chatwithketch

Q: Hi doc. I missed my period 3 month ago because I am pregnant but recently I started seeing blood stain but today it was so heavy with serious abdominal pain. What could this mean?

A: Bleeding during pregnancy can be worrying whether it’s a little or a lot. But, it may not necessarily be the sign of a problem.

Bleeding can occur in early pregnancy, close to or about the same time as the menstruation would and thus be mistaken for a period. This bleeding could be due to implantation as the fertilized egg implants itself in the uterus (womb). Other causes of bleeding in early pregnancy include ectopic pregnancy, miscarriage and infections.

For more information on ectopic pregnancy and miscarriage please click on these links:

Daily Health Tips: What Are My Options After Ectopic Pregnancy And Failed IVF?

Daily Health Tips: Miscarriage And Infertility Re-visited

Bleeding in pregnancy may not necessarily be an emergency but because there are other causes of these episodes of bleeding, which are potentially life threatening like ectopic pregnancy, bleeding in pregnancy should always be checked out in the hospital. Better safe than sorry 

I hope this helps 🙂

Q: Good morning, Dr Ketch. Thank you for helping us out health wise. I’ll like to ask…as a Nigerian, do you know of any food that is healthy for a recovering stroke and hypertensive patient apart from Semovita and wheat? Thank you, ma’am

A: Stroke as the name implies refers to an incident that happens suddenly…without warning. It usually occurs when the brain is deprived of some of its blood supply and consequently oxygen supply. This can happen when there is a blood clot in a vessel in the brain or due to a burst blood vessel leaking blood onto the substance of the brain or around the brain. This blood leakage can lead to undesired pressure on the brain.

There is really no such thing as a partial stroke. Oftentimes, people refer to a Transient Ischaemic Attack (TIA), as a partial stroke. This condition occurs when a blood vessel is partially blocked. This would usually be resolved within 15 minutes and is a sign that a major event (a stroke, proper) may not be far off. This is a warning that should be taken seriously.
It is important to know the signs of a stroke because if action is taken immediately, it can prevent permanent damage from being done. If the brain is deprived of its blood supply for about 4 minutes, irreversible changes begin to occur in the brain. If this deprivation continues beyond this time, permanent changes would have occurred that may affect different facets of the individual’s functions.

The signs of stroke to look out for are known by the acronym FAST.
• F stands for drooping of a side of the face. Ask the patient to smile and you will observe that the smile looks lopsided.
• A stands for weakness of one side of the body. Ask patient to lift both arms and it will be seen that one side is being ‘dragged’ or lagging
• S stands for speech difficulty like slurring. Patient cannot enunciate words properly again
• T stands for time. Once these symptoms are notices, it’s time to call for help. In climes where there are emergency numbers like 911 or 999, please call these. Otherwise, efforts should be made to take the person involved to the hospital immediately.
Patients may also complain of sudden inability to move legs, feel confused, have blurred vision etc

There are risk factors for stroke and they include:
• Age: The older you are the more prone to stroke. People from age 55 years are more likely to have a stroke, though this can also happen in children eg those born with heart defects and those with Sickle Cell Anaemia etc
• Race: Africans and Asians are more at risk
• Sex: Females are more at risk…as if we don’t have enough problems
• Family history of stroke: The presence of this increases risk
• Previous history of a stroke.https://c0.pubmine.com/sf/0.0.3/html/safeframe.htmlREPORT THIS AD

Other risk factors:
• Hypertension
• Diabetes Mellitus
• Overweight
• Sedentary lifestyles
• Not eating healthy
• Smoking
• Drinking Alcohol

The rate at which one recovers from stroke and indeed the degree of symptoms experienced, depends on the area of the brain affected, how serious the damage to the brain is etc and so recovery will be different for different people.

Patience is key. Speech therapists may be needed to help the person re-learn the art of speaking. Physiotherapists will help improve motion on the affected side and indeed, mobility. Other therapists may help with eating…if swallowing is a problem, relearning the art of reading and reasoning etc

Usually, people who visit find it difficult to understand their speech during recovery and this can put even more pressure on the patients. Speak slowly and listen carefully so you can understand what they are saying.

Perhaps, swallowing is an issue in the case mentioned above. Apart from that, if Diabetes is an issue, she needs to be on a strict diet and that will determine what she can or cannot eat. This will ultimately affect weight gain or loss. If this is a big concern, please discuss with her doctor. For specific foods to eat, reduce your intake of cholesterol and trans fat-rich foods. 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.https://c0.pubmine.com/sf/0.0.3/html/safeframe.htmlREPORT THIS AD

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 help with reducing bad cholesterol and also preventing strokes.

You may need to walk with a stick as you re-learn the art of walking. Recovery may be long and tedious but you’ve got to keep at it.

All the very best.

Have a good night, people 

Q: Hello Dr Ketch a test was carried out on me and my fiance and discovered we have Staph aureus some drugs were prescribed like Ciprotab, Fluconazole but I am still having symptoms. I feel I need a good drug prescription. Please does Staph aureus have a cure? Please, I need your advice.

A: Thanks for writing in. I get a lot of questions on Staph aureus infections and though I have answered this a couple of times, the fact that they keep coming means that it is a topical issue. I will make a few comments and then place the link for the last post I made on this topic here.
First, Staphyloccocus lives normally on your skin and nose (and mine too :D) minding its own business until there is a cut or injury that moves it from the skin inside the body.

So, it’s not necessarily a sexually transmitted infection but it can result in an STI if there is contact between an infected area and the genitals.

If the doctor prescribed Fluconazole, it pre-supposes that there was also a fungal infection noted. Again, fungi in the vagina generally mind their business until there is a condition that leads to their overgrowth like abuse of antibiotics, wearing tight panties, douching etc

Giving prescriptions and complying with it is one thing, but even if we take the right does for the appropriate number of days, if we keep leaving ourselves open to conditions that make us more at risk, then we will have recurrent infections. Personal hygiene is important in preventing Staph infections as they are spread by person to person contact and preventing conditions that encourage overgrowth of fungi will help prevent fungal infections. Please click on the link below for more on Staph and vaginal yeast infections:

Daily Health Tips: Why Do I Have Recurrent Candidiasis?

Daily Health Tips: Why Do I Keep Having Staph Infections?

I assume that a swab was taken from you for investigation. The most appropriate drug to use is the one that would have shown up on the results of the test ordered by your doctor. If this wasn’t effective, please return for an evaluation. If it turns out it is the same infection, take the drugs as prescribed and this time, be sure to work on preventing re-infections as this is very easy. Ensure that your partner gets treated too and observes the same rules.https://c0.pubmine.com/sf/0.0.3/html/safeframe.htmlREPORT THIS AD

And so, yes, it is possible to treat Staphylococcal infections.

Have a great weekend, y’all 

Q: Sorry to disturb you, ma’am. I’ve been having one problem for years now my body is always expelling water it’s been affecting me if I drink water now in few minutes I will go and urinate. It has made my skin so dry and rough and always feeling thirsty. I have done so many tests. They can’t find anything. They said it’s ordinary water but why is my body is making too much water without using it? I urinate more than I drink even waking up in midnight to pee but I noticed that if I consume a lot of beans it will reduce but if I eat carbohydrates it increases that is I urinate more

A: Frequent urination may actually be due to the simple fact that you’re drinking way too much fluid. However, where this is not the case, it is likely to be due to a health problem.

Some causes of frequent urination include:

1. Sexually Transmitted Infections
2. Some medications
3. Drinks that contain caffeine, alcohol etc
4. Infections that along the urinary tract or changes to the bladder
5. Infection or enlargement of the prostate
6. Disease conditions like Diabetes Mellitus etc
7. Some cancer treatment eg radiation treatment for the lower abdomen

If this is due to excessive fluid intake, limiting this will help. If this symptom is associated with others like difficulty with urination, pain during urination, passing out bloody urine, incomplete emptying of bladder when urinating etc, please see your doctor ASAP.

So, I suggest that you just go and see your doctor. He will take a good history, examine you and order some investigations. The treatment of course will depend on the cause of the problem.

For related posts, please click on the following:

Daily Health Tips: Urinary Tract Infections In Men

Daily Health Tips: Why Do I Have Pain When Urinating?

Daily Health Tips: Train That Leaking Bladder!

Daily Health Tips: Prostate Enlargement

Daily Health Tips: More on The Prostate Gland

All the best!

Q: Dr. I’m glad because of this your page. You ‘re so wonderful by the testimonies of the page. May Almighty who for His mercy loved you to this kind gesture, bless you abundantly. Please, do me a favour, because I’m confused. Can a woman have menstruation and Ovulation at the same time? If possible, is it normal?

A: Amen to your many prayers and I love you right back! :d
Can one menstruate and ovulate at the same time? Yes…this may not be very common but it is very possible. Is this normal? It’s not abnormal :d It all depends on a woman’s cycle. To understand this some more, I reproduce the details of a post I made a while ago on a related question.

Q: Please Dr, is it absolutely free to have sex during menstruation? Secondly, if it is free, can a woman get pregnant during that period?

A: I had to hide a quick smile when I read this  I’m not sure what you mean by free. Free from stress or free from sexually transmitted infection? Or perhaps you want to know if it’s safe?
Well, having sexual intercourse during a lady’s menstrual period does not make a man impotent, neither does it kill vital organs in his body…contrary to all the stories you have probably heard 

However, it is obviously messy and it is also easy to contract Sexually Transmitted Infections at this time.

Can one get pregnant at this time? Unlikely but not impossible. It depends on the length of a woman’s cycle. If she has a short cycle, she could be seeing her period a few days away from her ovulation. Thus, if she has sexual intercourse, perhaps towards the end of her period, the sperm, which can stay ‘alive’ for days after sexual intercourse, are still available to fertilize the eggs released during ovulation. So, having sexual intercourse during menstruation is NOT a means of contraception, people 

For more on this topic, please click on this link https://chatwithdrketch.com/2015/04/10/daily-health-tips-irregular-periods/

Have a good night everyone 

Here’s to a healthier you!

Q: Hello! Doc my friend is having a condition of bleeding from anus. She visited a doctor and they said it’s constipation but after a month the bleeding started

A: Hello! Thanks for writing in.

The first question I have for you is whether the blood is bright red or altered (almost brownish/black)? If it’s bright red, it is likely coming from the anus or somewhere close by. If it’s altered blood, it’s likely coming from higher up in the digestive system eg bleeding from a peptic ulcer. You should see your doctor immediately, if you experience this.

Common causes of bright red bleeding include:

·      Anal fissure

·      Piles (haemorrhoids)

·      Cancer of the rectum or colon

·      Gastro-enteritis: infection of the stomach and intestines

·      Inflammatory bowel diseas

·      Anti-coagulant drugs

You cannot make the diagnosis of what is serious and what is not. So, I suggest you see your doctor to examine you and make a diagnosis.

I will discuss the first two conditions (anal fissure and piles) below;

Constipation can lead to conditions where the stool is so hard that it causes a tear of the skin lining the anus (anal fissure) leading to blood seen with the stool.

Prevention is focused on ensuring that you have enough fibre in your diet (fruits, vegetables, whole grain), getting at least 30 minutes of exercise daily and drinking at least 8 glasses of water daily. When you have the urge to poo, try not to delay it for too long. Go and try to take your time to do your business!

How can you help this?

§  Include some fibre in your diet. Fruits and vegetables, oatmeal, local rice and other whole grain meals are helpful.

§  Drinking at least 8 glasses of water daily. Remember that this number, 8, is not cast in stone. It’s just a helpful guide. If you’re in a hot area, you’ll probably drink more

§  Get at least 30 minutes of exercise/activity per day or on at least 5 days of the week.

§  If these do not help, you may want to see your doctor for a proper examination as some diseases like Diabetes Mellitus may also cause constipation.

Now for piles…

Piles, known as haemorrhoids in medical lingo are swollen veins in the anal canal. They can be internal, external or both internal and external can co-exist. Internal haemorrhoids occur when veins swell within the rectum and external haemorrhoids are found under the skin around the anus.

These haemorrhoids develop when there is undue pressure in the pelvic and anal area as can occur when people strain to pass faeces (if they have diarrhoea or are constipated), in pregnancy (especially the last 6 months), in obese people, people who eat diets low in fibre and people who practice anal intercourse. When women strain in labour, haemorrhoids can also be made worse. For those who love to visit the toilet with their newspapers and spend ages reading them in there, well, you’ve got breaking news!  Sitting on the toilet seat for prolonged periods can also cause haemorrhoids. As people grow older, the support structures for these veins also grow weaker…naturally 😀

Some internal haemorrhoids can be small veins which stay within the rectum. Usually these internal haemorrhoids, stay inside the anus causing no problems. Other internal haemorrhoids can be big veins that sag and protrude out of the anal canal. Straining would cause their delicate surfaces to bruise and bleed. Sometimes, the straining is sufficient to cause the haemorrhoids to protrude out of the anal canal. This is probably what has been described above in the question. When the haemorrhoids are compressed by anal muscles, the pain is made worse and the pressure can lead to cutting off of blood supply to the haemorrhoids.

External haemorrhoids can clot due to irritation forming a hard, painful lump under the skin around the anus.

People with haemorrhoids will complain of streaks of blood in the stool after stooling, blood on the tissue after cleaning up, anal pain, anal itching or a lump around the anus.

Treatment involves the use of ointments to relieve pain, inflammation and itching. There are other minimally invasive and surgical options available that range from rubber band ligation to surgical removal of the haemorrhoids.
You can also limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) to clean up after using the loo, sit on a bowl of plain warm water for about 15 minutes about twice or three times per day and also use some pain relief, if in pain.

To prevent this, ensure that your diet has sufficient amounts of fruits and vegetables. Remember that if you take a regular flat plate, half of this should be filled with fruits and vegetables, half of the plate with complex carbohydrates and the last half with proteins.

Limit the time you spend sitting on the toilet seat (read your newspapers elsewhere :D), use the toilet as soon as you feel pressed (that way the fluid in the stool is not absorbed making the stool hard) and then don’t strain when you do go. Drink sufficient quantities of water daily, exercise (to keep everything moving along nicely :D)

Remember though that there are other causes of blood in faeces. That’s why this case has to be checked out in the hospital so that a proper diagnosis can be made.

I hope this helps.

Have a good night y’all 

Q: Good afternoon Dr. How can I deal with nausea? I’m 7 weeks pregnant. I’m failing to eat the whole day

A: Repeating this post on morning sickness for this new motherMorning sickness during pregnancy can be really trying! I know…I suffered through it! Oh boy! Thank God I’m over all of that now…I’m a grandmother in waiting

Now, for the rest of you who still have to go through this, I’ll share some tips.

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. 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

More importantly, women going through this need love and support more than ever. If you can’t stand cooking now, because of this, get help etc.

All the best!

Q: Is this diet of fruits, vegetables and whole grains applicable to children? I feel that, because they are growing, they need sugar and the likes.

A: You are certainly right. They need sugar to fuel all that activity that makes parents continually yell,’what’s going on there?’ 

 But, it’s probably not the sugar that you meant…that is, refined sugar from baked goods, soft drinks etc. Remember that all food we eat, eventually gets converted to sugar in the body. The sugar from refined products cause sugar spikes and lows such that the people who eat them, get hungry very quickly after they felt full. So limit the sugar from these sources. Sugar from other sources like complex carbs are released slowly causing a feeling of fullness for longer.

As parents or caregivers, we have to model the right food behaviour for the children. We can’t tell them to take fruits and then turn around to take soda. In the same vein, we can’t eat junk and expect them to grow up and have healthy food habits. Another thing we do, which may promote the wrong image of food in children, is that we oftentimes give them sweets or candy as reward for good behaviour. So, it’s only natural for them to now desire this.

So what should they eat? Pretty much the same diet requirements as you but with varying calorie needs at different ages.

Serve a variety of fruits and vegetables, especially those in season. They are cheap and readily available. Serve a variety of different coloured fruits and veggies. And remember that fruit juices are not as good as fresh fruits themselves (they are loaded with sugar and even if you don’t see sugar on the label, the ‘concentrate’ you do see is loaded with it!). An exception to this would be 100% fruit juice.

Seafood, beans, eggs and unsalted nuts are good protein sources. Dairy is also a good source of protein. Once a child is about 2 years old, please switch to skimmed or 1 to 2% milk. Cheese, yoghurt and soy drinks are also great dairy options.

Whole grains found in brown/local rice, oats, whole wheat bread and popcorn too (yep! popcorn :D. But be sure not to douse them with sugar or salt) etc provide complex carbs and fibre for that feeling of fullness and of course great bowel movement with no constipation 

Keep healthy snacks around the house like nuts, fruits and vegetables that can be dipped in sauces.

Have a great week ahead, peeps 

Q: Good morning Doc. Please, what will I do? Anytime I finish giving my child breast milk and keep him on his bed, he will vomit all the milk. After a little while, he will begin to search for another feed, but he is healthy. Please, tell me what to do because he stresses me.

A: Thanks for writing in.

Please don’t be stressed 🙂

 The post below written in response to a mum like yours, should answer your question. Enjoy….

Q: Good afternoon Dr Ketch. I have a 3-week old son who vomits sometimes after breastfeeding. Please I will like to know what causes it and what I can do to remedy it. I intend to do 6months exclusive breastfeeding. Thank you and remain blessed

A: Hi dear, congratulations on your new baby. This baby will do super-amazing awesome things…Amen!

Now, is your baby ‘vomiting’ or spitting up the milk? Bear in mind, that when I say spitting up, it’s not the type that you and I do. Spitting up in babies refers to an easy flow of the milk your baby just took out of his mouth accompanied by a burp sometimes. Vomiting, however, is more forceful and would move a couple of inches more from the baby’s mouth.

What causes reflux? There is a ring of muscle that separates the stomach from the esophagus (the food pipe). In babies, this muscle is not well developed and so allows food that has moved into the stomach to sometimes come back up. This would continue, sometimes, up till when the baby is about 12 months but is more common within the first 3 months of life. It is also common in babies who are over-fed 

You can help to reduce this by

If your baby, however, ‘vomits’ forcefully, is not gaining weight, gags, has difficulty swallowing or sleeping etc, please see his doctor for a review.

Please keep your commitment to the exclusive breastfeeding plan. It’s a sure winner. My love to your baby!

Have a great evening, y’all 

Q: Please good morning doc. Please i want to know if pelvic inflammatory disease causes infertility. Is there any treatment for that?

A: PID known as Pelvic Inflammatory Disease is an infection of the reproductive organs of a woman (uterus, fallopian tubes, ovaries and surrounding tissues) and it’s usually due to infections which may or may not be sexually transmitted (more likely to be the latter, though). The two most common causes of PID are 2 bacteria: Chlamydia and gonorrhea. Other bacteria found in the vagina and cervix (not associated with STIs) can also travel up the vagina and cause a PID.

People more at risk of this condition include people with multiple sex partners, people who use Intra Uterine Device as contraceptive, people who douche ( douching involves injecting fluid up the vagina to cleanse it. This process can carry bacteria up the vagina), people who have had an STI, young women less than 25yeras who are sexually active.
How do you know if you have this infection? Sometimes this is difficult as it may not give any symptoms. However, in other cases, patient could complain of vaginal discharge, painful urination and sex, fever, lower abdominal pain and irregular bleeds.
If this is left untreated, it may lead to ectopic pregnancy (pregnancy that implant outside the womb), fallopian tube damage and blockage with subsequent infertility and long term abdominal pain.

To diagnose the condition, your doctor may take samples from the vagina and cervix (mouth of the womb), carry out blood tests and he may also want to look-see using laparoscopy.

Based on the results, he will prescribe a course of antibiotics which has to be adhered to and the dose completely finished even if one feels better before the complete dose is finished. It is important that there is no sexual intercourse until infection is treated and indeed, sexual partner should also be treated as well. Remember the ABCs of sex.

So, I suggest that you go see a gynaecologist. You can check the Teaching or Specialist Hospital closest to you. As noted here, the treatment is based on the result of your tests. Please schedule this specialist appointment as quickly as possible…the consequences of untreated PID are severe. If any damage to the reproductive organ has already occurred, starting treatment may not reverse them. So the earlier you deal with this, the better.

For related articles:
https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/
https://chatwithdrketch.com/2014/07/02/daily-health-tips-should-i-use-emergency-contraception-as-my-regular-means-of-contraception/
I wish you the best!