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Water No Get Enemy ….Peju Adeniran

To improve my health, I started an exercise program a few months ago. Before now, in conjunction with eating healthy, all I did for exercise was to take long, power walks in the evenings at least twice a week.

But as I grow older, it is has become apparent that this is not going to be enough; metabolism slows down the older one gets, and I need more than my usual to maintain my weight and health.

So, I joined a gym and met brutal Chioma, my gym instructor. While I will save my adventures with Chioma for another day, I will talk about working out and water.

More than half of our bodies and our entire planet is made up of water, so Fela knew what he was saying when he sang ‘Water No Get Enemy.”

But many of us are ignorant of the ways in which water can be useful to us aside from just drinking, cooking and washing.

In the spirit of World Water day, let us share some tips on how water can help keep us stay healthy and well in and out of the gym.

  • Water is an excellent detoxifier. Our bodies need water for the huge amount of the chemical processes that go on in our body especially in the digestive system.
  • When it comes to digestion the question is “to drink or not to drink?” Well, it depends. The stomach uses a natural acid, Hydrochloric acid, to digest food. Over-dilution of this acid by drinking too much water WHILE eating could hamper the digestion. But drinking water 30 minutes BEFORE and two hours AFTER eating will help in rinsing out your stomach of food debris and keeping it ready for the next meal.
  • Muscle-building is a useful tool in the gym to tone up the body and increase your metabolism rate. However, when you first start weight-lifting, you will experience minute muscle tears and re-building. Myoglobins (the cellular protein unit in your muscle) will be released into your blood stream for disposal. These proteins, because they are heavy could damage your kidneys, especially if you have some degree of prior kidney damage. So, when body-building ensure to increase your water intake to flush the proteins.
  • Do not limit your imagination to the fact that water is only available in the liquid form and in your glass. Many of the popular fruits and vegetables have a high amount of water, and are more interesting ways to hydrate your body.
  • Water is a great friend of your skin. Drink water and sweat your way to clearer skin by eliminating toxins through your skin pores during your cardio work out. Increase the rate of toxin removal by drinking water.
  • Water is also useful for practical weight loss purposes. If you are doing weight training for instance and have no dumbbells, no problem. Take a look at this; a litre of water is approximately 1kg of weight. Therefore if you are training with 1kg dumbbells, just take a litre container of water, fill it up and you have one kilogram to work with. You want two kilograms, use two litres etc. Note that different liquids have unique weights and this only holds for water.
  • Water your hair and nails from the inside! Challenge your hair to grow by drinking 8 cups or 2 litres daily, and watch your hair and nails sprout like plants!
  • Water is the first medication with most domestic accidents. Chemical splashes on/in the skin, eyes, ears and nose? Flush vigorously with water, then rush to hospital. Same with accidental ingestion of MOST poisons
  • Water is recommended in copious amounts for all people, except for those that are suffering from certain chronic kidney ailments. Everyone else should keep drinking up!

The Curious Case Of The Everlasting Cough……by Peju Adeniran

If you ask most people what a drug addict looks like, they will paint you a compelling picture: “An Un-kempt person in rags with uncombed hair, sitting on a rubbish dump, and looking aggressive.”

Well, that is not quite right as we will see in a minute.

This edition, I want to focus on something that is very solemn and disturbing. A while ago, I served as a health consultant to an educational consulting establishment that focuses on child and adolescent education in Nigeria. In one of our programmes, we had cause to give a series of lectures about illicit drugs, drug use and the Nigerian child.

I had to give lectures to parents, not only about the dangers of drug use and the possible complications, but how to recognize and prevent drug use among their children and their wards.

What struck me the most was how, because of previous media campaigns and education programmes, most of the people had an idea of what a person with a drug problem looked like. Remember the one I shared at the beginning?

But the truth is that in many cases, signs of drug use are less obvious, much more subtle, and therefore likely to have caused a lot of problems and had a lot of consequences before they are detected.

It was a great irony to me that the first time I would hear about the “cough problem” it was brought to my attention not by doctors or medical media but by a patient.

She had come for a different complaint of her own and after consultations and counseling was already on her way out, when she turned back to me and asked if there was any permanent cure for her son’s cough.
“Cough? Tell me more,” I enquired.

“Well,” she said. “He has had this cough now, for over six months and it has refused to go in spite of the over the counter cough medication he has been using.”

The various tests showed that there was nothing wrong with him, nothing in his lungs or otherwise, but she didn’t know what else to do. I asked her to bring him in to see me, but they never came back.

I sort of forgot about it, until I read somewhere, in a newspaper I think, of someone who had written in to comment about a disturbing new trend involving teenagers and Codeine.

The article described an eye-witness account of some teenagers who had flocked outside a pharmacy before eventually cajoling a passing adult into helping them go inside and purchase something.

The man had hesitated, but after the promise of quick cash, eventually went in and came out with an innocent looking bottle of cough syrup that had Codeine in it.

She wrote in, a little concerned about what she just saw, but not really sure why.
Now, you see; Codeine is a powerful sedative drug, a popular pain-killer medication because of its selective effect on central nervous depression. It is also used to treat cough and cold conditions, mostly to allow the body to rest and accommodate the effect of the active ingredient in the drug.

Codeine also produces a dreamy or euphoric feeling of well-being, that could also blunt emotional feeling as well as physical and emotional pain.
This makes it nearly ready-made for addiction.

Some patients develop this addiction through no fault of their own but for others, it’s very deliberate. For the teenager with no access to “street” drugs Codeine can and has become, for so many, a convenient drug of choice, because it comes “clean in a bottle, is sold in a store, and is just a little fun”

As I paid more attention to these two incidents I finally uncovered a disturbing trend; that this thing has been going on for far longer than many of us parents, doctors and relevant authority have paid any attention to.

Teenagers, (and some adults actually) walk boldly into a drug store, complain of cough that does not let them sleep at night and then go: “please can I have that cough medication, the one that has Codeine it. Thank you?”

“Spanish Fly” and Other Concotions. . . . by Peju Adeniran

You will recall that in my last piece, I shared with you a story from when I was a “Baby Doc’ in medical school. My Professor had told me that in clinical practice I would find all kinds of human reactions to the idea of sex and sexual performance.

And so I return again to the sad story of the young undergraduate who, allegedly and inadvertently poisoned a friend with a “sex enhancing” drug presumably with the intent of not just having sex with her, but with plans to make the experience a much more pleasurable one for both of them.

As was alleged in news reports, the story ended tragically with an allergic reaction to the drug, and is still a pending investigation.

That story brings to mind how many people, (and I am restricting my comments to Nigeria where I practice,) dabble with sex enhancing drugs for entertainment without proper knowledge of what they really contain and the possible side effects.

Various potions and drugs from the benign to the ridiculous are advertised to enhance sexual desire and performance. When you run through the list from the harmless ones like malt stout and “suya” pepper, garlic marinated in alcohol, to “honey moon snacks” like exotic dates and nuts which are popular in the north, and the Yohimbe tree (Corynanthe yohimbe) bark steeped in alcohol to the dangerous ones like caffeine stimulants, herbal concoctions, and narcotic drugs, it becomes quite clear that bedroom anxiety is a real enough medical issue for many.

Let’s take the “Spanish fly,” which is the stuff of legends.

As a teenager in secondary school looking to head to University, one of the earliest stories I was told about the university was that girls who were too friendly with boys on campus would have “Spanish fly” slipped into their drink when they weren’t looking, and subsequently be robbed of their virtue.

I made a solemn vow there and then that when I got into the university, I would always have enough money to pay for my own soft drink and to never let it out of my sight.

It was a fortunate thing, even though disappointing for my curiosity that I never saw or heard about “Spanish fly” in all my years in the university.

But then I eventually got to see this drug in clinical practice when a patient who had been having sexual difficulty at home brought it to me, early one morning, to ask whether it was safe to use with his wife.

It was quite an unremarkable powdery substance in a small, brown bottle. He bought it at a very expensive price; he said and wanted to have a medical opinion on its safety, especially since his wife had asked him to.

Now you see, “Spanish fly” is a specific type of drug that is gotten from a beetle called Cantharis vesicatoria or Lytta vesicatoria.

The truth about it is this; when taken in moderate doses Spanish fly produces irritation of the genitals which results in an increase in blood flow to the area thus mimicking the engorgement and erection that occurs with sexual excitement.

However, this drug can be extremely toxic when ingested and may cause priapism; a very painful and dangerous condition in which the male has an erection for an extended period of time—hours or even days.
In spite of my lengthy explanation, my patient, holding on to the bottle with all the hope a person could have, still asked me;
“Ok Doctor, but… does it work”?
“Well, yes. And no,” I told him.
I had to break his heart that day, and to make sure he didn’t do anything stupid, I took the bottle from him before sending him home. The small brown bottle remains in my work drawer to this day. (And it is still unopened, I swear!)

Now, there are some people for whom sexual dysfunction is a real problem, and I do empathize, having seen first hand at work, how distressing a condition it can be.

Most problems of sexual dysfunction are not solvable by drugs, but instead through lifestyle modification and counseling.

But a great number of people continue to try quick and usually dangerous fixes to the problem of sexual dysfunction. And many others who have no real illness, just for the sake of increased performance and excitement.
Like many sex therapists preach, good sex actually happens in the head, and not quite solely in the genitals.

P.S: My patient and his wife saw a sex therapist, spent more time together as a couple and have come in to see me many times since then, and not once, has he ever asked to have his bottle back.

Cholera . . . .by Eghosa Imasuen

In a previous article I ranted about the misuse of antibiotics in the treatment of diarrhoea. That was a prelude to a series of articles on the topic of diarrhoea and its many causes. This time I will talk about a specific cause of diarrhoea.
Cholera has been in the news recently. Last year, an outbreak in the northern states of Nigeria had pundits abusing our government, our health-care providers. How could they let this happen? In Naija? In 2010? Shame! For an outbreak that was quite effectively contained I feel these pundits were angry with the government for other reasons. The reaction was prompt. The drugs were delivered. Doctors are working overtime in these places. In another part of the world, Haiti’s recovery from last year’s tragic earthquake was shaken by the reaction of some of its people to the cholera outbreak there—they believe that the aid agencies brought the disease to the island.
Cholera is caused by a rod-shaped bacterium called Vibrio cholerae. It causes a severe diarrhoeal illness, with associated vomiting, severe dehydration, and abdominal pain. Symptoms may start suddenly and quickly, sometimes as little as five days after contact with contaminated food, effluent, or other patients. The diarrhoea caused by the disease is especially profuse—the classically described “rice-water stool,” so described because of the flecks of detached damaged intestinal bits that float in the stool. An untreated cholera patient may produce as much as 8-10 litres of diarrhoeal fluid in a single day. This massive efflux is the result of a toxin produced by the vibrio cholerae bacterium that compels profuse amounts of fluid from the blood supply into the small and large intestines.
The transmission of vibrio cholerae is via the faeco-oral route. This simply means that after an infected person, or a carrier stools, somehow this contaminates either food or water, and the person who drinks the water or eats the food ingests live bacteria. (Note: It doesn’t mean that someone defecated in another person’s mouth o.)
Oddly enough, cholera is rarely spread directly from person to person. And vibrio cholerae is found naturally in some shellfish and plankton, but remember that there exist toxic and non-toxic strains of these bacteria.
Now for the serious bit: although cholera can be a devastating disease, killing rapidly before treatment can even begin, its prevention is very straightforward: sanitation and common sense. Living in a country with advanced water treatment infrastructure and sewage systems helps, but so does listening to mommy when she says; wash your hands after poo-poo, boil your drinking water, etc.

  • Sterilization: All materials that come in contact with cholera patients should be sterilized by washing in hot water using chlorine bleach if possible.
  • Sewage: anti-bacterial treatment of general sewage before it enters the waterways or underground water supplies helps prevent undiagnosed patients from inadvertently spreading the disease.
  • Sources: Warnings about possible cholera contamination should be posted around contaminated water sources with directions on how to decontaminate the water (boiling, chlorination etc.) for possible use.
  • Water purification: Chlorination and boiling are often the least expensive and most effective means of halting transmission.

There is a cholera vaccine available. It is used to stop outbreaks from spreading, and to prevent spread to health workers.

Cholera treatment works on two main premises. One is to attack the disease-causing organism itself, the other is to prevent death via dehydration of the sick patient. Aha, so this is where those famous antibiotics – tetracycline, flagyl ad septrin – come in.

Cholera has traditionally been treated with tetracycline. Antibiotics shorten the duration and lessen the severity of the diarrhoea. But the mainstay of cholera treatment has always been fluid replacement. Not diarrhoeal stoppage o. FLUID REPLACEMENT. This is what saves lives. In most cases simple oral rehydration therapy with the generic proprietary brands of ORT solutions used judiciously will keep a patient alive until the disease runs its course. Where the person is very sick, we may upgrade to intravenous fluids.
Nursing care is also important. Cholera is a disease that destroys the dignity of its sufferers. You literarily shit yourself to death. I remember the sniggers in class when we were first shown a cholera bed in medical school. The bed had a hole in the middle, a funnel that emptied into a bucket. When we asked our professor why the beds needed holes he told us that the diarrhoea was so uncontrollable in the acute phase of the disease that patients did not have time to ask for toilet breaks or bed pans. And that as the epidemics worsened, nurses did not have time to respond promptly to every patient. Our professor warned us about the dignity of the patient. He punished those who sniggered at the beds with extra call duty.

The Truth About Diarrhoea – By Eghosa Imasuen

When it comes to diarrhoea, ask any doctor what the most annoying, disturbing, and depressing misconception they have to correct amongst their friends, family, and patients is and they will tell you that it is the use of antibiotics in the treatment of diarrhoea.

Everyone I have worked with, every doctor, every nurse, every Health Extension Worker, has described how they cringe with embarrassment when seemingly educated people say things like, “Kai, bros  I wan purge die yesterday. If not for the Tetracycline/Flagyl/Septrin wey I drink, I for don die since.”

So first off, I am going to say this: Almost all cases of diarrhea are self-limiting episodes. That is if you give it time, it will stop on its own. Yes, you will feel some pain and discomfort but it will stop. Whether you took antibiotics or not, the “speedo” would still have to end on its own. ON ITS OWN! Good to get that off my chest.

You see, people, by far the most common infectious cause of diarrhoea—which is described as loose voluminous stooling, i.e., stool that takes the shape of the container  in which it finds itself—is viral. And antibiotics are used for the treatment of bacterial infections. Note that in the previous sentence I said that the most common infectious cause. The most COMMON CAUSE of diarrhoea is actually food poisoning, a two-worded entity that conjures up dreams of wicked stepmothers, and far-removed cousins, in our paranoid West African environment.

Food poisoning in this sense means getting sick from eating tainted food. What happens is that when food has been contaminated with bacteria through improper handling or poor hygiene or exposure, the bacteria thrives in it and produces certain chemicals that are consequences of its metabolism. These bacterial toxins, these by-products of the bacteria’s metabolism cause profuse diarrhea.
The irony is that diarrhoea may actually have been designed to serve a protective function. Because it causes prompt emptying of the gut, it ensures that the bacteria, in question, has minimal chance of thriving in an environment where it would otherwise be quite at home.
But the thing about nature is this: defence mechanisms have a way of actually killing what they
are supposed to protect, i.e., you. So the most dangerous complication of diarrhoea is the loss of fluids and electrolytes, the hypovolaemia and electrolyte imbalance that results is what kills people, sometimes, especially those at either extreme of the journey of life–children and the elderly–who can barely survive the assault on their delicate bodies.
By now it should be clear what the real treatment for Acute Watery Diarrhoea is: Fluid replacement in whatever guise – Oral Rehydration or IV-drips (in cases where vomiting has complicated the clinical picture.)
But, you say, where did the idea of tetracycline, septrin, and flagyl come from? First, tetracycline has saved countless lives in the fight against a major killer, cholera. The last two are used to treat the two main types of dysentery. (I should define dysentery here. Dysentery means bloody mucoid diarrhoea, sometimes painful.)

So, the point I am trying to make here is this, when you drink tetracycline or flagyl because you have diarrhea, you are doing three things; wasting time and wasting money and probably contributing to the rise of superbugs, extremely hardy multidrug-resistant strains of normally mundane gut flora.

(Brief Bio: Dr. Eghosa Imasuen, a Nigerian novelist, was born on 19 May 1976, and grew up in Warri. A medical doctor, he graduated from the University of Benin in 1999 and lives in Benin City, Nigeria, with his wife and twin sons. He is the Acting Managing Director of Royal Savings and Loans, a primary mortgage institution in Warri.)

Things You Don’t Really Learn In Medical School. By: Peju Adeniran

Reading the sad story of the University of Lagos female undergraduate, who was alleged to have died in unfortunate circumstances that had to do with sex, consent and an alleged concoction of sex pills my mind went back to a lesson l learnt many years ago in my 4th year of Medical school.

One of the lessons taught in Clerkship involved creating physician room scenarios where pretend patients, with pretend illnesses would be admitted, examined, diagnosed and treated by medical students under the guidance of the lecturers.

On this day, I was pretending to be treating a patient who was a middle-aged hypertensive man and had come into the emergency room in a hypertensive crisis, despite being long-term diagnosed of the condition and placed on properly designed medication.

I was presenting to a Professor, who we had nicknamed “Go forth and do like I say” because of his habit of admonishing his students to do just that.

I had my clinical case notes and had presented, to my mind, a near perfect scenario and how I, as a future doctor, would handle it. Everything had gone well until I got stuck at the final question that the Professor asked me:

“What is the first reason why this patient, who has been hypertensive for five years, would present in an emergency room?” asked the Professor.

All my answers were wrong, as varied as they were:  from the expected and logical “hypertensive stroke” or “cardiac arrest” to the illogical; “food poisoning?”

“All wrong”!” boomed the Professor. “In a middle-aged hypertensive man from these parts, from clinical experience, the most likely reason why he would present in your emergency room is sex!”

A pin could have dropped on the floor that day and it would have been heard on the other side of the ward.

Not quite getting what my teacher was trying to say, I asked him if he meant that a hypertensive patient could present in the emergency room from a heart attack or stroke that occurred during sex but he said a loud “no” and continued the lecture.

“This is what you must know,” began the Professor, leaning close towards us like he was about to tell the world’s most important secret. “You must always be careful when you are prescribing drugs, for instance like one for hypertension, even to a patient that might be currently at the risk of death. If the drugs will affect his ability to have sex, your patient will eventually stop taking your drugs and be non-compliant. So, the treatment will fail, the patient’s health will fail and you the doctor, would have failed them both!”

“But Sir…” I stammered in protest “Are you saying that a patient will fail to take his drug even though he knows that he  might die just because he doesn’t want to give up sex?…. That does not make sense.” I was incredulous.

Choosing to ignore my impudence, the Professor instead looked at me and asked.

“Baby doc, have you treated any real patients before?”
“No, Sir” I said sheepishly, now sufficiently humbled.
“Have you treated Nigerian male patients before?”
Silence
“Or perhaps you have been married to a Nigerian male before?”

Indeed, at year four, I hadn’t. So, silence reigned.

“Then you have no insights into the politics of sexual virility and the bedroom antics of the Nigerian male. You need to gain some insight because it is going to affect how you treat your male patients….”

This time I could only nod my bowed and chastened head in agreement.

“So, do not argue with me, just keep this in mind when designing treatments for your patients and go forth and do like I say.”

I never forgot that lesson, and it is fortunate that I did not.

Today, years later, and in clinical practice and experience of my own, I have seen that my esteemed Professor could not have been any more right. And that was the lesson that came to mind as I read about the girl who died after her boyfriend plied her and himself with sexual stimulants.

As the facts of the case are still currently under investigation, I will not state my opinion, professional or otherwise on the case per se. What I will, however, add is that our society is to blame because it keeps promoting the myth of sexual virility and performance, especially in the male thus leading to pressure and unrealistic expectations.

*Postscript/ introduction to blog
It is on a sad note, and while mourning Ella, that we introduce this blog, where you get to sit in with me in my physician’s room, and we discuss not diseases, but people and how we all cope with disease. Welcome to my doctor’s room, sit in that chair, and let me tell you what I know.

(Brief Bio: Dr Adeniran is the C.E.O and Editor in Chief of Docsays Integrated Services (www.docsays.com) a health content production and consulting company based in Lagos., which also produces “The Docsays” radio show, a popular call-in medical talk show programme that airs three times a week on City FM 105.1 with immediate plans to syndicate. Her first degree is in Medicine, from the University of Lagos.)

The challenge is over!


The challenge has come to an end but your lifestyle changes should not.
Over the last 21 days we gave you tips that allowed you to

1. Eat more healthfully
2. Exercise more
3. Reduce stress
4. Get rejuvenating rest periods
5. Laugh more and bod with family
6. Release toxicity from your life
7. Embrace joy
8. Practice forgiveness

And so much more.
Your very last challenge is to incorporate all these into your lifestyle and the good news is that the challenge information is still online, here on the site so you can do it all over again if you like!

Live well, be happy and prosper!

Almost the last day!

Today’s challenge is simple but powerful!

Stop worrying!

We spend a lot of time worrying about everything under the sun. For Christians the bible actually commands us not to worry. Worry can be damaging to the body, by draining our energy, reducing our immunity and limiting our ability to be creative. 

Today your challenge is to stop worrying and we will give you some tips you can use to get it under control.

1. Write it down. When you find yourself up at 3am consumed with fear about some issue, write it down on a journal or note book.
2. Classify the worry into actionable or not. For example, If you are worried about the state of your finances. That can be actionable, because there are things you can do to fix it. However if you are concerned about global warming as a whole, that may beyond your control.
3. Those things that are actionable – create an action plan. If you are concerned about your weight, create an action plan about eating healthier and working out. If your money is funny, then create an action plan about how to reduce your spending and increase your income.
4. For those things that are not actionable, sometimes it is helpful to create a ritual around them. For those who are religious, pray about the concern and hand it over to God. For those who are not, perhaps you can tear out the sheet where you have the worries written and throw them in the trash or burn them, while determining that you refuse to harm your body by focusing on the negative aspects of life, because you choose to believe that life will be good.

Healthful eating with Dr Lara Adejumo

Dr Lara Adejumo drops by ewell radio to discuss eating healthy versions of our traditional food. Dr Lara is a medical doctor practicing family medicine in Clinton, MD. Her book is called Healthful eating for the African and it is filled with tips and advice for transforming our diet so as to avoid diabetes, cardiac disease, cancer and more. Click on the play button to hear more from Dr Lara. Her book can be ordered from her website drlaraa.com.

Listen to internet radio with Ekene Onu on Blog Talk Radio

It’s the 12th day of the Be well challenge!

It’s day 12, how are you feeling? Here at EwellAfrica, we hope you are feeling fabulous, because you deserve to!

Your challenge today if you choose to accept it is…

Spirit challenge: Be grateful.
Count your blessings, literally one by one. Sometimes in life, we get so focused on what we don’t have that we get depressed and frustrated. Today we want you to concentrate on what you do have and revel in its beauty. From the simple to the sophisticated, there are so many things we all have to be grateful for. Take some time and write down all the things you are grateful for and count your blessings indeed.


Mind challenge: Write a mission statement.
Write a mission statement for your life. Write down your vision for your life, where you see yourself in 5, 10 even 20 years. Write down an action plan of how you plan to accomplish your vision. Once you have done this, know that you are one step closer to living the life that you have dreamed about.