I had abortion and my urine stinks, can’t stop milk flow

Following an abortion, you can experience a number of complications including infection, perforation or tear of internal organs and severe blood loss.

Photo credit: Fotosearch

What you need to know:

  • Abortion can cause a number of complications
  • Milk let down will gradually decrease
  • If you do not get appropriate treatment, the symptoms may persist and worsen

Dr Flo,
After having an unplanned abortion due to my age, I have been facing a lot of health problems for about six months now.  I always feel tired, my urine has a bad odour and my breasts have been producing milk since April. Due to lack of funds, I have not been able to see a doctor.
Millicent

Dear Millicent,
Following an abortion, you can experience a number of complications including infection, perforation or tear of internal organs, severe blood loss (which can cause fatigue, dizziness, fainting, palpitations, headache, swelling of the feet among others) and psychological disturbances. The tiredness could be from blood loss, and the foul smell of the urine is most likely from an infection. The infection can also cause tiredness.
After an abortion, milk let down will gradually decrease and stop since there is no breastfeeding. If the milk production is causing your breasts to swell and be painful, you can use warm or cold compresses, or take a hot bath. Avoid stimulating the nipples or expressing the milk since this will increase milk production. However, if the milk is a lot or it lasts for long, you can take medication to stop this, and to relieve pain from engorged breasts.
You need to urgently see a doctor, preferably a gynaecologist, for thorough examination, tests and treatment. If you do not get appropriate treatment, the symptoms may persist and worsen, and you may develop further health complications, including risk of infertility, future ectopic pregnancy and the risk of infection spreading throughout the body.
Since you are short of funds, you can visit a government health facility, some of which charge a consultation fee of as low as Sh50 or even Sh20. There are also NGO-funded clinics, depending on where you are, that may either be free or provide services at very subsidised costs.

Dr Flo,
I have been having chest pains since July. I did an X-ray, which showed all was okay. The weird thing is that, I am not coughing and I do not have a fever. I have taken antibiotics, which did not work. Kindly advise me.
Reader

Dear Reader,
The chest has many components including the heart, lungs and pleura (lining of the lung), a part of the oesophagus, muscle, bones, cartilage, nerves and blood vessels. Therefore, the chest pain can arise from a problem with any of them. You should see an internal medicine specialist/physician, so that the exact cause of the pain is identified, then you can be referred to a sub-specialist if need be.
The heart: Some of the symptoms of a heart problem include chest pain and heaviness, palpitations, difficulty breathing, running out of breath or getting tired easily and coughing. Tests can be done to establish if there is a heart problem.
The lungs and the pleura: Inflammation of the lung and/or pleura may be caused by infection or by irritants like chemicals and dust. An infection will cause significant pain, a cough, fast breathing or difficulty in breathing and fever. If an infection is present, symptoms usually worsen over time if there is no treatment and they do not disappear on their own. Inflammation caused by irritants and cold, however, may come and go depending on exposure. Avoiding the trigger will prevent the pain. Some medication can also be prescribed to manage the symptoms.
The oesophagus: In its journey between the mouth and the stomach, the oesophagus passes through the chest. Sometimes, problems with the oesophagus can present as chest pain. These include oesophagitis (inflammation of the oesophagus), hyperacidity and reflux and oesophageal strictures caused by scarring of the lining of the oesophagus. In addition to the chest pain, you might also have heart burn, discomfort or pain when swallowing food, nausea and/or vomiting, and other gastrointestinal problems. If you have these symptoms, have an endoscopy done by a gastro-enterologist (stomach specialist) to determine the cause, and you will be started on treatment.
The muscles: In between the ribs, there are three layers of muscles, known as the intercostal muscles. There are also many other muscles on the front and back of the chest and along the spine. Any of these muscles could ache, and this is called myalgia (muscle pain), either due to recurrent strain, repetitive activity or even from muscle cramps. Usually, after some rest, this pain goes away on its own, or you may require painkillers and muscle relaxants.
The nerves: There are many nerves running within and across the chest wall. Any of them could get “trapped” or damaged, leading to chest pain. This is usually much more difficult to diagnose, but the treatment is medication for pain, and usually the pain goes away with time. If a number of nerves are involved, however, an MRI may need to be done to determine the exact source of the problem for appropriate intervention.
The bones (and cartilage): There is cartilage that connects the ribs and the sternum (the breast bone). In some cases, there is inflammation between the cartilage and the bone (either the ribs or the sternum). This is called costochondritis, and the resultant pain may feel as though the heart has a problem. The pain is usually on the left side of the chest, and it may be sharp, or aching, or feel like pressure. The pain is usually worse when you take a deep breath, when you cough or with physical activity, and it usually affects more than one rib. It usually has no clear cause, though it may be triggered by injury, or physical strain, or arthritis. Less likely causes include infection or tumours in the joint. Treatment includes pain medication, physiotherapy with stretching and nerve stimulation exercises (TENS), hot or cold compresses and rest. Usually, the pain improves on its own after several days or weeks, but sometimes will recur after several months.

Dr Flo,
I keep experiencing a dull pain on my lower left abdomen every time my periods are about to stop. What could be causing this pain and should I be alarmed?
Worried lady

Dear Worried Lady,
Usually, period pain should be on both sides of the pelvis, and/or in the middle. If the pain is on one side, it may be suggestive of an abnormality in the shape of the uterus, or it may be due to endometriosis. Abnormalities in shape of the uterus are inborn, and some can be corrected surgically, if need be.
Endometriosis means that there is endometrial tissue (the tissue lining the inside of the uterus, responsible for your periods) outside the uterus, for example on the ovaries, fallopian tubes, bladder, intestines, the lining of the pelvis, or anywhere else in the body. This tissue, wherever it is, still responds to the normal monthly cycle of hormones, and “bleeds” when there is bleeding from the uterus. Endometriosis can be quite painful. The symptoms depend on where this tissue is, so if it is on the left side of the pelvis, you might have pain on the left side during your periods.
To diagnose either of these issues, you will need a pelvic exam and a pelvic ultrasound scan. If any obvious abnormality is found, you will be advised on a further course of action. If not, then pain killers and warm compresses, like a hot water bottle, can help manage the pain.


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