chatwithketch

Q: Hello Dr Ketch. Please kindly advise me. I need permanent cure to my persistent cold of sneezing and nasal congestion. Best regards.

A: I’ve been asked this question several times and in different ways. But ‘why is my nose blocked all through the year?’ is the common thread that runs through all the questions. ‘Stuffy nose’, ‘blocked nose’ or nasal congestion are different names used to describe this condition. In the simplest of terms, this condition refers to a situation when there is an obstruction (blockage) to the flow of air, in and out of the nose. This may be due to swelling of nasal tissues (tissues in the nose) and blood vessels with excess fluid.
Some causes include:
Common cold. We are all familiar with this common cause of nasal congestion 😀 This causes blockage of the sinus which results in nasal congestion.
Allergies in which an individual’s immune system reacts in an exaggerated manner to certain foods or to pollen is a cause of nasal congestion. This ailment tends to run in families and so history of people with same condition or asthma etc in that family is not uncommon.
A nasal septum (the wall between the nostrils) that is crooked or bent to one side may cause nasal congestion. This ‘deformity’ may be from birth, due to injury or occur as a process of growth.
Excessive use of nasal decongestants can also lead to this as after the decongestant is stopped, there is rebound nasal congestion. And so, one ends up with the same situation they were trying to solve from the beginning! 😀 So, if you must, do not use your nasal decongestants for more than three days
Sinusitis is an inflammation of the sinuses (air cavities) that line the nose. When these air cavities (which are supposed to be filled by air) become filled with fluid as a result of blockage, bacteria, fungi and viruses can thrive in this environment and cause infection. Pus-like nasal discharge, facial pain and persistence of symptoms for more than a week, maybe suggestive of this.
Other conditions include:
• Cold weather

• Foreign body in the nose
• Presence of tumour or polyp (a small growth with a stalk protruding from a surface)
• Medications for high blood pressure
• Spicy foods (remember how you start sniffling once you start on a hot dish?)
• Stress etc

There’s a pretty long list of causes, but your doctor will attempt to narrow down to what the probable cause for you is.
In the meantime,
Ø try drinking a lot of water
Ø Use saline sprays instead of the nasal decongestants, if you’ve been indulging in this 😉
Ø Use a humidifier which loosens the mucous. Turning on the hot water shower and inhaling the steam is another great idea.
Ø Avoid irritants of the nose like smoke
All these measures will help reduce the nasal congestion.
Have a great night y’all 😀

Q: This was really informative. Am 22wks now & just took my first dose of Fansidar today. I used to feel feverish at times & my urine is yellowish. I assume, I am infected with fever. Will the Fansidar I took get rid of it or it’s just to prevent in case someone is not infected yet or do I need another brand of anti-malaria drug? I hope to get your useful reply soon. Thank You.

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 😀 Again, fever is more a symptom of a disease than a disease itself. We need to find out the cause of the fever.

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 evil 😀 Insect 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, y’all 😀

Among women ages 40 and older, two in three get up at least once a night to urinate.

Source: Full bladder wakes 2 in 3 women at night

If you’ve ever had a kidney stone, you surely remember it. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body. For many, kidney stones aren’t a one-time thing: in about half of people who have had one, another appears within seven years without preventive measures. Preventing kidney stones isn’t complicated but it does take some determination. Prevention efforts include drinking plenty of water, getting enough calcium from food, cutting back on salt (sodium), limiting animal protein, and avoiding stone-forming foods like beets, chocolate, spinach, rhubarb, tea, and others.

Source: 5 steps for preventing kidney stones

Why is my baby’s tummy making noise? Why does my baby appear to be losing all her hair? Is my baby teething too early? Is my daughter small for her age? K legs, bow legs..what should I do?

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

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 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.

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 😀

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 😀