chatwithketch

Have you ever recovered from a bout of illness and found it difficult to get your appetite back? You know that situation where everything you eat tastes like sawdust? Most of us have probably gone through this. The question below typifies someone going through the same experience and then you get some great tips for dealing with this, the next time it dares come your way! 😀

Q: Hello Dr Ketch, I have just recovered from a bout of malaria. I have not had malaria for over two years and so this really destabilized me. I was really ill for about two weeks. Even when the fever resolved, I struggled to get my strength back. It’s been about a week after my illness, but my appetite is still not what it used to be. I basically force myself to eat every day. Is this appetite loss normal and what can I do to get my appetite back?

A: Thanks a lot for writing in and I’m glad to hear that you no longer have a fever…even if you’re not entirely back to your normal self. It is not unusual to experience some loss of appetite during and soon after a bout of illness. Unfortunately, your body needs nutrients more than ever at this time…to build up damaged body tissues and heal.

Here are some tips to help you get back into the groove of eating normally 😀

• Focus on portion sizes and try to eat small portions during each meal. You can use smaller plates (to stop you from feeling overwhelmed by lots of food on one plate).

• Remember that you can have 5 small meals: breakfast, a mid-morning snack, lunch, an afternoon snack and then, dinner. Good snack options are fruits, nuts, yoghurt etc

• If you cannot stand any snack at this time, go for a nourishing drink. This provides the nutrients you need in a drink form. Complan is one such nourishing drink, which contains proteins, carbs, fats, minerals and vitamins. It has all the nutrition of a complete meal in a drink form. These nutrients replenish the body stock and help healing and convalescence.
• There is a lot of focus on repairing damaged tissues at this time, so be sure to include proteins in your choice of meals. Good examples include fish, chicken, beef, milk, cheese, eggs, Complan etc. For more on protein sources, please click on https://chatwithdrketch.com/2015/06/26/daily-health-tips-how-can-i-get-more-proteins/
• In the same vein, starchy foods are also needed to help you build up your energy. So get at least one serving per meal. Good examples are rice, potatoes, bread.

• Attractive looking foods also look appetizing and are more likely to tempt a sluggish palate/appetite 😀
• Exercise also helps to work up an appetite. You may not have the energy to get back into your regular exercise routine…assuming you had one before 😀 But taking a walk before meal times can help improve your appetite.
• As a result of the energy needs at this time, it may be necessary to have some foods that we ordinarily would not suggest 😀 😉 And so, at this time, ice cream, butter, full cream milk etc may be used to supplement energy needs. Please note that this is just for this period of appetite loss. Once you got it back, kindly ease off 😀 Remember a second on the lips, a lifetime on the hips 😉
• Cold drinks and even cold foods may be easier to also tolerate at this time. Be sure to stay hydrated by taking in sufficient fluids. Eat and drink slowly, generally during this period to enable you keep more down.

These tips should get you firmly back on your way to health and great appetite. In the meantime, keep your head high and your spirits up. Trust me…this too shall pass 😀

Q: Hello doc, pls how can one avoid protein in urine during pregnancy?

A: A high blood pressure reading in pregnancy with protein in urine is a worrying situation. Blood pressure readings are interpreted as same, pregnancy or no pregnancy. Any level more than 140/90mmHg is seen as hypertensive. A woman may already be hypertensive before pregnancy and on medication. She may be found to be hypertensive before 20th week of pregnancy in which case it is believed she had previously undetected high blood pressure or she may be discovered to have high blood pressure after the 20th week, in which case it is believed that this high blood pressure is pregnancy-induced (Pregnancy Induced Hypertension: PIH). This would usually resolve within 6 weeks of having a baby. If a woman with PIH goes on to develop protein in urine, she is at risk of preeclampsia (in which protein leaks from kidneys into urine) or eclampsia (in which the woman experiences fits and seizures)

The risk of preeclampsia is higher in women who have had this condition in a previous pregnancy, first pregnancies, women who get pregnant after the age of 40 years, women who are obese and women with multiple pregnancies or those who have a long interval between babies (greater than 10 years) or short interval between babies (less than 2 years) etc

High blood pressure in pregnancy needs to be addressed as this poses a danger to both mother and baby. It may affect the flow of blood and nutrients to baby leading to slow growth or pre-term delivery. It may also lead to eclampsia or separation of placenta from the uterine wall before the baby is born.

Your doctor will determine the best course of action and may prescribe medications (to reduce blood pressure, or to even prepare your baby’s lungs for life outside the womb given the anticipation of preterm delivery), hospitalization to monitor you or delivery of the baby if the doctor believes the womb is now a hostile environment for the baby due to any of the dangers mentioned above.

There are varying thoughts about strategies thought to help prevent this condition. However, ensuring that risk factors are reduced by reducing weight, eating and living healthy may be helpful strategies.

For more on blood pressure, please click on the links below:

Daily Health Tips: Blood Pressure – The Fact Behind The Figures

Daily Health Tips: Pre-hypertension

Daily Health Tips: My High Blood Pressure Risks

Be sure to make your antenatal classes interactive. Ask your doctor questions about your health and indeed your blood pressure readings if they are cause for concern.

Have a great evening, y’all 😀

Here’s to a healthier you!

Q: Hello Doctor. I just put to birth, one month plus now and I am having heavy menstrual flow with clots. A scan had been done but no retained products of conception were found; the uterus is clear. Please what should be done?

A: Bleeding after having a baby is normal. When the placenta separates from the wall of the womb, the open blood vessels start to bleed. And so for the first couple of days there is bleeding composed of blood, bacteria and tissue from the area of separation. In the first few days, the discharge is made up of more blood making it bright red in colour which changes to pinkish and eventually yellowish/whitish as the uterus contracts and seals up open blood vessels. This process is supposed to be over within 2 to 4 weeks. Some may extend to about 6 weeks!

Heavy bleeding that occurs within 24 hours of putting to bed is called primary post-partum (after delivery) haemorrhage (bleeding) and any bleeding that occurs between 24 hours and 12 weeks is known as secondary post-partum haemorrhage (PPH).

Bleeding can be caused by any remnant of the product of conception which may be a piece of membrane or part of the placenta or it could be caused by a uterus that has not contracted properly to stop the bleeding. Infections are also a common cause of secondary PPH.

People who are more prone to having PPH include those who are anaemic, obese people (BMI above 35), those who had a history of bleeding in pregnancy due to placenta previa or placenta abruptio, having ha a PPH in a previous pregnancy or having had more than 4 children etc. During labour, women who are older than 40 years or deliver through Cesarian Section, have an episiotomy, have an induction or forceps delivery etc are also likely to experience PPH.

For primary PPH, focus is on ensuring that placenta has been delivered, that there are no remaining membranes left in the uterus and that the uterus has contracted. Different procedures to effect this will be instituted as the doctor deems it.

If the bleeding is due to infection as can happen with secondary PPH, antibiotics will be instituted.

Depending on how heavy the bleeding is, blood transfusion may also be given. In all of this be guided by your doctor and ensure that if this bleeding continues with clots, is still bright red, you start to feel dizzy or get irregular heartbeats, please get to the hospital immediately.

Finally, ensure that you are under the care of an obstetrician.

For related posts, please click on

Daily Health Tips: Placental Abruption!

Daily Health Tips: Placenta Previa

All the best.

Have a great evening everyone 😀

I was in church on Sunday….unfortunately, not early enough to snag my favourite seat in the house. There’s really nothing special about the area I like to sit in…just that I like the aisle seat. As I got to church this Sunday, this seat had been occupied by a young lady.

As I sat down, I started to fan myself…all of that racing from the car park to the church was taking its toll! The young lady in question turns to me and informs me that she’s cold and so I was to stop fanning myself! And I looked at her like, ‘can’t you see what I am dealing with here?’ I answered with, ‘But I’m hot’. I however, proceeded to change the general direction of my blowing such that it wasn’t getting to the left (hopefully) where she was seated. So, all in all, it wasn’t a great start to a moment of renewing of minds and souls 😀

My pastor did a great job as usual, but during the service, I couldn’t help but notice same young lady repeatedly blow her nose into a ‘face towel’ which she was using as a handkerchief. She would transfer this towel from hand to hand. I did worry about that because at the end of service, we always shared this song as a church and we were all supposed to hold hands while singing it. I wasn’t quite sure how I was going to get out of shaking ‘my friend’s’ hand without causing offence. I hoped that perhaps, she would decide to leave before the signature church song. Well, she didn’t 😀

I considered the options open to me 😉 Interestingly enough, preaching had been on divine healing. I wasn’t quite sure whether to tempt/test my faith by holding her hands or exercising wisdom by not doing so…after all, ‘…shall we continue in sin for grace to abound?’ Sin in this case being shaking a hand that I knew had a significant number of germs in them 😀

I decided to go the way of the ‘path of least resistance’. I moved away to another seat at the back of the church. I watched though to see whether ‘my friend’ would shake the hands of the people close to her. And guess what? She did! She shook hands with the guy next to her after nicely transferring her ‘handkerchief’ to another hand! I was in shock!

Now, I may have made this sound funny, but it really isn’t. Germs…all sorts are transmitted in this same way. In the light of the fact that Global hand washing Day was just celebrated, it is important that we remind ourselves of the hygiene rules of engagement for times that we need to be in public.

• If you have a cold, try and find somewhere close to the back of the church to stay. It’s important not to share your germs.

• After you have blown into your tissue (tissue is better as it can be disposed of after use, as opposed to handkerchiefs which are used repeatedly in a day becoming a rich culture medium of germs which can be easily passed on), keep your hands to yourself. If people want to shake your hands, you should politely explain that you have a cold. You will earn the respect of the people who asked for a handshake.

• Wash your hands as soon as you can…often too.

• Cough into the crook of your arms.

• At home, keep drinking cups and glasses separate.

For more on this, please click on this link:

Having A Cold? Here’s Your Survival Tool Kit!

Have a great week ahead, y’all 😀

Q: Dr, how do you manage vulva itching that is not responding to drugs?

A: The vagina is filled with important bacteria which are actually useful and cause no problems. If left well alone. However, some of our activities sometimes alter the delicate balance of bacteria in the vagina causing overgrowth of bacteria. This condition is known as bacteria vaginosis and people with this problem would usually present with a burning sensation in the vagina and a fishy smell apart from itching too. In other instances, there is fungal overgrowth leading to vaginal discharge (cheese-like or egusi-like) and itching.

What can help prevent these?

• Use antibiotics only when prescribed and be sure to finish the entire course.

• Do not use vaginal douches

• Change out of wet clothes eg swim suits as soon as possible

• Avoid the use of perfumed products on your vagina like soaps, sanitary products etc. Use the un-perfumed varieties.

• Wear loose fitting cotton undies 😀

• Stay away from or limit time spent in hot tubs or saunas

• Wipe from the front to the back after using the toilet to prevent depositing bacteria from poop onto the vaginal area leading to urinary tract infection

I suggest you see your gynaecologist as soon as possible so he can take samples of your vaginal discharge and send for laboratory work. This will help determine what organism is causing the infection and then appropriate treatment can be instituted. The preventive measures stated above will help prevent a re-infection.

For related posts on this subject, please click on these:

Daily Health Tips: What Is Douching?

Daily Health Tips: Is It Okay To Wear Panty Liners Daily?

Daily Health Tips: Why Do I Have Recurrent Candidiasis?

Have a good night people 😀

Q: Doc thanks for all those helpful health tips. My wife has given birth. Ever since, going to 4weeks now, the baby has been drinking food. Within 3weeks she had finished 4 tins of Nan 1. Her mother’s breast milk is not dropping…at times little like a spit. Hundreds of advice has been given and used; yet, no significant change. Please please Doc, what can we do??? Thanks.

A: Congratulations on your new baby! May she grow to do great things in her generation.

She does sound like one hungry child 😀 which is good. The truth is breastfeeding is touted as being best for baby because of the nutrients it contains, the bonding time it affords mum and baby and also because it is cheap! You need no money to feed your baby as often as needed…beyond the monies required to ensure mum feeds well. There’s also the challenge of keeping baby’s bottles and other feeding equipment completely clean and free from germs.

How can we help mum to establish or re-establish breastfeeding? To answer that I’ll reproduce part of a post I had made on this subject.

Mum needs loads of support from her medical team (be that the nurses that provide support for lactation or the doctor who does same). This support can range from teaching her how to latch baby on properly to the doctor prescribing medications that encourage milk production. Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

This process, though, requires loads of patience. You have to put baby to the breast as often as possible (at least every 3 hours) or failing that, use a breast pump to extract as much milk as possible. It is thought that some of the galactogogues ‘improve’ the taste of breast milk making the baby spend more time on the breast.

Remember that the sucking process/nipple stimulation encourages milk let-down. Being relaxed and thinking about you and your baby in a nice cozy environment, breastfeeding and bonding may also help this process along.

You may want to assume the regular position you used to adopt when baby was breastfeeding and ensure that baby gets skin to skin time with you. It may be easy for baby to immediately go back to breastfeeding, other times, it may take a while. You need to know when the baby is sucking and indeed whether he’s getting enough. Your baby should make at least 6 wet nappies per day. If baby is not getting enough breast milk at the beginning of this process, you may have to supplement with formula. Use a cup and spoon to avoid nipple confusion.

Be sure that you are getting enough fluids yourself and eating nourishing foods.

For more on breastfeeding, please click on the links:

Daily Health Tips: Can My Breast Milk Get Sour If I Don’t Express It And My Baby Refuses To Feed?

Daily Health Tips: I’m A Breastfeeding Mother Who Just Developed A Painful Lump in My Breast. Could It Be Cancer?

Daily Health Tips: Breastfeeding Challenges

Daily Health Tips: Please Help! My Breasts Still Feel Engorged Though I stopped Breastfeeding Some Days Ago.

Daily Health Tips: What Should I Do After Having My Baby If My Breast Milk Doesn’t Come In Immediately?

All the best to you, baby and wifey!

Have a good night y’all 😀

Q: Please, can I drink aloe vera and lime to lose weight?

A: Aloe vera is great with many health benefits. But useful for weight loss in combination with lime? It sounds like one of those fad diets I have heard about. This is a variation of another question I have been asked before…

Q: Good morning Doc, please what is the best solution for weight loss? Is hot drink and lime a good idea to achieve a weight loss?

A: Hmmm! What did you have in mind? Taking the hot drink (alcoholic spirit) alone or in combination with the lime? 😀 Now, you have to forgive me, but I’m always amused at the fact that we think that there are short cuts to these stuff. Unfortunately, losing weight is pure hard work: sweating and grunting.

Alcohol’s health benefit is usually touted in the area of heart health where moderate alcohol consumption is thought to provide some benefits to the heart. Moderation is described as one drink of alcoholic beverage per day for women and also for men 65 years and older and two drinks for men younger than 65 years. However, even these moderate servings of alcohol are also associated with cancers and other disease conditions. Indeed, the beneficial effects of this moderate alcohol on the heart can be reproduced by paying attention to diet and exercising at least 150 minutes per week.
In addition, alcohol contains empty calories which will definitely mess up anyone’s weight loss plan and when people drink alcohol, they lose their inhibitions and may completely forgo their diet plan and eat all sorts 😀

Lemon on the other hand is thought to have some cleansing properties and also helps whiten the teeth. It is full of vitamins and anti-oxidants that help fight disease. Too much of this can lead to erosion of the enamel of the teeth (leaching away of the top coating of the teeth).

Remember that any diet that leads to undue restrictions by completely eliminating certain food groups or restricting diets to liquids only may not only be a health hazard but is also not sustainable. Sustainable diet plans focus on making sure you get the right quantity of foods from each food group to nourish your body.

For more of what to do to lose weight and lose your big tummy, get details from the book, Just For The Health Of It. You can get a copy via the shop now link on our facebook page. Or you can get it through:

1) Jumia.com. Just click on this link http://www.jumia.com.ng/jumia-books-just-for-the-health-of-it-with-dr-ketch-179486.html and get a copy. You have the option of paying when the book is delivered to you or paying online. This service is available all over Nigeria.

2) Another option for those in Lagos is Laterna Bookshop on 13, Oko-Awo Close, Off Adetokunbo Ademola Street,. Victoria Island.

3) If you’re outside the country, please visit Amazon through this link http://www.amazon.com/Just-Health-Ketch-Pregnancy-Parenting/dp/9789398026/ref=sr_1_1?s=books&ie=UTF8&qid=1426246647&sr=1-1&keywords=just+for+the+health+of+it+with+dr+ketch+olalere+nkechi

Remember that this book is a great Christmas, Baby Shower and Bridal Shower gift for anybody 😀

Have a great day, y’all 😀

Global Hand Washing Day was celebrated earlier this week, on the 15th of October with the theme ‘Raise A Hand For Hygiene’

How many of us can confidently raise our hands for hygiene these days? Last year and some parts of this year when the Ebola scourge was at its highest, people became very hygiene-conscious. People washed their hands often and on, used hand sanitizers when they could not wash their hands and were generally careful about what and who they touched. Alas! A couple of months after we were declared malaria-free, it’s back to business as usual now for most people.

How many people still wash their hands after using the toilets now? Some people believe it’s only important to wash hands after passing out faeces but not necessarily when they urinate. How many times do you wash your hands before eating or before cooking or before picking up a new baby? How many times do you cough or sneeze into your hands and then proceed to shake people with the same hands…thereby passing on your germs to them? The ways and means by which we pass on germs by not washing our hands are too numerous to count and so I wonder about how many of us can really raise our hands for hygiene at this time.

Just before the end of the work-week, 2 new cases of Ebola were announced in Guniea. If the same were said for Nigeria, would you say that your hygiene measures at this time are sufficient to withstand your getting infected? Well let’s give you a reminder class on when to wahs your hands and how to wash your hands:
Mums wash your hands before you make your baby’s/family’s food, after you change baby’s diaper, after you blow your nose, after cleaning etc. You can also use a sanitizer if it is not possible to was your hands at that time.

Sanitizer tips:
Remember that sanitizers are only useful for hands that are not visibly dirty. For visibly dirty hands, you’ve got to wash!

Also remember that when choosing the sanitizer, look for products that have up to 60 percent alcohol and ensure that when you use it, you rub until your hands are dry.

We should ensure that we teach children and indeed remind ourselves to wash hands after playing or doing stuff outside the house, before eating, after using the toilet, after playing with pets or disposing of their wastes (in fact children should not be encouraged to play too close to their kennels or sheds), before cooking and even after handling dirty laundry!

Tips for effective hand washing: wet your hands with water, apply soap, then scrub thoroughly paying attention to your nail beds, in between fingers, palms and back of hands. Then rinse thoroughly before drying your hands.

Remember that clean hands, save lives!

Q: Hello Doc, l am 1 month pregnant now but I have been experiencing loss of appetite. So please may I know what food do pregnant women eat? Thank you.

A: Early pregnancy can be a trying time for a number of women as they go through tiredness, breast tenderness, loss of appetite, nausea etc

Loss of appetite may be due to the nausea of early of early pregnancy where it appears the tummy cannot seem to keep anything down. If you feel nauseous, the following tips may help:

The standard teaching is to try eating some bland foods like Crackers biscuits or dry toast. That personally didn’t work for me. I preferred tart things…which some may want to avoid. I loved lemons during my pregnancies. They were the one thing guaranteed to ‘wake up’ my mouth and chase nausea far away. I also had a particular brand of very tart bubble gum, I indulged in grin emoticon These were key for me because, though I didn’t have the real bad case of morning sickness that sent you to the hospital, brushing my teeth in the morning always sent me into a bout of retching/vomiting. So, I always had a ready supply of the gum or lemon/lime to pop into my mouth once I was done brushing/retching! Not a very pleasant memory ;D

So, if lemons work for you to prevent nausea, go for it. Remember that moderation is key. A few drops (one or two) in a glass of water are enough to provide that tart kick that sends nausea far away. There is a catch here though…remember the heart burn associated with pregnancy. The acid content of lemon might make the heart burn and any pre-existing gastro-esophageal (stomach and esophagus/gullet) problems worse. So, this is all the more reason to be very moderate or stop if it exacerbates an already bad case of heart burn. Wherever and whenever in doubt, please be sure to see your doctor.
Other tips:
• Eat little amounts of food frequently as an empty tummy increases the likelihood of throwing up. Remember this is not an excuse to binge and over eat 😀
• Avoid fatty and greasy foods.
• Avoid smells that trigger nausea
• Cold foods may be preferable to hot as the former does not give off smells that may cause you to feel queasy.
• Get loads of fresh air and rest
• And drink sufficient fluids daily
Talking more generally, here are 5 general nutrition tips for a pregnant woman:
• 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. If you don’t eat enough, your baby will start drawing on your own stock from your bones. So, drink up your milk!
Have a good night y’all 😀

Q: Dr is it good to have only 1 or 2 days menstrual period?

A: There are various shades of ‘normal’ in menstrual cycles with the menstrual flow lasting between 2 to 8 days and the cycle lasting anything from 21 to 35 days. A reduction in flow (scanty period) is called hypomenrrhea (pronounced hai-po-men-oria) and a reduction in the number of days of flow to less than 3 days is called oligomenorrhea (oli-go-men-oria).

Now at the onset of puberty, the flow and cycle can vary from one cycle to the other; the same goes for the other extreme of life (old age).

Other issues that can cause a decrease in flow include pregnancy (the supposed period may be an implantation bleed), crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C), where the procedure was too ‘vigorously’ done can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.

You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.

Have a good night y’all 🙂

Here’s to a healthier you!