chatwithketch

Q: Good morning, Dr Ketch. Thank you for helping us out health wise. I’ll like to ask…as a Nigerian, do you know of any food that is healthy for a recovering stroke and hypertensive patient apart from Semovita and wheat? Thank you, ma’am

A: Stroke as the name implies refers to an incident that happens suddenly…without warning. It usually occurs when the brain is deprived of some of its blood supply and consequently oxygen supply. This can happen when there is a blood clot in a vessel in the brain or due to a burst blood vessel leaking blood onto the substance of the brain or around the brain. This blood leakage can lead to undesired pressure on the brain.

There is really no such thing as a partial stroke. Oftentimes, people refer to a Transient Ischaemic Attack (TIA), as a partial stroke. This condition occurs when a blood vessel is partially blocked. This would usually be resolved within 15 minutes and is a sign that a major event (a stroke, proper) may not be far off. This is a warning that should be taken seriously.
It is important to know the signs of a stroke because if action is taken immediately, it can prevent permanent damage from being done. If the brain is deprived of its blood supply for about 4 minutes, irreversible changes begin to occur in the brain. If this deprivation continues beyond this time, permanent changes would have occurred that may affect different facets of the individual’s functions.

The signs of stroke to look out for are known by the acronym FAST.
• F stands for drooping of a side of the face. Ask the patient to smile and you will observe that the smile looks lopsided.
• A stands for weakness of one side of the body. Ask patient to lift both arms and it will be seen that one side is being ‘dragged’ or lagging
• S stands for speech difficulty like slurring. Patient cannot enunciate words properly again
• T stands for time. Once these symptoms are notices, it’s time to call for help. In climes where there are emergency numbers like 911 or 999, please call these. Otherwise, efforts should be made to take the person involved to the hospital immediately.
Patients may also complain of sudden inability to move legs, feel confused, have blurred vision etc

There are risk factors for stroke and they include:
• Age: The older you are the more prone to stroke. People from age 55 years are more likely to have a stroke, though this can also happen in children eg those born with heart defects and those with Sickle Cell Anaemia etc
• Race: Africans and Asians are more at risk
• Sex: Females are more at risk…as if we don’t have enough problems
• Family history of stroke: The presence of this increases risk
• Previous history of a stroke.

Other risk factors:
• Hypertension
• Diabetes Mellitus
• Overweight
• Sedentary lifestyles
• Not eating healthy
• Smoking
• Drinking Alcohol

The rate at which one recovers from stroke and indeed the degree of symptoms experienced, depends on the area of the brain affected, how serious the damage to the brain is etc and so recovery will be different for different people.

Patience is key. Speech therapists may be needed to help the person re-learn the art of speaking. Physiotherapists will help improve motion on the affected side and indeed, mobility. Other therapists may help with eating…if swallowing is a problem, relearning the art of reading and reasoning etc

Usually, people who visit find it difficult to understand their speech during recovery and this can put even more pressure on the patients. Speak slowly and listen carefully so you can understand what they are saying.

Perhaps, swallowing is an issue in the case mentioned above. Apart from that, if Diabetes is an issue, she needs to be on a strict diet and that will determine what she can or cannot eat. This will ultimately affect weight gain or loss. If this is a big concern, please discuss with her doctor. For specific foods to eat, reduce your intake of cholesterol and trans fat-rich foods. What foods can help reduce bad cholesterol in the body and increase the level of good cholesterol? Here are some examples:

Oats and other whole grains which form soluble fiber that reduce the absorption of cholesterol and in addition, give you a feeling of satiety for long. This prevents you feeling hungry more often and reaching for ‘unhealthy’ snacks Other foods in this group include okro, beans, apples, citrus fruits and garden egg (egg plants).

Soya beans, heart healthy oils like Olive oil and Canola oil, nuts (which should only be served in handfuls) and fatty fish like mackerel also reduce LDL.

Generally eating healthy with lots of fruits and vegetables, cutting out the white carbs (pastries etc), exercising (at least 150 minutes weekly), ensuring you are not overweight and quitting smoking help with reducing bad cholesterol and also preventing strokes.

You may need to walk with a stick as you re-learn the art of walking. Recovery may be long and tedious but you’ve got to keep at it.

All the very best.

Have a good night, people 😀

Q: Doc my heart beats too much, mostly if I lift heavier weights

A: Thanks for writing in.

The post below would speak to your question.

A: Palpitations occur when you get the sense that you can feel your heart beat. Ordinarily, your heart goes about its business of keeping you alive and well by beating inside your chest without you being aware, right? Some conditions, however, may make your heart beats obvious and you probably have experienced some: anxiety, panic attacks, stress, after some exercise or intense activity (like lifting heavy objects as described above), when you have a fever, after taking some coffee or any caffeine-containing food/fluid and also after taking in nicotine as in cigarette smoke, cigar or even chewing tobacco. Conditions like pregnancy and taking drugs eg cough medicines that contain stimulants may also cause palpitations.

Usually these palpitations would disappear after a brief appearance, but if they appear frequently and are accompanied by other symptoms like chest pain, being short of breath etc, please be sure to see your doctor to confirm that this is not a sign of a bigger problem with significant complications.

Treatment is focused on the cause. Where stress or anxiety is the trigger, management is really all about coping with stress and making sure that you have more ‘good’ stress than bad stress (remember that good stress has a life cycle…it starts and ends within defined periods while bad stress is from situations that are not handled properly and remain a source of ‘worry’ continually). If it’s due to caffeine and nicotine…simple: stop or significantly reduce. For coffee, 2 cups (teensy weensy lady-like cups :D) a day should be the very maximum For nicotine though, you just have to let it go.

Finally, if you indulge in other drugs of ‘recreation’ eg cocaine etc, please leave well alone!

Have a good night, people and keep those hearts doing their things without you knowing

Q: Are snails, crabs and prawns healthy to eat?

A: Sea food is generally healthy containing a good amount of protein and Omega 3 fatty acids which are very heart healthy. They are also rich in a lot of minerals and vitamins like Zinc, Vitamin B12, Selenium etc and they are low in calories. However, snails, crabs, prawns and shrimps are also pretty high in cholesterol and so should be taken as an occasional treat by people who have high cholesterol.

Are these seafood best taken fresh or frozen, raw or cooked? Are they safe to take in pregnancy?

For answers to this, 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

If you have ever worried about protecting your eyesight, you should read this:

http://www.health.harvard.edu/healthbeat/5-truths-about-protecting-your-eyes

Q: Good day to you Doc. Please, how long should a Copper T (contraceptive device) be used in a woman’s body? My wife had been using it since December 2013 and it’s perfectly okay with her. But I’m anxious as to whether it won’t have any effect if it is there for a longer time than this. Though, we are planning to have our baby next year. Please, I hope there’s no negative effect as regards its longer period?

A: There are two types: the Paragard IUD and the Mirena IUD.

The Paragard IUD is a copper-containing IUD. This is probably the one your wife had inserted. The copper is poisonous/toxic to sperm and the IUD also prevents implantation of the fertilized egg into the uterus, should fertilization still occur. Paragard can be used during breastfeeding and its removal leads to a quick return of fertility, generally. It usually prevents pregnancy for about 10 years after insertion.

The Mirena IUD contains hormones which make the cervical mucous extra thick preventing the sperm from getting to the womb and it also makes the lining of the womb thin such that even if a fertilized egg were to get there, it would not be able to implant on the thin lining of the womb. It also prevents ovulation. Mirena helps reduce the cramping pain of a menstrual period and also reduces bleeding. It prevents pregnancy for up to 5 years after insertion.

Side effects of Paragard include back ache, cramps, severe pain during menstrual period and heavy bleeding etc while Mirena can cause breast tenderness, weight gain, irregular menstrual cycles etc Both IUDs can also be expelled, spontaneously, that is for no reason.
There are warning signs to look out for when you have the IUD on. If you experience any of these under-listed symptoms, please see your doctor immediately.

• Severe vaginal bleeding with at least 2 sanitary towels soaked every hour for 2 or more hours.
• Smelly vaginal discharge. This could be associated with fever and chills
• Severe pain in abdomen or pelvis

General information about IUDs:
• They are more than 99% effective
• You and your partner cannot feel the IUD either during sexual intercourse or while checking for it
• Your partner may however be able to feel the string during sexual intercourse and the string can also be felt if a finger is into the vagina.
• People who have inserted IUDs may feel abdominal cramps or lower back ache for a few weeks after insertion
• Bleeding in between periods may also happen.
• There is a risk of infection if the user of IUD or her sexual partner have other sexual partners.

If your wife is not sure of the IUD she had inserted, please get her to visit her healthcare provider to confirm. The IUD is usually quickly reversible and so your wife should be able to get pregnant when you’re ready without much stress.

Have a great weekend, everyone 😀

Q: Ma’am, please I really need your help. Is there any drug you could prescribe for me that can wash away sperm from my body? I don’t want to get pregnant. Please Ma’am

A: Hmmm, I’m not sure where to start from. From your panic, it appears you had unprotected sex at a time you were not ready and committed to pregnancy. You need to remember that beyond pregnancy, you could be opening up yourself to sexually transmitted infections. Unfortunately, there is no drug that washes away sperm after they have been deposited. Emergency contraception taken up to 5 days after sexual intercourse may also help prevent pregnancy. Emergency contraceptives have their place but they are not meant to take the place of regular contraceptives as they are less effective than the regular ones. Regular use of these emergency contraceptives may cause your periods to become irregular and unpredictable. I’m sure you don’t want to have this problem

There is a simple ABC that guides these affairs. The first is abstinence. Honestly, this is your safest bet. If you’re not ready to deal with the responsibilities of having a baby, please leave well alone. You can’t have an STI, HIV/AIDS, or otherwise if you don’t have sex. And of course, you can’t get pregnant.

Now, if abstinence is a problem, be faithful to one partner…who hopefully is being faithful to you too. If you can’t swear on this, revert to plan A.

Finally, if all else fails, ensure that you use a condom to prevent STIs and pregnancy. Other contraceptives can also help. There is no contraceptive that is 100% fool proof. They all have their pros and cons and really the best method for each person depends on personal preferences, cost, ease of using it, intended duration of use etc

I suggest that you walk into a family planning clinic where a nurse will take you through all the different methods.
Have a great night, y’all

Q: How can a bad smell of arm pit or other part of the body be reduced?

Q: Hi Doc, my daughter is 7 years old and she now has smelly armpits. I have tried baby powder. What else can I do?

A: Thanks for writing in, both of you.

The tips for dealing with body odour works for both young and old.

From around the age of 8 to 10 years, children begin to sweat a little more and of course with the sweat comes the possibility of body odour. So, this is the time to teach her some hygiene lessons that will be helpful forever 😀

She needs to take a shower twice a day or failing that, at least once a day. This helps wash away sweat as well as reduce the number of bacteria on her skin.

Most people don’t know but sweat on its own is virtually odourless. But when bacteria that live naturally on your skin mix with sweat, they multiply quickly and become smelly.

Teach her to towel off after a bath or shower. She needs to pay close attention to areas where she sweats a lot. Sweat causing bacteria love moist areas.

Get her a deodorant or anti-perspirant to use on her underarms twice a day, in the morning and the evening. Deodorants do not actually prevent sweating, but they mask the smell of bacteria on the skin. Now that she has underarm hair, she has to shave that and groin area hairs frequently as they trap sweat and encourage smells.

Change undergarments frequently. Honestly, panties and underpants should be changed whenever you take a bath. And please remember to wash the discarded ones when you change.

When sweating heavily or in very hot weather, she should change clothes frequently…and it’s important to wash those sweaty clothes before wearing them again! Fresh clothes help keep body odour down.

Teach her to change her socks too, especially if she tends to have foot odour. Deodorant powders or detergent based running shoe cleaners used in shoes are useful.

When she starts menstruating, she needs to change her sanitary towel often and ensure that she takes a bath as often as is needed to remain fresh every day. If after a change, a bath is not possible but she really feels she needs one, she could use a moistened cloth or paper towel to wipe down her privates and surrounding areas.

For the adult, if you use the gym or engage in physical activity that make you particularly sweaty, a visit to friends immediately afterwards is not a good idea as you would seriously stink 😀 Try taking a bath, first.

Eating garlic and onion meals may also contribute to a smell around you. As a result of the fact that they contain some very active nutrients needed in the body, we may not be suggesting that you stop eating them 😀 Try something minty after these meals. It has also been suggested that perhaps eating some more veggies like carrots or taking lemon juice may neutralize the smell. Be sure to also scrub the smell off your hands too.

Let me know how these work out and remember that a positive self-esteem also smells absolutely amazing!

For the mum who wrote in, be sure to reassure her that this is all part of growing up and as is usual with this process, she has new responsibilities that go with this stage 😀

Have a good night, y’all 😀

Q: Ma’am, I did some test on semen analysis and culture, and the result was ok, but they detected infection. What drugs do you prescribe for a quick cure?

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

If you have an infection, this can be easily treated with antibiotics under your doctor’s guidance.

All the best.

Have a good evening, everyone 😀

Q: Good morning Doc. Please, what will I do? Anytime I finish giving my child breast milk and keep him on his bed, he will vomit all the milk. After a little while, he will begin to search for another feed, but he is healthy. Please, tell me what to do because he stresses me.

A: Thanks for writing in.

Please don’t be stressed 😀 The post below written in response to a mum like yours, should answer your question. Enjoy….

Q: Good afternoon Dr Ketch. I have a 3-week old son who vomits sometimes after breastfeeding. Please I will like to know what causes it and what I can do to remedy it. I intend to do 6months exclusive breastfeeding. Thank you and remain blessed

A: Hi dear, congratulations on your new baby. This baby will do super-amazing awesome things…Amen!

Now, is your baby ‘vomiting’ or spitting up the milk? Bear in mind, that when I say spitting up, it’s not the type that you and I do. Spitting up in babies refers to an easy flow of the milk your baby just took out of his mouth accompanied by a burp sometimes. Vomiting, however, is more forceful and would move a couple of inches more from the baby’s mouth.

What causes reflux? There is a ring of muscle that separates the stomach from the esophagus (the food pipe). In babies, this muscle is not well developed and so allows food that has moved into the stomach to sometimes come back up. This would continue, sometimes, up till when the baby is about 12 months but is more common within the first 3 months of life. It is also common in babies who are over-fed 😀

You can help to reduce this by

• Feeding your baby in an upright position and keeping baby upright, if possible, for a couple of minutes after breastfeeding

• Burping your baby after meals
• Feeding baby small and more frequent meals to prevent overfeeding at any meal time.For those bottle feeding, check that the hole in baby’s bottle teat is not too big.

• You can also check to see whether your diet is culprit. If you suspect one, eliminate for at least a week and see if there is an impact.

If your baby, however, ‘vomits’ forcefully, is not gaining weight, gags, has difficulty swallowing or sleeping etc, please see his doctor for a review.

Please keep your commitment to the exclusive breastfeeding plan. It’s a sure winner. My love to your baby!

Have a great evening, y’all 😀

Moderate exercising like walking the dog or riding a bike for just an hour a day could alleviate or even eliminate the dangers caused by sitting all day.

Source: Get up, stand up, for your health: A little exercise offsets a lot of sitting