MANAGEMENT OF POST PARTUM BACK PAIN

MANAGEMENT OF POST PARTUM BACK PAIN

A reader sent this question last week: Please I want to know the cause and remedy of back and waist pain. The back ache started after the delivery of my first child, after the birth of my second the pain increased. Now it's almost 6 months and it is affecting me seriously, I'm careful in doing certain chores. Please help!

A postpartum period begins immediately after the birth of a child and extends for about six weeks, as the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. Post partum back ache therefore means back ache experienced by mother after delivery. Many of the physical changes that can cause low back pain during pregnancy may contribute to back ache now.

CAUSES

·         The body releases progesterone and relaxin hormones during pregnancy to loosen the ligaments and joints of the pelvic bone to help the baby come out with ease the weak ligaments and muscles lead to back pain. These hormones stay raised for a few months after delivery.

·         As the uterus expands during pregnancy, it weakens the abdominal muscles and pulls the lower spine forward, putting pressure on the lower back muscles.

·         Being overweight puts extra pressure on the back. The delivery process stresses the lower back, and it takes time to recover.

·         Bending frequently for lifting the baby or for something else results in back pain.

·         If you had back pain before and during pregnancy, it is likely to continue postpartum as well.

·         Having a wrong posture, especially while breastfeeding, can strain the muscles, causing backache.

·         Also, while giving birth you may have used muscles you don't normally use, so you could feel those effects for some time, especially if you had a long or difficult labour.                                                                                                                                                                                                                     

·         And the overall exhaustion and stress of taking care of a newborn 24/7 can also make it harder to recover from all aches and pains after childbirth, including back pain.

SYMPTOMS

Back pain usually gets better within a few months after delivery, though some women will continue to have pain for much longer. Those with back ache before or during pregnancy are likely to have back ache after pregnancy, especially if it was severe or began relatively early in pregnancy. Being overweight also increases the risk of chronic back pain.

PREVENTION AND TREATMENT

• Stand – and sit – up straight.
• Pay attention to your body position when feeding your baby, whether you're nursing or bottle-feeding. Choose a comfortable chair with armrests, and use lots of pillows to give extra support to your back and arms. If you're breastfeeding, consider buying a breastfeeding pillow that goes around your middle. Also try using a footstool to keep your feet slightly raised off the floor.

• Learn to position yourself properly while nursing, and always bring your baby to your breast, rather than the other way around. Also try different breastfeeding positions. Always bend from your knees, and pick up objects (and children) from a crouching position to minimize the stress on your back.
• Take rest as much as possible as strenuous physical activities will aggravate your pain.
• Avoid wearing high-heel footwear for a few months after delivery.
• Avoid carrying the baby on one hip for a longer time because it puts constant pressure on the back muscles. Use a front pack to carry your baby.
• Avoid stretching your arms while picking your baby. Instead, get closer to your baby and then lift.
• Sleep in a comfortable position and use pillows for support.
• While placing your child in the back seat of the car do not bend or stretch your arms. Instead, kneel down on the back seat and place your baby in the car seat.
• Taking analgesics like ibuprofen or acetaminophen. Don't take more than recommended.
• Try transcutaneous electrical nerve stimulation. Some people report that using one of these small, inexpensive devices temporarily relieves their low back pain.
•  Physical therapy (Physiotherapy):  A physical therapist can teach you exercises to relieve or prevent low back pain. Note: If you have had a C-section, then wait for at least six weeks before you start with this exercise.

CONCLUSION
Most times the back pain resolves itself after a few month post delivery. But, you must call a doctor if: The pain is severe and gets worse gradually; It is accompanied by a fever; Pain is caused by trauma such as a fall; There is numbness in one or both the legs; You suddenly feel uncoordinated; If the back pain persists even after six months.

CATCH THEM YOUNG, PROTECT YOUR ADOLESCENTS.

CATCH THEM YOUNG, PROTECT YOUR ADOLESCENTS.
In my last piece, I established that the health of the girl child is so important in the adolescence period because of the numbers of hormonal agents at play. I will take it further today by focusing on how to prevent and protect the adolescent girls from contracting sexually transmitted diseases (STDs), oral cancers, genital warts and cancer of the cervix in the future. The adolescent boy is not excluded as they can also be prevented from the same STDs, oral cancers, genital warts and cancer of the penis. A medical breakthrough was reported recently. The world first cervical vaccine for Human Papilloma Virus (HPV) made a positive impact on health care a decade after it was first administered. This resulted in a number of new cervical cancer cases being halved. The vaccine also protects against cancers in the throat and mouth in both men and women. Research done in Australia shows that there has already been a 90 per cent reduction in HPV infections in the 10 years that the programme has been running. This is because the vaccine is given routinely to young girls and boys in Australia.
Human Papilloma Virus
Human papilloma virus is a common virus that affects both males and females, which is passed from person to person through sexual contact. It is one of the commonest sexually transmitted diseases (STDs). HPV can stay in the body for years, causing changes to cells that can lead to a wide range of HPV-related cancers and other serious diseases. It is a highly contagious virus that is transmitted through different forms of sexual contact. Approximately 40 types of HPV affect the genital area and spread from person to person through sexual contact.
Cervical cancer
Cervical cancer is one of the few human cancers known to be directly caused by HPV. Most people get rid of the virus themselves without knowing they’ve contracted it, but one per cent of the population that get it get persistent infection that lasts for years. Other risk factors for cervical cancers include smoking, a weak immune system, starting sex at a young age, and having many sexual partners, adolescents who may be experimenting with kissing, oral sex, anal sex are more at risk. At the early stage, cervical cancer typically has no symptoms. Later, symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during sexual intercourse. While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer. Weight loss is also a late sign of cervical cancer.
Genital Warts
Genital warts are small fleshy growths, bumps or skin changes that appear on or around the genital or anal area. Genital warts are very common. Genital warts are the result of a viral skin infection caused by the human papilloma virus (HPV).

Prevention and protection

The best time to be vaccinated is before a person becomes sexually active. If a person has had sexual contact, then they may have been infected with some of these HPV types. If they have already been infected with any of these types, their protection against HPV-related cancers and disease after vaccination may be reduced. A series of three shots is recommended over six months.

Vaccinating males against HPV (protection from penile and anal cancer, some cancers of the head and neck, and genital warts) helps to protect unvaccinated females from cervical and other HPV-related cancers by reducing the spread of the virus.

HPV vaccine is prophylactic, It is 90 per cent protective of cervical cancer. It is recommended for our girls especially before first sexual experience. The concentration has been on girls worldwide, because girls are the one prone to cervical cancer. The disease is the second leading cause of female cancer after breast.

All girls and boys over the age of nine should be given the vaccine to protect them against cervical cancer and other HPV infections and complications in future. Women can also get the vaccine but regular pap smear tests for older females are still essential because the HPV vaccine does not protect against all cervical cancers. This is a sensitisation piece for us to act, spread the word and help to reduce the incidence of cervical cancer.Because none of the currently available HPV vaccines protects against all HPV infections that cause cancer, it is important for vaccinated women to continue to undergo cervical cancer screening.

Other measures that may be put in place to support the adolescent includes sexual education and stressing on ways of acquiring/preventing sexually transmitted diseases (STDs),an example is the ABC prevention of  STD: A-Abstaining from sex , B-be faithful to one partner, C- correct and consistent use of condoms. This will help the adolescent live a life free of STDs and ultimately a life free of HPV.

MANAGEMENT OF MEN’S SEXUAL HEALTH

MANAGEMENT OF MEN’S SEXUAL HEALTH
Men's sexual health refers to health issues specific to human male anatomy. These often relate to structures such as male genitals to conditions related/caused by male hormone (Testosterone).
When providing health care to a man, a doctor always has it in his mind that beyond curing men’s illness is the improvement of the quality of their life.
Men’s sexual health has become a major public health issue because of the challenges associated with their health which includes: lack of awareness and understanding of the health issues they face, men not openly discussing their health and how they’re feeling, reluctance to take action when they don’t feel physical or mentally well, men engaging in risky activities that threaten their health, not carrying their partners along, also stigmas surrounding men’s health are also some of the challenges.
Ten common men’s health issues seen in daily clinical practice includes: Erectile dysfunction, low sperm count, zero sperm count, hernia, urethritis, epididymoorchitis, prostatitis, male menopause, bening prostrate enlargement (BPH) and prostate cancer.
Others are premature ejaculations, testicular torsion, and undescended testes.
A patient of mine who was on honey moon had told the wife few days after their wedding that he had to get to the bank, only for him to be in the hospital to complain about inability to have erection.
He got married about five days before coming to the hospital, he said the wife saw her menstrual period on their wedding night ,the sight of blood had affected him that he could not have an erection and this persisted till after the wife menstrual flow ceases on the third day. This is a case of erectile dysfunction.
He was confused and came for consultation. He was counselled, treated and was asked to come for follow up. He was offered medications which was really helpful to him..
The man was called by the hospital staff to remind him of his appointment. He told the staff that the drug is effective and that he will not be honouring the follow up appointment.
Another patient had said the friend told him that such acts of erectile problems during honeymoons are spiritual and that he does not need medical intervention.
Greater percentage of men may be helped via medications even while there is no harm for tackling the problems spiritually via prayers, counselling and support.

Erectile dysfunction (ED) commonly called impotence is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It often causes serious distress, prompting men to seek medical attention they may not otherwise seek.

Erectile dysfunction (ED) is the most common sexual problem in men. The incidence increases with age and affects up to one third of men throughout their lives.
It causes a substantial negative impact on intimate relationships, quality of life, and self-esteem. History and physical examination may be sufficient to make a diagnosis of ED in most cases while few may require test.

However, problems affecting men's health extend far beyond erectile dysfunction and other commonly recognized men's illnesses.

About one in 10 men will have an abnormal result on the first Sperm (semen) test but this does not always mean they have a 'true' abnormality. So, if the results of the first semen test are abnormal, the test should be repeated.
Ideally, this repeat test should be done three months after the first, but if it looks as though the sperm count is very low or no sperm at all, it should be repeated as soon as possible.
Another closely related disease is the Sexually Transmitted disease (STD’s), this also affects men adversely as some presented with rashes, sores, warts and wounds on their genitals. This can easily be transferred to the partner with or without symptoms. STD’S can be prevented by being faithful to the partner, abstinence and the use of condoms. The common STD’s that men should  beware of are: Gonorrhoea, HIV, Hepatitis B Virus, Hepatitis C Virus, Syphillis, Herpes and Genital warts, Chlamidia and the newly discovered STD called Mycoplasma Genitalia, They are highly contagious and men with these should be treated without delay.
The import of this piece is to increase the need for men to seek medical care especially in sexual health issues that are specific to men and also to carry their partners along because some forms of therapies may directly or indirectly come from the women folks. .

MANAGEMENT OF OLIGOSPERMIA

OLIGOSPERMIA

Low sperm count (Oligozoospermia) is one of the main causes of male infertility. It is considered that a man has low sperm count when he has less than 20 million spermatozoa per one ml of ejaculate.

Causes of Low Sperm Count

Malnutrition and nutrient deficiencies - deficiency of some nutrients (for example Zinc, Selenium, vitamin C,Testicular injury and disease - injuries that affect the testicles may affect sperm production and cause low sperm count,Problems with sperm production - such problems can be genetic (for example Klinefelter's syndrome) or based on a hormonal disorder ,Overheating - excessive heat from hot baths may decrease sperm production and lower sperm count ,Smoking - smoking cigarettes is known to reduce sperm count and sperm lifespan, Drugs - the use of cocaine and heavy marijuana is known to reduce sperm count by 50%,Excessive alcohol consumption - alcohol is toxic to sperm and may reduce sperm count and quality Environmental toxins, radiation and heavy metals - Obesity - many studies find association between low sperm count and obesity in men ,Stress and excessive physical or mental exertion - these can cause some hormonal changes in the body that can affect sperm count and fertility ,Varicocele – worms like swelling on the scrotum, Bicycling - blood vessels and nerves may be damaged due to the pressure from the bike seats

Tests and Diagnosis of Low Sperm Count

Sperm production is complex - low sperm count can be caused by many factors and should be treated depending on the exact cause. Your doctor will test you and carefully examine your reproductive organs, as part of your examination, you will have to give a semen sample which will be analyzed and the sperm count will be measured. Anything less than 20 million sperm per mls is considered low sperm count. If your sperm count is lower than this number, you may want to consider undergoing a proper treatment.

Treatment for Low Sperm Count

Some commonly used medications and supplements for increasing sperm count are testosterone, certain vitamins, high-protein diets, anti-oxidants, and herbal semen enhancement pills. The effectiveness of most of these has not been clinically tested; yet, there are some quality semen enhancement pills that show significant results in improving both sperm count and quality. In addition to increasing sperm count, Volume Pills provides the following benefits: Improved overall male fertility, improved sperm quality and motility Increased sexual stamina, increased libido and desire for sex, bigger, harder and longer-lasting erections

Prevention

Switch to a healthier, balanced diet, rich in vegetables and whole grains, Exercise regularly. Try to reduce stress, Loose the excess weight. Don't smoke .Reduce or eliminate alcohol consumption. Don't use recreational drugs. Ejaculate less often; maintain a gap of three days between ejaculations. Avoid tight underwear, saunas, hot tubs and anything else that may increase the temperature of the testicles. Maintaining a healthy weight, sticking to a healthy diet, avoiding alcohol, cigarettes, and illegal drugs can all help you get your sperm count back to normal.

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