chatwithketch

Aspartame. Saccharine. Some common names bandied around by people who want to live healthier by avoiding sugar. These are non-sugar sweeteners. But….are they healthy? Do they help the weight loss journey? Aspartame has certainly received a bad rap over the years. Do you want to know why? Read!

Q: Good day. I bought a 400MG DE-WORM DRUG. How do I take it? Is it before eating in the morning or I can take it this evening before eating or after eating?

A: Hey! Thanks for writing in.

How do you know your symptoms are due to worms? Was your stool (faeces) examined? It’s important that you visit the health facility to get a proper diagnosis so that appropriate treatment can be started and/or so you don’t take medicines you don’t need.

Having said that, worms oftentimes do not present with any symptoms but sometimes people with this infestation complain of non-specific symptoms of the digestive system.

So, what is a worm (helminth) infection? There are different types. I will explain a couple.

A) Ascariasis – This is a type of roundworm infection and is one of the most common types of worm infections. This infection is spread when a person comes in contact with ascaris eggs in soil mixed with human feces or infected water. This is common in many developing countries, with poor sanitary conditions leading to people defaecating in fields and ditches and sometimes, human feces is used as fertilizer. When children play in this sort of environment and inevitably put dirty fingers in mouths or when unwashed fruits and veggies grown in the contaimnated soil, infection occurs

Most people will show no symptoms but a heavy infestation will cause problems depending on the area of the body affected.

In the intestines, the severity of symptoms depend on the number of worms

• Abdominal pain, which could be vague or severe
• Nausea and vomiting
• fatigue
• Diarrhea or bloody stool
• Weight loss
• Presence of worm in stool or vomit

In the lungs, they cause symptoms that resemble those of asthma

• Wheezing
• Persistent cough
• Shortness of breath

Prevention is really through good personal hygiene. Wash your hands before meals, before food prep, after using the bathroom, after gardening or coming in from outside. Just make it a habit to wash your hands, consistently.

Then practice good food hygiene too. Wash your fruits and veggies thoroughly before use, especially those that will be eaten raw. Drink only potable water – use bottled water (especially when you travel) or boil and filter your own water at home.

Other soil transmitted helminths are hookworm (usually causes iron-deficiency anaemia) and trichuris trichuria aka whipworm.

Diagnosis is by stool microscopy and treatment with anti-helminthics, mebendazole, ivermectin or albendazole is usually effective.

Surgery may be necessary in cases of heavy infestation to remove worms and repair damage or obstruction of the intestines, remove inflamed appendix or remove bile duct obstruction

B) Another example of infection caused by worms is elephantiasis. Elephantiasis is a disease condition in which there is swelling of the limbs, genitals or other body parts making them appear swollen and puffed-up, resembling an elephant. How does this happen? It actually starts with the bite of an infected mosquito (Aedes, Culex, Mansonia or Anopheles mosquito) which transmits filarial worms that block the lymphatic system. I see the look of confusion already on your faces! J What’s the lymphatic system, you say “)

Well, the lymphatic system is a network of vessels and glands distributed all over the body. They help to fight infections and drain excess fluids from tissues in the body. When this system is blocked, fluid no longer drains freely from the tissues leading to collection of fluids in the tissues, resultant body swelling and fever when this fluid collection gets infected. Chronic (longstanding) infection with these worms leads to elephantiasis with swelling (lymphedema) and hardening of the limbs. It really does require years of exposure to these infected mosquitoes for elephantiasis to occur. It is important to handle the infection before it gets to this stage.

Most people, however, will not have symptoms until years after being exposed when they develop these swellings.

There is no medication that is really active against adult worms. Focus is on management of symptoms. Exercise encourages lymphatic drainage, healthy diet, good skin care to prevent infection can help. Wearing special compression stockings/garment or having a special massage by a specialist to help lymph fluid drainage are also helpful aids.

Prevention of elephantiasis is key.

• Use of mosquito nets
• Use of medications to kill microfilariae in the blood
• Antibiotics for infections
• Surgical prevention of infected tissue

C) Schistosomiasis, another worm infection, is acquired by exposure to fresh water contaminated by snails especially in sub-Saharan Africa. Infection can persist for many years after exposure and symptoms include those of:

• Chronic renal failure
• Bladder cancer
• Portal hypertension

Diagnosis is made by:

• Stool microscopy
• Urine microscopy
• Schistosoma serology

Treatmentis usually with a medicine called Praziquantel.

So, as first steps, I suggest you go visit your doctor and get a proper diagnosis. After that, the right treatment option for you, including best way to take it  (eg with fatty foods, during or after meals etc) will be decided.

All the best!

Q: Hello Doctor! Help a lady she’s in need, Mmm my 3-month baby worries me. I breastfeed and use formula at the same time. His faeces are green. What might be the problem?? Thanks

A: Thanks for writing in.

In babies, green poo can be due to:

• Baby not nursing sufficiently from one breast before being moved to the other breast. This means that the baby gets more (watery) fore milk than the fattier, nutrient-dense hind milk.
• If baby is bottle-fed, it could be due to the particular formula being used. Try switching to another formula and see if it helps
• Diarrhea
• Inadequate intestinal flora in breastfed babies

Though this question is about babies, I’ll mention some cause of green poo in children and adults:

• Eating a lot of veggies
• Diet rich in iron
• Diarrhea
• Presence of green food dyes etc

I hope this helps.

All the best! J

Have you ever bought shoes and then found later that they appear quite tight…and despite everything the salesperson had told you about how the shoes will ‘expand’, it’s just not happening? Or perhaps, you find that when you buy shoes for your children the same happens and so, you are now consistently buying ‘Obi’s big shoes’  Well, this article is for you. It tells you when to buy and how to buy!

8 tips for buying shoes that are good to your feet http://www.health.harvard.edu/healthbeat/8-tips-for-buying-shoes-that-are-good-to-your-feet

Q: Hello Dr. please post for me and hide my ID. Just wanted to find out when ‘hot flushes’ end.  I am 52 going on 53 years old soon.  I started having hot flushes when I was 39 years old.  I haven’t had my pees (periods) for over a year now but still have the hot flushes. It can be embarrassing at times.  If there is any remedy? Please advise. Thanking you in advance

A: Menopause is a period defined by at least 12 months of cessation of menstrual period. It occurs as a natural process of aging which can start as early as late 30s as the ovaries start making less amounts of hormones (estrogen) but typically around the 40s and 50s. Menopause can also be induced by chemotherapy or radiotherapy (treatment for cancers), surgical removal of the ovaries etc. This is called premature menopause and is likely to run in families.

Symptoms of menopause can start months or even years before the cessation of periods and may last for up to four years (and sometimes even longer) after your last period as appears to be the case here. Common symptoms include:

• Reduced sex drive
• Vaginal dryness
• Night sweats
• Difficulty with sleeping
• Anxiety
• Hot flushes, as you have described

Hot flushes are typically described as a sudden feeling of heat that seemingly appears from nowhere and spreads throughout the face and body. This may happen occasionally but some women have several episodes a day, which they find uncomfortable and embarrassing.

The real culprit here is the deficient hormone, estrogen but this can also be triggered by wearing thick clothing, a high temperature, anxiety, drinking coffee or alcohol, eating spicy foods, some medicines etc

To reduce these symptoms, focus on the related cause. Examples include reducing coffee and alcohol intake, keeping the room temperature cool, sipping on cool drinks, having lukewarm baths/showers as opposed to hot ones, reviewing medicines with doctor if you suspect the medicine you are taking etc. Other helpful tips include spraying your face with some cool water if you feel a flush coming on, wearing more of cotton fabrics and stopping smoking.

Treatment for menopausal symptoms (including hot flushes) include hormone replacement therapy, eating healthy, balanced diets, exercising and cognitive behavioral therapy for people with anxiety. Your doctor will be able to assess what will benefit you most after reviewing any other medical condition you may have.

All the best!

Q: Hi Doc, I am sorry to just barge into your inbox. I have a problem. I am breastfeeding an 11-month old baby, while pregnant for 10 weeks. Is it safe?

A: It’s generally considered safe to continue breastfeeding in pregnancy. In fact some mothers would even breastfeed the new baby and the older one, concurrently. This is called tandem nursing. However, given the requirements of breastfeeding and of pregnancy, this mum must ensure that she is eating healthy and drinking sufficient fluids.

If your already born baby can talk, he may comment on the fact that the taste of your breast milk has changed especially towards the end of pregnancy and a few days after the birth of the new baby as colostrum is produced.

For more posts on colostrum, please click on this link: https://chatwithdrketch.com/2014/05/27/daily-health-tips-what-should-i-do-after-having-my-baby-if-my-breast-milk-doesnt-come-in-immediately/

For the mum, she may notice more breast tenderness…sorry 😀 And also, milk production reduces as pregnancy progresses.

The process of letting down milk involves the release of a hormone called oxytocin. This hormone can also cause uterine contractions, which you absolutely do not want when you’re pregnant until it’s time for delivery. The good news is that the oxytocin released is not enough to cause significant contractions that can lead to a pre-term labour. However, people who already have a history of pre-term or premature contractions need to check with their doctors as nipple stimulation (either during sexual intercourse or breastfeeding may lead to pre-term contractions)

Your 7-month old baby can take water (of course). You can give him freshly squeezed fruit juices (this basically means you’re buying the fruits and squeezing out the juice yourself or blending up a smoothie). Remember that your baby must not have any cow milk until the baby turns 12 months…well, unless it’s in yoghurt (unsweetened, flavor-free yoghurt). You can add some bananas to the yogurt and blend it up.

For more on weaning and preparation of yoghurt, please click on these links: https://chatwithdrketch.com/2014/12/29/daily-health-tips-weaning-foods/

Have a good night y’all