DO YOU NEED YOUR KIDNEY AT ALL?

I had the opportunity to educate my fellow colleagues in the Akatakyie fraternity on measures to take good care of their kidneys, identify the risk factors that predispose them to the development of various kidney diseases, and measures they could employ to reduce these risks to the progression of kidney diseases. The purpose of this post is educate my readers who could not join the session last night on the various kidney disorders, signs and symptoms you could look for, if you suspect a person has a kidney disease for prompt referral to the hospital for a resolution of these symptoms.

I remember back in primary school, usually on my way from home, we used to fill our journeys with stories. Random stories children of today would not talk about. It was a myth that people who traveled long distances from Ghana to Libya drank their urine as they passed through the desert. This happened when they had ran out of water to drink and felt very thirsty. I had wondered why anyone in his right senses would take in something so bitter and toxic without cringing. As I passed through medical school, I got to understand the composition of urine and this probed me to understand their motives in these times of crisis.

Why a kidney? Do you need two kidneys at all? Why are the kidneys positioned in your abdomen and not near your neck? The kidneys play a vital role in ensuring you have the best of health. It works by basically filtering your blood. By this I mean it absorbs all the toxins you have ingested from the different kinds of drinks and food you have consumed, and makes sure your blood has the right composition at all times. The right composition of blood makes sure your hormones, electrolytes and cells work optimally at all times.

This is done by employing the use of the nephron- the basic functional unit of the kidney. It is said the kidney has about 1 million nephrons which work day and night to make sure your kidneys produce urine continuously even when you are asleep. A part of the nephron known as the glomerulus plays its role by acting as the bodyguard at a party who ensures people either enter or leave the party without an invite. This invite is their respective sizes. The glomerulus does not restrict the movement of water and some proteins; however larger molecules and other blood components which include white blood cells and platelets are not allowed entry through the glomerulus. If these are found in your urine, it could signify an underlying renal damage for which you would need urgent intervention by a renal specialist.

The kidney also produces a hormone known as erythropoietin which is vital in the production of red blood cells, in instances where your blood oxygen level is low. Lung diseases such as pneumonia and pulmonary edema (fluid in the lungs) could reduce these oxygen levels so require the production of an increased amount of red blood cells. These red blood cells are needed to trap oxygen from your lungs. Conditions such as Chronic Kidney Disease result disrupt the synthesizing ability of the kidneys in producing erythropoietin thereby cause anemia.

Some people with kidney diseases also present with weak bones mainly caused by a deficiency of calcium. This is termed hypocalcemia.

After urine is produced, it has to move from the kidney to the bladder by means of a long pipe called the ureter. Because there are two kidneys, there are two ureters. But there is only one bladder. These ureters run their course and end in the bladder located at the groin region. Kidney stones located in the ureters can prevent urine from reaching the bladder. However if this happens in one kidney, the other ureter can compensate for the extra function of the malfunctioned ureter. This could be seen on imaging (X-ray) as a dilated ureter. Kidney stones also known as renal calculi can impact themselves along various aspects of the urinary tract and cause severe pain which initially begins at the region of the kidney, and moves along to the groin. It could manifest as blood in the urine. This is termed as hematuria.

Blood in the urine should always be reported at the hospital because this could signify any underlying pathology from the kidney to the urethra. However certain medications used in the treatment of tuberculosis, and certain foods which includes blackberries and beet could cause a red discoloration of the urine. A test known as a urine dipstick can be used to differentiate the red discoloration being caused by the presence of blood from that due to other causes.

The National Academies of Sciences, Engineering, and Medicine has determined that an adequate daily fluid intake for men should be 3.7L and 2.7L for women. But the water that is taken should match or possibly exceed your daily losses through urine. In the presence of a dry atmosphere, there might be the need to consume more water to prevent dehydration which could have an adverse reaction on organs in your body which includes your brain.

Some people pass a lot of urine in a day. For this to be a problem, the amount should be greater than 3L per day. This is termed as polyuria. The opposite on the spectrum is known as oliguria where people pass scanty urine a day (500mls or less). Causes of oliguria include an acute renal failure or an obstruction along the point of the urinary tract. Anuria is the condition where no urine is passed at all, in 24 hours. This is an emergency so there is the need for swift presentation to a clinic for evaluation of its cause and treatment.

Most people present to the clinic with signs of infection which could be caused by either infections of the kidney and its associated tract. This is known as a urinary tract infection. If this infection happens from the kidney to the ureter, it is termed as an upper urinary tract infection. If it occurs below, it is known as a lower urinary tract infection. Their presentations differ, so it is essential the health professional identifies the symptoms and signs based on the story told by the individual and the findings elicited on examining the patient.

Based on the symptoms, signs and doctor’s discretion, he might order tests which include a renal function test to evaluate the functional capability of your kidney, a full blood count to assess the blood cells or identify any underlying infection, an ultrasound of the kidneys to estimate the sizes of the kidney and a CT scan in extreme cases.

The risk factors differ for the diverse forms of the kidney diseases. Being at risk means it is more likely you will get kidney disease. But this is not absolute. Risks factors that predispose to the development of kidney diseases include a family history of kidney disease and being hypertensive or diabetic. Africans are known to have an elevated risk for kidney disease notably chronic kidney disease, compared with European Americans. Much of this risk is due to genetic variations in a gene that creates a specific protein in the body.  As you progress in age, your predisposition to diseases increases, mainly due to a weakened immune system. This could result in having a kidney disease.

In addition, taking alcohol in extreme amounts and smoking have been shown to be risk factors of kidney disease. Obesity further compounds these problems and worsens your protection from illnesses of the kidney. The use of herbal preparations for different reasons is a disturbing cause for presentation of most of our energetic guys to the hospital with kidney disease for which they might require dialysis.

It is therefore essential you protect yourself against these risk factors because Prevention is better than Cure. Because high blood pressure and diabetes are the most common causes of kidney failure, many of the prevention tips are related to managing these two conditions. Ways you prevent kidney diseases include

1. Managing your blood sugar

2. Managing your blood pressure

3. Maintaining a healthy weight

4. Eating a heart-healthy diet

5. Reducing salt intake

6. Drinking enough water

7. Limiting alcohol

8. Cutting down smoking

9. Limiting over-the-counter pain medication

11. Exercising regularly

Life is meant to be enjoyed and enjoyed to the longest extent. Protect your kidneys because Healthy Kidneys are a Healthy You.

Thanks for reading. Have a lovely weekend!

Eliezer

FLOPPY BABY SYNDROME

On 20th May 2018, 09:05am, My Whatsapp alerted me of a link i had received from Jessie. Right after church, i was led to click the link; to add to the 665,700 people who had watched the video.

The link drove me right to Youtube with the opening words of “the Story of a Father’s Love” This seized my attention, but the 3MB of data remaining did not allow me to be great. I had no choice than to borrow a phone with active data connection just to watch the video.

This is the link to the video

https://youtu.be/aPCK4THZtng

After watching the video, I was really touched. I was amazed at the sacrifice and love demonstrated in the video. This was the remarkable story of a father’s devotion to his wheelchair- bound son and how their bond inspired millions of people worldwide.

Rick, born in 1962 was diagnosed of Cerebral Palsy, with the spastic quadriplegia subtype – This is just for start.

This resulted because his brain was deprived of oxygen, at the crucial time of his birth. His parents were advised to institutionalize Rick because he would be nothing more than a “vegetable”. There was no chance for recovery and little hope for him to live a “normal” life.

In spite of his disability, his parents treated him just like any other child; never losing hope. They ensured he had weekly access to medical care. Her mother went to the extent of teaching Rick, letters of the alphabet herself. He was seen beyond his physical limitations and integrated into the public school system. They were humiliated and had intense opposition, but they still fought on.

To top it all off, He graduated Boston university with a degree in Special Education.

Dick, a great father he was, sacrificed his energy and time just to put a smile on his son’s face. He worked on his fitness so much even with pushing his son, he was able to obtain a personal record of a 5km run in 17 minutes- just to provide his son with that able bodied feeling.

Over the next 3 and a half decades, they achieved and surpassed not only their goals, but also everyone’s expectations of a wheelchair bound adult son being carried and pushed by his father. They inspired millions by proving that anything could be done with stubborn persistence, dedication and bottomless depths of love that could only be found between a father and his son.

To learn more about them, you can visit their website: www.teamhoyt.com

What is cerebral palsy or floppy baby syndrome?

Cerebral palsy is the most common form of movement disability that begins in childhood. A majority of cases were identified to be caused by antenatal factors- factors that occurred during the pregnancy. However, it could also be caused by infections transmitted during delivery from mother to the baby.

Cerebral Palsy is considered a neurological disorder that occurs when the child’s brain is under development in the early stages of life.

Children who are born preterm (before 38 weeks of pregnancy) are vulnerable to brain damage leading to cerebral palsy. Even after a baby is born, accidental injury and infections such as meningitis could result in cerebral palsy.

Such children are identified to be at risk in the first days of life. Their usual presentation includes an abnormal posture. They could feed poorly and throw up everything they eat, because they coordinate swallowing badly.

Cerebral Palsy affects their ability to control their muscles. Their muscles either contract too much or too little. Their arms and legs can be stiff and be forced into painful, awkward positions. Fluctuating muscle contractions can make their body tremble, writhe, shake and bake.

Balance, posture, and coordination can also be affected by Floppy Baby Syndrome.Tasks such as walking, grasping objects, sitting and tying shoes may be difficult.

My first encounter as a doctor, with such children was at the pediatric emergency unit some weeks ago. A 9year old child was brought to the hospital because he had convulsions. Just from appearance, his small for age stature made his small head conspicuous. Even at the age of 9, he only smiled. He had not made any attempt to walk and talk. He was discharged home the next 5 days after his seizures were controlled to continue rehabilitative care.

Other complications of Cerebral Palsy to take note of, are: intellectual impairment, seizures, and vision/hearing impairment.

A few points I would like us to bear in mind

1.Cerebral Palsy is non-life-threatening so it is expected affected children live into adulthood.

2.Cerebral Palsy is incurable but the effects on the body can be managed.

3.Cerebral Palsy is not contagious; it is not communicable.

4.Cerebral Palsy itself will not change for better or worse during a person’s lifetime.

5.Cerebral Palsy is manageable. Treatment, therapy, surgery, medications and assistive technology can help maximize independence, and incorporate the child into the society, leading to an enhanced quality of life.

It is said that, every case of Cerebral Palsy is unique to the individual. One person may have total paralysis and require constant care, while another with partial paralysis might have slight movement tremors and still require little assistance.

To all the children living with Cerebral Palsy, I would love to end with a note from Joshua 1:9

Be strong and courageous. Do not be afraid; do not be discouraged, for the LORD your God will be with you wherever you go.

Say a prayer for all the children living with cerebral palsy after reading this. Lets make the world a better place with them in it.

Thanks for reading and have a blessed day!

Eliezer

Photocredit: Google Images.

THE SOBOLO NIGHT

It was 9:00pm on the dot. Seated next to me; with a happy face, was a cruet; from which life flowed.

Leaving me with no option, I self medicated with the second bottle of ‘Sobolo’ which was prepared and savored from the handpicked red flowers of Agyeiwaa and her mother.

I couldn’t help but absorb and engulf the extract strenuously dripping from the bottle covered in ice. Appreciating its zest, i handclaspped the bottle a couple of times. The ice, in recognition, dissolved in bits giving way to this liquid filled with life and goodness.

Sobolo, selected from the choicest of cellars granted our ancestors victory in every war they fought. Solobo is the drink that can ease your pain and wipe your tear away. Sobolo is the drink that can fill your belly with the relish of not seeing eye to eye with junk food. Sobolo can detoxify and drive out any uncleanliness just by the sound of the name. Sobolo can infiltrate the depths of your thoughts just to bring out the real you – hidden deep.

Then the story began, I remember telling her- Agyeiwaa, why i wanted be a psychologist in the coming years; just because the drink had changed my mood. This drove her to probe in her memories, recollecting her proclamation of being a neurosurgeon at a very tender age. I couldn’t help but concurrently look at a picture of Dr. Ben Carson smiling, on the wall of the living room.

Just a touch of my bottle jolted her memory, zooming her mind’s scene to how helpless she had been when she had lost a colleague of hers. – Her friend was rushed to the hospital after she had briefly lost consciousness during a hike. At the hospital, she was diagnosed of a brain pathology, which needed surgery. However she passed on because her savior had not yet been born. Out of pain, she decided to be a neurosurgeon with the utopia of preventing such occurrences.

I wont go into details of how she found her profession in a field far from medicine.

The trigger of this conversation was not induced by the Solobo, desperately trying to gain access to my brain, vainly using my vein as a train. It was just the intuition of noticing a good writer when you see one.

I was of the firm belief, any skill that was mastered automatically became a talent. All that mattered was the doorstep, that paved way, as she raced to the finish line in attaining her passion.

Introducing the concept of the ‘lizard brain’ which i had picked up some days ago, I dived into the deep sea, trying to extrude the writer in her. “The lizard brain is the reason we are afraid, the reason we don’t do all the art we can, the reason we don’t write when we can. The lizard brain is the source of the resistance.”

With the Sobolo glaring right at us, we had already switched topics to psychology, after she made reference to a talk, given by a health care professional in her school. According to her, it was assumed 9 in 10 persons suffered from mental illness of a sort, which Agyeiwaa found so hard to believe. With the aid of a Venn diagram, i tried to find the intersection between her assumption and my conclusion. They were disjoint!

It was a glorious opportunity to enlighten her on the diverse mental health disorders, from a very competent lecturer bearing my name. She found herself taking a personality quiz in the end.

It was then, i was notified of the colour in my eye – Sobolo was making me cry. I turned off the tv and slowly retreated to the room, happily ever after with my new found love – Sobolo.

Sobolo is a Ghanaian drink, usually prepared with Bissap flowers. It is known to have a vast array of health benefits.

Drink Sobolo for a healthy tomorrow. In case you cannot locate a nearby vendor, contact me for your priceless Sobolo 🍷 at a very affordable cost; trust me, your life wouldn’t never be the same again.

What ever you believe, you can achieve – with Sobolo!

Picture of Agyeiwaa, the boy and another boy.

Watch this space for her new blog 👀.

Thanks for reading! A Solobo inspired story.

Eliezer

DUTY OF CARE

I was listening to the morning show on the radio yesterday. I was glued to my seat because the topic then being discussed was an interesting one. It was a narrative of how a 28 year old man had reported to the hospital for simple appendectomy (surgical procedure to remove the appendix) resulted in extensive third degree burns to his abdomen, waist and knees. A procedure scheduled to last 10minutes by a very skilled surgeon, inadvertently left the man being discharged from the hospital with severe complications.

The cause of this was from a malfunction of a diathermy machine (a machine which utilizes electric current to either cut through tissues, or to cauterize (burn/close) small blood vessels to stop them from bleeding.

This had happened at Ridge Hospital some months ago and left the patient admitted for several months, inspite of the medical condition he came with.

I become worried because this wasnt an expected complication. Checks were seemingly not done before the surgery. Was this the first time the diathermy machine was used? Who has to perform such checks? Doctors? After the surgery, he recuperated from the appendicitis 2 days afterwards, but the appalling state of his wounds warranted the desideratum for his daily dressings, that he spend months on his hospital bed.

According to him, he hardly saw his doctor around because of his busy surgical schedules. Surprisingly, the nurses neglected him without exception. He thus wondered the responsibility of care he had to be offered. To make matters worse, he had spent of a lot of money on drugs and hospital bills that he had run out of money.

Later, the hospital assumed responsibility for everything that had happened and paid him back every penny he had spent; but the scars still lingered.

A lot of people have openly lashed out at us with concerns on the state of health care in the country. On my recent facebook post, a user suggested the relatives of the patient sue the doctor who failed to perform adehiolysis– a surgery intended to improve the condition termed frozen abdomen in my previous post.

A lawyer well versed in medical knowledge, was then invited on the show, to inform the populace on measures they could take, if they questioned the health care rendered by a health care practitioner. According to him, before any consent form was signed, the patient of a sound mind, or a close relative had to agree to the procedure and be informed of the risks involved. In addition, they were supposed to know the complications to expect after the surgery and finally, where to report to, if things went wrong.

I literally laughed in my head, when the long list was metered out by the lawyer. Indeed, that was standard practice! I recall the first time, I asked a patient to sign a consent form for surgery. I was interrupted mid-way as I was explaining the procedure to him, not because he did not understand the language being used. He said he was going to die one day, whether he consented to the surgery or not. He did not give me the opportunity to proceed further because He was of the firm belief that his life was his and no one else’s. “Health care knowledge cant be forced! Stop talking!” As rude as he was, i hurriedly took back the paper because I was relieved that I had enough time to attend to the fifteen patients who were yet to be seen to that day.

My next session was hilarious, you should have seen me trying to explain to an 80 year old woman; who has never sat in a classroom; how a tumour of the pancreas had obstructed the flow of her intestinal contents, and the fact that she needed surgery to get better. The relatives of the patient requested she was discharged the next day because they had heard of a miracle man who could melt “stomach things” just by the touch of his hands. Further explanation fell on their stony dull ears. They brought a letter requesting for her discharge the next day.

I wont pull out the many encounters we have had with patients, but it is with unmarred patience that, we as doctors endure this profession. Many people see the labcoat and think we sleep and wake in a bed of riches, oblivious of the things we go through physically and emotionally.

They are amnesic to the fact of how it feels when your wife does not see you in 3 days? Blind to how it feels when your sleep is interrupted at 1am by the patient who is pouring his bowels out at home; right after you have returned from duty? Incognizant to how it feels when you are attacked in the middle of the night with knives because your duty could not afford you the luxury of getting home early. Inattentive to how it feels to empty your pockets everytime your duty of care conscience probes you to give willingly.

This is not the time to apportion blame, or direct fingers; as to whether the government has provided the necessary things needed to optimize health care, or unbalanced doctor-to-patient ratio which has rendered health care suboptimal. I believe it all starts at the bottom – the mass! We have to join hands as individuals to move the nation forward; by understanding things that could adversely affect our health, we have to know when to report to the hospital for health care, and know how to help doctors to help our own selves.

Its astonishing how doctors spend a majority of their time in the hospital, but so little time in church; but believe healing comes from God. There are many instances we have to gallop out from church service, just to ensure we keep the patient, on the hospital bed, who is near death, alive!

Before you lash out at any doctor or health care practitioner, please take the time to ask questions, clarify your doubts and keep a clear conscience; and not just fling insults at us, because you were treated unfairly by a doctor.

We as doctors have sworn the Hippocractic oath to make the lives of our patients our topmost priority. We are of the firm avowal, going against an oath like this carries many repercussions.

Anytime you go on your knees, pray for that doctor you have not seen yet, who spends 48 hours a day, to complete his shift, completes eight surgeries in a day and beats himself mentally and physically, that the inmates under the umbrella of his care, get well.

Pray for God’s supernatural strength for him and the mental capacity to take care of any person, with the same love and compassion. Because we, as doctors, are also human!

Eliezer

FROZEN ABDOMEN

He was the talk of the news which kept every radio and tv station grimacing to the utterance of his name. How he rose to such fame was unknown by all and sundry.

He was known in the entertainment industry as “the Pop”. I had access to him because we were connected by blood – After I had a spill on my glove as i tried to take a blood sample from his vein.

He had built a huge mansion for himself, kept family on the outskirts of his life and surrounded himself by the people he thought loved him; neglecting the same people who had been with him, as he sprawled in the sands of poverty and the air of nothingness.

In this mansion, he had a wedded wife, with who God had blessed with three fine daughters. His daughters were his pride that he held them in amour-propre, ensuring they had the best of education by enrolling in one of the top schools in the country.

As the weeks went by, he came across a very strange inheritance as his value kept soaring- another woman; who would satisfy his passion, in the absence of the other woman and her daughters. The woman who would sift through the bits and pieces of his hefty bank account with her extravagant living; leeching it as she toured the luxurious restaurants and shops in town; raiding them through the cold touch of her mouth and hands.

Church was a wisp to his ears now. He spent his Sunday mornings either dining at expensive food joints with his new found friends, or offsetting from the exquisite wines he had consumed the previous night. To him, luxury was acquired through sheer persistence and hardwork; and so he didn’t realize the need to give attribution to God, abstracting the fact that his sixth phone which kept notifying him of his bank account alerts was his own idol.

He bought himself a gym at home because he loved to watch her wife run on the treadmill- to develop quick feet to run away from home with her daughters sooner or later.

It was all a matter of time, he was hit by the knuck chuck of fate and destiny. He presented to the hospital with severe abdominal pain. His abdomen kept getting bigger and bigger with the glissade of time. He had not emptied his bowels in a week, and spewed everything he ate; surprisingly, containing blood every time.

He sojourned different hospitals with the aim of recovery, but he was unlucky.

On 28th May 2015, there he was, on the hospital bed, on the verge of death. He couldnt control his tears as he divulged his past. He had sold his mansion and cars to pay off his hospital bills and lost quite a considerable amount of weight. Sadly, he had no asset to pass down to his family, just a bucket of tears.

His friends had foreseen this and blacklisted his contact number. The only people he had close to his hospital bed was his lovely wedded wife, and his three daughters who visited him day and night.

It was decided he endured the last of the surgeries; to relieve the plague, obstructing his intestines.

Everything was set for the final day after he had undergone prior lab tests. He had the notion of returning to normal after enduring this “last and only surgery”. Little did he know what would stare at the face of his surgeon.

Following this, I wanted to be in the operating room to observe how things would transpire.

On that day, the man was laid on the table and put to sleep. His abdomen was wiped clean give the surgeon the green light to cut and tie, with his doubled-up white gloves.

15mins into the surgery, the surgeon frustrated, was closing up the skin – “Surgery unsuccessful, it is a frozen abdomen.” The sound of the word frozen sent chills down my abdomen.

The tumour of his stomach had spread to involve the whole of his abdomen thereby, leaving him with a condition called “frozen abdomen” that would make further surgical intervention dangerous.

He was sent to the ward, and managed palliatively, until he went back to his Maker.

Gastric cancer is the fourth most common cause of cancer-related death in the world, and it remains difficult to cure, primarily because most patients present with advanced disease. Unfortunately, only a minority of patients with gastric cancer will be cured of their disease.

Signs and symptoms of gastric cancer include the following:

1. The feeling of fullness right after eating.

2. Loss of appetite.

3. Vomiting, which could contain blood.

4. Passing feces which are blood stained.

In the late stages, there could be weight loss, breathlessness and jaundice.

Things that can increase your chance of developing a gastric cancer include smoking, obesity, eating very salty food, having an ulcer of your stomach and lastly, when someone in your lineage has been diagnosed of a gastric cancer.

Cancer of the stomach can extend to obstruct your intestines. It can also cause the “frozen abdomen” by invading the structures in your abdomen; thereby sticking them together like a freezer. I know you didn’t see the rhyme.

When you present to the hospital and gastric cancer is confirmed, it is important to start treatment right away, to prevent further spread and early death. Treatment could include surgery to remove the tumor, and the use of radiation and drugs to kill the tumour cells.

Avoiding risk factors and increasing protective factors may lower your chances of having stomach cancer, but there is no guarantee you can prevent it.

Exercising, reducing salty food intake, and consuming fruits and vegetables are known to protect against gastric cancer so stay safe for a better tomorrow!

Eliezer

#DoctorDiaries

LANGUAGE

Language is one of the most cognitive functions any individual can possess. It is an indirect mark of power; whatever you say can make you and break you.Language entails the ability to comprehend what you are being told, and the ability to express yourself. Children who experience language problems may have difficulty understanding what they are being told, interpreting what they hear and following instructions and explanations.

Being able to express yourself depends on your artillery of vocabulary in combination with the skill to produce the needed word to construct a meaningful sentence at any given time. Speech production difficulties include problems affecting the ability to flow between words, the ability to articulate and word naming. Some children have problems with forming a sequence with similar words, others find it difficult to control the speed and rhythm at which their words flow. Their speech may be inappropriate in tone, incongruent and hesitant- stammering between words.

Sometimes, there are problems with word retrieval, which implies they are unable to find the exact word when needed. A handful of the children also find it difficult to construct sentences, organize narratives and use grammar acceptably. With others, their problem stems from their with phonetic background, which adversely affects their reading ability, writing and mathematics.

Some children with semantic problems have trouble learning the meaning of words, thus are likely to use words out of context (not contest).

Language weaknesses can interfere with the ability to recall concepts learnt in the contest areas, such as sciences and social studies courses which entails the processing and utilization of abstract concepts. All academic skills are largely taught through language therefore it’s not surprising that a majority of children with language problems underperform academically. This can even affect the how the kids socialize.

Interestingly, children who possess very strong language skills are able to use their linguistic ability to compensate for any academic problems.

In approaching a child with disordered language, it is important to identify what is causing the speech problem and tackle it appropriately.

The first step in evaluating the problem is to rule out a hearing problem. If no hearing issues are found, you can seek an evaluation from a speech therapist. A speech therapist can work one on one with your child to build his vocabulary and improve his grammar.

Also if the child has emotional difficulties as a result of language issues, you might want to consider psychological help.

However, what you can do as a parent at home is to communicate with your child as much as you can. Listen to your child, give your child ample time to respond and resist the temptation to fill in the silence.

It is noted that Some kids with language disorders may also have related conditions which includes dyslexia, ADHD, and mental health disorders, so seek help for the child now!

Eliezer

THE UNPLEASANT SURPRISE

I paced through the wards frantically trying to adapt to the new ballgame at hand. In this case, I was no longer that medical student jumping from one patient to the other, but the doctor to whom a patient’s life would be entrusted to. As usual my white lab coat was neatly ironed. Did I say as usual? I mean it’s because it’s the first day. With your first day at work, impressions matter. I smiled to every patient as I was being introduced to them, intently taking notes.

To my right was the Senior Resident of the team; dictating our schedules for the week, and to my left, were my colleagues who were co- house officers, Dr. Akpaloo and Dr. Adu Poku. The work seemed to submerge us because we did not know what to do a particular time. Belinda would ask, “When are we taking blood samples?”, “Where are we retrieving the patient’s labs from?”, “Which drugs are covered by the Health Insurance?”, “Should I wait for the relatives to come over so I discuss the prognosis or should I call them over the phone?” The work was a lot but we knew we would definitely come through. It was all a matter of time.

Making things worse, we met the lead clinician and team head who taunted us with a few of the medical school questions. “What are the complications of a thyroidectomy?”, “For clean cases and contaminated cases, which one would you operate first and why?”. The why part thrust me into dandelions of wonder because I knew this was common sense. You obviously bath your face first before your feet but I couldn’t look askance. I was as cool as a cold cucumber. I tried so hard to rhyme.

The patients on the ward had cases ranging from appendicitis through hemorrhoids to gastric and rectal malignancies. There were lots of distended abdomens which rendered the wards not a pleasing sight to behold. I then thought to myself “These were all ‘normal’ people. What could have possibly gone wrong? This situation would not last forever.”

I came to work the next day, noticing two empty beds which were occupied the previous day. Empty beds signaled good news. The patient has been discharged. The question then would be discharged where? Home? Or the other side of town? In that sense, Doctors tried all they could but the patient just couldn’t survive. It was just their time.

The first patient on the male ward I encountered was a 36 year old man diagnosed with rectal carcinoma a year ago. I used carcinoma? I mean cancer. He was “in his usual state of health” until he noticed a bulge emerge in his perineum as he passed stools. Making things worse, He also noticed his faeces were stained with bright red blood.

These red lights brought him to the hospital in a swift. He looked so energetic and well at that time. He was just a worried man concerned about his health. Laboratory investigations confirmed he had a rectal carcinoma in situ.

Rectal carcinoma in situ means the cancer was just in the bud. Just like a caterpillar growing in a cocoon. Being in its early stages indicated the cancer had not grown beyond the inner layer of the rectum.

Chest X- rays and CT scans excluded the possibility of metastasis (spread of the cancer). Risk factors for rectal cancer include old age, drinking three or more alcoholic drinks per day, smoking cigarettes, and being obese. However his risk factor could not be determined. He was just 36 years, had a health weight, had never smoked cigarettes nor drank alcohol. It was idiopathic.

Then he began to lose weight. The scare. His workplace was thrown into a frenzy. Everyone thought he had AIDS because he kept wasting. He had his own shop where he sold and repaired computers and according to his friends, he was so good at it but they were bad at sympathizing with him.  At this rate, He could not wear his clothes any longer and continued to spew out anything he ate.

He was brought to the emergency department one day when he suddenly lost consciousness on his way to work. All his laboratory values checked were deranged. Notably, was his hemoglobin level which was 1.7g/dl. Normal ranges are 13.0 -18.0 g/dl. He had bled out.

He was given 8 units of blood and further tests revealed the cancer had spread to a large area of his large intestine. His forebodings were now justified and he cringed on the bed, weeping like a baby. Why him? At this crucial stage of his life? He was just married 6 months ago to a beautiful lady and there was no way he was starting life this way.

He was counselled for surgery to limit the spread of the cancer. The surgery involved resection (removal) of the part of the large intestine affected, together with the rectum. In order for this to be possible, a permanent colostomy had to be done.

A permanent colostomy meant the healthy end of the large intestine had to be brought to his abdomen, creating a channel for the passage of feces on his skin. This was heavy news! But that was the only feasible way to save his life. It took 3 days with the clinical psychologist before He budged on his decision. “The rapture that was associated with being alive, was what mattered.” His wife told him.

He had his surgery done and started chemotherapy a week afterwards. This was the state I had met him – A week after his first shot of chemotherapy. He always lay in bed because he did not have the strength to get up and walk. Amazingly, his wife never left his side despite the state he was in. He had all the love and support he needed. He was aware of his prognosis and he gave up most of the time, but his wife always stood by him when he faltered.

A week after the surgery, He was rushed back to the operating theatre because the surgical intervention failed. It took a lot of steady hands which worked tirelessly, quick feet which rushed for blood, and a miracle before He made it out of the operating room alive.

Fast forward to 4 weeks later in the consulting room, I can’t help but stare at a young man taking strides confidently into the room. I couldn’t hide my joy. “Kweku!! You look good!” Surprisingly,  He had no complaints just a headache which resolved upon taking a tablet of paracetamol in the morning. He smiled and said a big thank you to the team for saving his life, and left the consulting room exactly as He came.

Grace has the power to give beauty for ashes, strength for fear, gladness for mourning and peace for despair.  It is true tough times never last but tough people do. Two men may have the same affliction but to one it shall be as gall and wormwood, yet it shall be wine and honey to another. So hold on!

God has a thousand ways to turn your situation around that you’ve never even thought of. Just because you don’t see a way doesn’t mean God doesn’t have a way – Joel Osteen

Thanks for reading.

Eliezer

PARANOIA

Walking down memory lane, I remember a novel I read 9 years ago – Paranoia by Joseph Finder. It sounds like a nice name you would want your eldest son to bear but don’t dab. It caresses like a chained cat in a cage.
Right after reading the book gladly, I didn’t understand the concept, but the delectation that followed the reaction of finishing a novel was priceless. Just like the ‘Thank You’ slide at the end of a PowerPoint presentation.
So what is Paranoia? I know it sounds like the worst insult you would want to throw at a foe, or push off the back of a friend, but its incarnate hands touch and hold the mass. In the world of psychiatry, paranoia is a thought process which hangs on the scale of anxiety and fear.
Anxiety is something we all experience naturally. Especially stepping in the big shoes of a mentor or holding the hot cup of a friend in fiery fire. But when it slides into the mud of irrationality that your heart hits faster than the speed of light or you sweat drizzly than a dolphin, you know its abnormal.
Paranoid people – I think I rhymed there… are ubiquitous in our society. They sit at the four corners of every room and keep burying themselves in a hole of hostility. The King (Paranoia) takes its throne on their heads and rules their heart and mind. Unless it’s dethroned and decapitated, it would keep dissolving the world from generation to generation.
Paranoid people have small eyes which reel in the world of perfection…I think I rhymed again. Those with gigantic eyes wear thick glasses encased with a rim of intentional persecution which thrive in an atmosphere of watchful waiting…from parents down to pals.
Paranoia swims in the sea of unforgiveness and bears a shield of defense in response to imagined criticism. It tries to emerge from a mole of mistrust preoccupied with hidden motives. The poet in me tried to rule there… Paranoid thoughts and feelings are connected to events and relationships in a person’s life.
Paranoid people are faithful (in the negative sense) because delusions hallmark their dreams. Delusions are odd beliefs that a person would firmly insist are true despite evidence they are not.
Paranoia slimes like a slithery snake of suspicion and bites any on looking person with bitter bile.
Let me get back to the real deal, Paranoid people are worried a lot and expect others to criticize and reject them. They take a step back when everyone moves forward. They ace summaries with distinctions and come to conclusions so easily with a strong impenetrable head.
There can be specific things that may engage paranoid thoughts; like sleeping less or taking medications but their vile vulnerability vehemently voices their childhood. They were bullied at school and always appeared last in class. Paranoia just like a potted plant kept growing in their palms.
Paranoid thoughts emanate usually from rich homes where there is isolation from the rest of the world. The only connection to the global maze is through smart screens and wavy wires.
Paranoid people worry a lot and are likely to interpret things in a negative norm. However, paranoia could stem from a myriad of physical illnesses such as strokes, dementia and Alzheimer’s disease. Alzheimer (I think I would name my puppy this).
There is a strong influence in parenting when it comes to paranoia – It gropes in the genes and transcends the trolley from father to son or mother to daughter.
But paranoia can be treated. It involves building a trusting and collaborative relationship with people; moving in groups when there is the tendency to icily isolate yourself. Treatment is gradual but there are success stories.
Get tested for paranoia and receive treatment because the world has to be a better place!
Enjoy your day!

Eliezer Bernard Owusu Ntim

PhotoCredit : GoogleImages

PERSISTENCE!

It’s 6:57pm and the last day of the month of October. I look at my wrist watch after jogging for 57 minutes. I feel so burned out, but I am proud of a feat as such, especially in school. 57 minutes and counting! The maximum I could do was 30mins and this usually happened after I’d had a long sleep prior to running. “I know I can do this!”. However, my body confesses “Eliezer, you have reached your limit, you can do this another time.” I know there’s no other time to do this. It’s now or never!
I lope so hard and complete the last lap finally ending at 7:00pm. I feel pleased with myself. 1 hour of jogging non-stop! Well I would never have envisaged this happening! Reminiscing my past, I could pant so hard after walking for just 3 minutes. The ”problems of being fat’ are endless. I had lots of friends because they loved to look skinny any time they walked with me. I’m now jogging for 60 minutes with a feeling so high spirited people wonder if I plan to compete in the next national marathon.
Well I started jogging 4 years ago. After a loooonng period of inactivity of probably 10 years. Eating was my friend and companion. My brain could practically not tell whether I was bored or hungry. People used to bet over the large volumes of food I could eat. I felt so much joy eating.

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I couldn’t play soccer back in high school; not because I wasn’t good. Well, I was better than most of my mates but my energy level immediately dropped from 100 to 1 every time I kicked a ball. I could heave and puff for so long everyone thought I was dying. I wondered why everyone else could play so actively but not me.
Post hoc, I would return to the dormitory and finish 2 bowls of kenkey- a local dish known for its satiety with ease – The gratification!
Then, one day during vacation. I borrowed my dad’s jogging shoes in an attempt to achieve the impossible with my fat body. I planned to run for 10 straight minutes, not even jog, and return home. I felt I was on cloud nine already, did a few push ups – 3 actually without breaking a sweat.
Then I set off. Suddenly, I started to feel dizzy after jogging a few centimetres from the gate. The world kept spinning and running in circles that I had to hold a wall to keep me from falling. My heart kept hitting hard against my chest. My stomach and legs felt so sore. “Was I burning calories already?” I asked myself as I slowly moved back to my room and continued my sleep.
I never went jogging until I got back to school. Eugene, a good friend of mine introduced me to jogging again – in a different style. He could jog for 40 minutes or more and move around afterwards like nothing had happened.
I would set the alarm at 5:30 am, however sleep could overwhelm me so much, water had to be poured on me to wake me up. I would then sulk walking 85% of the journey and jogging 2%. What I did with the rest of the journey, I have no idea!

Then I made up my mind, If he was doing it, I could do it too! He wasn’t less human than I was. He was a sports boy back in high school so he had an earlier start. I could do this, I kept encouraging myself.
I made it a daily routine, jogging at least 10 minutes every day. “Start low and go slow”. I ran every day until it became a habit. I would return feeling so sore that I slept throughout the day without attending lectures – My dad isn’t supposed to see this.
Jogging felt so good I wanted to do it often.

Now, I was jogging both in the morning and evening. 15 minutes in the morning and 15 minutes in the evening. Sometimes I would get so tired, and skip jogging for 2 solid weeks. My body, in response, would bounce back into its former state- just like a yo-yo.
How was I to unravel this mystery. The curious me kept reading about how to lose weight in various forms. The meal therapy. The water therapy. The no – sleep therapy. There were so many remedies I never knew of. So I gladly tried all, which were all exercises in futility. The yo-yo effect was so strong!
Then I let go of the bitter pill. I was ready to accept the outcome no matter what. Just keep jogging, no matter what. “Anytime I jog, it’s for my own benefit” I would say to myself whenever I started the journey.
Then, I started to jog for 20 minutes a day – in the morning, I cut down my food intake – The most painful part, and I started taking in lots of fruits.
I couldn’t see the effects but I was changing! I had lost so much weight now, that everyone who saw me asked if I had fallen ill recently. It’s amazing how everyone links losing weight to falling ill.
Physically and mentally, I was different! They say the key to a sound mind is a healthy body. Studying was less difficult now. I could walk for miles and jump rope for days, feeling so proud of myself. I checked my weight very often. It started from 90 kg dropped to 85 and finally to 70kg over the last two years.
Currently, I jog more than an hour and resume daily activities like nothing really happened. No matter how hard the journey may seem, all you need is a speck of resilience, determination and persistence. It can be done. Forget failure! If things don’t work out the way you want, hold your head high and be proud, try again. And again. And again!

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Nothing in this world can take the place of persistence. Talent will not! nothing is more common than unsuccessful men with talent. Genius will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan Press On! has solved and always will solve the problems of the human race. – Calvin Coolidge

Have a wonderful week!

PhotoCredit : GoogleImages and my gallery