chatwithketch

Q: Hello doc I’ve been having discomfort in my throat for a while now it feels like there’s something stuck in my throat especially in my chest; fatigue and headache is present and there’s this huge discomfort in my chest, like something is stuck there and when I swallow something I can feel that part becoming irritated. I coughed while I was eating yesterday and some pain emanated from there. I just quit smoking recently and I’m 22 years old. Do you think this could be cancer? Two things also – I’ve been smoking for over a year now and sometimes acid pushes up into my esophagus also

A: Hey! Thanks for writing in.

A little Biology class to get us started…:)

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 those you have described, really – 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. Your doctor will advise as to what works best for you.

Now, as you can see from this post, your main symptoms are most likely due to smoking. I’m not quite sure whether you are still smoking or you’ve quit. If you haven’t, this is really the time to give it up, don’t you think? J

Tobacco use is a major preventable cause of death worldwide.

The first step to quitting is having a clear desire to quit.  You have to be positive, reminding yourself why you need to quit. Apart from having a good support system, avoiding the areas where one usually is encouraged to smoke is a good idea. Friends and acquaintances that encourage you to smoke, should not be seen too frequently…especially as you start off on this process.

It is important to have other hobbies and activities that take your mind off smoking or take the place of smoking…in a sense. Getting more active with a sporting activity or church activities or volunteering etc are all activities that can take the edge off quitting. Some have found switching to oral substitutes like chewing gum, carrots and mints, helpful.

Apart from home support, having a support group of people who wish to quit also helps a lot. I have sent the phone number of a psychologist who can help you during this process. I will update this post shortly with websites that have information on support groups in Lagos for people who wish to quit.

You need to get on with the first part of the work, which is making the decision to quit. Having a wonderful family that you wish to be there for is an extra push. Knowing that many people have been able to kick this habit before you should confirm that you can do this!

I’m rooting for you!

Share the good news as the days progress. You could be encouraging someone else who wishes to quit! Let’s show that this can be done!

For a related post, please click on this https://chatwithdrketch.com/2015/02/24/daily-health-tips-im-trying-to-stop-smoking-pot/

Have a good night, y’all 😀

Question: Dear Dr. Ketch. Thanks for your wonderful advice. God bless. I have a one-year old grandson – very gorgeous and healthy. Thank you Jesus! At this time, he is struggling with a blocked nose and a lot of snot, yellowish in colour. Some runny but also a lot of phlegm that catches in his throat. What can you recommend I give him for it? Thank you.

A: Congratulations on your gorgeous grandchild! I can just imagine your pride and joy! May he grow up to fulfill his destiny!

As a parent, how much more a doting grandparent, it’s very normal for you to feel worried when your baby is ill especially when it appears you’re helpless and really can’t do anything to help him/her.

First, a note about cough syrups which many parents like to give, because the symptoms you described are often associated with cough, too.

First, if your baby’s cough is due to a cold, you really don’t need to give your baby any drug. A cold is a viral infection and once it causes an infection, it will run its course before it stops. And so, with or without drugs, a cold will go. It would usually last for about a week to 10 days and then disappear. There’s no need for antibiotics for a viral infection. Indeed, taking antibiotics when they are not needed leads to antibiotic resistance where the antibiotics can no longer properly do their jobs when they are really needed to fight infections.

Then some of the ingredients in the cough syrups can also cause a baby’s heart to beat faster, may cause convulsions and basically do not treat the cause of the cough. They are actually not supposed to be used for children younger than 2 years of age.
Now, what can you do in the meantime to relieve the blocked nose:
Let your baby sleep in your arms or in a semi-upright position.

You can prop him up with lots of pillows at night.

Offer your baby fluids and use a saline spray to ease the congestion in his nose. You can ask your doctor or pharmacist for this.

An air humidifier also moistens the air and makes it easier for your baby to breath. If you don’t have this, you can let your baby breath in steam from a hot shower. This has to be done carefully under adult supervision. An easy way is to run hot water in the shower and walk around with your baby in the bathroom.

A suction bulb can also help remove mucous/snot from your baby’s nose. You can ask for one in the hospital or a pharmacy.

Please see your baby’s doctor if this cough continues and/or your baby develops a fever and the symptoms persist after 2 weeks. If your baby also has difficulty breathing, cannot breath or feed, you should also see his/her doctor.

All the best!

Have a great week ahead!

Q: Hello Dr. I hope this finds you well. I’m a twenty year old lady and I’m very hairy…it’s even on the chest area. I was told it’s because of some steroids I took as a child for severe eczema I had. Can this be treated and how? Thanks, hope to hear from you soon

A: What you’ve described sounds like hirsutism which is a situation in which there is excessive hairiness in a woman in places like the face, chest and back. Funny enough, growing up, very hairy ladies were considered pretty special…In a good way 😀

This situation can be caused by any situation that increases the male sex hormones (androgens) or increases the response of hair follicles to androgens. Some conditions that can cause this include Poly Cystic Ovarian Syndrome (PCOS) or from taking medications such as prednisone (a steroid) over a long period as appears to be the case here, some drugs, obesity etc It is more likely in people who have a family history of this and in people of Asian, Mediterranean and Middle Eastern origin. This can also be found in women with no risk factors and women where no specific cause can be found.

If specific causes are found eg obesity or PCOS, these should be addressed.

As you may have found out, permanent methods of getting rid of the facial and other unwanted hair like laser treatment (which does not destroy the hair follicles) and electrolysis (which destroys hair follicles but may leave small scars on face) are expensive with laser being more popular and more expensive.

Mild cases of hirsutism can be dealt with by shaving, waxing, plucking or using depilatory creams…much as you would take care of underarm hair.

Birth control pills used over a period of 6 to 12 months may improve this condition by helping reduce the effects of androgens and reducing the production of more sex hormones. Anti-androgen drugs can also be used.

So, make out time to go find a gynaecologist as soon as you can and discuss this. He will carry out a detailed investigation and then confirm treatment options that would work best for you depending on his findings eg whether the contraceptive pills are an option for you etc

Until you’re able to do that, you may have to keep shaving, plucking, waxing or using depilatory creams. As soon as you can afford it, laser treatment should be considered.

Have a great evening, y’all 😀

Question: Good evening, Doctor. For some time now, I have been having swollen knee. It comes and goes.  The last time it happened, I visited the hospital, doctor said it arthritis. I was treated for malaria, I took injection that will make me urinate more, and he said I should stop salt.  The knee went down. Now since Friday, it came with full force, I can’t walk, have been using stool to walk. Yesterday I began to walk though with support. I’m treating it this time in a traditional way but it’s paining me. The knee is heavy, I cannot bend it. Please is there anything I can do and can I massage it like bending the knee? Please help me.

A: I believe that a doctor made the diagnosis of Rheumatoid Arthritis and that’s why you are sure that’s what you have. Over time, I have heard people use the term rheumatism (which is a lay term that is not really used in the medical world anymore) for osteoarthritis or rheumatoid arthritis. I will briefly describe both conditions.

Rheumatoid arthritis is an auto-immune condition. This means that in this situation, the body no longer recognizes components of itself and its immune system begins to fight itself. In other words, the body launches a war against itself!

In this instance, the body’s fight against itself leads to joint pain, swelling and stiffness, especially in mornings and can lead to permanent damage. It affects multiple joints, can involve multiple organs (eg lungs, heart, eyes etc) and there are usually nodules (small lumps known as rheumatoid nodules) found under the skin, especially the elbows. Some people are lucky and have long periods between flare-ups; others are not and have symptoms often. This disease is more common in people aged between 40 to 60 years, women and if a family member has it, it’s more likely one may also have it.

There is no cure as it is not clear why the body turns on itself. The focus is on management of the symptoms: Physiotherapy to keep the joints supple, medications to take care of the pain and inflammation and sometimes surgery for joint repair or replacement.

For anyone who has this condition, be sure to take your medications, eat healthy, exercise and learn to relax 😀

Now to osteoarthritis (OA), this is a more common type of arthritis. It would usually occur due to wear and tear (ageing) of the cartilage at the end of bones which allows free movement at the joints. The knees, hips, neck, lower back are usually affected and symptoms would include stiffness, pain and swelling. This disease is common in older people, women and the obese (clearly, being obese puts more stress on the weight bearing areas of the body like the knees etc), some types of occupation eg people who carry a lot of heavy loads are more likely to have osteoarthritis of the lower back. A family history of OA puts one at risk and having some diseases like Diabetes Mellitus makes one more at risk.

Where this disease affects the knee, it can lead to bow-leg and limping as the cartilage continues to wear away with even more wear and tear. Just like for RA, there’s no cure. Focus is on limiting pain and maintaining joint movement.

Treatment includes pain relief (using drugs in the class of ibuprofen or Paracetmaol), physiotherapy and sometimes, surgery. Injection of steroids into the joint space of affected joint has also been found useful but cannot be given too often.

Just like for RA, exercise, eat healthy, keep a healthy weight, use support (like walking stick) if need be etc

I hope this was helpful.

Have a good night, everyone 😀

Carrots and green veggies – which are better for the eyes? Should I read with bright or dim lighting? Is there such a thing as taking a break from prescribed glasses or contact lenses to rest the eyes? :O Can I exercise my eyes? Will the exercises delay the need for glasses? And is staring at a computer screen all day really bad for your eyes?

Well, I’m sure y’all think you have the answers to these questions but you could be very wrong! 😀 Read!

https://www.health.harvard.edu/staying-healthy/5-truths-about-protecting-your-eyes

 Q: Please Dr. What causes heart failure – I mean pains in the heart?

A: Hey! Thanks for writing in.

For the record, chest pain does not necessarily mean heart failure. But it’s always a good idea to check out chest pain in the hospital. Better safe than sorry 🙂

‘Despite the name, heart failure does not mean the heart has failed completely. Instead, it means the heart isn’t pumping efficiently enough to meet the body’s need for blood.

When the body first detects that it’s not getting an adequate blood supply, it tries to compensate. Stress hormones rise, pushing the heart to beat faster and harder. Blood vessels narrow in an effort to keep blood pressure stable. To keep blood flowing to the heart and brain, the body diverts blood away from less important tissues. The body also retains sodium and fluid in an attempt to supplement the volume of circulating blood.’

For more, please click on source: http://www.health.harvard.edu/healthbeat/what-are-the-symptoms-of-heart-failure

Question: Hey Doc. I’m living a stressful life as well anxiety is killing me every day. I slept with this guy since 2016 and I don’t know his HIV status. So, I heard he was dating a girl living with HIV. I confronted him and asked him whether he’s HIV+ or not .So, he said NO, and last year I even found an HIV self-test in his room but never asked him anything about it. So now that we broke and lost our child, I’m living a stressful life. I’ve tested Negative ever since 2017 up until this year Jan. I really need your advice DOC. Coz anxiety is killing me and this guy, I know for sure he’s HIV positive.

A: Thanks for writing in.

It is not clear to me whether you are still having sexual relations with him or not.  If you have tested negative for six months after exposure, then you may not need to worry especially if you have been tested in a proper laboratory and if you have not engaged in any risky behavior since then. However, if you have continued to have sexual relations with him or have exposed yourself to risky sexual behavior, my first advice would be to get tested immediately. Post exposure prophylaxis may be recommended by your doctor. These drugs used to treat HIV are usually taken daily for about 4 weeks to reduce chances of becoming HIV positive.

Having said that, the length of time before a subject tests positive to HIV following exposure (sero-conversion), known as the window period would depend on the type of test done.

An antibody test can read positive from 3 to 12 weeks, if there is sero-conversion. An antibody is a disease-fighting protein produced by the body in response to an infection (HIV infection, in this case).

A combination antibody/antigen test (which detects both antibody and antigen…which is a part of the virus) can read positive from 2 to 6 weeks after exposure, if there is sero-conversion.

A Nucelic Acid Test (NAT) can detect HIV infection in the blood from 7 to 28 days following infection.

Generally, if the initial test is negative, a repeat test is done 3 months after the exposure to ‘close the window’. Some may stretch this to a further screen after 6 months. Be guided by your doctor.

All the best!

Q: Good day Doc, please l want you to prescribe drugs to cure kidney stones for me. Thanks

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.

For more, read this! https://www.health.harvard.edu/blog/5-steps-for-preventing-kidney-stones-201310046721

And for part 2…

Q: Hello, doc. thanks so much for the educating info that u keep feeding us and responding to our inquiries, so much appreciated. Doctor my wife is having her first pregnancy and these first two months have proved to be hell for her. She also has a fungal infection in her privates. With this her condition what best medication can she use that will not affect the pregnancy. Thanks a bunch.

A: Hello dear, her doctor probably diagnosed vaginal candidiasis. This occurs when the fungi which live normally in the vagina overgrow and cause an infection. Usually, there is yeast (fungi) in the vagina and they generally mind their own business until something comes along to disturb the peace of the environment. This disturbance can be in the form of abuse of antibiotics (which kills off the good bacteria that hold the fungi at bay causing them to take over and overgrow the environment) or even in pregnancy (where the estrogen hormone produced in pregnancy messes with the normal order of co-existence of fungi and bacteria, again, allowing the fungi to take over). Other conditions associated candidiasis include Diabetes Mellitus, disorders of the immune system, use of oral contraceptives, the hormonal changes associated with menstrual cycle etc
In pregnancy, the decrease in tolerance to glucose which may occur, also means that the vagina has a rich supply of sugar which encourages the fungi to grow and multiply as they love the dark, warm, moist and rich environment 😀
How can this be prevented? Trust me, I’m not going to suggest not getting pregnant 😀 There are things that can be done to reduce risk of this infection. They include:
• Wear cotton panties instead of tight fitting nylon panties.
• Always wipe from the front to the back, after using the bathroom
• Do not use perfumed personal care products like sanitary towels, tissue etc
• Do not spray perfumes in your genitals and avoid perfumed soaps
• Change out of wet swimming gear as soon as possible
Now, this infection can be treated using oral drugs (tablets to be taken by mouth) 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 advice on 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/

Hope y’all had a good day 😀