chatwithketch

Q: Good day doctor. Good work you are doing here. God bless you. After 4 months miscarriage on September 5th. The breast milk continue to run. Please what will I do to stop it? Or is it normal. Thank you ma’am

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 you are surrounded by loving supportive family and friends. 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:

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.

Now, I’m a bit worried about the fact that it sounds like you’re feeling feverish. If that is so, if may be that there is an infection of a breast duct (mastitis) such that the skin over that area feels hot to touch, reddens, mum feels feverish, ill and aches all over. This infection is usually treated with a course of antibiotics, which will be prescribed by your doctor.

I suggest you see your doctor, if this condition continues an you need reasssurance.

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

Loads of hugs…

Q: Hello Dr. I weaned my two months old baby a week ago. He always sleeps between 8pm and 9pm and won’t drink anything till 6am or 7am when he gets up. If I force him he just cries and just wants to sleep. If I insist he will only take some little millet porridge but not milk or water. A part from that time he eats and drinks well. Is it healthy? How many times can i feed him? I am worried I do not want my baby to be affected by weaning. Please help. I trust you can give me the best knowledge. Thanks.

A: In the first few days and weeks of your baby’s birth, he’s likely to spend a lot of time sleeping. Indeed, he may be sleeping up to 16 hours per day…but really not at a stretch, usually. Ordinarily, he should be breast fed on demand and that means everything he asks for a feed. The problem is that your baby may just forget this all important function, ‘feeding’ 😀 and sleep for a looooong time! At this stage, you should never let your baby sleep for more than 4 hours at a stretch without waking him up for a feed. When counting the hours between feeds, remember that you are counting from when your baby started feeding and not when he stopped feeding. For instance, if your baby started feeding by 9am and finished at 9.30am; if he sleeps off, he’s due for another feed by 1pm and not 1.30pm. He should regularly be having about 7 to 9 feeds per day now. And just to be sure that he’s getting enough to eat, he should be having at least 8 diaper changes per day.
As your baby grows and becomes more aware of his environment, his sleeping and feeding needs will change to accommodate his new stage. Where in doubt, always have a chat with his paediatrician. The times you go for your baby’s vaccinations should be good times to check in with the doctor.
For more information on breast feeding and related issues, please click on the links below:
https://chatwithdrketch.com/2014/09/01/daily-health-tips-breastfeeding-challenges/
https://chatwithdrketch.com/2014/05/20/daily-health-tips-can-my-diet-cause-my-baby-to-have-diarrhea-while-breastfeeding/
https://chatwithdrketch.com/2014/09/25/daily-health-tips-breast-feeding-strike-and-menstrual-migraine/
Have a great week, ahead y’all 😀

Q:Good day ma’am. Please, I want to know if something is wrong with me. I started menstruation at 14 years with full 3 days flow but the flow started reducing, now it’s less than 2 days, 1 & 1/2 days. I have gone to clinics, checked my PCV and have even taken prescribed drugs for infections yet d flow keeps reducing. I am scared because they said normal menstruation should be 3 days minimum and 7 days maximum. I am now 28 and not married yet. Is anything wrong with me ma’am?

A: First things, first. The fact that you are 28 and not yet married does not mean that there is anything wrong with you! Absolutely not! You are beautiful, brave courageous (it takes guts to even ask questions about what could be wrong with you! Most people prefer to bury their heads in the sand and hope that this will go away!). Even if there is something medically wrong, the first step towards healing is asking questions about what the problem could be. Then, you can take next steps.

What is normal in terms of menstrual cycles varies from person to person with menstrual flow lasting between 2 to 8 days and the cycle lasting anything from 21 to 35 days. A reduction in flow (scanty period) is called hypomenrrhea (pronounced hai-po-men-oria) and a reduction in the number of days of flow to less than 3 days is called oligomenorrhea (oli-go-men-oria). Women with oligomenorrhea may go up to 35 days without a period.

Now at the onset of puberty, the flow and cycle can vary from one cycle to the other; the same goes for the other extreme of life (old age).

So, what else could have caused your flow to reduce? They include pregnancy (the supposed period may be an implantation bleed), crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones, Diabetes or thyroid problems and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C) can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.

Oligomenorrhea is not necessarily a serious problem, but it could be indicative of an underlying disease. You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.

Have a great evening, great people 😀

Q: Can you shed more light on using contraceptive for the treatment of hormonal imbalance associated with hirsutism? Thanks for your response

A: Hirsutism can be caused by any situation that increases the male sex hormones (androgens) or increases the response of hair follicles to androgens. Some conditions that can cause this include Poly Cystic Ovarian Syndrome (PCOS), some drugs, obesity etc It is more likely in people who have a family history of this and in people of Asian, Mediterranean and Middle Eastern origin. This can also be found in women with no risk factors and women where no specific cause can be found.

Specifically to your question, birth control pills (contraceptives) used over a period of 6 to 12 months may improve this condition by helping reduce the effects of androgens and reducing the production of more sex hormones. Anti-androgen drugs can also be used.

However, if specific causes are found eg obesity or PCOS, these should be addressed.

Permanent methods of getting rid of the facial and other unwanted hair like laser treatment (which does not destroy the hair follicles) and electrolysis (which destroys hair follicles but may leave small scars on face) are expensive with laser being more popular and more expensive.

Mild cases of hirsutism can be dealt with by shaving, waxing, plucking or using depilatory creams…much as you would take care of underarm hair.

So, seeing a gynaecologist is a good idea. He will carry out a detailed investigation and then confirm treatment options that would work best depending on findings eg whether the contraceptive pills are an option etc

Until this is done, shaving, plucking, waxing or using depilatory creams are great options. Laser treatment should be considered if cost is not a barrier.

Have a great evening, y’all 😀

Happy Boxing Day everyone! I trust you had a good celebration yesterday 😀

Q: Hi Dr ketch. I need advice I have 15 years old. I don’t know how to handle him. I’m trying to be a better parent to him but he doesn’t want to hear me. He started talking about smoking, drinking and talking about the girls with their friends. When I asked him, he said he doesn’t do that. So please help me. I want to believe but it is hard. Please, give me the advice.

A: When I was younger, the picture of a cool guy wasn’t complete without a cigarette in his hands. Then, if he had a cigar, men! That was hyper ultra-cool! He would usually be seen leaning on a cool car, with lots of other dudes hanging on to his words and pretty girls dying to be given the eye by him. In fact, some television adverts for cigarettes would go so far as to show how with puffs of cigarettes, a regular guy not only becomes super-cool but also becomes a super athlete, star etc. Do they actually possess these powers? Hmmm!

For the younger ones, repercussions that are too far in the future are difficult to comprehend today when they are all hip and cool. The talk of all the consequences is kinda like lots of smoke without fire! And the tobacco companies have also gotten innovative, they take the advert to where the young ones actually hang out. The time of discovering tobacco is about the same time that alcohol is discovered and so the young‘uns are hanging around bars and night clubs (I thought there were age limits for admission? :O). This is where the tobacco companies go and they have a huge and captive audience.

Tobacco use has a lot of health implications and has been noted as a risk factor in lung diseases, heart diseases and cancers. This may appear to be too far in the future and difficult for our teenagers who are in their prime to contemplate. So, perhaps educating them about more short to medium term consequences may be helpful. Some of these include:

• Reduced fitness levels…making them appear old and fuddy-duddy! They can’t even join the cool sports teams.
• Nasty smelling breath that even tooth paste, breath mints and candy cannot mask.
• Becoming unattractive to non-smoking peers
• Stained teeth and fingers
• Wasting money that could be used for clothes, music or other items
• Finally, the fact that the teenager loses control and can’t stop smoking once addiction to nicotine appears.

I had a very close relation who smoked…a lot. He also drank…a lot. He eventually died with complications of hypertension, Diabetes Mellitus, liver cirrhosis and lung disease. Granted, there was a whole lot more going on than just the smoking but it’s now a case of which came first, ‘the cart or the horse’. I don’t know but I can surely tell you that smoking didn’t help him any. Tobacco use is a major preventable cause of death worldwide. The reasons for tobacco use are many and diverse, but in a nutshell, appears to be a way from which people attempt to escape stress and the pressures of life. So the campaign for eradicating smoking goes beyond the individual and involves the Government which must provide the right socio-economic support for the issues people stress out about. Having said that, we also have a role to play.

There has to be a clear desire to quit and so being positive, being around supportive people and avoiding the areas where one usually is encouraged to smoke or drink, are steps in the right direction. Getting other hobbies, switching to oral substitutes like chewing gum, carrots and mints are also helpful. Brushing your teeth often is also a good idea as toothpaste makes cigarette taste really bad…so I hear 😀

Methinks though that the best way to discourage your teenagers from smoking is by setting a good example. They learn much more from what we do than from what we say. Remember that at this age, they also discover the opposite sex and it is important that we provide the right information to them.

Parents and/or guardians, would you even consider having a discussion about sex with your teenagers? Scratch that…let’s start with when your children were younger. Did you even tell them the proper names of their private body parts? Did you tell them the full implication of coming of age as happens in puberty? Did you indulge in those half-baked stories we heard a while ago about how girls would get pregnant if a boy so much as touched their hands…provided they had started menstruating? Do you think the teenager you were talking to believed you?

As the mother of teen and tween (that twilight zone before the real teens) 😀 daughters, I absolutely confess that it wasn’t as easy to have that chat with my first daughter as it was to give it to other teenagers. It got easier though and with my second daughter, and now we can all discuss all aspects of reproductive health without cringing, mentally or physically 😀 My son is still struggles…but we’re getting there 😀

The US Department of Health and Human Services points out that the following groups of teenagers are less likely to get pregnant or get someone else pregnant:

• Those who have supportive parents that they can freely communicate with
  • Those who have healthy family and peer relationships
  • Those who have proper understanding of sexual and reproductive health
  • Those who have knowledge of contraception and the importance of abstinence.
  Teenagers more at risk of getting pregnant include
  • Those that live in unstable homes (financially or emotionally)
  • Those who were born to teenage mothers
  • Those who use drugs of addiction. Remember that using these messes with good judgement
  • Those who have sex at a young age
  • Those with low self esteem.

Now, remember that risk factors are just as the name implies…factors that increase your risk 😀 It does not follow that people who live in homes with conflict must have teenage pregnancies. No! It just means they need to be aware of their increased risk (loaded gun) and be sure not to pull the trigger…and get pregnant.

If you’re a parent, are you providing adequate information and a safe home environment where your children can thrive in all ways? Are you comfortable discussing these issues with your children? Are you aware that if you’re not providing this education yourself, you’re probably allowing your teenager to learn from his friends and/or the internet…where he/she may very well be learning all the wrong things!

Truth is that if you have never been open and close to your son before now, it’s probably that much harder. However, you’ve got to try. Engage him in activities he’s interested in like sports etc and encourage open discussions without judging.

Hopefully, this helps

Have great night y’all 😀

Merry Christmas, y’all 😀

I hope y’all had a great day! The year is gradually coming to an end. How far have you gone with your goals for the year? Don’t give up yet. There’s still one week to go and then you can start taking stock for next year!

Now, I’m sure a lot of you ate a lot today. I hope you ate the right things? 😉 Let’s deal with a question that has to do with eating the wrong things.

Q: Does eating too much soil cause illness and where does this soil go in the body does it get out through waste and what will be the treatment if too much soil is found in my body?

The constant and repetitive eating of items that have no nutritional value like soil, ice shavings etc is called pica. The list of non-food items eaten include paint chips, hair, glue, soap, tooth paste, chalk, hair and the list goes on!

Causes of non-food cravings include:
• Pregnancy: it is thought, though, that women with pica in pregnancy probably had this before pregnancy or have a positive family history of it.
• Deficiency of some nutrients like iron and zinc. Talking about iron, do you know that one out of every two women of reproductive age in Nigeria is likely to have anaemia (shortage of red blood cells)? Out of this number, half of them are likely to have iron deficiency anaemia. Question is, are you likely to be one of these women? Do you eat enough green leafy veggies? Do you use iron fortified seasonings or foods? Discussion for another day!
• Poverty can also lead to this as children and adults alike look for ‘things’ to fill their tummies. In the same way, people on fad diets, look for non-food items with little or no calories to fill their tummies and take the edge off their hunger
• It has also been found that some developmental problems like autism may be responsible.
The exact cause of pica has to be found out as it puts one at risk of:
• Lead poisoning from eating paint
• Bacterial and parasitic infection from eating sand
• Constipation by eating things like hair or even obstruction of the intestines!

So, yes, the soil is passed out through faeces with the attendant complications.

Treatment is dependent on the cause. If pica is due to learned behaviour, a therapist will work with the person to ‘unlearn’ this and work on ways of restricting access to these non-food items. The doctor will also look out for nutrient deficiencies etc.

I hope this helps

Merry Christmas, y’all 😀

Q: Good morning Doctor, I would like to find out how do you keep the vagina clean from sperm after intercourse? I got married a virgin so it’s been embarrassing for me to ask anyone this question. The sperm does not come out all at once after intercourse, and becomes smelly as days go by as it comes out in bits. Please help.

A: Congratulations on your wedding and marriage…and don’t be embarrassed to ask. I’m here to answer your supposedly embarrassing questions! 😀 Welcome to a new world.

The sperm, after sexual intercourse travels a loooooong way…trust me, you would not want to wash all the way there. When a man ejaculates, the initial force of that pushes some of the semen a significant way into the vagina. The rest of it flows back. Some sperm cells are retained at the back of the vagina, some make it all the way to the cervix and some others get into the uterus and make the trip into the fallopian tubes to fertilize an egg.

You would want to wash your vagina with disinfectant or perhaps antiseptic soap to make sure that you kill off all the germs and deal with the sperm, right? Wrong!

Some people believe douching is a good way to go. Vaginal douches usually contain water and vinegar. Others have antiseptics and fragrances in addition. These douches are usually sprayed upwards into the vagina to ‘clean’ it up. Apart from destroying the hard-working bacteria which ‘protect’ the ‘intimates’, it can also lead to irritation of the very delicate vaginal skin.

All you need is…clean hands, soap that is not perfumed (if you can tolerate it) and water; c’est finis! Do this after sexual intercourse. It will take care of the semen that flows back after sexual intercourse and if you do this every time you take a bath, you will be fresh all the time 😀

Q: Doctor hi, am three month pregnant, I had ultra sound where the doctor to noted uterine fibroid measured 2.56*1.7cm. Will it affect my baby, am i going to take medication during pregnancy?

A: Fibroids can co-exist with pregnancy in which case pregnancy may be normal or associated with breech pregnancy, pre-term delivery (delivery of pre-mature babies) etc. However, once a woman registers in a good antenatal center under a good obstetrician, these issues will be anticipated and addressed promptly. Please be sure that you are seeing an obstetrician who will help you during this pregnancy. Many patients with fibroids in pregnancy have normal pregnancies and deliveries.

Some women find out for the first time that they have fibroids when they get pregnant. Most of them cause no problems during pregnancy. However, some of them may act up.

Fibroids during pregnancy are managed conservatively…that is they are not managed aggressively. It’s kind of a wait and see approach. A condition called red degeneration in which the fibroid outgrows its blood supply causing it to turn red and die can occur. This leads to intense abdominal pains and contractions.

Will this pain last forever? Usually it occurs around 12 to 22 weeks of pregnancy and bed rest for a couple of days coupled with pain killers should do the trick. Judicious fluid intake is also advised.

For more on fibroids, please click on this link:https://chatwithdrketch.com/2014/05/29/daily-health-tips-are-there-other-treatment-methods-for-fibroids-other-than-surgery/

https://chatwithdrketch.com/2014/04/05/daily-health-tips-should-i-stop-taking-folic-acid-because-i-have-fibroids-in-pregnancy/

Good night, y’all

Q: I have not being seeing my monthly period for months now, and even it comes once after three months it will not even flow very well. I went to see the doctor and he said I have polycystic ovaries (PCOS). He gave me some drugs which I have to take for 28 days before my period can be able to come out. But once I stop the drugs it won’t come out again. Doc: I really need your help on this because I can’t continue taking drugs every month before I will see my monthly period and I want to also be a mother someday. Thank

A: Ovaries are small bean-shaped organs on either side of your womb. Every month, your ovaries develop sacs called follicles from where eggs are released monthly and female sex hormones produced. After the egg is released every month, the sac disintegrates. But sometimes, the egg is not released and the sac remains or the egg is released and the sac does not disintegrate. This follicle becomes the fluid-filled cyst sac. Usually this is not a problem as it could form during every menstrual cycle and usually resolves on its own. These cysts are called the functional cysts. However, these cysts could get very big and in some instances become twisted or they could rupture causing problems. This latter type is called pathological cyst.

Examples of pathological cysts occur in PolyCystic Ovarian Syndrome and endometriosis. In the former, small cysts appear all over the surface of the ovary and is also associated with irregular menstruation and high hormonal levels. In endometriosis, the tissues of the uterus (womb) are found outside of the uterus. These two pathological cysts are associated with fertility problems. Functional cysts are hardly associated with fertility issues except they become extremely large.

Treatment depends on your particular situation. Your doctor could order serial scans to continually observe the size of the cysts and see if they reduce in size. Another treatment option is the use of birth control pills (which it appears you are on) to prevent the development of more cysts in future menstrual cycles. The final option is surgery. Have a chat with your doctor and let him know your concerns about taking medications all the time.

All the best!

Have a great evening, people 😀

Q: Can abortion prevent me from conceiving?

A: Difficulty with conceiving in a woman could be due to problems with ovulation, problems with the uterus and cervix, blockage or damage of the fallopian tube, thyroid problems, cancer, previous instrumentation resulting to damage to the lining of the womb etc.
Previous instrumentation (like Dilatation and Curettage, D and C, where the procedure was too ‘vigorously’ done or even in situations where the placenta attached too deeply into the womb making it difficult to remove retained tissue) can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. Severe forms of pelvic inflammatory disease (PID) can also cause Asherman’s Syndrome. For more on PID, please click on this link: https://chatwithdrketch.com/2014/09/22/daily-health-tips-what-is-pid/

In Asherman’s Syndrome, adhesions/scar tissue form inside the womb or moth of the womb, cervix. This leads to stocking together of the front and back walls of the womb. Asherman’s Syndrome can lead to infertility, miscarriages, growth retardation of babies in the womb, placental problems etc

So, yes…abortions may lead to infertility if instrumentation like D and C is involved.

Have a good night, people 😀