The Survival Debate

By the time you'd finished reading this, you should be more grateful to you your mum (and dad).

When a lady stutters for words to describe her complaints, you know as a doc that she's probably got one of those "private" issues...itching, discharge etc. or a sexual intimacy related matter. They're all 'issues'... (Serious issues).

Another scenario that would make a lady stutter, especially a young, school-age lady is a pregnancy, ‘an UNplanned pregnancy’. This was the case of my 20 year old patient.

I'm First; No you're Not, I am

She doesn't know which is first or second between her twins.

She came in with the child, a year old baby with cough. I didn't know the baby was a twin until she told me.

Usually the names Taiye/Taiwo - the first twin and Kehinde - the second twin; would have been used to register the case file. But not in this case.

So I asked her who's Taiwo and who's Kenny? Surprisingly she had no answer! She didn't know who to call Taiwo and who to call Kehinde between the two.

This was what happened. She was in labour and the labour became obstructed. With "Taiwo's" head visible from outside, it had gotten trapped in the pelvis.

So the doctors took her to the operating room for a Caesarian Section and brought "Kehinde" out first.

Thus she discarded the terms Taiye and Kehinde.

Sickle Probability

A peep into My Patients' Files took me to Sickle Cell Disease (SCDx).

SCDx is a blood disorder in which the Red Blood Cells (RBC) loose their discoid shape and become sickle-shaped thus losing their ability to transport oxygen and also blocking arteries thereby preventing blood flow to the organs. Sufferers of the disease are commonly referred to as "sicklers"  or "SS". They possess the genotype SS. Normal individuals are AA while AS is the carrier state. They suffer agonizing pains known as "crisis" leading to frequent and recurrent visits to the hospital.

My patient is a 29 year old woman and she already has her 4th child. Lucky woman you are, I teased. At 29, four kids already.

Not that lucky she replied. My first child, a boy is AA, the second, a girl is AS while the third is SS. This 3 month old I'm carrying, only time will tell what his genotype is.

The third child had been falling ill frequently and it was discovered that she suffered from SCDx. It was at that time that the couple also realized they were both carriers, AS-AS. They had no pre-marriage testing.

I had many questions on my mind for her like, "would you have married him if you knew from the outset that you were both carriers?"how did you feel knowing you have given birth to a sickler?" but I asked her only one - Why did you go ahead to having a fourth child after discovering that your third child is a sickler? I would have expected that you'd stop child bearing after three kids. Is it an automated natural compulsion to procreate or have you calculated the probability and found out that the fourth cannot be sickler?

As the full effects of the symptoms manifest as the child grows older, I wonder how it will impact on the whole family and how they would handle it. 

The truth is this, the occurrence of SCDx actually lies only in the hands of God. There are families who had no sicklers, while there are others who had multiple. However, the choice "to" or "not to" take the risk lies in our own hands.

This peculiar case got me calculating probabilities. I disliked the topic back in secondary school. Circle geometry was my favorite. Just curious, for you math gurus, what is the probability that (a) the fourth child would be a sickler and (b) what is the probability that he would not?

9 Months Abstinence

It is our responsibility to raise awareness and educate people at every opportunity at our disposal. It makes the world a better place. Ignorance is indeed a terrible malady that makes individuals suffer needlessly.

This next encounter on My Patients' Files is a perfect depiction of this fact and it was an issue I took personal.

She is a first-time mom who delivered via a caesarian section. Her diagnosis was a urinary tract infection and possibly vaginal candidiasis. But she was more worried about her menses, its now 9 months since delivery and she's yet to see it.

I explained to her its due to breastfeeding. Can I get pregnant without seeing it? she asked...I replied that its not impossible but under normal circumstances, she should not.

She explained that she did not want to get pregnant because of the caesarian section she had, and that is why she has taken the extra precaution of not allowing her husband to come near her in the last nine months!

I could not hide my shock! Nine months of no sex for you and your husband? Are you kidding me?

Did he offend you? She said no. Haven't you ever heard of family planning? pills, injectables, IUCD? She answered no. Ok ok, what about Condom...Gold Circle?

Either her husband is equally as ignorant or he has simply and secretly been helping himself outside the home in the last nine months.

You have your say.

I asked her: do you really think your husband has been abstinent in the past nine months? Her answer: Please where is the family-planning clinic?

Jambite Rush: The Ekpoma Teen

I’ve seen and attended to her in the clinic once before. She was on admission for I think typhoid fever and was being closely watched by her mum. I won’t blame the mum, her little girl is just 16 years old. The reason I remember her was her extreme fair complexion and the incredulously short shorts she was wearing.

So the next time I saw her walk into the hospital again,

Pill in the nose

She barged into the consulting room while I was seeing another patient. I should have told her to walk out, but I saw the apprehension in her eyes and I knew something must be awfully wrong.

Mongoloid Baby?

She is 31years old and she had lost two pregnancies since she got married. But that doesn't matter any longer for she now has a baby...a baby boy. But there is a problem, a problem she is not aware of.