chatwithketch

Q: Hi Dr. Good day to you. Please Dr. I have been having a sharp pain on my leg right inside the bones for some time now. The pain is occasional and lasts for seconds. What might this be and what should I do about it? Thanks

A: Thanks for writing in. The pain in your right leg may need further evaluation.

There are quite a number of causes of pain in the leg. Pain in one leg may be due to an injury, a fall or hitting the leg against an object. This pain may be felt immediately after the incident that caused it and subside after a few days, with the proper care. It can also linger for some time, if perhaps there was a break in the bone which was not properly taken care of and affected some nerves.
Other causes include arthritis, leg swelling from different causes like infection, vein abnormalities, diseases like heart problems, diabetes, and liver problems. In long standing hypertension, or diabetes that is not properly managed, there could be nerve problems, often described as a cramp, feeling of lack of blood, or a feeling like pins pricking the feet. The pain could also result from a muscle cramp, which typically occurs at night and may last a few seconds to minutes. There is also condition known as familial recurrent knee dislocation, in which there is repeated dislocation of the knee, followed by a fall, due to lack of stability. It runs in families and can be very painful too. There are also some cancers that can give similar symptoms.

I would advise that you reduce stress on your legs as much as possible, i.e. avoid standing for too long. You could also start some mild exercises focusing on the legs. These may help to strengthen any lax ligaments and improve blood flow, thereby helping any nerve disease, if that’s responsible.

Good diet, rich in proteins and vitamins are also important. You may occasionally take a mild pain relief to reduce the pain (but do not make it a habit). If the pain worsens or continues despite pain tablets, please see your doctor.

In conclusion, I strongly recommend you see a doctor who will take a proper history and examine you thoroughly, and proffer a line of management for your symptoms.

Hope this helps, Best wishes

****The answer to this question was contributed by a doctor guest blogger.

Q: Hello Dr. Good day. Dr I need your help. I have this problem. Any time I have sex, I quickly discharge. And after that I wouldn’t be able to continue. Even if I force myself to go again I will feel like something was taken out of me after the second round.
Secondly, I normally have this headache and fever and after treating them, like one month after, the symptoms will be back. My hands will be shaking. My friends said that I should quit beer which I did but it still shakes. What is my problem Dr?

A: Premature ejaculation is the most common type of sexual dysfunction in men younger than 40years. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. In most cases the cause may not be identified. It may be due to anxiety, guilt, depression, or if it has been a long time since last ejaculation. It may occur with a new partner, or only in certain sexual situations. In some cases, medical conditions, hormonal problems, injury or certain medications can cause it.

In most cases, it resolves on its own over time without medical treatment. Cutting down on alcohol, tobacco and illegal drugs may improve this. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation. Antidepressant drugs have also been found to delay ejaculation. There are also creams, gels and sprays which can be applied before intercourse. I would advise you visit a doctor who would be able to evaluate you and give you further advice.

The recurrent fever and headache could be poorly treated malaria, and infection, a problem with the immune system, or some more sinister problems. Have these checked with a doctor and do continue to cut down on your alcohol intake. It sure will help in the long run. Cheers!

****This post was contributed by a guest doctor blogger.

For a related post, please click on this link https://chatwithdrketch.com/2014/04/13/daily-health-tips-premature-ejaculation/

Have a great night, beautiful people 

Q: Hello Ma I’ve a pot belly and I want to trim it down. Please, advice on what to do. Thank you

A: I’ve been getting a lot of questions on pot bellies, big tummies after child birth or just big tummies…after nothing, full stop:D So, I’ll reproduce part of a post I’d written on this subject (the trio of diet, exercise and stress). Remember that you can always visit my bloghttp://www.chatwithdrketch.com and type in any subject you want to know about in the search box. You will be presented with all my posts on that subject. There’s a lot I’ve written on weight loss et al 

I hate to be the one to break it to you…but alcohol is not the only thing that gives you a pot belly!:D Pot belly is caused by consuming way too many calories and these can be from your chilled bottle of beer or from your huge bowl/basin of rice (especially polished white rice) or yam. It is important to know what to eat, how to eat it and how much of it to eat.

The bad thing about tummy fat, is that it is not on the outside. It is actually on the inside, around the organs. So, no amount of sit-ups can touch this fat…exercise can help tighten abdominal muscles (especially for those who just put to bed) but it won’t get to the fat around organs (visceral fat). This fat is associated with some disease conditions like Diabetes Mellitus etc.

A diet full of junk food (meat pies, doughnuts) is unhealthy on a lot of fronts. It contains empty calories which give you calories you don’t need and make you demand even more calories in a short while. They also cause your blood sugar to yo-yo (jumping up) jumping up and down in a way that doesn’t help blood sugar control. A diet that is also full of white carbs like white bread, polished rice etc is also not ideal for the same reason. So what should we eat? A balanced diet…a diet that contains all food groups in sufficient amounts for the body to use them efficiently.

I have had cause to describe the ideal plate of food several times: Half the plate should be filled with vegetables, a quarter with complex carbohydrates like beans, local rice (like Ofada/Abakaliki/brown/wild rice), sweet potatoes, oatmeal etc and the last quarter with protein (fish, chicken etc). Remember that carbs are necessary to provide the energy needed for our daily activities. So, do not ‘demonise’ (:D) them….however, not all carbs are created equal. Complex carbs are superior because they supply energy and fibre and some also supply minerals and vitamins.

Then remember portion control. Reduce the plate size you usually use, if you need to lose weight. This automatically reduces the quantity of food you can eat.

Remember also to make a conscious effort to chew your food properly and take your time. Don’t wolf it down…or inhale it  Chew intentionally so as to give your brain sufficient time to process the signal from your brain which says that you are full. Have you observed that when you rush your food, you move from being very hungry to being completely stuffed! There’s no in-between, where you realize that you’re full before you get to the stuffed part. That’s because your brain didn’t have enough time to process that info before you became ‘over-full’.

Note that, even if a food is considered healthy, it doesn’t mean you should eat as much of it as you want. For instance, beans is healthy on so many levels but it also high in calories and so you still need to stick to the portion described. Moderation in everything!!

Exercise is critical because it makes your heart strong, improves your body’s ability to break down food, resist diseases and generally provides a feel-good attitude. It also helps you lose weight. Mathematically, exercise helps to burn what you have eaten such that, if you do enough and watch your portions, at the end of the day, there will be a food balance between what you have burnt and what you have taken in. If you have not been engaged in any exercise for a long time, please see your doctor before you start any vigorous regimen. A minimum of 150 minutes of exercise per week is essential for good health. Try to get this exercise anyway you can: walking, dancing, skipping, arm wrestling, pillow fights etc. All the activities count and help you keep you fit, trim and healthy. If you use the gym, that’s great. You can get the instructor to put you on a regimen that involves aerobics, strength training (training with weights) and then focus on troublesome spots like your tummy etc. (in that order) or suggest useful regimens that are helpful.

Finally, I will talk about stress because quite a number of us are stressed out. Stress causes the release of a hormone called Cortisol which, amongst other things, causes fat to be deposited around our tummy. So, reduce your stress consciously by figuring out how to better cope with your sources of stress or even eliminating the stresses that you have control over. It’s your life after all.

I suggest you also click on this link to read my post on low glycemic eatinghttps://chatwithdrketch.com/2014/02/16/daily-health-tips-low-glycemic-eating-whats-that/

Have a good night, y’all 

Q: Evening Dr Ketch. I hope you’re good. I.am only 18. I have been having abdominal pains and I was told that I have ovarian cyst. I am on medication but they said if it doesn’t work then I’ll have to undergo an operation. I am scared because they told me I have less chances of conceiving. Could this be true?? (I’ve never had an abortion before). Please help!

A: Thanks for writing in, dear.

Ovaries are small bean-shaped organs on either side of your womb. Every month, your ovaries develop sacs called follicles from where eggs are released monthly and female sex hormones produced. After the egg is released every month, the sac disintegrates. But sometimes, the egg is not released and the sac remains or the egg is released and the sac does not disintegrate. This follicle becomes the fluid-filled cyst sac. Usually this is not a problem as it could form during every menstrual cycle and usually resolves on its own. These cysts are called the functional cysts. However, these cysts could get very big and in some instances become twisted or they could rupture causing problems. This latter type is called pathological cyst.

Examples of pathological cysts occur in Polycystic Ovarian Syndrome and endometriosis. In the former, small cysts appear all over the surface of the ovary and is also associated with irregular menstruation and high hormonal levels. In endometriosis, the tissues of the uterus (womb) are found outside of the uterus. These two pathological cysts are associated with fertility problems. Functional cysts are hardly associated with fertility issues except they become extremely large.

Treatment depends on your particular situation. You could get away with no surgery and no pills, if your doctor orders serial scans to continually observe the size of the cysts and sees a reduction in size. Otherwise, the other treatment options are the use of birth control pills to prevent the development of more cysts in future menstrual cycles and surgery as the final option.

Have a chat with your doctor and share your worries about these treatment procedures. He/she will guide you through this.

All the best!

Hello y’all 

How has your day been? I have had an absolutely fabulous day…lying down on my bed! 

By popular demand, I reproduce the recipe for yoghurt here. I have had a lot of people asking about it in recent times.

Remember that yoghurt is full of healthy bacteria that may help fight vaginal infections, prevent brittle bones (osteoporosis) in old age because of the calcium content and help digestion amongst other uses. And now for my home made brew…without fancy machines and stuff…

• Get your measuring cups, warm water, a clean dish towel,, some already made (store bought yoghurt with pro-biotics, an airtight container and milk. This recipe uses powdered milk
• Mix one cup of milk with 4 cups of warm water. Whisk it all up.
• Scoop out one cup of the mixture and add a quarter cup of your already made yoghurt with pro-biotics (Any already-made yoghurt will do, really)
• Then pour the mixture from the point above to the milk mixture and whisk.
• Pour in an air-tight container and cover with the tea towel.
• Do not move, mix or stir the mixture during the ‘setting’ process. Leave it for at least 4 hours. I usually leave mine overnight and wake up to a jar of fabulous home-made yoghurt!

So, mix up your own batch and after the first go, feel free to mix and match the recipe as you like. As you can see, there was no added sugar to mine  If you ant a healthy sugar kick, you can blend some fruits eg banana ith the yoghurt. Tastes….delumptious!

This recipe can also use bottled milk in which case it has to be warmed before (not boiled) before use and repeat all other steps as above.

Q: Good day ma’am, please, evaporated milk and powdered milk which is best for children of 4 to 8 years?

A: Hello there! Thanks for writing in. Although the baby in question is between 4 to 8 years, I’ll start the discourse from the time weaning starts – six months.

From six months, baby is ready to be introduced to some other food than just breast milk and water. For a long time, the standard teaching had been to go for rice cereal as the first add-on meal because it is bland and babies tolerate this well. Other studies question this wisdom now and suggest that foods like meats with lots of essential nutrients like iron may be a good place to start. What should you do? You can boil beef/chicken very soft and blend it up for baby. If baby tolerates this, then by the next week, you could try adding some rice cereal. Try not to introduce more than one food per week so that you have time to study how your baby adapts to it and of course, look out for/isolate food allergy. And, to start off, only one meal of the complementary feed should be given daily. The rest should be the usual…breast milk 😀 This will, of course, as baby tolerates.

Generally, foods to start off weaning should be just slightly thicker than milk and so, if it retains its shape on a spoon, it may be too thick.

From 9 months, baby can be allowed to start experimenting with regular family meals…minus the spices, of course 😀

From one year of age, you can add other regular cereals and it’s also okay to introduce regular cow milk at this time. Full cream cow milk is advocated at this time for proper brain development. Thereafter, please switch to skimmed/1%/2% milk as full cream milk has a lot of saturated fat which may contribute to poor heart health. Grains, green leafy vegetables, regular cow milk, honey, whole eggs can generally be introduced after the baby turns 1 year old. Should the milk be evaporated or powdered? Well, you missed out fresh – this should be the first choice. Failing that, either of the two (powdered or evaporated) will do. But be sure to reconstitute them properly because both have had some level of water removed from their content. As usual, it never hurts t hear from your baby’s dctor

Generally, other weaning foods that can be introduced include:
Boiled egg yolk (egg whites contain substances that baby may react to), sweet potatoes, fish, chicken, beef, fruits like banana, avocados, boiled beans (with skin removed if possible etc
Simple recipes include, blend some chicken or beef with the stock or mash a banana and add to baby’s cereal.

Our local cereals can also be used and fortified with some breast milk or formula.

As baby tolerates these meals, you can get a little more adventurous.

Boiled carrots mashed with some coconut oil or a little yoghurt with mashed banana may not go amiss too.

An example of a recipe I make for my children is boil potatoes in a pot and place a stainless plate on top of the pot. Add your egg yolk and a drop Olive oil and when the yolk is cooked and potatoes soft, mash all together and feed baby.

Now I know we are all very busy, but weaning is no easy task and so we must commit to trying as much as to prepare these meals ourselves. Packaged meals usually contain additives that may trigger problems/allergies etc in the baby. Hygiene is also critical!

All the best and whenever in doubt, consult your baby’s doctor.

Q: Hello Dr Ketch, please I want to know how to get rid of washer man’s finger. It’s really spoilt 6 out of my 10 finger nails. Thanks so much.

A: So sorry you are experiencing this. I can just imagine what you may be going through. From the description of your symptoms, it’s rather difficult to say exactly what is going on with your finger nails/ hand. The term washerman’s finger, which you used may have beclouded what you really wanted us to address. Then mentioning your fingernails being spoilt, gives it the picture of a fungal nail infection. There are quite a number of conditions that can affect the hands, fingers and the nails, some of which can be a bit challenging to diagnose and even treat. I would advise you see a doctor, who would be able to have a look at your hands, fingers and nails; examine them and then advice you on what to do.

Washerman’s hand is a skin condition in which the skin of the hands or feet loses its elasticity and tugor. There is wrinkling of the fingers and feet and they become white, like no blood is flowing in them. It is more pronounced after the hands or feet have been immersed in water for a long period of time.
Fungal infections are quite difficult to treat and can be very disturbing especially those affecting the nails. It can affect one or more finger or toe nails, more often the big toe or little toenail. It may cause white or yellow patches on the nail; the end of the nail may lift up, and there may be complete destruction of the nail. This will require antifungal tablets for months.

If any of these is what you describe, I would advise you avoid immersing your hands in water for long periods. If however, the nature of your job does not allow this, then getting a waterproof pair of gloves may be of some help. You can also moisturize the hands frequently with a moisturizing cream like coconut oil and keep them dry most of the time. Hope this helps!

****This post was contributed by a guest doctor blogger.

Have a great night, beautiful people