chatwithketch

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 😀

Nearly half of all heart attacks have no symptoms at all and go completely unnoticed by the people experiencing them

Source: Silent heart attacks: Much more common than we thought in both men and women

It’s easy to eat your way to an alarmingly high cholesterol level. And the reverse is true too — changing what you eat can lower your cholesterol and improve the composition of the armada of fats floating through your bloodstream. Fresh fruits and vegetables, whole grains, and “good fats” are all part of a heart-healthy diet. But some foods are particularly good at helping bring down cholesterol.

Please click the source link below for details:

http://www.health.harvard.edu/healthbeat/5-foods-that-fight-high-cholesterol

Q: Good Evening Dr. Ketch, please I wanted to find out if smoked goat cheese is safe to eat during pregnancy

A: Thanks for writing in. Cheese is a great source of calcium and should ordinarily be a great prescription for pregnancy where we are trying to ensure that you build up enough calcium stock to prevent the baby ‘stealing’ from your bone stock 😀 However, because of the possibility of getting infected with Listeria, especially when you eat the soft goat chesses which are mould-ripened, you may want to give it a rest. Generally, the goat cheese is considered safe if cooked. The point of cooking is to ensure that the cheese has been heated all the way through, killing any harmful bacteria and making it safe for consumption. Smoking may not do that. If you’re unsure whether it’s cooked or not or what kind of cheese it is, play safe, give it a miss. Better safe than sorry. Though listerosis (the disease caused by the Listeria organism) may be mild causing no symptom or perhaps, flu-like symptoms, it could lead to miscarriage and still birth. So, you want to be sure you stay away from potential sources.

Also, avoid raw, under-cooked and uncooked seafood and shellfish. Make sure prawns and shrimps are a milk white colour when cooked. Generally, when pregnant, the main concern is the amount of mercury in the fish or sea food. Large mackerel, Swordfish,Tile fish and Shark contain a large amount of Mercury that could cause defects in the baby’s developing nervous system.

For foods you should eat:
• Eat a balanced diet with a variety of foods from different food groups.
• Be sure to include a lot of high fibre foods like vegetables, whole grain cereals etc to deal with the constipation associated with pregnancy.
• Ensure you take your antenatal medications (prenatal vitamins) in addition to eating well.
• Be sure to also take foods rich in iron eg and foods rich in folic acid eg green leafy veggies and beans. Folate prevents deformities of the spine.
• Drink at least 4 servings of milk, other dairy products or calcium rich foods like those noted above. If you don’t eat enough, your baby will start drawing on your own stock from your bones. So, stock up on calcium!

Have a great weekend, people 😀

Q: Please ma’am, I really need your help. I am confused. I have increased hunger and I urinate too much especially in the night; sometimes, I eat 5 times and will still be hungry

A: Thanks for writing in.

Your symptoms sound like the classic textbook description of the symptoms of diabetes. They include:

• Increased hunger
• Weight loss despite the increased appetite
• Increased thirst
• Frequent urination
• Fatigue
• Frequent infections of vagina, wounds etc

What’s Diabetes Mellitus (DM)? Usually starchy foods we eat are converted to glucose. The body, in response to the presence of glucose in the blood, releases insulin from the pancreas. The insulin helps the glucose to move into the cells where it is needed. In Diabetes Mellitus, it is either insulin is no longer or barely being produced (Type 1 Diabetes Mellitus) or the insulin is being produced in insufficient amounts or the cells no longer responds to the insulin prod (stimulus. The latter is called Type 2 Diabetes Mellitus.

There is little or nothing that can be done to prevent Type 1 as it is not yet clear what causes the body to destroy the cells that produce insulin in the body. People with this type of DM will require insulin injections. However, people with Type 2 DM can control their DM using a combination of diet and exercise (staying lean and staying active). With time though, they may require oral drugs and/or insulin.
Now, how do we make exercise a part of our day? You need at least 30 minutes daily. The requirement per week is 150 minutes and so you could do 30 minutes on 5 days of the week or 1 hour on 3 days of the week. Just break it up and find ways of doing the things you love in a more active way. Activity/exercise ideas are pillow fights, arm wrestling, taking walks, dancing, joining a gym, jumping jacks during commercial breaks etc. At work, being more active speaks to getting up and walking on the spot whenever you get a phone call, walking to the printer to pick up documents and walking to colleagues’ desks to ask questions/confirm issues, walking over to the bank ATM instead of driving there, using the stairs and not the elevators, installing an exercise/activity reminder on your computer to remind you to get active if you forget to do any of the above 😀

How can we make healthy foods the easier choice? Surround yourself with the right foods. Fresh fruits, veggies, dried fruits (which can also be added t nuts), nuts, dairy like yoghurt etc

Then make the right choices. It’s one thing to buy up all the healthy things that have been suggested, it’s another to eat them and not reach for the doughnut that your colleague just brought into the office.

In our high powered, we-are-all-busy-racing-to-somewhere world, eating breakfast may sound like a luxury, few can afford, but guess what? Studies have shown that eating breakfast may reduce the risk of obesity and Diabetes. So, whether you’re skipping breakfast because you think you don’t have time or because you want to lose weight by kipping meals, it’s bad news. So, how can you ensure that you’re not only eating breakfast but eating the right foods? Here are our tips for eating a healthy breakfast on the run:

Oatmeal is always a great idea. Rich in fiber which reduce cholesterol and help protect your heart and keeps you feeling fuller for longer. If you’re not a huge fan of oatmeal, you could sprinkle some cinnamon on it and be sure to take with skimmed milk. Another idea for oatmeal I learnt from a chef is overnight oats. Soak your oats with milk and unsweetened yoghurt overnight (just enough to cover the oats). Cover and leave in the fridge overnight. In the morning, bring out and sprinkle some cinnamon, add some apple or banana slices, a couple of nuts (optional)…and you’ve got a delicious bowl of healthy deliciousness in your hands! Some whole wheat/grain cereals (unsweetened) also not go amiss. Whole grain bread with peanut or almond butter (peanut butter is just ground up peanuts or groundnuts), an egg with a cup of fresh juice or some fruit slices also sounds good 😉

If you want to go for a smoothie, be sure to add some veggies (carrots, a handful of green leafy veggies etc) to ensure it is super healthy and not just another sugar rush 😀

Beyond these, get a dietician to draw up a diet plan for you and see a doctor asap to take a proper history and make an actual diagnosis. All we have done above is based on a high index of suspicion.

Have a good night, y’all 😀

Q: Hello doctor. I went to greet one of my male friend yesterday and during the visit one thing led to another and he forced sex on me. When i got home and I used a mirror to take a closer look at my pp, i discovered a tear down there. I have never had sex before. I am afraid i don’t know what to do. The blood has reduced but the pain is still much especially if I want to urinate.

A: Hello dear, my heart goes out to you for what happened. There are two things you must do…report this ‘friend’ to the police and get yourself checked out in a hospital. Usually when people are raped, they experience a deep sense of shame making it difficult for them to seek help and indeed prosecution for the person accused. This should not be. Please seek help…for you to ensure that you do not end up with any STI, for emergency contraception, to get checked out by a doctor especially if you suspect you have a tear etc and to ensure that your predator is not emboldened to do this to another person, ever again. Going to law enforcement as soon as possible would help as the clothes may contain some forensic evidence. And yes, this rape can be man against woman or rarely, woman against man.
The bleeding that occurs after first intercourse is usually due to the breaking of the thin piece of skin that covers the vagina, called the hymen. Some women may, however, experience no bleeding and no pain. In those who experience this bleeding, it usually does not continue beyond the third day. The hymen can also break before first intercourse in females that ride horses and females that use tampons.

To help prevent this, practice personal safety and trust your instincts. If the situation looks or feels fishy, it probably is. Try to ensure you go with company if you must visit any friend of the opposite sex or better still, meet in a public place etc.

Project alert (http://www.projectalertnig.org/) and the Lagos Domestic Violence centers  (http://domesticviolence.com.ng/help-for-domestic-violence/) will also be able to provide some more practical support in terms of counselling and probably legal help, if required.

Stay safe, okay?!

Loads of love and hugs coming your way…

Have a great night, people 😀

Q: Dear Dr Ketch, my 5-year old daughter will sometimes have vaginal discharge. I am so worried. I’ve checked her but there is nothing amiss…is it normal & what can I do..??

A: Yes a little girl can have a vaginal discharge.

I am slightly worried about your checking her! 😀 I hope this did not involve unnecessary poking around???  The cause of the vaginal discharge can actually be a foreign body that got in there…a hair bead or even a bit of tissue left after cleaning up, for example. That is sufficient to cause significant discharge.

Other causes include:

• Prolonged contact between skin in the genital area and faeces and/or urine
• Other skin irritants like perfume, use of bubble bath and/or perfumed soap
• Lack of cleanliness.
• Bacterial infections
• Other infections like measles

Poor personal hygiene is a common cause as children start to go to school and begin to take care of their hygiene themselves especially after using the bathroom. It is critical that our babies are taught to clean themselves properly by wiping from the front to the back. Please do some sort of spot check to ensure that they have cleaned thoroughly 😀

Is this discharge associated with itching? If so and the discharge is cheesy white and thick, it may be candidiasis. Candida is not a usual cause of vaginal discharge in this age group, though. Please let the doctor confirm the diagnosis. He will take a detailed history and find out what exactly this discharge is or is not.

If it is due to candidiasis, it may be due immune system compromise by antibiotics and is also found in children diagnosed with diabetes.

To prevent this discharge, start by ensuring your baby wears loose cotton undies and do not give her antibiotics she does not need. As had been mentioned on this page before, all that is needed to wash your delicate inner self is clean water and clean hands. Teach her that. Ensure that your baby dries properly, especially the vulval area (pat dry) after a bath to prevent the build-up of fluid and warmth that encourages fungal growth. Discourage tight clothing and if anything, encourage her to wear skirts. Encourage her to also sleep without underwear at night as often as possible and if your home situation is conducive enough for it.

Have a good evening, y’all 😀

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Q: Dear Dr Ketch, I had a vaginal suture when I delivered my first child and everything was fine until after my third child. I observed that my vagina is wider than ever. With my husband’s infidelity, I knew something was wrong with me…maybe it’s not his basis for his infidelity but I just need to correct this problem. It’s about marriage. Please, help me. What can I do???

A: Sweetheart, you are not responsible for your husband’s infidelity. Noting is wrong with you! We need to stop this ‘humbility’ thing we do…blaming ourselves for everything that goes wrong with the world and especially our husbands. Your husband would be faithful if he felt it was worthwhile. The fact that he doesn’t feel it is worthwhile to do so, means something is wrong with him and not you!

By all means, do everything you can always, to make your home a haven of peace, joy and happiness. But, because it takes two to tango, nothing you do would be good enough until your husband decides to also see there is something in it for him. The bible says, ‘two cannot walk together, except they agree’. Be a great wife but do not empower your hubby to practice more infidelity by making excuses for him.

So, having said that, perhaps you can seek out counseling services. But remember that a philandering husband is an STI risk! For more on this, please click on this link: https://chatwithdrketch.com/2014/09/08/daily-health-tips-my-husband-cheats-how-do-i-prevent-stis/

Now, as to correcting the issue of feeling wider down there…it’s normal after child delivery. The simple solution is Kegel exercises. The exercise mimics the movements we make when we want to stop the flow of urine. Try holding this for about 10 seconds and then doing about 10 repetitions per set. Try about 4 to 6 sets per day and increase this as you feel ready.

Keep our head up, Sis. Get busy too…get a job or get a source of income and empower yourself. I am sure that you will be able to use your story to empower other women sometime soon.

Have a great night y’all 😀