SHORES OF THE LONG LAKE

"Shores of the Long Lake" has been a constant pm on my BBM. Now friends are puzzled about what this means and have often asked me what it meant. But really, I haven't been to any lake, how much more to determine it's length, or even consider looking around for shores
" Shores of the Long Lake" is one of the soundtracks to "the Hobbit: Battle of the Five Armies". An esoteric classical piece by Howard Shore. One of the music masterminds to epic, suspense filled moments in great movies, from "Lord of the ring" to "Titanic".

When I say esoteric, I mean a soundtrack capable of taking your mind and soul into any realm of your choosing, "goose pimpling" you into auditory orgasms.
But I wasn't going into orgasms of auditory origin this time. This time the classical piece cast my mind to the river behind Federal Medical Centre, Yenagoa, where I served as a medical intern. Separating the full length of the hospital from the river was a little land on which the Long fence was built. Sometimes during morning reviews in the seminar room upstairs, I sometimes trail off and stare over the early morning stillness of the river over the fence, thinking about something unrelated, sometimes my thoughts would double back and I would think in relation to the medical cases being presented.

Like a regular church bell jingling at the background on an early Sunday morning, I heard the words, "he had a similar episode 3 months ago, but was said to have had massages at home". Those word, like cold hands seized my raw flesh and dragged my back to real time. Turned out that he was an elderly man who was rushed into the accident and emergency ward on account of a sudden fall, lost consciousness and woke up with loss of function of the right hand and leg.

The attending doctor, taking a jigsaw walk through three month earlier in this elderly life, began placing puzzles together to arrive at a diagnosis. Mr Tari is a farmer, elderly, and lives in a remote part of Bayelsa State, quite a distance from Yenagoa. When he had his first attack 3 months ago, he still was able to move his right arm and leg. His relatives had consulted a traditional doctors who mixed some herbal stuff and placed in both eyes, gave him some palm oil to lick on, onions and garlic to chew on. Over the next few weeks following, he had series of rigorous massages. Meanwhile, a local drug store was consulted too and was thus given a cocktail of grinded drugs. Stroke among other brain illnesses​ were placed on the 'most wanted' list of diseases being suspected

Hypertension and stroke are a strongly related pair and since he has never been to a clinic, it was impossible to note a hypertensive history. and considering the cocktail of medicine he's been on, and coming into emergency with a normal blood pressure, antihypertensive drugs were strong suspects in the concoction. A Repeat Stroke was therefore a tentative diagnosis. The rest they say, is history.

Stroke in simple terms is largely a physical manifestation of something wrong going on in a part of the brain. majorly either due to lack of blood supply, or a burst of a blood vessel supplying that part of the brain. And of course, there are other causes of stroke.

After Cancer and Ischaemic heart disease, it is the 3rd commonest cause of death. In the part of the world from where I'm writing,  it is on the rise due to adoption of less healthy lifestyle, ranging from the food we eat, to the type of jobs we take on and even to our social life which includes smoking and heavy alcohol intake.

How do you recognize a stroke? Perhaps, let me rephrase. What are the symptoms of stroke?

A headache perhaps, but this doesn't really mean every headache is a stroke. Hence vomiting, visual disturbances, paralysis of one side of the body. Usually seen​ as being unable to move the upper or lower limb of the same side usually, speech difficulty. A combination of these or more may give a clue to the type of stroke.

Now, what do you do when a friend or a relative strokes? Sure as hell ain't gonna give onions or garlic or palm oil.... c'mon! You'll only give the physician a bad breath to deal with. I mean, like seriously? Nor would you traumatize poor Mr Tari with rigorous massages. But the best thing to do is bring him to the hospital as soon as IMMEDIATELY sounds. You just might be saving your loved one and yourself a lifelong disability to deal with... I mean, it won't be funny buying and changing adult Pampers.

But why are we even talking about stroke in the first place? Is it avoidable? Of course yes.

1) Ever considered going to the hospital for no reason at all? Sounds funny right? Like, "I'll just be too full of myself and just go to a hospital?". Well, it's not funny and it is called "going for a check up". How about twice a year, or three times a year or 4times a year? I'm pretty sure 4 days spread out into 365 days isn't that bad. Besides here are the benefits;

You are going to be screened for possible risk factors that predisposes you having certain conditions. For example I mentioned earlier that Mr Tari could have been hypertensive, but it was impossible to know since he never went to a hospital in his life. Might I mention that hypertension and stroke are like siblings, strongly related. Other possible risk factors that could be placed in perspective include, blood sugar to screen for diabetes, and even age.

2) food! Food! Food! Food! They say, we are what we eat... I couldn't have agreed more. More of natural and less of processed or oily food seem like a fair deal right?

3) with great food comes great obesity. I'll just end on that.

4) adequate exercise... probably a 30 minute early morning cardio. From a simple walk to jogging exercise

So what do you do for your loved one after a stroke
Your doctor would most likely tell you what to do. But to mention but a few

1. regular check up is key
2. stick to medications religiously
3. physiotherapy, with emphasis​ on the now weaker or paralyzed limb
4. Presence of a loved one most times for emotional and mental support. And also for nursing care

Stroke is a serious illness in our society to be taken seriously, I mean the way the Americans would see terrorism as threat to national security. It is a major cause of death and is on the rise in our 3rd world society. the Aftermath of an event can be debilitating to individual and can cause high dependence on relatives, which could be quite frustrating to them (considering having to clean up after them, everyday for the rest of their lives). And it could be prevented.

P.S. the topic has been highly watered down for better understanding, and the name used was made up.

IT CAN SNOW IN AFRICA FOR ALL I CARE, BUT HEALTH IS SUPREME

Its 2 days to Christmas and it still feels like August rush. Caesar must  have resurrected and continued the legacy of seeking baby Jesus.
"Let it snow, let it snow" screams Relient K's hard rock song. Blaring through my little sound system. "It doesn't snow in sub Sahara... Blehhh!!!!" With my tongue sticking out. Although my friend told me it actually snowed a few days back in some parts of the Sahara desert"
"Deck the halls"  was next on the playlist. 'You might as well break your knuckles from too much decking'
Its 1 day to Christmas, you know, December the 24th, what we call watch night, or is it wash night in some native accent. Gotta purchase a Christmas tree with some glowing bulbs around it. Since Christmas ain't coming to me, I'ma come to ya... I think that's the quote or so. Mum's got plans to buy some food stuffs for Christmas. The thought of mummy's stew simmering marinates my thoughts with glee. I know I'll be like every other kid who steals some pieces of meat from the sieve that drains the hot oily sweats from the golden brown lumps. Respect to us kids who defy the natural laws of eating which says that, 'wait until its time to eat before you get your share of the meat'. We are the true rebellious ones. We are the true opposition leaders of tomorrow. For it makes no sense why the government would have funds in meat currency and deprive its citizens of the riches of life.
So we zap into the nearest future, a future full of fried chicken and goat meat. But its still a day to Christmas, just that its only a few hours away. And here I've already snacked on my 3rd piece. I sit on the sofa, a bottle of malt having cold sweats because of me, dstv remote smeared all over with oil, watching The Headies when I suddenly said to myself, "Jesus is the reason for the season", smiling heartily with oiled lips, thinking about the age old rhyme 'reason and season'. Something has got to rhyme with chicken too, when I said, "there is chicken in the kitchen". Wow!! I swore I could have been a lyricist in another life.

 'If you finish the meat, we'll be serving empty rice tomorrow' came the familiar angry voice of mum. "Busted" I said to myself. But I can't just be caught red handed like this. So I said, 'mummy, I was on my own when the meat appeared in my mouth. I just wanted to make sure it really was one of the meat and why it likes my mouth'. She shook her head and summoned me to help out in the kitchen. 'The meat and my mouth are very compatible', I added.
We zap again into 6am tomorrow. My tummy reminds me that Rome wasn't built in a day, hence I shouldn't have built meat castle last night. A whooping 8 pieces of chicken and 3goat meat went down.... A moment of silence for the true patriots of war. They fought hard but my tummy reigned supreme. But now, I've been to the white house twice, sat in the oval office twice like I was the next US president.
I've since started feeling Christmas and I ain't gonna stop now. Christmas is on Sunday, rice is ready and drinks flourish. I know I'll be eating to stupor today and tummy has got to deal with it.
I won't be leaving this house for church until first dose is upon me... But the thought of diabetic patients come to mind. Festive seasons such as this are dicey. The temptation of forgoing their strict dietary plan. Risking their blood sugar blaring through the roof. Worst cases coming in the emergencies comatose. Or is it those with liver diseases risking drowning their livers in beer and spirits. Perhaps a period to prompt the discovery of "the newly diagnosed".

Eat right for your health. Seek your doctor on the best advice on how meals should be taken. He'll most likely tell you to reduce your carbs in rice, more fish, perhaps a small piece of meat not to deprive you of the Christmas jollimentation. No sweet drinks, rather more natural fruits and juices, more veges, oh bananas in place of dodo. And if you're on a medication, strict adherence. More so if you're diabetic watching your blood sugar is ultimate. Above all, water... Yeah, keep drinking it, don't stop drinking it... Unless.... You've got a kidney problem, then Sidney the kidney has got to stick with doctor's advice.

Merry Christmas and a Happy New year  to all my readers.

Comments and criticisms are most welcome... Thank you

MAMA IJAW!! MAMA IJAW!! YOU HAVE KILLED YOUR CHILD!! PT 2

"Have you the booked theatre?", The Registrar asked. From what I could observe, he seemed to handle the situation with so much calm. A doctor fine tuned over time into an autonomic machine, with each move already calculated and ingrained in his subconscious. "Yes chief" was the reply from my colleague. From the look on his face he appeared wearisome and apprehensive. Then I asked, "so sir, what is the diagnosis?" "Well" he said, "this is a classical case of prolonged obstructed labor with chorioamnionitis until proven otherwise" "What about the results of the samples sent to the lab, are the results out yet?" I had already ordered for the two bottles filled with blood samples I collected earlier on to be sent to the laboratory a few minutes ago. I could understand his apprehension, but there was no way the results would have been out in such a short time. "I'm on it sir" I said, with the hope of jogging down to the laboratory as soon as I had prepared a list of materials and medications necessary for the looming caesarean section.

So I went out of the labor ward to see the relatives and called the husband aside to keep him abreast of the progress made and what the next step might entail.
"Oga, as this matter be so ehn, plenty things dey to do o and we have to be fast because na emergency we  land so." A few month worth of experience in internship was just about enough to sense nonchalance from relatives and friends of patients. "So this na the list of things wey you go buy now now so that we go run this surgery sharply because na your wife and baby life we dey talk about so." I watched his face to note any reactions as this would influence my method of communicating with him. He looked away and asked, "how much e be?" I answered, "I no know o, but e no suppose reach #10,000." "Pharmacy people go know better." I added, still studying his face. He finally met my eyes with his and I could see the reluctance masking his face. " na only #5000 dey with me o. I no get another money." He finally said.
"What of your people them, make una rally round gather money, like #20,000. If we no do anything now, your pikin go die, your wife fit die. E no go make sense if after all these 9 months, something happen to your pikin o". His response gave me a 21st century shocker. "If the pikin die, make e die. I go born another one" he said defiantly. Getting really unsettled and sad at the same time by this ignorant statement, I helped him complete his nonchalance by adding calmly, "and if your wife die, you go marry another one shey?" "Your family don turn commodity wey you fit replace." I immediately left him to think about the implication of what he just said, besides the thought of such statement brought bile to my mouth.

I went inside to the labor ward to inform the registrar of the new development. By now the other senior doctors on call were present and coordinating preparations for the surgery, examining and re-examining and stuff. Now one of the senior registrars said, "let's go have a talk with her husband." "you see, sometimes you have to put on a tough skin to handle some of these people. Truth is many of these patients come to the hospital without any funds and expect magic from doctors." We got back to the patient's husband and relatives and the first thing the senior registrar said was, " You people want to kill this poor woman abi? Your wife will die in a few hours if you just sit down there and expect miracles. In fact, Ehen! you people should come and write that you don't have money and that if anything should happen, its fully your responsibility." Turning to me he said, Doctor please get a plain sheet for them to write and sign. There's only so much we can do. Hospitals are not charity organizations"
As though enchanted I could see the husband looking around to his relatives and muttering something in Ijaw language, they too suddenly apprehensive replied and in a matter of a moment's notice the husband informed us that he would start making calls to secure funds.

Patient's temperature was still high, pulse still racing and the heart rate of  the baby wasn't encouraging from what the registrar noted. Events unfolded in rapid turns and in a matter of minutes, the patient was ready for surgery, medical materials duly procured and the patient was wheeled into the theatre.

The surgery went well however, the baby had respiratory problems, but sepsis was already top on the list of presumed disease to contend with, and was subsequently taken to the Special Care Baby Unit for prompt attention. The patient however was going to stay in the ward a little longer due to the infection (chorioamnionitis)  she was diagnosed of during labour.

Women and children constitute a major part of our Nigerian society. We have no reason for deaths among women due to child birth. Antenatal visits are paramount to curbing the high incidence of maternal mortality in our country. With ignorance and lack of education as background issue, the longer people stay away from the hospital when having one symptom or the other could mean undue funds to be spent in the long run. Traditional birth attendants may have some skill when attending to women in labour, but they are often unable to handle complications that could possibly arise. Hence the best option still is to see a doctor.

MAMA IJAW!! MAMA IJAW!! YOU HAVE KILLED YOUR CHILD!! PT 1

Like a mother, she opens her arms to anyone who comes
Like an inn keeper, she would prepare a bed and a bath
All who spend a night in her inn have had testimonies or more
Natives of her land have so much faith in her powers or so
More respected than the man cloaked in white apparel
Gravid women throng into her bed in anticipation for a new suckling

But buried deep in her  backyard lies the skull and bones of many
Of children who never knew what if feels like to breath in oxygen
Of  mothers who's labor pains was next to unbearable for days
Mama Ijaw! Mama Ijaw! We know you mean us well
But you have killed your child and the baby of your child

Hehehe! Please spare my poem with no rhyming scheme, I thought about  a dramatic entrance to introduce to you traditional birth attendants and its effect on the health of the community. In the Ijaw land they are otherwise known as mama Ijaw. When ever this phrase is mentioned , I see myself painting a picture of a mean old woman, with her hair totally grey, holding a walking stick carved out of the branch of a guava tree. Her voice so feeble but her hands strong as she is known to massage vigorously any ailing part of the body. With my imaginations running a little too wild, she's a representation of the traditional herbalists and birth attendants in every society.

It was a calm call in the labor ward the other night, it seemed women in labor had decided to give us a break, especially after a very busy day with the number of patients we had to look after. I had hoped that somehow the night would remain calm as there were no emergencies to attend to. Until its was about 10 pm when suddenly a nurse came into the doctor's call room to inform us about an emergency just brought in. Quickly, I went out to see the emergency at this particular time of the night. The patient was seated at the waiting/ consulting area in severe labor pains. Each labor pain from what I perceived was dreadful,  one more unbearable than the previous. She appeared dehydrated, and exhausted all over. While my fellow House Officer was already on his way to inform the Registrar, a more senior doctor, a rush of adrenaline had filled my blood stream as I revved into emergency protocol. I had only asked two questions when it seemed apparent that she was eventually going to end up under the knife, "madam! Madam! When labor start?", I asked. Which much grimacing and waist holding and twisting on the chair, she said,"na yesterday". At the same time I was fixing a cannula into her veins and collecting some blood samples, I asked her,"which time yesterday?" "Around morning time eh". I was now getting troubled and worried. Luckily enough she had large visible veins and at a single thrust of the cannula needle, I got venous access and filled about two blood sample bottles. " Ehen madam! So you dey try yarn me say you dey labor pass one day so o. Where you come go since na?" I asked? " I be go native". She answered just the same time another contraction came on. Well, I guess she had no other options, but to tell us the truth and nothing but the truth, any information to alleviate her present torture. Luckily there were emergency materials available and while I was setting up the intravenous fluid (drip) to rush the first litre of fluid, the Registrar came in and swung into action, asked quick questions of which I paid keen attention to.

Turns out that mama Ijaw had used all sorts of herbal concoctions in her private part because the baby had refused to pass thought the mouth of her womb. Mama Ijaw had also done some series of tummy massages, which alone can be unsettling for a fetus yet to be called a baby, yet to be given a name.

The nurses had already taken the vitals of  this woman and her baby; her temperature was through the roof, a sign that she's already had some form of infection from Mama Ijaw's crude methods, her pulse rate was racing. The good thing so far was that her breathing pattern and her blood pressure was within normal range. The heart rate of the fetus was irregular, which to us spelt fetal distress. An sign which meant a myriad of possible conditions that could have happened or currently happening to the baby. From the stress of the uterus trying to push the baby out for so long, to problems that might arise from the placenta, which is the life support of the baby.

Other discoveries found out was that, she had never gone for antenatal care,where the well being of her and her baby would have been top priority, where risk associated with her pregnancy would have been picked up by the doctors then, the period of her delivery would have been predicted by calculations and hence she would have been well prepared for the delivery. This current emergency would have been avoided.

To be continued...