chatwithketch

Q: Please I want to ask, if a man sperm touches one inner wear like pant without having any direct sex, is it possible for her to get pregnant?

A: Yes, it is possible to get pregnant even if there was no direct sex and/or penetration. How? The pre-ejaculate (a lubricating fluid produced as soon as the penis is erect, before the man ejaculates) may contain some sperm cells and so even if your partner is able to withdraw before ejaculation when there is actual penetration, ejaculates near your vagina, his erect penis comes into contact with your body near your vagina or his sperm gets into your vagina through any means including touching your vagina when he has semen or pre-ejaculate on his fingers, the harm would have been done. The risk of this is small but there is a risk.

You should also worry about the potential for STIs. I suggest that if this is a real situation, you visit your doctor for confirmation of pregnancy – though most GPs would ask that you wait until you actually miss your period. Then, if you are not pregnant, I suggest that you visit a family planning clinic for help with choosing a means of contraception. And remember your ABCs. A is for abstinence. Honestly, this is your safest bet. If you’re not ready to deal with the responsibilities of having a baby, please leave well alone. You can’t have an STI, HIV/AIDS, or otherwise if you don’t have sex. In addition, you can’t get pregnant. Now, if abstinence is a problem, be faithful to one partner…who, hopefully, is being faithful to you too. If you can’t swear on this, revert to plan A. Finally, if all else fails, ensure that you use a condom to prevent STIs and pregnancy.

All the best!

Q: I brush my teeth every day, morning and evening, still, my teeth get more yellowish, what could be the problem please? Thank you.

A: Smoking, drinking coffee, wine, tea etc can cause your teeth to change colour. Generally brightly coloured foods like some candies, berries and sauces also have the potential to stain teeth if they are left on the surface long enough.

To prevent these stains, try the following tips:

Avoid or significantly reduce the amount of these fluids or foods in your typical diet.

If you can’t avoid them, then reduce the amount of time the foods or fluids have contact with your teeth by chewing and swallowing promptly. Yes, I know I’ve said you should chew intentionally so that your tummy has the chance to receive signals from the brain which tell it that it’s full  But, in this instance, we’re trying to choose the lesser of two evils

Use straws. These will ensure that the fluids get little contact time with your teeth.

Learn to swish your teeth with water after you’ve taken any of these foods to ‘wash’ away the residue of the stain-causing foods.

If you already have stained teeth, here’s what to do:

There are easily obtainable teeth whitening tooth pastes. They help remove surface stains that may be caused by coffee or nicotine.

When whitening paste is used at least twice a day for a period of time between 2 to 6 weeks, significant results are seen. However, care has to be taken to ensure that these pastes are used according to the manufactures’ instructions otherwise, they can cause erosion of the enamel of the teeth.

Please note that the whitening tooth pastes do not alter the natural colour of your teeth and by extension are not useful, if the stain is deeper than the surface of your teeth!

Whitening strips and gels are also available. Apart from all these, there are a couple more sophisticated treatments available from the dentists’. So check with yours.

Beyond all these, please don’t forget the place of regular brushing of teeth in the maintenance of a bright and gorgeous set of teeth.

Fruits like apples and strawberries actually contain substances that help whiten the teeth. So, just like the doctor ordered…an apple a day, keeps the doctor (and the dentist :D) away.

A DIY (Do It Yourself) solution is to mix the juice of one lemon with one or two pinches of baking soda. Then dip a cotton ball into this and leave this on your teeth for 1 minute ONLY! Yes, I had to scream that for emphasis 😀 If you leave it longer than that, the lemon juice can lead to the erosion of the enamel. So, if you can’t manage this, please just see your doctor who will suggest other solutions too or get it done for you professionally.

Have a good night, y’all 

Q: Good Evening Dr, please can a pregnant woman take food or drink that contains vinegar inside it. Thanks Dr

A: Thanks for writing in.

Vinegar is acidic and because of the heart burn associated with pregnancy, vinegar may potentially worsen a bad situation. For more on the heart burn and other symptoms of pregnancy, please click on this link:

Daily Health Tips: What Do I Expect During The Second And Third Trimester Of Pregnancy?

Having said that, a splash of vinegar on thoroughly washed salad greens is okay and shouldn’t cause any problems. This is certainly a better option than soaking up the calories with the very ‘sinful’  salad dressings available everywhere! Remember that moderation in all things is key. If you do experience a worsening of heart burn, please stop.

Have a good night, people 

Q: Hi Doc. I am a breastfeeding mom and l have discovered l have a painful lump in one of my breasts, Could it be cancer? Should l stop breastfeeding?

A: Painful lumps in the breasts of breastfeeding mums may be blocked milk ducts. Usually your milk ducts block if you’re making milk faster than you’re expressing it and indeed you should feel some relief every time you breastfeed from that breast…so stopping breastfeeding may just be making a bad matter already worse 

What causes this milk duct to block? It could be that your baby is not latching on well to the breast and thus not sucking enough from that breast. It could be that you don’t feel well and are not feeding baby often enough, or you decided to wean baby suddenly. Other causes include tight nursing bra, sleeping on your tummy, a nursing pump that’s not powerful enough, a blow to the breast or it could just be that a feed was skipped.
Solutions? Nurse your baby some more, ever so often….especially from that particular breast  Yes I said that. Baby sucks hardest then and hopefully that strong sucking action would dislodge the plug. Otherwise try a nursing pump or just use your hands to express the milk.

Placing warm towels on the affected area may also help the breast milk flow faster and thus dislodge the plug.
Rest as much as possible, eat healthy (loads of fruits and veggies) and use pain relief, like Paracetamol, if needed.

If this condition is not handled immediately, it could lead to an infection of that duct (mastitis) such that the skin over that area feels hot to touch, reddens, mum feels feverish, ill and aches all over. This infection is usually treated with a course of antibiotics, which will be prescribed by your doctor.
So, if you try all the suggestions above and don’t improve, please see your doctor to confirm if this is an infection or indeed something else.

Have a great evening, y’all 

Q: Good morning ma’am, please I have a question. I am a first time mum…just five weeks and my baby has been having this stomach problem. At first I thought it was a gas problem but I don’t think so. I complained to the doctor. After checking on him, he said the baby is fine since he passes out normal stool and eats well; that his muscles are still stretching and adjusting. Please I need to be cleared on this…and how long will it take for him to be fine because he is not comfortable and sometimes cries when the stomach turns? He doesn’t sleep well because of that. I was asked to give him Nospamin drops but there is no change. Please ma’am, help me to be clear and is there any remedy for this?

A: I’m glad you have been to see your baby’s doctor first. That’s always the first and best place to start. Like he said, the good news is that your baby makes stool and also farts (?) normally.

The stomach aches that babies have (colic) can be very distressing for a parent to watch but perhaps understanding what it’s about may be helpful. Colics usually start occurring in some children between 3 to 6 weeks of age and disappear between the 3rd to 4th month of life, without any treatment. So, your baby fits right into this age group.
Some modifications may help reduce their severity:

Be sure to burp baby after each feed• Hold baby and gently rock her after a feed

• Hold your baby upright during her feed

• Check your diet: reduce caffeine-containing foods and sometimes, it may be the dairy in your diet that you baby is reacting to. Taking dairy off your diet for a week or two may lead to improvement in symptoms.

Remember to see your doctor where in doubt, especially if this continues past the time noted above.

Just a note about gripe water which a lot of people want to give their babies when they have this condition….honestly, the benefits are more in our imagination than in actual fact 😀

So, with or without gripe water, this colic shall pass

Have a great night, y’all 😀

In honour of Alopecia Awareness Day, we continue yesterday’s discourse this time talking about baldness

Q: Hello Dr Ketch, I am a 33 year old guy from Lagos. I am experiencing rapid hair loss which is resulting in baldness. Please I’d like to know if there are natural remedies or vitamin supplements for men with no side effect on fertility. Cheers.

A: Baldness is excessive hair loss from the scalp. It usually starts from thinning hair before it involves wider areas of hair loss.

How does this happen? Usually, a hair follicle produces hair and each hair grows from a follicle for as long as three years before it is shed and a new one produced. Testosterone is produced normally by the hair follicle and these follicles now convert testosterone to Dihydrotestosterone (DHT). In baldness, the hair follicles are overly sensitive to the effects of DHT causing the hair to thin out and also last less than the usual 3 years.

Now it is usually assumed that being bald is a sign of great virility but studies have shown that this is not true. Bald people do not have more than normal amounts of male sex hormones, their hair follicles are just more sensitive to the effects of the hormones.
Baldness runs in families and may start as early as late teens in some people with most men at 6o years of age having experienced some level of hair loss. It is, of course, more traumatic when it happens at an early age like 33 years as in this case.

Treatment runs from doing nothing (always an option :D), wearing wigs or styling hair in such a way as to cover the bald patch if possible to surgery where individual hair strands are transplanted. Other treatment options include the use of medications like Finasteride (which prevents conversion of testosterone to DHT thus allow the hair follicles to enlarge back to normal) and Minoxidil. It usually take about 4 months for any effect to be noticed, though. There are still issues surrounding the effects of these drugs on fertility.

Diet may not really help with baldness. However, ensure that your diet has sufficient amounts of protein and iron rich food to prevent thinning out of hair.

So, have a chat with your doctor and hear what he suggests. Ultimately, you may very well decide to just love the skin that you’re in and leave well alone or perhaps, settle for a wig.

Have a good night everyone 😀

Tomorrow is Alopecia Awareness Day. In honour of this, I repeat the post below

Q: Dr Ketch well done and good job you’re doing. Please, my hair is pulling off on its own at both sides and in front. I am not on any drugs but a hair specialist told me it could be alopecia which is immune system working against the hair follicles. So please, what do I do to gain my hair back or boost my immune system?

A: Thanks for your kind words.
There are different types of hair loss (alopecia)
• The hair loss due to cancer treatment is well known and well documented. This is called anagen effluvium and hair would start to grow back a few months after chemotherapy stops.
• There is the male and female pattern baldness: This is more common in men starting as they age (around 50 years of age) and is thought to run in families. Male pattern baldness usually starts with thinning of the hair in front followed by thinning of the hair at the sides and the crown of the head.
This situation is less common in women but it could happen in women who have been through menopause.
• The hair follicles (the holes from which hair grows) could be destroyed due to disease conditions and the hair never grows back. This condition can occur in both men and women.
• Hair loss could also be due to a problem with the immune system which could very well be what your doctor has diagnosed. This would usually occur on the scalp but can occur anywhere in the body. They also occur at any age though they are more common in teenagers and young adults. Usually, after a few months, the hair grows back, oftentimes white and finer than it was before. It would then become thicker and go back to its natural colour after some time. Some people with this condition, however, go on to develop a condition in which they never recover their scalp hair or a condition in which they never recover the hair on both scalp and body. This condition can be treated with steroids or with a procedure called immunotherapy.
• Widespread thinning of the hair occurs in a condition known as Telogen effluvium. Triggers for this condition include pregnancy due to hormonal changes, periods of intense emotional stress and physical stress like child birth, crash dieting, long term illness like cancer and severe short term illness like severe infection, some medications etc The good news here is that most cases would stop and hair would start to grow back within 6 months.
As noted above, most causes of hair loss would reverse on their own. If your hair loss continues, does not reverse to itself and does not respond to therapy suggested, please see a dermatologist. Some treatment options available include medications, hair transplants and/or artificial hair implants. Wigs are also a stylish way to deal with this.
Hair loss may have emotional impact on people as it is part of our identity. Find people you can confide in and talk through your feelings.
To prevent this, especially for the ladies, avoid tight hair styles and pulling at your hair. Treat your hair gently eg combing with a wide toothed comb after washing your hair and try air drying instead of blow drying all the time. With the recent craze for going natural, this advice should not be too difficult to adhere to 😀
Have a good night, y’all 😀

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.

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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 

Q: Good morning doc. Please doc, I am 23 weeks pregnant and according to the test I ran, my blood level is just 32 which they said that it is low. What can I eat to boost it? I mean as a pregnant woman, my blood is low, 32. How can I increase it?

A: Congratulations on your pregnancy!

Have you always had anaemia/low blood level? Or have you just had malaria? If you have had malaria, a frequent cause of anaemia in our environment, to build up your blood,  your doctor will ensure that the Folic Acid dose you’re getting in your prenatal drugs is not more than 0.4mg. Doses of Folic Acid higher than or equal to 5mg affects the efficacy of the anti-malarial, SP. So, be sure to check with your doctor before you start buying other non-prescribed prenatal vitamins.

Other nutrition tips that will be useful for you include:

I’m sure you know about insecticide –treated nets…and probably still don’t use them because of the heat 

 Well, if you have nets on your windows too and have a good fan (praying that you’ve got electricity to power it), it is not really so bad. Some people react to the chemicals in the insecticide and so for these ones you may want to air the net outside for a couple of days before you start use. To encourage your children to use them, you could work it into the décor of the room and make them look like nice, funky four poster beds!

Be sure to fumigate your house to rid them of mosquitoes and other creepy crawlies. Ensure the vendor tells you what chemicals will be used, how long you need to be away and whether it’s compatible with artwork etc. Cover up foodstuff and take off beddings etc. and then do a major clean up afterwards.

Did you know that the buckets of water used to store water in areas where pipe-borne water is not constant, can be a huge source of mosquitoes? Have you observed them rising from these buckets of water when you approach in the evening? If you have to store water, get covers for them and ensure they are closed all the time.

Did you know that if your bathroom drain is blocked, apart from the fact that it’s unhygienic, the water there also acts as a comfortable home for mosquitoes? So, ensure that your drains are free-flowing with no stagnant water. Keeping it smelling nice and fresh is also a good touch ;D

Did you know that your flower pots with lots of water also serve as a breeding place for mosquitoes? The water used on the flowers should be completely absorbed by the soil with none left on top. Watch out for lazy helps who want to do a month’s watering in a day 

Did you know that the unwashed drains and gutters outside, bushy lawns, potholes and broken concrete slabs serve as lovely homes for mosquitoes? Be sure to clean up your environment often.

Have a good night, y’all 

QL Please doctor my husband is suffering from arthritis, swollen and painful leg, Please any remedy??

A: I believe that a doctor made the diagnosis of Rheumatoid Arthritis and that’s why you are sure that’s what your husband has. Over time, I have heard people use the term rheumatism (which is a lay term that is not really used in the medical world anymore) for osteoarthritis or rheumatoid arthritis. I will briefly describe both conditions.

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

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

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

For anyone who has this condition, be sure to take your medications, eat healthy, exercise and learn to relax 😀

Now to osteoarthritis (OA), this is a more common type of arthritis. It would usually occur due to wear and tear (ageing) of the cartilage at the end of bones which allows free movement at the joints. The knees, hips, neck, lower back are usually affected and symptoms would include stiffness, pain and swelling. This disease is common in older people, women and the obese (clearly, being obese puts more stress on the weight bearing areas of the body like the knees etc), some types of occupation eg people who carry a lot of heavy loads are more likely to have osteoarthritis of the lower back. A family history of OA puts one at risk and having some diseases like Diabetes Mellitus makes one more at risk.

Where this disease affects the knee, it can lead to bow-leg and limping as the cartilage continues to wear away with even more wear and tear. Just like for RA, there’s no cure. Focus is on limiting pain and maintaining joint movement.

Treatment includes pain relief (using drugs in the class of ibuprofen or Paracetmaol), physiotherapy and sometimes, surgery. Injection of steroids into the joint space of affected joint has also been found useful but cannot be given too often.

Just like for RA, exercise, eat healthy, keep a healthy weight, use support (like walking stick) if need be etc

I hope this was helpful.

Have a good night, everyone 😀