chatwithketch

Q: Hi Dr, I have milky white discharge, no smelling and I’m not pregnant. What’s wrong?

A: Well, you didn’t really specify what sort of discharge you were referring to. I will attempt a guess and say, perhaps, vaginal discharge.

Some level of vaginal discharge is normal on a daily basis as the vagina sheds cells and produces fluid needed to clean and provide protection for its delicate skin. You would have observed the difference in the consistency depending on your menstrual cycle.

If this discharge however develops a strange smell, becomes itchy with swelling and pain in the vagina or you notice bloodstained discharge, then it is time to see a doctor. Abnormal discharges could be due to candidiasis, pelvic inflammatory disease, sexually transmitted infections or in the case of blood stained discharge, may be cancer etc

Usually, a sample of the discharge is sent for investigation and it will confirm what infection is there, if any, and what drug will be useful in treatment.

All the best!

Q: I slept with this girl around October last year and started experiencing weird symptoms and got tested end of December, the results was negative, and on February results was negative and around march results came back negative

So, I’m worried because I’ve been experiencing oral thrush

A: I guess my first question is, ‘what did you test for?’ HIV? Well, that could be the reason but it could also be due to other issues. Believe it or not, our bodies are filled with different micro-organisms, all of which are searching for relevance and dominance 😀 These good and bad micro-organisms usually maintain a delicate balance until something happens (like when one takes some medications like steroids, uses antibiotics, has a depressed immune system as occurs in extremes of age: very young and very old and also if one is infected with HIV, has cancer or Diabetes Mellitus) to disturb this delicate balance. When this happens, fungal organisms which were minding their own business before, have an opportunity to overgrow in the mouth and cause problems.  This condition can also happen in the vagina causing vaginal thrush or even in infants causing diaper rash.

What does this look like? It looks like creamy white patches on the tongue (which is why you referred to it as tongue thrush), on the inside of the cheeks, gums, tonsils, back of throat etc. They look like you can just scrape them off but any attempt to do that would usually lead to bleeding. People with this condition may also experience pain when swallowing or eating. Children with this condition are usually irritable and fussy.

Treatment of this condition is with the use of anti-fungal drugs which would usually have to be taken for about 10 to 14 days. For nursing mothers, there may be a need for antifungal cream applied on the breasts as the baby and the mother may pass the infection back and forth to each other. Talk about joy in sharing 😀

To prevent this:

• Practice good oral hygiene: brush your teeth twice a day being sure to spend time brushing the surface of the tongue
• Rinse out your mouth after every meal, if you can’t brush, especially if you have just taken a lot of sugary foods.
• Limit your intake of sugary foods
• If you use dentures, take them off before you go to bed
• If you smoke, don’t reduce the number of sticks you smoke. Just quit! 😀
• Remember the ABCs. Abstain…which is always the best bet if you’re not married, be faithful to one partner (who is hopefully being faithful to you) or use condoms

The risk of HIV infection through oral sex may be reduced by the use of barriers like condoms and avoiding ejaculation in the mouth. Use of pre-exposure drugs (prescribed for people at risk) and ensuring that anti-retroviral drugs (drugs used for the treatment of HIV) are being used correctly by partners who are HIV positive may also reduce risk of HIV infection through oral sex.

All the best!

For those who take Ciprofloxacin at will, you should read this! 

https://www.health.harvard.edu/staying-healthy/fda-certain-antibiotics-may-bring-serious-risks

Are you one of those who need a coffee-pick-me-up every now and then? Well, did you know that just as coffee can increase your energy levels, it can also decrease it? Read!

https://www.health.harvard.edu/healthbeat/drink-for-energy

Q: Hello ma’am, my question is this … ‘How can one cure throat itching and scratching on the body?’

A: An itchy throat as the name suggests refers to an irritating/itching sensation in the throat often accompanied by pain and difficulty when swallowing, fever etc. The tickling sensation in the throat can be a source of mild irritation/annoyance.

Causes of itchy throat include:

• Allergies: Itchy throat due to allergies usually lasts longer than that from other causes. It is usually seasonal and may also be accompanied by other symptoms like runny nose, red and itchy eyes, shortness of breath etc

• Infections: These could be fungal (as occurs in people who are immune-suppressed like HIV positive people), bacterial (as occurs in sore throat from streptococcal infections) or viral (as occurs in common cold).

• Over-use: Excessive talking, shouting, loud singing etc can lead to drying out of the throat leading to itching.

• Dehydration: This can occur from smoking, not taking enough water or taking way too much caffeine-containing drinks or even from open-mouthed breathing when one has a cold etc

Treatment depends on the cause.

• Anti-histamines are used for the itching. This is particularly useful in allergies.

• Viral infections require only supportive treatment. For more on this, please click on

• Bacterial infections require antibiotics

• Drugs like ibuprofen will help fever and pain, if associated with this condition

Other remedies include:

• Drinking sufficient water to prevent dehydration

• Salt water gargle: Add about a teaspoon of salt to lukewarm water (about 237 mls. If you have a 1 liter bottle, mentally divide this into 4 sections. One section will be approximately this amount). Sip the fluid, tilt your head back and gargle for about 10 seconds. Then spit the water out. Repeat about 3 times and continue to do this as often as needed during the day.

• Throat lozenges help reduce irritation and also stimulate salivation which reduces dryness and throat itching. Please do not give to children younger than 4 years old as this may present a choking hazard.

• Breathing in moist air from a humidifier or from steam bath is helpful

• Rest your voice.

Now to problem number 2:

Body itching can be caused by different conditions including:

• Skin reactions to heat or allergies
• Skin conditions like eczema, dandruff or psoriasis. For more on eczema and dandruff, please click on these links https://chatwithdrketch.com/2014/03/01/daily-health-tips-what-can-i-do-about-the-eczema-on-my-skin/; https://chatwithdrketch.com/2017/05/18/hlwdk-daily-health-tips-help-with-dandruff/
• Parasitic infestations like scabies. For more on scabies, please click on this link: https://chatwithdrketch.com/2017/07/22/hlwdk-daily-health-tips-scabies/
• Fungal infections like jock itch or athlete’s foot. For more on scabies, please click on this link: https://chatwithdrketch.com/2018/03/31/hlwdk-daily-health-tips-athletes-foot/
• Hormonal changes during pregnancy or menopause
• Other medical conditions like thyroid, liver or kidney problems
• Dry, cracked or irritated skin. For more on eczema and dandruff, please click on this link: https://chatwithdrketch.com/2017/12/29/hlwdk-daily-health-tips-i-itch-after-every-bath/
• Nerve dysfunction
• Medications

Treatment of skin rashes is, of course dependent on the cause. It may include any or a combination of medications (anti-histamines), wet dressings on affected areas and phototherapy. If the itch is severe enough to affect your daily life, lasts more than 2 weeks, keeps coming back, is all over your body, is associated with other symptoms like yellowness of the eyes, please see your doctor immediately.

What can you do at home to provide relief and minimize harm to yourself? I’ll split them into dos and don’ts

Dos

• Keep your nails short so that you don’t do mortal damage if you do scratch J
• Or if you don’t want to do that, you could wear gloves to sleep at night – that way, even when you scratch unconsciously, no harm done
• Try patting the itchy part instead of scratching
• A cold compress held against the itchy part can also help reduce itching
• Wear more cotton fabrics to allow your skin breathe and not chaff your skin
• Use cotton beddings for the same reason

Don’ts

• Avoid hot baths. Keep bath water cool or lukewarm. Want to know why? Read this!
• Avoid vigorous drying off after a bath. Dab your skin dry
• Avoid perfumed products – soap, deodorants, shower gels, lotions etc
• Avoid tight-fitting clothes. They make a bad matter (itch) worse 
• Avoid harsh detergents for laundry
• Avoid spicy foods – they increase blood flow to the skin and make itching worse

Have a good evening 😀

Q: Good morning, Dr. Could you please advise – I have a hernia problem. My doctor told me that it might be repaired later but it’s troubling me – pains into my rib and my back. When I eat my stomach is so bloated, I look pregnant. I’m so ashamed. I noticed for the first time, very dark stools and I am worried it might be more serious then what the Dr thinks. Thank you and have a blessed day.

A: First rule of thumb for any condition you have is that where in doubt, please revert to your doctor again or seek a second opinion. If indeed you have hernia and you are now having pain, as you will see in this post, see your doctor IMMEDIATELY.

Starting from the beginning, hernia is the protrusion of an organ through a defect (like a hole or opening) in the wall of the muscle or cavity which usually holds it in place. There are different types 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 diarrhea 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 J 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 needs 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, counseling. 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. These are the self-help options available to you now. I am worried though, about the possibility of strangulation. I suggest that you go to a Government hospital. Consultation fee will be moderate and a doctor will give you a proper diagnosis after examining you.

Dark stools could be due to iron supplements, upper digestive tract bleeding etc. You really should go back to see your doctor or get a second opinion to tie in all these symptoms.

All the best!

You don’t need loads of money to get your children or nephews/nieces etc a great toy! No you don’t! Harvard Health recommends three types of toys they should have: 
‘Toys’ that help them use their imagination (blocks that can build different things they imagine or even writing materials so they can recreate those images from their ever-active imagination)
Toys that encourage interaction like ludo, scrabble, monopoly etc 
Toys that encourage movement like soccer, basket ball and roller/ice skating. For more details, click here: https://www.health.harvard.edu/blog/3-kinds-toys-really-help-child-2016121310853

Now about ice skating, I consider myself an open-minded and adventurous mum. We won’t bother asking my children what they think 😀 But I always drew the line at skating of any sort – I just felt it was an activity that could go wrong really quickly and disastrously! At one point those shoes, ‘wheelies’ or so were all the rage. My son talked himself into getting a pair but his mother (that would be me :D) would never let him wear them! I still see those shoes at home – spanking new. I couldn’t even allow him to give it out – visit that potential misfortune on someone else?! Mba oh! 
And so, my children have never skated….until last month when my second daughter experienced ice skating! Oh my! Y’all should have seen her trying to get her ‘ice-legs’. It was hilarious! Good news is, watching her, it didn’t look so dangerous after all. So the rest will now get their day(s) on an ice rink somewhere…fingers crossed! 😀
Have a fab weekend 🙂

Q: Hi Doctor, I ovulate during my periods. Is it possible to fall pregnant if I have sex during my periods?

A: Well, having sexual intercourse during a lady’s menstrual period does not make a man impotent, neither does it kill vital organs in his body…contrary to all the stories you have probably heard 😀

However, it is obviously messy and it is easy to contract Sexually Transmitted Infections at this time.

Can one get pregnant at this time? Unlikely but not impossible. It depends on the length of a woman’s cycle. If she has a short cycle, she could be seeing her period a few days away from her ovulation. Thus, if she has sexual intercourse, perhaps towards the end of her period, the sperm, which can stay ‘alive’ for days after sexual intercourse, are still available to fertilize the eggs released during ovulation. If in your case, you’re sure that you ovulate during your period, then I end by saying, ‘having sexual intercourse during menstruation is NOT a means of contraception’ 😀

Have a good night everyone 😀