chatwithketch

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!

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!