chatwithketch

Q1: Dr I had my baby 2years ago and since then, I’ve been suffering from hormonal imbalance. My breast still discharges milk and my menstruation isn’t coming forth. I’m not able to conceive again. What is the way out? Thanks

Q2: Good day doc. Please a friend of mine has been experiencing water coming out of her breast lately and it’s affecting her menstrual flow as it’s no longer normal. What is the possible cause and what is the remedy medically. Thanks ma’am

A: A collection of tissues called the endocrine system is responsible for the production of hormones which control various functions in the body like metabolism, sexual reproduction, mood etc. Sometimes, these hormones are produced in excessive or too little amounts throwing the whole body off.

Treatment of hormonal imbalance is dependent on the cause. Excess weight can lead to high estrogen levels. So, exercise and weight loss can be beneficial here. High levels of thyroid hormones can be treated with drugs, radioactive iodine or surgery. The stress hormone, cortisol is produced when one is stressed and so treatment is focused on stress management techniques. The hormone, prolactin which is responsible for lactation in nursing mothers may be produced even when one is not lactating. Focus here is on reducing this hormone levels as will be described below. So, the doctor has to investigate to find out the exact cause of the imbalance and then treat accordingly.

Some women who are not pregnant may have milky fluid come out of their breasts when they are not breastfeeding or even in women who have never been pregnant. This is called galactorrhea (pronounced gulactoria). This is not a disease on its own but a symptom of a problem. The hormone, prolactin is usually produced in these cases.

This milky fluid can be expressed by pressing or it can spontaneously come out on its own. It can affect one or both breasts and usually there are no blood stains involved.

Sometimes, the cause of this discharge may not be known but some causes could be some medications, some drugs like cocaine, spinal cord injuries, some birth control pills, stress and even excessive stimulation during sexual intercourse.

Galactorrhea can also happen in men and new born babies! In new born babies this can happen if the mother has a high level of estrogen which crosses over into the baby and stimulates the formation of breast tissue and sometimes, some milky white discharge.

If you notice this, please visit your doctor who may try to express this discharge to study. The discharge may also be clear, bloody or even tinged yellow. These need further evaluation and the presence of lumps should also be checked for. The level of prolactin will also be assessed. This may, however, be normal in people who are overly sensitive to prolactin. In this class of people, prolactin level is normal but there is still milky discharge from the nipples.

To determine cause, the doctor may do a scan, take tissue sample to examine (biopsy) etc. Treatment depends on cause. If due to pregnancy or breastfeeding, it will eventually stop. If due to stimulation, the discharge will continue as long as the stimulation is present. If due to injury, it will also stop with healing. If the discharge is due to medication, stopping the medication is sufficient to bring this to a stop or switch to something else under the supervision of your physician (doctor). If there is a tumour producing prolactin, drugs can be taken to shrink it or surgery can be done. If no cause is found, drugs that reduce prolactin level are prescribed. Remember, that you could be pregnant and so a pregnancy test may not be out of place.

In the meantime, breast pads can be worn to prevent the embarrassing leaks from staining clothes, limit manipulation of breasts either by self-breast examination or during sexual activity and try not to wear clothes in which there would be friction between the nipples and the material.

Generally, causes of breast discharge include:
• Pregnancy
• Breastfeeding: The release of milk may also persist for a while even when breastfeeding has been stopped.
• Stimulation of the nipples during sexual foreplay or even pressing the nipple by people who are worried about the nipple discharge or friction between fabric and nipple can lead to nipple discharge.
• Breast abscess or infection
• Hormone imbalance
• Injury to the breast
• Some medications
• Cancer of the breast

Bloody discharge, discharge from one breast only and discharge that happens spontaneously without the breast being touched or pressed is likely to be abnormal. These should be checked out as soon as possible in the hospital.

If the discharge is present during a menstrual period and persists into the next cycle, please see your doctor too.

High prolactin levels are associated with infertility and so this could be a factor in your case. Please see your doctor who will take a proper and detailed history from you and decide on the best treatment option.

I hope this helps.

Have a great weekend y’all 😀

Q: Good morning Dr, I missed my monthly period. I think I am pregnant lolzz (Happy me). I need your advice. Please, my church is embarking on 10 days praying and fasting. Should I fast? If yes, what time should I break my fasting? When is the right time to run a Pregnancy test?

A: Congratulations!!! 😉 I join my faith with yours and…..fingers crossed!

Should you fast? There is contradicting medical evidence as to how safe (or not) it is to fast while pregnant especially during the first trimester. So, this is a question I believe you should ask your doctor who has your medical history and is better able to speak to how you can/will cope or not.

Generally, during a fast, the body truly enters a fasting mode after it has absorbed the nutrients from the last meal. This takes about 8 hours. Its next source of energy is the glucose in the liver and muscles. If fasting continues, then it moves to the next source…which is fat. After it has depleted this source, then it goes into real starvation mode and begins to break down proteins!

I presume that you will be breaking your fast daily and so you will hardly be candidate for the starvation mode! Let your doctor guide you on the issue of whether or not to fast and how many hours to do so, if you participate. Ultimately, the greater goal is to have you and baby well enough to praise God.

A pregnancy test reads positive about 6 to 12 days after implantation has occurred. There are two types of pregnancy test (PT): the blood PT which is more sensitive and the urine PT.

For a related topic, please click on the link below:

Daily Health Tips: Keeping Healthy During A Fast

I hope this helps 😀

Happy celebrations to the muslim folks J Have a great celebration.

Good night y’all 😀

A new study links too much sitting at work and home with the development of heart disease and diabetes, as well as dying early.

Source: Too much sitting linked to heart disease, diabetes, premature death

“Computer vision syndrome” is a cluster of eye-related symptoms that tend to afflict computer users.

Source: The times, they are a-changin’ (and bringing new syndromes)

“Computer vision syndrome” is a cluster of eye-related symptoms that tend to afflict computer users.

Source: The times, they are a-changin’ (and bringing new syndromes)

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 🙂

Q: Hello Dr, my job is waste collection. I work with ministry of environment. What can I take to prevent infections from the constant inhaling of the waste I am exposed to?

A: Thanks for writing in. This is a very important question given that you are exposed to these conditions on a daily basis. This also important for the rest of us as we go about cleaning our environment especially over the weekends.

To start off, ensure that you are dressed appropriately with the right long sleeved overalls. These overalls are usually reflective and if they are not be sure to ask for a reflective vest. This makes you visible to other drivers and even the driver of your own garbage truck. Accidents have been known to occur where a person collecting waste is run over by their own duty truck! Ensure that you also wear gloves and heavy boots.

The gloves protect against cuts from shards of glass and other sharps that may be in the bin liners (dustbin bags). It can also protect from potentially dangerous and corrosive substances like acid etc.

By the way, even when cleaning the home, please use gloves to clean areas like the toilets. Yes, I know that it is your poo…but guess what there are loads of germs in there! So, wear gloves to scrub and then be sure to scrub your hands thoroughly afterwards 😀

One of the injuries you are exposed to is that from lifting heavy garbage bins etc. This may lead to herniae or spinal injuries, especially if you don’t lift properly. For more on herniae, please click on https://chatwithdrketch.com/2014/05/14/daily-health-tips-i-am-scared-because-i-have-hernia/

Ensure that you lift with both hands after testing to feel the weight of the bag/garbage. You may want to invest in a back support body belt too. This will help prevent back strains. There are also potential injuries from slipping on slippery surfaces especially when it rains. To prevent this, ensure that you wear the right heavy non-slip boots.

Earplugs (disposable and re-useable) should be used to protect the ears from the continuous noise of the truck. Disposable masks may also be used to reduce the impact of the smell of garbage.

Given the potential for being cut by sharps, please ensure that you get vaccinated for tetanus and hepatitis. Eat healthy ensuring that your diet has lots of colour (fruits and vegetables). This helps build up your immune system ensuring that your body is ever ready to fight infections.

Studies show that though people are prone to infections due to the very nature of this job, the most problems encountered really speak to injuries obtained due to lack of use of personal protective clothing. So, play safe and dress safe 🙂

Have a fab weekend, everyone 😀

Q: I am a teenager of 18 years 8 months, my height is 171 cm and weight is 45 kg. My BMI is 15.4. I am underweight and I really, really need to add weight before April – June 2017 for a BMI screening. Please Doctor what should I do?

Q: Thanks for writing in, dear.

Your BMI is a quick way to tell whether or not you might be underweight or overweight, and what health problems you might have or develop because of your weight.

It is actually a measure of weight to height. It is calculated by dividing your weight in kg by your height squared in meters (that is height x height). Eg, if one weighs is 80kg and is 1.6m tall, the person’s BMI is 31.25. Different BMI readings have different meanings.

If you’re under age 21, your age and gender need to be factored into your BMI to account for the different speeds at which guys and girls develop.

If your BMI is less than 18.5, you are in the underweight category. Talk to your doctor to find out if your weight is a symptom of a medical problem. A registered dietitian can help you learn about healthy eating.

If your BMI is between 19 and 24.9, you are in the recommended weight range for your height. But your health may still be at risk if you are not getting regular physical activity and practicing healthy eating. So, don’t start rejoicing just yet

If your BMI is 25 to 29.9, you are in the overweight category. This may or may not be unhealthy, depending on some other things, like your waist size and other health problems you may have.

If your BMI is 30 or higher, you’re in the obese category. You may need to lose weight and change your eating and activity habits to get healthy and stay healthy

Apart from your BMI, your waist measurement also plays a significant role in your health status.

It’s interesting that being underweight comes with its own problems…much like being overweight. People who are underweight are prone to having nutritional deficiencies like brittle bones because of lack of calcium. This leaves them open to bone fractures. They are also prone to diseases as they have weak immune systems. They are always tired, hardly having any energy to do stuff and they also have menstrual irregularities. If they haven’t started having periods, it’s further delayed and if they have started having periods, then it becomes irregular.

The first thing would be to find out why you are underweight. Have been ill, recently? Have you been snacking more than you’ve been eating proper food? Are you stressed? Are you avoiding food so that you don’t add weight?

Generally though, to add weight in a healthy way:

Focus on calorie-dense but nutritious foods like eggs, nuts and milk. Full cream milk is definitely an option, especially if you don’t have a high cholesterol level.

Eat often…6 ‘small’ meals per day is not out of place. Starchy carbs are great too (local rice, potatoes, oats, whole grain/wheat bread etc). Some exercise before meal times is a great and healthy way to work up an appetite. Taking some fruits as appetizer before mealtimes also helps stimulate an appetite. Smoothies are also great breakfast and snack options. Dried fruits and nuts can be added to cereals, salads and even yoghurt. Try not to drink too much water before or during a meal to ensure you have enough space for the main event which is the food  😀

Remember that it only takes a little effort to pile on the weight…a second on the lips and a lifetime on the hips, aye 😀 So focus on complex carbs and lay off the sugar-filled calories and pastries (these are empty calories which create more problems than they solve) and remember that nuts should be taken by the handful, dairy should not exceed 4 glasses per day, oil should be used sparingly etc. Indeed, moderation in everything…as usual.

If none of these help, please be sure to see your doctor to ensure that this is not the symptom of another problem like an eating disorder.

All the best, sweetheart 😀

Have a fab weekend, everyone 😀