chatwithketch

Q:  Good evening ma’am. Please, I have been having these symptoms for some months now…like belching constantly and pain in my middle chest. I was told to do abdominal scan, which I did but nothing was wrong. I was just told I had some gas-related issue. I was told to do an Ulcer test, which came out to be H.pylori positive. So, I was prescribed with some drug like Ulsa Kit for two weeks and after that, I was also told to use Nexium Omeprazole also for two weeks. I did all that and I am still feeling same symptoms. Please help me ma’am. What exactly is wrong with me? At times I just feel burning pain in my back.

A: Gastric acid is secreted normally in the stomach to help the process of digestion. Peptic ulcer is a sore in the stomach, esophagus or duodenum and occurs when there is either over-production of this gastric acid in the stomach or reduction in the quantity of mucous that protects the stomach from the acid. Infection with an organism, Helicobacter pylori (H. pylori) has been found to be a cause of peptic ulcer.

In the past, it was thought that spicy foods caused peptic ulcers. However, there’s no evidence to support this, though spicy foods can certainly make the symptoms of ulcer worse 😀 Smoking, stress and drinking alcohol are also likely to worsen the symptoms of peptic ulcer. Caffeinated and carbonated beverages may also be culprit.

Ulcers are also common in people who take certain pain relieving drugs known as Non- Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen.

People with peptic ulcer usually complain of abdominal pain or even sometimes, chest pain as the pain can be anywhere from the breast bone to the navel…giving room for a wide range of descriptions 😀 The pain is usually worse at night or when the stomach is empty.

People with ulcers may vomit blood or pass out fresh or altered blood in stool. For the latter, the stool looks tarry black. Complications of peptic ulcers include internal bleeding, leakage of the acid into the abdominal cavity etc

Treatment is targeted at reduction in acid production, neutralization of acid, treatment of Helicobacter infection, promotion of healing or protection of stomach lining. Your doctor will determine the best option or combination(s) with your active participation, of course J

Thus, prevention is targeted at switching pain relieving drugs (if you have an ulcer, please stay away from NSAIDs), reducing your level of stress, stopping smoking and reducing your alcohol intake. Maintaining a healthy diet filled with loads of fruits and veggies which provide sufficient vitamins to aid healing, is also a good way to go. It is still not very clear how H. pylori infections spread but it is thought to be probably from person to person or from food and water. So, judicious and very frequent, hand washing will certainly help 😀 If the test for Helicobacter pylori is positive then antibiotics will be prescribed.

Does milk help? Well, temporarily but it quickly makes it worse. Milk coats the surface of the stomach, reducing the pain but then stimulates more acid production. Sounds like you can’t win, aye?! ;D

For links to related posts, please click on these links: https://chatwithdrketch.com/2015/04/22/daily-health-tips-chest-pain-and-self-medication/

https://chatwithdrketch.com/2014/04/24/daily-health-tips-why-do-i-always-have-heart-burn/

Daily Health Tips: What Is GERD?

Have a great evening, y’all 😀

Q: Hi doc…I am on malaria treatment and I have completely lost my appetite and saliva is just flowing to my mouth. Is this normal? And how can I improve my appetite?

A: Thanks a lot for writing. It is not unusual to experience some loss of appetite during and soon after a bout of illness. Unfortunately, your body needs nutrients more than ever at this time…to build up damaged body tissues and heal.

Here are some tips to help you get back into the groove of eating normally

• Focus on portion sizes and try to eat small portions during each meal. You can use smaller plates (to stop you from feeling overwhelmed by lots of food on one plate).
• Remember that you can have 5 small meals: breakfast, a mid-morning snack, lunch, an afternoon snack and then, dinner. Good snack options are fruits, nuts, yoghurt etc
• If you cannot stand any snack at this time, go for a nourishing drink. This provides the nutrients you need in a drink form. Complan is one such nourishing drink, which contains proteins, carbs, fats, minerals and vitamins. It has all the nutrition of a complete meal in a drink form. These nutrients replenish the body stock and help healing and convalescence.
• There is a lot of focus on repairing damaged tissues at this time, so be sure to include proteins in your choice of meals. Good examples include fish, chicken, beef, milk, cheese, eggs, Complan etc. For more on protein sources, please click onhttps://chatwithdrketch.com/2015/06/26/daily-health-tips-how-can-i-get-more-proteins/
• In the same vein, starchy foods are also needed to help you build up your energy. So get at least one serving per meal. Good examples are rice, potatoes, bread.
• Attractive looking foods also look appetizing and are more likely to tempt a sluggish palate/appetite
• Exercise also helps to work up an appetite. You may not have the energy to get back into your regular exercise routine…assuming you had one before 😀 But taking a walk before meal times can help improve your appetite.
• As a result of the energy needs at this time, it may be necessary to have some foods that we ordinarily would not suggest 😀 And so, at this time, ice cream, butter, full cream milk etc may be used to supplement energy needs. Please note that this is just for this period of appetite loss. Once you got it back, kindly ease off 😀 Remember a second on the lips, a lifetime on the hips 😀
• Cold drinks and even cold foods may be easier to also tolerate at this time. Be sure to stay hydrated by taking in sufficient fluids. Eat and drink slowly, generally during this period to enable you keep more down.

These tips should get you firmly back on your way to health and great appetite. In the meantime, keep your head high and your spirits up. Trust me…this too shall pass 😀

Have a good night, y’all 😀

Q: Good day I am 23 years old and I am under-weight. I want to gain healthy weight

A: The first guide is your Body Mass Index (BMI). If your BMI is less than 18.5, you are in the underweight category. Even at that, you still will need to talk to your doctor to find out if your weight is a symptom of a medical problem.

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. 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

Some exercises like weight training may also help add bulk to you in the form of muscles so that you don’t look too skinny on the legs or arms.

I hope this helps 😀

Q: Please Dr. I am close to my delivery date yet no water is coming out of my breast, Please ma’am, is it OK for me or not?

A: Hi dear, worry ye not! 😀 I’m sure your breasts will rise to the occasion of breastfeeding as soon as it’s time.

You didn’t mention how many weeks or months pregnant you are. Generally, the milk glands start the job of milk production early in pregnancy (1^st trimester). Some women may notice leakage of yellowish milk from their breasts as early as second trimester but some may not see anything until after baby has been delivered.

Feeding should, ideally, start within one hour of having your baby. Your breast already has a stock of breast milk but it does take your baby sucking to make the breast milk ‘come out.’ So, the earlier you put the baby to the breast, the sooner proper breastfeeding can be established. Your baby will probably sleep away the first 24 hours or so, so it may be a challenge to put the baby to the breast. Try the best you can and make sure that your baby’s mouth covers the areola which is the dark coloured area of the nipple.

Some women who had their babies through Caesarian Section may also experience delays in breast feeding just like some other women. There’s no specific reason for this and the same advice of putting the baby to the breast often suffices. The more often you put your baby to the breast, the better your milk supply will be.

Just in case you’re worried that your baby will starve before full breast feeding is established, don’t be. Your baby doesn’t need more than a few teaspoonfuls of colostrum (which your breast already has and baby gets as he suckles) in the first few days. They contain a lot of substances that help build your baby’s immunity. If, however, by 72 hours you’re still not making breast milk, be sure to discuss with your doctor so that he can confirm that your baby is getting enough to eat. Before this time, don’t get tempted to offer glucose water or formula feeds if you plan to breast feed.

Now just in case you wondered about pap with milk and whether this helps breast milk come in faster? Well, my answer is this. If you want to take your pap, please indulge…in sizeable portions. If it helps your breast milk come in, that’s fine. I guess if the pap is watery enough, it will help hydration and you certainly need to be well hydrated for breast feeding to happen without stress 😀

Have a fabulous day, people 😀

Regular walks are an incredibly popular way to exercise — and it’s easy to see why. Walking is easy and free (except for a good pair of shoes), and can be done just about anywhere. But it’s those very qualities that can also make it very tempting to skip. If your walking routine is in danger of lapsing, try one or more of these strategies to keep going.

For details, please click on this link:

http://www.health.harvard.edu/healthbeat/6-tips-to-help-you-keep-a-walking-regimen-on-track

Q: Good evening Doctor. Any time I am having sex with my husband, he complains that he is perceiving an odour from my vagina. What is the cause and the remedy to the odour? Thanks

Some degree of vaginal odour is common with all women. The vagina has a natural musky smell. In the same way, some degree of discharge is also normal as the glands in the vagina and cervix produce fluid which wash away dry, dead cells and flush out bacteria. A strong vaginal odour which appears different from normal especially when associated with other symptoms like a burning sensation, itching, discharge etc may be suggestive of a problem…some more easily solved than others.

For instance:
Poor vaginal hygiene. This can be easily remedied by washing the vagina daily with or without soap (if soap is used, unscented or mildly scented soap should be used) and loads of water, not douching, cleaning from the front to the back etc. Vaginal odour may also be more pronounced during a menstrual period and after sexual intercourse. And so, more frequent baths (as much as practicable) during and/or before these periods may be helpful. Frequent change of sanitary towels and tampons are also helpful measures. Forgotten tampons are actually a cause of vaginal odour.

For more on vaginal hygiene, please click on the links below:https://chatwithdrketch.com/2014/04/02/daily-health-tips-should-i-wash-my-intimates-with-disnfectant/

https://chatwithdrketch.com/2014/10/24/daily-health-tips-should-i-add-vinegar-to-my-bath-water-for-intimate-cleaning/)

A fishy smell associated with vaginal discharge is suggestive of overgrowth of the vagina by bacteria (bacterial vaginosis). This may be caused by over use of antibiotics or douching.

Douche is a French word which means to clean or soak. People who douche usually inject/spray a mixture of water and vinegar into their vagina. Other douches contain antiseptics and fragrance too. They believe that douching serves one or more of the following functions:

• Cleaning the vagina
  • Cleaning out menstrual blood after a period
  • Prevent pregnancy
  • Prevent STIs
  • Get rid of odour

Unfortunately, douching serves none of those purposes and indeed, may even be harmful.

To clean the vagina during or after a menstrual period, one does not really need anything other than water. Mild, unscented soap may also be used on the outside. Douching disturbs the natural balance between the good and bad bacteria which live in the vagina, causing other organisms like yeasts to over grow the vagina. So avoid this and other scented feminine hygiene products.

Douching does not prevent pregnancy as loads of sperm may have already swum up to the womb before douching is done, after sexual intercourse. In fact, for those that may not have reached the womb (uterus), the force of douching may very well help deposit the sperm firmly in the uterus😀 Talk about a boomerang!

STIs cannot be prevented by douching. In fact, if anything, if there is a vaginal infection, douching can actually push it all the way up to the fallopian tubes, potentially. These may lead to pregnancy complications in baby, labor and indeed, preterm delivery.

In summary, leave douching well alone!😀

Yellow or greenish or frothy discharge with a bad smell with pain and itching while urinating is suggestive of trichomoniasis infection (a sexually transmitted infection)

Some cancers like cervical or vaginal cancer may also cause vaginal odour.

What’s the remedy? Well, if it’s due to lack of vaginal hygiene, that’s easily solved as noted above. If there are other associated symptoms which may suggest other problems, than a proper diagnosis needs to be made so that adequate treatment can be given. So, see a doctor asap.

In the meantime, vaginal hygiene is a good place to start. Try taking a nice leisurely bath before sexual intercourse and incorporate the other tips noted above.

I hope this helps.

Have a good night, y’all

Q: Good day Dr Ketch. Please, it’s exactly 2 weeks today I put to bed. I was hypertensive during pregnancy. I’m still on BP drugs. I bled after delivery. Up till now my breast milk still drops in trickles. My baby feeds more on formula and water. Please, is there any kind of food or supplements you can recommend for me? This is my second baby. Please, your advice will be greatly appreciated.

A: Congratulations on your new baby! May he/she bring you joy and fulfill destiny!

Breast milk is the best food for baby, generally speaking. The supply of breast milk is based on its demand. And so, if demand for it is high, supply will be high and vice versa. The more efficiently milk is removed from the breast, the more milk production is stimulated. And so, you need to make a conscious effort to get baby to suck more.

If your baby sucks, the let-down reflex ensures that your breast fills up with breast milk. Flat nipples can appear to be a challenge for breast feeding, especially for first time mothers but remember that babies are supposed to latch on to the areola (the black area surrounding the nipples) and not on to the nipples. Press on the areola with your thumb on top and fingers underneath and push back against your chest wall while pressing in with your thumb and fingers. This helps elongate the areola and so, provided you position the baby properly on the areola, breast feeding can go on with no issues.

Here are other tips that could help increase milk supply:

• Be sure that baby is attached properly and get him to suckle on the breast very often. Remember that breast milk production is a function of the breast milk let down reflex which is activated when baby sucks.
• Increase the number of feeds per day. You could work with a timetable of a feed every 2 to 3 hours. In your case, as many times as is possible when you get back from the office.
• Switch breasts during a meal time. Let the first breast ‘empty’ before switching baby to the other breast. This can be repeated several times during a feed.
• Massage your breast and stroke towards the baby
• Perhaps over the weekend, room in with your baby and get him to feed as much as possible. The let-down reflex will be greatly stimulated and so, you could even pump some for when you will be at work and freeze.

Personally, I found that using my hands to ‘milk’ my breasts produced sufficient amounts of breast milk for my always-hungry-can’t-seem-to-get-enough-food-baby. You may want to try that.

What should you be eating? You definitely need to be hydrated 😀 If you plan to really breastfeed that child, you need to stock up on fluid requirements for yourself! Then you need the regulars: fruits and veggies, carbs (especially complex carbs like whole wheat bread, beans, local/wild/brown rice, proteins (eggs, fish etc). Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

Blood pressure readings are interpreted as same, pregnancy or no pregnancy. Any level more than 140/90mmHg is seen as hypertensive. A woman may already be hypertensive before pregnancy and on medication. She may be found to be hypertensive before 20th week of pregnancy in which case it is believed she had previously undetected high blood pressure or she may be discovered to have high blood pressure after the 20th week, in which case it is believed that this high blood pressure is pregnancy-induced (Pregnancy Induced Hypertension: PIH). This would usually resolve within 6 weeks of having a baby. You are just 2 weeks post-baby, so you’re doing good. Ensuring that risk factors are reduced by reducing weight, eating and living healthy are also helpful strategies in dealing with this. Be sure to ensure you are taking your prescribed medications too.

Relax, enjoy your baby and be sure that you’re getting all the help that you need. Don’t ry to be super-mum and do it all 😀

Loads of hugs coming your way…

Have a great night, folks 😀

Q: Dear Doc, I am a 26 year-old guy. Are there any future consequences of penis enlargement? It’s not that I am too small down there. I am 6 inches when erect and can be very small when flaccid. But it’s embarrassing cos i think its small. I am considering enlargement because I need to be able to satisfy my future wife very well. So please, just be honest with me with the probable future consequences. Thanks so much ma’am.

A: Thanks for writing in. Very interesting question. Should you or shouldn’t you? Well, I’ll help you out with excerpts from a post I had written a while back on a related subject.

Here goes…

The issue of penile length has been a problem forever and people generally think that bigger is better. Is it? The average penile length is about 8 to 13cm when not erect and this can be pushed up to 13 to 18cm when erect, give or take a few. Does the penile size determine whether a man can father a child or not? Absolutely not…penile size does not affect fertility.

A woman’s vagina is about 7.5cm and would lengthen to about 10cm when aroused and so, generally, there should be no problems with sexual intercourse as the average length of a penis can adequately cover this gap.

Now the challenge…a lot of men who think they are small in this area are actually within the average measures but perception can make them think otherwise. For instance, the only way they can assess the size is by looking down at it and this automatically makes it look smaller. If you looked sideways in a mirror, you might just think, it looks longer. Men who are fat also appear to have smaller penises because the fat around the stomach may hide part of the base of the penis, making it look shorter. For instance, in this case, the 6 inches erect penis translates to about 15.24cm which is totally normal!

It does appear that guys with small penises achieve about 100% increase in length during sexual excitement, probably nature’s way of compensating as opposed to men with longer ones who may achieve about 75% increase in length.

There are all sorts of touted treatments that help increase penile length including surgery, vacuum pumps, extenders, creams, pills etc. There is little evidence that people who go through this are satisfied with the result or that they work. Indeed, some can cause permanent damage.

So, what to do?

Take charge…lose weight if you’re overweight and have a heart-to-heart chat with your partner about this. You just may be surprised to hear that she doesn’t care. If you still feel bad about this, you may try talking with your doctor.

I end by saying, ‘if it ain’t broke, don’t fix it!’ 😀

Have a great night everyone 😀

Q: Hi Doc, my friend told me that he used to ejaculate but now he no longer does so. His wife complains of dry sex. Please advise him on how to revive his sperm back again.

A: Anejaculation is a situation in which there is failure of ejaculation. It can be primary (in which case it is present at birth and is a lifelong condition) or it could be secondary, as appears to be the situation here. In secondary anejaculation, the problem is acquired.

The same conditions that cause retrograde ejaculation are also suspect here. Retrograde ejaculation (RE), refers to backward ejaculation. To understand this, a refresher course on how ejaculation happens is needed:

Usually, during ejaculation, the muscle at the neck of the bladder tightens ensuring that semen does not enter the bladder. In people with this problem, this muscle does not tighten enough to prevent backtrack of the semen into the bladder. So, in these people, their ejaculate during intercourse is usually very little (sometimes almost non-existent, even though they certainly know they have had an orgasm) or their urine after sexual intercourse cloudy as a result of the sperm going into the bladder and mixing with urine.

Retrograde ejaculation does not interfere with a person’s ability to enjoy sexual intercourse, have and maintain an erection or even climax. Usually, these people would show up in the clinic because of infertility.

Does your friend have these issues?

RE and secondary anejaculation can start after a surgery on the bladder or prostate; it can occur as a side effect of some anti-hypertensive drugs (drugs used to treat hypertension), or as a complication of some surgeries or medical conditions like Diabetes Mellitus, multiple sclerosis or spinal cord injury. A few people are actually born with a weakness of this muscle that closes the neck of the bladder during ejaculation.

If RE or secondary anejaculation is caused by medications, your doctor may consider changing them or stopping them for a while. Otherwise, there are some drugs used to ensure the neck of the bladder is closed during ejaculation. Your doctor will weigh their side effects against their potential benefits in deciding whether to prescribe them to you or not. For those who desire babies, your doctor will also discuss options of ‘harvesting’ sperm to be used on your spouse.

For spinal cord injuries, the ejaculatory pathway may be intact or there may be need for penile vibratory stimulation depending on the level of the injury.

His doctor should be able to take a proper history, carry out a detailed examination and make a proper diagnosis.

Have a great evening, people 😀