chatwithketch

Q: Please Doctor find time to give me a response. God bless you

I am 29 after an active sexual life I stopped having sex but just last year after 11 months the last time I had sex, resuming sex practice has been painful for me which after having sex I have pain and my vagina suffers inflammation on the body of the two inner closure of my private part and it is becoming disturbing to me and my partner. Please what could be the cause or prevention to it?

A: Pain during sexual intercourse is more common with women but can also happen in men. The first question above was sent in by a woman and the second one was sent in by a man. 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. This will be discussed some more at the end of this post.
• 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

In men, the cause of this problem could be due to:
• Infection of the urethra (the tube which conveys urine from the bladder out of the body and also conveys semen out during ejaculation)
• Infection of the prostate gland.
• Infections, some of which may be due to STI
• Emotional issues may also be involved eg feelings of guilt.

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.

For related topics, please click on https://chatwithdrketch.com/2014/08/22/daily-health-tips-why-am-i-not-into-my-husband/

I will spend a little time on vaginal dryness or inadequate lubrication. Vaginal dryness can occur due to variety of reasons and at any age. Usually the vagina has a thin film of fluid that coats it. This fluid helps lubrication during sexual intercourse, maintains the normal environment of the vagina preventing the overgrowth of organisms like fungi, flushing out dead cells and menstrual blood. The level of this fluid/moisture varies with the level of estrogen released in the body. During sexual intercourse, there is increased blood flow to the vaginal area leading to an increase in the volume of moisture. During menopause, however, the level of estrogen is very low leading to vaginal dryness, loss of elasticity and thinning.

The main consequence of vaginal dryness is the fact that it affects sex life such that these women experience significant pain and sometimes, bleeding. Other problems that vaginal dryness could cause include soreness, itching and burning around the vaginal area, recurrent urinary tract infections and frequency of urinating etc.

There are other conditions, other than menopause that can lead to low estrogen and consequent vaginal dryness. They include childbirth, breast feeding, cigarette smoking, some medications (like anti-estrogen drugs used to treat cancer) and douching. Douching refers to the practice of cleaning the vagina with a ‘cleansing’ fluid. For more on this topic, please click on this link: https://chatwithdrketch.com/…/daily-health-tips-what-is-dou…/

Other very common causes of vaginal dryness include a lack of foreplay during sexual intercourse, feelings of guilt, relationship issues, allergy etc

Treatment depends on cause. If it’s due to low estrogen, the focus would be on replacing this either through Hormone Replacement therapy or through the insertion of estrogen pessaries (tablets, cream or ring) into the vagina) should help. If due to rushed foreplay, there should be a conscious effort to slow down allow enough time for foreplay and sometimes, discussion with the partner may be helpful. Avoid heavily perfumed products like sanitary towels, tissues etc which may lead to irritation of the vagina and subsequent dryness etc.

Use of vaginal moisturizers can also help. Vitamin E may be useful as a vaginal moisturizer with the gel rubbed on the vagina.

Please discuss these with your doctor and don’t be embarrassed to discuss your symptoms with him 😀

I hope this helps.

‘A study shows that, for many people, less is more when it comes to vitamin D.‘ Now what do you think about that?! Read!

https://www.health.harvard.edu/staying-healthy/too-much-vitamin-d-may-harm-bones-not-help

Dear all, it is the season for the sniffles again. it always boggles my mind how the hygiene practices that we take for granted are not really known and practiced by everyone. For instance, sneezing or coughing into ones hands and then going around touching doors, shaking hands and touching other surfaces is a quick way of sharing ones germs with others. Please don’t do that! A reminder class below on how not to share your germs with others:

Okay…so no one loves to have the sniffles; carrying tissues around and sneezing/blowing our noses into tissues and just feeling miserable! We hate even more when we are in the uncomfortable position of ‘rejecting’ a handshake because we want to avoid getting infected by someone who has the flu.
Here are top tips for escaping the cold and flu as it makes its rounds:

• Wash Your Hands: Wash your hands with anti-bacterial soap for at least 20 seconds…time taken to sing happy birthday twice. Use safeguard soap and this will not only remove millions of bacteria but stop their re-growth for at least 12 hours. Dry your hands thoroughly.

Get a flu shot: This may not be perfect and certainly does not protect everyone, but you do have more of a chance of beating the flu with it than without it

• Live healthy: A balanced diet, regular sleep and exercise work wonders for your immune system and helps you resist the flu.

• Cover your cough: Don’t sneeze into your hands…you’re more than likely to see someone you know and shake them soon enough…spreading your germs. Rather sneeze or cough into the crook of your arms. This limits significantly the spread of germs.

• Give that immune system of yours some extra boost by:Taking a break from stress. Stress messes with your ability to stay healthy, especially during cold and flu season. Try taking a mini meditation break during the day – just close your eyes and focus on breathing in and out for a few minutes.

Trying to stick with a bedtime. Consistently getting eight hours of sleep a night gives your body the chance to repair cells and build up your immune system.

Please spread this news and let’s stop the spread of these nasty viruses 😀

Happy New Year Fam.

I trust the year has started well and you are all set to impact your world this year and decade!

And now, our question for today which is the second part of a question I addressed last week, I believe.

Q: I have pains from my left shoulder to fingers most time and slurp (I assume this means drool) morning saliva. I am 65 years. Please can you give tips of stroke and signs?

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.

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 arms – 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. Symptoms like yours located on one side of the body are therefore suspicious. I suggest you get a doctor to check you out properly.
• S stands for speech difficulty like slurring. Patient cannot enunciate words properly again
• T stands for time. Once these symptoms are noticed, 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. Symptoms like yours located on one side of the body are also suspicious. I suggest you get a doctor to check you out properly.

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.

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.

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.

The person recovering from a stroke may need to walk with a stick as s/he re-learns the art of walking. Recovery may be long and tedious but s/he’s got to keep at it.

I hope this is helpful

Have a good night, people 😀

Dear Family,
As we come to the end of the year and decade, I reflect on my journey.

Where I’ve been and what I’ve seen.

Where I succeeded and where I failed.

What I feared and the strengths I developed

If I had to say anything to my 10-year younger self, it would be: Go on! Dare to do it! Do it afraid! Whatever you do, just do it!

My journey could have been faster but who knows, i may not have learnt as much as I have. I may not have dared to dream the dreams I have dreamed and may not have achieved what I have.

And so, as I stand on the threshold of a new year and new decade, I urge you as I urge myself to dream dreams that are so big that they scare you and then get to work achieving them one at a time. There will be obstacles (expect and anticipate them) but when they come, understand that you will overcome them – spend time to understand the challenge, and then find a way to deal with them or work around them. Sometimes, you may fail, but that’s okay too – make sure you learn from them and ask yourself what you would do differently another time.

Happy New Year and bon voyage as we wait to take the first step into the new decade! If you have already taken that first step, Godspeed!

With Love,

Dr. Ketch

Q: My questions are what signs & causes of a low sperm count & watery sperm? Do they have any remedy? Can they fertilize egg?

A: Thanks for writing in.

One of the causes of ‘watery’ sperm is pre-ejaculate (a lubricating fluid) which may contain some sperm cells. It is believed that the sperm in the pre-ejaculate is not there at the time the fluid is produced, but is sperm from previous ejaculations that was probably left in the urethra. It is thought that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations. Diets poor in protein, frequent ejaculation as occurs in people who masturbate and exposing the testicles to high temperatures like in saunas could lead to a watery consistency of semen.

Just to be sure you do know what normal semen should look like, below is a guide.

Using WHO reference values, a normal semen sample should fulfill the following:

• Volume amount of sperm produced in one ejaculation): Greater than or equal to 1.5 ml
• pH (whether acidic or alkaline. If less than 7, it’s acidic and greater than 7 is alkaline): Greater than equal to 7.2
• Viscosity (being semi-fluid):  viscous
• Transparency: opaque
• Motility (percentage of sperm that move forward normally):  This should be more than 40%
• Morphology (percentage of sperm that have normal shape): This should be greater than or equal to 15% normal, oval sperm heads
• Liquefaction (time taken for the semen to become ‘liquid’): This should be complete within one hour
• Pus cells should be less than 1 million/ml or less than 5/hpf
• Total sperm count: This should be greater than or equal to 15 million.

The causes of low sperm count, which is often considered a cause of watery sperm, could be medical, environmental or due to lifestyle issues. Sometimes, the cause(s) can, also not be identified.

Medical causes include infections like gonorrhea and chlamydia, certain drugs used for cancer and fungal infections, hormone imbalance, undescended testes, varicocele (swelling of veins that drain the testicle) and cancer.

Environmental causes include over-exposure to industrial chemicals, heavy metals and X-rays; over-heating the testicles by frequently using the sauna and hot tubs; prolonged bicycling

Lifestyle causes include alcohol use, tobacco smoking, illegal drug use, obesity and emotional stress.

To get a woman pregnant, a man has to have at least 40 million sperm per ejaculate. People with low sperm count usually have less than this.
If you have been diagnosed with low sperm count, then do something about it. Here are some tips that could help to improve your sperm count. Treatment is generally based on the cause:
Stress has been found to contribute to infertility problems such as hormonal issues. So, prevent excessive stress and perform relaxation exercises. Remember that infertility and life in general can be stressful. Learn to relax.

Stop smoking because smoking significantly reduces both sperm count and the movement of sperm cells.

Prevent overheating of the scrotum: When scrotal temperature rises (caused by tight underwear, long stays in a sauna or Jacuzzi, for example) sperm production can be impaired.

Maintain a healthy weight: Not too under or overweight since weight influences estrogen and testosterone levels.

Stop using drugs: Prolonged use of recreational drugs (for example, alcohol, marijuana, cocaine)

If you have infections like gonorrhea and chlamydia, these need to be treated.

Surgeries can be done for varicocele and cancers. Radio and chemotherapy are also treatment options for cancer.

Medications or hormone replacements can be used for hormonal problems.

The major challenge with low sperm count is infertility. Sometimes, the treatments listed above do not work, especially when the cause is not known. But IVF is an option that exists for this group of people.

So, first thing is to confirm from the doctor what exactly the cause of the low sperm count is (if known) and then review your options from there.

All the best.

‘Women at high risk for breast cancer might benefit from taking medication to prevent the disease, says a new recommendation from the U.S. Preventive Services Task Force (USPSTF), a national group of experts’

Want to know more? Read! https://www.health.harvard.edu/womens-health/high-risk-for-breast-cancer-you-might-benefit-from-preventive-medication

Q: Dr. please why sweating profusely is on with me? My BP always 150/100 but thank God, it was 139/90 on my last clinic. Question 1) early headache between 4-6am. 2) pains from my left shoulder to fingers most time and slurping of morning saliva. Age 65yrs. Please tips of stroke and signs.

A: Thanks for writing in. There are a number of questions here. We’ll take some today and the others tomorrow.

Sweating is normal during strenuous physical activity and in warm weather. In fact, as we sweat and it evaporates, we actually feel cooler. Unfortunately, for some people sweating is an issue as they ‘appear’ to pour the stuff by the buckets or would start the day with patches of sweat on their under-arms etc. This inevitably leads to body odour.

However, there may be other medical causes for your sweats. Symptoms that may suggest medical causes include night sweats, generalized sweating all over the body, worsening sweats etc

Medical causes of excessive sweating include Diabetes Mellitus, Stress, thyroid problems, pregnancy, menopause, cancer, obesity, alcoholism etc. Medications have been implicated in excessive sweating and a spinal injury may cause sweating on one leg. Discuss this with your doctor and he will be able to isolate the cause.

On headaches…my firat question is whether you are getting enough sleep? This is enough to give you a tension headache! This is the more common type of headache seen as the everyday sort of headache. It affects both sides of the head as a constant ache. Its causes are not very clear but they can be triggered by stress, hunger, dehydration, etc They can last a couple of minutes to several hours but are not severe enough to stop regular activities. Resting and sleeping well, eating properly and staying hydrated can help prevent this.

Other common causes of primary headaches include:

Migraines: These are felt as severe throbbing pain at the front or side of the head. Some people may experience other symptoms like nausea, vomiting and being sensitive to light. The pain lasts from a couple of hours or can stretch on for days. Thus, it is more severe than the tension headaches and can stop an individual from carrying out their daily tasks. Some find that they need strong medication prescribed by doctors to get relief but others are relieved by using over the counter medications.

Cluster headaches: These cause severe pain around one eye and are associated with red or watery eyes and a blocked nose or runny one. They tend to occur for one or two months at a time at about the same time of the year. Most times medications do not work for these headaches. Your doctor will prescribe specific treatment courses.

Chronic daily headaches may be due to medication overuse. This would occur in people who use pain medications too often and then end up with rebound headaches…the exact condition they were trying to avoid. Moral of the story: Never abuse your medications J Use only as directed by your doctor.

Sex headaches: Yes, this can occur. It’s also known as post-coital headache, orgasmic headache etc. It could occur during sexual intercourse, during orgasm or after sexual intercourse. And it can also occur at any time of the day and during any type of sexual activity. It is felt at the back of the skull just above the neck and is usually described as throbbing. Or it could build up gradually during sexual intercourse and intensifies as the sexual excitement before an orgasm increases. They can last anything from a few minutes to a few hours; may never recur or may happen a couple more times before gradually fading away.

It is thought to be due to the release of adrenaline and rapid rise in blood pressure which occurs as one approaches orgasm. And so in these cases, the headaches may not be a cause for concern. However, it is also a possibility that these headaches are a sign of a more serious condition like bleeding onto the surface of the brain.
People who usually have migraines, who use recreational drugs like marijuana, use birth control pills etc are more likely to have sex headaches.
Should you swear off sex? Yes, if you’re unmarried And no, if you’re married;) If you have just experienced this, try lying quietly for about an hour or two after taking an analgesic (like paracetamol) to handle the pain. However, it is very important to see your doctor as soon as possible to let him/her know what happened. This is important because, while there may very well not be any underlying issue, you want to be sure to rule out any serious medical condition causing these headaches. Your doctor will also prescribe some drugs on a regular or intermittent basis to deal with your symptoms.
Primary headaches may be triggered by stress, skipped meals and dehydration as noted above. However, they may also be associated with alcohol, foods that contain nitrates like spinach and bad posture.

Secondary headaches may be due to dental problems, hangovers ear infections, blood clot in the brain, wearing tight gear on the head like hats or even wigs (yes, I see you ladies :D) or even eating cold stuff like ice creams etc.

So, what should you do? If you find that tight head gear or eating ice cream is the problem, see if stopping helps.

If you find that these headaches are now more frequent than usual, more severe than usual, stops you from going about your daily activities, is no longer responding to the over the counter medications you used to take etc, please see your doctor. If you have been seeing the same doctor, as it appears to be in this case, with no relief, please seek another opinion or request a review by a neurologist.

We’ll get to the rest of your questions tomorrow.

Have a goodnight y’all 😀

Q: Good day ma’am, how can one treat blocked fallopian tubes & what is “polyp’?

A: I do not know if both tubes were damaged or how much damage was done to the tube(s), but 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. 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 minutes. 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.

Your question can also mean that you had tubal surgery and now wonder if you can get pregnant. Tubal surgery is usually done for people who have:

• Had pelvic inflammatory disease (PID). For more on this, please click on this link: https://chatwithdrketch.com/2014/09/22/daily-health-tips-what-is-pid/
• Had abdominal surgery like surgery for ectopic pregnancy. For more on this, please click on this link: https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/
• Pelvic tuberculosis.

The decision to undertake repair with tubal surgery depends on the degree of damage. The doctor could decide to open up the blocked tubes with surgery or breakdown scar tissue that may have formed due to infections from PID. Again, pregnancy after this is not guaranteed and depends on the skill of the surgeon (ask for a surgeon who is specialized at this), the age of the woman, degree of tubal damage at the very beginning, the level of damage to the inner lining of the tubes which cannot be corrected etc

So, I suggest you book an appointment to see your doctor and have a long discussion on options open to you.

Remember that adoption is also an option to consider.

I wish you all the best and I’m giving you a huge hug with my heart right now 

On polyps, you will need to provide more details like where the polyps are located.

Good night y’all 😀

I love Christmas! My children will tell you, I love everything Christmas – decorations, carols everything!

Do you have Christmas traditions? We do! Christmas starts for us with a Christmas Eve dinner where we plan an elaborate menu, really dress up to eat and each person opens their smallest gifts from under the Christmas tree. Then we do a bible study centered around Christmas. Some years, we listen to performances by the children (guitar, piano and/or singing). At some point, we will all crash out in bed. So, Christmas morning typically starts late and lazy.

I have always said I would like to wake up on Christmas morning to the sound of my favorite Christmas songs…only that for me it’s favorite Christmas song (singular) 😀 I love the song in question so much I could play it the whole day! I drive my children crazy playing it again and again and yet again! This year, I got my wish….woke up to the beautiful sound of ‘Mary, Did You Know?’ by Pentatonix. Heavenly! Do you know this song? I fell in love with it since 2016 and it’s been a consistent love affair, every Christmas! Can’t seem to want to listen to anything else 😀

So, now I share it with you, my family. 😀

Merry Christmas! May His birth bring renewal into any dead or struggling area of your life!