chatwithketch

Q: How can I deal with the problem of watery semen?

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.

Have a good night, everyone 😀

Q: Hello Doctor, thanks for the wonderful work you doing. I’ve been reading your posts since I was pregnant and they really helped me, God bless you. I need your help. I gave birth to a girl a week ago. Her eyes are yellow. At first she spent three days without pooping because I did not breastfeed her a lot but now she poops normal. Is it normal for her to have yellow eyes? Can it be jaundice?

A: Jaundice is a condition in which there is yellowing of the eyes or the skin. So, the condition you describe is jaundice. It can happen in both children and adults. Usually, when old red blood cells are broken down, a yellow pigment, bilirubin is released as part of that process. The bilirubin is removed from the body through urine and stool. It is the bilirubin that gives rise to that yellow colour seen in jaundice.

Other symptoms of jaundice include deep yellow urine and pale stools.

In newborn babies, there are two types of jaundice (neonatal jaundice) that can occur: Physiological jaundice and pathological jaundice.

Physiological jaundice occurs as a natural process of life. While in the uterus, the baby’s bilirubin is removed through the placenta. Once the baby is born, he/she has to handle this bilirubin business by himself/herself J (talk about responsibility immediately after touching down in planet earth!)because his organs are unable to deal with all the bilirubin released from breakdown of red blood cells. As the bilirubin accumulates in blood, jaundice results. Typically, this jaundice appears about 24hours after birth, actually gets worse until the 3^rd or 4^th day. It would usually have disappeared by the end of one or two weeks.

Pathological jaundice is due to a disease condition like infection, mother and baby’s blood groups not being compatible etc. This is typically present before 24 hours of birth.  Indeed, this is the main difference between the two types of jaundice. The one that occurs naturally is seen after 24 hours while the one due to disease is seen before 24 hours…rule of thumb 😀

Jaundice may be mild, disappearing on its own, especially physiologic jaundice. However, sometimes, the yellowness deepens, the baby may develop a high-pitched cry and/or develop arched back. These are dangerous signs and this child should be in a hospital. Indeed, if you observe jaundice in your baby after you have left the hospital, please get it checked out in the hospital just to be sure.  Most babies are able to deal with this excess bilirubin on their own without needing treatment. However, some other babies may be put under special lights called phototherapy or in more serious conditions, an exchange blood transfusion may be done (literally, this involves practically exchanging the baby’s bilirubin-filled blood with ‘new’ blood).

The main focus in jaundice is to bring down the level of the bilirubin. If this is not done, it could cross the blood/brain barrier and stain the brain leading to brain damage, a condition called Kernicterus.  More frequent feeding is usually suggested as this helps the baby get rid of more bilirubin.

All the best!

Q: Hello Dr, please I need your help. I’ve not seen my period for two months now. I’ve done pregnancy test but it’s negative. If I overwork myself, I see light blood. If I take a rest, the bleeding will stop. Please help me

A: Thanks for writing in. If I were a mystery writer, I would call this the ‘Curious Case of The Missing Period!’ 😀

In cases like this, perhaps, the more material question would be, if you have had unprotected sexual intercourse in the intervening period between your last period and now. This is your most usual ‘go to’ question when a period is missing.

Then the next question would focus on the regularity of your periods. Could this be due to an irregular period?

A ‘regular’ menstrual cycle is supposedly one in which the cycle (the length of time from the 1st day of a menstrual period to the first day of the next menstrual period) is about 28 days but there is nothing abnormal about cycles that fall outside of this range. It could range from about 24 days to 34 days with ovulation happening at mid cycle. Indeed, in some women each period appears to have a different cycle. For young girls who have just started menstruating, skipped or irregular periods may occur.
What do people refer to as irregular periods? Well, if the time between each period changes, or the length of days of the period changes or indeed when the quantity of blood lost during each period changes, the period is termed irregular. What can cause these changes? They include:

• Changes in hormone levels, as is common in the puberty period or menopausal period (not an issue here)
• Stress
• Excessive weight loss or excessive weight gain
• Fibroids
• Problems with the thyroid (hyperthyroidism)
• Polycystic Ovary Disease (PCOD)
• Scarring from previous surgery in the uterus
• Breast feeding mothers may also experience irregular periods as the hormones released may delay return of menstruation. Remember, however, that this is not an effective means of contraception.

So, it’s always a good idea to keep a record of your periods: length of cycles, number of days the period lasts, presence of pain etc. If you keep a chart of this over time, you would be able to know what is normal for you.

Treatment of irregular periods (which could be a cause of the ‘missing period’) depends on cause: fibroids, PCOD, hyperthyroidism all have to be treated. If irregularity is due to stress, learning coping mechanisms or relaxation techniques may help. Reduce weight or go easy on your exercise routine, if weight issues are a problem.

So, you might want to go and see your doctor to check you out.

All the best.

Good night y’all 😀

‘… the best way to help your shots and other allergy medicines do their job is to reduce your exposure to allergens. Avoidance is the best medicine!’ Want to know more? Read!

https://www.health.harvard.edu/healthbeat/allergies-tips-to-minimize-your-exposure-to-mold  

Q: At what age should a mother start brushing for her child?

A: Hey! Thanks for writing in. I’ve answered your question and thrown in a bonus for when to start potty training too! That’s to apologise for not posting yesterday. The day just vanished before I knew it! :O

Taking care of your baby’s mouth/teeth starts from birth. If you don’t start this early enough, you may end up with a situation known as baby bottle tooth decay. This condition occurs when babies’ teeth are exposed to prolonged contact with sugary liquids or substances. In children, this can also be caused by allowing children to go to sleep while feeding at the breast, on a bottle or giving them pacifiers that have been coated with honey or other sugary substances. During sleep, saliva production reduces; thus, these sugary substances, which lead to the production of acids, stay on the teeth for prolonged periods leading to erosion of the enamel and subsequent tooth decay.

•    Mothers are advised to practice exclusive breastfeeding but if for any reason bottles have to be used for any period, this should be carefully monitored. Ensure that baby never falls asleep with a bottle containing milk (be it expressed breast milk or formula), fruit juice (fresh or packaged) or any other sweetened fluids. This also goes for children who are breast-fed. Please don’t let them fall asleep on the breast. This ensures that the baby’s teeth is not in contact with sugary fluids for prolonged periods of time. This prevents tooth decay.

•    Even before your baby’s teeth actually erupt, clean baby’s mouth and gums at least once a day, gently massaging the gingivial tissues and gum. This can be done using a piece of moistened cotton gauze wrapped around a finger. This helps to clean baby’s mouth, establish the development of healthy teeth and aid teething.

•    As soon as the first tooth erupts, plaque removal should commence. Ensure that babies’ teeth are brushed at least twice a day. Before the child can spit out, please use a non-fluoride containing toothpaste. We don’t want the child swallowing fluoride and coming down with some ailments and other disease conditions including the development of whitish patches on teeth. However, as soon as the child can spit, please introduce fluorinated toothpaste.

•    Wean the baby from the bottle as soon as possible and use a cup for liquids. During the weaning period, dilute the bottle feeds as much as possible to the point where only water is taken with the bottle.

•    If your baby uses a pacifier, please use for only short periods of time and be sure not to coat with honey or any other sugary substance to ensure that his teeth is not in prolonged contact with substances that will lead to tooth decay.

For more on this, please click on the links below:

Daily Health Tips: Is It Bad To Let My 2-Year Old Son Swallow His Toothpaste?

When to start potty training? Well, usually between the ages of 18 and 30 months, a child shows some signs that he/she is ready for the next big step…potty training. Here are some of the signs to look out for:
• They can remove clothing, talk, climb etc
• They are usually aware of having soiled their diapers
• They have bowel movements at about the same everyday
• They no longer have bowel movements (poop) at night
• The gap between wet diapers is about 2 hours.
• They know when they are urinating
• They can tell you when they need to urinate

This process would usually take an average of 3 months. However, your child needs to feel ready, otherwise it will be a battle of wills…and trust me, you won’t win! Remember the one who has to clean up all the ‘accidents’? 😀 So, look out for the signs of readiness and remember that if a child is emotionally destabilized, he/she may relapse to pre-potty training ways. Patience is key. If you decide your baby is not ready yet and suspend temporarily, be sure to re-introduce as you observe the signs noted above.

Have a fabulous weekend, people 😀

Q: Hello there, I need your help Doc. I’ve been experiencing a huge discharge which even burns my panties down there. What might be the problem? It stresses me. God bless you

A: Vaginal discharge is quite common in females especially in sexually active females, though it can also occur in people who are not sexually active. It can be rather disturbing if associated with symptoms like itching, sores in the genital area and bad odor.

There are different causes of discharge and many organisms responsible for vaginal discharge (bacterial, fungal and protozoan), and the offending organism/cause will determine the treatment.

Some causes include poor hygienic practices, use of harsh chemicals to wash the genital area, use of tampons and pads for long periods without change, insertion of herbs or other objects into the vagina, and wrong cleaning practices, like cleaning from back to front (the correct way should be from front to back)

From the description of your symptoms, it is rather difficult to determine the cause of your discharge.

I would advise you try to maintain a high level of cleanliness, eat healthy, involve in exercise as this helps in cleansing the system, try to keep the place dry always, by during with a towel or tissue after washing (wash with only water or water and a mild toilet soap). Washing and urinating after intercourse can also help. I would also advice you visit a doctor, who would request you have some test done and then based on the results would prescribe the appropriate drugs for you.

Following the result of your tests, your doctor may advice that your partner be treated if he thinks it’s a sexually transmitted infection. This would prevent you from getting reinfected on meeting him after your treatment. It’s important to note that this is not always the case…your symptoms may not be due to a sexually transmitted disease and in that case, there may be no need for your partner to be treated.

Fungal infection such as candidiasis are not usually transmitted through intercourse and so would not require this.

Sorry, about the discomfort you may be going through, but once treated properly you will be preventing yourself from likely complications and recurrence.

Hope this helps. Cheers!

******This post was contributed by a doctor ‘guest’ blogger. For related posts, please click on these links:

Daily Health Tips: Is Vaginal Discharge Normal?

Daily Health Tips: Is Vaginal Odour Normal?

Daily Health Tips: Toilet Infection…seriously???

Have a good night, y’all 😀

Is there a relationship between food and depression? Read!

https://www.health.harvard.edu/mind-and-mood/food-and-mood-is-there-a-connection

Q: Hi Doc, I know you must be busy but this is very scary for me… For two years now I have been experiencing bad breath but recently people around me; in taxis, school, home, church etc complains of perceiving a dead rat even when I am not talking but just breathing from the nose. Please help.

A: This is a very frequent question and so I have decided to revisit it today.

Bad breath, also called halitosis, may be as a result of poor hygiene habits, eating strong smelling foods or could be a sign of other medical conditions.

If adequate dental hygiene is not maintained, food particles can remain in our mouths, encouraging bacterial growth bacteria in our mouths can break down food particles and raise a serious stink. Proper dental hygiene habits includes:

Brushing your teeth twice a day (this sounds like a ‘no-brainer’ but the right technique is important. Mentally divide your mouth into four quadrants and spend at least 30 seconds on each quadrant. This way, you spend a minimum of 2 minutes brushing)

Brushing your tongue (if you finish brushing and you can still see all that whitish residue on your tongue, you haven’t done a good job. Some of the smell comes from there. Some tooth brushes come with a tongue scraper at the back of the brush…use that. If not, buy one or just use your brush)

Flossing your teeth everyday. Ask for this in your local super markets. This gets rid of the food particles between your teeth where your tooth brush can’t reach.

Using a mouth wash can also help the prevention of mouth odour.

Eating strong smelling foods like onions and garlic could also cause mouth odour which may not be taken care of by brushing. This is because these ‘foods’ are absorbed into the blood stream and excreted through the lungs. So, the smell will persist until excretion is complete. The small can be masked with mouth wash etc

Disease conditions that can lead to bad breath include mouth infections, Diabetes Mellitus, sinus infection etc.

Other conditions like use of tobacco (chewing or smoking), some drugs and dry mouth (which is the reason for morning breath :D) are also culprits.

Prevention is focused on the tips given above and ensuring that you visit your dentist at least twice a year, brushing at least twice a day (if not after every meal) with a fluoride tooth paste (remember that fluoride is not recommended for children less than 2-3 years and even then, only a pea size is recommended), change your tooth brush once every three months and drink lots of water.

Let’s keep the pearls shining and the breath smelling really fresh.

By the way, would you tell a friend, if he/she had bad breath?

I asked that question during one of my shows and most people didn’t want to be the one that causes offence by telling someone that they have bad breath. However, most people also wanted to be told if they had bad breath. So, who will bell the cat? :d

Did you miss the show? Catch it here and watch me have fun putting OC Ukeje on the hot spot. https://chatwithdrketch.com/2015/05/03/watch-the-dr-ketch-show-episode-on-bad-breath-here/

Have a good evening, y’all 😀

Q: Hi Doctor, I’ve been having a very painful headache since last week Wednesday. I took headache pills but it’s still the same and very painful. What should I do and what could be the cause of it?

A: Headaches refer to pain or ache anywhere on the head. They may be primary, in which case they are due to problems with the structures sensitive to pain in the head. Or they may be secondary in which case the pain is due to an underlying disease that causes the pain-sensitive structures in the head to be activated.

Common causes of primary headaches include:
Tension headaches: 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.

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.

All the best.