chatwithketch

Q: Good morning doc. Please doc, I am 23 weeks pregnant and according to the test I ran, my blood level is just 32 which they said that it is low. What can I eat to boost it? I mean as a pregnant woman, my blood is low, 32. How can I increase it?

A: Congratulations on your pregnancy!

Have you always had anaemia/low blood level? Or have you just had malaria? If you have had malaria, a frequent cause of anaemia in our environment, to build up your blood,  your doctor will ensure that the Folic Acid dose you’re getting in your prenatal drugs is not more than 0.4mg. Doses of Folic Acid higher than or equal to 5mg affects the efficacy of the anti-malarial, SP. So, be sure to check with your doctor before you start buying other non-prescribed prenatal vitamins.

Other nutrition tips that will be useful for you include:

I’m sure you know about insecticide –treated nets…and probably still don’t use them because of the heat 

 Well, if you have nets on your windows too and have a good fan (praying that you’ve got electricity to power it), it is not really so bad. Some people react to the chemicals in the insecticide and so for these ones you may want to air the net outside for a couple of days before you start use. To encourage your children to use them, you could work it into the décor of the room and make them look like nice, funky four poster beds!

Be sure to fumigate your house to rid them of mosquitoes and other creepy crawlies. Ensure the vendor tells you what chemicals will be used, how long you need to be away and whether it’s compatible with artwork etc. Cover up foodstuff and take off beddings etc. and then do a major clean up afterwards.

Did you know that the buckets of water used to store water in areas where pipe-borne water is not constant, can be a huge source of mosquitoes? Have you observed them rising from these buckets of water when you approach in the evening? If you have to store water, get covers for them and ensure they are closed all the time.

Did you know that if your bathroom drain is blocked, apart from the fact that it’s unhygienic, the water there also acts as a comfortable home for mosquitoes? So, ensure that your drains are free-flowing with no stagnant water. Keeping it smelling nice and fresh is also a good touch ;D

Did you know that your flower pots with lots of water also serve as a breeding place for mosquitoes? The water used on the flowers should be completely absorbed by the soil with none left on top. Watch out for lazy helps who want to do a month’s watering in a day 

Did you know that the unwashed drains and gutters outside, bushy lawns, potholes and broken concrete slabs serve as lovely homes for mosquitoes? Be sure to clean up your environment often.

Have a good night, y’all 

QL Please doctor my husband is suffering from arthritis, swollen and painful leg, Please any remedy??

A: I believe that a doctor made the diagnosis of Rheumatoid Arthritis and that’s why you are sure that’s what your husband has. Over time, I have heard people use the term rheumatism (which is a lay term that is not really used in the medical world anymore) for osteoarthritis or rheumatoid arthritis. I will briefly describe both conditions.

Rheumatoid arthritis is an auto-immune condition. This means that in this situation, the body no longer recognizes components of itself and its immune system begins to fight itself. In other words, the body launches a war against itself!

In this instance, the body’s fight against itself leads to joint pain, swelling and stiffness, especially in mornings and can lead to permanent damage. It affects multiple joints, can involve multiple organs (eg lungs, heart, eyes etc) and there are usually nodules (small lumps known as rheumatoid nodules) found under the skin, especially the elbows. Some people are lucky and have long periods between flare-ups; others are not and have symptoms often. This disease is more common in people aged between 40 to 60 years, women and if a family member has it, it’s more likely one may also have it.

There is no cure as it is not clear why the body turns on itself. The focus is on management of the symptoms: Physiotherapy to keep the joints supple, medications to take care of the pain and inflammation and sometimes surgery for joint repair or replacement.

For anyone who has this condition, be sure to take your medications, eat healthy, exercise and learn to relax 😀

Now to osteoarthritis (OA), this is a more common type of arthritis. It would usually occur due to wear and tear (ageing) of the cartilage at the end of bones which allows free movement at the joints. The knees, hips, neck, lower back are usually affected and symptoms would include stiffness, pain and swelling. This disease is common in older people, women and the obese (clearly, being obese puts more stress on the weight bearing areas of the body like the knees etc), some types of occupation eg people who carry a lot of heavy loads are more likely to have osteoarthritis of the lower back. A family history of OA puts one at risk and having some diseases like Diabetes Mellitus makes one more at risk.

Where this disease affects the knee, it can lead to bow-leg and limping as the cartilage continues to wear away with even more wear and tear. Just like for RA, there’s no cure. Focus is on limiting pain and maintaining joint movement.

Treatment includes pain relief (using drugs in the class of ibuprofen or Paracetmaol), physiotherapy and sometimes, surgery. Injection of steroids into the joint space of affected joint has also been found useful but cannot be given too often.

Just like for RA, exercise, eat healthy, keep a healthy weight, use support (like walking stick) if need be etc

I hope this was helpful.

Have a good night, everyone 😀

Q: Good day Dr Ketch. Though I don’t know how the online consultation works but I really need to talk with you. I am on a contraceptive and have been bleeding for close to a month now; am scared I might become anaemic soon. I look forward to my appointment with you on Friday. Thanks ma’am

A:Hi dear, if you want an online consultation, you come to my inbox and click on get started and follow the prompts to make an online or offline payment. These appointments provide an opportunity for in-depth one-on-one discussions about specific cases. Apologies we didn’t respond to this on time. I will answer your question here but please feel free to book that appointment again if you want a one-on-one and specific issues addressed

You didn’t tell me what sort of contraceptive you used. I will hazard a guess and say it’s the contraceptive implant.

The contraceptive implant, as the name suggests, is implanted under the skin….under the skin of the upper arm and protects against pregnancy for about 3 years.
This birth control method contains the hormone progestin which prevents the egg from being released from the ovary (if there’s no egg, then there’s nothing to fertilize, right? :D) and also makes the mucous in the uterus so thick that the sperm cannot sperm cannot swim through to get to the egg, even if it were released!

This method of birth control is good for breastfeeding mothers (because it does not contain estrogen which affects mother’s breast milk production) and is long lasting such that the woman does not need to take pills every day. However, this implant can cause unwanted side effects. While some women would have heavier, prolonged periods, some others experience fewer and lighter periods. Indeed, some may stop seeing their periods after one year of use. Other side effects include headaches, nausea, mood change, nausea, acne, infection at the site of insertion etc. These symptoms would usually stop within the first few months (3 to 6 months). If, however, these continue or you experience severe headaches or excessive bleeding as in this case, please see your doctor.

Please note that, this method is not suitable for women with breast cancer.
If you experience a new lump in your breast, yellowing of the eyes, you have concerns about the location of the implants or just have questions to ask, please see your doctor.

I hope this helps.All the best!

Q: Good evening ma’am. Please ma’am, for someone that was given an episiotomy how long is she supposed to sit on warm water? If she undergoes stitching of an episiotomy twice due to opening of the 1st stitch, what can be applied on the surface or taken for quick recovery?

A: Sitz bath is a warm water bath that helps cleanse the perineum. Just in case you wondered, the perineum is that space between the rectum and the genitals. The right temperature is the one that you can handle without sustaining burns. Putting a few drops of this water on the inner surface of your wrist can help confirm this.
Plain warm water is sufficient but some people add salt to the water which is soothing. Your doctor may also suggest other things he/she may want you to add to the water.

To prepare this, you can either use the plastic Sitz bath kit, (a special bowl specifically made for this which fits on your toilet seat so you can sit down easily on it), or your bath tub. Be sure to thoroughly scrub your plastic Sitz bath kit or bath tub before and after use. If using the bath tub, add sufficient warm water to sit on and then get in. To get the job done properly, you can try hanging your legs out of the tub. Usually, you are encouraged to sit for 10 to 15 minutes on the water. Pat the perineal area dry after you’re done. Do not rub vigorously…remember the area is sore and if you’ve had stitches, it could mess things up 🙂 This can be repeated up to 3 to 4 times daily as needed.

To ensure that the episotomy site heals well, use prescribed pain medication, avoid sitting on hard surfaces. Try using a pillow ( a regular or circular one/boppy pillow). Avoid constipation and indeed diarrhea and try placing a pad over the suture area while bearing down to poop. Urinating presents a challenge as pain is experienced during this process. Try using water to rinse off afterwards, preferably using a squirt bottle.

Eat healthy, keep the surgery site as clean as possible and enjoy your time with your baby. This too shall pass. Be sure to let your doctor know if you have concerns.

Have a good night y’all 

Q: How can high blood pressure be reduced besides taking bp tablets?

A: To reduce your risk of high blood pressure, incorporate these lifestyle measures:
Reduce your intake of salt. Use salt sparingly while cooking and there should be no added salt after cooking. Remember that there are hidden sources of salt that we probably don’t think of like in salted nuts, processed foods like bacon and sausage, chips etc

Eat less oil. If you have to use oil at all, be sure to do so sparingly. Even the heart healthy oils are loaded with calories.

Eat more fruits and vegetables as they contain loads of goodness. They also ensure that you do not pile on excessive weight that may also predispose you to high blood pressure.

Exercise or make sure that you are involved in activities for at least 150 minutes every week. This could be in the form of going to the gym or doing other activities that you enjoy that will add to your activity chart for the week. You could dance, skip, run, hike, climb stairs instead of using elevators etc.

Quit smoking and reduce your alcohol consumption.
Learn to cope with and manage your stress better. Stress is a part of everyday life and it is practically impossible to live without stress. What we can do is to manage our response to our everyday stressors.

Remember that high blood pressure is a silent killer and really doesn’t give any signs. If your friend is having headaches attributed to high blood pressure, then he really needs to do something NOW. Please let him go see his doctor to make a proper diagnosis and then recommend appropriate treatment.

For related posts, please click on these links:
https://chatwithdrketch.com/2014/06/12/daily-health-tips-pre-hypertension/

Daily Health Tips: My High Blood Pressure Risks

Have a good night, people 

If you’re a parent, how do you give your child his/her medication? With a table spoon? Teaspoon? The dosing cup that comes with the medication? M mum taught me how to position the dosing spoon on the corenr of the baby’s mouth and settle in for the long haul. No matter what the baby did, he could not control the trickle of the med down his throat and he had to swallow. And then muh later, I learn the dosing syringe trick.

What tricks did you learn from your mum on how to do this?Do you oftentimes wonder whether you are giving the right does? You should read this!

https://www.health.harvard.edu/blog/2-simple-ways-to-ensure-you-give-your-kids-the-right-dose-of-medicine-lots-of-parents-dont-2016091310350

Q: Good day doctor. Good work you are doing here. God bless you. After 4 months miscarriage on September 5th. The breast milk continue to run. Please what will I do to stop it? Or is it normal. Thank you ma’am

A: Condolences on your loss! I cannot imagine what you are going through. Please make out time to mourn your baby and then as soon as you can, open up your heart to the possibilities in your future. I hope you are surrounded by loving supportive family and friends. Hugs 

Sometimes after a miscarriage, the body does not quite recognize that there is no longer a need to feed a baby. And so, it just continues to produce milk.

Now, for stopping milk production:

In the good old days, mothers would tell their daughters to tie a wrapper tightly across their breasts. This helps. In fact, I believe that this is still being done by lots of people. If you’re more jet age, though wear a firm supportive bra, night and day.

For the pain, take analgesics and also apply cold packs to your breasts. These cold packs can be packs of frozen veggies or even cold cabbage leaves. For the latter, wash the cabbage leaves and put them in the fridge. Remove the areas that have big veins as they may hurt your tender breasts. Put this cold cabbage leaves in your bra and change to another set of cold ones every 2 hours or when the cabbage leaves feel limp.

Try not to stimulate the nipples during this period. Use a breast pad to prevent leakages.https://c0.pubmine.com/sf/0.0.3/html/safeframe.htmlREPORT THIS AD

If you find that your breasts still fill up, then express some breast milk. Express until you fill comfortable…not until you empty out the breast.

Keep hydrated and try to lie on your back or your side when sleeping.

Now, I’m a bit worried about the fact that it sounds like you’re feeling feverish. If that is so, if may be that there is an infection of a breast duct (mastitis) such that the skin over that area feels hot to touch, reddens, mum feels feverish, ill and aches all over. This infection is usually treated with a course of antibiotics, which will be prescribed by your doctor.

I suggest you see your doctor, if this condition continues an you need reasssurance.

Your baby will always have a special place in your heart. And you will yet smile….very soon.

Loads of hugs…

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