shake anyone and wash your immediately.

Q: good day ma’am, I have a problem. I have a girl friend & I’m planning to wed her after I have had so many failed relationships. Both of us are AS AS genotype & we both don’t have a family history of sickle cell. Now can I marry her? Thanks

A: Hello dear, thanks for writing in.

Sorry to hear about your past failed relationships…but two wrongs don’t make a right. You can’t correct the wrong things that had happened in the past with another wrong thing.

As I have explained in earlier posts, for every pregnancy, there is a 25% probability that you and your partner will give birth to a child with SS genotype, 50% chance that you will have children who have the trait (AS) just like you and another 25% chance that you would have a child with AA genotype. This is the information that you would be given at genetic counseling. Truth is, you could very well have all SS genotype children or all carriers of the trait or all normal genotype AA or any combination of the genotypes.

The decision as to whether to get married or not is yours. As adults, we always have the option of choices. This is the reason why, you are never forced into any procedure in a hospital, even if it is for your good. You must always sign an informed consent form stating that you understand what needs to be done, the risks involved and that you give your consent for the procedure to be carried out. In this case, it is important, however to weigh all the issues and consequences thoroughly before embarking on this lifetime voyage. Perhaps, it may be wise to visit a Sickle Cell Center and have a chat with the doctors about what to expect during a crisis or generally, just bringing up a child with Sickle Cell Anaemia. It is possible to know the genotype of the baby before birth through prenatal diagnosis. Speak with your doctor about this.

I have included a post I wrote a while back on sickle cell. Please click on it and read: https://chatwithdrketch.com/2013/06/29/love-is-blind-is-it/

What do you all think about people with the potential for having children with SS genotype getting married? Remember to be kind J

Have a great day J

I once came across a saying, ‘Why worry when you can pray?’ and then another one that analysed the fact that whether we can do something about a situation or not, there’s no point worrying. If you can do something about it, do it…why worry. If you can’t, then you can’t…why worry? 😀

The link below provides more insight. Enjoy!

http://www.health.harvard.edu/healthbeat/when-to-worry-about-worrying

It is great news that Nigeria is getting out of recession…but people are still out of jobs and are struggling to make ends meet. How can you handle anxiety without medication? Read!

http://www.health.harvard.edu/healthbeat/treating-anxiety-without-medication