chatwithketch

Q: Good morning ma’am. Please help me. A friend of mine has been going through a lot of emotional pain.. She has been in a relationship for 3yrs and she didn’t know that her fiancé had hepatitis B. He just told her last week when he was sick that he tested positive for hepatitis B some years ago, but they told him that it wasn’t the serious one. She’s doesn’t know what to do – maybe she has contracted it. Please your advice ma’am.

A: Hepatitis B infection is caused by the Hepatitis B virus (HBV) and it can cause very serious symptoms in people or it could very well pass unnoticed and be discovered by chance. The infections that occur in adults are usually acute and the body is able to clear the infection within 6 months. However, in a small proportion of adults and in a lot of infections occurring in children, the infection remains the body for a long time (chronic) leading to complications like liver failure and cirrhosis of the liver.

The symptoms include yellowness of the skin and eyes, dark urine, fatigue, body and joint aches etc. These symptoms vary in severity and appear about 3 months after infection.

Causes of HBV infections include contact with infected sharps like needles, sexual contact with an infected person, having multiple sexual partners, sharing needles used for intravenous drug use.

If one suspects exposure to HBV infection, an immunoglobulin injection, if taken within 24 hours can prevent the infection. Treatment depends on the type of HBV infection…whether acute or chronic. To confirm whether the infection is acute or chronic, the doctor runs a couple of tests.

The Hepatitis B surface antigen. A positive test result confirms that an infection is present but does not tell us if it is acute or chronic.

The Hepatitis B surface antibody. A positive test confirms that an infection had occurred but the body had developed antibodies to fight off the infection. This person is no longer contagious.

The Hepatitis B core antibody. A positive result tells us that a past or present infection exists. This is mainly interpreted in conjunction with the other two tests.

If the core antibody is positive and the surface antibody is positive, it means that the body had encountered this infection and fought it off in the past. This is likely to be an acute infection.

If the core antibody is positive and the surface antigen positive, it is more likely to be a chronic infection.

Treatment for acute infections focus on alleviating the symptoms noted above. Treatment for chronic infections focus on use of antiviral drugs and other medications that improve liver function. If liver function Is badly affected, transplant might be an option.

So, the first focus for her is to confirm if she has been infected. If yes, then, confirm if it is an acute or a chronic infection. That will determine the way forward. Remember that you can improve liver function by staying off alcohol, exercising, eating a lot of fruits and vegetables and not self-prescribing.

Generally, to avoid this infection, reduce your risk factors: Know the Hepatitis status of partner and be faithful to that person, where necessary, use condoms, stop the use of illicit drugs, do not share needles and other sharps, be careful with tattooing et al.

Vaccines are available for this virus and is now listed on the National Program on Immunization schedule. All adults who also have risk factors as noted above should also take this vaccine.

I hope this helps

Q: Good evening doc, I had a miscarriage last year due to fibroid, I went surgery in March, now we are in July. I am not yet pregnant. What should I do?

A: Sorry to hear about your miscarriage. Take heart.

Fibroids may or may not cause inability to have a pregnancy. It depends on size and position. Big fibroids in the area of the womb where a baby is meant to implant may cause a miscarriage or indeed, failure of the fertilized embryo to implant.

Fibroids develop from the muscle tissue of the uterus (womb). These growths can range in size from seedlings to big masses. They are differentiated by the sites where they are found: inside the cavity of the womb (sub-mucosal), within the muscle of the uterus (intramural), on the surface of the womb (sub-serosal). Fibroids do not cause infertility per se, but sub-mucosal ones in the cavity of the womb, can take up the place where a baby would have implanted causing infertility. Fibroids can also distort the shape of the ovaries and fallopian tubes causing problems with conception.

Please note that fibroids can also co-exist with pregnancy in which case pregnancy may be normal or associated with breech pregnancy, pre-term delivery (delivery of pre-mature babies) etc. However, once a woman registers in a good antenatal center under a good obstetrician, these issues will be anticipated and addressed promptly.

On not getting pregnant, it depends on how long you’ve been trying. There has to be frequent (at least three times a week), unprotected intercourse for a period of at least one year (six months for women older than 35), for this to be seen as a problem.

The causes include impaired sperm production (quantity and/or quality), erectile dysfunction, or new disease conditions in males. In females the causes include tubal damage (that is damage to the tubes from infections or adhesions in which case certain body surfaces stick together following surgery), ovulation problems (menstrual abnormalities), uterine conditions (infections from complications during a prior delivery, retained placenta, or a miscarriage which wasn’t properly cared for), complications from previous pregnancy(excessive bleeding following delivery) and changes in you or your partners’ risk factors; like changes in age (increasing age), weight, smoking and use of certain medications or disease conditions.

Find a hospital with a good Obstetrics and Gynaecology specialist. The closest teaching hospital to you may be a good place to start your search. S/he will examine you properly and advice.

All the best!

Alcoholism is a disease which is chronic and often progressive and includes problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect (physical dependence), or having withdrawal symptoms when you rapidly decrease or stop drinking.

It is also possible to have a problem with alcohol, even when it has not progressed to the point of alcoholism. Problem drinking means drinking too much at times, causing repeated problems in your life, although you’re not completely dependent on alcohol.

Want some tips to help you stop? Click on the link below.

Please remember that if you are pregnant, operating heavy machinery, using certain prescribed drugs or plan to drive, DO NOT DRINK!

https://www.health.harvard.edu/healthbeat/11-ways-to-curb-your-drinking

Q: Hey doctor I have aborted 4 times and now the 5th pregnancy has turned to be ectopic. Can I give birth again?

A: Ectopic pregnancy is a situation in which a pregnancy implants outside of the womb (uterus). Usually, fertilization of the egg by the sperm happens in the fallopian tube and then this fertilized egg travels to the uterus where it is implanted. In ectopic pregnancy, this doesn’t happen. The fertilized egg may attach to the ovary, remain in the fallopian tube (tubal pregnancy), attach to another organ in the abdomen or the cervix. None of these places are ideal for supporting a growing life and so there is a great threat of serious bleeding.

Ectopic pregnancies are usually discovered in the first couple of weeks of pregnancy (it would have been discovered by the 8th week of pregnancy). The patient would usually come into hospital with complaints of light abdominal bleeding, abdominal pain or cramps, extreme dizziness from the bleeding. If the tube ruptures (bursts), patient could faint from profuse bleeding into the abdomen.

The risk factors for ectopic pregnancy include history of previous ectopic pregnancy and/or Pelvic Inflammatory Disease, Sexually Transmitted Infections, failed tubal ligation (tying up of the fallopian tubes for people who no longer want to have more babies), congenital abnormality of the fallopian tubes, pregnancy while on Intra Uterine Contraceptive Device (IUCD) etc

Once the doctor makes a diagnosis of this, he will choose from either giving a drug to dissolve the pregnancy tissues, if the pregnancy has not progressed too far and the fallopian tube is not ruptured; pin-hole surgery (laparoscopy) is also an option here. However, if rupture of the fallopian tube is suspected, the whole fallopian tubes and ovary may have suffered significant damage needing their removal. In cases like that, IVF is an option.  IVF by the way, means Invitro Fertilization and is the process of fertilizing a woman’s egg with a man’s sperm cell outside the human body. In the early days they were called test tube babies. Unfortunately, IVF is not a cheap procedure and you do need deep pockets and loads of patience because it may take a while. But, if you can afford it, please go for it.

You could still have a normal pregnancy if the fallopian tube did not rupture and this was discovered early. Let your doctor guide you.

Give your body time to heal and do everything that improves your chances of having a successful pregnancy and healthy baby. Eat well (more fruits and vegetables) and try to work out daily…even if that means taking a walk for about 30 days. Get support from family and friends and remain positive…pregnancy is more likely to happen if you’re relaxed and focused on living a full and happy life as opposed to fretting about it.

Remember that adoption is also an option to consider.

So, speak with your doctor and find out what options are available to you.

Final advice –  if you’re not ready for pregnancy please remember the ABCs of safe sex: Abstain…which is always the best bet if you’re not married, be faithful to one partner (who is hopefully being faithful to you) or use condoms.

I wish you all the best

Q: Hello my dear doctor Please want can I do when i cant taste any food and my nose is not perceiving any smell

A: Hey! Thanks for writing in.

The symptoms you describe could e due to a common cold, to be honest, but given that his has recently formally added to the list of symptoms of COVID-19, you should call your country’s/state’s hotline for guidance on what to do and where to get tested, if need be.

As a reminder of symptoms of COVID-19, I repeat an earlier post.

Common symptoms of corona virus are a fever, shortness of breath or difficulty breathing and cough. The cough can be of any type, but it is most commonly a dry cough.

Unfortunately, most of these symptoms are present in a serious common cold or flu, and so they are not necessarily symptoms of corona virus every time they are experienced.

To be safe, any time these symptoms are observed together, after recent travel or contact with people who have been diagnosed with the virus, or in locations with community transmission, please consult your doctor or call the COVID-19 hotline. Calling in with your symptoms is a better idea than visiting the health facility for now.

The hotline will advise on the next course of action.

Stay safe, people!