babymama01:
Hi doctors I'm 13wks + preggy nd diagnosed of typhoid nd malaria a dr placed me on zinnat 500mg, artesunate and fansidar bt when I told another dr abt d prescription he said d drugs ar too strong 4 me that I shoud go 4 augumentin and coartal-forte instead nd also reduce d zinnat to 250mg. Pls wats ur thought on this tnx.

You're barely 3months pregnant and combine regimen of zinnat, artesunate, and fansidar is just too strong for a 13wks pregnancy. The first physician should have gone with Arthemeter Combined Therapy, plus ciprofloxacin, which is milder on early pregnancy than artemisinin(artesunate), while the ciprofloxacin is more effective and safer in treating typhoid.

Well, you can ask your physician(the 1st doc) if it's ok to drop the fansidar, and just go with ACT antimalarial and ciprofloxacin or zinnat. I'm not so sure about the efficacy of augmentin in the treatment of typhoid compared with fluoroquinolones like ciprofloxacin, though it depends on the outcome of the sensitivity test.

And try to always sleep under mosquitoe nets(LLITMN).

Kittana:
Hi, doc Marc. Please any advice will be appreciated. I've always had irregular periods but they seemed to have been put under control after I got on BC pills for three months. Got on the pills when my once in 2-3 months cycle, went really crazy and started showing up once every 2 weeks. Towards the end of the 3rd month on BC pills, I read I definitely couldn't be ovulating and given that I'm married and also have to worry about ttc, I did a little self-medicating by taking clomid...during the final withdrawal bleed.

Waited and waited for my first natural cycle, did some reading again (crazy and not too wise, I know) and found that not seeing a period after clomid could as well indicate an annovulatory cycle which prolly could be because the dose wasn't enough....plus, I read clomid can be taken without a period. So I did something crazy. I took 100 ml of clomid on cd 42 and my ovaries got hyperstimulated. Confirmed by a pelvic scan (I had done one after coming off the pills which showed everything was normal). But I did get a period exactly 14 days later.

2 months later, a menstrual cycle in each and another pelvic scan report to show that I was again in the clear, I ran off to see an actual ob/gyn. He placed me on 50mg clomid and parlodel for that month and the next one, he performed a hydrotubation on me. This hydrotubation happened in october 2014. The procedure made me bleed (heavily) for 26 days. After that, went on to have a period in november 6th, had mere spotting that lasted five days though, on december 12th and bam! A very very very heavy period that started on christmas day and lasted for 5 days.

Wrote that off as nothing as the spotting in that cycle was actually just spotting...a drop or two for every five hours but yesterday, I started to bleed again and I'm really just confused and really upset. I don't know what to blame it on. Do I have some sort of infection, Cervical cancer or is it just hormones playing tricks on me? In as much as I am not comfortable with the too frequent periods, I wouldn't mind conceiving like right now. Please what do you think and what should I do?

It's definitely not cervical cancer. The actual differential diagnoses are leiomyoma, adenomyosis, endometriosis, PCOS.

The gynae ought to have indicated you run a full hormonal assay to find out the level of your sex hormones, then a pelvic scan would be run to check the outlines of the uterus and the endometrium.

My suspicion is endometriosis. So, why not run a pelvic scan, HSG, and then hormonal assay.

NoQualms1:
@marc9, my baby is 7 weeks old but I'm always scared anytime I want to b.reastfeed her. I've been having sore and painful n.ipples since her first week. I'm tired of going through this pain several times everyday. What can I do/use to stop this pain?

She latches on well.

The pain in the n*pples, with the sore, is due to mastitis, an inflammation of the bre*st, particularly the n*pples and d the areola. An increase growth in Staph aureus in bre*st-skin most often leads to such pain and sore. Also, hyperprolactinaemia(high prolactin in the blood) can also result in painful n*pples.

The less painful n*pple should be used in bre*stfeeding, for a day or more, to give room for the other to heal up. Then you can interchange to also give room for the other to heal. You can take anti-inflammatory drug to relieve the pain, and also dab the n*pple/areola with warm water.

@Marc,am not overweight.used to weigh 69kg-73kg.Now, am currnetly on Blood pressure drugs and my readings are okay at home(116/69) and thereabout.When I want to take in,am I to stop taking the drugs?and do I need to take it throughout d pregnancy when I conceive?

Marc9:


The pain in the n*pples, with the sore, is due to mastitis, an inflammation of the bre*st, particularly the n*pples and d the areola. An increase growth in Staph aureus in bre*st-skin most often leads to such pain and sore. Also, hyperprolactinaemia(high prolactin in the blood) can also result in painful n*pples.

The less painful n*pple should be used in bre*stfeeding, for a day or more, to give room for the other to heal up. Then you can interchange to also give room for the other to heal. You can take anti-inflammatory drug to relieve the pain, and also dab the n*pple/areola with warm water.

Thank you. I will do that.

Marc9:


You're barely 3months pregnant and combine regimen of zinnat, artesunate, and fansidar is just too strong for a 13wks pregnancy. The first physician should have gone with Arthemeter Combined Therapy, plus ciprofloxacin, which is milder on early pregnancy than artemisinin(artesunate), while the ciprofloxacin is more effective and safer in treating typhoid.

Well, you can ask your physician(the 1st doc) if it's ok to drop the fansidar, and just go with ACT antimalarial and ciprofloxacin or zinnat. I'm not so sure about the efficacy of augmentin in the treatment of typhoid compared with fluoroquinolones like ciprofloxacin, though it depends on the outcome of the sensitivity test.

And try to always sleep under mosquitoe nets(LLITMN).

thank u very much doc I already dropped d fansidar and artesunate I now take coarte-forte 80/480 and zinnat 250mg

Please can you prescribe any for me.

Marc9:


I can recommend blood booster because it's OTC. You can buy any good blood booster(Aminomin).

But for the medication that would likely shrink the fibroids, it's prescriptive.

bensky:
Please can you prescribe any for me.

Send me a PM/e-mail

CoolOne1:
@Marc,am not overweight.used to weigh 69kg-73kg.Now, am currnetly on Blood pressure drugs and my readings are okay at home(116/69) and thereabout.When I want to take in,am I to stop taking the drugs?and do I need to take it throughout d pregnancy when I conceive?

Yes you have to stop taking the drugs when you're about taking in. In fact your pressure has dropped insignificantly below the normal range. 116(120-130)/69(80-90)mmHg.

In the course of pregnancy, your blood pressure will be monitored, and in the event your BP seems to be on the rise, then you'll be placed back on the drugs for a short while.

I have been monitoring my ovulation on ultrasound since November. I do ovulate but I don't get pregnant. I went to my doctor to know if it's the d&c but he said it can't be as it was the sacking tube they used and it can't block the tube or cause a scar tissue. Is that true? And what could cause me to ovulate and not get pregnant


Then secondly I started my scan this month on cd 10 then on cd 12 it was 1.96 cm, cd14 was 1.8 cd 16 it had reduced in size to 1.6 and had irregular border with ET of 13.5mm. The sonographer said I had ovulated on cd 16. Am still confused does it mean it released the egg on cd 16. Because I didn't bed on cd 16 but did a day before. Please help a confused lady

Marc9:


It's definitely not cervical cancer. The actual differential diagnoses are leiomyoma, adenomyosis, endometriosis, PCOS.

The gynae ought to have indicated you run a full hormonal assay to find out the level of your sex hormones, then a pelvic scan would be run to check the outlines of the uterus and the endometrium.

My suspicion is endometriosis. So, why not run a pelvic scan, HSG, and then hormonal assay.

Thanks very much doc Marc. I'll run these.

Kittana:


Thanks very much doc Marc. I'll run these.

If you stay in lagos, around surulere, you can go to Prism Diagnostic Centre, along Bode Thomas.

diegs:
I have been monitoring my ovulation on ultrasound since November. I do ovulate but I don't get pregnant. I went to my doctor to know if it's the d&c but he said it can't be as it was the sacking tube they used and it can't block the tube or cause a scar tissue. Is that true? And what could cause me to ovulate and not get pregnant


Then secondly I started my scan this month on cd 10 then on cd 12 it was 1.96 cm, cd14 was 1.8 cd 16 it had reduced in size to 1.6 and had irregular border with ET of 13.5mm. The sonographer said I had ovulated on cd 16. Am still confused does it mean it released the egg on cd 16. Because I didn't bed on cd 16 but did a day before. Please help a confused lady

I just started monitorin mine dis mnth started on cd 12 tho but cudn't complete the tracking due to i travelled and it fell on sunday. You can run a Progesteron test as i did. I sent u a pm.

diegs:
I have been monitoring my ovulation on ultrasound since November. I do ovulate but I don't get pregnant. I went to my doctor to know if it's the d&c but he said it can't be as it was the sacking tube they used and it can't block the tube or cause a scar tissue. Is that true? And what could cause me to ovulate and not get pregnant


Then secondly I started my scan this month on cd 10 then on cd 12 it was 1.96 cm, cd14 was 1.8 cd 16 it had reduced in size to 1.6 and had irregular border with ET of 13.5mm. The sonographer said I had ovulated on cd 16. Am still confused does it mean it released the egg on cd 16. Because I didn't bed on cd 16 but did a day before. Please help a confused lady

If you do ovulate, then you should observe these primary signs: cervical mucus(very indicative), elevated temp, increase libido, and slight abdominal pain.

If you didn't or don't these signs, then it's unlikely you ovulate.

But if you observe these signs, then other factors might be responsible for unsuccessful TTC.

Sperm motility, seminal fluid quality, uterine position, vag*nal Ph concentration, and others could be responsible.

Your 2nd question, well there are two case scenerios. Either you had two dominant follicles growing beyond the 16mm at cd8, then when it was cd12 both were 19mm, with one of d follicles releasing the egg, while the other began to shrink in size and got reabsorbed. Or only one follicle was growing. When it got to cd14, your LH wasn't sufficient enough to trigger the release of the egg, so the follicle began to shrink in size for reabsorption.

Okay! I have all the symptoms. I forgot to say pockets of fluids was seen in POD cd12. I usually have a 30day cycle. Too early for ovulation. Thanks marc9

cionon:



I just started monitorin mine dis mnth started on cd 12 tho but cudn't complete the tracking due to i travelled and it fell on sunday. You can run a Progesteron test as i did. I sent u a pm.

I have passed the 21day mark for a progesterone test. Replied your pm

Good day doctor I must confess u are doing a great job here, God bless u
Please doctor Is there any chance of getting pregnant after the tretatment of Ashermans Syndrome? Also can it be treated without surgery doc?

AdeolaArewa:
Good day doctor I must confess u are doing a great job here, God bless u
Please doctor Is there any chance of getting pregnant after the tretatment of Ashermans Syndrome? Also can it be treated without surgery doc?

Of course there is, though the chance depends on the severity of the scar, and the effectiveness of the treatment.

Apart from surgery, there is a particular medication discovered to have the property of disintegrating dead/scarred tissues.

thank you doctor, may God continue to bless you. my email is bensky4real@yahoo.com

Marc9:


Send me a PM/e-mail

good morning doc in the house.
I am 30. been ttc for 6months, married.
i never used any drug either as contraceptive or to aid pregnancy.
Although I saw a doctor October 2013 when I had irregular periods. scan showed I had Dormant Right Ovary...and hormonal imbalance. I was given contraceptives to take for 3 months to help with d irregular period. after then my circle changed to 34days.
right now, am on cd39 with no sign of menstruation. I feel sick every night n did PT dis morning which came out negative.
I am worried. Pls advice on wat step I should take.
Pls note that d doc I saw is in Abuja while am in Lagos now.

iOmoge:
good morning doc in the house.
I am 30. been ttc for 6months, married.
i never used any drug either as contraceptive or to aid pregnancy.
Although I saw a doctor October 2013 when I had irregular periods. scan showed I had Dormant Right Ovary...and hormonal imbalance. I was given contraceptives to take for 3 months to help with d irregular period. after then my circle changed to 34days.
right now, am on cd39 with no sign of menstruation. I feel sick every night n did PT dis morning which came out negative.
I am worried. Pls advice on wat step I should take.
Pls note that d doc I saw is in Abuja while am in Lagos now.

Ladies should learn to be quite patient when TTC . A lady is only assumed to have difficulty in TTC after a year of attempt. Six months of TTC is still within the confine of normal TTC attempt, not until it exceeds a year, then anxiety can set in.

The scan simply revealed the functional(left) and non-functional(right) ovaries. I wonder how the scan revealed you had hormonal imbalance, when hormonal assay wasn't carried out!

Now, you had menstrual irregularities(probably hypomenorrhea, inconsistent menstrual cycle, and so), which means you were having hormonal disruption. Contraceptives inhibit the secretion of these hormones(responsible for regular menstruation), so I wonder why you were placed on contraceptive in correcting menstrual irregularities?! Unless your menstrual irregularity is associated with endometriosis, or myomas.

First of all, ultrasound doesn't reveal hormonal level. You should have run hormonal assay to determine the level of your s*x hormones.

Second of all, did the scan show the right ovary having a cyst? And was any fluid observed in the 'pouch of douglas and the 'cul de sac?

the hormonal imbalance was noticed when they took my urine/blood samples.
there was no fluid in d ovaries but just that it was dormant.
I guess d contraceptive was to correct the hormonal imbalnace. I didnt take it because I didnt know how to stick to a drug for 3 months same time everyday.
I Wasnt ttc conceive then. so I felt I would be alright before ttc.

iOmoge:
the hormonal imbalance was noticed when they took my urine/blood samples.
there was no fluid in d ovaries but just that it was dormant.
I guess d contraceptive was to correct the hormonal imbalnace. I didnt take it because I didnt know how to stick to a drug for 3 months same time everyday.
I Wasnt ttc conceive then. so I felt I would be alright before ttc.

Contraceptive is not indicated in hormonal balancing therapy. To the contrary, contraceptive prevents you from getting pregnant by inhibiting the hormones responsible for ovulation, and implantation. Some contraceptives are used off label in treating heavy menstrual bleeding, due to fibroids, endometriosis, or adenomyosis. Was that what you had, heavy menstrual bleeding?

I've come to realise that the right ovary, in most ladies, is particularly the functional and active ovary, beginning from menarche. After years of activeness, when much of its eggs would have been released, it goes dormant(non functional), and pass the responsibility to the left ovary, which then assume the function of egg release. Probably explains why your right ovary is dormant, considering the years of activeness.

Pls., doc. in the house,can I use duphaston 10mg at cd 5-14 or cd 14-24?as a pharmacist told me. My day 21 progest.test result was 26.5nl/mol as at oct.2014 wch my gynae.says its ok. I need quick response pls. TTC almost 3yrs.
Can I use along with prenatal multivamitamins?

Marc9:


Contraceptive is not indicated in hormonal balancing therapy. To the contrary, contraceptive prevents you from getting pregnant by inhibiting the hormones responsible for ovulation, and implantation. Some contraceptives are used off label in treating heavy menstrual bleeding, due to fibroids, endometriosis, or adenomyosis. Was that what you had, heavy menstrual bleeding?

I've come to realise that the right ovary, in most ladies, is particularly the functional and active ovary, beginning from menarche. After years of activeness, when much of its eggs would have been released, it goes dormant(non functional), and pass the responsibility to the left ovary, which then assume the function of egg release. Probably explains why your right ovary is dormant, considering the years of activeness.

Please what do you advice I do now
and which hospital would you advice I visit. I ovulated in November but didnt notice anything last December.
today is the 39cd and no sign of menstruation. I did PT n blood test and they both came out negative.

Lordavmercy:
Pls., doc. in the house,can I use duphaston 10mg at cd 5-14 or cd 14-24?as a pharmacist told me. My day 21 progest.test result was 26.5nl/mol as at oct.2014 wch my gynae.says its ok. I need quick response pls. TTC almost 3yrs.
Can I use along with prenatal multivamitamins?

At cd21, your average progesterone is meant to exceed 30ng/ml. To me it's not that okay yet. The lower the progesterone level within the luteal phase, the lesser the chances of a successful implantation.

I'l advise you use the duphaston from cd12 to cd 26. That's the best period to boost your progesterone level. You can also combine the prenatal vitamins with it.

Has your husband been ruled out from the cause of your TTC delay?

iOmoge:




Please what do you advice I do now
and which hospital would you advice I visit. I ovulated in November but didnt notice anything last December.
today is the 39cd and no sign of menstruation. I did PT n blood test and they both came out negative.

Well, I suspect it's likely PCOS. Most likely!

What part of lagos are you?

Marc9:


Well, I suspect it's likely PCOS. Most likely!

What part of lagos are you?

I stay at Ajah.
I work on d island.

am 30 going 31 by July.

iOmoge:


I stay at Ajah.
I work on d island.

am 30 going 31 by July.

You can check my profile, my pin is on it. Feel free to add, I'll refer you where you can get the best of help.

"To solve a problem, one has to understand the problem very well".

God is in control!

Marc9:


You can check my profile, my pin is on it. Feel free to add, I'll refer you where you can get the best of help.

"To solve a problem, one has to understand the problem very well".

God is in control!

ok.

thank you very much.

adding u after work hours say 3pm.

dear doc, i have been ttc for 2 yrs now but since december 2014 i have
been having cough & carttar and have taken sulphatriad, menthodate and septrin
but the cough have not stopped and the carttar have stopped. i even eat bitter cola and tom tom.

please doc any drugs that you can prescribe for me.

Thank you

diegs:
I have been monitoring my ovulation on ultrasound since November. I do ovulate but I don't get pregnant. I went to my doctor to know if it's the d&c but he said it can't be as it was the sacking tube they used and it can't block the tube or cause a scar tissue. Is that true? And what could cause me to ovulate and not get pregnant


Then secondly I started my scan this month on cd 10 then on cd 12 it was 1.96 cm, cd14 was 1.8 cd 16 it had reduced in size to 1.6 and had irregular border with ET of 13.5mm. The sonographer said I had ovulated on cd 16. Am still confused does it mean it released the egg on cd 16. Because I didn't bed on cd 16 but did a day before. Please help a confused lady

Google and saw this. I have been monitoring since cd 10 as well but my sono didn't say it has irregular border. It just said it reduced in size and told me I ovulated. Maybe I should post it here.