Dear doctor, I am breastfeeding a one-month-old baby. I want to know if I can take emergency pills?
Dear Hajara: It is unfortunate that many mothers deliver away from hospital missing out on advice about contraceptive methods and when to start them resulting in unwanted pregnancies. Then this leaves the kind of advice to be given when she attends postnatal (six weeks after delivery). In a few cases this has come too late when a mother is already pregnant.
Anyhow, though there is great variation in the return to fertility and sexual activity following childbirth, the earliest time of ovulation after delivery is 27 days. This means that no contraception may be needed until 21 days after delivery. It is therefore true that a mother can get pregnant before attending her postnatal class making it imperative that she gets contraception advice before leaving hospital after delivery.
Emergency contraception (plan B) in Uganda usually involves use of a progesterone pill (hormone levonorgestrel) which will not harm the breastfeeding baby or even if it is taken when one is unknowingly pregnant it will not harm the unborn child. The pill will also not harm the mother or even dry up the breast milk. Use of combined pill as emergency contraception is obsolete and should not be tried since it has lots of problems including, a likelihood of enhancing blood clots as well as drying up the milk.
Emergency contraception may not protect one for a whole month. So, if you are having regular sex you ought to visit a family planning clinic for regular contraception.
Dear doctor, I used to feel a lot of pain and when I went to hospital, one of my balls was removed. Will I be able to have children in future? — Mugwanya
Dear Mugwanya: Testicular torsion is a very painful condition due to twisting of the spermatic cord (the stalk that supplies blood to or sperms from the testes). This causes blood flow to the testicle to be cut off leading to the death of the testicle and hence has to be surgically cut out. This is common in adolescents due to rapid growth of the testicle during puberty.
Those who get testicular torsion have an inherited condition that allows the testicle to rotate freely inside the scrotum. This inherited condition may affect both testicles so that if one has lost a testicle, he should have an operation (orchiopexy) to fix the remaining one and prevent torsion as well. Fertility is maintained even after the loss of one testicle and one will father both girls and boys unless there are other problems.
Patients who have lost a testicle, however, should protect their treasure by avoiding contact sports, where they risk injury to the remaining testicle.
Should I cleanse?
Dear doctor, there is this craze of washing the stomach. I was having constipation and went for a wash but now it is worse. I now have a headache and a bloated stomach. Should I go for more cleansing?
Dear Adela. An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. The decrease in number of the useful naturally occurring microorganisms may allow harmful germs to thrive, to the detriment of our health.
Apparently, you have constipation which requires investigating and proper treatment and advice given by your doctor. A diet with enough fibre (high-fibre foods include beans, matooke, whole grains and cereals, fresh fruits, vegetables) and limiting foods that have little or no fibre, such as ice cream, cheese, bread, meat, kalo and processed foods. Engaging in regular physical exercise may be as useful as taking lots of fluids without waiting to get thirsty.
Send questions to firstname.lastname@example.org