chatwithketch

Q: Hey doctor, is it possible to ‘fall’ pregnant with a contraceptive implant in the arm?

A: The short answer is yes, but rarely.

For those who do not know, 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 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 your experience severe headaches or excessive bleeding, 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.

Although this contraceptive is more than 99%effective, less than 1 out of 100 women who use the contraceptive implant for one year will get pregnant. If this happens, there’s a high risk that the pregnancy will be ectopic (implantation of a fertilized egg outside the uterus). However, given the more than 99% effectiveness, cases of ectopic pregnancy are rare. For more on ectopic pregnancy, please click on this link: 

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

So, the brief answer to your question is, ‘yes, pregnancy can happen with a contraceptive implant in place, but it is very rare’. I suggest you go see your doctor for a proper examination.

All the best!

Q: Good evening. Trust you are well. Kindly advise. I have just confirmed that I’m pregnant.  I’m a bit scared, I lost my pregnancy this year in march. It was about 5 months; it was one painful ordeal. My doctor told me to rest and not to get pregnant soon but I believe God has good plans for me. It came unexpected and I’m here embracing it well. Kindly advise – how can I take care of myself.  Thank you

A: Oh sweetheart, condolences. I feel really sad that the miscarriage happened! But it’s all good

There are no standard answers really, as to when to start trying to get pregnant after a miscarriage. If this is the first time you’re experiencing a miscarriage, some doctors still advice people to wait 3 to 6 months before trying again so that it’s easier to date the pregnancy etc. Others will just ask you to wait until you’ve had one menstrual period

It is normal to feel worried and a bit scared going into another pregnancy, but you have to trust that all will work out well this time. Surround yourself with good professionals (OBGYN) and loving family/friends. Then relax and enjoy the ride 😀

Generally, food focus during pregnancy is on the same things you ate before you got pregnant…assuming you were eating right :D. More fruits and veggies, complex carbohydrates (they are rich in fibre and keep you feeling full for a longer period of time) like beans, oatmeal, sweet potatoes, brown rice etc. Load up on proteins too (fish, chicken etc), calcium rich foods like yoghurt, skimmed milk etc

Eat 5 small meals a day: breakfast, snack, lunch, snack and dinner. This should keep the hunger pangs at bay and deal with the cravings. You probably will still crave stuff: Iyaalamala’s food 😀 , ice cream with all the toppings, a ‘ginormous’ (for the uninitiated, this is a word formed from a mixture of gigantic and enormous. Cute, right?) burger etc. and guess what? You can give in once in a blue moon, just don’t make it a habit! If you take in more calories than you need, you run the risk of having a big baby with all the complications associated with that during pregnancy and delivery and of course, it’s harder to get back to your pre-pregnancy weight after the baby.

I hope this helps.

All the best!

Have a good night y’all 😀

Q: Please Dr I need your help because I can’t sleep at night

A: Sleep problems may show up as difficulty falling asleep, difficulty staying asleep if one wakes up in the night, waking up too early and being unable to fall back asleep or waking up feeling very tired etc. This is called insomnia. These problems may (secondary insomnia) or may not (primary insomnia) be related to other health/disease conditions. Usually this person wakes up extremely tired and feels sleepy during the day. Women over 60 years of age are more prone, people who are stressed and travel long distances across time zones are also more likely to have insomnia.

This can be due to events of sudden onset like work or emotional stress, jet lag after travelling across time zones, medications, late meals, taking a lot of caffeine, alcohol and smoking etc. It can also be of a longer duration when the person finds himself unable to sleep for about 3 nights per week. The causes of the latter include depression and stress that has been going on for some time (divorce, death of a loved one etc). Other causes include medications, anxiety, pain or discomfort etc.

Treating insomnia depends on the cause. Your doctor may provide some counseling in helping you or could give you some drugs to help you relax for a short period of time…so you don’t get dependent on them. He may also want to try some behavioral therapies with you.

Insomnia without underlying medical conditions can be treated with lifestyle modifications like the under-mentioned ones:

• Have a regular sleep routine that allows you (an adult) about 7 to 9 hours of sleep daily. Go for the higher limit, by the way 😀 
• As much as you can, try sticking with a particular sleep schedule so that your body falls into that pattern
• Limit day time napping. Save it all up for the night 
• Limit your intake of fluids before bed to avoid waking up to urinate and being unable to get back to sleep.
• Cultivate good sleep habits (no TVs in room, no work before bed time, a warm bath before bed etc).
• Lay off the caffeine and alcohol before bed time too.
• Regular exercise helps relieve everyday tension but vigorous exercise before bedtime may lead to inability to sleep too.
• Make your room a haven for sleep and clear out all clutter and be sure that you have invested in a good mattress and pillows. It’s a good idea to ventilate the day’s issues before you actually start getting ready for bed, so you can mentally file every issue away in a ‘to-do’ or ‘done’ box ahead of the next day.

Insomnia due to underlying medical condition needs the medical condition to be addressed. In the case of depression, please ensure that you are taking the medications prescribed by your doctor.

I hope this helps. Good night y’all 😀

Q: What about cases where the amniotic fluid refuses to rapture and there are contractions?

A: For most women, their waters will break during labour at the peak of contractions. However, in some other women, it doesn’t.

In some, labour may proceed slowly leaving the doctor to take a call on that amniotic sac that refuses to break. This will usually involve manual rupture of the amniotic sac using a sterile plastic hook inserted into the pregnant woman’s vagina. This hook is used to pull on the amniotic sac until it ruptures. This is thought to speed up the contractions and labour. However, some studies suggest that this may not necessarily speed up labour so that some schools of thought prefer to rupture the amniotic sac only if the baby’s head has descended low enough to cover the mouth of the womb. You will be guided by your doctor.

In some rare cases, the baby may actually be born with some portion of the amniotic sac attached to them or born completely inside the sac. Both situations can be addressed by the attending medical team

Have a great evening y’all J

Q: Good evening Doc, Please I am 31weeks pregnant, and I have noticed an odorless water coming out from my vaginal, I don’t think it’s urine. It just flows without urine urge, no pain, nor any sign of labour, Nothing else…just the flow

A: Thanks for writing in, dear.

Amniotic fluid is the fluid that surrounds and cushions a baby while in the womb. The fluid is contained within a sac called the amniotic sac. Usually just before a woman goes into labour, this sac ruptures and the fluid is released…that’s what is referred to waters breaking. When I had my last baby, my waters broke right in the hospital reception! And so, there was I with water all over my legs and people in the reception area watching 😀 It wasn’t quite funny on that day! But I digress…

Sometimes, this sac of fluid bursts or it could start leaking very gradually before the pregnancy is 37 weeks. This is called Pre-term Pre-labour Rupture Of Membranes (PPROM)

Question is whether what is leaking is urine, amniotic fluid or vaginal discharge.

Here are some tips to help you know:

If it’s urine, it has the peculiar smell of urine and is usually leaked when one coughs, laughs or sneezes.

If it’s vaginal discharge, it’s there constantly and may be clear, white or yellowish

If it’s amniotic fluid, it’s likely to be clear, or slightly mucoid and/or blood stained and it wets panties continuously irrespective of whether one laughs or not

The most significant issues with PPROM is the danger of infection, premature birth and the dangers associated with it.

So, my advice would be to see your doctor immediately so he can examine you and make a diagnosis. He will confirm whether indeed it is amniotic fluid and then take a decision as to what step to take next. If the leakage is little, you may be asked to stay in hospital for a few hours while wearing a sanitary pad to check for whether it becomes soaked. An ultra sound scan, vaginal exam etc are also useful in making a diagnosis.

If you develop a fever, the discharge changes to green, develops a foul smell, you experience vaginal bleeding, contractions, abdominal pain or baby appears not to be moving as normal, be sure to see a doctor immediately.

Enjoy the rest of your day, y’all 😀

Have you ever wondered common places in your house where germs hide? People readily think of the toilet…but have you spared a thought for other areas or things in the house? Well that’s why we’re here! Let’s tell you some top hiding places for germs:

• Studies have shown that germs really love the kitchen sponge. Take a little moment and think about it and it may not be so strange! To disinfect it you could soak it in lemon juice or bleach, wash in the dishwasher or just hand wash it. Do this every evening after the night washing up is done.

• Your TV remote: This is a no-brainer right?! How many times do you reach for the remote control daily…while eating (with those very grimy hands), after having had a fumble in your nose, after rushing out from the toilet (before washing your hands) to catch the last few minutes of that show etc. Use some anti=bacterial wipes to clean your remote controls or add some hand-sanitizer to some tissue/kitchen paper and make sure you reach all the tiny nooks and corners.

• The bathroom and kitchen faucets. We touch them with those dirty hands that need washing and pay them no heed afterwards. Be sure to give them a good scrub every night before bed.

• Light switches and door knobs: Everybody uses them: children and adults alike and we smear with all sorts of germs. Guess what? They really thrive there.

• Shower curtains: Notice the colour change on your shower curtains after a few years of use? They come from soap scum and bacteria which have the perfect breeding ground given that these curtains get wet every day and stay wet. Wipe Down Curtain After Showering.

• Your gas cooker, micro-wave, oven etc knobs. We touch these very often in the kitchen and forget to clean them. Grimy germs make their homes there.

So, get cleaning people! Have a great weekend 

Have you ever heard of the phenomenon, ‘white coat hypertension?’ It happens in people who typically have normal blood pressures at home and other non-medical settings, but develop a temporary rise in blood pressures when they visit the hospitals for medical appointments.

Are you one of those? Want to learn more about this? Read! https://www.health.harvard.edu/heart-health/high-blood-pressure-at-the-doctors-office-but-not-at-home?utm_source=delivra&utm_medium=email&utm_campaign=WR20190913-BloodPressure&utm_id=1574091&dlv-ga-memberid=11052531&dlv-emuid=6b19e29b-9b0e-4e39-8520-42bd14e0d959&dlv-mlid=1574091

Q: Hello Dr. Ketch. Can a pregnant woman take paracetamol in the first trimester?

A: Don’t be quick to go take any medicine without prescription. Remember that every drug is a potential toxin and your doctor is really in the best place to weigh potential risks of taking any medicine against the potential benefits. 

Having said that, paracetamol has been routinely used during all stages of pregnancy for the management of pain and high temperature. There is no clear evidence that this has any adverse effect on the baby, especially when taken at the smallest effective dose for the shortest possible period.

For a related post, please click the link below: https://chatwithdrketch.com/2017/11/29/hlwdk-daily-health-tips-is-chloroquine-safe-in-pregnancy/

All the best!

Q: Hello Doc, how’s life with you and your beautiful angels? My regards to all. It feels good to write in again. My problem is about dark patch round the eyes, remedy pleeeease! Is avocado useful in anyway in connection to this?

A: Hello dear! Thanks for writing in. My and I are fine, thank you 😀

The skin around the eye is very thin and as a result, any movement of fluid in or out of the area is very visible there. Typical examples are the dramatic sunken eyes when one is dehydrated (maybe from stooling) and the equally ‘gossip-worthy’ swollen eyes after a night of crying 

Usually in the body, fluid would move from an area of low salt concentration to an area of high salt concentration (osmosis). After crying, your salty tears are an attraction for fluids, which move from areas of low salt concentration to accumulate there. On the other hand, going on an alcoholic binge (drinking till you drop) causes dehydration with the accompanying sinking eyeballs.

Now dark circles may be ‘false’ and just look that way when puffy eyelids cast shadows on the area or due to sunken eyeballs as people age. Real dark circles however, may occur due to prolonged bouts of crying, allergy (as may be the case in the question here, with the associated itching), having a cold, drinking a lot of alcohol, rubbing or scratching the eyes often, exposure to sun, ageing, sleeping with make-up on and it also runs in families…I bet you didn’t know that one 

Other causes of dark circles include sleeping positions. If you sleep on your side or on your tummy, thanks to gravity fluid will also accumulate around your eyes. Let’s also not forget the commonest cause…burning the candle on multiple ends!

Treatment will be based on the cause. If it’s due to a cold or allergy or sinus problems, when these are taken care of, then the symptoms will disappear. Modification of lifestyle habits like removing all make-up at night, wearing sunglasses and using sunscreen when out in the sun, changing sleeping positions by sleeping on your back (if possible) or elevating your head with more pillows and leaving alcohol and your eyes well alone (no scratching and rubbing of eyes!)  may also be helpful.

Quick fixes for these bags include using concealer or even foundation to cover it up. Using cucumber slices on your eyes or teabags are also helpful as short term measures. By the time you hit your 30s, you really should invest in a good eye moisturizer because this is the first place to show the sign of aging 

Other solutions include surgery and injection of fillers etc.
Remember that no matter how many concealers, surgeries, moisturizers et al you use, if you don’t rest and avoid fatigue, you’ll just be throwing money down the drain. And this also goes for avocado oil which some people swear is a great remedy for this.

If these circles persist, however or seem to be just under one eye, please see your doctor or dermatologist for more advice.

So, as you all start contemplating where to hang out next weekend, be sure not to show up at work with the ‘telling’ bags under your eyes on Monday 

‘ Have you ever had one of those days where you are so weary, you can’t seem to do anything except binge-watch Netflix? ‘ Perhaps you should be taking further actions than just,’Netflix and chill’ 😀 Read! https://www.health.harvard.edu/blog/dont-take-fatigue-lying-2017041411485