chatwithketch

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 😀

If you drink a lot of coffee, you’ve probably noticed that there are times when it feels like you can’t hold that cup of coffee still. Truth is, you probably notice this too when you are stressed, tired and/or haven’t slept well. What else is responsible for this and how can you cope? Read!

https://www.health.harvard.edu/diseases-and-conditions/whats-causing-your-shaky-hands

Q: How are you? How can I completely stop menstruation pains? I have abdominal pain, back pain, headache, commuting during menstruation. I am not yet a mother and I am in my 30s. Please help me.

A: Menstrual cramps can take the very joy out of living…at the time you have them.

Cramps usually occur as the uterus tries to get rid of the foreign body, in this case, blood within it. Cramps appear, sometimes, to be more of an issue for some girls than the actual menstruation itself. For most girls, in the first few years of starting their periods, they usually do not have cramps and when these cramps eventually start showing up, they usually last for a few days.

How do we relieve menstrual pain?

Anticipate the pain before it actually arrives by taking some analgesics in the same class as ibuprofen called NSAIDs. These drugs have to be taken with food because they can cause peptic ulcer and so it is important NEVER to start using them without confirming from your doctor that this is fine for you.

Avoid foods that contain caffeine, salty foods, alcohol, smoking and sugary foods. You’ve probably heard the story about alcohol being a great idea during periods…I’m just not sure whether it’s meant to put you in a stupor so you don’t really feel the pain or for some other reason. I can tell you though that it helps you none, during your period Focus on complex carbohydrates during this period (and other times too: whole grains, fruits and vegetables)

Rest up when you need it and you could also use a hot water bottle on your lower abdomen.

Drinking warm fluids and exercising are also very helpful.

Remember to maintain the greatest sense of hygiene during this period (bath at least twice, change sanitary towels and panties often and ensure you smell nice….just don’t pour the whole bottle of perfume over yourself. That makes it smell like you’ve got a secret you’re hiding :D)

Usually after having had a baby, the cramps from period totally disappear or reduce significantly. In other instances though, it may be a good idea to see your doctor as fibroids and some other conditions can make menstrual cramps really painful and heavy.

If self-help remedies do not work, please see your doctor to get checked out and rule out other causes of severe menstrual pain like endometriosis, a situation where some tissue of the womb/uterus grow outside of the uterus or fibroids.

I hope y’all had a great day?l 😀

Does your blood pressure jump up and down and you’re never certain from one moment to the next, whether your blood pressure is normal or not? You should read this!

https://www.health.harvard.edu/heart-health/what-is-labile-hypertension

Q: You’re the best, but please why is it that no one talks about low blood pressure as much as the opposite? Thanks.

A: Low blood pressure is a blood pressure reading below 90/60mmHg. Though this is low, if it does not cause any problems, then it is not something to worry about. If, however, it is accompanied by symptoms like dizziness, light-headedness, confusion, fainting etc then the low blood pressure becomes a cause for concern.

Have a good night, y’all 😀

Q: Kudos to you Doctor. I was given a questionnaire to fill, by a group of Medical Students, in which my blood pressure, weight and height were measured. Can you please interpret the outcome to me ma’am, as it is written on the form, by the medical students, which I attached to this post?

A: A measure of weight to height, calculated by dividing your weight in kg by your height squared in meters (that is height x height) is called Body Mass Index (BMI). Your BMI is a quick way to tell whether or not you might be underweight or overweight, and what health problems you might have or develop because of your weight Eg, if one weighs is 80kg and is 1.6m tall, the person’s BMI is 31.25. Different BMI readings have different meanings.

Here are 5 things you should know about your BMI

• If you’re under age 21, your age and gender need to be factored into your BMI to account for the different speeds at which guys and girls develop.

• If your BMI is less than 18.5, you are in the underweight category. Talk to your doctor to find out if your weight is a symptom of a medical problem. A registered dietitian can help you learn about healthy eating.

• If your BMI is between 19 and 24.9, you are in the recommended weight range for your height. Yours is within this range, 20.4 to be precise. But your health may still be at risk if you are not getting regular physical activity and practicing healthy eating. So, don’t start rejoicing just yet 😀

• If your BMI is 25 to 29.9, you are in the overweight category. This may or may not be unhealthy, depending on some other things, like your waist size and other health problems you may have.

• If your BMI is 30 or higher, you’re in the obese category. You may need to lose weight and change your eating and activity habits to get healthy and stay healthy

Apart from your BMI, your waist measurement also plays a significant role in your health status. So, keep those tummies flat by eating healthy, y’all 😀

As for blood pressure, high blood pressure used to be defined as blood pressure reading of 140/90mmHg or more. Not anymore!
The new guidelines by the American College of Cardiology and the American Heart Association state that only blood pressure readings below 120/80mmHg can now be considered normal blood pressure.
A systolic blood pressure reading between 120 and 129mmHg is considered elevated blood pressure.
Stage 1 high blood pressure is between 130 to 139mmHg systolic blood pressure reading and between 80 to 89mmHg diastolic blood pressure reading.
Grade 2 high blood pressure is any reading above 140/90mmHg

Do you understand what systolic and diastolic blood pressures mean? Here are a few facts to guide you:

• Blood Pressure is the pressure with which blood pushes against your vessels as it passes through your body. A normal blood pressure allows blood to flow and deliver oxygen and food to different parts of the body.
• We measure blood pressure with two numbers (ie, 124/84 mmHg). The first number is called the systolic blood pressure and the second is called the diastolic blood pressure. These two numbers are written as ‘systolic/diastolic’ followed by the unit of measurement.
• Systolic blood pressure is your highest blood pressure measurement and is recorded when your heart contracts.
• Diastolic blood pressure is your lowest blood pressure measurement and is recorded when your heart relaxes and fills with blood

For elevated blood pressure, the new recommendations point to non-drug interventions like the follow:

• Reduce your risk generally by imbibing lifestyle modifications:
• Be physically active for 30 to 60 minutes on most days of the week. Try walking, biking, swimming, dancing or any other physical activity that you enjoy. Remember that even a little bit of physical activity is better than no activity at all
• Eat a lot of fresh fruits and vegetables, low-fat dairy products and other foods low in fat and salt. Avoid fast foods, canned foods or foods that are bought prepared, as well as any foods where you can see the fat in them
• If you are a man and take more than two alcoholic drinks each day or a woman and you take more than one alcoholic drink, drinking less will help to lower your blood pressure. A regular-sized bottle or can of beer or a regular-sized glass of wine are each equal to a single alcoholic drink.
• Keeping your body weight within a healthy range also prevents high blood pressure. If you are overweight, losing about 10 lbs (5 kg) will lower your blood pressure, and reducing your weight to within a healthy range will lower your blood pressure even more
• It is important to stop smoking if you have high blood pressure. Smoking increases the risk of developing heart problems and other diseases. Ensuring that you live and work in places that are smoke-free is also important
• Other lifestyle modifications include weight control, diet watch (portion control, use of less salt, using less oil in our foods and when we do use oil to focus on the heart healthy oils) etc

Changing your diet to the type described above can bring down systolic blood pressure by as much as 11 points, and each additional healthy habit you adopt can bring it down another four to five points.

For stage 1 hypertension with no cardiovascular disease and low risk for developing it, lifestyle changes still work.

However, 1) the presence of cardiovascular disease and stage 1 hypertension or  a combination of no existing cardiovascular disease but a significant risk of developing it, or stage 2 hypertension means that lifestyle changes have to be combined with medications.

How do you know your risk of cardiovascular disease? Click on this link and assess yours. It’s easy to use.

Therefore, I suggest, you have a long discussion with your doctor but be guided by him/her. If after careful monitoring, your blood pressure falls into any of the combinations that mean you should take medicines, please start on them. Taking a pill a day is a small price to pay to be here for your family and enjoy your life. And don’t forget the lifestyle modifications. Salt should be used very sparingly and the only way to this is really re-training our taste buds to ‘accept’ less salt as tasty. Remember that you can use spices to ‘jazz’ up your food.

All the best!