Dr. Vijayalaxmi K

Postpartum is the period after one's labour and delivery. Pregnancy and postpartum are a time when a woman's body changes to a great extent in order to first accommodate the baby and then go through labour and delivery. A vaginal delivery can have many implications when it comes to the postpartum. The same goes for a Caesarean Section or C Section as well. Let us find out what your postpartum care routine should include:

1. Vaginal Soreness: Deal with vaginal soreness with the help of stool softeners and pain relievers, as prescribed by your gynaecologist. You should also make hygiene a priority at this time. Use a wash cloth and warm water to clean the area every time you urinate. Also, you can use an ice pack if the wound is particularly painful.
2. Discharge: Vaginal discharge in the postpartum period is called lochia, and it usually carries on for a few weeks after the baby is born. You must use a sanitary napkin during this period and clean up regularly. If your bleeding or discharge is accompanied by fever, then you should contact your gynaecologist immediately. 
3. C-Section Wound: In case there is redness and swelling in the wound, accompanied by symptoms like pain and foul smelling discharge from the vagina, you will need to get in touch with your doctor immediately so that he or she can check for possibility of infections.
4. Movement: After a C Section, you will need to take as much rest as possible so that the wound heals properly. This includes avoiding making too many trips up and down the stairs as well. It would be a good idea to have a family member or partner around who can help as well. Gentle walks after a week or two are usually recommended for the body to come back to normal gradually.
5. Kegels: Do kegels or contracting exercises for the strength of the pelvic floor to return, especially after a vaginal delivery. This will help in alleviating pain and burning sensation during urination at this time.
6. Nutrition: Take special care to eat nutritious and home cooked food, especially if you are breast feeding. This will also help in the healing of the vaginal or C Section wound. Also, a high fibre diet will help in better bowel movements which will lessen the pain while visiting the bathroom.

Taking care of your body in postpartum is a matter of bringing it back to normal gradually even as you deal with the side effects of delivery. Ensure that you are in touch with your doctor.

OVERVIEW

Urinary Tract Infections are common infections, affect men and women of all ages, and vary dramatically in their presentation and sequelae.

Urinary Tract Infections are a common cause of morbidity and can lead to significant mortality.

WHAT IS AN UTI?

A UTI is an infection involving any part of the Urinary Tract such as the Urethra, Urinary Bladder and the Kidneys.

UTI is an inflammatory response of the urothelium (lining of the urinary tract) to bacterial invasion.

INCIDENCE AND EPIDEMIOLOGY

Women are most at risk for a UTI. Nearly half of all women (50%) will experience a UTI during their lifetime.

WHY?

Women have a short urethra which makes it easier for the bacteria to enter the bladder and cause infections. Also the urethra is in close proximity to the anal canal, which is the source of these organisms.

What causes the UTI`s?

The most common causative organisms of UTI`s are bacteria from the bowel such as E.coli, proteus, pseudomonas etc.

Once the bacteria enter the urethra, they travel upwards causing infection in the bladder and sometimes other parts of the urinary tract.

Sexual intercourse is commonly associated with UTI`s in women. During intercourse, the bacteria in the vaginal area are sometimes transferred into the urethra by the motion of the penis.

Using spermicides or a diaphragm also can cause more frequent UTI`S , due to increased binding of the organisms to the lining of the urethra.

Menopause also increases the risk of getting a UTI. During menopause, the level of estrogen decreases which causes changes in the periurethral tissues that can lead to a UTI.

In men, urethritis is usually the result of bacteria acquired during sexual contact.

SYMPTOMS AND SIGNS OF A UTI

1. A strong persistent urge to urinate.
2. A burning sensation during or after urination.
3. Passing frequent, small amounts of urine.
4. Blood in the urine (Hematuria) / Cloudy Urine / Foul smelling urine.
5. Pain in the lower abdomen and the pelvis.
6. Penile discharge in men.
7. Pain in the flank region/ back, fever , nausea and vomiting, fatigue  (Infection of the kidneys)

HOW ARE UTI`S DIAGNOSED?

The Urologist will take a proper history and examine the patient and order some basic investigations like Urine Analysis and Urine Culture and sensitivity. UTI`S in males require more detailed investigations like the Ultrasound of the Abdomen to elucidate the cause of UTI.

TREATMENT

Based on the severity of the symptoms, the urologist may prescribe antibiotics empirically based on the common sensitivity patterns. The antibiotic may be changed based on the Urine C/S report , which usually takes around 48 hours time. You may also be prescribed a medicine that will relax the bladder while the antibiotic starts to work.

Patients must make sure they take the complete course of treatment as directed and to return back if the symptoms are not relieved.

Patients are also advised to drink plenty of oral fluids, which help in flushing out the bacteria from the urinary tract. Patients are also asked to avoid coffee, alcohol, and soft drinks containing caffeine until the infection is cleared because these can irritate the bladder and cause worsening of symptoms.

Kidney Infections (Pyelonephritis) usually require hospitalization and more intensive management.

PREVENTION OF UTI`S

1. Drink plenty of oral fluids to flush out the bacteria
2. Do NOT hold the urine for long periods of time. Urinate when you feel
3. Wipe from front to back after a bowel movement.
4. Urinate before and after sexual contact emptying the bladder completely each time.
5. Avoid using spermicides/ diaphragms , in case of recurrent UTI`s
6. Avoid use of feminine “hygeiene” products like douches and sprays, which could upset the delicate bacterial balance of the genital region.

Being able to pleasure your woman in bed can be a very rewarding experience. However, you must know that the key point in pleasing your partner is to bring variety.  It is said that variety is the spice of life and it is certainly the case, especially in the bed room. To provide variety, you need to know certain points in her body which are erogenous in nature:

1. Head: The skin on the human head is pleasurable to the touch and that is the reason head massages feel so good.  If you stimulate the scalp correctly, feel good hormones called oxytocin and serotonins are released in the body. It also increases blood flow to your partner's brain and her entire body. So next time, don't just kiss and cuddle, but also stroke her head. The result will be phenomenal.
2. Ears: Ears usually get less attention although there are many nerve endings present in them. This makes them an extremely erogenous spot. Your partner can be aroused by a light caress near the ear or even soft music while you are cuddling together. 
3. Lips: The lips are the most sexually exposed parts of the body. A huge number of nerve endings are present in the lips. Stimulating the lips also a feel good hormone which affect not only your partner's emotions but also her lady parts. This reason makes the act of kissing the lips extremely essential for couples. 
4. Neck: The neck is another very active erogenous zone within the female body and is sensitive to even the lightest touch. It is also an extremely sexy place to touch and kiss your partner. Even a gentle breath on the neck can arouse her. It is a great place to sexually stimulate her.
5. Nipples: The nipples are extremely sensitive and erogenous in nature. If you are able to stimulate them properly, your partner will experience the same pleasure she will derive from the stimulation of her clitoris and her vagina. Some women can even orgasm from the stimulation of nipples.

Some of the other erogenous parts include the clitoris, the inner thighs, the lower back and her feet. Just feel free to explore them in her body, and you will be able to give her the pleasure you wanted to. Also, remember every woman is different and while certain things may be sexy for one person it may not be the same for another person and ensure that you communicate with her regarding what she likes and dislikes.

Puberty is a time when a girl's body begins to define itself in more womanly terms. This is the start of a process that will usher in decades of sexual activeness and child bearing years. The changes that a girl goes through during this period can be quite challenging with a play of hormones as well as physical changes like the growth of hair in private parts and the development of breasts, among various other changes. When these changes come at an early age, it can be all the more challenging to cope and comprehend the process. The onset of early puberty is something that is becoming more and more common with girls between 12 and 13 becoming more prone to the symptoms. How can you help deal with early puberty? Here's a list of tips!

Self-Image: One of the most important side effects of early puberty remains one's image of the self, as this phase in life is characterised by the most dramatic physical changes that can leave a lifelong effect on the girl's mind. The reinforcement of positive self-image to help the girl grow more comfortable in her skin despite the wide array of feedback she may be getting from sources outside the home, will help in creating a positive impact on a lifelong basis.

Doubts: This is a time when the child goes through a number of doubts regarding looks and appearance as well as how well she may be able to cope with the onset of the new process. As parents, the best thing to do is to let the child explore this terrain even as you remain firmly in the background for hand holding when the child asks for it. This will help the girl become even more confident to take life's decision more efficiently and seriously.

Talking About It: The best thing to do is to talk things out. Once you start seeing the changes in the girl's appearance by way of hair growth and sudden sprouting of breasts and height, it is important to understand that puberty may be close by. So have a talk about menstrual cycles and the changes that the child will be seeing soon. This will help in mentally preparing the child and giving her the leeway to ask questions that you can answer over a period of time.

Opposite Sex: It would also be beneficial to discuss the changes in the behaviour of boys towards her, as this will help her blossom into a more confident lady in the years to come.

Remember to love and support your child through this important milestone of her life, as the way you reach can have a lasting impact on her.

In case you have a concern or query you can always consult an expert & get answers to your questions!