Medicine | Health | Wellness

In Memoriam: A Few Words About A Deadly Disease
Nigeria Goes Polio-Free
I Didn't Even Know I Was Pregnant
A Note About Galactorrhea
How IVF Has Developed Since Louise Brown

Saturday, December 19, 2015

As I looked at the now still form of what used to be a 7-month old baby, I tried not to hear the hair-splitting wails of the woman who had just ceased to be a mother. I tried to mentally lock out the drama that was playing out around me as she thrashed about on the floor, asking God why He would be so wicked as to take from her 28-year old self her 7-month old only child; I tried not to notice how determinedly her husband was standing by the corner trying to “be a man”, to show full composure; perhaps even to show no emotion, his pain suggested only by the furious twitching of his lower lip and the mist that clouded the tiny slits that occupied the place on his face where people would normally have eyes. I tried not to notice all this because, as I looked down at the little innocent who had so needlessly died, all I felt was rage. Rage at the parents, rage at her grandmother, rage that acknowledgement of their grief would only worsen – not temper. Rage because the child that had just died, the 7-month old child that had just walked away from a 28-year old mother and a 33-year old father, had been taken on that walk by no less a phenomenon than malaria.

Strange as it sounds, malaria still kills thousands of people the world over, and hundreds of children in your own locality in the time it takes a woman to have two menstrual cycles. In the time it takes the English Premier League to complete one season, about 300,000 people in Nigeria die from malaria. And this, not because the disease itself is untreatable, but because of the continued supremacy of the ignorance of the people, by the people, against the people.

Ignorance of the disease and how to go about its treatment is no excuse. That is why this 28-year old woman will never get her daughter back. That she did not know that she should not have kept in her house a 7-month old child with fever who was vomiting and passing watery stools in not enough; that she did not know that her generous aliquots of pastor’s prayers and grandma’s concoctions may be more potent in exorcising evil spirits than in curing malaria does not matter.

But I already resolved to be kind. So instead of giving the couple the verbal bashing I think they deserve for killing their own child, I resolved there and then to try to save another couple from killing theirs. Hence this piece, which has been written in as informal and as simple a manner as I can handle.

Malaria has long been blamed on the mosquitoes that thoroughly infest our environment, and with good reason. It is mosquitoes, the females among them no less, that transfer the malaria parasite from one infected person to another uninfected person. The malaria parasite itself can cause malaria in human beings but does not cause malaria in mosquitoes. Like I have hinted at earlier, a patient who is down with malaria has excellent chances of full recovery if appropriate treatment is commenced on time and fully carried out. But for appropriate treatment to be initiated, one must recognize that malaria is afoot, and for one to recognize the presence of malaria, one must be familiar with its – common – symptoms.

Now, while I will not presume to tell you what your own malaria symptoms could be (perhaps because I am sure you know them already), I will make bold to tell you what you may notice in a child around you, or what a child around you may complain of when he or she has malaria. Someone with malaria infection may have all (or some of) these symptoms listed. In some cases, the malaria sufferer may not even have any of these symptoms, or may have just one of the symptoms listed. The paucity of the symptoms exhibited by the person doesn’t make the sickness any less dangerous.
  • The child may refuse foods or be uninterested in food and drink.
  • Fever with chills – the person may be noted to have very hot body temperatures, while at the same time shivering from cold. Caring for the person may be challenging because, one minute, the person may complain of being cold and needing a blanket. The next minute, once the blanket is applied, the person throws it off, complaining of heat. And all the while, their body temperature remains burning hot. The episodes of fever are sometimes followed by excessive sweating, following which the body temperature may drop to normal.
  • Cough
  • Nausea
  • Vomiting
  • Diarrhea
  • There may be yellowing of the eyes
  • Fatigue – the person may notice that they become too easily or too frequently tired after little or no physical activity.
  • Malaise – the person maybe uneasy, without being able to say precisely what it is that is responsible for their unease.
  • Joint pains 
  • Muscle pains
  • That telltale bitterness that fills the mouth

OK. So when your usually active child who always fights with you for your mobile phone or for the remote controller of the television suddenly begins to prefer the company of his pillow, when the child who previously could not get enough of breast milk (to the scarce-expressed chagrin of his father who has had to wait in a never-moving queue for his turn at the breast) suddenly loses interest in all things round and beautiful, that is not the time to quote the scriptures with the local pastor; that is not the time for “trying” the herbal remedies Mama brought with her from the village when she came for the customary omugwo. Mbanu. It is time to dress the child up and take him to a hospital so he can be properly diagnosed. His fever may not be spiritual. It may be malarial.

In fact, in recognition of how big the problem posed by malaria is, Community health experts now advise us to commence antimalarial treatment within 72 hours of onset of the aforementioned symptoms if we cannot get the patient to hospital and symptoms fail to abate within that timeframe. The consequences of treating for malaria when it is not present are far more tolerable than are the consequences of NOT treating for malaria when it is present.

So, how do you treat for malaria?

Before I talk about antimalarial medications, let me say a few things about handling the fever that is due to malaria. That fever usually responds well to paracetamol, although you may prefer to use ibuprofen. Your doctor will tell you how to administer the drug. But it is the tepid sponging that those busty nurses at teaching hospitals yap about that I want to highlight here. Tepid sponging refers to the use of tepid water – made from a mix of warm and cold water – to try to reduce the body temperature. This is done by dipping and wetting a towel in the tepid water and then dabbing different body parts of the feverish person with it. Dabbing, not scrubbing, not washing, not anointing. Dabbing. When next the child has a fever, take their clothes off them and do a tepid sponge. It works. 

I would like to say that antimalarial combination therapy is the preferred mode of treatment. This means that you make simultaneous use of two different antimalarial medications in treating the condition. Happily, many of the antimalarials on pharmacists’ shelves today are pre-combined in just the right doses. This is to ensure that instead of taking two or more different antimalarial tablets each time, you take one tablet that contains the two different drugs. An example of these pre-combined medications is Lonart. Another is Amatem. Then there is Coartem. And Artecam, Artequin, and many others.

You or your child can take your antimalarials whether or not you have had your meal. Don’t prevent your child from taking their antimalarial because they have not had a meal or because they have refused to eat. The truth is that loss of appetite is one of the first symptoms that appears when you have malaria, and one of the last symptoms to completely disappear after you have successfully treated the condition.

If you are treating your child, maybe it is preferable you use tablets. I know there are these equally effective antimalarial powders that come in bottles to which you can add water to form suspensions which you can give the children to drink. But some people add too much water – to make the drug last longer –This excess water that they add to the powder just lessens the effective dose of drug that the child gets to drink at each administration. For this reason and for no other, I think tablets are better. 

Do not give more than the recommended dose at any one time because you are in a hurry to make your child get well. An overdose does not make your child get well faster. It may actually make your child get sicker. With malaria and with at least one more thing else. Recommended doses are printed on the medication packs and on the leaflets that accompany them. Try to read those leaflets before you discard them. Reading does not kill. 

Try not to skip any dose. Try not to forget. But if you do forget to take a dose, please take the next dose when you remember. Don’t come and go and be forming drug amebo, taking double dose, one for yesterday night and one for this morning, all at once. Haba! You want to go from malaria survivor to suicide survivor?

Let me hasten to say that if you live in Nigeria, and you use chloroquine or any of the variants of that “three-at-once” drug they call Fansidar (or Amalar, etc) to treat malaria, just know that every day is for the thief, and one day is for the owner of the house. And in this case, you are the thief, not the house owner. Those drugs are not effective in treating someone who already has malaria. They may have been effective when granny was a twelve-year old Girl Guide but that was many years ago, and I don’t even know whether the Girls’ Guide exists anymore. Many things have changed since then, and more particularly, the malaria parasites have become more stubborn. A la Donald Trump, chloroquine and “three-at-once” medicines are now ways of ensuring that your child who is suffering from malaria dies faster. 

Speaking of dying, that is something malaria can bring about too. Something that it brought about in the patient whose death inspired this post. People with untreated malaria are liable to die young. And before they die, they may have convulsions. They may behave irrationally. They may experience kidney failure. They may see blood in their urine. Yes, malaria can be wicked like that, and in many other ways. 

When you have treated your child and recovered him from the valley of the shadow of the darkness of malaria, you can take the following steps to keep him/her in the light of health, and out of easy reach of the next hungry, infected mosquito:

  • Try to ensure that there are no stagnant water deposits around your house, whether clean or dirty. Although they can do dirty, the mosquitoes that spread malaria actually prefer to breed in clean water where they can find it. Their only requirement is that the water be stagnant.
  • There is also that piece of advice about spreading a film of oil over surrounding stagnant water deposits in order to deprive whatever eggs are there of oxygen. 
  • When children are going out in the evenings, let them be fully clothed in long sleeved shirts, trousers, socks, and gloves. Let there be a minimum of skin which mosquitoes can bite.
  • Let us all sleep under those insecticide treated bed nets. Doors and windows can also be protected with nets. Sometimes, we can use insecticides to fumigate our homes; although the producers of these insecticides nowadays claim that it is essentially harmless to humans in low doses, I think this fumigation is better done when there will be no one indoors, no one forced to stay and inhale the substance, no one to share the final moments of the mosquitoes with them as they embark on their one-way trip to insect-hellven.

May her soul rest in peace, and may God comfort her grieving parents. Amen.


Medicine | Health | Wellness

Nigeria Goes Polio-Free
I Didn't Even Know I Was Pregnant
A Note About Galactorrhea
How IVF Has Developed Since Louise Brown

Sunday, September 27, 2015
A couple of days ago, the World Health Organization removed Nigeria from its list of polio-endemic countries, leaving only Afghanistan and Pakistan as the undisputed members of that unenviable club.

It is a pity that a milestone that would have been achieved by Nigeria several years ago was set back in 2003 by the efficient work of scaremongerers and by the inadequate countermeasures deployed by the government of the day. But it is also a thing of joy that the Nigerian government in 2013 refused to back down from the immunization drive despite the murder of nine vaccinators in Kano. 

Today, we harvest the reward of the doggedness of those who went through the length of northern Nigeria, counselling, encouraging, immunizing. Together, we pushed out Ebola. Together, we have just committed Polio to history.

Is Malaria listening?



Medicine | Health | Wellness

Friday, August 07, 2015 from
Just as a much-needed vacation was getting under way last summer, Jennifer West woke to a painful period: cramps, back pain, achy all over. Miserable, she was ready to stay right where she was until her discomfort passed. But lying in bed, staring at the ceiling, wasn't helping. In fact, her back felt a little worse like that. Her side, maybe? No luck. She sighed. So much for vacation.

West, 31, and her husband, Dan, of Villa Park, Illinois, were staying in a cabin in Wisconsin with two friends, Anna Puccinelli and Jan De Keyser. Dan's parents were just down the hill in another cabin. They'd planned a low-key long weekend for the Fourth of July, but on the morning of July 3, the thought of just watching fireworks made West cringe. She couldn't get comfortable, no matter what. She walked in circles around the cabins, and up and down the steps that connected them.

By afternoon, she was so exhausted that she begged off mini-golf. "Come on, you'll be fine," Puccinelli, her best friend since childhood, urged. But West knew she wasn't up to it.

"I'm going to try to nap," she said. "I'm sure I'll feel better by the time you all get back." She managed to nap, fitfully, for an hour or so, but woke up panicked. Could the pain actually be worse? Five years before, a fibroid tumor had caused a similar sensation in her abdomen. Then there was the ruptured ovarian cyst she'd experienced in 2002, which had also hurt like terrible cramps—and had started with a backache. She couldn't bear the thought of dealing with either again.

So while she was relieved when Dan and her friends returned, what they saw took them aback. Pale and unhappy, West was whimpering involuntarily every few minutes. "This isn't like you," Dan said. "I think we should go to the hospital." "No, no," she protested. "I'll be fine." Whimper. If she didn't go, she thought to herself, then nothing could really be wrong.

But Dan could tell that something was wrong. His wife was not one to moan and groan. She'd stoically made it through ulcers, the fibroid tumor, the cyst. For her to be near tears was bad—and the fact that they were so secluded was making him nervous. "Jen," he said, "we're going." And they went.

An unbelievable surprise

They arrived in the emergency room of Hayward Area Memorial Hospital around 7 p.m. "I'm having the worst period of my life," West told the nurse on duty. After she gave her medical history, another nurse ran an ultrasound wand over her stomach, listening for the noise fibroid tumors make as blood flows through them. West heard a familiar "thump, thump," and her heart sank.

"Well, it could be another tumor, or it could be a baby," the nurse said.

"It's not a baby," West said. Wondering if she'd need surgery again (and when? How soon? Would she have to miss work?), she realized that this, at least, might explain the weight she'd gained recently: She knew that large fibroids can sometimes cause abdominal swelling.

The nurse left to get a doctor. When Brent Kelley arrived, he gave West an internal exam. Then he said the last thing she expected to hear.

"You're eight centimeters dilated."

"What?" West said. "What?!"

A nurse rushed out into the hall to tell Dan: "Great news. Your wife's in labor!"

"My wife? Oh, sorry, you must have the wrong guy," he said.

But she didn't. While Dan stood, shocked, trying to take in what the staff was saying, his wife was trying not to panic. In labor? How could that be? Her mind raced. But she'd been getting her period! They were using condoms!

She noted that the nurses seemed excited for her, but why, when she was about to have a nervous breakdown? She wanted to tell everyone to stop so she could think, but apparently there was no time for that. All she could do to keep herself together was to listen, very intently, to every word the doctor and nurses were saying. As she was wheeled into the delivery area and told what to expect, she tried to take in their breathing instructions, figuring that if she could do everything exactly right, she'd be okay.

By the time she was asking, "Can you repeat everything you just said?" Dan's mother, Linda West, arrived. She'd left her cabin soon after Dan and Jen had. "I'll just see if the kids need anything," she'd told her husband. "It's so boring sitting in a hospital." Not tonight.

She first spotted Dan standing under a sign that read, "Labor and Delivery," and thought, Uh, oh. Jen must have more female issues. Why else would she be seeing a gynecologist? But when she reached her son, he was stone still. The nurse told her, "Jen's about to deliver."

"Deliver what?" Linda said. A second later, the words sank in. She was floored, like Dan, but also scared. In labor? If Jen hadn't known a baby was on the way, how far along could she be? She didn't think this could end well.

Back in the delivery room, things were moving fast and West was almost fully dilated. To her, Linda's voice was the most beautiful sound in the world. She was so relieved: Someone calm! Someone who's done this before!

By 8 p.m., Linda was diving in to give her daughter-in-law a crash course in pushing, and trying to keep her own worries at bay.

The hospital staff were concerned, too, but were sure, at least, that the baby couldn't be dangerously premature, given the size of West's waistline (there'd been no time for a full ultrasound). They gave her antibiotics, since she hadn't been screened for any infections during pregnancy, and braced themselves. No one knew anything for certain about this baby except that the mom hadn't had any prenatal care.

Still too overwhelmed and scared to play the role of supportive dad-to-be, Dan left the coaching up to his mom and walked the halls. Babies were a part of his fuzzy future with Jen, not their life now. Is this for real? Am I going crazy? he wondered as he paced.

Meanwhile, West tried to focus on pushing, but the baby's heartbeat kept dropping, so she was given an oxygen mask, which quickly became her security blanket: Behind it, with the sound of the flowing oxygen drowning out everything else, she felt just a tiny bit calmer. But then she'd put it aside and the noise and craziness would hit her all over again.

Not to mention the pain, which was unlike anything she'd ever felt. It was too late for an epidural, and after pushing for nearly an hour without any relief, she tried to hang on by telling herself it had to end soon: No one could handle this much agony for very long. She was right. Minutes later she gave a last, tearful push, and her baby—a boy—was born. At eight pounds even, he was as healthy as could be. West held him and felt like she was in a dream, but then, her little baby looked right at her, and everything changed again. "Okay," she found herself saying to him, "I'm your mommy. And I'm going to take care of you."

Adjusting to family life

Three days later, the Wests drove back to the cabin (Jen was too sore and tired to endure the seven-hour ride home). In the back was a car seat—their first baby gift—from Puccinelli and De Keyser. And buckled into the car seat was Robert Hayward West—"Robert" after Dan's father, and "Hayward" in tribute to the town where the baby was born and where Jen and Dan were married five years earlier. They stayed at the cabin for three nights, where Robbie slept snuggled in a drawer set atop a dresser. Dan's parents and nearby friends supplied basics like diapers and clothes, and Jen's mom and sister, back in Illinois, sprang into action, hastily planning a shower for when the new family returned.

For Jen and Dan, adjusting to life with a baby was more complicated than for most new parents. Jen found herself grappling with unexpected guilt: "Robbie would have these three-hour fits of crying, and I didn't know what to do. I'd think, 'Is this because I didn't know I was having you?'"

But as the days turned into weeks, and the family settled in back at home, Jen and Dan started to become parents. Suddenly, they had opinions about diapers and how to get Robbie to smile. Best of all, they told their story to so many well-meaning visitors that the whole thing began to sound a little less crazy.

How did Jen miss her pregnancy?

What everyone wanted to know, of course, was: How did you not know? Looking back, though, there was a logical explanation for how West had missed all the obvious symptoms. Morning sickness? She thought she had the flu when she would've been about eight weeks pregnant. Missed periods? She thought she was getting her period just like she always had—that is, irregularly. (The bleeding the day she gave birth may have been the bleeding due to labor or could have been the expulsion of the mucus plug that protects the opening of the cervix.) Heartburn and stomach pain late in the pregnancy didn't raise a red flag, either. "I was sure I'd aggravated my ulcer," she says. Her gynecologist didn't catch her condition because she saw her for an annual exam just before West would have conceived.

Even the baby's movements, which would be so obvious for most women, got past her: She has a tilted uterus, a common condition in which the top of the uterus is angled back, instead of straight up. In West's case, it may have prevented her from feeling Robbie kick, but it probably caused back pain that West attributed to strain.

What she didn't miss was her weight gain, which totaled more than 20 pounds and, near the end, seemed focused on her middle. "I never used to gain weight there, but I figured my body had changed since I'd turned thirty," she says. She took up bike riding and tried watching what she ate but couldn't seem to shed the pounds.

West wasn't the only one who noticed her progressive plumpness. Her older sister, Jeanne Cox, poked her and said, "What have you got in there, a baby?" but West said, "No, I'm just getting fat," so her sister let it go.

Ironically, Jeanne was pregnant herself. "I was thrilled for her, and excited to be a part of a pregnancy from the very beginning," West says. "I actually said to Jeanne that helping her was the next best thing to having my own baby!"

When her sister gave birth at the end of June, West dropped everything to help her. In fact, less than a week before her own baby was born, she was scrubbing Jeanne's house from top to bottom. Meanwhile, Dan was happy about the new baby in the family—Jeanne's husband, Justin, has been Dan's best friend since high school—but still wasn't inspired to start his own family. Babies, it seemed, changed everything.

He was right, of course, but as his own mom points out, it's that way for everyone. "The day Dan was born—not the day I found out I was pregnant—was the day my life changed," she says. No one can imagine life without Robbie now, least of all Jen: "When he was born, I was overwhelmed, but I loved him from the start."

The Wests feel their good fortune extends beyond Robbie's presence and good health. "It isn't until something unexpected happens that you realize how important you are to people," Jen says of the support she's gotten from family, friends and coworkers. They not only pitched in from day one but gave the couple what they needed most: reassurance that despite the rather unusual nature of Robbie's birth, Jen and Dan weren't nuts, and that they're still smart, caring, good parents. But that doesn't mean they're taking any chances for next time around. As West says, "I think I'll be taking a pregnancy test every month for the rest of my life!"


Wednesday, August 05, 2015

In early June, I received this rather terse SMS from someone:

“had a terrible day! was with a girl this morning and discovered her breasts had milk or something. she denied having a baby. i am scared!”

As many of my friends are in the habit of playing pranks on me (some of them no doubt returning favors similar to the ones I had previously done them), I decided that this was another prank and therefore thought nothing about it until, several text messages and phone calls later, I realized the dude was serious about being scared - of his girlfriend’s milk-making!!! 

I have just evaluated another patient this afternoon for a similar complaint. 

Between that SMS and today, I have seen at least 12 patients with the same problem - they are not breastfeeding mothers, yet their breasts are making (and oozing) milk. So yea, this deserves a post.

We think nothing of breastfeeding mothers. It is absolutely normal for a woman who has a child suckling at her breast to be able to discharge from that breast something that rewards the child for its suckling efforts, yea? However, we are worried when we manipulate our breasts - or breasts that, for whatever reason, we feel somewhat entitled to, albeit temporarily - and get for our efforts, nipples discharging fluid rather than nipples stiffening in bothers us because it is not the normal response that we are used to or that we have come to expect. It also bothers us because a lot of people have told us about breast lumps, breast cancers, and the like.

Well, that condition - the one where an adult non-pregnant female who is not breastfeeding, (whether she be in her reproductive years or long past them), has a milky discharge coming from her nipples, either of their own accord, or when someone manipulates them - that condition is called galactorrhea (or, in Britspell, galactorrhoea). 

Although I have specifically mentioned women in this definition, it may also occur in men. It may also occur in newborns, but that is usually because of a hormonal abnormality in the mother during her pregnancy.

Why does this condition occur?

Well, quite frankly, there are a number of things that may cause this. Sometimes, it may be possible to determine the cause, at other times not.

A lot of times however, the condition results when your body produces too much of the hormone that controls milk production when you have a baby. That hormone is called prolactin.

Now, why would your body just decide to go on a prolactin production bazaar? What could be responsible?
  1. If you take cocaine or some other drugs like opioids, some antidepressants , or certain anti-kolo drugs among others, those may be responsible.
  2. Certain herbal concoctions cause increased prolactin levels.
  3. If you are taking oral contraceptive pills, be aware that some of them may be responsible.
  4. If your brain has a kind of tumor called a pituitary tumor, that tumor may be producing high levels of prolactin which will lead to that milky breast discharge.
There are other reasons you may begin to notice a milky breast discharge, including:

  1. use of certain medications against hypertension.
  2. excessive breast stimulation by you or by your sexual partner(s) as part of foreplay.
  3. excessive nipple manipulation during overzealous breast self-examinations.
  4. the existence of a protracted kidney disease or of some diseases of the thyroid gland (the thyroid gland is a gland in the neck).
  5. certain types of chest injuries as well as some spinal cord injuries.
Sometimes, in addition to the discharge from the breasts (it may affect either or both breasts), you may notice a headache. Your menstrual periods may or may not be affected - but you will not know for sure if your periods are affected and to what extent if you have the bad habit of not keeping a calendar!!!

What to do?

You should see a gynecologist. 

Before going to the gynecologist, however, 

  1. take some time to look carefully at the discharge. You are looking to confirm that the discharge is all milk and no blood; note that it should be more important to you that there is no blood in the discharge than that it is all milk.
  2. Note when the discharge started. Doctors just love to ask “when did this start?”. Humor them. They are not babalawos. If they were, you wouldn’t be wearing your shoes in their office.
  3. Note any and all other symptoms you have, even if you think they are unrelated to this particular complaint. What you think and what the doctor knows to be the case may be very, very different.
  4. Note the date of your last menstrual period and the date of the one before that and the one before that. Note also any changes in your period since you noticed the discharge. By changes I mean things like whether the flow is heavier, whether it is more or less painful than usual, you know, stuff like that.
  1. Run a pregnancy test if you can. (You actually can).
  2. Note all the medications you had taken before you noticed the discharge (and this includes all the herbals you have taken). If you had taken any medications after noticing the discharge, please note them too.
  3. Oh, and puhleeeeaaaase, keep a menstrual calendar. You may not learn to do so from watching the Kardashians but then...
Sometimes, you cannot get to see a gynecologist as soon as you would like to. In cases like that,
  1. adopt other methods of foreplay. Just leave the breasts alone.
  2. stop traumatizing your breasts in the name of breast self-exams. Be more gentle in checking for lumps and so on. And perform those self-exams no more than once a month.
  3. ease up on the cocaine, if you can. You may no longer get your highs, but then, there will also be no spilled milk to cry over.
  4. get and use breast pads - especially if the discharge flows out even when you don’t squeeze. That way, you will not have to explain the cause of the embarrassing wetness that could appear on your clothes.

In fewer words,

If you have a breast discharge, or you notice that someone you care for has a breast discharge, examine the discharge. If it is clear, yellowish, or bloody, please check for any breast lumps and urgently see a doctor. It may be a sign of an underlying breast cancer. If it is milky however, it may not be cancerous, but you need to see a doctor all the same.

If you see a gynecologist and he examines you and conducts tests for you and determines that the breast discharge is nothing for you to worry about, then please quit worrying. Your worry will neither reduce the milkiness of the discharge nor its quantity.


Medicine | Health | Wellness

Tuesday, August 04, 2015
By Adam Eley

In July 1978 Louise Brown was hailed as the world's first "test-tube baby", born through the fertility treatment IVF. But how does her story compare with modern procedures?

"On the day I was born, my mum had to be taken to the operating theatre for her Caesarean section in pitch darkness, with just a torchlight showing the way," Louise Brown explains.

"Only a few staff knew who she was, and my parents didn't want others realising her identity and tipping off the newspapers."

Louise's birth was cloaked in secrecy. Even her father John's first visit to see her in Oldham General Hospital was under the eye of police officers, who lined the corridor outside.

The reason was that his daughter, from Bristol, had become the world's first "test-tube baby", as the press hailed her.

More accurately, she was the first to be born through in-vitro fertilisation (IVF), a process in which an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory, before being implanted into the uterus.

It is a treatment used to enable couples with a range of fertility problems to conceive a child, and now allows same-sex couples and single mothers to have children too.

Technological advancements mean - according to 2013 estimates - more than five million people worldwide have been born through this process.

But in 1978 it was highly experimental, and Dr Mike Macnamee, chief executive at the world's first IVF clinic - Bourn Hall in Cambridge - believes Louise "really was a miracle".

The two men who pioneered the treatment - gynaecologist Patrick Steptoe and Nobel Prize-winning physiologist Robert Edwards - "had gone through hundreds of embryo transfers before Louise was conceived", he adds.

The pair had joined forces a full 10 years earlier, with skills that perfectly complemented one another - Edwards having developed a way to fertilise human eggs within the laboratory and Steptoe having devised a method for obtaining the eggs from the ovaries.

When Louise's mother Lesley was put in contact with Steptoe by her doctor, she was warned there was a "one in a million" chance of success.

So when it worked, it was such a momentous scientific advancement that the birth had to be filmed - under agreement with the overnment - to give documented evidence that Louise was indeed her mother's.

Even before her mother was able to hold her newborn, Louise had undergone around 60 different tests to ensure she was "normal".

This is a far cry from modern procedures, which - owing much to the work of Bourn Hall in the 1980s - follow a refined and well-established clinical process.

"Once they [Steptoe and Edwards] worked out how to fertilise the egg, they very soon wanted to restrict the number of embryos they transferred into women - so they didn't have too many multiple births," Dr Macnamee explains.

"Development of the freezing technique in the mid-80s meant they could implant one or two embryos [into the would-be mother] and then freeze other embryos for future use, saving her the uncomfortable procedure of having the eggs removed again."

Progress can also be seen in the modern use of ultrasound imaging to harvest the eggs under a mild sedation, rather than the form of keyhole surgery known as laparoscopy that was previously employed.

Techniques developed in the late 1980s also made a big difference in treating male infertility by injecting single sperm directly into the egg.

These, and other, small incremental steps mean the success rate for each round of IVF has grown from 10% to 40% since the early 80s, when Dr Macnamee's first role included the hands-on task of mixing the eggs and sperm in a petri dish.

The chances of successfully conceiving through IVF decline with age, but the process is now more effective per cycle than natural reproduction. It does not, however, have approval from all quarters.

In November, Pope Francis said the process promoted children as "a right rather than a gift to welcome" and was "playing with life".

Yet in August 1978, Cardinal Albino Luciani - shortly to become Pope John Paul I - unexpectedly refused to criticise Louise's parents for using IVF, saying they had simply wanted to have a baby.

"It helped to counteract some of the negative things people were saying," Louise says.

"My mum got loads of letters from people. They were mostly positive, but there was some hate mail.

"They got an awful box from America which had a broken test-tube, fake blood and a pretend foetus inside. It came with a threat that the people who sent it were coming to see them."

Despite such isolated incidents, Louise - who conceived her two sons naturally - sees it as a privilege to have been the first person born through IVF.

"My mum and dad have had lots of people say that if it wasn't for them, they would never have been able to have children," she says.

Dr Macnamee thinks the chances of women conceiving through IVF will only increase in future - and says he hopes to see a 60% success rate in IVF cycles before he retires.

One prominent area of research is aimed at exploring the way in which embryos interact with the lining of the womb when they are implanted.

Many believe it is when the two fail to engage with each other that the IVF cycle can prove unsuccessful.

Progress is slow - as there is no model to undertake tests in the lab - but workers believe this line of research could be key.

This post was culled from the BBC, where it first appeared on July 23, 2015.


Medicine | Health | Wellness

Friday, July 31, 2015
This morning, I read an article which broke news of something researchers have discovered that could bring us closer to a cure for HIV. 

Shoro niyen abi? 

We have read so many such articles over the past many years; too many times we have been brought “a step closer” to a cure for HIV without being any the closer to any sort of cure. 

This BBC article is shaa different. Somehow. 

It tells of how researchers have shown in a study published in PLoS Pathogens that HIV can be “flushed out of its hiding places in the body” using a certain cancer drug. Yesso. There is this drug that is used to prevent cancer in sun-damaged skin; now, a component of it – called ingenol mebutate or PEP005 – is thought to be potentially useful in the struggle to find a cure for HIV. 

Let me tell you a short story about HIV, a story that will avoid the usual talk about how you can get infected (or infect others) and instead talk about how it behaves after it has established a military garrison inside your body. 
The HIV virus

You see, HIV is an expert at 21st century warfare. It fights hard and it fights dirty. It launches into an all-out shock-and-awe shooting campaign after it has spent several years using guerilla (hit-and-run) tactics to progressively wear down the body’s defences. 

The “hit” part of the tactics is well-known to doctors, nurses, and those gloved, needle-wielding, laboratory scientists who take your blood and perform your HIV test and then, with faces as bland as the word itself, write the result on a piece of paper, put that in an envelope, send it to a counselor who then calls you and, rather than tell you the result you are desperate to hear, launches into a lengthy sermon about abstinence from sex, faithfulness to one uninfected partner, and correct, consistent use of condoms. Yea. They all know the “hit” part, because that is the part that begins to give you symptoms. That is the part that makes you have that diarrhea that never stops, or to begin to have that mild cough that, for some reason, refuses to go away despite all the Septrins, Erythromycins, Augmentins, “miksierem ogwus”, and Aboniki balm-flavoured steam inhalations. It is also the hit part that ensures the virus is detected in blood when you run that test whose results they seem to take forever to tell you (sort of like how they behave when you go for a pregnancy test at a time when you hope you are anything BUT pregnant). 

But there is also the “run” part of the “hit-and-run”; the part where the virus evades attack by your body’s natural defences. 

Under normal circumstances, your body routinely fights against foreign invaders. Sometimes, it appears to enjoy those fights sef; those fights – which it turns into service drills – enable it to ensure that its white-blood-coat soldiers are kept “in form”, and that military equipment like “the complement system” are readily available and updated to meet new challenges; these drills ensure that subsequent challenges from enemies like chicken pox and tuberculosis are summarily dealt with, without you even being aware of it, and without your having to send a plane-load of cash to South Africa for purchase of equipment. 

HIV seems to be adept at avoiding your soldiers’ fire and merciless at destroying your military hardware. It penetrates your Defence Headquarters and compromises the military software too (that one you guys call DNA, abi?), at which point your body becomes its (and your) own enemy, generating more HIV cells instead of generating more soldiers to fight the HIV. Ya Allah, HIV is as devious as it is methodical. 

And more, it is forward-looking. It plans for the rainy day. It doesn’t just go taking and spending money from the Excess Crude Account without making provision for the occurrence of an unforeseen economic downturn, you get my drift? Yea, HIV “hides” copies of itself in areas of the body where it is very, very difficult or near impossible for drugs to reach in enough amounts to be useful. So, in the event of a rainy day when you finally get a drug that comes into your body and destroys all the viruses in your blood and clears them like President Obasanjo cleared Odi, Bayelsa, there are copies of the virus safely hidden away which can continue the missionary work of destruction once the drug’s job is done and the drug is gone. 

Which is why this news from the BBC is such cheery news. If indeed a drug is discovered which, in safe doses, is able to reactivate latent HIV and allow for the subsequent total elimination of the virus, which is in effect able to smoke HIV cells out from whatever holes they may be hiding in, then perhaps, perhaps…


Medicine | Health | Wellness

Suheir Kilani | | Monday, May 25, 2015
Finding out that you have been diagnosed with gestational diabetes can be a frightening experience for a pregnant woman, especially if you haven’t had diabetes or other medical conditions prior to your pregnancy. Fortunately, gestational diabetes is a condition that can be easily diagnosed and treated, and you can still experience a healthy pregnancy and deliver a healthy child. When you visit your doctor, he or she will discuss the various treatment options listed below that will help you maintain a healthy blood sugar level throughout your pregnancy.


You should adopt a schedule of self-monitoring to keep track of your blood sugar levels and any changes that may be potentially threatening to you and your child. Self-monitoring will make you more aware of changes and what may have precipitated the change, such as consuming certain foods or making changes to your lifestyle.

Dietary Modifications

The primary method of controlling your blood glucose during pregnancy is through changes to your diet. Your doctor can recommend a variety of foods that will regulate your blood sugar and minimize the potential risks associated with gestational diabetes.

Quitting Smoking

Smokers can minimize the risk of developing gestational diabetes by quitting smoking during pregnancy.


While there has been no definitive evidence that moderate exercise during pregnancy can assist in maintaining healthy blood sugar levels, many doctors and medical professionals will recommend a regular fitness routine to improve your health and assist you in ensuring a healthy pregnancy.

By adding the lifestyle modifications listed here to your regular routine, you will be able to minimize the risks associated with gestational diabetes and maintain control of your blood sugar levels. These steps, along with others recommended by your physician, can help to ensure that you deliver a healthy baby.


Medicine | Health | Wellness

Monday, May 04, 2015
I had been writing something else until a few short days ago, when someone re-shared a post to a WhatsApp community to which I belong. The inaccuracies I saw in that post compelled me to jettison my earlier draft and instead undertake a clarification of the issues raised in that post. In order to reduce the length of this post, I have only quoted selected portions of the "offending post" relevant to my rejoinder.


IT MEANS NOT EATING FRUITS AFTER YOUR MEALS! FRUITS SHOULD BE EATEN ON AN EMPTY STOMACH. If you eat fruit like that, it will play a major role to detoxify your system, supplying you with a great deal of energy for weight loss and other life activities.
FRUIT IS THE MOST IMPORTANT FOOD. Let's say you eat two slices of bread and then a slice of fruit. The slice of fruit is ready to go straight through the stomach into the intestines, but it is prevented from doing so. In the meantime the whole meal rots and ferments and turns to acid. The minute the fruit comes into contact with the food in the stomach and digestive juices, the entire mass of food begins to spoil.....So please eat your fruits on an empty stomach or before your meals! ...The fruit mixes with the putrefying other food and produces gas and hence you will bloat! Greying hair, balding, nervous outburst and dark circles under the eyes all these will NOT happen if you take fruits on an empty stomach...If you have mastered the correct way of eating fruits, you have the Secret of beauty, longevity, health, energy, happiness and normal weight...Just eat fruits and drink fruit juice throughout the 3 days and you will be surprised when your friends tell you how radiant you look!

There is no documented hard evidence that cancers can be cured simply by adhering to a prescribed timing of fruit consumption. Nor is there any reason to believe that eating fruits on an empty stomach will send the cancers packing. If that were the case, no one would be dying from cancers today; instead we would probably be having non-governmental organizations (NGOs) dedicated to the preservation of fruit trees from the onslaught of a human population eager to obliterate all of its cancers. Fruit trees of all kinds would have become endangered species and genetic engineering would have had a much larger segment of it dedicated to fruits. That people are still dying from cancers today tells a story; that mangoes and cucumbers and pineapples are cheaper than a litre of petrol on our streets tells the same story; that story is that the assertion that eating fruits on an empty stomach cures cancers is a steaming broth of concentrated and unadulterated nonsense.

Then there are those rotten parts of this sordid piece of work that aver inter alia that:
“the whole meal rots and ferments and turns to acid. The minute the fruit comes into contact with the food in the stomach and digestive juices, the entire mass of food begins to spoil…The fruit mixes with the putrefying other food and produces gas and hence you will bloat!”

The process of digestion which occurs in our stomachs and other parts of our digestive tract ensures that, among other things, all food that is eaten is thoroughly mixed - all food, without bias to food class - and this mixture is made with hydrochloric acid and a number of other digestive juices. The food is so thoroughly mixed and so continually in motion as to make it quite impossible for any rot, spoilage, or putrefaction to be even remotely possible.

Eat your fruits, as much as you can, when you can, how you can, where you can, because you can. 


Drinking Cold water after a meal = Cancer!

Can you believe this?? For those who like to drink cold water, this article is applicable to you.  The cold water will solidify the oily stuff that you have just consumed. It will slow down the digestion. Once this 'sludge' reacts with the acid, it will break down and be absorbed by the intestine faster than the solid food. It will line the intestine. Very soon, this will turn into fats and lead to cancer. It is best to drink hot soup or warm water after a meal.

This is essentially beautifully packaged nonsense. Your body has internal mechanisms that help it to self-regulate its own temperature at all times. When you take in cold water, those mechanisms begin to warm it up, and within a few minutes, the temperature of the “cold” water is brought to par with the core body temperature. In fact, it actually appears that the ingestion of cold water leads to a burning of calories as the body works to equilibrate the water temperature with its core temperature. That burning of calories is good, not bad. The temperature of the food you eat is not necessarily affected by the temperature of the water you drink since all temperatures are made to equilibrate with core body temperature in a matter of minutes.

It is hilarious how the writer struggles to tie cold water with cancer causation all in a bid to justify the recommendation to drink warm water or hot soup after a meal. Suffice it to say that intestines “lined with fats” are a sign of cancer, not a cause of cancer. They tell you that there is a cancerous process already on-going; they do not necessarily lead to the beginning of a cancerous process.

It is probably more sensible to advocate that people include more fruits and vegetables into their diet. This will increase the intestinal transit time (think of it as the speed with which food moves through the intestine and out of the body) and so make the accumulation of cancer-causing agents less likely.

For avoidance of doubt, cancers arise when the part of a body cell that is responsible for making copies of itself undergoes an abnormal change leading to uncontrolled release of abnormal copies of that cell. These abnormal copies eventually crowd out their normal equivalents. The excessive amounts of energy that are used for making these cell copies are responsible for the weight loss that accompany nearly all cancers.

Cancers do not arise simply because one chooses to take cold water or warm water after a meal.


Women should know that not every heart attack symptom is going to be the left arm hurting. Be aware of intense pain in the jaw line. You may never have the first chest pain during the course of a heart attack. Nausea and intense sweating are also common symptoms. Sixty percent of people who have a heart attack while they are asleep do not wake up. Pain in the jaw can wake you from sound sleep. Let's be careful and be aware. The more we know the better chance we could survive.

The information contained in this segment has a tolerable level of accuracy; however, its coherence is questionable. Its apparent insinuation that heart attacks are a problem exclusive to women is erroneous. Heart attacks can happen to anyone who has a heart.

For the avoidance of doubt, where jaw pain is a symptom of a heart attack, it typically accompanies other symptoms which may include:

  • an uncomfortable squeezing or painful sensation in your chest which may last for more than just a few minutes
  • moderate to severe chest pains which may extend to the left arm, the shoulders, the neck, or the jaw
  • light-headedness
  • nausea
  • excessive sweating (which is unexplained by activity)
  • shortness of breath
  • nervousness
  • cold or clammy skin
  • irregularities in the heart rate (you may notice that the rhythm of your heartbeat may...well...not have any rhythm at all)
It is important to state that all these symptoms will not necessarily always occur in the same patient. It is not mandatory that all of these symptoms be present before one realizes that he or she is in heart failure. Once you have one or more of these signs, seek expert medical help.

A heart attack can happen to anyone who has a heart. Once you have any of the listed symptoms, seek expert medical help.


Medicine | Health | Wellness

Tuesday, April 28, 2015

When I came across this picture online, I burst into a long bout of hearty (and maybe even raucous) laughter - a reaction I think the writer must have intended to provoke. It did not help any that the notice, in addition to pointing out what the toilet floors were not designed to handle, went further to allude to the prohibitive cost of "professional" removal of semen stains on the floor, and then advised readers on what to do when they got bored. Hilarious!

At first.

Then that got me thinking.

Sometimes, in the course of our fertility consultations, we encounter people - guys and babes alike - who worry that they masturbate too often. Especially among menfolk of all age groups, there seems to be this nagging uncertainty about the health impact of their hands getting all too busy down there all too often - usually when the girls are not looking. By “too often”, some of these men mean they masturbate two to four times a month, others mean getting down and creamy one to two times a day.

My take is that neither of these frequencies is outside normal limits. As such, these men do not have anything to worry about. Masturbating a few times every day is not exactly harmful, in itself. In fact, if facts are to be believed, then it is instructive that a 2003 study in Australia found that men who ejaculated more than five times a week were a third less likely than their peers to develop prostate cancer. Of course, such a frequency of ejaculation can be attained by sexual intercourse too - but that comes with its own risk of sexually transmitted infections.

So while regularly getting busy with your hands may not be expressly harmful for you, there is something else that could. If your masturbation interferes with your normal life by getting in the way of your schoolwork, your work, your sexual and other relationships, then you are in need of the services of a sex therapist. As conventional sex therapists are not exactly commonplace sights in Nigeria, you may wish to settle for an assessment by a psychologist working in conjunction with a gynaecologist who is a fertility specialist.

In summary, it is not the frequency of your masturbation that could affect you negatively. It is how much your masturbation gets in the way of your normal life that could become a problem. If, as per the notice above, you have to leave school and go home to masturbate, well, that would be you qualifying to be labelled an addict to masturbation. As with an addiction to drugs, an addiction to masturbation feeds on itself to the detriment of the sufferer. But that is what happens when masturbation goes from recreation through preoccupation to obsession.

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