chatwithketch

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 😀

Q: Hi doctor I want to lose weight but I don’t have time for exercise because of my work. Please, is there anything else I can do?

A: You can lose weight without exercise. All you need do is watch your portions.

First try reducing the size of plate you normally eat with. Then ensure that this plate is half-filled with vegetables, the other half should be divided into two and have equal portions of carbs (go for complex carbs like beans, local rice, oats, whole wheat bread etc) and proteins (like fish and chicken).

Ensure that you go easy on the salt. It leads to water retention and increases blood pressure if used too liberally. Remember that if you can taste the salt, that’s probably because it is too much. Try using spices and herbs to substitute for salt.

Also, go easy on the oil. Remember that even if the oil is healthy like olive oil, one table spoon contains 120 calories. You don’t need that. Oil must always be used sparingly. My rule of thumb here is that, if you’re done cooking and you can see the oil in the food, you have most definitely used too much.

Having said that, you still need exercise because it strengthens your heart and you come away from every session oif exercise with a fee-good emotion due to the release of some feel-good hormones (endorphins).

You know all the regulars:

• Don’t use the elevators; use the stairs
• Don’t call to ask about a report; walk down and get it
• Start a dance class after office hours

If you work long hours and think you do not have time to exercise, here are a few tips (the not-so regulars):

• If you drive yourself to work, try parking a little distance farther from your regular parking space and walk briskly down to your office.
• If you commute to work with a bus, try stopping at a bus stop farther than where you usually stop and walk the rest of the day.
• When you get to work, make a conscious effort to stand up whenever you get a call. Stand and walk on the spot.
• You can also try to move your intercom, to a table farther from you so that you actually have to stand up to pick your calls.
• You can start a work-place pedometer challenge to find out who racks up the most numbers on their pedometers.
• Try installing some free apps on your system that notify you when you have been sitting for one hour. Studies have shown that even if you exercise the optimal 150 minutes in a week, but then you sit down for hours on end to work, you are still prone to all the cardiovascular and other risks that people who do no exercise at all, are prone to. Stretch clock is one such app.
• Try having walking meetings or even standing meetings. You know those ‘tall’ tables usually used at cocktails? Those are the classic tables for standing meetings.
• While sitting, every couple of minutes or after your hourly stretch exercises, try flexing and extending your leg and butt muscles. You could try Kegel exercises at this time too.
• If you are a Human Resource practitioner, try putting the water dispensers in the stairwell (landing) so that people have to climb up and down the stairs to get water. While at it, you might as well provide some music so that people can have some fun dancing (and burning calories) while getting water.
• Pillow fights with kids and arm wrestling are also great ways to exercise
• Get up and dance or just do jumping jacks when there’s a commercial break during your favourite TV show.

So, there you have it! Your food and exercise prescriptions! You probably have other great and innovative ideas on how to get more exercise…please share. We all could find more ways to be super healthy 😀

Have a great weekend 😀

Q: Dear Dr I went for a Lab text last month and The result showed that am having pelvic inflammatory disease (PID). My Q is this: could it be that my fallopian tube might have been blocked or what?

A: PID known as Pelvic Inflammatory Disease is an infection of the reproductive organs of a woman (uterus, fallopian tubes, ovaries and surrounding tissues) and it’s usually due to infections which may or may not be sexually transmitted (more likely to be the latter, though). The two most common causes of PID are 2 bacteria: Chlamydia and gonorrhea. Other bacteria found in the vagina and cervix (not associated with STIs) can also travel up the vagina and cause a PID.
People more at risk of this condition include people with multiple sex partners, people who use Intra Uterine Device as contraceptive, people who douche ( douching involves injecting fluid up the vagina to cleanse it. This process can carry bacteria up the vagina), people who have had an STI, young women less than 25yeras who are sexually active.
How do you know if you have this infection? Sometimes this is difficult as it may not give any symptoms. However, in other cases, patient could complain of vaginal discharge, painful urination and sex, fever, lower abdominal pain and irregular bleeds.
If this is left untreated, it may lead to ectopic pregnancy (pregnancy that implant outside the womb), fallopian tube damage and blockage with subsequent infertility and long term abdominal pain.
To diagnose the condition, your doctor may take samples from the vagina and cervix (mouth of the womb), carry out blood tests and he may also want to look-see using laparoscopy.
Based on the results, he will prescribe a course of antibiotics which has to be adhered to and the dose completely finished even if one feels better before the complete dose is finished. It is important that there is no sexual intercourse until infection is treated and indeed, sexual partner should also be treated as well. Remember the ABCs of sex.
So, I suggest that you go see a gynaecologist. You can check the Teaching or Specialist Hospital closest to you. As noted here, the treatment is based on the result of your tests. Please schedule this specialist appointment as quickly as possible…the consequences of untreated PID are severe. If any damage to the reproductive organ has already occurred, starting treatment may not reverse them. So the earlier you deal with this, the better.
For related articles:
https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/
https://chatwithdrketch.com/2014/07/02/daily-health-tips-should-i-use-emergency-contraception-as-my-regular-means-of-contraception/
I wish you the best!

Have a good night, y’all 😀

Q: Dr Ketch,good evening. This is the second time my menstrual flows has rushed up to two weeks. I am worried and disturbed. I don’t know what might be the cause. I am 29yrs. Should I see a doctor? I like eating calcium a lot. I don’t know if d calcium and nzu (clay) is it part of my problem.

A: First I would like to say that it is always a great idea to see your doctor for any medical issues you have. This page only provides limited advice. When you see your doctor, he/she can examine you properly and then decide on course of treatment.

Having said that….

Heavy menstrual flow, also known as menorrhagia, can be a source of major concern for the sheer inconvenience and the fact that it can lead to anaemia, as the body is unable to produce enough red blood cells to replace those being lost in the bleeding.

People who have this condition would usually use more than one pad/tampon per hour, would need to change their sanitary towel during the night, layer on about 2 pads at the same time, bleed for more than a week and with significant quantity of clots, be restricted on their daily activities and experience symptoms of anaemia like fatigue.

Probable causes of this include fibroids, cancer, bleeding disorders, use of Intra Uterine Contraceptive Device, hormonal imbalance which may also result from ovaries that don’t function normally leading to progesterone lack, some medications and of course, as a complication of pregnancy in which a woman miscarries or has an ectopic pregnancy (a pregnancy in another part of a woman’s body other than the uterus)

Treatment is really targeted at symptoms and underlying cause. Analgesics in the class of Non-steroidal anti-inflammatory drugs (e.g. ibuprofen) are given for the cramps and iron supplements are usually prescribed for the anaemia. Oral contraceptives could be given to regulate the cycle, oral progesterone to make up for the deficiency and correct hormonal imbalance and a special Intra Uterine Contraceptive Device (IUCD) called Mirena can help thin the uterine lining and reduce bleeding.

Surgical options also exist and can be used if the other treatment options are not successful.

If the underlying cause is a fibroid, clearly this will need to be addressed and same for the other causes.

Constantly eating non-food items like chalk, hair, glue, sand, clay etc, generally called pica, could be associated with some disease conditions like iron deficiency anaemia. This may very well be confirmation that you are losing a lot of blood.

So, see your gynaecologist so the cause of the menorrhagia can be determined and proper treatment started.

Have a great evening, people