chatwithketch

Q: Hi doctor. Does a loop cause smelly discharge or just lots of discharge?

A: Intra Uterine Device (IUD) are also known as loop contraceptives. There are two types: the Paragard IUD and the Mirena IUD.

The Paragard IUD is a copper-containing IUD. The copper is poisonous/toxic to sperm and the IUD also prevents implantation of the fertilized egg into the uterus, should fertilization still occur. Paragard can be used during breastfeeding and its removal leads to a quick return of fertility, generally.

The Mirena IUD contains hormones which make the cervical mucous extra thick preventing the sperm from getting to the womb and it also makes the lining of the womb thin such that even if a fertilized egg were to get there, it would not be able to implant on the thin lining of the womb. It also prevents ovulation. Mirena helps reduce the cramping pain of a menstrual period and also reduces bleeding.

Side effects of Paragard include back ache, cramps, severe pain during menstrual period and heavy bleeding etc while Mirena can cause breast tenderness, weight gain, irregular menstrual cycles etc Both IUDs can also be expelled, spontaneously, that is for no reason.

Although vaginal discharge may get heavier after inserting an IUD, the real danger/warning signs to look out for when you have the IUD on are listed below. If you experience any of these under-listed symptoms, please see your doctor immediately.

• Severe vaginal bleeding with at least two sanitary towels soaked every hour for 2 or more hours.
• Smelly vaginal discharge. This could be associated with fever and chills
• Severe pain in abdomen or pelvis

So, you should see your doctor immediately to check this discharge out.

Have a great night 😀

Q: Dr, I also notice I usually feel pain when swallowing food from my throat down to my stomach. Each time I want to eat, I will first feel pain on my cheeks.

A: The symptoms you describe call for a little biology class 🙂

When we eat, the food moves down from the mouth, to the esophagus (the food pipe) and into the stomach. There is a sphincter (you can look at it as a valve or control) at the lower end of the esophagus just before the stomach. This valve usually allows food to move in one direction: from the esophagus to the stomach. However, in people with Gastro-Esophageal Reflux Disease (GERD), this valve called Lower Esophageal Sphincter allows food to also move back from the stomach to the esophagus. This food, which contains acid from the stomach, causes burning sensations in the esophagus described as heartburn. A condition called hiatal hernia increases the chances of GERD and is usually seen in obese people, pregnant women and during situations that increase the pressure in the abdomen like coughing, sneezing etc.

Symptoms typically include burning sensation in the chest after eating, difficulty with swallowing, and sensation of having a lump in the throat, chest pain and regurgitation of food or sour-tasting fluid. If your symptoms are worse at night, you could also have disrupted sleep and chronic cough.

Lifestyle factors that play a role in GERD include certain foods like fatty, fried foods, alcohol, minty foods etc, smoking, eating huge meals, lying down immediately after a meal etc

To avoid these eat smaller meals and try not to lie down until about 3 hours after a meal, keep your weight within normal limits and give tight clothes a rest 😀 Avoid foods that act as triggers and stay off smoking. Elevate the feet of your bed by using blocks under the bed. Do not use pillows to achieve this as it just increases pressure in the stomach and worsens the problem.
Other treatment modalities include medications and surgery. First course of action is to go see your doctor who will make a definitive diagnosis and advice on what works best for you.

All the best

A: If you’ve ever had a kidney stone, you surely remember it. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body. For many, kidney stones aren’t a one-time thing: in about half of people who have had one, another appears within seven years without preventive measures. Preventing kidney stones isn’t complicated but it does take some determination. Prevention efforts include drinking plenty of water, getting enough calcium from food, cutting back on salt (sodium), limiting animal protein, and avoiding stone-forming foods like beets, chocolate, spinach, rhubarb, tea, and others.

https://www.health.harvard.edu/blog/what-causes-kidney-stones-and-what-to-do-2019051716656

Happy Children’s Day! And no, I am not just referring to your children, I’m referring to you! 😀 You are somebody’s child 😀 My mother still sends me a message every 27th of May…so, go figure! 😀

And to celebrate today, we will take a question related to children….

Q: Hi Dr, my question is, ‘when does a baby start to grow? And is there a difference between the growing process or boys and girls?’ A: Hey! Thanks for writing in.So, when does baby start growing? Well, from the time of fertilization (union of the sperm and egg). If you use the 40 weeks of pregnancy typically used by your doctor, then that means that fertilization and commencement of growth of baby happened around week 3 (remember that we count from the first day of your last menstrual period and so that means that the 40 weeks includes your last menstrual period days).

I’m assuming that this growth refers to height and will focus this discussion on that. A person’s final height is as a result of a combination of factors: genetics (if your parents are short, you are more likely to be short), nutrition (during the critical growing up years and especially before birth), general health and hormones (growth hormone, thyroid hormone and sex hormones). Having said these, there’s no hard and fast rule really, as some ‘short’ parents give birth to tall children and vice versa.

The fastest period of growth is experienced before the baby is born. Thereafter, another growth spurt is experienced during puberty with boys generally growing more than girls do. During this period, the growth plates (areas of growing tissues located at the ends of long bones. These are the areas where bones grow) are very active until they end of puberty when they mature, fuse and stop growing. Once the growth plates are fused, growth has been concluded and height cannot be increased. There is no specific age at which this occurs really: people who start puberty early will probably stop growing before others who started later.‘Normal’ when used to describe height can vary from place to place with differences in ethnic groups, cultures and continents.

Sometimes, there may be a medical condition associated with height variations (short or tall statures), but most people are normal and just at the lower end of normal (for the short) and at the higher end of normal (for the tall).If the cause of ‘shortness’ is a medical problem or a hormone deficiency, this can be rectified. For instance, if there is a deficiency of growth hormone, this may be administered. However, this can only be done in children…before the growth plates fuse (at about 14/15 years for girls and at about 16 years for boys). Once this has happened, no drug can increase height. Surgery in which the legs are cut apart and then gradually separated to increase height is an option, with attendant possible complications of infection and of course, fracture. Not really advisable.

So, from the time the baby is born, focus on the right feeding. Start with breast milk. Breast milk, beyond being cheap, temperature regulated and readily available 😀 is formulated with everything your baby needs for each stage of his growth. It’s chock full of immunoglobulins (which makes them resistant to illnesses), vitamins, minerals, proteins, fats and oils. So, it is indeed a complete meal! It also helps the womb to return to normal size after childbirth. From six months, baby is ready to be introduced to some other food.

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.

From one year of age, you can add cereals and it’s also okay to introduce 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, cow milk, honey, whole eggs can be introduced after the baby turns 1 year old.

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.

I hope this helps!

Have a good night, y’all 😀

Q: Good evening Doc please am having this pain on the upper right side of my chest. Please what is the cause?
A: Chest pain is not necessarily a sign of a serious medical condition, but because it could be potentially life threatening, chest pains should be checked out in the hospitals.Common causes of chest pain include:

Chest sprain/sprain. This condition would typically be relieved by rest and is brought on by a chest injury or exertion

Heartburn. Typical symptoms include regurgitation (bringing up) of ingested food and/or bitter tasting fluid, feeling bloated. Symptoms usually start after eating and are usually described as burning.

Anxiety or panic attack. Symptoms include palpitations and fast heart beats, dizziness, sweating and is usually triggered by a stressful situation

Pneumonia. Associated symptoms include coughing (yellow or green mucous), high temperature and chest pain on breathing in and out

Shingles. Symptoms include skin rashes that turn into blisters and tingling on the skin

Heart problems. This is the key reason why chest pains should be checked out in the hospital because it could be a heart attack, which is life threatening. Other common causes include angina (caused by poor blood flow to the heart) and pericarditis, in which the protective covering around the heart becomes inflamed with leakage of fluid into it. Chest pain from heart problems is usually described as pressure, fullness, burning or tightness in your chest

So, my advice would be to go get checked out in the hospital and this should be immediate if the chest pain spreads to the back, neck or arms; makes your chest feel tight or heavy, lasts for more than 15 minutes, starts with sweating, shortness of breath and/or feeling of being sick

All the best!

Q: Hi Doctor, is it possible for a 3 month-old baby to start teething?

A: Your baby is certainly in a hurry :D. Seriously though, babies start teething at different times. On the average, most children start teething at 6 months. Some start earlier than 4 months (as early as 2 months) and some others may wait up to a year or even after, to start the journey. Some children are even born with one or two teeth. These are called natal teeth and ‘No, this is not associated with witchcraft or enemies pressing remote controls’ as we like to think in Africa 😀 Some children also develop their own teeth within the first four weeks of life. These are called neonatal teeth. Natal and neonatal teeth can cause problems with feeding and may even be swallowed. The paediatric dentist will decide whether to remove them or leave them alone based on factors like whether the teeth are loose, excess etc.

Generally though, in instances like the one addressed in the question, provided the teeth do not negatively affect baby’s feeding, they are left well alone.

Have a fab evening 😀

Hey Doc, of recent, I have been having this splitting of urine which is of concern to me. What baffles me is that it doesn’t happen all the time I urinate, and also it tends to occur less when I am well hydrated. Please your advice will go a long way. Thanks Dr Ketch

A: A split stream of urine is typically caused by urinary obstruction. Some conditions that can lead to this include problems of the prostate gland and urinary strictures.

A urinary stricture is the narrowing of the urethra (the tube that leads urine out of the body). This, naturally, leads to restriction of the flow of urine out of the body leading to a variety of medical problems.

This condition is more common in males than females because of the position of the urethra and although sometimes the cause is unknown, common causes include

• Straddle injury (falling astride an object),
• Endoscopy (a procedure in which an instrument called a probe is inserted into the urethra)
• Prolonged use of a catheter
• Trauma or injury to the urethra or pelvis
• Sexually transmitted infections
• Cancer of the prostate or urthra
• Prostate enlargement
• Previous prostate surgery

The prostate gland is a small organ located just below the bladder. It produces semen and the urethra which transports urine from the bladder and semen from the prostate, passes through the prostate. This organ grows throughout a male’s life and sometimes grows so big that it blocks the flow of urine from the bladder. This condition is known as Benign Prostatic Enlargement or Benign Prostatic Hypertrophy or Benign Prostatic Hyperplasia. This is more likely to happen as people age and when there is a family history of this.

The symptoms of this are also typical for urinary strictures and include

• Feeling like urinating very frequently
• Feeling the need to urgently urinate
• Not being able to start urinating immediately despite the urgency
• Straining at urine
• When the person does start urinating, the flow trickles 
• Split stream of urine
• Feeling that the bladder was not completely emptied
• Urinary tract infections due to the fact that there is always urine in the bladder encouraging the growth of micro-organisms
• Bladder stones
• With time, kidney function becomes reduced

These are some of the symptoms that may bring the person to the hospital. The doctor will perform a detailed examination which include a rectal examination and order an array of tests.

Treatment modalities include medications and surgery. The doctor will determine which works best for you.

Prostate-friendly diets include loads of fruits and veggies and less fat in the diet. Exercising daily and limiting alcohol intake are also thought to be helpful.

Having said all this, the first thing you need to do is to go see your doctor and get yourself checked out.

All the best!

Q: Doctor please, how can I treat thrush infection? I’ve taking several antibiotics but they are not working. I keep having white discharge. Please, l really need your help and drug prescription

A: Thrush/candidiasis is caused by an organism called Candida, a fungus (yeast). This infection can result in cheesy white (like ground melon/egusi seeds) vaginal discharge and vaginal itching. This itching can lead to irritation in the vagina which can become further infected by bacteria.

Candidiasis is very common in diabetics (the sugar in their urine makes the vagina a rich culture medium for them) and pregnant women who have altered glucose tolerance. This infection is also common in people whose immune systems are compromised and people who wear tight panties that do not allow their delicate inner selves to ‘breath’. Preferred materials for undies would be cotton and should be loose (I see my fashionistas frowning :D). It also happens in people who take a lot of antibiotics. Normally, some bacteria and fungi (yeast) co-exist peacefully 😀 in the vagina. To encourage this peaceful co-existence, the bacteria produce some acid that hold the yeast in check and prevent their over-growth. When antibiotics are abused, this leads to a situation where the yeast takes over 😀 (almost like a coup, right?). Though this infection can be passed on through sexual intercourse…especially oral-genital contact, it’s not really called an STI because women who are not sexually active can be infected with this.

Treatment is with anti-fungal vaginal tablets and/or anti-fungal cream which can be used for between 1-3 days depending on drug of choice. A single course dose of Fluconazole can also be taken orally. Any of these regimen may be extended if the infection is complicated…let your doctor be the best judge of that 😀

Prevention is targeted at causes:

• Wear loose fitting cotton undies 
• Stay away from or limit time spent in hot tubs or saunas
• Stick strictly with the prescription for antibiotics in terms of quantity and duration
• Change out of wet clothes eg swim suits as soon as possible

Now, this infection can be treated using oral drugs (tablets to be taken by mouth) (antifungals and not antibiotics) but these are not recommended during pregnancy and breastfeeding. Vaginal pessaries and creams are better bets in pregnancy. However, because of the very small possibility of hurting your cervix (the neck of the womb), it is advisable not to use the applicator to administer the pessary. Instead, use your finger to insert the pessary. It may be necessary to continue the drug application for about 6 days as opposed to the shorter 3-day course. Your doctor will confirm diagnosis and advice on medication duration.
For more on candidiasis, please click on the following links:
https://chatwithdrketch.com/2014/06/26/daily-health-tips-why-do-i-have-recurrent-candidiasis/
https://chatwithdrketch.com/2014/03/07/daily-health-tips-toilet-infection-seriously/
https://chatwithdrketch.com/2014/04/27/daily-health-tips-is-vaginal-discharge-normal/

Good night people 😀