chatwithketch

Q: Good morning Doc. I am 6 weeks pregnant and its my first baby would like to know if its true that if i wear heels its risky and might lead to miscarriage. Is it true?

A: I love my heels! I am petite (that’s fancy grammar for vertically challenged or not very tall. I draw the line at using the ‘s’ word :D). I also walk like a soldier (no kidding) whenever I wear flats…no regard to finesse et al! I probably missed all those classes where catwalks were taught (sigh!). So how do I live without my heels; I’d be looking up to everybody!!! But more seriously, the question is ‘are heels good for your feet or not?’

Truth is high heels can create deformities by altering the normal shape of the foot, can cause problems with your Achilles tendon (the prominent tendon at the back of the ankle), cause foot pain and increase the possibility of sprains and ankles (imagine falling from the great height of a six inch heel…ouch!!!).
I would love to feel that all heels would be thrown away now that we know they are bad….maybe, or maybe not Okay, how can these heels be worn safely though?

For people who are not pregnant, heels with soft insoles are very comfortable and if your heels don’t come with them; you can buy and fix in (I am sure they should be available in shoe shops or even big department shops anywhere), the larger the base of the heel, the better; don’t wear shoes that over-flex your arch (the natural curve of your foot) or shoes that you can’t walk in! If you can’t do the normal everyday things you do while wearing them, then don’t. If you try on a heel and your toes automatically slide to the front, they are not for you and could create more pressure and pain on your toes. Open-toed heels are helpful especially for people who have corns or calluses. Finally, switch the heels around and try and wear a mix of heels….throw some low heels into the mix, perhaps not higher than an inch (which is the ideal recommended height of a heel!!!).

When you get pregnant, it’s a different story! As your baby grows, your center of gravity shifts forwards, causing you to compensate by leaning backwards…the classic pregnancy pose (perfected by Nollywood, if I say so myself 😀  This pose together with relaxed ligaments around the joints due to the hormones being released in pregnancy and weight gain, already make posture a huge problem. I always jokingly say that I always used to know I was pregnant whenever I sprained my ankle…it happened in 2 out of 3 pregnancies! It may not be an exact science, but it worked for me :D….thanks to those hormones that made the ligaments holding my ankle joints together, quite lax ;D So, adding heels to this mix is not a great idea and a fall could be imminent! This could be injurious to both you and the baby. This is where the threat of a miscarriage could arise and not wearing the heels on its own.

For those who insist on wearing heels, please bear the following in mind:

• Low heels may pass in the first trimester
• Sturdy comfortable heels are a better option at this time and not stilettoes or pencil thin heels
• Take breaks from the heels during the day…relax your feet now and again

Point to note:

Flat shoes like ballet shoes may also not be a great idea as they do not give the feet sufficient support. Comfortable footwear with some absorbency is the way to go. Good examples are trainers or cushioned shoes that provide support for the foot arch.

So, it may just be a good idea to give ‘fashion’ a rest for 9 months in terms of shoes 😀 Don’t sigh…just yet! Whatcha think ladies? What do you do when pregnant? Wear your heels or not? What are your tips?

Have a great night, y’all 😀

Q: Hi Doc, is there something like Diabetes Insipidus and what causes it?

A: There is something like Diabetes Insipidus and before you ask…no, it’s not related to Diabetes Mellitus 😀

Normally, the kidneys remove excess fluids in the bloodstream and store this temporarily as urine in the bladder prior to urination. This process maintains the fluid balance in the body as thirst is triggered when there is loss of body fluids eg through sweating and urination is triggered in instances where there is excess body fluids. In the first instance, the body conserves fluids and makes less urine. This process is regulated by a hormone called the Anti-Diuretic Hormone (ADH) which is released when there is dehydration which causes the body to conserve fluids and the kidneys to release water back into the blood stream. This causes urine to become more concentrated.

In Diabetes Insipidus (DI), a rare disease condition in which one always feels thirsty even after drinking lots of water and the person produces large quantities of urine, there is an imbalance of water in the body with excretion of large amounts of urine…up to 5 times the normal output of urine in extreme cases. This will present as frequent urination, especially at night and bedwetting.

There are different types of Diabetes Insipidus:

• Central DI, in which there is damage to the gland (pituitary gland) that produces the ADH
• Gestational DI, which is rare but could occur in pregnancy and in this case, an enzyme produced by the placenta destroys ADH in the mother
• Nephrogenic DI, in which the kidneys are unable to excrete or reabsorb water as needed. This can be caused by some medications and can also be present at birth. In the latter case, the cause is genetic. It also affects more males than females. So, check with your baby’s doctor if he urinates more than 10 times a day.
• Primary polydipsia, in which the problem is excessive intake of water which dilutes

Treatment depends on the type of DI:

For Central DI, treatment is with a synthetic (artificial) hormone, desmopressin

For Gestational DI, treatment is also with desmopressin but where it is caused by an altered thirst mechanism, this is not needed.

For Nephrogenic DI, low salt diet and drinking sufficient amounts of water may be all the treatement needed. If medications are the cause, you will need to stop these.

For primary polydipsia, treatment is simple. Reduce fluid intake.

I hope this helps.

Have a great evening everyone J

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) Jumia.com. Just click on this link http://www.jumia.com.ng/jumia-books-just-for-the-health-of-it-with-dr-ketch-179486.html and get a copy. You have the option of paying when the book is delivered to you or paying online. This service is available all over Nigeria.

4) 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.

For those in Awka, please call 08189944090.

Have a great week ahead, y’all

Announcing our winners for 10^th December, 2016

• Osazuwa Christy Ijebor (from facebook.com)
• Ruth Michaels (from facebook.com)
• Tochukwu Emmanuel (from chatwithdrketch.com)

Congratulations, guys!

Please send an email to healthylivingwithdrketch@gmail.com for instructions on how to pick up your gifts.

Be sure to catch our show on DSTV 151 by 4.55pm on Sundays after the Hush omnibus!

Q: Hello. I’m a nursing mother. I have no appetite. What can I take to boost my appetite? Is appetite pills good for me to take them?
A: As a nursing mum, you need to keep your strength up and so dealing with loss of appetite is a no-no!
The first thing really, would be to find the cause of the loss of appetite. Some people experience this as a symptom of an underlying disease which can range from thyroid problems, infections to cancers. So, excluding all these is important

Then what to do?

• Eat smaller and more frequent meals/snacks. Some people naturally, ‘freak out’ when they see a huge bowl of food…how much more someone trying to get back into the grove of food

• Limit your fluid intake when you eat and much as it breaks my heart to say so, do not fill up on too many veggies. They keep you full but provide few calories…which you need if your appetite loss is leading to weight loss.

• When you do feel hungry, don’t be shy…make up for lost time

• Go for visually appealing meals and easy to digest foods like pap (ogi), custard, puddings etc

• If weight loss is a real issue at this time, go for peanut butter spreads on bread, mayonnaise dressings, full cream milk, full fat yoghurt, fried foods etc.

• Exercise is also a great way to work up an appetite at this time.

• If you feel food is bland, try using some spices and experiment with different textures eg some crispy cereal or nuts sprinkled on oatmeal porridge.

• It may also be a good time to experiment with and discover new dishes. All of us are creatures of habit and most tend to stick to the same meals…forever! Switch things around and try something new.

In Nigeria, most people look to a multivitamin to help stimulate hunger. You do need multivitamin supplementation if your loss of appetite is making you not eat sufficiently. Please let your doctor know if all the tips above do not significantly help so he can prescribe one while figuring out the cause of the loss of appetite. Finally, remember that ‘loss of appetite’ for a few hours (most likely less than a day) is not sufficient excuse to go on a binge with all the high calorie-foods mentioned. Let’s not exchange one problem for another, people. If in doubt, please see your doctor.

Have a great weekend, y’all 😀

Q: Evening over there. I have a serious problem with my teeth. I am unable to eat with a particular area. Each time I try to do so, I feel much unbearable pain. Please, kindly help as I await a prompt response

A: Tooth aches are mainly due to tooth decay which may give rise to a hole (cavity) in the tooth as is being experienced by the person who asked the question above.

How does a tooth get to the point of a cavity? 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

Q: Hi Dr. I have terrible heart burn. I am 6 weeks pregnant and I just don’t know what I should do

A: 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.

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

Here’s to a healthier you!

Q: G/a Dr. Please, I want know the reason why a nine month old baby refused to eat except breastfeeding. We’ve tried all what we could but are greatly surprised he didn’t eat. We have tried pap, he didn’t take it. We also tried custard, he refused to take it as well. Please Dr, what can I do? Thanks and God bless you.

A: I reproduce a post I had made to a similar question.

Just like adults, a good number of babies are resistant to change. They are comfortable eating what they had been eating? Life was good…why do you want to change it???? 😀 Okay, that’s some babies. Others are more than happy to move on to the next stage!

When to start? At 6 months. From birth to 6 months, please focus on exclusive breastfeeding with not even a drop of water. From six months, baby is ready to be introduced to some other food.

For a long time, the standard teaching had been to go for rice cereal as the first add-on meal because it is bland and babies tolerate this well. Other studies question this wisdom now and suggest that foods like meats with lots of essential nutrients like iron may be a good place to start. What should you do? You can boil beef/chicken very soft and blend it up for baby. If baby tolerates this, then by the next week, you could try adding some rice cereal. Try not to introduce more than one food per week so that you have time to study how your baby adapts to it and of course, look out for/isolate food allergy. And, to start off, only one meal of the complementary feed should be given daily. The rest should be the usual…breast milk 😀 This will, of course, as baby tolerates.

Generally, foods to start off weaning should be just slightly thicker than milk and so, if it retains its shape on a spoon, it may be too thick.

From 9 months, baby can be allowed to start experimenting with regular family meals…minus the spices, of course 😀

From one year of age, you can add the cereals mentioned in the question and it’s also okay to introduce cow milk at this time. Full cream cow milk is advocated at this time for proper brain development. Thereafter, please switch to skimmed/1%/2% milk as full cream milk has a lot of saturated fat which may contribute to poor heart health. Grains, green leafy vegetables, cow milk, honey, whole eggs can generally be introduced after the baby turns 1 year old.

Generally, other weaning foods that can be introduced include:
Boiled egg yolk (egg whites contain substances that baby may react to), sweet potatoes, fish, chicken, beef, fruits like banana, avocados, boiled beans (with skin removed if possible etc
Simple recipes include, blend some chicken or beef with the stock or mash a banana and add to baby’s cereal.

Our local cereals can also be used and fortified with some breast milk or formula.

As baby tolerates these meals, you can get a little more adventurous.

Boiled carrots mashed with some coconut oil or a little yoghurt with mashed banana may not go amiss too.

An example of a recipe I make for my children goes thus: boil potatoes in a pot and place a stainless plate on top of the pot. Add your egg yolk and a drop Olive oil and when the yolk is cooked and potatoes soft, mash all together and feed baby. It is yummy!

Now I know we are all very busy, but weaning is no easy task and so we must commit to trying as much as to prepare these meals ourselves. Packaged meals usually contain additives that may trigger problems/allergies etc in the baby. Hygiene is also critical!

I hope y’all had a great day?

Q: My child started purging and has serious fever. They said it’s a sign of teething but I have given him all kind of drugs they mentioned, but no way. I even took him to hospital but it’s still serious. Please Doc, I need your words he is 6month (FTM) but I did Ex-breastfeeding

A: It is thought that the inflammation of the gum around the area where the tooth will erupt from may cause low grade fever which is why the babies may experience some fever.

Another significant symptom believed to be associated with teething is diarrhea (purging, as you said). There’s no conclusive research that has shown any link between the process of erupting a tooth and diarrhoea. If anything, we’ve found out that this is the same period when children start picking up things and of course the natural ‘tourist’ destination for anything they pick up, is their mouths! 😀 What happens? When they pick up dirty stuff and suck on it, it would ultimately lead to diarrhoea.

So, more than ever, that’s a time to be watchful and ensure that the children are not stuff their mouths with rubbish and ensure their toys are cleaned.

Having said that, how can I help my baby through teething what with the itch and discomfort they feel around the ‘erupting tooth’ area? Even the drooling? Well, here are a few things you could do:

Rub over the teething area with your finger (thoroughly scrubbed and clean, of course :D) or use a finger covered with clean gauze or even the baby’s wash cloth. If this is cool to touch, this is even better. Massage the teething area with this…it helps to soothe the discomfort.

Teething rings are great ideas too and you could also refrigerate these to provide more comfort. Please do not freeze them.
Clean off the drooling saliva as this could cause irritation around the baby’s mouth, worsening his crankiness.

Over the counter analgesics like paracetamol could also be helpful provided it’s given in the appropriate dose for the baby’s age. This will also help with the fever. Please avoid Aspirin as it causes a disease called Reye’s syndrome.

Several studies have been conducted on the efficacy of gripe water though it is liberally used by parents and doctors alike, and it has not really been found to be particularly useful in teething. Older formulae contained alcohol which were thought to be perhaps, responsible for the soothing effect it had. Other components like the herbs etc may not go down well with all children.

If the fever continues, please take the baby to see the doctor to rule out other causes of fever. Dehydration is the more critical issue. If your baby is still stooling, fluid needs to be replaced. Please take him in to see his doctor to determine if the fluid loss is serious enough to warrant replacement. In the meantime, keep breastfeeding.

So, there you go!

Have a good night, y’all 😀

A study tested how certain types of light affected migraine pain. In this research, some people said that green light eased their pain somewhat.

Source: Shining a light on migraine relief