SEX; FOR PLEASURE OR REPRODUCTION?

A man will pour millions of sperms into a woman’s birth canal, turn on his left side, sleep for hours, wake up, pour another round of five hundred million or so sperms, and sleep like a baby. He will wake up a third time, pour another millions of sperms, then fall asleep and wake up three hours later to leave. And when this time comes, he will leave with hands in his pockets, chest puffed out and a stupid grin on his face. Another one will be whistling contentedly with hands in his pockets while his feet kick every pebble on the way (his way of telling the world he just had unprotected sex).

The woman will toss and turn, then wake up and rush to the chemist for the emergency pill, or she will wake up to count the number of used condoms on the bed side table and try to recall how many rounds you both went, or she will wake up, retrieve her oral contraceptives and confirm that she didn’t by any chance miss her pill yesterday. While she checks her calendar to reassure herself that it is not yet three months since she last had her shot of depo, he will be “hi fiving” and receiving pats on his back for being able to bed that “girl”. While the man goes on with his life without a care in the world, she will be waiting for her period anxiously. That is the only way she can know she is not pregnant for sure.

The same man will tend to react in three ways if by some ill luck that girl gets pregnant; one, he will deny that stomach, “everyone knows you are a hoe or ho, just go find the father of your child.” Two, he will accuse the girl of trapping her “you did this on purpose, kwani you were not on the pill?” Three, he will try to get the girl to abort, give them that little speech of I am not ready and neither are you, raise ten thousand shillings and lead them to some nasty back street clinic, have your baby yanked out of her womb and then avoid them forever. A few however accept and I have to give them that though it leads to unplanned parenthood but hey, the world is too full of dead beats we will take any who is ready to man up and admit that it was one out of the billions of sperms that fertilized that ova.

If there is a chance for men to decide when to have children and when not, by all means they should. If they won’t ‘wear’ the condom, then they can have that pill. Or better still, go for the safest of them all, vasectomy.

Vasectomy is a family planning method that is not for small boys. It is for men who have had their desired family size. During vasectomy, the vas deferens on both side are ligated and tied (done under anesthesia of course!!). This prevents sperms from entering the seminal stream.

Pregnancy is still possible shortly after vasectomy and therefore couples are advised to continue with another complementary family planning method until a semen analysis is done in which zero sperms are found on semen.

A man undergoing vasectomy

It is important to remember that vasectomy will not protect you from sexually transmitted diseases. It doesn’t affect your sex drive also! And the first human vasectomy was done in 1924!

FEAR KILLS

I have been seated across from this woman for four or five minutes now. I have been wording and re-wording the sentences I will say to her in my mind. It is an incredibly cold morning. Been raining all cats and dogs, and still, the skies are heavily laden with dark clouds. It is windless outside, but the relative calm is punctuated with the sound of thunderstorm from time to time. I can’t stop thinking that ‘I am cooking a storm’ for the young lady seated before me. She looks older than her thirty eight years. Must be the doings of cancer. Her once beautiful face is now just bones covered in a thin sheet of muscle and skin, with minimal fat.

She looks at me for the first time our eyes meet. I have been hoping that she will somehow read my mind, pre-empt my thoughts and save me from having to open my mouth and utter the very words. But there are no signs this will happen. So I clear my throat and look in the general direction of her face. She avoids my eyes and looks right past me to a point on the wall behind me. “It is stage four (b)”, I say. She sighs and focuses her eyes on mine. She frowns and I count five lines on her forehead. “surgery?”, she asks. “No”, I reply. Before I explain further, she stands up, unties her wrapper and re-ties it. She walks to the door then walks back to her sit and lowers her little self onto it. Today is one of her good days; she can actually walk without feeling dizzy, thanks to the multiple transfusions she has had.

There is a knock on the door as I lean foward to tell her more. Whoever is on the door shouldn’t have cared to knock in the first place. she lets herself in even before I let her in. Turns out it is the counsellor from the palliative clinic. I had been waiting for her. I am over- joyed. I quickly forget her bad manners and offer her my chair. I had briefed her about this lady. She will definitely do a better job than I have been trying to do. I leave her to it and quickly close the door behind me without as much as glancing behind me.

I let out air from my lungs once I step out. Didn’t know I had been holding my breath all this while. As I walk away, I can’t stop thinking about this lady. She will be lucky if she lives to forty. Cervical cancer stage four (b). It means it is no longer a local disease. The cancer cells have spread to the liver, and the spleen. The only option we have is to palliate her (add quality to her remaining days, not quantity). Send her for radiotherapy to reduce the local disease, take care of her pain and do serial blood transfusions. Sad, right? It is actually sadder when you think about her children who will remain mother-less thanks to a highly preventable and treatable disease like cervical cancer.

It is sad because women will experience symptoms up to one year, others two years before finally walking to a hospital. And why is that? You ask, it is because of fear. While some fear discussing ‘embarassing’ topics like vaginas, breasts, and sex, others fear being tested and diagnosed with illnesses like cancer, HIV and AIDS, and other sexually transmitted diseases. We all know a person or two who would rather die than be diagnosed with cancer. These are people who will never show up for voluntary screening and testing. For some weird reasons, they believe knowing they have a certain terminal illness will kill them faster. What they forget is that, the earlier some of these conditions are caught, the better for them.

Take cervical cancer for example, stage one is a totally treatable condition. Stage four is un treatable. The difference between stage one and four is just time. A person will be stuck in stage one cancer for a while before the disease becomes stage two, then three, then eventually four. While a few are lucky to be diagnosed with stage one disease, majority will show up three years too late when there is virtually nothing that can be done. Those who show up late will tell you that they feared coming early. And fear will be the cause of their death.

Men are worse off than women. First off, they are poor healthcare seekers. That coupled with the fear of the unknown will make them shy away from hospitals. That is why most of them will hide at home with their big prostates and only show up in hospital accident and emergency department in the wee hours of the morning when they can’t ignore the burning pain in their bellies thanks to retained urine.

I believe it is time we all took our health a little more seriously. Let us make use of all available screening tools. Let us have annual health check-ups. Let us make those decisions to lose a breast than a life early enough. Let us give up those problematic prostates. Because when we are dead, we won’t even need the breasts that we so refuse to part with in life. Or the prostates for that matter.

124 DAYS… AND COUNTING!

For the past one hundred and twenty four days, public hospitals have been non-operational owing to the nurses’ strike. For one hundred and twenty four days, Kenyans have had to seek for alternative ways of keeping their sick alive as they wait for the government, ‘their government’, to do something.

The national government has been quoted on several occasions saying healthcare is a devolved function, in other words, the nurses’ strike is the headache of county governments. Meanwhile, the very national government that has exonerated itself from matters nurses’ strike is hopping from one county to another bragging about ninety four referral hospitals it has ‘opened’, MRI machines it has bought and installed across counties, numberless C-ARMS, dialysis machines bought and installed and blah blah blah. That the deputy president had the audacity of standing before the people and God in Vihiga County and mention machines and referral hospitals on the 4th/10/2017 in the midst of the longest nurses’ strike is plain sad. That two or three people clapped for him says a thing or two about us.

For a hospital to run, doctors, nurses, cleaners, lab technologists, porters, security personnel, sonographers, clinical officers, et cetera are needed. If hospital cleaners went on strike for an hour, hospital operations will grind to a halt. Same applies to cooks, lab techs, doctors and nurses. Nurses are a vital part of the healthcare system. This part has been missing for the past four months.

In the four months that nurses’ have been out of hospital, too much damage has happened. Too much that can not be undone. There are women who have died while giving birth; there are those who have lost their un-born children. HIV positive mothers have remained uncared for through-out pregnancy, some have had to give birth at home hence exposing their babies to HIV. Children born months before and those born during this strike are missing their immunizations and this will haunt us in the future.

Patients who were waiting in line to have operations are dying without ever stepping in theatre and this is after selling plots for theatre fees. Patients needing dialysis have had to do without dialysis for as long as their bodies can, they have changed their dialysis needs from twice a week to intermittently because that is what they can afford with the rates charged in the private hospitals. Cancers are progressing, cancer patients are making do without their morphine because palliation centers have been closed.
The old men have had to live with infected urinary catheters. Hypertensive patients have had to post-pone their check-ups. Diabetics have resorted to alternative medicine and prayers and hope. Meanwhile, their kidneys are getting damaged; blinding cataracts are slowly but surely growing in their eyes. Killer clots are developing in their arteries.

Too much damage is happening. But sadly, life is going on even as our children die of simple diarrhea and vomiting, pneumonia and malaria.
We have been so busy politicking that we have forgotten we have no place to take our sick, our injured. The media has been so busy with one political headline after another; it has no time for stale news about the health of the bottom class.

The opposition is so keen on getting into power it won’t talk on behalf of their poor supporters! We are busy feeling sorry for Uganda we have forgotten that we have no healthcare in our own country! Meanwhile, we are busy ‘advising’ women and girls to go for breast cancer screening because that is what the whole world is doing. We seem to be forgetting that we practicallyhave no hospitals at the moment!

ASTHMA; The constant in my life

Living with asthma can be draining; both physically and emotionally. While living off drugs sucks, it sucks even more when you have to remind yourself that you can’t ‘get too mad’ because that may trigger an attack! See, that there is the true definition of “sucks”. I had a chat with seventeen year old Bruce Morara and I can’t help but marvel at his courage. Twice in our conversation I fought with my own tears. But then I had to remind myself that what he really needs is not pity, but all the support so he can achieve all his dreams.

‘I can’t sing. I can’t walk for long before I become breathless. I can’t have a six pack because I am not allowed within a five kilometer radius of a gym.( he he he) Damn I am not even allowed to be stressed. I have always wanted to join the army but I realize now I can’t.’ ‘So what will you become then,’ I ask. ‘Well, since I can’t join the army, then I hope to become a scientific researcher, find the cure of asthma.’

Bruce has been asthmatic for as long as he can remember. Asthma has always been the constant in his life. When I ask him the number of times he has been hospitalized he says; ‘many, I can’t put a number to it, but just know it is many times.’

Every attack has obviously been a bad experience to you. What has been your worst experience though?
‘I had been involved in an accident. I broke my left leg and was admitted in Tenwek. At some point I had to undergo skin grafting. Midway through the surgery, I had an attack. It was bad. My surgeon panicked. They thought they were going to lose me. I was under spinal anesthesia and I saw it, heard it all. It was pathetic.’
In the absence of a chronic illness, every man and woman for that matter lives under the fallacy that, they will wake up tomorrow. Not Bruce! when I asked him what his greatest fear is, his answer surprised me.

‘My greatest fear has been to sleep today and not wake up tomorrow’. ‘Do you think this can happen?’ I ask. ‘I am used to the fear. It is real.’
Asthma is basically “an allergic disease of the airway”. Over the years, he has come to know his triggers to be; dog fur, cat fur, lab chemicals, perfumes, cold, flu and dust. For him, dust is the worst. But how does he survive lab experiments now that lab chemicals are a trigger? ‘ I have to nick my nose, sometimes I get out of the lab. There was a time I was given a gas mask but the teacher took it away, said it belonged to the school’.

Like most sickly teens, he has not been fortunate enough to escape bullies. ‘ I have had to stand at the sidelines and look as my friends played. They used to keep me off their trucks telling me we enda ukatembee na daktari, unaeza tufia saa yoyote. I had a teacher who used to torture me psychologically. He used to say that I only know how to make mistakes and when beaten starting croaking like a frog.’

Being a student and asthmatic has been tough for him. ‘There are times when I spend half my day in the sick bay and the other half in a hospital casuality getting nebulized. This has dragged down my performance. I am always trying to catch up, always copying notes.’
‘Being in boarding school, away from people who really care about you, you might get an attack any time, any place. Are you confident that other students will help?’ I ask. Well, it depends on who is around. But some students can be arrogant.’ His answer says exactly the kind of children we are bringing up. I still don’t know how someone can walk away from an asthmatic having an attack. I mean how do they live with themselves after that?
His school tries to be supportive. But he wishes his school had a nebulizer. It would be a lot easier than making these journeys to the hospitals every time he gets a severe attack.
Being sick is a lonely affair. It is something that no one else is going to understand. The doctor may come close, but even then, he/she won’t understand. His girlfriend has always been there for him. She knows all my dreams. ‘She might become my wife and I want her to understand me.’ ‘Has she ever seen you during an attack?’ I ask. ‘ Yes, two times. She didn’t panic. She just put me on a motorbike and rushed me to the hospital. Then she called my brother’. (such a gem!)

It is hard not to admire his courage. During each and every attack( and they have been many). It is like facing death head on. But he has lived through all those attacks to dream. He wants to get into research! Mary Anne Radmacher once said, courage doesn’t always roar. Sometimes courage is the quiet voice at the end of the day saying, ‘I will try again tomorrow’ Bruce has been courageous. I have seen him two or three times when he had an asthmatic attack and, apart from feeling like crying, I was scared. But even then, he wanted to go back to school. It took me sometime to convince him that he had to be admitted. (Do you remember, Bruce?).

Having a chronic illness sort of sets you apart. There are certain things you can’t do and one of them is to stay without hospital insurance. Bruce is a beneficiary of NHIF; which makes matters better financially speaking.
As an asthmatic, he has to remember to keep his inhaler close!

Post Trauma…

My small brother was three when the 2007 clashes happened. He spent nights inside maize plantations with my parents hiding away from the killers, the rapists and the thieves as they drove cows away into the Mau, chanting war songs. He spent nights inside windowless classrooms and days huddled next to other terror stricken children. He was an internally displaced person for days, many days. For a long time, he talked about our cat and his only pair of boots which ended up in ashes after our house was torched down.

The first time I took a pen to write, I wanted to talk about the unfairness of it all. But then I felt that maybe, I had no right. I was miles away when it was all happening. But then I remember sitting across from my father and listening. Night after another he talked about the screams, the arrows that were driven into men and women I had always known, the ashes left in places where houses had once stood. I listened as he listed names of those who had died.

Small wars like big wars leave scars. Small clashes like any big wars create victims. Long after the sound of gun fire ceases, long after the wails of a mother become silent, long after everyone has forgotten, some soul is left struggling. While people go on with their lives, victims of small wars are left alone with their haunted dreams, constant flashbacks. Small wars create victims of post traumatic stress disorder.

Post traumatic stress disorder abbreviated as PTSD, is a mental disorder that usually develops after a person is exposed to a traumatic event, such as rape, warfare, traffic collisions, police brutality, or even terrorist attacks.

Those who directly experience a traumatic event, those who witness as a traumatic event occurs to another person, those who learn that a close family member or friend suffered a traumatic event and those who experience every tiny detail of a traumatic event that happened to a close friend or family can suffer from PTSD. Now you can try guessing just how many victims this election alone has created. Start with the family of Chris Musando, Maryanne Wairimu, Nyarangi, baby Samantha Pendo……then those who have been raped and left to sort themselves at these difficult circumstances given our hospitals are almost non- operational.

When all is said and done, the Victims of WAR, RAPE, POLICE BRUTALITY, TERRORISM, and PHYSICAL FIGHTS will be forgotten. Life will move on. But the victims will always remember with an astounding clarity something about the rape, the shootings, and the killings. Years later, they will struggle to fall asleep, scream at the horror of their dreams, some will be unable to concentrate on anything. As a way to cope, they will drink themselves to their graves, waste away their lives and scream in the loudest voice at anyone who might try to help. Peter Straub describes it all better “It is as though some old part of yourself wakes up in you, terrified, useless in the life here, its skills and habits destructive but intact and what is left of the present you, the person you have become wilts and shrivels in sadness or despair, the person you have become is only a thin shell over this other, more electric and endangered self. The strongest, the least digested parts of your experience can rise up and put you back where you were when they occurred, all the rest of you stands back and weeps- the Throat

Like any disease of the mind, PTSD is treatable.

Victims of trauma should be supported. According to S. Kelley Harrell; “Often it is not the initiating trauma that creates seemingly insurmountable pain, but the lack of support after”

PTSD victims should be seen by psychiatrists and counselors; they will need to be listened to. They will need to be assured, and redirected. They will also need drugs from time to time

PS; what syllabus do Kenyan policemen use when training? Remember Kwekwe Mwandaza? And now one of them clobbered a six month old Samantha Pendo to death.

IT IS THE WORLD BREAST FEEDING WEEK! (Pt 2)

There are three reasons for breast feeding; the milk is always at the right temperature, it comes in attractive containers; and the cat can’t get it- Irena Chaimers.

Exclusive breastfeeding is defined as “an infant’s consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications.

Infants should be fed exclusively for the first six months of their lives.

The benefits of breast milk to the child and the mother are numerous;

  • Breastfeeding helps mother and child to bond

You already love your child when they are born, when you breast feed them, you love them more and they love you back.

“Mother and child mutually gazing into each other’s eyes, telling each other secrets with just their eyes”

It is often said that a child knows the smell of its mother, and that a mother’s breast will produce milk on its own when the child cries, no matter how far apart mother and child are.

  • Breast fed children have a higher IQ than their counterparts who were never breast fed

See, breast feeding your child makes them wiser and brighter.

Breast milk contains galactose for brain development

  • Breast milk is cheap, clean and gives babies an attractive smell

I do not need to overemphasize the fact that breast milk is cheap, and readily available. Any mother who has tried formula feeds will tell you how much pocket damaging they can be.

Then apart from the issue of cost, there is the other problem of water, your feeds are as clean and safe as the water you use for mixing them and the containers you use

  • Breast milk protects against allergies

Compared to their bottle-fed counter- parts, breast fed infants have a low incidence of allergies such as atopic dermatitis.

  • Colostrum has endorphins good for birth associated stress

Colostrums is the first milk that is normally yellowish in color because it contains a high fat content

  • It reduces the risk of juvenile onset diabetes mellitus , rheumatoid arthritis and inflammatory bowel disease

These diseases are commoner in children who were not breast fed for some reason or another

  • It reduces infant mortality- otitis media, pneumonia and diarrhea are less in breast fed infants

This is because breast milk contains anti-bodies which protect the baby from infections

  • Breastfeeding helps mothers lose weight

Pregnancy is a weight gaining experience (he he) some mothers also gain a lot of weight during the period after giving birth. (What with everyone musing about the way they should eat so that they can breast feed their younglings?)

Breast feeding helps lose some of that undesirable weight

  • Suckling promotes uterine involution and this prevents post- partum hemorrhage

After the baby is born, the uterus contracts and this helps to prevent bleeding

Breast feeding helps in further contraction of the uterus hence reducing the chances of post partum bleeding

  • It is a contraceptive although it is not 100 percent effective

Some women will not start getting their periods until six months after giving birth. This phenomenon is known as lactational amenorrhea.

It is more pronounced in women who breast feed their children exclusively.

During this period, such women will not get pregnant

Note; this is not very effective and it is therefore important to use a contraceptive. If you do not want to be that woman who finds themselves pregnant when her baby is barely five months old

  • Breast feeding helps reduce breast and ovarian cancers

Suicide takes considerable courage

They tell you that suicide is selfish, that it is cowardice, and that it is wrong. That suicide is no way to die. What they don’t know is that it takes courage to tie a noose, put your neck in and grit your teeth, shit your pants, clasp and unclasp your hands as you wait for the rope to cut deeper into your flesh. Honestly speaking, it takes courage to swallow a liter of sulphuric acid, let it burn its way down your throat, down through the esophagus and wreck havoc as it settles down your stomach. Tell me what is the cowardice in swallowing triatix? I mean you all know how bad it smells even the ticks can’t stand it. There is absolutely no cowardice in choosing to die via a bullet let loose by your own hands. Suicide is many things but it is not cowardice! David Mitchell says that; cowardice has nothing to do with it- suicide takes considerable courage.

Most people would rather not talk about suicide. It is a taboo amongst most African cultures. (Ever attended a funeral of someone who committed suicide? Then you know what I am saying) in the church setting, it is a murder which is a violation of the commandments. Suicide and attempted suicide is viewed as a curse in most communities. Most people will go Iraq and Iran on victims of attempted suicide. They will rush them to the hospital alright but they often receive an uncalled for tongue-lashing. There is this grown man who had drank a whole bottle of a pesticide and his brothers rushed him to the hospital. While he was retching and clutching his stomach in pain, a brother of his who happened to be a teacher kept glaring at him and reminding him that he is the one who had chosen the pain. Needless to say, he passed away hours later. A mother of four drowned a bottle of triatix. Her husband and good Kenyans rushed her to the hospital only for them to chide her for being so stupid. She died after a two day stay in hospital, because her husband didn’t have money to buy her drugs that could reduce the side effects of the poison!

Living on the edge

Suicide is common. Attempted suicide is commoner. Approximately seven hundred thousand people take their own lives annually. Most of these are young people between the age of thirteen and thirty five. Quite unfortunate that people who have literally a life- time before them are the very ones who do not see the need to live. You ask yourself “why?” why is it that someone will literally fight for their dear lives in intensive care units, why is it that a patient with stage four lung cancer would cling to life so much while a seemingly ‘whole’ person would jump in front of a an over-speeding car. Why would someone be that cruel to themselves? Why would someone not give a hoot about life?

No one is born not wanting to live. Most of the times, life becomes too much. Sadly, in the world of face book, twitter, and Instagram no one realizes another person’s struggles. Everybody is busy and when it happens, everyone runs to social media with questions like” why man why? “Really now?” “Did you have to do it?” everyone is apt to call you selfish after you kill yourself but David Mitchell writes that ‘what’s selfish is to demand another to endure an intolerable existence, just to spare families, friends and enemies a bit of soul-searching.’

People commit suicide for reasons bigger than cowardice, and fear. They commit suicide because;

  1. THEY are DEPRESSED

Over half of all attempted suicides are as a result of depression.

Depression is sadness multiplied infinite times. It is darkness, pain, hopelessness, and anhedonia all inhabiting the same person.

  1. DRUGS

Case on spot here is the seemingly “ harmless” alcohol

Most depressed people tend to lose themselves in alcohol in an attempt to escape their persistent pathological melancholy.

It works for some time, helps them forget themselves for some time, puts a song in their lips and gets them newer friends. But with time, it ceases to comfort them.

Alcohol leads to loss of whatever little self control was left and that is how a person is found hanging from his roof reeking alcohol.

  1. DISAPPOINTMENT and LOSS

Divorce, death, break-ups, this world is so full of disappointments and when people can’t deal with them, they remove themselves from them permanently

  1. PERSONALITY ABNORMALITIES

Then there are those who are kind of impulsive. They will fallout with girl-friends, threaten to kill themselves and they do. This is common among teenagers

Sometimes, a person will commit suicide out of the blues. They will be alright, and then the next minute they will be found dangling from a tree, lifeless. Most suicidal individuals however will behave in a certain way for sometime before they kill themselves.

Here is how to tell if someone is suicidal;

  1. They focus on the gone past- they dwell on past losses and defeats.
  2. They anticipate no future- some might say the world will be a better place without
  3. They are distracted and lack humor
  4. They are pre-occupied with death
  5. Some are dominated by hopelessness and helplessness
  6. Some will let you know that they are intending to kill themselves- take it seriously

A person preparing to die will visit family and friends to say good bye, some will write a suicide note therefore checking their rooms would be prudent. Some will write a will and others will purchase a means to their end, a rope, a gun……

If you suspect that a person close to you might commit suicide, here is what to do;

  1. Ensure he/she is not left alone. A determined person commits suicide when there is no one to stop them. Don’t let them sleep alone. Don’t let them take a walk alone.
  2. Remove anything that they may use. These are many and varied. Some use knives to open a vein, stab self, guns, pesticides and herbicides, ropes, guns
  3. Commit such a person to a safe secure and supervised facility-hospital
  4. Treat underlying psychiatric illness- depression, alcohol dependence, schizophrenia….

Here is a list of patients who should not be ignored;

  1. A person who has attempted suicide before. Some people try suicide as a way of seeking for attention. Their initial intention is never to die. Others try a first time and fail, learn from their mistake, try harder a second time and succeed. Anyone who has attempted suicide should be reviewed by a psychiatrist for this reason
  2. Patients who engage in activities that indicate they are leaving life ( writing a will, visiting friends and making funeral plans)
  3. Patients with a family history of suicide. They tend to commit suicide at around the same age their relatives committed suicide or during their death anniversaries
  4. Patients recently discharged from psychiatric hospitals. The time after discharge is usually very tough as they try to get back into the normal life
  5. Depressed patients who often see death as the only way out of their pathological sadness
  6. Patients with command hallucinations- these will often respond to the voices in their minds telling them to kill themselves

A suicide can only be prevented. It can never be treated and no matter how much we talk about the way it should never have happened, once it is done it cannot be un-done.

Motion Sickness

There are people who will get in a matatu, with groundnuts on one hand, fries on their laps and a container of milk on the other. For them, the process of travelling is as simple as eating their fries slowly, washing them down with a sip of milk and occasionally confusing their digestive juices with a ground nut or two. Others will get in a matatu and sleep as soon as they are in motion. They will sleep through bumps and rough patches in the road. Then there are those who will get in a matatu and head for a seat by the window roll down the window, rummage through their luggage for a black polythene bag and keep it close. Once the vehicle is in motion, their stomachs churn and they retch and retch. Most will throw up the bitter acid from their stomach and food from a day ago. The other passengers will of course look at them and wonder why people eat too much just before they travel. Bad conductors will bark nasty stuff like having to clean the matatu and self-control and stuff like that.

Well, what most people don’t know is that, throwing up when travelling is a disease! Motion sickness is a disease just like malaria. And no, you can’t fight the urge to vomit.

So what is motion sickness?

Also called car sickness or sea-sickness, is the feeling you get when the motion you sense with your inner ear is different from the motion you visualize

Symptoms of motion sickness begin as soon as a car is in motion. These include;

  1. Uneasiness
  2. Cold sweat
  3. Dizziness
  4. Hyper salivation
  5. Headache
  6. Fatigue
  7. Nausea
  8. Vomiting

There are people who will get in a matatu and travel for fun. There are those of us who try as much as possible to avoid travelling. For those of us who suffer from motion sickness, travelling is an awful experience that will be punctuated by retching, vomiting and awful glances from fellow passengers.

Motion sickness is an awful experience that for some reason is commoner in women and young children. Those prone to this condition will avoid travelling as much as is possible. But they will more often than find themselves in a matatu, clutching a black polythene bag travelling to school, to their places of job or to the country-side.

The good news is, motion sickness can be prevented. Here is how;

  1. Avoid fatty meals 24 hours before traveling
  2. During Car travel- sit in the front seat if possible- this helps to visualize the motion that you will perceive
  3. Avoid smoking- cigarettes are not only bad to your lungs apparently! (Of course you know this).

You can also take some anti-emetic (drugs that prevent vomiting) before travelling. Here are some that can be used;

  1. promethazine- these tiny tablets work wonders.

They will prevent nausea and vomiting but they will make you very sleepy, you will miss the scenery and if you are too unlucky, You might get robbed ( God forbid)

  1. Cyclizine- can be bought over the counter. Take 30 minutes before travelling.
  2. Scopolamine- this is administered as an injection.
  3. scopolamine- may also be used.

So next time you are seated to a bored young lady who won’t accept your roasted maize in a matatu, don’t be quick to call her proud. She might be suffering from motion sickness.

If you are among the lucky majority, here is how you can make life a little better for the unlucky minority;

  1. Let them have the window seat- you can always look at the scenery on the return journey.
  2. If you must eat, please avoid njugu karanga, roasted maize and fries. The smell from this food stuff worsens the nausea!
  3. Avoid strong perfumes and body sprays!
  4. Don’t remove your shoes in the matatu ( PLEASE)
  5. Don’t drink and travel ( ha-ha).
  6. Fill your petrol tanks before passengers board( DRIVERS and CONDUCTORS)
  7. Travel clean- with brushed teeth!
  8. You have a right to be disgusted but remember everybody hates vomiting. Be kind!

CHILDHOOD DIABETES; PART ONE

What is peace when you have a four year old on insulin? After the shock of learning that your underage child has diabetes wanes, you will spend all your life being overprotective, making decisions and unmaking them, running to the doctor for the slightest reasons and before you know it, you have a spoilt brat for a child. But I dont blame you. We have all grown up knowing that diabetes is a disease of the fat old rich. Most of the people we know who have diabetes are either amputees or blind, and so, you, as a parent has every reason to be worried. You have every reason to ask yourself questions on behalf of your unsuspecting child.

Your child will have a relatively normal life if the condition is well managed. So don’t forget to push your child a little more, don’t shy away from asking them about their grades. If your child wants to dance, let them.

As a parent, your role, apart from being a mother or a father to your sick child, you will also be the primary caregiver. You are the one who is going to be administering the insulin to your child, you are the one who will watch their diet, you are the one who is going to look out for any complications and you are the one who will ensure your child sees a doctor regularly for check up. If your child is going to be in and out of hospital, then you are the one who is going to be spending time with them in the hospitals. You cannot therefore afford to know nothing about diabetes.

Here are some of the things you need to know;

WHAT IS DIABETES?

A disease in which too little or no insulin is produced or insulin is produced but cannot be used normally resulting in high levels of sugars in the blood

INSULIN –a hormone that allows the body to use the sugar that is generated from the foods we eat.

The foods that we eat are usually broken down into glucose (sugar). Insulin helps the body to use this sugar.

THERE ARE TWO TYPES OF DIABETES!
Most people just know diabetes. But doctors will tell you that there is type one and type two.

The problem in both type one and type two is high blood sugar level but the two are basically different entities.

TYPE ONE

This is the type that normally affects children

Caused by insulin deficiency

TYPE TWO

Commonly affects adults

Cause- insulin resistance. Here, there is insulin but it is unable to perform its work

A diagnosis of diabetes is made by measuring the sugar levels in blood, in a hospital setting.

But here are some of the symptoms that should make you suspect diabetes in your child

  1. Excessive eating
  2. Excessive urination
  3. Taking too much water
  4. Recurrent urinary tract infections

If your child develops any of the above symptoms, then it is prudent to have their blood sugar levels tested

NOW THAT YOUR CHILD HAS DIABETES;

  • They will be on insulin for life or until a doctor feels it’s time to change to something else.
  • They need to watch what they eat- but how do you explain to a four year old that they can’t have muffins and fanta orange while all the children in their class are having fanta orange?
  • They must never skip their insulin doses-

You cannot afford to skip a dose. Forgetting is unforgivable.

  • It is a lifelong disease- once diabetes visits, it stays with you through all your ups, downs
  • There is no permanent cure – not yet. But it doesn’t mean you won’t lead a sufficiently normal life
  • You need hospital insurance get a good cover, you cannot afford o be stressed about the hospital bills too
  • They will need a personal doctor aka pediatrician- a child is no small adult. Get them a nice paedtrician to walk with them.

 

For diabetes in particular, we know there’s a relationship between lack of glucose regulation and complications like blindness and kidney failure. So if you were diabetic and you knew that you could get your glucose in a tight, normal range by just adjusting your lifestyle, wouldn’t that be great? ERIC Topol

FOLLOW-UP

Diabetes is a lifelong disease that basically means you will make more trips to the hospital more than the average person.

Here is why you need follow-up

To review the insulin dose based on the sugar levels

To prevent complications- by regularly checking blood sugar levels, do organ function tests

Understand your Headache

MIGRAINE

A condition marked by recurring moderate to severe headache with throbbing pain that usually lasts four hours to 3 days. Typically begins on one side of the head but may spread to both sides and is often accompanied by nausea, vomiting and sensitivity to light or sound {Merriam Webster dictionary]

Some migraines occur without a warning, but most are often preceded by an aura.

What then is an aura?

AURA

In the gray quiet I see a zigzag of blue, yellow, orange. I see bright dots scattered here and there. They are beautiful. They are a welcome sight in this grey. I could reach out and touch each of them, walk the whole extent of the room till I see the ends of the blurry multi-colored zigzag. But I can’t. These things are non-existent, and beautiful as it is, I can’t enjoy, it means I am about to get the misery headache, a MIGRAINE.

Aura is the slice of heaven I experience before the hell of a migraine. It is a different experience for different migraine sufferers. For others it is chaos; visual chaos, cascading, distortion, melting, dots spots. All in bright colors never in grey!

Others don’t see, they feel things creeping up their fingers or legs. Others still hear strange sounds, feel strange smells or lose sensation in some parts of their bodies.

This usually happens an hour before all hell breaks loose.

Then the pain comes, usually one sided, pulsating. It does feel like a really fat man in a long sharp stiletto stepping on your head then stepping away, your head then away. It is as if he is responding to some rhythm.

It is usually one of those moments when your life ceases momentarily, and all you think of is the pain

WHAT CAUSES A MIGRAINE?

Sadly, the underlying cause of a migraine is not known; however, the following are the risk factors

  1. Female gender
  2. Genetics- migraines tend to run in families
  3. Triggers- here are some of the triggers;
  4. Stress
  5. Sleep- excess sleep or sleep deprivation
  • Drugs –estrogens , nitroglycerin
  1. Coffee withdrawal
  2. Hormonal changes – some females have attacks during their menses
  3. Red wine – (oh no ?!)
  • Chocolates ( poor soul?)

SIGNS AND SYMPTOMS

The symptoms of a migraine present in stages/phases

  1. Prodromal phase-this is a sort of a premonition phase characterized by
  2. Altered mood
  3. Depression or euphoria
  • Cravings for certain foods
  1. Sensitivity to smells or noise
  2. Aura phase- occurs minutes to hours before onset of pain
  3. Pain phase-this is the phase when the headache occurs
  • Normally it is accompanied by nausea, vomiting, sensitivity to noise and smells
  • It is best to lie in a dark quiet room during this phase
  1. Post drome- this is the phase after the headache has ceased
  • During this phase, some people may feel euphoric others depressed. It is different for different people

PREVENTION

Nobody would want to have a migraine two times! Unfortunately, migraines attack the same person over and over again.

That’s why it is best to prevent them.

  1. Migraine prophylaxis with drugs as topiramate, gabapentin, verapamil (note these are prescription drugs, not over the counter medications!)
  2. Avoid triggers

TREATMENT

Remember to lie in a dark, quiet room!

  1. For mild to moderate headache- use pain meds like paracetamol, ibuprofen
  2. Severe migraines- your doctor should be able to prescribe triptans and ergots