chatwithketch

Hey! Thought to share this again.

Q: Hello Doctor, thanks for being a source of medical education to most of us. Please, I would like to know if it is normal for a baby’s navel to get bigger. My boy is 7 weeks old and his Navel is getting bigger than it was after the normal birth treatment. My daughter presses it in my absence. Could it be the reason for it to get bigger almost by day? Again he stretches a lot…could that also be the reason? I’m just curious ma’am. Thanks for being there to lean on.

A: It does sound like your baby has an umbilical hernia. Don’t go shouting and screaming just yet! It’s probably not as horrible as it sounds. It looks all dramatic any time the baby cries and does appear to ‘swell up’ causing parents to panic. But, it usually closes up on its own by the time the baby turns 1 year though some may last slightly longer. If this persists up till the age of 3 years, please see your baby’s doctor.

Now, what’s a hernia? This is the protrusion of an organ or its covering through the wall of the cavity that usually contains it. There are different types of hernias (or herniae) and they include:

Inguinal hernia: The most common type of hernia. It usually happens in situations where the pressure inside the abdomen is increased.

Other hernias include incisional hernia (where a protrusion develops from the site of a previous surgery, especially abdominal surgery), femoral hernia (which has the same risk factors as inguinal), umbilical hernia (common in black children where the umbilicus, aka navel does not form a small ‘button’ on the abdominal wall but protrudes) and hiatal hernia (where the stomach squeezes through a hole meant for the oesophagus (the pipe through which food gets to the stomach).

Typically, all hernias are caused by a weakness in the wall of muscles or containing cavities and an increase in pressure. Examples of activities that increase pressure in the abdomen are long standing cough or frequent sneezing, carrying heavy loads regularly, straining at stool whether due to constipation or diarrhoea etc. The walls of muscles are usually weakened in people who are obese, pregnant women, smokers and malnourished people. It is also more common in men and as people grow older.

What are the symptoms? People with hernia would usually notice a protrusion after a strain eg lifting something heavy or coughing. Sometimes, they are able to push it back. Other times they are not. The worry about hernia and the reason why they have to be treated quickly is that they may strangulate. Yes, just think about the word strangle and you understand what strangulate means  The protrusion may become squeezed by the opening through which it passes blocking off blood supply to the area protruding. Once a part of the body is deprived of blood, it dies. We don’t want that to happen 

The decision as to whether to go for surgery or not depends on where the hernia is located (inguinal and femoral hernias usually need surgery), the contents of the hernia sac and the symptoms. A truss (a supportive device that prevents enlargement of a hernia) may be prescribed by your doctor to help for a short period of time. Typically a doctor will schedule a surgery to repair a hernia. Complaints of pain in a hernia patient may mean strangulation, which need to be dealt with immediately. Umbilical hernia does not usually require surgery as the protrusions usually ‘return’ on their own. If this persists beyond 5 years, then surgery may be needed.

If you do require surgery, you don’t need to fret about it…really. This is not major surgery…it’s intermediate (sort of like half way between minor and major :D). Your doctor will provide answers to all the questions you have and of course, counselling. There are options for laparoscopic surgery which is surgery done through small incisions guided by a camera.

Preventive measures include having a healthy weight, giving up smoking, treating conditions that may lead to long standing coughs, eating healthy to prevent straining at stool etc.

So, peeps, you can’t dodge this stuff. It’s healthy living and eating all the way  Have a great weekend.

The Novel Corona Virus is a member of the corona virus family that causes illness ranging from the common cold to more severe diseases. It is novel because it is new – we are just trying to understand more about it.
Although the first cases were seen in China, a couple of other countries have since reported cases too. So, this concerns everyone! How do you stay safe? Well read the advisory below from the WHO website:
WHO’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows, which include hand and respiratory hygiene, and safe food practices:
Frequently clean hands by using alcohol-based hand rub or soap and water;When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;Avoid close contact with anyone who has fever and cough;If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.
Stay safe!

‘As we age, our digestive systems can become more sensitive to certain types of foods and methods of food preparation. While you once may have handled the spiciest of foods without breaking a sweat, now that super-hot chicken curry gives you the digestive drama known as diarrhea—uncomfortable, unformed, watery stool.’

‘Learn how to identify the foods or ingredients that give you the runs.‘

Read! https://www.health.harvard.edu/digestive-health/is-something-in-your-diet-causing-diarrhea

Q: Hello Dr Ketch! I’ve been suffering from pile for the past 3 years and earlier this year I’m feeling much to the extent that I can’t sit down very well. Please, I need help

A: 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.

Have a great evening 😀

‘Over-the-counter pain medicines that contain caffeine can be effective at stopping some headaches. But drinking a large amount of caffeinated beverages might actually trigger a headache for some people with migraines, according to a study published in the August 2019 issue of The American Journal of Medicine.’

Do you want to know more? Read! https://www.health.harvard.edu/diseases-and-conditions/troubled-by-migraines-cut-back-on-your-caffeine-drinks

Q: Dr Ketch, there is something I want to tell you. Many years ago I had abortion. After the abortion, I do see surgical threads in my private part when I am menstruating. I went to the hospital to complain about it but when the doctor inserted his finger inside my Private part he didn’t see anything. Now that I am married am still seeing it. Please, what should I do?

A: Hello!

It is strange that you are seeing surgical threads years after surgery. Do you have any other symptoms? Pain? Discharge? Swelling? I suggest you go to another OBGYN for a second opinion.

Q: Can abortion prevent me from conceiving?

A: Some abortions (termination of pregnancy) involve instrumentation (like Dilatation and Curettage – D and C). In a situation where the procedure was too ‘vigorously’ done or even in situations where the placenta attached too deeply into the womb making it difficult to remove retained tissue). a condition called Asherman’s syndrome can occur. This manifests as reduction in menstrual flow. Severe forms of pelvic inflammatory disease (PID) can also cause Asherman’s Syndrome. For more on PID, please click on this link: https://chatwithdrketch.com/2014/09/22/daily-health-tips-what-is-pid/

In Asherman’s Syndrome, adhesions/scar tissue form inside the womb or mouth of the womb, cervix. This leads to stocking together of the front and back walls of the womb. Asherman’s Syndrome can lead to infertility, miscarriages, growth retardation of babies in the womb, placental problems etc

So, yes…abortions may lead to infertility if instrumentation like D and C is involved.

Have a good night, people!

‘A study published in JAMA provides some insight into the degree to which 10 specific foods and nutrients affect the risk of dying from cardiometabolic disease like type 2 diabetes, heart disease, or stroke’

Want to know the 10 foods and how they protect you? Read! https://www.health.harvard.edu/blog/10-foods-that-may-impact-your-risk-of-dying-from-heart-disease-stroke-and-type-2-diabetes-2019100717965

‘You hear it all the time: the advice to “eat less processed food.” But what is processed food? For that matter, what is minimally processed food or ultra-processed food? And how does processed food affect our health?’

Want to know more? Read! https://www.health.harvard.edu/blog/what-are-ultra-processed-foods-and-are-they-bad-for-our-health-2020010918605