Daily Health Tips:Erectile Dysfunction

Posted on February 26, 2016 by chatwithdrketch

Q: I’ve suffered ED for the last two years. Kindly help me.

A: Erectile dysfunction (ED) occurs when a man is no longer able to get or maintain an erection sufficiently enough to have sexual intercourse. It may be really dramatic in some men, such that where they used to want intercourse very frequently, they find that there is reduced sexual desire.

Oftentimes, this may be due to just stress and better stress coping mechanisms help. However, because this is a sensitive topic, many men do not seek medical help such that this causes significant strain in their relationships. Other causes include depressions, relationship challenges, high blood pressure, high cholesterol level, high blood sugar, obesity, some medications, tobacco use, substance abuse, alcoholism etc

Your doctor will probably order some tests to confirm possible cause(s) and then decide on a course of action. Now I know that quite a number of men are quick to go and buy Viagra and some even overdose on it thinking the more they take the better the performance :DPlease don’t do that! More seriously, these drugs are not for everyone and so if you have Diabetes Mellitus, heart disease, if you have had a stroke etc, please be sure to mention these to your doctor…and indeed you should not self-prescribe any of these (or indeed any other) drugs for yourself.

 

Treatment depends on cause. If this is emotional, psychological or due to stress etc, some degree of counselling may help. Other treatment options include oral medications like Sildenafil (Viagra), penis pumps, implants, injections etc. Please speak with your doctor to find out what options are available to you.

Remember that your partner may not understand what you’re going through and probably think that you no longer desire her. Be sure to re-assure her and let her be a part of your therapy. More importantly, try to be open about what is going on to your doctor so he can work with you to find the ideal solution.

Good night people 😉

 

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Daily Health Tips: Semen Flow Back Re-Visited

Posted on February 25, 2016 by chatwithdrketch

Q: Good day Dr. Please, whenever my wife and I have sex, all the sperm flows out immediately she leaves the bed. What’s the cause and solution?

A: I’ve received this question in various forms from men and women alike and so it must mean that this is an important issue for a lot of people.

Lots of couples wishing to have a baby appear to believe that semen flowing out of the vagina signifies a problem and so, they do different things to stop this including, raising the female partner’s legs in the air or even performing a cycling motion. None of these need to be done, really.

A man’s ejaculate is made up of more than just sperm cells. The sperm count in ejaculate (which should be about half to 2 teaspoons in volume) is any number from 20million to several hundreds of millions! That’s a lot of sperm cells for 1 teaspoon, right? Now, when a man ejaculates, the initial force of that pushes some of the semen a significant way into the vagina. The rest of it flows back. In case you’re worried about the semen that flows back, just like the person who asked this question, the truth is that you don’t need more than 1 sperm cell to fertilize an egg.

Some sperm cells are retained at the back of the vagina, some make it all the way to the cervix and some others get into the uterus and make the trip into the fallopian tubes to fertilize an egg. And in addition, these sperm cells can remain alive and active for even up to 3 to 5 days after intercourse, depending on conditions. So, if there was no egg to fertilize at the time of intercourse, if the woman ovulates within this window of 3 to 5 days, she could still very well get pregnant.

Now, if you have been trying for up to one year to have a baby with no luck, please see your doctor and let him evaluate you and your partner. Analysis of the semen with sperm count etc will be helpful in defining course of treatment.

For more on this, please click on this link https://chatwithdrketch.com/2014/12/14/daily-health-tips-miscarriage-and-infertility-re-visited/

I hope y’all had a great day? Have an extra special night 😀

 

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Daily Health Tips: Can Asthma Be Cured?

Posted on February 24, 2016 by chatwithdrketch
Q: Good afternoon Dr, can asthma be cured & how can I live with asthma or how do I prevent/ minimize attacks?
 
A: Asthma is a disease of the lungs which manifests as difficulty in breathing. The severity differs from person to person and it can develop in both adults and children. There is no cure for asthma but it can be controlled.
 
The cause of asthma is not really known but appears to run in families. Other people who are more at risk of developing this include those with other allergies, those born pre-mature or with a low birth weight and those who were exposed to tobacco smoke in the womb (having a mother who smoked) etc.
 
In asthma, the airways (the passage/pipes through which air passes to and from the lungs) are sensitive and easily irritated. When this irritation occurs, the airways narrow and the muscles around them squeeze tightly; the airways further get swollen and produce thick mucous which worsen the problem of air actually passing through the airways.
 
The patient, during an attack, would typically complain of cough, wheezing (this sounds like whistling), and difficulty in breathing and tightness in the chest. The ‘things’ that can irritate these airways are called triggers and include dust, tobacco smoke, cold air, exercise, allergens like pollen, dust mite, feathers etc, some drugs (like those in the same class of drugs as ibuprofen), emotional disturbances (stress) etc
 
An attack can be acute in which case a trigger causes an attack that happens pretty quickly or the attack could be chronic, in which frequent irritations of the airways has led to an airway that is permanently narrowed. People diagnosed as asthmatics during their childhood days are likely to ‘grow out of it’. However, this may also return during the adult years, especially if they had the moderate or severe type.
 
Treatment is usually individualized and is based on severity of symptoms, age and triggers. They range from inhalers used to provide quick relief by opening up swollen airways to medications needed to prevent inflammation and thus, attacks.
 
Prevention is focused on preventing triggers: stop smoking and avoid second-hand smoke, reduce allergens like dust mites, discuss your exercise regime with your doctor, prevent respiratory infections by building up your immunity: eat healthy (more fruits and vegetables), exercise and keep within a healthy weight. Follow your action plan for treatment as prescribed by your doctor etc. For more on preventing allergens like the dust mite, please click on the link below
 
 
If you’re asthmatic, be sure to have your inhaler with you at all times, especially if you’re travelling and make sure you take your medications as prescribed. If an asthmatic finds that they have more frequent attacks and need to use their inhalers more frequently, these could be signs that their asthma is getting worse. If during an attack they have no relief from using their inhalers or have shortness of breath even when there is no attack per se, they should see their doctors immediately as these situations could be life threatening.
 
Have a good night y’all 😀
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Daily Health Tips: Ulcer?

Posted on February 23, 2016 by chatwithdrketch
Q: Good morning ma’am. I found out that I have sharp Ulcer yesterday and I feel pains in my stomach that extends to my waist. Please what am I going to do to the Ulcer and the pain? Thanks
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 😀
 
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 😀
 
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
 
Have a great evening, y’all 😀
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Daily Health Tips: How Can I Get My Children To Take Fruits?

Posted on February 22, 2016 by chatwithdrketch
Q: Good afternoon Dr. I need your advice as regards what to do for kids that do not like fruits at all. Is there a more delicious way I can improvise the fruits or smoothies intake for kids of between 5 – 6 years of age?
 
A: Great question 😀 I never liked fruits myself as a child and even as an adult, I never got into the groove. Well, except for fruits like mangoes (I lived on this during my first and second pregnancies :D), apples and grapes. For the rest, I could not abide them until I discovered smoothies. The trick is to mix tart fruits with sweet ones so that you find the right balance. I absolutely got my son, who hated fruits like me to begin a love affair with them 😀
 
What fruits can your baby take? Practically, all types of fruits. If you’re introducing fruits for the first time, start gradually. Blend the fruits into smoothies or add some to fruits, like mashed bananas to cereal. You can actually blend up some fruits with the re-constituted milk (powdered milk mixed with water) and serve your baby. Start small and increase amounts as baby tolerates.
Get some fruits in season. I love to use mangoes and/or bananas. If you’re going to use both, one small mango and one medium sized banana is sufficient for a long glass. Scoop out the pulp of the mango and then cut up the bananas. Add the fruits to a blender one measuring cup of yoghurt. If you don’t have a measuring cup, just estimate. Blend both. If you want it thick, don’t blend for too long. If you want it runny (like drinking yoghurt) then blend for longer.
 
Serve in a nice, long cup. If you like some crunch, you can sprinkle some unsalted nuts (almonds, cashew or even peanuts) or some whole grain, crunchy cereal on top.
 
Improvisations:
If you don’t have a blender, you can mash up the fruits and add to the yoghurt. You will expect that the blend will not be so smooth and will have nice, delicious bits and lumps in it.
 
If you don’t have yoghurt or can’t make it immediately, you can replace the yoghurt with skimmed milk.
 
Yum, yum, yum!!!
 
Another delicious healthy milky/fruity snack you can make for your children is a milk popsicle. Even you will love it! Here’s how:
 
• You can juice some sweet oranges, or blend mangoes or any other fruit you like.
 
• Mix it with some milk
 
• Put it in fruity shaped ice moulds or even a regular ice tray that comes with most freezers or get a popsicle maker and pour it in with your popsicle stick in.
 
• Allow to freeze
 
• And….you’ve got the ideal sugar rush snack for your children.
 
Try it out and feel free to tinker with the recipe whichever way you want!
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Daily Health Tips:Sexual Intercourse After Baby

Posted on February 20, 2016 by chatwithdrketch

Q: Good day ma’am. May God bless & protect you for us. My question is, when is it ok for a woman that just delivered to start having sexual intercourse and is it true that it is going to affect the baby?

A: Good question 😀 The honest answer is, as soon as you and your spouse feel up to it. Usually, 6 weeks is advocated at which time the woman would have had a post-natal check.  However, there is really no scientific basis for this and the time a woman feels like intimacy could differ from woman to woman. Some women feel ready earlier and some much later. Bear in mind that there are new issues contending for attention here…namely the new baby who requires a lot of attention, the overwhelming emotion of being in charge of a new life especially for new mothers, the sheer exhaustion after looking after the baby’s needs and sleep deprivation, the pain of vaginal suturing, if the woman had a tear, the dryness of the vagina at this time etc. We could go on and on! So, with all these, it may be difficult to feel really sexy…trust me, I know 😀

 

So, what’s the way forward? New mums, get as much help as you can so that you don’t feel exhausted every night. Also, rest whenever the baby is taking a nap. Perhaps, timing for intimacy can also be re-scheduled to other times…maybe mornings while the baby is still sleeping etc. Then again, you don’t have to wait for full sexual intercourse to be intimate. You can start off with cuddling and then move on to more adventurous things. Lubrication may also be a great idea to help with vaginal dryness. To help restore muscular tone to the vagina, pelvic floor exercise (Kegel exercises) should be started as soon as possible. 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.

Remember birth control even if you’re breastfeeding exclusively. You don’t want to get pregnant while nursing a baby, right? 😀

 

Is it safe to have sex while breastfeeding? Yes, it is…provided the two activities are not occurring at the same time. The breast milk and the sexual activity have totally different pathways 😀 Is it healthy? It’s definitely NOT UNHEALTHY.

 

I hope this helps 😀

 

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Daily Health Tips: Re-Visiting Chronic UTIs

Posted on February 19, 2016 by chatwithdrketch
Q: Hi Dr I am from Tanzania. I am suffering from UTIs and I have had this several times. So can I use dilute antiseptic liquid for my daily vagina washing? Does it work in prevention of UTIs?
 
A: Urinary Tract Infections occur anywhere in the urinary tract (Genius me, right :D) and include infections of the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder (the reservoir or store house for the urine) and the urethra (the tube that transports the urine from the bladder to the outside).
 
So, who is more likely to have an infection and why? Women are more likely to have infections and this is because they have short urethrae (those tubes that transport the urine outside) and because the opening of this tube is very close to the opening of the anus. And so, if a woman urinates and has not quite mastered the art of cleaning from the front to the back, she could transfer bacteria from her anus to her urethra and this in turn travels up and infects the bladder.
 
Women who also use the birth control method, diaphragm appear to also be at risk as it may cause the bladder not to empty completely when they urinate. Indeed, not urinating immediately after sexual intercourse in women may also predispose to this as the urethra may have may have become irritated, making it easier for germs to move in. People with depressed immune systems, frequent constipation and some people born with some disorders of their uro-genital system are also prone to UTIs. In men, narrowing of the urethra which may happen in men who have had straddle injuries (eg falling astride {with legs apart} on a pole…ouch!), history of STIs or prostrate problems may make a man open to UTIs.
 
Recurrent and chronic urinary tract infections (UTI that keeps recurring) may be due to changes in hormone (estrogen) level as one gets to menopause, problems with the urinary tract in terms of function or shape, kidney or bladder stones, bacteria getting into the urinary tract during sexual intercourse etc
What symptoms does a person with UTI have? They would complain of feeling they have to urgently urinate often and then when they do get to the toilet, they can only pass out very little urine, pain or burning sensation during urination, pain in the flank (just under the ribs at the back), the urine may be cloudy or reddish or coke coloured, fever with chills and rigours etc.
UTIs have to be treated because these infections could keep back tracking from the urethra to the bladder to the ureters and then to the kidneys…we don’t want that do we?! 😉
 
Treatment is focused on eradicating the infection…of course 😀 Usually a urine sample is taken to the lab. Part of the lab work is a culture and sensitivity test to find out the organisms causing the infection and the specific antibiotic that is active against it. Please take your prescription for the right period of time even if your symptoms disappear before you finish. Your doctor may also order other tests as he sees fit eg checking out for congenital defects etc.
 
Apart from the preventive tips above, be sure to drink lots of water which help dilute your urine and help flush out the bacteria.
Now as for using antiseptic fluid for intimate cleansing…..Hmm, this is a question I’ve been asked often and it does make sense to ask 🙂 You would want to wash your vagina with disinfectant or perhaps antiseptic soap to make sure that you kill off all the germs, right? Wrong!
 
There are some bacteria that are actually useful in the body. Those found in the vagina, mainly lactobacillus, fall into this group. They produce substances that help to fight the growth of fungi (candida) and other unwanted organisms. So, when you wash with antibacterial soap or disinfected water, you mess with that natural balance in your intimate parts leading to overgrowth of unwanted organisms like candida.
 
Another similar activity is douching. Vaginal douches usually contain water and vinegar. Others have antiseptics and fragrances in addition. These douches are usually sprayed upwards into the vagina to ‘clean’ it up. Apart from destroying the hard-working bacteria which ‘protect’ the ‘intimates’, it can also lead to irritation of the very delicate vaginal skin.
 
Other activities that can cause over-growth of the vagina by unwanted organisms are abuse of antibiotics, a weak immune system from disease or stress and the hormonal imbalance that can occur in pregnancy.
 
So, the feeling better is really all in the psyche. No real work is being done. Truth is, if there is actually an infection, the douche and disinfectant et al are unlikely to be able to deal with them! So, there 😀
 
So ladies, all you need is…clean hands, soap that is not perfumed (if you can tolerate it) and water; c’est finis!
Have a great evening!
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Daily Health Tips: Can I Have Cucumber In Pregnancy?

Posted on February 17, 2016 by chatwithdrketch

Q: Is cucumber good for pregnant women?

A: Cucumber is a rich source of calcium and is generally considered safe in pregnancy unless of course you’ve had any allergic reactions with it before. Where in doubt, please speak to your doctor. Other good calcium sources are spinach, cabbage and other greens.

Eating right in pregnancy is critical and trust me….eating right is not necessarily eating for two…I know we’ve all heard the feeding for two fable. Trust me, in pregnancy, your calorie requirement doesn’t increase in first trimester, increases by just 300 calories in second trimester and about 400 calories in the 3rd trimester …if you’re carrying just one baby. For multiple pregnancies this increases slightly.

Other nutrition tips to help you during this period:
• 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!
Pregnancy provides an opportunity for a mother to adequately prepare her baby for life in 9 months. Make sure that you get all the nutrients that give your child a great health boost.

Have a great evening 😀

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Daily Health Tips: Safe Sex In Pregnancy

Posted on February 17, 2016 by chatwithdrketch
Q: Can someone who is 4 days late with sore nipple or tender breast continue to have sex if she is trying to conceive? Though it hasn’t been confirmed if it’s -ve or +ve.
A: Hi dear, even if you have been confirmed pregnant, you can continue to have sex.
There are many different causes of nipple pain and they include:
• Vigorous rubbing of the nipples. This would usually heal without incident and applying a moisturizer will help the process.
• Friction: In this case, not wearing a bra or wearing a poorly fitted bra during exercise routines may lead to rubbing of the nipples against the fabric and consequent soreness/pain. Wearing a proper
• Sensitivity to the weather (hot or cold), certain fabrics, detergents or even creams/lotions may lead to nipple pain. If this is caused by specific detergents or creams, you may have to change them.
• Hormonal changes as can occur close to a woman’s menstrual period. This pain will usually disappear after a few days.
• Pregnancy and breastfeeding can also lead to this condition. In pregnancy, the pregnancy hormones lead to the nipples being extra sensitive and during breastfeeding, the baby may not latch on well to the nipple, there could be blocked ducts or mastitis or breast abscess etc leading to pain. During pregnancy, be sure to choose bras made with fabric that can ‘breath’ like cotton. And during breastfeeding, be sure to get help with making sure you know how to put baby to the breast to prevent sore nipples etc.
• Cancer (Paget’s disease of the breast) can also be a cause of nipple pain.
 
So, where in doubt…especially if you have tried to rule out the causes above, please see your doctor.
Sex is generally considered safe during pregnancy. Except the doctor has noted some medical issues that may cause some restrictions on sexual intercourse, couples can generally continue to have sexual intercourse during pregnancy.
Having said that, it doesn’t mean that every woman wants to indulge 😀 Unfortunately, no. Some women do experience increased libido, some decreased libido and some are just completely exhausted by their itinerary (wife, worker, sister, daughter, intending mother, worries about the pregnancy or intending birth, care of already existing children, if she has them etc) that sex is the farthest thing on their minds, most times. So, where’s the solution or compromise? Communication lines between couples have to be open. The husband needs to understand what’s going on in the mind and body of his wife. Providing emotional and tangible support by helping her out with some chores/activities, providing a daily evening massage….which becomes something wifey can look forward to, can help create the right mood. Remember that for women, sexual Intercourse starts from the emotional before it gets to the physical 😀 Couples can also explore other means of sexual intimacy apart from sexual intercourse.
Some issues that may cause a doctor to issue some restrictions on sexual activity include:
Threat of a miscarriage
History of pre-term labour
Unexplained bleeding in pregnancy
Cervical incompetence (where the mouth of the womb is open leading to a risk of miscarriage) etc
If you’re not sure whether you belong to any of these groups or not, please ask your obstetrician.
Now, there also some risky activities during sexual intercourse in pregnancy:
 If you indulge in oral sex, hubby please do not blow into your wife’s vagina as this can lead to an air bubble being lodged in a blood vessel causing problems in mother and/or baby
 Having STI with an infected partner can lead to STI in pregnant mum. This infection can be transmitted to the baby. So, hubbies be sure that you stay faithful
 Anal sex is also discouraged.
In your case, please see your doctor to confirm if you are pregnant or use a pregnancy test kit. If your nipples are sore, be sure to gently communicate this to your partner so that he is extra gentle during sexual intercourse.
All the best 🙂
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Daily Health Tips: How Do I Stop Diarrhea In Pregnancy?

Posted on February 16, 2016 by chatwithdrketch

Q: Hi Dr Ketch, please I am 4weeks pregnant. 2 days ago, I ate vegetable soup and it’s been making me purge seriously; and I also feel weak. Please what drug can you advise me to take that will stop the stooling?

A: Hi dear. Congratulations on your pregnancy. We share in your joy!

Pregnancy is a very interesting time. Your body produces pregnancy hormone that help to keep your pregnancy. However, they come with some baggage too 😀 These hormones cause constipation and they also cause diarrhea. And so, even for those that may not be able to point to specific foods they ate that could have triggered the episode may just have diarrhea due to the hormones of pregnancy J

Other causes of diarrhea especially in early pregnancy include:

Changes to diet: Most women change their diets after they get pregnant and start to eat healthier. This diet would include fruits and veggies which in turn cause diarrhea when the body is not used to this sort of diet 😀 This is, however, temporary and stops after a little while.

Some antenatal drugs: The iron in the antenatal (prenatal) vitamins can contribute to the constipation experienced in pregnancy but other pre-natal vitamins can cause diarrhea. If you suspect this, speak with your doctor or skip the medication for one or two days to see if you feel better. If this is confirmed, your doctor will prescribe an alternative.

Lactose intolerance can also lead to frequent, watery stools during pregnancy. If this is the case, then your doctor will advice you stay off milk but you have to find other calcium sources needed by your growing baby like sardines, soya beans, fortified cereals etc

Infections with viruses or bacteria can also cause bacteria. Bacterial infections will require treatment with antibiotics.

What is important during these episodes is to ensure that you are hydrated. Drink lots of water, soups and Oral Rehydrating Solutions (ORS), if you’ve got them. Please do not take our sugary soft drinks. I have heard people say that if you take one of the soft drinks (the one that comes in the green bottle and is colourless like water), it is equivalent to taking ORS. This is not true, at all. These soft drinks can worsen diarrhea by drawing fluid into the tummy and making the diarrhea last even longer.

The BRAT foods are thought to help. Bananas, Rice, Apples and Toast (BRAT) are traditionally thought to be easy on the stomach especially during these incidents. However, addition of other foods rich in other minerals and vitamins like lean meats, yoghurts, starchy foods (like crackers, unsweetened cereals etc) helps.

Generally, mild diarrhea in pregnancy with less than 3 episodes of stools per day, would resolve on its own depending on the causes as noted above. However, if you have 3 or more episodes of stooling and can see mucous or blood in the stool or indeed, the stool is purely liquid, be sure to see your doctor immediately.

Have a great evening, y’all 😀

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