chatwithketch

Q: Good day doctor, please which malaria drug can a pregnant woman in her first trimester take for prevention of malaria not cure…a doctor prescribe consider, but someone said consider can not be use in first trimester…please help

A: Pregnancy can affect different women differently. For some women, they hardly feel a thing and others spend the whole nine months (…and then some :D) in bed. And so, you may very well feel you have malaria when the only issue you’re dealing with is the new life growing in you! I felt like that for a long while before I discovered I was pregnant 😀

Fansidar is a specific brand of the drug Sulphadoxine-Pyrimethamine (SP). It is used for the prevention of malaria in pregnancy. Its use for this is referred to as Intermittent Preventive Treatment of Malaria in pregnancy (IPTp-SP).

Is it safe in pregnancy? Yes and no. In the first trimester, it is not recommended for use but from the second trimester, it is considered appropriate and indeed is recommended by World Health Organization (WHO) for administration to pregnant women. If you live in a malaria endemic area like Nigeria, your doctor will ensure that you get your Intermittent Preventive Treatment (IPT) courses for malaria (sulphadoxine-pyrimethmine) during your pregnancy, as your doctor has already done. The assumed rule before was for pregnant women to receive 2 doses of this drug (full dose of 3 tablets) but WHO has since clarified that the appropriate regimen is for women to receive the full dose of Sulphadoxine-Pyrimethamine from week 13 of pregnancy. She should get a full dose at every antenatal visit provided the last dose was taken at least one month before. There is evidence that women who received 3 or more doses of IPTp had children with higher average birth weights than those who got 2 doses.

Your doctor will ensure that the Folic Acid dose you’re getting in your prenatal drugs is not more than 0.4mg. Doses of Folic Acid higher than or equal to 5mg affects the efficacy of the anti-malarial, SP. So, be sure to check with your doctor before you start buying other non-prescribed prenatal vitamins.

If you do have malaria Quinine, Clindamycin, Proguanil are considered safe by the WHO treatment guideline in the first trimester. But, don’t be quick to go take any of them without prescription. Remember that every drug is a potential toxin and your doctor is really in the best place to weigh potential risks of taking any drug against the potential benefits. To put this in perspective, a recent study appears to now suggest that acetaminophen (the main ingredient in paracetamol) may lead to Attention Deficit Disorder in children! And yet, we refer to it as ‘ordinary’ paracetamol. There is nothing ordinary about any drug, my friends

Doing all of the above will be meaningless if you do not pay any attention to the environment.

Those anopheles mosquitoes that are associated with malaria need a place to lay eggs so they can muster the right army to wreak havoc. So deprive them of a breeding camp. Who would know the conditions necessary for a terrorist camp to be set up and make their homes or environment, the right one for that? Nobody…in their right minds at least 😀

If you have to go out in the evenings, depending on whether you will be out in mosquito infested areas, wear protective clothing that cover arms and legs, preferably in light colours. Mosquitoes love dark colours and the dark….no wonder their deeds are evilInsect repellent creams used on exposed areas are also not a bad idea.

So, my advice is to see your doctor to confirm what is wrong with you…if anything at all, beyond pregnancy 😀

Have a good night and a great weekend, y’all 😀

Q: Is spotting at 35 pregnancy dangerous? And will my baby be okay? I’m very scared and worried

A: Bleeding in late pregnancy may be due to a variety of issues ranging from infections to the ‘show’ that heralds the start of labour.

Causes of bleeding at this time include:

• Cervical changes which can lead to bleeding after sexual intercourse
• Infection of the cervix
• Infection of the vagina

Other causes include:

• Placenta previa.
• Placental abruption.

These are two conditions that affect the placenta.

The placenta is created during pregnancy and is attached to the wall of the uterus (the womb) by blood vessels. It is through the placenta that the baby receives vital nutrients and oxygen and also through this that it excretes waste products. The baby is connected to the placenta through the umbilical cord. So this is a pretty important organ in the general scheme of things. The baby’s and mother’s blood do not mix in the placenta usually, though. The baby’s blood flows on one side and the mother’s on the other side.

The placenta usually implants at the top part of the uterus or the side, but in placenta previa the placenta attaches low in the uterine wall and covers the mouth of the womb (the cervix) partially or completely. It could be just low lying, near the cervix but not covering it, just covering part of the cervix or fully covering it. Due to this abnormal placenta position, pregnant women with PP would show up in hospital with bright red vaginal bleeding which may happen with or without contractions.

What causes this? Well, in instances where the placenta is bigger than normal or in cases where surgery had been performed on the uterus. Thus, women with multiple pregnancies (twins, triplets etc), who have had fibroid surgery or previous Caesarian Section, who have had children before may be at risk of this. Other risk factors include age at pregnancy older than 35 years, smoking, use of cocaine etc.

The doctor (obstetrician) will order a scan to confirm the diagnosis. Low lying placenta that hardly get to the opening of the cervix can actually be ‘drawn’ up as the uterus expands to accommodate the growing baby in it. However, the women with complete PP are most likely to go through Caesarian Section.

Can you prevent it? No, you really can’t 😀 What to do? Once you notice any vaginal bleeding, please be sure to see your doctor. PP is likely to cause bleeding from sometime around the second trimester of pregnancy, but of course, every episode of bleeding in pregnancy, irrespective of trimester, should be checked out in the hospital. Depending on the severity of the bleeding and the age of the pregnancy, the doctor would decide whether bed rest or emergency Caesarian section would be applicable. If bed rest is recommended, sexual intercourse and physical exertion including exercise, at this time may not be wise. Please discuss this with your doctor.

You’ve got to make sure that the person with PP is under the care of a good obstetrician. This is not the time to play hooky and try out different treatment options from unorthodox practitioners (not that any time is a good time, anyway :D). It may very well be that if the bleeding continues significantly, the baby may be delivered pre-term. So you have to be in a center that is equipped to handle that eventuality. Better safe than sorry 😀

In placental abruption, the placenta separates, completely or partially, from the wall of the uterus before the baby is born. This situation is not very common but when it does happen, it can deprive the baby of vital nutrients and oxygen and lead to bleeding in the mother. This situation may happen suddenly or may develop gradually with symptoms like vaginal bleeding, abdominal and/or back pain, sore uterus, fewer baby movements, contractions etc

We don’t really know the cause of placental abruption apart from the fact that it could be caused by trauma to the abdomen. Other risk factors include:
• A previous history of placental abruption
• Multiple pregnancy
• Premature rupture of membranes
• Substance abuse eg smoking
• Maternal age greater than 40 years

Now, remember that having a risk factor doesn’t automatically mean that you will come down with the ‘disease’.

Treatment depends on the severity of the abruption, the age of the pregnancy and the effect on the baby. Your doctor will make the call as to whether to go for an emergency Caesarian Section or keep patient on bed rest while waiting for baby to mature some more, depending on these factors.

Can this be prevented? Well, given the fact that we’re not quite sure of the cause, we can’t really do much other than try to guide against risk factors that can be prevented like not smoking.
Just be sure to let your doctor know that you have had this problem before so he can be extra watchful. With the right care, you should be fine.

So, I suggest you go see your obstetrician to confirm that this bleeding is nothing serious.

Have a great night, y’all 😀

Constant stress — whether from a traffic-choked daily commute, unhappy marriage, or heavy workload — can have real physical effects on the body. It has been linked to a wide range of health issues, including mood, sleep, and appetite problems — and yes, even heart disease.

To learn more, please click on http://www.health.harvard.edu/healthbeat/5-ways-to-de-stress-and-help-your-heart

Have a great evening 😀

Q: Hello ma! please I discover a tough black stains on my teeth but don’t know what to used to wash it. What can I used to wash it?

A: Thanks for writing in. Brown teeth can be embarrassing. Smoking, drinking coffee, wine, tea etc can cause this. Generally brightly coloured foods like some candies, berries and sauces also have the potential to stain teeth if they are left on the surface long enough.

To prevent these stains, try the following tips:
Avoid or significantly reduce the amount of these fluids or foods in your typical diet.

If you can’t avoid them, then reduce the amount of time the foods or fluids have contact with your teeth by chewing and swallowing promptly. Yes, I know I’ve said you should chew intentionally so that your tummy has the chance to receive signals from the brain which tell it that it’s full 😀 But, in this instance, we’re trying to choose the lesser of two evils 😀

Use straws. These will ensure that the fluids get little contact time with your teeth.

Learn to swish your teeth with water after you’ve taken any of these foods to ‘wash’ away the residue of the stain-causing foods.

As for what to do if you already have stained teeth, I reproduce one of my posts on that subject:

There are easily obtainable teeth whitening tooth pastes. They help remove surface stains that may be caused by coffee or nicotine.
When whitening paste is used at least twice a day for a period of time between 2 to 6 weeks, significant results are seen. However, care has to be taken to ensure that these pastes are used according to the manufactures’ instructions otherwise, they can cause erosion of the enamel of the teeth.

Please note that the whitening tooth pastes do not alter the natural colour of your teeth and by extension are not also useful, if the stain is deeper than the surface of your teeth!

Whitening strips and gels are also available. Apart from all these, there are a couple more sophisticated treatments available from the dentists’. So check with yours.

Beyond all these, please don’t forget the place of regular brushing of teeth in the maintenance of a bright and gorgeous set of teeth.
Fruits like apples and strawberries actually contain substances that help whiten the teeth. So, just like the doctor ordered…an apple a day, keeps the doctor (and the dentist :D) away.

I hope this helps J

Q: Hi Dr Ketch. Thanks for a job well done. It’s only God that can reward you abundantly. I am not sure if this question is appropriate here, but I still believe you will help me out. Doc, there is this hair that has been growing on my chin a long time ago. I usually shaved it then but I stopped doing it when I noticed that it keeps increasing. As a young lady, am not feeling comfortable with it and it is really weighing me down. I am counting on you ma’am. Please, help me out. Thanks and God bless

A: Thank you so much for your kind words. And Amen to your prayers.

What you’ve described sounds like hirsutism which is a situation in which there is excessive hairiness in a woman in places like the face, chest and back. Funny enough, growing up, very hairy ladies were considered pretty special…In a good way 😀

This situation 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.

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

As you may have found out, 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.

Birth control pills 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.

So, make out time to go find a gynaecologist as soon as you can and discuss this. He will carry out a detailed investigation and then confirm treatment options that would work best for you depending on his findings eg whether the contraceptive pills are an option for you etc

Until you’re able to do that, you may have to keep shaving, plucking, waxing or using depilatory creams. As soon as you can afford it, laser treatment should be considered.

Have a great evening, y’all 😀

Are you a new mum trying to figure things out? Well, this is for you!

Do you remember trying to sit down after you delivered your baby? If you had an episiotomy (a surgical tear to help ease the passage of the baby), you probably froze in shock at the pain, right? Well, I did It was just plain excruciating to attempt to sit, much less, adjust yourself to a more comfortable sitting position. Then, do you remember the first time after that when you tried to pass gas? It was sheer agony! Agony that melts away as you behold the bundle of joy that was a result of that process 😀 Now, if you haven’t had your baby yet, this may sound very scary, but there’s a solution for this pain.

Ever heard of a Sitz bath? It’s a warm water bath that helps cleanse the perineum. Just in case you wondered, the perineum is that space between the rectum and the genitals. The right temperature is the one that you can handle without sustaining burns. Putting a few drops of this water on the inner surface of your wrist can help confirm this.

Plain warm water is sufficient but some people add salt to the water which is soothing. Your doctor may also suggest other things he/she may want you to add to the water.

Do you wonder what to do with your baby’s umbilical cord stump? How many times to clean it? What to clean it with? Methylated spirit, antiseptic lotion or water? Or perhaps you should just ignore it, hoping against hope that nature does its thing and the stump falls off when it should, leaving your baby with a nice looking navel?

For details of how to get your Sitz bath running, how to care for your baby’s cord and answers to all those questions you have on pregnancy, taking care of baby and weight loss afterwards, get a copy of the book, Just For The Health Of It. 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 linkhttp://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.

Remember that this book 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, Christmas gifts etc. It’s a gift that keeps on giving 😀

Complan Saturday Nutrition Quiz

Watch the video on our facebook page (www.facebook.com/healthylivingwithdrketch) and answer the following questions:

Mention the 4 ways the video teaches to avoid stress.

What is the link between stress and nutrition?

Give one personal way that you deal with stress.

Terms and conditions:

The first 3 persons to answer correctly will win our prizes.

Participants must be followers of our blog and/or facebook page.

Only one answer per participant will be accepted.

If a participant provides more than one answer, the first answer will be used.

Edited answers will be disqualified.

Editor’s decision is final.

This challenge lapses by 11.59 pm on Friday, the 11th of November, 2016

So, what are you waiting for?! Best of luck, guys!

Congratulations to our winners for the 30^th October quiz!

Amaka Oshiomele Isedu (from facebook)

Chukwunonso Onochie (from http://www.chatwithdrketch.com)

Oyiwodo Elizabeth Agbo (from facebook)

Congratulations, guys!

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

Q: I am about to finish my exclusive breast feeding and it keeps him very healthy and fast growing. Since I gave birth to him, he has never been sick or have rashes on his body but now I don’t know the kind of good foods and drinks to introduce to my son. Please Doc, help me (FTM)

A: Congratulations on your new baby! And great job for going through with exclusive breast feeding. You’re a super mum!

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 increase, 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 is 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.

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?

Have a fab weekend! 😀

Your body needs a little bit of salt every day for the sodium it contains. But too much sodium can boost blood pressure and stress the heart and blood vessels. The low-sodium Dietary Approaches to Stop Hypertension (DASH) diet is high in fruits, vegetables, and whole grains; moderately high in nuts and low-fat dairy products; and low in red and processed meats. Following it can lower blood pressure and reduce the risk of heart disease and stroke.

Want to know how else you can reduce your salt intake? Read this: http://www.health.harvard.edu/healthbeat/6-ways-to-eat-less-salt

Q: Good day ma’am. I have this wound on my toe they call it (wick lo) so I went to a pharmacy and was given Ampicillin and Flagyl but when I used it, I started seeing blood coming out whereby I have stopped my menses. I am also a breastfeeding mother so please ma’am, what drug can I use for it? Thank you ma’am

A: Whitlow usually refers to Herpetic whitlow caused by Herpes Simplex Virus. It usually affects the tip of the index finger or thumb. Occasionally, this happens on the toes. It happens when the finger skin, especially the cuticle, is broken and invaded by virus causing infection of the soft tissue around the nail. This can happen through skin to skin contact or when infected fluid touches the breach/cut in the finger skin. In children, this can happen when a child with cold sore (what we usually term fever blister), sucks on a finger with a cut on the thumb or also through contact with someone who has genital Herpes.

The virus may remain inactive in the skin for up to 3 weeks before symptoms manifest. This condition is intensely painful and patients would complain of swelling and blisters in the affected area, tenderness over the area and, of course, pain. As is usual with viral infections, whitlow is self-limiting. This means that the infection will run its course and disappear. They usually clear up within 3 to 4 weeks without treatment. However, your doctor may prescribe an anti-viral agent to prevent recurrence of the infection.
If you already have a whitlow, prevent its spread by covering it up with a plaster (it could spread to another finger, you know :D), wearing glasses to prevent passing on the virus to your eyes, ensuring that your baby does not suck his ‘whitlow finger’ (Eeew! :D) and washing your hands often.

I’m a bit confused about the rest of your complaint. You’re breastfeeding? But you have stopped seeing your period…as in menopausal? Or you have not seen your period since you had your baby? And perhaps you believe that if you are breastfeeding, you cannot menstruate? Well, if the latter is your assumption, you’re not exactly correct. Breastfeeding your baby does not necessarily stop menstruation and while on it, it may also not stop another pregnancy. If you’re exclusively breastfeeding, feeding your baby on demand (every 4 hours), you’re within 6 months of your baby’s birth and your menstrual period has not returned after the birth of your baby, you stand a better chance of not getting pregnant during this period. However, this is not a reliable method.

So, I suggest you go see your doctor to find out the cause of bleeding. It may, very well, be your period! Or something else. Better safe than sorry J

I hope this helps.

Have a good night, y’all 😀