Living With Lupus

Lupus or SLE is short for systemic lupus erythematosus, a chronic autoimmune disease in which, your immune system fights your healthy body cells! The result is, literally every part of your body, from your skin, your kidneys, heart, lungs, etc are affected. Seal, the Grammy Award winning singer and song writer suffered from discoid lupus, a type that affects the skin, which left his face scarred. Nick Cannon, the AGT host experienced kidney failure due to complications from lupus. There is an estimated five million people in the world with some form of lupus. Despite this, not many governments have dedicated any meaningful relations towards funding lupus. The month of May is dedicated towards raising awareness about lupus.

Once a person is diagnosed with lupus, there is never being free of it. Your life is characterized by periods of flares and remissions during which the symptoms wax and wane. During a flare, your life takes a back seat as the auto antibodies wreck a havoc in your body. Remissions is the time when you take your drugs and suffer the side effects of those drugs, live your life and wait for a flare because it is always coming!
Aside from the physical manifestations of the disease, lupus, like all other chronic illnesses will affect your life financially, socially, and emotionally.
Lupus is an expensive affair! Apart from having to buy drugs that cost an arm and a leg and doing a zillion tests, you also have to pay doctor’s consultation fees on a monthly or two monthly basis. Then there is the cost of moving from home to hospital and numerous other miscellaneous expenditures that don’t apply to persons who are well enough. It is important for me to mention that as much as we encourage all persons to take a medical cover, most people with lupus have to pay for drugs out of pocket because most regular pharmacies and hospitals do not stock these drugs.

Most people are diagnosed with lupus at the prime of their lives; late teenage to twenties, while they are busy trying to be alive and wrapping their minds around the fact that they will be sick for life, their colleagues are making a nark for themselves in the career world! The result is, they give up on their dreams, become under- employed or unemployed. For those who are diagnosed later in life when they are gainfully employed, they may not be able to stay employed because of being constantly absent. Though there are laws that protect employees, some employers will retrench, or sack you at the slightest provocation!
Chronic illnesses always have their effect on marriages and family life. Those that come early in life have a way of separating the sick from their soul mates and lupus is no difference. Love may be strong but not stronger than the constant fear of losing a loved one. One of the consequences of lupus is habitual pregnancy loss and this in itself worsens the already bad situation.

People with lupus may have less friends because they are almost always missing in action. Today they are okay but tomorrow morning they are too tired they can’t move a finger to scratch their scalp! And so they have to cancel a dinner on the eleventh hour and some friends can’t understand that! They miss a baby shower because they convulsed at night and they don’t want to ruin it by convulsing right in the middle of the photo shoot, and also baby showers remind them of their own babies who came out as clotted blood.

Being constantly sick, relying on meds for life, the strain to get enough money for your illness, having very few people who understand your sickness and the lupus itself have an adverse effect on mood. It is therefore uncommon for people with lupus to suffer from mood disorders such as depression! Caregivers and primary doctors should therefore be able to screen for any signs of depression and refer these patients to psychiatrists on time.

It is now possible for people with chronic illnesses like HIV and TB to get drugs at no cost. People with lupus should also be able to get their drugs and tests for free or at a subsided cost. This will go a long way into improving their survival rates and quality of life, because with the proper treatment they can be productive people who will contribute immensely to the growth of this nation. If you see Nick Cannon hosting AGT, you wouldn’t think that he has lupus; a chronic illness that can be debilitating at times.

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!

APRIL; AUTISM MONTH #LIGHTITUPBLUE#

I bet we all remember Susan Boyle; a Scottish singer who first came to international attention in 2009 after appearing as a contestant on Britain’s Got Talent. She stood before an audience in “Clyde Auditorium” and said that she was trying to become a professional singer (at forty) and that she hoped to be as successful as Elaine Paige (The audience smirked at her on hearing this). She performed the song “I dreamt a dream” so beautifully and so powerfully, everyone including the judges was surprised. They hadn’t expected much from her. She finished second in the contest, losing to the dance troop ‘Diversity’. Every time I am in need of inspiration, I go to you tube and watch her performing “I dreamt a dream”, while ignoring all the people in the congregation who were waiting for her to falter so they can burst out laughing. Susan Boyle was diagnosed with Asperger’s syndrome (now autism spectrum disorder) in 2012. She made her diagnosis public in 2013. Now, autism is a developmental disorder that is characterized by; difficulty in social interaction, challenges in communication and restricted repetitive behavior. World Autism Awareness Day is marked every second day of April as a way to raise the awareness of autism. April is autism awareness month. Autistic children and adults live in our world, amongst us; hence, we cannot afford to be ignorant about autism!

Parents and guardians will first notice symptoms in their children during the second and third years of life. Symptoms vary depending on the age of the patient and severity of the disease. Here are the “defining” symptoms of autism:
speech
1. Delay or lack of development of spoken language. This is often the reason why parents will seek for help.
2. Those who are able to speak are unable to start or sustain a conversation with others
Many children exhibit echolalia i.e repeat phrases and words they hear.
Impaired social interaction-

1. They lack emotional reciprocity
2. John Elder Robinson, said; ‘and I know it is perfectly natural for me not to look at someone when I talk. Those of us with Asperger’s are not comfortable doing it. In fact, I don’t know why it is considered normal to stare at someone’s eyeballs”
Autistics lack non-verbal cues; they are unable to maintain eye contact, unable to understand and use gestures, lack facial expressions and other forms of non-verbal communication.
3. They are unable to adjust behavior to suit social contexts. Hence they are unable to develop, maintain and understand relationships!

Restricted, repetitive patterns of behavior, interests, or activities,
1. They insist on sameness and adhere to routine in an inflexible way.
They may have to sit in a particular chair, dress in a particular way, or eat particular foods every single day.
They become quite distressed if a routine is disrupted.

2.Insensitive to pain or temperature, light or noise.
They are prone to injury since they can withstand extreme pain and temperature.

3.Stereotyped or repetitive motor movements, use of objects, or speech –

simple motor stereotypes, lining up of toys, flipping of objects, echolalia, idiosyncratic phrases
4 they have highly restricted and fixated interests.
They become fascinated with parts of an object for example the wheels of a car.
5.though some will have intellectual disability, others have normal intelligence. Some have very specific talents or abilities especially in music and mathematics. Susan Boyle?

Parents whose children have been diagnosed with autism live in constant fear. They worry their children will hurt themselves, they worry they will grow too fast and the world will hurt them, they worry they will have to face the world someday alone, and the world will not know how to handle them! These are all genuine worries. The good news is that there are others who have done it! I know that most of us have heard about Susan Boyle, but maybe we haven’t heard of other autists like John Elder Robinson, who grew up knowing he was different and was only diagnosed with autism(Asperger’s) at the age of forty by his therapist friend. He taught himself about electric circuits and sound waves and used the self- taught knowledge to design guitars and toys. Then there is Temple Grandin a professor of animal science, consultant to the livestock industry on animal behavior and autism spokesperson and there is Kerry Magro who was diagnosed with autism at four but went on to beat all the odds and became a professional speaker and a best-selling author. These are just but a few of autists who have gone on to become great despite having autism. And who tells you that your child cannot become as great if not greater?

There was a time Temple Grandin wouldn’t talk! “I can remember the frustration of not being able to talk. I knew what I wanted to say, but I could not get the words out, so I would just scream.

Without Consent, It Is Rape

If your hand or arm is going to “accidentally” brush against my ample bosom once, I will turn my eyes the other way and let you be. While I agree that accidents will always happen no matter what; I will not be looking forward to similar accidents from you ever. Which is why I am taking time off to inform you that accidents that involve you touching my body parts are not going to be forgiven twice. And since there is no way I am going to shrink my bosom, please learn to keep your distance, your roving eyes and arms slash hands to your space.

Dear colleague, note that I prefer shaking hands than hugging, for the simple reason that hugging is informal and is preserved for my close friends and relatives not colleagues. But if you ever find me crying and feel the urge to hug me as a way of comforting me ( we all have those moments when all we need is a hug), please don’t press your body so much into mine, because well, then you will not be hugging me but trying to squeeze air from my lungs! A hug doesn’t have to be full body to work. The Cambridge dictionary defines hug as to hold someone close to your body with your arms to show that you like, love or value them. Please put emphasis on “hold” and ignore the rest of the definition from love onwards.

Dear colleague, on behalf of those colleagues who are well endowed posteriorly, butt groping will never ever be treated as an accident! As a matter of fact, butt groping is a form of sexual assault. So don’t go grabbing buttocks that you have no right over and think you are better than rapists. If you are going to grab buttocks or thighs for fun, then you can wait and go to be sorry in court because there is no way in hell I am going to stand and wait for you to apologize to me for “accidentally” feeling my ass or thighs or any part of my body for that matter!

And finally colleagues, when it comes to sex, there is no such a thing as implied consent. We have far too many bosses assuming that a worker who stays late in the office is sending them some message. How they assume it is sexual, I am yet to find out. Someone cannot work late and have peace, dear colleagues. The moment some of you discover a colleague is staying late, you start staying late too, time your toilet breaks with theirs, somehow find yourselves in their offices for no intelligent reasons at all and before long, your thrusting your hands into places you should never touch in the first place. And you will think of yourself differently from a rapist, accuse your victim as a pretender and of passing mixed signals. Mixed signals my left foot! Why on earth don’t you just man up or woman up and ask for sex.

If you are going to have sex with someone, the least you need is a consent. Sneaking up to your colleagues and assuming that given your familiarity with them you can try grabbing their breast then hopefully end up laying them doesn’t make you any different from a rapist. Rape isn’t having sex with an unfamiliar person, it is having sex with someone who has not consented!

PRE-MATURITY

When you get pregnant, the world congratulates you. Mothers share their labor stories with you. They will mostly tell you about the pain which is always so much, words cannot describe it. They will tell you about the not so wonderful regular vaginal examinations that you will be expected to endure. They will advise you about where to go for your antenatal clinic, what to eat and what to avoid, where to buy your maternity and baby clothes, how much pain you should anticipate et cetera. Nobody will ever talk to you about going into labor pre-maturely. Nobody will talk to you about giving birth to a one kilogram child. Because it is never expected. Everybody assumes you will get pregnant, have an uneventful pregnancy, deliver at term to a bouncing baby boy or girl and everything will just be normal.

But sometimes, you will give birth pre-maturely for one reason or another. While a normal pregnancy is assumed to last for forty weeks, some women may deliver at late second trimester or early third trimester. A child born before term is usually under-weight, has immature lungs, is unable to regulate their body temperature, has fewer stores of essential vitamins and minerals and has reduced or no native reflexes. These are children whose suckling reflex is either absent or not well developed hence cannot attach on the breast. They need to be fed via a naso-gastric tube, need to nursed in a warm environment. They may need to be put on oxygen, especially during the first days of life.

Some of the reasons why a pregnant woman may go into labor prematurely include;
– Multiple pregnancy– most twin or triplet pregnancies will rarely get to term.
Mothers carrying multiples should be psychologically prepared to deliver before term
– Hypertensive disease in pregnancy– severe cases are normally induced at thirty four weeks
– Preterm rupture of membranes– followed by drainage of liquor “water”
This is mostly caused by infections
– Third trimester bleeding– may be due to placental separation or abnormal placentation. If the bleeding is massive, then delivery may be done before term.

Going into labor before term is actually a nightmare, the child comes when you are just not ready for them, both emotionally and psychologically. One minute you are pregnant and the next minute you are holding a tiny little thing on your hands who is then quickly snatched from you and rushed to a nursery. Then you literally become a prisoner, living in the hospital waiting for your child to grow to at least two kilograms. Every three hours of the day or night, you are seated before your child, who happens to be sharing an incubator meant for one with four other pre-terms who look extremely like your own.

So you live in the hospital waiting. Your child adds three grams in three weeks and loses five grams in a day. Sometimes you leave them well only to come back and find cardiac monitors sticking from an impossibly small chest, and nasal prongs inserted into the tiny nostrils, with oxygen being literally driven into those tiny lungs. But they live through such days and so do you.
When you have your child too early, the temptation to leave and quit the whole motherhood thing is strong. But then you draw strength from your pre-term child every time you see them work their muscles so hard in a bit to breath. Every time you see their eyes open and they gaze at you, you learn that the gaze is just as genuine, just as penetrating as any other and that alone is enough to push you through the rainy days!

Children born before term, if they receive good care, grow. They grow up normally, attain normal milestones and become as normal as those born at term. No, prematurity doesn’t cause intellectual disability or short stature. I have seen big men and women whose birth weights were as little as one kilogram. I know a doctor who was born pre-maturely, a university student pursuing engineering and as teacher. With pre-maturity, once you grow past the neonatal age, then you can grow on and conquer the world with your smallness!

LABOUR

I knew the time had come when I had my first contraction. Never in my life had I experienced such pain that intense. I remember calling the names of my relatives to the third generation, pacing the entire length of the sitting room, clenching and unclenching my hands, closing my eyes tightly and gritting my teeth. It passed after what seemed like an eternity. My next contraction found me in the hospital on the examination couch. I remember shouting obscenities in my mother tongue. I caught a glimpse of amusement on the face of the male nurse who was putting on gloves, ready to examine me.

He was kind enough to let the contraction pass before finally doing the vaginal examination. I was not a good patient I must confess. First off, I had climbed onto the examination table with my panties on! That didn’t sit well with my nurse who gave me a little pep talk. Apparently, there are some things you must lose when you walk into maternity and one of them is your undergarments. The second thing is shame. Yeah, once you walk into the maternity walk, you hang your ability/tendency to be ashamed on the maternity door and get in.

The vaginal examination was a little worse than your worst nightmare. Nobody had warned me that a reasonably fat gentleman would thrust two fingers inside my vagina then try stretch them and then look at my face and tell me that I am “only four centimeters dilated, and that my pelvis is adequate”. I had four more vaginal examinations before my son came out. And I remember each one of them. I remember fighting with the nurses but giving in in the end.

In between contractions, I remember counting from one to one thousand, counting the number of boxes in the ceiling board, listening to music from my phone, playing phone games and listening to other women wail and collectively curse the male gender for putting them in the family way. One woman vowed to remove her uterus. Another vowed to join the convent after having this one child. A teenager promised the gods to go back to school and chew the books like she was supposed to do. I remember one woman swearing to become a secondary virgin and remain thus till death. I on the other hand cursed my husband silently. All this time he was pacing in the hospital parking lot, dead worried about me. He sent me thousands of texts telling me the way after all it was just me he wanted and no child would ever come between us (I am not sure if this holds to date).

I had my son after what felt like hours and hours. he wasn’t easy that boy. I remember pushing and pushing, with some nurse standing at the foot of the bed urging me to keep pushing. And I pushed. Pushed all the stool from my rectum, then pushed out a three kilograms male who announced his arrival on earth with a shrill cry. Thirty minutes later, I was holding the boy on my hands, my husband was hovering around with a big chicky grin, and I couldn’t help but think to myself that it was all worth it, that I could go through all the pain if in the end I would hold a little version of me on my hand!

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.

RAPE

Three year olds are supposed to be innocent. But the one I met two weeks ago wasn’t. She was lying in the hospital bed fast asleep, one hand tightly clutching that of her sixteen years old auntie and her legs tightly pressed together. I remember standing by the bed and staring at the tiny little thing for a while. The moment my hand touched her face, her eyes shot open and she immediately sat on the bed and buried her face into the bosom of her auntie. All children hate men and women in white coats, but this one was a little too afraid.

I remember sitting at the edge of her bed and taking her hand as gently as possible into mine. It took lots of coaxing, tickling and exchange of sweet little edibles before she finally warmed up to me. I took her to the examining room immediately without giving her time to change her mind. But she wouldn’t let us remove her trousers that easily! She kicked and held on to it. We were able to remove it just because there were three of us against her. Soon as it was out she pressed her legs together so tight that a sigh escaped my mouth. She slapped her auntie when she tried to pry open her legs (yeah you read it right, slapped!). It was apparent we couldn’t see anything. We had to take her to theatre and examine her under anesthesia.

With her under the anesthetic slumber, and totally relaxed, we saw it all. Saw the multiple lacerations along the wall of her small vagina. The ragged torn hymen, the reddening around the anus. I struggled with my tears as various scenes flashed through my mind. I saw this little girl walk willingly into the hands of her cousin. Saw her hand holding tightly onto the bigger hand of the cousin as they walked towards the shop so he could buy her a lollipop. saw as he scooped her up and rushed her to his room instead. Saw him collapse on top of him and drive a monster of a penis into the vagina of a three years old, saw as he flipped her over so he could have anal. All this long, the tiny girl kicking and pushing and screaming.

Any grown woman can willingly tell you that first time sex is not a mixture of pain and pleasure in equal measure. First time sex is majorly pain with a tinge of pleasure. It must have been excruciatingly painful for a three years old of course, because, try and imagine a grown ass man on top of a tiny girl, moving his pelvis back and forth like a possessed antelope, with the child struggling to breathe and cry from all that pain at the same time!
You know I started talking about the unfairness of it all but one of the nurses told me that this particular three years old was hurt physically, but not like a three months old they had seen one year ago. It was claimed that she was raped by the father so violently that she developed a recto-vagina fistula (a communication between the rectum and the vagina). That baby had to undergo corrective surgeries and even though she got well, she was physically so hurt that you wouldn’t want to imagine how hard she had cried as his father closed his eyes to savour the moment (yuck)
Most of us teach our children to never trust strangers but most people are being raped by people they have no reason not to trust. It is fathers who are raping their sons and daughters, cousins raping their cousins, favorite uncles raping their nieces, house helps asking the little boys and girls they take care of to lick them down there.

What do we do then? We cannot afford to not talk about sex to our young ones. We need to teach them to run if they can. We need to check them, create time, undress them, bathe them. We need to know them, know how to read their body language. We need to be close enough to them so that they can trust us and tell us if it ever happens to them. We need to install CCTVs in our houses. We need to stop protecting relatives who rape our children. Let us stop this madness of ‘talking’ where rape has happened.

Before you open your mouth to protect a rapist, think about the three- year- old who has to walk with legs far apart to avoid irritating the soreness left between her legs by a rapist. Think about the three -month-old baby forced to live with a colostomy so her rectum can heal or else leak shit for life. Think about that little boy holding his breath as a fat woman makes him lick her. Think about all those living with sexually transmitted illnesses that they got out of rape.

Rape can never be justified no matter what. Even animals know when the mating season is over!

Free Maternity: A big fat lie

It is all quiet except for the blip blip of the anesthesia machine and the chiming of the clock. Standing on the right side of the patient cutting through skin, fat, fascia et cetera, I almost feel alone with my thoughts.

It is three thirty six hours, and the four humans in theatre four are either too lost in their own thoughts or too tired for small talk. Soon, the fifth person arrives and without respect for the silence, announces his arrival with a shrill cry. This brings a tired smile on the human lying on the operating table. He is wiped and wrapped with warm and fluffy blankets then placed under a warmer. He kicks and throws tiny pink fists punching the air, and then realizing he has been ignored, breaks into a continuous monotonous newborn cry.

Nobody tries to soothe him. I am stitching the uterus, the scrub nurse is busy massaging it, the anesthetist is trying to maintain the pressures, preventing them from falling, and the circulating nurse is on phone, calling everywhere she thinks we can get even a single bottle of oxytocin. Her pleas for oxytocin are punctuated by calls to the lab for blood. This woman walked to the hospital to have her second child. Her first child was born vaginally but this one wouldn’t just come out. Her uterus won’t contract on it own, and the last oxytocin dose was used on the previous patient hence nothing is left for her. So she is losing blood slowly but steadily, in other words dying, becoming a statistic, one among the many face-less women who die while giving birth. Her baby is about to become motherless, her husband is about to become a widower.

Women from her village or estate will have too much to talk about caesarian section. For many, it will re-affirm their strong hatred for c-section. She will be used as a warning, and so most women will prefer delivering under the watchful eyes of their mothers-in-law and traditional birth attendants. Most husbands will warn their wives against signing those theatre consent forms and we all know that maternal mortality will remain high.

Free maternity is a good campaign slogan that is currently a big fat lie; it has been a lie for the last one hundred and Fifty one days that nurses have been out of work. It was a lie for the one hundred days that doctors were on strike. It is a lie in many hospitals that make women to carry their own water to the hospital, their own cotton, their own examination gloves and their own infusion fluids, oxytocin, sometimes even cord clamps!

BREAST CANCER- AWARENESS SAVES LIVES!

In my final year of med school, I remember standing at the assistant’s side during a breast-removing surgery, which is otherwise known as mastectomy. After removing the breast tissue, the surgeon asked me if I felt like crying. He had performed several such surgeries and from his experience, mastectomy is a surgery that irks females the most. I have seen diabetics refuse toe amputations. Men will do anything to avoid prostatectomy (a surgery to remove the prostate gland). It is not easy for a woman to sign that consent form that will lead to the loss of her breast(s). Even those women who undergo breast reconstruction surgery soon after mastectomy have a hard time deciding to undergo mastectomy. It is certainly harder for those who undergo the surgery only to spend the rest of their lives with one breast and a large scar in place of the other one. While some are able to go on with their lives without a care, life changes for most of them. Such surgeries don’t just change the way they look, they change marriages. Most women will spend hours before the mirror trying to make their padded bras to “work” with their outfits.

While most women undergo mastectomy once diagnosed with breast cancer, Angelina Jolie, a Hollywood actress had a double mastectomy to reduce her risk of getting breast cancer after testing positive for BRCA1 gene. BRCA1 gene is basically a ‘breast cancer susceptibility gene’. Jolie’s mother had died at age fifty six to breast cancer ten years after she had been diagnosed with the disease. Jolie stated that the decision to have a mastectomy wasn’t an easy one. She was however glad to have undergone mastectomy as that reduced her risk to develop breast cancer greatly.

Unlike Angelina Jolie, most women who undergo mastectomy in our set up do so for curative rather than preventive purposes. Most of them present when already suffering from breast cancer. This is either because of our poor health seeking behaviors or because of poverty or ignorance.
As we draw towards the end of October, I would like to make you aware of some factors that may increase your chances of getting breast cancer. Women with these risk factors should visit their doctors for regular check-ups. Those with a high probability of suffering breast cancer should consider mastectomy early enough just like Angelina Jolie, because you are better off alive with no breasts than dead with breasts.

HERE ARE SOME RISK FACTORS;

  • Advancing age. The risk for breast cancer increases with age. Average age for diagnosis is fifty years.
  • No pregnancy. While pregnancy is protective of breast cancer, those who appear to be protected are those who get pregnant during their twenties.
  • Breast cancer in the contra lateral breastP. eople who have suffered breast cancer in one breast are at risk of developing cancer in the opposite breast. T hat’s why most people opt for a double mastectomy once diagnosed.
  • Family historyB. reast cancer tends to run in families. Daughters of mothers who have suffered breast cancer are at a higher risk of breast cancer.
  • Early onset of menstruation and late menopause. Onset of menses earlier than thirteen.
  • Late onset of menopause of later than fifty
  • Age at first delivery. If aged 30 years or older, relative risk is 2 times that of patients who gave birth when younger than 20 years.
  • Oral contraceptive pills.
  • Hormonal replacement therapy.
  • Obesity.
  • Cigarette smoking and Alcohol consumption. Smoking is actually a risk factor for several other cancers.
  • Diet-Fatty diet.
  • Exposure to radiation in the chest

 

NOTE1; while these risk factors increase the likelihood of suffering from breast cancer, they in isolation don’t cause breast cancer.
People with certain risk factors are likelier to suffer from breast cancer than others. Case in question here is a family history of breast cancer.
Therefore, people with these risk factors are advised to be extremely vigilant. Don’t forget to perform those regular self examinations on yourselves.
Make a point of visiting a doctor for regular check-ups.
If a suspicious lump is found during the course of these check-ups, have it investigated.
Remember cancer, if found early enough is curable.
When it comes to your healthy, be proactive