chatwithketch

Q: Hi Dr. Ketch…I really need your help on this. I have suffered from haemorroids for almost 9 months. They come and disappear after sometimes. So recently, I have been having excess gas and farts of more than 20 times a day and it’s even worse during the night. It’s so embarrassing for me especially when I am sharing a bed with someone who doesn’t really understand my condition. Some people can even term it as lack of manners or control. How can I reduce the flatulence and live a normal life again? I am looking forward to your response. Thanks in advance. Merry Christmas and a happy new year.

A: Thanks for writing in and I trust you had a merry Christmas too J Here’s wishing you and the rest of my ‘Healthy Living with Dr. Ketch’ family a happy new year in advance. There are still a couple of hours left of 2018. Make them count even while you’re already making plans for 2019 😀

‘Excess gas’ is produced in the body when we swallow it or when our body produces it as a result of what we have eaten. This is usually caused by the twin factors of what you have eaten and how you chose to eat it.

For what you have eaten, easy culprits are rich, fatty foods, beans, dairy (especially in lactose intolerant people), high fibre foods (if lots of water is not taken afterwards) etc.
How can the way you eat cause you a problem?

If you tend to over-eat or rush your food (eat it very fast or like a friend of mine would say, ‘inhale’ it :D), then you are a target for bloating (that feeling of being swollen with gas). The reason is that you eat so fast that you don’t give enough time for signals to travel to your brain from the stomach confirming that you are full. By the time that signal arrives, you are all stuffed up and bloated to boot! Note that it may take up to 20 minutes for those signals that confirm fullness to get to the brain…sounds like a long journey 😀

Other causes of bloating are swallowed air (which can happen when we eat too fast or drink too fast) and smoking.

Prevention?
This is really simple: Reduce portion sizes, limit your intake of fats, eat slowly, quit smoking and limit your intake of foods that cause this, if all else fails.

If your bloating is caused by swallowed air, avoid carbonated drinks (most soft drinks fall into this category), don’t drink with straws (at least on a regular basis) avoid chewing chord…oh, sorry! 😀 I meant to say, avoid chewing gum and stay off your candies that you suck so hard and suck in quite a bit of air too!

Remember that if this ‘gassiness’ continues ‘regularly, you should see your doctor to be sure this is not the symptom of something else.

For tips on what to do about haemorrhoids, please click on this link: https://chatwithdrketch.com/2014/03/12/daily-health-tips-help-please-i-have-chronic-piles-haemorrhoids/

Have a great day! 😀

Q: Good day Doc. Thanks for the medical lectures you have been giving to us. Please I want to know if treating malaria during first trimester is harmful to the baby

A: Pregnancy can affect different women differently. For some women, they hardly feel a thing and others spend the whole nine months (…and then some :D) in bed. And so, you may very well feel you have malaria when the only issue you’re dealing with is the new life growing in you! I felt like that for a long while before I discovered I was pregnant 😀

Fansidar is a specific brand of the drug Sulphadoxine-Pyrimethamine (SP) is used for the prevention of malaria in pregnancy. Its use for this is referred to as Intermittent Preventive Treatment of Malaria in pregnancy (IPTp-SP).

Is it safe in pregnancy? Yes and no. In the first trimester, it is not recommended for use but from the second trimester, it is considered appropriate and indeed is recommended by World Health Organization (WHO) for administration to pregnant women. If you live in a malaria endemic area like Nigeria, your doctor will ensure that you get your Intermittent Preventive Treatment (IPT) courses for malaria (sulphadoxine-pyrimethmine) during your pregnancy, as your doctor has already done. The assumed rule before was for pregnant women to receive 2 doses of this drug (full dose of 3 tablets) but WHO has since clarified that the appropriate regimen is for women to receive the full dose of Sulphadoxine-Pyrimethamine from week 13 of pregnancy. She should get a full dose at every antenatal visit provided the last dose was taken at least one month before. There is evidence that women who received 3 or more doses of IPTp had children with higher average birth weights than those who got 2 doses.

Your doctor will ensure that the Folic Acid dose you’re getting in your prenatal drugs is not more than 0.4mg. Doses of Folic Acid higher than or equal to 5mg affects the efficacy of the anti-malarial, SP. So, be sure to check with your doctor before you start buying other non-prescribed prenatal vitamins.

If you do have malaria Quinine, Clindamycin, Proguanil are considered safe by the WHO treatment guideline in the first trimester. However, don’t be quick to go take any of them without prescription. Remember that every drug is a potential toxin and your doctor is really in the best place to weigh potential risks of taking any drug against the potential benefits. To put this in perspective, a recent study appears to now suggest that acetaminophen (the main ingredient in paracetamol) may lead to Attention Deficit Disorder in children! And yet, we refer to it as ‘ordinary’ paracetamol. There is nothing ordinary about any drug, my friends

Doing all of the above will be meaningless if you do not pay any attention to the environment.

Those anopheles mosquitoes that are associated with malaria need a place to lay eggs so they can muster the right army to wreak havoc. So deprive them of a breeding camp. Who would know the conditions necessary for a terrorist camp to be set up and make their homes or environment, the right one for that? Nobody…in their right minds at least 😀

If you have to go out in the evenings, depending on whether you will be out in mosquito infested areas, wear protective clothing that cover arms and legs, preferably in light colours. Mosquitoes love dark colours and the dark….no wonder their deeds are evil. Insect repellent creams used on exposed areas are also not a bad idea.

So, my advice is to see your doctor to confirm what is wrong with you…if anything at all, beyond pregnancy 😀

Have a good day and a great weekend, y’all 😀

Q: Good day Doc. Thanks so much for your medical lectures on Facebook. God will continue to strengthen you. I am a first time mother I had my daughter last December. During the 1st trimester I was bleeding heavy but later stopped after medical consultation but I noticed my daughter is using only her left hand and holding the right hand so tight but if I force to open it and move it I found out nothing is wrong with it. My question is how can I help her to use the right hand too. Thanks ma’am as I await your response. God bless

A: It does sound like you assume the bleeding affected your daughter’s preference of what hand to use? If you think so, you’re wrong. No link.

Now, please be sure that there is really nothing wrong with your baby’s right hand. The way you describe her clenching it is a bit curious. If she appears to be in pain, please get it checked out in the hospital. If there’s nothing wrong and this is just an issue of being right handed versus being left handed, then leave well alone.

This issue of converting left-handed children to right handed orientation has come up again and again. Our culture, in Nigeria and perhaps other places in Africa, suggests that doing things with the left hand is wrong, rude and simply abnormal. But just take a moment and think about it? Why is it wrong? Or rude? Where is it written? When was it decided? Were you at the meeting?

Perhaps an understanding of how people become right or left handed is important here. The brain is cross wired such that the right side of the brain controls movement of the left hand side of the body and the left side of the brain controls movement of the right hand side. Most people are right handed and that’s because the left side of their brain which controls writing, language, logic, scientific skills etc is dominant. The left side of the brain controls emotional expression, imagination, creativity etc.

There are several reports of children who have been changed from left to right hand suffering unneeded hardship mentally, emotionally and socially as a result of this. Some articles have reported bedwetting, stuttering, being withdrawn, poor concentration and memory etc as fall outs of this change from left to right. It would appear that the brain is confused as it tries to re-define which area of the body it controls.

The way I put it is, ‘if it ain’t broke, don’t fix it!’ So, leave your child well alone. Right handed, left handed ambidextrous (one who has use of both hands), please love these children the way they are and encourage them. Ever seen the most powerful man on earth (president of the United States, Barrack Obama) sign a document? Well, if you do, take a close look. He’s left handed and that doesn’t appear to have hurt him much!

Let me know what you think.

I hope y’all had a great day 

https://www.instagram.com/p/Br0DDM0lKc5/

Q: Good evening, Doctor. Please I have been noticing some string (something?) on my foot nails – some said it’s fungi. How can I treat it both medical and herbal or let me say, home remedies?

A: Fungal infections of the nails occur when nails are infected by fungi (as if you didn’t know that! :D), yeasts or mold. These infections can happen when there is a cut on a finger or when your nails are constantly in moist and warm environments. These nails are colonized by the fungi and result in nails that are discoloured, brittle, distorted in shape, dull or even hardened. The nails could even separate from the nail bed and then, there’s that smell, that signifies that something is not quite right ether 😀 The infection would usually start off with a white or yellow speck under the nail tip which spreads and may involve the whole nail. So, if you see a white or yellow spot under your nail tip, race to see your doctor and start treatment early!

Fungi love warm, moist places. So, toe nails are more easily infected by fungi because they are oftentimes hidden away in shoes that really don’t allow them to ‘breathe’ and are not as rich in blood supply as finger nails. Walking around barefoot in wet areas, sweating heavily and working in wet and humid conditions are also pre-disposing factors. People who have had athlete’s foot and are diabetic are more prone to these infections for reasons I have already mentioned.

How to prevent this? For finger nails, wear rubber gloves if you’re going to be working with water for extended periods, keep your nails short and trim; And yes, just in case you wondered…that means that wearing those artificial nails may be doing more damage than we know as it provides the warm, moist environment needed for fungi to grow. If you like DIY manicure and pedicure, try not to cut too close to the skin around nails to avoid injuries that could be good places for fungi to breed. Opt for reputable nail salons that have the right tools and man power and indeed buy your own manicure set.

Treatment could be with oral medications (that is drugs taken by mouth). This could be taken for up to 3 months and essentially, the infection is over when a new healthy nail grows out. Other times, your doctor could prescribe a nail polish (which contains anti-fungal ingredients) or advice a mixture of cream and lotion to be applied on the nail bed. Another option is surgery, especially if the nail is painful

As with most fungal infections, the watchword is ‘patience’. Don’t be in a hurry to conclude the medications; it may take a while. Take solace in the fact that, ‘this too shall pass’ 😀

This Harvard post reminded me of a question I had received a while ago…2 questions, actually. Here goes the first one

Q: Hello Dr, I have been having swollen legs since I traveled almost 17hrs by air. All tests been done, no fault discovered. What shall I do?

A: Hello dear, thanks for writing in.

Swelling of the legs and feet during flights is common and usually not suggestive of a more serious problem. It happens when blood pools in the leg veins due to long periods of inactivity as can occur during a long-haul flight. This swelling usually lasts for a few hours. If the swelling persists, occurs more in one leg and is associated with leg pain, please see your doctor immediately as it may be suggestive of a more serious problem, like a blood clot in the leg.

I repeat a post I made some years back on preparing for flights. It focuses on preventing the condition you already have. However, if you already have swollen legs due to pooling of blood as described above, rest, elevate and exercise your legs to reduce swelling. Exercise tips are given in the post below.

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Dear Diary, you’re probably the only one who really understands how very busy the past few days have been. So, as I race through Lagos traffic towards the airport, I’m actually looking forward to catching up on some much-needed sleep on the plane…

I know quite a number of people who tell me they can’t sleep when they are in a bus, on the plane or in a car. They can’t sleep when there is even a bit of noise, when the curtains are not drawn, when the lights are on or the lights are off! Different variations! Well none of these define me! Once I’m tired, I can sleep anywhere…in the middle of a room filled with noisy children, in a squashed cramped car on a long trip, in the squashed space of a bus, in the tiny economy space of local and international flights and I daresay I can sleep on top of a trailer filled with sacks (I haven’t had this dubious pleasure yet!). In fact, I rather look forward to these trips sometimes because it presents an opportunity to sleep undisturbed. Provided I am travelling alone and not with my family, I am sure that I am unlikely to be disturbed for bathroom breaks, hunger, any sort of telephone call or work emergency. Oh bliss! (Just in case you wondered, I totally, absolutely and completely love my family :D).

So that’s my story. If you’re like me, you would stock up on some good novels to read at some point (when you open your eyes briefly) but if not, you are dreading the 6 or 12 hours (or perhaps even more) flight.

So, plan for it. Whether you’re travelling first, business or economy class, you don’t have to be worn out when you arrive at your destination. If you’re travelling economy, enquire at the booking desk if the flight is full. If it’s not, you could get a seat with empty seats beside you. Almost like flying in business class….albeit devoid of the personal touch, but who cares, right 😉

Wear comfortable and loose-fitting clothes. I’m consistently amazed by slay-queens who dress to the nines complete with high heels when travelling! I’m in awe! 😀

Get comfortable…take off your shoes and….nothing else, please :). This should help minimise discomfort especially if foot swelling occurs. Pressure stockings are also a good idea to help prevent this swelling.

Get a travel pillow…those U-shaped pillows they sell at the airports. They are pretty comfy and prevent you from getting a crick in your neck during that long flight.

Take walks round the cabin every hour or so to help circulation and stop you arriving at your destination with swollen legs/feet. You could use these walks to network and/or catch up with friends/colleagues/business associates who happen to be on the same flight.

For the sleepy heads like me, try some ankle rotation exercises during those small intervals when you are conscious 🙂

Lay off the coffee and alcohol. And drink a lot of water. Yes this may increase your visits to the bathrooms which you really don’t want, what with the long queues of people waiting to use them; but it is much better than getting dehydrated as the air in the cabin is pretty dry and could dehydrate you.

As for the food…perhaps you’re one of those who hate the ‘plastic’ food and laugh at the oyibo’s attempt at jollof rice (I’ve tried explaining to them that the art to cooking jollof rice is only in the gene of Nigerians and jambalaya is not even a close substitute! Please note that the study about the jollof rice-gene interaction has only been carried out in my head…so this is clearly proprietary material right here! :)), then you have no problem because you probably ignore the food. But you could stock up on some nuts (almonds, cashew nuts etc), granola bars, fruits and water to take with you. They are useful during those long lonely hours when you’re waiting for the flight to board and to take onto the plane if you’re going to ‘dis’ (code for disrespect, my son tells me) the food! It’s also most certainly cheaper and healthier than the over-priced airport food which you may be tempted to indulge in. However, if you’re going to indulge, you might want to book online and order the lower calorie options.

Pack some breath mints in your bag. There’s nothing as thoroughly embarrassing…no scratch that! There’s nothing as humiliating as trying to discuss with a business associate who you happened to meet on disembarking from the plane, while trying not to come too close because you know you’ve got morning breath! So be a boy scout! Be prepared!

If you’re, perhaps going for a conference, resist the urge to indulge in all that free food (close your eyes and visualise banquet tables groaning under the weight of all types of food: chocolate fountains, pasta, all kinds of gravy, pastries of different shades and colours, fish, chicken and beef dishes of all kinds!) and look for those healthier alternatives (fruits, salads…not soaked in dressing, quinoa, grilled fish, vegetables etc). Load up on all these…loads of beautiful colours on your plate!

You know all those free books they give you at the conference? Take only the ones you really mean to read. This way you’re not tempted to trash them at the airport when ‘they’ tell you, you’ve got excess luggage! This is becoming a huge ‘international’ joke!

I am actually on my way to a conference and so this advice is as much for you as it is for me! 😀

And the second…
Q: Hello Doc, I want to find out if swollen feet are associated with pregnancy?

A: Good question…and yes, it is normal for the body to tend to retain more fluid during pregnancy apart from the fact that the uterus (womb) as it grows, puts pressure on the veins preventing the proper return of blood to the heart. Increased blood flow and hormonal changes (causing foot ligaments to relax and therefore bones to spread out) may also play roles in this.

To prevent this …or significantly reduce it, try the following:
• Wear comfortable shoes and try not to stay on your feet for too long.
• Kick up your feet and relax as often as you can.
• Exercise helps…gentle stretching and other exercises safe in pregnancy (speak with your doctor where in doubt as to what is safe) help to move the fluid along. In addition, foot exercises, are also great and would include gentle rotation of the ankles.
• Sleep on your side, drink sufficient fluids during the day and limit your salt intake….remember that for salt, if you can taste it, it’s definitely too much

Having said this, some swelling in pregnancy is due to a condition called pre-eclampsia. So, be sure to check with your obstetrician if the swelling observed appears to be sudden or indeed, worrying.

Have a good night, everyone 😀