chatwithketch

Q: Please help me out because I am tired of this life already. Sometimes I will be thinking of suicide. I have been going from one hospital to another complaining of frequent urination, and each time i urinate I feel as if I am losing my energy. I feel dull. It is even affecting my speech making me to stammer whenever I want to talk, I have lost so much weight, always feeling headache if I am hungry. it has even made me to develop ulcer. I am just tired. I don’t know what to do again. It’s even causing me chest pain, increased heartbeat, thirst, hunger. I have done so many tests. They told me they can’t find anything including urea, c&s aerobic bacteria, electrolytes, creatinine, ECG, kidney test, FBS. They can’t find anything. For some months now, I have noticed that I urinate more whenever I eat anything carbohydrate. Once it’s carb, I will be urinating, feeling hungry and thirsty with headaches. So, the only food I consume every day is beans- morning, afternoon and night. If I try carbs, I will start feeling terrible. The worst is minerals (soda). If I take them for 2 days, I will be feeling headache and more urine. Please what could be the problem? I can’t even gain weight anymore. My skin is so dry, I am always feeling warm, feeling like staying inside water without coming out. Sometimes I get tired of eating only beans but if I try carbohydrate food, I will start feeling bad. I am currently using ciprofloxacin. If I don’t use it for 1 or 2 weeks, I will start feeling like I have malaria. Please help me. I can’t even think straight, always making me feel moody, I can’t socialize with my friends anymore please doc

A: Hello dear! So sorry to hear about what you’re going through. My heart goes out to you and my prayers are with you.

But, suicide is not the answer. You will just be creating a cycle of pain – leaving other people in pain as they mourn your death…God forbid!

The symptoms (frequent urination, excessive thirst, fatigue and weight loss) that you describe could be due to Type 2 Diabetes Mellitus. Have you visited a specialist hospital? Or did you go to labs for tests and treatment? My recommendation, even if you had visited a hospital before now, is to go to a specialist hospital (like a Teaching Hospital). I am sure that when you give your symptoms they will refer you to an endocrinologist, who will take a proper history and speak to next steps.

There is always a solution to any problem life throws at us…never give up hope. Never lose faith. Help is close by. Some tips to help you:

•    Develop a strong social and spiritual support system. Join activities in clubs, churches, art centres etc.
•    Exercise regularly and reduce your stress. If the latter is not readily viable, improve on your stress coping mechanisms.
•    Eat healthy and get the necessary amount of sleep daily (7 – 8 hours)

I have also shared the phone numbers of some Suicide hotlines on my Facebook page (www.facebook.com/healthylivingwithdrketch) if you need to talk.

Should the issue actually be Type 2 DM, here’s what you should know.

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 type 2 Diabetes Mellitus, the cells no longer respond to the insulin prod (stimulus. The latter is called Type 2 Diabetes Mellitus.

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? A dietitian should be able to provide practical guides for the right diet to eat.

Here are our tips for eating a healthy breakfast on the run:

Oatmeal is always a great idea. Rich in fibre 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 😀

All the best. Please let me know how it goes.

Q: Please Doc, my 8year old boy has started having this odour especially when he sweats. Please, what can I do to stop this or is it normal because when I checked his armpit I found some hair coming out? Please I need answers ASAP. Thanks

A: Thanks for writing in. Is this normal? Well, from around the age of 8 to 10 years, children begin to sweat a little more and of course with the sweat comes the possibility of body odour. So, this is the time to teach him some hygiene lessons that will be helpful forever 

He needs to take a shower twice a day or failing that, at least once a day. This helps wash away sweat as well as reduce the number of bacteria on his skin.

Most people don’t know but sweat on its own is virtually odourless. But when bacteria that live naturally on your skin mix with sweat, they multiply quickly and become smelly.

Teach him to towel off after a bath or shower. He needs to pay close attention to areas where he sweats a lot. Sweat causing bacteria love moist areas.

Get him a deodorant or anti-perspirant to use on his underarms twice a day, in the morning and the evening. Deodorants do not actually prevent sweating, but they mask the smell of bacteria on the skin. Now that he has underarm hair, he has to shave that and groin area hairs frequently as they trap sweat and encourage smells.

Change undergarments frequently. Honestly, panties and underpants should be changed whenever you take a bath. And please remember to wash the discarded ones when you change.

When sweating heavily or in very hot weather,  he should change clothes frequently…and it’s important to wash those sweaty clothes before wearing them again! Fresh clothes help keep body odour down.

Teach him to change his socks too, especially if he tends to have foot odour. Deodorant powders or detergent based running shoe cleaners used in shoes are useful.

Be sure to reassure him that this is all part of growing up and as is usual with this process, he has new responsibilities that go with this stage 

Have a good night, y’all 

Q: Evening Dr. Please kindly assist. I have a thing under my right armpit. I don’t know whether it’s a folliculitis or a boil. It hurts and it’s affecting my arm. Which home remedy should I use or must I go and see a doctor. Your help you’ll be appreciated!

A: Well the first thing to do is to figure out what this painful lump is.

The more common causes/triggers of painful lumps in the armpits, include:
• Deodorants: These can cause skin irritation which can lead to boils. The delicate and sensitive skin of the underarms and the sweat that can accumulate there making it a rich culture medium for germs are factors that have been implicated. Solution: You may have to try another one…find one without fragrance or perhaps, formulated for sensitive skin. Reading the labels will provide this information 

• Shaving: A lot of people can identify with this…bumps in the underarm after shaving. This can happen if you do not shave properly. Shave along the direction of growth of the hair. Try shaving after taking a bath when the hair is moist and the skin hydrated. If this does not suffice, you may have to find alternative means of removing underarm hair eg depilatory cream.

• Infection of the hair follicles from cuts or injuries to the underarm, or from friction caused by wearing tight clothing. So, be careful while shaving and try to wear clothes that are more loose fitting (especially under the arms) and/or focus on fabrics that can ‘breathe’ like cotton

• Dirt or debris from excessive sweating can clog up hair follicles leading to painful lumps. Personal hygiene is key. Don’t be miserly with bathing and be sure to ‘take care’ of the underarms and other areas like the groin that tend to accumulate sweat and raise a stink 

• Infections due to viruses or bacteria.

• Cancer of the breast may also present like this.

I hope this helps. Keep checking your breasts and if you notice anything suspicious, please see your doctor.

Have a great night, y’all 

Q: Greetings Dr. Please help advice me. I am 21 weeks pregnant. I had a cervical stitch at 15weeks because of threatened miscarriage. Now I usually have stomachache especially when I lie on my left and right sides but a bit comfortable when I lie on my back but of which I know it is not the best position. Dr. is the regular stomachache normal or it will cause a problem? And what about lying on my back?

A: Hi dear, thanks for writing in.

Abdominal pain in pregnancy may or may not be serious.

Harmless causes include:

·      Constipation

·      Gas

·      The growing womb (uterus)

·      Braxton-Hicks contractions (these are ‘fake’ contractions preparing the womb for the main even :D)

Serious causes of pain during pregnancy include:

·      Ectopic pregnancy. To learn about ectopic pregnancy, please click on this link https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/

·      Pre-term labour. To learn about this, please click on this link: https://chatwithdrketch.com/2015/07/28/daily-health-tips-am-i-leaking-amniotic-fluid-liquor-amnii/

·      Miscarriage. To read more on miscarriage, please click on this link: https://chatwithdrketch.com/2015/07/23/daily-health-tips-im-scared-of-getting-pregnant-after-two-miscarriages/

·      Placental abruption. To learn more, click on this link: https://chatwithdrketch.com/2015/03/26/daily-health-tips-placental-abruption/

·      Urinary tract infection. To learn more, please click on this link https://chatwithdrketch.com/2016/02/19/daily-health-tips-re-visiting-chronic-utis/

·      Pre-eclampsia. To learn more, please click on this link: https://chatwithdrketch.com/2015/10/23/daily-health-tips-protein-in-urine-during-pregnancy/

Having said all these, you probably have no way of knowing what is harmless or not. So err on the side of caution and see your doctor if ‘it just doesn’t feel right’.

You should see your doctor immediately so you can stop lying on your back In the first trimester, if you’re used to sleeping on your back, you can continue. However, as you get into your second trimester, it is fact that pregnant women should not sleep on their backs especially close to term. This is because the woman may feel dizzy as the growing uterus puts pressure on the vein that returns blood from the body making the woman feel dizzy on getting up and the baby may also not get enough nutrients from the placenta in that position.

I hope this helps.

Have a great weekend ahead, y’all 

Good day doc. Please ma’am, as a pregnant mum, I have seen the ‘show’ for past 4 weeks now but yet to fall into labour. The pregnancy is 37wks. Please, how can I hasten the delivery without CS? Thanks ma’am

A:  Usually pregnancy lasts for 40 completed weeks plus or minus 2 weeks. At 37 weeks, pregnancy is considered to have been carried to term and your baby is good to be born…all things being equal. You could see ‘show’ from this time.  Show is a mucous plug that may be tinged with blood and is a sign that your cervix (neck of womb) is getting ready for labour.

And so, if a woman gets to 40 weeks without any sign of labour, she is tentatively given 2 more weeks, especially if there are no other risk factors present in the pregnancy. This is called watchful waiting and during this period, the baby’s kicks are counted, baby’s heartbeat is monitored and indeed, baby’s growth and other parameters are monitored. From the 41st week, if she does not spontaneously go into labour (without help), then there is a plan made for induction, having fully informed the woman of all possible scenarios. 

When a pregnancy goes beyond the Expected Date of Delivery (EDD), which is 40 weeks, it is called a post-dated pregnancy. If the pregnancy lasts beyond 42 weeks, it is called post term. It is not really clear why some pregnancies become post-dated but some associated risk factors include previous post-dated pregnancy, first pregnancies, mothers with high BMI and advanced age.

The main challenge with allowing a baby to remain in the womb beyond the 42nd week is that of the placenta no longer being able to supply sufficient amounts of oxygen to the baby. This can lead to brain damage or even death of the baby. The second issue is the threat of the baby having its first poop inside the womb and then aspirating (breathing in) it. The baby may also become bigger (fetal macrosomia) with potentials for complications like genital tract tears during vaginal delivery, prolonged labour etc.

You still have a couple of weeks before your 42^nd week deadline. So, just relax J If you do wish to have your baby rather than later, I suggest that you have a long chat with your medical team. Ask all your questions and make sure they understand your fears and explain everything to your satisfaction. Discuss all options available and the one(s) you are comfortable with.

Remember that you can also ask for a second opinion if you are not comfortable.

All the best! Let’s know when the baby is born! Lots of love and hugs.

Have a goodnight everyone 

Q: Good morning doctor, 27weeks gone and I don’t want my baby to be big. Please can I take Lipton tea and zobo without sugar? Thanks Dr.

A: Zobo is a drink made from the Hibiscus flower. This drink is known by many other names depending on where you come from. Some popular names include Karkadi, Karkada, Zenaf, Sour tea, Roselle and of course, Zobo! There are many more names, by the way…but this post is not about the many names of Zobo.

Some people drink Zobo, because there is an assumption that it is a healthier alternative sugary, soft drinks. Well, it depends. If you prepare it with bottles of the sugary soft drinks you were trying to avoid ab initio, then maybe, it may not be so healthy, right? 

Again, some of the touted benefits of Hibiscus on hypertension, cholesterol levels, colds etc do not really have significant medical evidence to back them up.

However, it has been shown that taking Zobo with Acetaminophen (our regular Paracetamol) may lead to a situation where your body gets rid of the drug faster than it would have done ordinarily. This implies that in a short while the effect of the Paracetamol would have worn off and the person probably back with the ache.

There is not sufficient evidence to really confirm that zobo and a lot of other herbal drinks are safe in pregnancy. It has been suggested in some quarters that Hibiscus in excessive amounts could lead to menstruation leading to miscarriages in pregnant women. The evidence for or against this is not in great supply but it is probably a great idea to give it a miss during pregnancy. I would do so 

Tea contains caffeine. There are conflicting reports as to whether some amount of caffeine is beneficial in pregnancy (less than 200mg) or whether increased amounts are a problem > or more than 500mg). One regular teabag steeped in a small teacup has about 55mg of caffeine. So, it may be a good idea to limit your consumption of tea. Big babies are usually seen in women who

1. Are diabetic.
2. Have gestational Diabetes (Diabetes that is observed during pregnancy),
3. Are obese
4. Have had another big baby before
5. Have had a lot of babies (from the 5^thpregnancy, the risk of big babies increase)
6. Excessive weight gain during pregnancy
7. Are older. From age 35 years, the risk of having a big baby increases
8. Have pregnancies that are overdue. When a pregnancy is more than 2 weeks overdue, the chances of a big baby are increased

For women with big babies (fetal macrosomia), a vaginal delivery may not be a complete no no! However, your OBGYN will weigh the risk of that against your medical history and other pre-existing medical conditions. Potential complications include having genital tract tears during delivery, prolonged labour and rupture of the uterus. The babies may be born with a higher than normal blood sugar level and be prone to childhood obesity.

However, none of this needs to happen if you eat nutritious foods and watch your portions. You should also register in a good center under the care of a qualified obstetrician.

To prevent having a big baby, remember that feeding for 2 is a fad. You don’t really need to eat like a horse  …you and your baby don’t need that much (an average of 12kg weight gain for 9 months…little over 1kg/month!); include some exercise (gentle stretches and walks, with your doctor’s knowledge and advice) and be sure that Diabetes is controlled, if you have this before pregnancy.

The link to my post on weight gain during pregnancy is included here to provide more information. https://chatwithdrketch.com/2013/12/02/daily-health-tips-eating-for-two/

So, for the remainder of your pregnancy, be sure to follow your doctor’s instruction on weight gain, medications etc. to the letter! Let’s share the good news when the baby is born.

All the best!

Hello everyone, how are you? I hope y’all had a great week. The question below was from someone who scheduled an online one-on-one appointment with me. His questions were very interesting and I thought I’d share the second part of it today. I hope this helps someone else! Remember that scheduling a one-on-one appointment is easy. Just go inbox to my facebook page (www.facebook.com/healthylivingwithdrketch) and follow the prompts 

Q: Hello Doctor good morning, may God continue to bless your efforts in promoting wellness and healthy living. I’ve been reading other people’s question but this time I have a very pressing need and please sought your help. It’s about a woman who bleeds from nose and mouth at the same time. And much amount of blood. It takes efforts to stop. It starts from the nose and when she tries to breathe in, it comes out from the mouth. And immediately after the bleeding she feels very dizzy and weak. 

A: Hello dear, thanks for your question. A nose bleed is called epistaxis and can happen from one or both nostrils. It can be heavy or light and last for a few seconds or a couple of minutes. It can be very frightening. A posterior nose bleed can lead to blood trickling down the threat and could be vomited. Perhaps this is the situation here. This situation is serious and should be suspected if bleeding lasts for up to 20 minutes or if the nosebleed happens after a head, nose, or face injury. Posterior nosebleeds are common in children between 2 and 10 years old and adults between 50 and 80 years old.Causes of nose bleeds include:

• Picking your nose

• Blowing your nose too hard

• Dry air as occurs in winter or harmattan.

• Common cold• Allergies

• Trauma to the nose…obviously 

• Alcohol use

• Pregnancy

• High blood pressure

• Use of drugs like cocaine, or drugs prescribed for thinning blood etc

Now, what should you do if you find your nose bleeding?

• Sit upright and pinch the bridge of the nose just above the nostrils for about 10 to 15 minutes. Sitting upright reduces the pressure in the nose vessels reducing bleeding

• Lean forward and breathe with your mouth. This prevents blood from draining down the back of the throat.

• Put an ice pack on the bridge of the nose to help prevent further bleeds.

To prevent bleeds, keep your nails short and trim to prevent scratching and hurting your nose. Then, keep your nostrils moist especially during the dry and cold seasons with some petroleum jelly, a humidifier to keep the air around moist or use a nasal spray to keep the tissue inside the nose from getting too dry.After the nosebleed stops, don’t pick or blow the nose for a few hours or longer to let the injury heal. Don’t smoke, which irritates the nasal passages, and don’t put any foreign objects in the nose, such as cotton swabs. 

If this nose bleed becomes frequent (more than once a week), is associated with any of the causes of posterior nose bleeds, please go and see your doctor even if you were able to stop the nosebleed. This is my recommendation for the lady referred to in this post especially as she feels dizzy after these episodes. This suggests that she is losing a significant amount of blood! Don’t delay. 

Have a great weekend, guys 

As we approach the festive season and the time when people cook a lot to celebrate, I reproduce a post I had made before. I have received a lot of questions on cancer since the post I made on it and I have also been asked this question on re-using oil, frequently. So, here goes!

Q: Should we re-use oils that have been used for frying?

A: This is a very important question. How do we tell the woman who has used a whole lot of oil to fry akara (bean cakes) to pour all that oil away afterwards? In these economic times? The truth is, even if she wanted to do that for her health, the economic imperatives make it impossible! Do you know how much that oil cost? 
Okay, so what can we do? Re-using oil can be done safely. First, the focus is on oils that have a high smoking point. Smoking point, simply put, is the heat point at which the oil begins to smoke  (Elementary, my dear Watson!). And so, oil that has smoked, is not good for use any more. In fact, you can consider smoking point to be that point at which oil goes from good to bad! At that point, the oil breaks down and forms free radicals that can cause cancer. Oils like peanut (groundnut) and Soya oils have high smoking points and do not break down easily.

So, you can re-use the oil provided it didn’t get to smoking point, it didn’t foam, change colour or develop a funny smell . To store the oil, let it cool, strain out all the food debris and then put in jars (glass, preferably) and refrigerate or freeze and use within one month. If food debris is left in the oil, it forms a rich culture medium for micro-organisms that can cause food poisoning to grow.

Finally, as much as practicable, try not to add salt to the food you wish to fry as salt lowers the smoking point of oils. And by the way, what’s with all the frying??? Grill, bake or roast 

Q: Thank you ma’am. How do we identify good oils for consumption?

A: Great question. The answer that I am sharing below speaks generally about things to do to prevent heart diseases and also addresses your question.

Nobody wants to die young and heart diseases are a leading cause of death worldwide. Eating healthy is a task that may appear daunting especially in a place like Nigeria, as we really do not have a culture of reading food labels in these parts. So here are some quick tips to help ensure you are getting enough of the good fats:
• Cook with healthier oils. Generally, oils that are liquid at room temperature are good for you. If the oil is solid at room temperature, give it a miss.
• Snack on nuts. You can also add them to salads for an extra crunch. I also like them in my yoghurt. Remember to go easy on portions and serve by the handful
• Avocados are a good source of mono-unsaturated fats which help protect your heart and prevent stroke. You can eat it on its own, use it in a wheat bread sandwich, throw it into a salad or even serve it up with some jollof rice
• Stock up on fatty fish like sardines and mackerel. They are good sources of Omega-3 fatty acids which is great for your heart
• Remember that even with healthy options, portion control is key. Always keep this in mind.
Have a good evening J 

In honour of World Heart Day 2020, I share the post below

Q: Dr, I would like to know how one can remove bad/excess cholesterol from the body.

A: Now, the first lesson we all need to learn is that cholesterol is not completely a demon 😀 There is good cholesterol and bad cholesterol. So, when we talk about high cholesterol, we usually refer to the bad one, Low-Density Lipoprotein (LDL) Cholesterol, which can lead to blockage of the vessels and inevitably, a heart attack…not good news! But we do need the good one, High Density Lipoprotein (HDL) cholesterol. It mops up excess cholesterol and prevents LDL from being changed into the form that causes heart disease. Indeed, we are encouraged to take foods that increase this and this in turn improves heart health.

So, what foods can help reduce bad cholesterol in the body and increase the level of good cholesterol?

Here are some examples:Oats and other whole grains which form soluble fiber that reduce the absorption of cholesterol and in addition, give you a feeling of satiety for long. This prevents you feeling hungry more often and reaching for ‘unhealthy’ snacks 😀 Other foods in this group include okro, beans, apples, citrus fruits and garden egg (egg plants). Soya beans, heart healthy oils like Olive oil and Canola oil, nuts (which should only be served in handfuls) and fatty fish like mackerel also reduce LDL. Generally eating healthy with lots of fruits and vegetables, cutting out the white carbs (pastries etc), exercising (at least 150 minutes weekly), ensuring you are not overweight and quitting smoking.

Have a goof evening everyone 🙂