chatwithketch

October is almost over!!! Who would have thunk it! 😀 And just before y’all start judging me, that wasn’t an error. That’s my special brand of ‘thought’ 😀 😉

We can’t let the month of October pass by without celebrating the fact that the month is Breast Cancer Awareness Month.

Breast cancer is abnormal growth of the cells of the breast. Though it is more common in women, it can also occur in men. It is important to examine your breast regularly and note if there are changes. Some changes that may signify cancer, to look out for include:

• A lump or thickening of breast tissue that feels different from surrounding breast tissue

• A lump in one or both armpits• Change in the skin of the breast eg giving the appearance of orange peel/skin of an orange

• Change in the shape, size or general appearance of the breast

• Nipple discharge (especially if it’s bloody) or recent inversion of the nipple

• Scaly skin around the nipple

Breast cancer may be inherited and so having a family history of breast cancer puts one at greater risk of having this. Other risk factors for breast cancer include

:• Being female• Starting period at an early age….earlier than 12 years• Starting menopause at a later age

• Hormone therapy during menopause

• Obesity• Having first baby at age older than 35 years

• Increasing age: The older one is, the more at risk of breast cancer one gets• Exposure to radiation like X-rays. That’s why people who work in environments where these tests are done have to wear protective clothing when running the tests.

• Drinking alcohol

If breast cancer is caught early, one has a greater chance of survival. Treatment of breast cancer depends on the stage of the disease, type of breast cancer, grade, size and how sensitive the cancers cells are to hormones. Treatment options include surgery (removal of lump or removal of whole breast or removal of lymph nodes), chemotherapy (medications that destroy cancer cells) and radiotherapy (using irradiation like X-rays to destroy cancer cells).

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Prevention of breast cancer in people with average risks includes:

• Eating healthy• Keeping a healthy weight within the BMI• Exercising

• Stopping or limiting alcohol use• Speaking to your doctor about screening options open to you.

Mammograms used to advocated for women 40 years and over. The new recommendation from American Cancer Society earlier this month recommends annual mammogram for women at moderate risk of cancer from 45 to 54 years of age and then every two years from 55 years onwards. U.S. Preventive Services Task Force mammogram guidelines recommend screening from 50 to 74 years.

So, be sure to discuss with your doctor so he can advice on your best options based on your personal history.

For related topics, please click on the links below:
https://chatwithdrketch.com/2015/04/05/daily-health-tips-breast-lump-in-a-man/
https://chatwithdrketch.com/2013/06/15/the-halfway-mark/
https://chatwithdrketch.com/2013/05/24/pinkie-swear/
Have a great evening.

Q: Good evening Dr, please why does my breast remain the same even while pregnant and any solution to flattened breast? Thanks

A: Thanks for writing in. Pregnancy affects different people differently, you know. Some people will feel that their bust doubled in size immediately and for others, it’s the opposite J

Please see below, normal symptoms of pregnancy and I’ve also thrown in a bonus…the red flags (symptoms that should make you show up in the hospital immediately).

Breast tenderness: this is inevitable as your breast ducts prepare for the job of lactation. Bra sizes could go up from 1 to several sizes up. Perhaps yours went up just one or perhaps even just remained the same. It is not abnormal. If it does start to increase, be sure to get a good support bra and keep going up sizes as your breast size increases. This will help reduce sagging.

Discharge: A thin milky discharge is normal during pregnancy. But if this becomes yellow, greenish or foul smelling, please see your doctor.

Heartburn and Constipation: These happen due to one of the hormones produced during pregnancy. The antenatal vitamins also play a part in worsening constipation J

Frequency of urination: As the baby grows in the uterus, it presses on the bladder making you feel like urinating more often.

Tiredness: As your body works overtime to support a growing life inside you, you would feel exhausted.

Food cravings and aversions: Well, I certainly had loads of aversions with my first pregnancy. I can’t remember any cravings as I couldn’t get any food to stay down. However, some people develop a craving for the oddest, craziest foods when pregnant. Go easy on eating for two though…the healthy living dictum of eating loads of fruits/vegetables and low calories does not change during pregnancy. The more you gorge or give in to the food cravings, the more work you have to do to get it off after the baby. However, if you find yourself craving things like clay, sand etc, please see your doctor as it could be a sign of iron deficiency anaemia.

Morning sickness/nausea: This is due to the hormones of pregnancy (again!). This may be mild or so severe that the person actually gets hospitalised. If your nausea is severe, please see your doctor. But generally, you can help push this back by eating some bland food especially in the mornings when it is worse like crackers or cheese. 

So, as you can see, most of the symptoms you have complained about can be explained away by pregnancy! 

Now for the red flags…these have to be checked out by your obstetrician immediately:

Significant bleeding. If you’re not sure what is significant and what’s not, please see your doctor all the same. Better safe than sorry.

Severe abdominal pain: This could be a sign of a threatened miscarriage

Severe nausea/vomiting: This could lead to dehydration which could affect the baby adversely

Severe dizziness

Too little weight gain or too much weight gain: Try to keep weight gain between 11 to 15kg during the pregnancy. Your doctor could have recommended more or less depending on your pre-pregnancy state.

Pain or burning sensation when urinating: This could be a urinary tract infection. It needs to be dealt with.

Vaginal discharge: Foul smelling, yellow or greenish colour could indicate an infection and could affect your baby.

High fever: This could signify an infection.

As for what you can do about the morning sickness, here’s a post I had done on this recently.

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  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. Therefore, 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 heartburn. 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

Have a great day, everyone 

Q: My son is a month and two weeks old. Ever since he was born, he grunts, fusses, kicks, punches, makes cry face and other funny faces when trying to pass gas and poop. He does it every day throughout the day. For example, he was just lying with me, he started stretching his legs out, making cry/fussy noises and pushing hard, all of a sudden, i hear the loudest fart and then he stops. I feel bad for him and I feel like since newborn poop is watery, it should not be a challenge to him. He also rubs his face, pulls his legs, stretches them out too as well as his hands, and makes groaning noises in his sleep. Please are these normal???

A: Thanks for writing in dear. The first thing to do when you are not sure what is wrong with your baby is to go see the paediatrician (the baby’s doctor). It is better to be safe than sorry.

The good news is that your baby makes stool and farts (?) normally.

The stomachaches that babies have (colic) can be very distressing for a parent to watch but perhaps understanding what it is 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. Unfortunately, we still do not really know what causes these colics and why some babies suffer from it while others do not. However, it has been found to occur more in first born babies (whether boy or girl), formula-fed babies and can also be associated with the diet of a breastfeeding mum.

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 

Q: Morning Doc. Kudos to you and well done. My question is that I have been facing some difficulties with my wife. She just came back from travelling 2 days ago & each time I tried to have sex with her, na wahala….because when I penetrate inside her, the next thing I see is blood coming out as if she’s a virgin. And that will just be the end of the fun because I get scared whenever it happens. Please what can be the cause and what’s the possible solution to it? Thanks and please replyy

A: Thanks for writing in.

There appears to be two problems: pain during intercourse and bleeding during sexual intercourse.

Pain during sexual intercourse is more common with women but can also happen in men. This condition is called dyspareunia in medicine.

Dyspareunia is a condition in which one experiences pain during or after sexual intercourse. In women, the cause may be due to:
• Vaginismus: a condition in which the vaginal muscles go into spasms when an attempt is made at penetration.
• Lack of adequate lubrication eg due to hasty foreplay etc
• Infections of the vagina (like candidiasis as mentioned in the question) or urinary tract can also cause pain during sexual intercourse.
• Injuries/wounds to the vagina
• Emotional issues like stress or emotional disconnect from partner.
• Fibroids around the vagina or cervix

Treatment depends on cause. If due to infections, they have to be treated. If it’s due to lack of lubrication, that has to be handled. Some lubricating gels may be suggested. If no physical cause can be seen and the problem appears to be emotional, some counseling may be required. Understanding that when people get married, they are actually two ‘strangers’ trying to get to know each other, should form part of the incentive for slowing down and trying to find out what pleases each member of the union.

The cause of vaginal bleeding after sexual intercourse depends on the woman’s age:

For women who are not yet at the age of menopause, the cause of vaginal bleeding is usually from the mouth of the womb (the cervix). However, this can also occur once in a while even when there is really no cause and may not be a cause for concern. It is important, though to get a pap smear done to rule out cancer of the cervix.

Examples:

1. Inadequate lubrication during sexual intercourse
2. Friction during sexual intercourse
3. Inflammation of the cervix
4. Genital sores from sexually transmitted infections
5. Normal bleeding before or after a menstrual period

After the age of menopause, vaginal bleeding after sexual intercourse could also be from the mouth of the womb (cervix). Other sources of this bleeding could be from the womb (uterus), the opening of the vagina or the opening of the bladder.

Examples:

1. Inflammation of the vagina
2. Vaginal dryness
3. Vaginal atrophy

So, I will suggest a little patience before sexual intercourse to get your wifey in the mood. I understand that she’s probably been away for a while and so the delayed gratification may be playing a part in this issue  Take a moment to get your wife emotionally ready before you get into the physical 

Your wife may also have some things on her mind..perhaps she’s worried about something? Take the time to find out.

If this continues, however, please get her to see a gynaecologist.

Have a good night, everyone