chatwithketch

Q: Good evening ma’am! Please, I had two kids through CS and the second child will be 3yrs in July and I used withdrawal method all through. Since last year July, I started trying for conception all to no avail. I went for scan and I was told there was no problem. But up till now, there’s no baby to show for it. I am worried and I am 36yrs! Please, Doc help me.

A: Withdrawal method involves pulling the male organ out of the vagina just before ejaculation. This method can protect against pregnancy if used well but does not protect against STIs. It has been argued in some quarters that the pre-ejaculate (a lubricating fluid) may contain some sperm cells and so even if your partner is able to withdraw before ejaculation, the harm would have been done. However, the sperm in the pre-ejaculate is not there at the time the fluid is produced, but is sperm from previous ejaculations that was probably left in the urethra. It is believed that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations. Congratulations on having been able to prevent pregnancy using this method! 😀

Secondary infertility is very common, but not often talked about. Even when women present themselves to the hospital, they don’t come out straight to let the doctor know what actually brought them to hospital, and rather list a series of symptoms most often, unconnected to their primary (main) concerns. Secondary infertility is the inability to become pregnant, or carry a pregnancy to term following the birth of one or more children. There however has to be frequent (at least three times a week), unprotected intercourse for a period of at least one year (six months for women older than 35), for this definition to be complete.

The causes include impaired sperm production (quantity and/or quality), erectile dysfunction, or new disease conditions in males. In females the causes include tubal damage (that is damage to the tubes from infections or adhesions in which case certain body surfaces stick together following surgery), ovulation problems (menstrual abnormalities), uterine conditions (infections from complications during a prior delivery, retained placenta, or a miscarriage which wasn’t properly cared for), complications from previous pregnancy(excessive bleeding following delivery) and changes in you or your partners’ risk factors; like changes in age (increasing age), weight, smoking and use of certain medications or disease conditions.

Oftentimes, no reason can be found for the infertility and this is even more nerve wracking, because nobody has an idea how long it’s going to last or what treatments are going to work best. Joining support groups and/or counseling sessions may be helpful during this period of waiting.

Prevention of infertility is targeted at the risk factors. Quit smoking, reduce alcohol consumption, exercise moderately and keep your weight within normal limits.

Find a hospital with a good Obstetrics and Gynaecology specialist. The closest teaching hospital to you may be a good place to start your search. He will examine you properly and advice on the best course of treatment for you.

All the best! J

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Source: New guidelines aim to help women prevent stroke

Q: Good evening Dr. Please do you have any suggestion of treatment for arthritis. My dad is having pains on his legs. He can’t move fast with it. We have been to the hospital and even done X-rays which confirm he has arthritis, but the drugs seem not to be working as he still has pains. Thanks ma’am! Waiting for response

A: There are two types of arthiritis that one could have.

Rheumatoid arthritis is an auto-immune condition. This means that in this situation, the body no longer recognizes components of itself and its immune system begins to fight itself. In other words, the body launches a war against itself!

In this instance, the body’s fight against itself leads to joint pain, swelling and stiffness, especially in mornings and can lead to permanent damage. It affects multiple joints, can involve multiple organs (eg lungs, heart, eyes etc) and there are usually nodules (small lumps known as rheumatoid nodules) found under the skin, especially the elbows. Some people are lucky and have long periods between flare-ups; others are not and have symptoms often. This disease is more common in people aged between 40 to 60 years, women and if a family member has it, it’s more likely one may also have it.

There is no cure as it is not clear why the body turns on itself. The focus is on management of the symptoms: Physiotherapy to keep the joints supple, medications to take care of the pain and inflammation and sometimes surgery for joint repair or replacement.

For anyone who has this condition, be sure to take your medications, eat healthy, exercise and learn to relax
Now to osteoarthritis (OA), this is a more common type of arthritis. It would usually occur due to wear and tear (ageing) of the cartilage at the end of bones which allows free movement at the joints. The knees, hips, neck, lower back are usually affected and symptoms would include stiffness, pain and swelling. This disease is common in older people, women and the obese (clearly, being obese puts more stress on the weight bearing areas of the body like the knees etc), some types of occupation eg people who carry a lot of heavy loads are more likely to have osteoarthritis of the lower back. A family history of OA puts one at risk and having some diseases like Diabetes Mellitus makes one more at risk.
Where this disease affects the knee, it can lead to bow-leg and limping as the cartilage continues to wear away with even more wear and tear. Just like for RA, there’s no cure. Focus is on limiting opain and maintaining joint movement.

Treatment includes pain relief (using drugs in the class of ibuprofen or Paracetmaol), physiotherapy and sometimes, surgery. Injection of steroids into the joint space of affected joint has also been found useful but cannot be given too often.
Just like for RA, exercise, eat healthy, keep a healthy weight, use support (like walking stick) if need be etc

I hope this was helpful.

Have a great eveing, everyone 😀

There are many causes for vitamin B12 deficiency. Surprisingly, two of them are practices often undertaken to improve health: a vegetarian diet and weight-loss surgery.

Source: Vitamin B12 deficiency can be sneaky, harmful