Ask the Doctor: What’s the maximum number of children I can bear by C-section?

Dear Doctor,
I had my first child in July 2007 through C-section. In September 2010, I conceived again but had to be operated upon because the pregnancy was ectopic. Our plan was to have four children. My question is, how many times can a woman give birth through C-section, especially in a case like mine? What are some of the disadvantages or effects of caesarean birth?
Santa, Nansana

Dear Santa,
If you are 32 years and above, an operation for ectopic pregnancy, which involves cutting out the involved fallopian tube furthe reduces your chances of getting pregnant.

The usual cause of ectopic pregnancy is having partially blocked tubes due to STDs. In such a case, when one tube has an ectopic pregnancy, the other may be normal, partially or completely blocked. This means one can use the remaining tube to get pregnant normally, get a second ectopic pregnancy or fail to get pregnant at all. But overall, ectopic pregnancy and the operation to treat it generally reduce a woman’s chances of getting pregnant again.

A caesarean section is an operation on the womb through the abdomen, to deliver a baby. It can be planned and therefore safer or done as an emergency.

Just like any major operation, though it is considered relatively safe, it may pose a higher risk of developing complications than a vaginal delivery. Recovery from a caesarean section takes longer than that of vaginal delivery.

Infection to the wounds, blood loss, blood clots on the legs that may move to the lungs, constipation and in a few cases problems due to anaesthesia can pose a problem to the mother. In the long term, giving away of the scar during late pregnancy but especially during labour is feared most and placenta attachment or location problems may also occur.

In the babies, accidental cut injuries and prematurity problems may occur. The latter especially due to poor estimation of birth dates.

Depending on the type of C-section done before, associated complications and a doctor’s advice, a woman can safely deliver by this operation three or four times. Today even in Uganda, these deliveries are increasing because they have become safer than before.

Dear Doctor,
I have a lot of gas and noise in my stomach and back pain which has persisted. I have tried to treat myself but the fartingand back pain has not stopped. I don’t know if it is because of the foods I eat like beans and curry powder or there is something wrong with me. Please doctor, help because the problem is too much.
Esther.

Dear Esther,
Flatulence is when one has excessive gas in the tummy. Harmless as this may be, people will feel embarrassed and get desperate for a quick solution because it can cause bloating, belching or passing of gas from the anus.

Most gas is formed from undigested food material worked on by intestinal bacteria. Foods like beans, salads, dairy products and onions produce much gas just like swallowed air or gas filled drinks. Therefore, in order to control the gases, one needs to change their diet and reduce the amount of air swallowed. If this does not help, then it could be that medical conditions like stress, menopause, sinus infection (with mucous flowing at the back of the mouth, known as post nasal drip), peptic ulcer disease, constipation, gall stones and giardia infection are involved.

Eating slowly, avoiding a straw, avoiding the said foods or others you suspect to cause the gas, and taking antacids or wearing anti gas-odour under panties in the meantime may help. If not, please visit your doctor.

Dear Doctor,
Ever since I changed salons, my scalp has been itching so much that I end up scratching it. When I comb, particles looking like a dry onion come off my hair. Will changing to another salon help?
Rapportoire Kente Esq

Dear Rapportoire Kente Esq,
We normally shed old skin without noticing. However, dandruff sufferers often shed too much skin due to a scalp fungus (Malassezia Globosa) infection. Its enzyme breakdown of scalp oils produces an acid which triggers excessive skin cell shedding.

This fungus can be killed off by drugs but will come back because you may not have addressed the cause of the fungus invasion. This includes imbalance of fatty foods caused by eating too much plant oils like sunflower oil (omega 6) and too little fish oils (omega 3).

Besides that, dry skin, oily skin, too much or too little hair washing, body immunity, stress or hygiene and an overall balanced diet have to be looked into before complete recovery is achieved. Many people blame salons for dandruff but even if the fungus was introduced on to one’s scalp, without the said factors above, it is unlikely to take root. Dandruff becomes contagious when it occurs as ringworm which is common in children before puberty.

Dear Doctor,
I am a diabetic on daily insulin injection. I have been following your advice of exercising a lot. What bothers me is feeling dizzy, restless, out of breath and headache after exercise. However, when I check for sugar, I find it low. Should I stop exercising, using insulin or both?
Jacobsen Kawonawo

Dear Jacobsen Kawonawo,
Whenever a person is told he has diabetes (sukaali or high blood sugar), he may become preoccupied with ruthlessly lowering the sugar level ending up with your said symptoms in what is called hypoglycaemia, which is far more dangerous to health than high blood sugar for which he may be on treatment. The symptoms are largely due to the body trying to lower blood sugar yet sugar is the only source of energy for the brain. If this is not corrected, it may worsen into confusion, convulsions, coma and finally death.

Hypoglycaemia (sugar below 60mg/dl, though symptoms may start below 50mg/dl) happens from time to time due to diabetes. It may occur regardless of proper diabetic control therefore, every diabetic has to learn how to detect and correct it before life is endangered. In adults and children older than 10 years, hypoglycaemia is commonly a side effect of diabetes treatment.

Physical activity has many benefits for people with diabetes, including lowering blood glucose levels which can happen up to 24 hours after exercise, managing weight, preventing heart complications and stroke.

The body uses glucose for energy and even much more glucose when one exercises, the most likely reason why you got symptoms of hypoglycaemia.

To help prevent hypoglycaemia caused by physical activity, it is important to check blood glucose before and after exercise so that a snack like a bogoya (sweet bananas) is taken if the level is below 100 mg/dL. Diabetics should discuss suitable exercises with their doctors, have proper meals and adjust insulin doses when exercising lest they end up with hypoglycaemia. One may also need to carry sweets in case symptoms occur during exercise and a tag to indicate diabetes in case the same happens in circumstances like during a jog so that one is not mistaken for a “drunkard and left for dead. Insulin from thigh injections can be absorbed faster during jogging exercises leading to exercise related hypoglycaemia requiring using another injection site like the abdominal wall.