FLYING WITHOUT WINGS

The 100^th operation in 2015

The lucky chap, a man

Married to a lovely woman

Yes, his wife is a woman!

Our man had a story to tell

Of course, it turned out usual

Headaches diagnosed as malaria

Yes, it’s always malaria!

Roaming doctor to doctor

One hospital to the other

And a pastor sandwiched

Yes, always in between!

The penny dropped late

He started walking funny

And collapsed in the house

Yes, it’s in his head!

A big tumour to boot

Pressing the brain

Blocking the fluid

Yes, an MRI is gold!

And so he came

A sorry sight to see

Tumour in a dangerous area

Yes, surgery the only cure!

The major question

Can it be done?

Here in Nigeria?

Yes, and with paper money!

For Nigerians want the best

Yet, fail to provide

Always looking for cheap

Yet, expecting the best!

The tumour is growing

More brain to damage

So, we need to hurry

Yes, to theatre we go

A spectacle to behold

A brain being strangled

By a perilous tumour

Yes, a killer for sure!

This particular tumour

Deserves respect

With gadgets and gizmos

Special instruments and monitors

Yet, we have none!

Still, a job to be done

And done well for sure

So we brought many cooks

Yet, not to spoil the broth!

More eyes better than one

More hands too for sure

For all hands on deck

Yes, flying to the Promised Land

Remove the whole tumour

Without removing brain

Clear the path

Free the brain

Yes, a tough nut to crack!

But, we managed

With skill and guile

A strong constitution

Yes, with Red bull for sure!

For this was a flight

To the Promised Land

With a wing and a prayer

Yes, perhaps just the prayer!

For we were flying

But without wings

Though flying for sure

Yes, feet firmly on ground!

And survived he did

With little more than

A bad headache

Yes, close shaves for sure!

For we are brain surgeons

Not barbers

And this an occasion

Not a beauty pageant

Yes, a real job for sure!

100^th operation!

A success to say

At least in the short term

For many rivers to cross

Yes, rivers still ahead

Radiotherapy

Chemotherapy

Adjuvant treatment

Yes, real money to spend

Patients with brain tumours

Deserve more in Nigeria

They need more

Than just a crazy hair cut

Yes, not barbers for sure

So, a job for government

Of that we are sure

As we cannot continue this way

Feet on the ground

Flying without wings!

NB: The operation was performed by a crack team of doctors, nurses and cleaners made in Nigeria. Not a single white skin in sight, unless you consider the scrub nurse speaking phonetics during surgery!

TETANUS The smiling assasin

It is fine if you have never heard of tetanus. But, if you are a farmer, have family who farm, work with soil, and work as a builder perhaps, or involved in a road traffic accident, you should know about tetanus. Have you ever had a nail puncture your foot or cut your nails with a rusty blade? Regardless, you should know about tetanus. As my father would say, ‘No knowledge is lost’.

Tetanus

Tetanus, also known as lockjaw, is an infection characterized by muscle spasms. It pulls the lips and face back in spasm, exposing the teeth in a deathly smile. Tetanus is the smiling assassin.

Tetanus is caused by an infection with a germ, commonly found in soil, dust and manure. Tetanus occurs in all parts of the world in the soil and in animal and human intestines. It is most frequent in hot and wet climates where the soil contains a lot of organic matter. The germ, a bacterium called Clostridium tetani, generally enters through a break in the skin such as a scratch, cut or puncture wound. The tetanus bacteria often enter the body through wounds, which can be caused by nails, splinters, insect bites, burns, any skin break, and drug injection sites.

The tetanus germ multiplies in a contaminated wound especially inside deep wounds or those with dead tissue. Puncture wounds are therefore favorite locations of entry for the bacteria. The commonest story is that someone steps on a rusty nail and it leads to infection with this horrible germ. Tetanus can also be a hazard to both the mother and newborn child (by means of the uterus after delivery and through the umbilical cord stump). It is important to cut the umbilical cord with clean and uncontaminated instrument.

The poison

The germ when in the body then produces toxins. The potent toxin that is produced when the tetanus bacteria multiply is the major cause of harm from tetanus. The particular toxins are essentially poisons that interfere with muscle contractions, resulting in the symptoms.

Typically, the infection starts a few days to about 3 weeks after the injury. In many situations, the original wound may have even healed and be forgotten about. Diagnosis is based on the presenting signs and symptoms.

The symptoms of tetanus begin with spasms in the jaw and then progress to the rest of the body. These spasms usually last a few minutes each time and occur frequently for three to four weeks. Spasms may be so severe that the body is bent into awkward positions and bones snap. Other symptoms may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate.

Smiling to death

Tetanus can make you pretty sick and render you at high risk of death. The spasms affect the muscles for swallowing and breathing requiring intensive care in some situations. In fact, without the appropriate treatment and supportive care, people die. Generally, about 10% of those infected die. For those who survive, it may take months to recover from the disease and be back to normal or near normal. It is important to know that the disease does not spread between people and you cannot catch it from someone else.

Prevention

Infection can be prevented by proper immunization with the tetanus vaccine. The vaccine is highly effective, widely available and everyone should be vaccinated against tetanus. Three doses of the vaccine are required to provide adequate and long lasting protection. People with a significant wound and especially following a road traffic accident should be given the vaccine.

Treatment

General measures to treat the sources of the bacterial infection with antibiotics and drainage of pus in the wound are carried out in the hospital. The wound should be cleaned and any dead tissue removed. Patients are also routinely treated with specific antibiotics to kill the germs and prevent them from multiplying and hence developing the toxin.

Other treatment is directed toward stopping toxin production, neutralizing its effects, and controlling muscle spasms. Sedation is often given for muscle spasm, which can lead to life-threatening breathing difficulty. The patient is monitored for any signs of compromised breathing muscles. Management in intensive care to help the patient breath may be necessary and life saving. Mechanical ventilation may be required if a person's breathing is affected. In more severe cases, breathing assistance with an artificial respirator machine may be needed.

In those who have a significant wound and less than three doses of the vaccine both immunization and tetanus immune globulin are recommended. In those who are infected tetanus immune globulin or if not available intravenous immunoglobulin (IVIG) is used. Muscle relaxants can be used to control spasms.

The toxin already circulating in the body is neutralized with antitoxin drugs. The tetanus toxin causes no permanent damage to the nervous system after the patient recovers. After recovery, patients still require active immunization because having the tetanus disease does not provide natural immunization against a repeat episode.

Now, you know! So, go and get vaccinated.

NB: The Annual General Meeting of the Association of Private General Practitioners of Nigeria will hold in Abuja in April 2016. We are talking about ‘Communicable Disease’ such as Malaria, HIV and Tuberculosis. Other important topics are cancer screening and medical missions. If this is your forte, then please be part of the process. Call or email me.

Big stomachs and big bottoms

Abujalicious at Christmas

Christmas is coming

Christmas is coming

Papa, buy shoes for me!

Oh mama, buy shoes for me!

But, the real question is, ‘Where will you go in those shoes?’

So, with pleasure, we bring to you the very best places to eat, drink and shop in Abuja this Christmas. These are the places to be and the places to be seen at in Abuja.

It is Abujalicious at Christmas!

Dominoes Pizza and Creamery

This fancy new place on Aminu Kano is a delight for sure. It is certainly worthy of being the first to mention in this article. A playful setting with intermittent singing by the staff! The pizzas are delicious especially the BBQ chicken, my favourite. Really, some people should be banned from going there too. I will tell the company to put a weighing scale by the front door so that anyone above 100kg is not allowed in. Doctor’s orders!

Sawadee

Just behind Dominoes is this hidden gem. They say they have been in operation for 5 years so what a well guarded secret! Well, guess what, we have just let the cat out of the bag! This is by far the only and the very best Thai food restaurant on the block. First time I went was when the Mansag crew were visiting Nigeria. Mansag is Medical Association of Nigerians Across Great Britain. They set up a fancy banquet full of ‘mede mede’ and other savoury stuff fit for kings. Well, if Mansag can go there, so can you!

Pan Asian Restaurant

The Pan Asian restaurant inside Ibeto Hotel on David Ejoor Street in Apo is not a pretender. For some restaurants pretend to be what they are not, especially with foreign food. What you see is real and authentic Asian food. It assaults the palate and tickles your taste buds with a million and one spices fighting to be released. The choices are numerous and I am having a great time going through the menu: one meal, one page, at a time.

The pool side bar and BBQ restaurant

This place is also in Ibeto and well worthy of mention in its own right. The ambience is cool with reflective lights and a cool shade under the shadow of the beautiful hotel. Go in the evening from 7 pm, order fresh fish grilled to perfection, a bottle of Medium sweet white wine (ask especially for Portell) and then relax listening to the live band. If you are an extrovert, join in the singing and dance like a top. After all, it’s Christmas and a time of joy and happiness.

Talking Pool sides?

The Suya bar at Transcorp and the whole of the pool side reverie has been transformed into a fabulous place for sundowners. Just fantastic what a little reorganisation with vision, style and class can do. The team at Transcorp got this one perfect and I would recommend a visit. This is by far the classiest pool side in Abuja, if not in the whole country. Pity it is adorned by so many pretty women: tall, short, white, black and Asian too. No, I have not been there. My wife wouldn’t let me.

Shoprite

Okay, what’s in a store? Just everything! The shops are springing up everywhere and even at Jabi Lake in Abuja for sure. The shops deserve recommendation as a place to hang out and just trip, shop, relax, feed the eyes and eat some great snacks. Why are our airports not this good? I hate Shoprite with a passion. But, the only reason I hate them is out of jealousy! Why on earth does it have to be a South African business?

The Tulip Bistro

This is one fine establishment in Wuse. They have spent time on creating a pleasant and pretty eye pleasing interior decor. If you want to impress someone, then this is the place to go. There are many corners where you can be almost alone and have a heart to heart conversation. Otherwise you can sit with the in crowd and watch great music videos on the big screen. The food can be good too if you can wait for it to arrive. Perhaps they cook it on a ‘sloooow’ stove! Try the salmon and the soft, delicious, super mashed potatoes.

Spice

This hideaway is in front of Bolton White Hotel, in Garki. I went here with a group of medics for a dinner buffet. It was worth a visit with a friendly owner and good Indian food. The only pity is that the place has pretty basic decoration. It reminds you of a ‘waiting room in a railway station’, although it would be so easy to do up the place. If you don’t care much about decor but just good food at a reasonable price, then visit Spice.

BluCabana

A great place fit for your lifestyle. There is a pool for swimming, a gym for exercise, lots’ of smokers for destroying your lungs and yes, heavenly food. The whole atmosphere is fab and decadent at the right price for a guy like you. Just take me along! After all, what are friends for? Learn to share food with friends so you can live long!

So there you have it.

Where is it going to be or will you visit all of them?

Do write me a note on your experiences.