#HLWDK Daily Health Tips: Surgery Complications

Q: Hi doctor, please I’ve a very serious issues I want you to address. I had priapism and I had surgery for it, but now the problem is I don’t or experience erection since after the surgery. So please help me to know if there is any solution for it.  Thanks

A: Thanks for writing in. Let’s start from the beginning….

Priapism is a condition, in which there is a sustained and oftentimes, painful erection of the penis, continues for hours beyond sexual stimulation (I suspect that ‘magun’ falls into this category 😀 I couldn’t resist that. Only Nigerians and Yorubas, specifically will get this joke!) or even when there is no sexual stimulation as described in your case. It is more common in men in their 30s.

There are three types of priapism (ischaemic, non-ischaemic and recurrent) but to understand this, we’ll take a look at the mechanism of erection. An erection occurs in response to stimulation, physical or psychological. As a result of this stimulation, the blood vessels and smooth muscles of the penis relax, allowing increased blood flow to the penis. This is what causes erection. When the stimulation is over, the vessels and smooth muscles constrict causing the blood to flow out of the penis and become flaccid. In priapism, the order of events causing the blood to flow out of the penis is changed such that the blood does not flow out of the penis

In ischaemic priapism, which is the more common type due to inability of blood to leave the penis, there is pain, rigid penile shaft but flaccid glans (penile tip) and the erection lasts more than 4 hours! Causes include blood disorders like sickle cell anaemia and injuries to the penis and/or pelvis, alcohol, cocaine and other illicit drug use, some medications like blood thinners and antidepressants, cancer of the penis etc.

Non-ischaemic priapism is usually due to an injury to the perineum or genitals that results in poor regulation of penile blood flow. It is not usually painful and manifests as erection that lasts for more than 4 hours but the penile shaft is not fully rigid.

In recurrent priapism, situation is similar to ischaemic priapism with erections that are painful, recurrent but ease after 2 to 3 hours. These erections may subsequently progress to become more frequent and more prolonged. It is common in males with sickle cell anaemia

Any sort of priapism should be checked out with a medical doctor (urologist) to determine type, cause and management. Erection lasting more than 4 hours is an emergency and may led to damage of the penis and subsequent erectile dysfunction

Treatment depends on cause and should be started as soon as possible.

Options include aspiration (in which blood is drained out of the penis with a syringe), use of medications to constrict the penile blood vessels, treatment of underlying medical condition like sickle cell anaemia and surgery in some cases. Note of warning, though it sounds very simple to use a syringe to drain out the blood in the penis, you must never attempt it on your own. You must visit a hospital and let a doctor work out the best treatment option(s) for you.

Patients who do not get treated early enough and some that went through surgery eventually end up with poor erectile functions despite the successful treatment. Therefore, I suggest you see the doctor who operated on you to get a proper evaluation and evaluate other options open to you.

All the best!

Have a good evening everyone J


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The latest on a simple way to help prevent food allergies in kids – Harvard Health

Physicians have always told parents not to give their children nuts before 2 years and seafood before 1 year of age. Well, all of that has changed now. Want to know the new recommendation? Read this!



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Daily Health Tips: Should I Teach My Daughter The Proper Name For Private Parts?


Q: Good morning, Doctor and God bless you much for always being there. I’m the lady that told you about my baby’s Mumps. She’s very fine now. Thank you so much

Doc I was wondering,..what should I teach her to call her Vagina? I don’t know if it’s proper and polite to use the real words as Vagina or Penis especially in public places. She’s my first child and I’m pregnant with my second child now.

Please help me out. Thanks a lot.

A: Hey you. Thanks for writing in. I’m glad your daughter is better.
Interesting question and I’m sure lots of parents will have lots of different views about what makes sense and what doesn’t.
Before I weigh in, I’ll tell you a story that I heard when in medical school. One of our professors was trying to explain why it was very important to ensure that in…

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4 things all parents should do to help prevent sexual abuse – Harvard Health

I came across this Harvard Health post and it reminded me of a question I had responded to on this page some years back. I repeat same here. Enjoy…

Q: Thanks Dr Ketch for all your advice. Please, at what age should my hubby stop bathing my daughter? She is 6yrs old now. During the week, we leave home early and so we help each other because we don’t want to have a house help and most times he helps with bathing the children.

A: Hmmm! Very valid question! You guys are getting into interesting territories! Important territories, too 😀

This issue actually goes both ways and indeed, the question should also be asked about when mothers should stop bathing their sons.
Children need their privacy and sooner than later may feel the need to voice out their need for this. I’m sure the husband in this case does not fall into this category but stories of parents sexually abusing their children also exist. We need to also be mindful of this…sad but true.

By the time a child is about 2 to 3 years old, he/she should be encouraged to wash their genitals by themselves. So, the parent bathes the child, but allows the child to wash the genitals while instructing/watching/supervising. Remember that these areas generally need just the gentlest of washes and so a child’s soft touch is plenty. This re-enforces the message that these areas are private and that not even mummy or daddy should cross these boundaries. Indeed, if a child has an injury on the genitals and an ointment or cream needs to be put on it, the cream should be put on the child’s hand and he/she should apply it by him/herself.

By the time a child is 4 to 5 years, he’s generally able to bath himself and should be given the privacy to do so…by both parents.
You know how you used to feel free to undress in front of your children because you felt….well, you just felt it was okay? Well, stop feeling so! By the age of, about, 3 to 4, fathers should stop undressing in front of daughters and vice versa. Around the age of 7 to 8 years, it may also not be cool for mothers to undress in front of daughters and vice versa. Now these are guides and depending on how fast your children catch on to these issues, you may have to fast forward these timings.

Generally though, as soon as a child stops feeling comfortable having you around when they are undressing or in the bathroom, please respect that boundary. My son kicked me out of his room and fired me from bathroom duties just before he turned 5 years. I was absolutely amused but I gave him his space. And I absolutely knock on his door before I enter.

So, kindly give your husband his sack letter tonight and let your daughter understand that she’s just moved up one more rung in the responsibility ladder 😀

What’s your take on this? For more on this subject, click on the Harvard Health link below:


Have a good evening, people 🙂

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#HLWDK Daily Health Tips: Swollen Legs After A Flight

Q: Hello Dr, I have been having swollen legs since I traveled almost 17hrs by air. All tests been done, no fault discovered. What shall I do?

A: Hello dear, thanks for writing in.

Swelling of the legs and feet during flights is common and usually not suggestive of a more serious problem. It happens when blood pools in the leg veins due to long periods of inactivity as can occur during a long-haul flight. This swelling usually lasts for a few hours. If the swelling persists, occurs more in one leg and is associated with leg pain, please see your doctor immediately as it may be suggestive of a more serious problem, like a blood clot in the leg.

I repeat a post I made some years back on preparing for flights. It focuses on preventing the condition you already have. However, if you already have swollen legs due to pooling of blood as described above, rest, elevate and exercise your legs to reduce swelling. Exercise tips are given in the post below.


Dear Diary, you’re probably the only one who really understands how very busy the past few days have been. So, as I race through Lagos traffic towards the airport, I’m actually looking forward to catching up on some much-needed sleep on the plane…

I know quite a number of people who tell me they can’t sleep when they are in a bus, on the plane or in a car. They can’t sleep when there is even a bit of noise, when the curtains are not drawn, when the lights are on or the lights are off! Different variations! Well none of these define me! Once I’m tired, I can sleep anywhere…in the middle of a room filled with noisy children, in a squashed cramped car on a long trip, in the squashed space of a bus, in the tiny economy space of local and international flights and I daresay I can sleep on top of a trailer filled with sacks (I haven’t had this dubious pleasure yet!). In fact, I rather look forward to these trips sometimes because it presents an opportunity to sleep undisturbed. Provided I am travelling alone and not with my family, I am sure that I am unlikely to be disturbed for bathroom breaks, hunger, any sort of telephone call or work emergency. Oh bliss! (Just in case you wondered, I totally, absolutely and completely love my family :D).

So that’s my story. If you’re like me, you would stock up on some good novels to read at some point (when you open your eyes briefly) but if not, you are dreading the 6 or 12 hours (or perhaps even more) flight.

So, plan for it. Whether you’re travelling first, business or economy class, you don’t have to be worn out when you arrive at your destination. If you’re travelling economy, enquire at the booking desk if the flight is full. If it’s not, you could get a seat with empty seats beside you. Almost like flying in business class….albeit devoid of the personal touch, but who cares, right 😉

Wear comfortable and loose-fitting clothes.  I’m consistently amazed by slay-queens who dress to the nines complete with high heels when travelling! I’m in awe! 😀

Get comfortable…take off your shoes and….nothing else, please :). This should help minimise discomfort especially if foot swelling occurs. Pressure stockings are also a good idea to help prevent this swelling.

Get a travel pillow…those U-shaped pillows they sell at the airports. They are pretty comfy and prevent you from getting a crick in your neck during that long flight.

Take walks round the cabin every hour or so to help circulation and stop you arriving at your destination with swollen legs/feet. You could use these walks to network and/or catch up with friends/colleagues/business associates who happen to be on the same flight.

For the sleepy heads like me, try some ankle rotation exercises during those small intervals when you are conscious 🙂

Lay off the coffee and alcohol. And drink a lot of water. Yes this may increase your visits to the bathrooms which you really don’t want, what with the long queues of people waiting to use them; but it is much better than getting dehydrated as the air in the cabin is pretty dry and could dehydrate you.

As for the food…perhaps you’re one of those who hate the ‘plastic’ food and laugh at the oyibo’s attempt at jollof rice (I’ve tried explaining to them that the art to cooking jollof rice is only in the gene of Nigerians and jambalaya is not even a close substitute! Please note that the study about the jollof rice-gene interaction has only been carried out in my head…so this is clearly proprietary material right here! :)), then you have no problem because you probably ignore the food. But you could stock up on some nuts (almonds, cashew nuts etc), granola bars, fruits and water to take with you. They are useful during those long lonely hours when you’re waiting for the flight to board and to take onto the plane if you’re going to ‘dis’ (code for disrespect, my son tells me) the food! It’s also most certainly cheaper and healthier than the over-priced airport food which you may be tempted to indulge in. However, if you’re going to indulge, you might want to book online and order the lower calorie options.

Pack some breath mints in your bag. There’s nothing as thoroughly embarrassing…no scratch that! There’s nothing as humiliating as trying to discuss with a business associate who you happened to meet on disembarking from the plane, while trying not to come too close because you know you’ve got morning breath! So be a boy scout! Be prepared!

If you’re, perhaps going for a conference, resist the urge to indulge in all that free food (close your eyes and visualise banquet tables groaning under the weight of all types of food: chocolate fountains, pasta, all kinds of gravy, pastries of different shades and colours, fish, chicken and beef dishes of all kinds!) and look for those healthier alternatives (fruits, salads…not soaked in dressing, quinoa, grilled fish, vegetables etc). Load up on all these…loads of beautiful colours on your plate!

You know all those free books they give you at the conference? Take only the ones you really mean to read. This way you’re not tempted to trash them at the airport when ‘they’ tell you, you’ve got excess luggage! This is becoming a huge ‘international’ joke!

I am actually on my way to a conference and so this advice is as much for you as it is for me! 😀

Have a good night, everyone 😀


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Hygiene is two thirds of health!


Who would believe a thing like that? Like…seriously? Isn’t this like taking the cliche ‘an ounce of prevention is better than an ounce of care’ too far? Or perhaps the more commonly known ‘prevention is better than cure’? But guess what? It is true…so true that it is amazing the number of diseases that are spread by the very lack of this ‘common sense’ virtue, if I may pre-suppose to call it that.

A few weeks ago in May, the World Hand washing Day was celebrated and it was an opportunity to further WHO’s campaign of ‘save lives…wash your hands’. Studies have shown how the introduction of simple hygiene like just washing of hands has been able to halve the prevalence of childhood illnesses like diarrhoea and respiratory infections. This clearly means that our hygiene status plays a significant role in determining our health and even the health of others…

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#HLWDK Daily Health Tips: Anal Protrusion After Childbirth

Q: Good day Doc. please I put to bed 3 weeks ago. Just today I just find out that there is a fresh like boil coming out of my anus. If I push it in after using the toilet it will still come out. Please help me. I am so scared right now.

A: Thanks for writing in and congratulations on your baby! It does sound like you may have haemorrhoids. Piles, known as haemorrhoids in medical lingo are swollen veins in the anal canal. They can be internal, external or both internal and external can co-exist. Internal haemorrhoids occur when veins swell within the rectum and external haemorrhoids are found under the skin around the anus.

These haemorrhoids develop when there is undue pressure in the pelvic and anal area as can occur when people strain to pass faeces (if they have diarrhoea or are constipated), in pregnancy (especially the last 6 months), in obese people, people who eat diets low in fibre and people who practice anal intercourse. When women strain in labour, haemorrhoids can also be made worse.

It is important to consult your doctor to make a proper diagnosis.

In the meantime, limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) or washing with unscented soap to clean up after using the loo, sitting on a bowl of plain warm water for about 15 minutes about twice or three times per day, applying cold compress and not standing or sitting for too long. Some believe sprinkling some powder there helps…it doesn’t! Avoid it J

To prevent this, ensure that your diet has sufficient amounts of fruits and vegetables. Remember that if you take a regular flat plate, half of this should be filled with fruits and vegetables, half of the plate with complex carbohydrates and the last half with proteins.

Limit the time you spend sitting on the toilet seat (read your newspapers elsewhere :D), use the toilet as soon as you feel pressed (that way the fluid in the stool is not absorbed making the stool hard) and then don’t strain when you do go. Drink sufficient quantities of water daily, exercise (to keep everything moving along nicely :D). Use pain relief only under the supervision of your doctor, especially if you’re breastfeeding.

I hope this helps you.

Have a fab weekend, everyone 😀


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