chatwithketch

Q: Dear Doc, I have been experiencing this for some time. I have been to many skin doctors but all to no avail. It started while I was washing the laundry and dishes, then later my hands at the fingers started scratching me. It itches so badly, my hands turned red and little rashes came out the next day. If I scratch it, it will swell up. I didn’t give it much attention. It later started bringing out pus and boils and water from the open wound. It will dry and leave scar and now, it’s dry, rough and looks as if fire or hot water burned me and it heals and comes back again. So Doc how am I to treat it and what’s the cause?

A: Hello dear, thanks for writing in. Condolences for the problems you have been going through. The only way of knowing what is really wrong with you is for you to see a dermatologist (skin doctor) who will properly examine you, perhaps conduct a patch test and make a diagnosis. If you still have the problem after seeing any particular skin doctor, please seek a second opinion.

Without the benefit of seeing you myself, I think that this could be contact dermatitis. This is a condition in which red, itchy rashes develop on the skin as a result of contact between the skin and some ‘irritant’ substances like detergent and other soaps (as could be the problem here), jewelry, fragrances etc. These rashes usually develop on the area of the skin in direct contact with the irritant and other symptoms apart from rashes include:

• Itching
• Swelling
• Blisters
• Dry and cracked skin, if this continues for long
• Appearance of pus and development fever which would indicate infection.

Allergic contact dermatitis occurs when a substance you are sensitive to triggers against an immune response on the area of the skin that has been in contact with the substance or it could enter the body through other sources eg food. Examples of substances that could cause this reaction include cosmetics, antibiotic creams, insecticide spray, antibiotic creams etc

Occupational contact dermatitis refers skin rashes due to contact between skin and irritants in the workplace. Examples include cosmetics, cleaning materials etc

The first key in treatment is identifying the irritant or substance that you are allergic to. Whatever it is, stay away from it. For you, try washing dishes and clothes while wearing hand gloves. And moisturize your hands a lot with a good hand moisturizer. If it’s the strap of your wristwatch causing rashes around your wrist, give the wrist watch a rest and later when the rashes have healed, you can change straps or line the inside of the strap with cello tape

Try not to scratch. Very tough, I know! 😀 If the temptation is great, cover the area with sterile dressing. And use cool compresses to cool the area down.

Use lotions that help with itching, like Calamine lotion and if need be, take an anti-histamine to also help reduce the itching.

Depending on where the rashes are, wearing soft cotton clothes will reduce possibility of irritating the rashes.

Given that personal care products like soaps and perfumes have been implicated in this, try to go for unperfumed products to reduce the risk of irritation.

Your doctor may also prescribe some steroid creams, oral medications and/or medications that repair skin.

So, the action point for you now is to see a good dermatologist and take it from there. A good place to start from would be the Teaching Hospital in your area.

Have a great weekend, y’all 😀

Q: Dr Ketch, please I have a 15-month old baby that has a very sensitive skin. Whenever he’s bitten by sand fly, it starts itching him. If he scratches it, it will form pus that will eventually become an open wound. Wherever the fluid from d previous ones touches, it forms another pus. l have giving him different antibiotics but to no avail. When it heals, after so time it comes back. So please Dr I need some advice.

A: Hi dear, thanks for writing in.

My first daughter, growing up had problems with sand flies. There appeared to be a lot in her school and every time she scratched (boy, did she scratch?!), they swelled up and eventually left ugly black marks! What did I do? I bought her long socks (really long socks) and tights to wear to school. And I encouraged her to stay away from the areas where the sand flies struck the most.

So, I share the same advice with you. Cover up your baby properly when you have to go to the areas where the sand flies are and if possible, avoid those areas. If despite your best intentions baby has a bite, try not to allow him to scratch it. The scratch opens the bite up and lays your baby open to infection. Soothe the area with a cool compress. You can use a cloth dampened with cold water to reduce pain and swelling. Applying calamine lotion also helps soothe the itchy area of skin.

If your baby develops a fever and/or infections of these sores (like those ones with pus), please consult the pediatrician. And don’t be too free with antibiotics. Let the pediatrician be the best judge of what should be taken and for how long.

I hope this helps.

Have a good night, y’all 😀

If your diet gave you high cholesterol, it can lower it, too

It’s easy to eat your way to an alarmingly high cholesterol level. The reverse is true, too — changing what you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream.

Doing this requires a two-pronged strategy: Add foods that lower LDL, the harmful cholesterol-carrying particle that contributes to artery-clogging atherosclerosis. At the same time, cut back on foods that boost LDL. Without that step, you are engaging in a holding action instead of a steady — and tasty — victory.

Details of this article can be found through this link: http://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol?utm_source=delivra&utm_medium=email&utm_campaign=GB20160803-Cholesterol&utm_id=214939&mid=11052531&ml=214939

Q: Dr. thank you for all the medical and health advice.  Please I have hiccups or belching constantly such that my chest pains me most of the time.  I have received so many treatments, done Echo test, MCR, several scan and X-ray, ECG etc that the Dr. advised me not to do or take more medications for that as I have taken so much over the years. Now I notice that if I keep away from food or heavy food, I feel better but I am leaning and feel tired because of hunger. What else should I do? Thank you.

A: Belching and hiccups are actually quite alike in terms of causes.

Belching is your body’s way of getting rid of excess gas.

‘Excess gas’ is produced in the body when we swallow it or when our body produces it as a result of what we have eaten. This is usually caused by the twin factors of what you have eaten and how you chose to eat it.

For what you have eaten, easy culprits are rich, fatty foods, beans, dairy (especially in lactose intolerant people), high fibre foods (if lots of water is not taken afterwards) etc.

How can how you eat cause you a problem?

If you tend to over-eat or rush your food (eat it very fast or like a friend of mine would say, ‘inhale’ it :D), then you are a target for bloating. The reason is that you eat so fast that you don’t give enough time for signals to travel to your brain from the stomach confirming that you are full. By the time that signal arrives, you are all stuffed up and bloated to boot! Note that it may take up to 20 minutes for those signals that confirm fullness to get to the brain…sounds like a long journey 😀

Other causes of bloating are swallowed air (which can happen when we eat too fast or drink too fast) and smoking.

Prevention?

This is really simple: Reduce portion sizes, limit your intake of fats, eat slowly, quit smoking and limit your intake of foods that cause this, if all else fails.

If your bloating is caused by swallowed air, avoid carbonated drinks (most soft drinks fall into this category), don’t drink with straws (at least on a regular basis) avoid chewing chord…oh, sorry! 😀 I meant to say, avoid chewing gum and stay off your candies that you suck so hard and suck in quite a bit of air too!

Remember that if this ‘gassiness’ continues ‘regularly, you should see your doctor to be sure this is not the symptom of something else.

Hiccups refer to involuntary contractions of the diaphragm. The diaphragm is the thin muscle that separates the chest from the abdomen. This is followed by sudden closure of the vocal chords with the resulting hiccup sound at the top of the windpipe.

Hiccups are quite common and can affect any age group. They usually occur without provocation and last for a few minutes before disappearing. These episodes may be linked to:

• Bloating…which may be a factor in your case, given your belching.
• Eating or drinking too quickly (in which case a lot of gas/air is taken in. Again, this could be a factor in your case)
• Smoking
• Drinking alcohol
• Drinking fizzy or hot drinks
• Sucking on candy

However, sometimes hiccups may last for prolonged periods and in these cases are associated with underlying medical conditions:

• Meningitis
• Diabetes
• Alcoholism
• Stroke
• Neck tumours

Most cases of hiccups do not require treatment. However, some may persist requiring treatments with drugs, injection of medications and/or surgery depending on the underlying condition.

I am sure most of you may have tried many home remedies like

• Putting a thread on your head! This one is laughable and I do not know anyone it has helped.
• Sipping on cold water. Well, if it helps, why not?!
• Holding your breath for a bit. Again, if it helps, go for it.

So, I suggest that you note the triggers noted here (generally, things that make you gassy), stay away from them and see if that helps. The triggers for belching and hiccups are basically same…factors that cause you to swallow a lot of air. Don’t stay away from food completely….we need you alive 😀 I believe this will help. Be sure to also check in with your doctor for a proper diagnosis to be made, if this continues.

Have a good night, people 😀

A recent study suggests that special “unloading” shoes might not be any better than good walking shoes at easing osteoarthritis knee pain.

Source: Beating osteoarthritis knee pain: Beyond special shoes

It’s a 2-question night 😀

Q1: Good evening Dr. Thanks for being there for us to share your knowledge with us. God will continue to increase your knowledge in Jesus name, amen. Now to my question…I am age 50-60 and I just discovered that I snore when I sleep. What can I do because my children complain about it. Please, help. Is there any medicine or what?

A1: Thanks for your prayers and Amen to them.

I actually answered this question not too long ago, but I repeat it here for you.

Snoring can be a problem as it can disturb sleep for you, your partner and perhaps even your neighbours 😀  When we sleep, our muscles relax. This includes the tissues in the airways (throat). Snoring occurs as air passes through the airways that are partially obstructed by relaxed tissues. As the air flows, these tissues vibrate and we hear the sound described as snoring.

Occasional snorers are mainly problematic to their partners (who may or may not put up with it) but habitual snorers impede sleep for their partners and the quality of their own sleep is markedly reduced. As a result, daytime sleepiness, morning headaches and not feeling quite rested after sleeping may be normal symptoms for both parties.

Causes of snoring include alcohol consumption (due to relaxation of throat muscles), being overweight (due to narrowing of the airways from extra tissues at the back of the throat), seasonal allergies, cold or sinus problems, enlarged tonsils or even sleeping position (sleeping on the back). Apart from the above, being a man and having a family history of snoring puts one at risk.

It is possible to stop snoring through lifestyle modifications and they include:
• Losing weight. If one is overweight, the fatty tissues around the neck can squeeze the airway and this makes it difficult for air to flow freely.

• Sleeping on your back! I keep trying to get my daughter to do this and I’ve failed woefully so far :DBut this may help as it helps keep your tongue out of your airway. It certainly helps my daughter when I can get her to stay in that position long enough to sleep
• Stop smoking as this irritates your throat and can cause swelling. Again, this prevents the free flow of air.
• You know how you feel alcohol makes one relax? Well, they kinda do the same thing to the muscles of the throat :DThis makes them collapse easily, reducing the airway. So, try and avoid this at least two hours before bedtime.
• Exercising often prevents you from being overweight and prevents those fatty tissues from squeezing your airways shut

Treating allergies or sinus/tonsil problems and slightly raising the head of your bed may also help.

I hope these tips help. If the snoring persists, please see your doctor. He may suggest some anti-snoring devices…any one of some oral appliances (provided by dentists specialized in snoring problems may help), nasal strips, pressurized masks, implants or surgery, as a final resort may be used to treat this. Or he may consider some other diagnosis like sleep apnea (in which one wakes up gasping for breath as the airways close up often during the night).

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Q2: Hello ma’am. I am a newly married man and my wife is pregnant but what is worrying me is the way she always wants to take a chocolate-based drink and milk. My question is that, will that not make the baby to over grow in the uterus and lead the delivery to be C.S.? Thanks ma’am

A2: Big babies are usually seen in women who

• Are diabetic.
• Have gestational Diabetes (Diabetes that is observed during pregnancy),
• Are obese
• Have had another big baby before
• Have had a lot of babies (from the 5^thpregnancy, the risk of big babies increase)
• Excessive weight gain during pregnancy
• Are older. From age 35 years, the risk of having a big baby increases
• Have pregnancies that are overdue. When a pregnancy is more than 2 weeks overdue, the chances of a big baby are increased.

For women with big babies (fetal macrosomia), a vaginal delivery may not be a complete no no! However, your OBGYN will weigh the risk of that against your medical history and other pre-existing medical conditions. Potential complications include having genital tract tears during delivery, prolonged labour and rupture of the uterus. The babies may be born with a higher than normal blood sugar level and be prone to childhood obesity.

However, none of this needs to happen if you are registered in a good center under the care of a qualified obstetrician. In these centres, all possible complications are anticipated during pregnancy and at the time of delivery.

To prevent this, remember that feeding for 2 is a fad. You don’t really need to eat like a horse 😀 …you and your baby don’t need that much (an average of 12kg weight gain for 9 months…little over 1kg/month!); include some exercise (gentle stretches and walks, with your doctor’s knowledge and advice) and be sure that Diabetes is controlled, if you have this before pregnancy.

Pregnancy is associated with increased cravings and of course growth of the baby, but you do not need significantly more calories to cope with this state. The recommended weight gain for pregnancy is 8 – 16 kg in all (with an average of 12kg).

Let me break it down for you.

During your first trimester, you actually do not need more calories than when you were not pregnant. You can continue with the activities you used to do before including exercise. However, exercise should be toned down from vigorous to moderate. Moderate exercise is any physical activity that you perform that but you’re still able to carry on a conversation without running out of breath…that’s as simple an explanation as it goes :D. It includes walking, swimming, dancing, pregnancy exercises (these are taught in some antenatal classes), stretching and relaxation exercises. Remember that you must never start on any exrcise regimen without discussing with your doctor who knows your specific medical history.

Please note that you should never to exercise to the point of exhaustion, not to over-heat yourself and not to carry on any jumping etc…partly because you are prone to injuries of the ligaments (like sprains)and because, it’s just not safe at the time. 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 😀 Just kidding…don’t try this at home 😀

During your second trimester, your calorie needs start to increase. The recommended increase in calorie intake is about 300 calories per day. Does this sound like much? It actually is not! A popular brand of wheat biscuits (serving size of 4) is 240 calories. That’s wheat biscuit :D. So, imagine the quantum of calories in the other junk foods we crave for during this time! Take the time to read labels of food packs and check what a serving size is. If there are two serving portions in a tub of ice cream and you finish the whole tub, you’ve clearly eaten double the calories that is written on the tub!

In the final trimester, the calorie requirement increase some more to about 400 calories per day. Note that for multiple pregnancies (twins, triplets etc), the calorie needs are extra 400 calories in second trimester and extra 500-600 calories in the third trimester.

So, what to eat? The same things you did before you hot pregnant…assuming you were eating right 😀 More fruits and veggies, complex carbohydrates (they are rich in fibre and keep you feeling full for a longer period of time) like beans, oatmeal, sweet potatoes, brown rice etc. Load up on proteins too (fish, chicken etc), calcium tich foods like yoghurt, skimmed milk…you don’t want to experience those muscle cramps of pregnancy. They can be excruciating! I know…I’ve had them J

Eat 5 small meals a day: breakfast, snack, lunch, snack and dinner. This should keep the hunger pangs at bay and deal with the cravings. You probably will still crave stuff: Iyalamala’s food, ice cream with all the toppings, a ‘ginormous’ burger etc and guess what? You can give in once in a blue moon, just don’t make it a habit! This includes your wife’s love for her chocolate drink. If she’s still in tune with recommended weight gain for pregnancy, that’s good. If not, she may need to make it an occasional treat. Some of these chocolate-based drinks also have caffeine which may not be a great idea during pregnancy, especially if she is over-indulging in it. If you take in more calories than you need, you run the risk of having a big baby with all the complications associated with that during pregnancy and delivery and of course, it’s harder to get back to your pre-pregnancy weight after the baby.

As usual, whenever in doubt, please speak with your doctor.

Have a good night, y’all 😀

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When should I start sexual relations with hubby? Immediately after a baby? After 6 weeks or 6 months? Whenever hubby feels like it? When wifey feels like it? Any method to this matter?

The book, Just For The Health Of It With Dr Ketch, explores these and other issues

You can get a copy in any of the following ways:

Get a copy from:

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 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

4) For those in Abuja and environs, please call 07030739403 or pick it up at No 5 Bricks Market, Dawaki 11 Market, Dawaki extension.

5) 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 😀

Q: Hello Doctor, thanks for being a source of medical education to most of us. Please, I would like to know if it is normal for a baby’s navel to get bigger. My boy is 7 weeks old and his Navel is getting bigger than it was after the normal birth treatment. My daughter presses it in my absence. Could it be the reason for it to get bigger almost by day? Again he stretches a lot…could that also be the reason? I’m just curious ma’am. Thanks for being there to lean on.

A: It does sound like your baby has an umbilical hernia. Don’t go shouting and screaming just yet! It’s probably not as horrible as it sounds. It looks all dramatic any time the baby cries and does appear to ‘swell up’ causing parents to panic. But, it usually closes up on its own by the time the baby turns 1 year though some may last slightly longer. If this persists up till the age of 3 years, please see your baby’s doctor.

Now, what’s a hernia? This is the protrusion of an organ or its covering through the wall of the cavity that usually contains it. There are different types of hernias (or herniae) and they include:

Inguinal hernia: The most common type of hernia. It usually happens in situations where the pressure inside the abdomen is increased.

Other hernias include incisional hernia (where a protrusion develops from the site of a previous surgery, especially abdominal surgery), femoral hernia (which has the same risk factors as inguinal), umbilical hernia (common in black children where the umbilicus, aka navel does not form a small ‘button’ on the abdominal wall but protrudes) and hiatal hernia (where the stomach squeezes through a hole meant for the oesophagus (the pipe through which food gets to the stomach).

Typically, all hernias are caused by a weakness in the wall of muscles or containing cavities and an increase in pressure. Examples of activities that increase pressure in the abdomen are long standing cough or frequent sneezing, carrying heavy loads regularly, straining at stool whether due to constipation or diarrhoea etc. The walls of muscles are usually weakened in people who are obese, pregnant women, smokers and malnourished people. It is also more common in men and as people grow older.

What are the symptoms? People with hernia would usually notice a protrusion after a strain eg lifting something heavy or coughing. Sometimes, they are able to push it back. Other times they are not. The worry about hernia and the reason why they have to be treated quickly is that they may strangulate. Yes, just think about the word strangle and you understand what strangulate means 😀 The protrusion may become squeezed by the opening through which it passes blocking off blood supply to the area protruding. Once a part of the body is deprived of blood, it dies. We don’t want that to happen 😀

The decision as to whether to go for surgery or not depends on where the hernia is located (inguinal and femoral hernias usually need surgery), the contents of the hernia sac and the symptoms. A truss (a supportive device that prevents enlargement of a hernia) may be prescribed by your doctor to help for a short period of time. Typically a doctor will schedule a surgery to repair a hernia. Complaints of pain in a hernia patient may mean strangulation, which need to be dealt with immediately. Umbilical hernia does not usually require surgery as the protrusions usually ‘return’ on their own. If this persists beyond 5 years, then surgery may be needed.

If you do require surgery, you don’t need to fret about it…really. This is not major surgery…it’s intermediate (sort of like half way between minor and major :D). Your doctor will provide answers to all the questions you have and of course, counselling. There are options for laparoscopic surgery which is surgery done through small incisions guided by a camera.

Preventive measures include having a healthy weight, giving up smoking, treating conditions that may lead to long standing coughs, eating healthy to prevent straining at stool etc.

So, peeps, you can’t dodge this stuff. It’s healthy living and eating all the way 😀 Have a great evening.

Fresh juice drinks have many of the nutrients found in the fruit, but can also raise blood sugar and pack on the calories.

Source: Are fresh juice drinks as healthy as they seem?

Q1: Hello ma’am, thanks for your teaching. Please, I have some issues bothering me. I did HVS and urine mcs. Both showed that I have heavy growth of Staph and moderate growth of candida but I’m surprised about the level of the Staph because I’ve been abstaining from sex for about a year now. My question now is, is Staph being contacted only through sex and what is the best treatment for it? But currently I’m on Rocephine injection. Thanks ma’am

Q2: Good day doctor, please I would like to know which is more productive in treating Staph that has lasted for some years: the English or native medicine? Note: I have tried the English medicine and it didn’t work

Q3: Hello Doc. I have followed your updates and advice overtime and really appreciate your efforts at contributing to the wellness of people. My challenge is Staph which I have battled for some years now and I wish I could give you a detailed explanation of my experience with it. As we all know Staphylococcus is a very stubborn infection even as some believe it’s incurable. I have treated it twice with local drugs but it keeps reappearing after some months. My own symptoms are cough and blisters on my chest and neck region. I am writing to seek for your prescription on effective medication that cures it permanently. Thanks as I await your reply.

Q4: How can I settle this Staph infection to be normal and eradicated?

Q5: Hi doc please does Staph aureus has a cure?

Q6: What is the best cure for Staph aureus? I do watch your program on DSTV

Q7: Dr, good evening. I have sent you texts severally with no reply. I have not seen my period for 3 month so I went for an infection test and the lab result shows I have scanty growth of Staph. So they prescribed some drugs for me and I purchased them and took them but up till this moment, I have not seen it yet. I am scared and worried.

Q8: Hi Doc! How does someone contact Staph? And does it have anything to do with not getting pregnant?

A: I could pull up tens more questions on Staph from this page! This is a representative sample of the sort of questions, a lot of you have on this subject. This is always a topical issue as people consistently worry about what this means. I reproduce a post I had made on this below:

Staphylococcus has received a bad rap over the years, especially in Nigeria. A whole lot of TV advert time in the past was devoted to traditional/alternative/native medicine practitioners who all claimed a cure for this ‘terrible’ Sexually Transmitted Infection. After the airwaves were made off limits, attention moved to the print media where all manner of cures are touted for ailments ranging from the indomitable staph to fibroids! Have you read about how some drugs can make people excrete their fibroids out???! I shake my head in wonder 😀

Generally, Staphylococci, Staph for short, are bacteria which can be found in people’s noses or skin all over the body, minding their own business until a cut or injury occurs giving the germs access into the body. This is the reason why surgeons meticulously scrub sites for surgery before they make a single cut because infections caused by Staph can be deadly. They usually cause infections like boils but can also get into the blood, as described for surgery above, and cause infections too. They are also responsible for Staphylococcal food poisoning and Toxic Shock Syndrome (TSS) as can happen in people who use tampons.

People who are more at risk of Staph infections include breastfeeding mothers, new born babies, diabetics, people with sores/injuries of any sort and also people with compromised immune systems.

It is usually spread by direct contact with an infected sore or use of infected personal care items like shave sticks, plasters or bandages.

Technically, Staph infections are not considered Sexually Transmitted Infections (STI); however, because Staph is spread through skin to skin contact, it can cause an STI if there is contact between the genitals and the area with a Staph infection. Remember also, that these bacteria are found on the skin and so can show up in urine. Thus, if this was isolated in your urine, it does not mean that it is sexually transmitted. As part of the test carried out in isolating the organism in your urine, specific antibiotics would have been shown as being active against the organism. Be sure to use this and complete the dose.

Given that Staph infections are spread through person to person contact, practicing good hygiene is a great idea. Wash your hands often especially after contact with situations described above. Remember that you can also spread the infection from one part of your body to another, so it is important to keep wounds clean and properly covered. If a towel is used to clean the area, this should be done once and then the towel washed in hot water. Do not share items of personal care like towels and be sure to bath every day.

Menstruating ladies who use tampons should be sure to change them often to prevent TSS.

More importantly, speak with your doctor if you believe you have recurrent infections and/or are not responding to treatment.

Have a good night, people 😀