Health Essentials
Fibroid… Threat to female reproductive health
“It is not my time of the month, what is wrong with me,” was the question Setriakor (not her real name) asked herself as she looks at her blood stained dress.
As the days went, the flow was heavier with thick dark clots, for which her usual pad could not sustain. She later resorted to the use of diapers. That also failed to absorb the amount of blood and clots ‘gushing out.’
She dares not laugh, cough or do any strenuous activity, lest her dress will be soiled, wherever she finds herself.
Setriakor, a 36-year old Scripter, looked pale and found it difficult to work for a number of weeks.
She decided to visit a local Chemist to explain her ordeal. In the end, a blood tonic was prescribed for her with the hope to replenish the lost blood.
He also advised her to visit the hospital to see a doctor.
Her visit to the health facility the following week ended up with the gynaecologist who performed a scan on her. The results of the scan revealed she had multiple fibroids.
Suddenly, all the stories she had heard about fibroid began racing through her mind. It took a lot of counselling from the gynaecologist to calm her down.
This is the challenge most young and adult women go through with some either losing their uterus or life in the process due to delay in seeking medical attention.
Fibroid, is non-cancerous growth that develops in or around the womb or uterus. The growth or growths are made up of muscle and fibrous tissue. They vary in size.
Many women are unaware they have fibroids because they do not have any symptoms.
Women who do have symptoms of fibroid are likely to experience heavy or painful periods, abdominal pains, lower back pain, frequent urge to urinate, constipation and pain or discomfort during sex.
Women who are diagnosed of fibroid often undergo hysterectomy in order to have it removed.
Most women of African-Carribean origin tend to develop fibroids more frequently and are common with around one in three women.
Types
The Chief Executive Officer of Ladybits Health and Wellness Clinic, Dr Victoria Partey-Newman in an interview with The Spectator said there were four types of fibroids which can occur in women.
The types, she said, were intramural, subserosal, submucosal and pendunculated fibroids.
She explained that intramural fibroids occur in the wall of the uterus. This type of fibroid grows quite large.
Subserosal fibroids grow outside the uterus and may press on other organs of the pelvic area.
Submucosal fibroids grow beneath the lining of the uterus and grow into the uterine cavity which is the central part of the uterus.
“Submucosal fibroids can make it harder for one’s uterus to support conception and maintain pregnancy,” Dr Partey-Newman stated.
According to her, submucosal fibroids are most likely to cause painful cramping as well as bleeding between periods.
Pedunculated fibroids are mushroom-like and grows at the end of small stalks within or outside of the uterus. When the stalk of a pedunculated fibroid become twisted, it can cause intense pain.
The uterine fibroids, however, are the most common tumour in women and very prevalent in infertility issues.
Infertility
Dr Partey-Newman said fibroids could be the sole cause of infertility in two to three per cent of women but the exact cause is unknown. It has often been linked to the hormone oestrogen.
Oestrogen is the female reproductive hormone produced by the ovaries.
Dr Partey-Newman said fibroids most often develop between the start of puberty and menopause, adding that the risk increases with age.
According to her, having a family member with fibroids could increase one’s risk of having it but said “you should not discount the symptoms simply because you do not have a family member with fibroids.”
She said fibroids cannot be prevented but can reduce risk by maintaining a healthy body weight and have a regular pelvic examinations.
Treatment
Dr Partey-Newman said surgery was not the only option for the treatment of fibroids.
They can be treated with medication.
Currently, Gonadotrophin-releasing hormone (GnRH) agonists and selective progesterone receptor modulators (SPRMs) are the most effective medical therapies with the most evidence to support the reduction of fibroid volume in menstrual bleeding.
Another way to treat fibroid was uterine fibroid embolisation which is done by cutting off blood supply to the fibroids. That causes them to shrink.
Dr Partey-Newman, however, said “if symptoms do not improve with medication or nonsurgical treatment, or if the gynaecologist suspects fibroids may be causing infertility, surgery may be the next treatment option.
“The goal of surgery may be to relieve pain, reduce menstrual blood flow, or improve fertility.”
Advice
She said since fibroids could reoccur after surgery, it was important for women to quickly get married and start making babies, especially those who have had their fibroids removed.
“In our society, where men are the ones that propose mostly, it somehow makes it difficult for women to marry early and start giving birth.
That contributes in making the fibroids recur again.
She advised women to visit the hospital when they notice changes in their reproductive cycle and urged them to adhere to doctor’s advice when diagnosed of the disease.
She cautioned that women diagnosed of fibroids must avoid herbal concoctions which could affect their kidneys in the long term.
By Jemima Esinam Kuatsinu
This week I bumped into Deborah, one of my avid readers and I promised her I will be writing this weekend. So Deborah, this is for your reading pleasure and to pick some golden nuggets for the future.
The quest to find the best way to make one’s golden years, happy, exciting, healthy and a time most people look forward to continues unabated. One factor that keeps popping up is the need to grow friendships with people more than 20 years younger than yourself.
Do not take this for granted. It is a form of “social security” since these close friends who are much younger than you will step in to support you in more ways than you can ever imagine.
Some conditions may make life challenging for older adults but knowing these Geriatric Giants helps us to take the necessary steps to reduce our risk.
“Geriatric Giants” refers to a group of chronic health conditions that are common in the elderly, typically 65-year-olds and older.
These conditions quite often co-occur and can impact on the independence, dignity and overall wellbeing and quality of life of an elderly person.
These Geriatric Giants include:
- Impaired Intellect/ Memory (e.g. Dementia)
- one of the major battles we need to deal with is challenges with memory
- Exercise, adopt the Mind Diet, build a great social network and enjoy time outdoors
- Keep reading and solving puzzles for as long as possible
- Instability – leading to much feared falls
- A good reason to indulge in Balance Training and Core Strengthening exercises from today
- Ensure your home is safe; avoid clutter such as cables crisscrossing floors, toys etc. These are all trip hazards and should be avoided
- Many healthy, happy and fun-loving older adults have died soon after a fall with its attendant complications.
- Do whatever it takes to avoid falling
- Immobility (opening the doors to pressure sores, joint stiffness)
- Even when you are unable to move about on your own it is important to get support to change positions as often as possible or get an appropriate mattress or bed that prevents prolonged pressure over any single point.
- Make sure you passively or actively move joints daily.
- Incontinence (urine, faeces or both)
- This is one of the reasons older adults prefer to stay at home and avoid going out to meet friends etc.
- Iatrogenic Disorders – adverse effect of medication
- Quite often most older adults are on several medications and some side effects such as drowsiness may seem to cause more unhappiness and may even lead to falls.
- Inappetite – this may result in poor nutrition
- This may also be linked to loss of teeth thus making chewing very difficult or limited.
- The loss of smell and taste may also reduce the amount of food one may willingly eat.
The power to reduce the impact of the Geriatric Giants starts now and should be a lifetime commitment. It is never too early to start making the appropriate lifestyle modifications, nor is it too late to reduce the impact of the giants on one’s life.
Other conditions that significantly impact on the lives especially of the elderly are:
- Sleep Disorders
- Good sleep has the power to give us energy, improve our thought pattern and even helps us to make good choices.
- Good sleep sets the tone for a healthy life
- Constipation
- This is a challenge that confronts quite a number of older adults.
- Movement, fibre and lots of water go a long way to reduce the stress that frequent constipation generates.
- Fraility
- Muscle loss is real and as we age, we lose a significant percentage of our muscle plus our bones also become brittle.
- Make sure strength training is part of your exercise schedule
- Polypharmacy
- Another headache that needs to be confronted head-on
- Everyone especially older adults need a good primary care physician or a general practitioner who can coordinate all medicines from the different Specialists who may be attending to an elderly person. This ensures that unnecessary medicines are dropped
The goal of care at all times is to optimise the quality of life. As family, professional caregivers and friends we should always show respect so that the dignity of the elderly is preserved at all times. For those of us who are not yet in the age group with such challenges, we need to start the conversation about the type of care we will prefer and take steps to stay healthy and independent for as long as possible. The goal should be a long Healthspan and not just a long Lifespan.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “There is no magic formula to being happy but making a conscious effort to be happy goes a long way.” – Dr. Kojo Cobba Essel
By Dr. Kojo Cobba Esse
The call to action
We must move beyond the cycle of temporary outrage. I propose a four-point blueprint for the Ministry of Health and the government:
1. A Digital Bed-Tracking Command Centre: Legally mandate all public and major private hospitals to update a live, digital bed-registry every hour. The NAS must be able to see a vacancy before they move. This must be matched with the available resources and services so that the right patient will be sent to the right facility.
2. Strategic Capacity Expansion: We must stop building “prestige projects” and start building high-volume stabilisation centres. We need a targeted investment to triple the ER bed count in Accra and Kumasi within 24 months. This should then be extended to other regional capitals.
3. Specialised Emergency Hubs: Designate specific hospitals as “Centres of Excellence” for Cardiac and Stroke care (and for other health emergencies), ensuring they have 24/7 imaging and intervention capabilities as well as the requisite expertise to manage these conditions. Policy makers must incentivise public-private partnerships to ensure that a heart attack in Accra or Kumasi can be treated with the same urgency as one in New York.
4. Develop a nationwide trauma system: This is extremely important because trauma is a major cause of deaths in Ghana. In the US, each state has a statewide trauma system with three levels. Level 1 trauma centres are usually University Teaching hospitals that provide comprehensive trauma care and also play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research. Level II trauma centres are expected to provide initial definitive trauma care for a wide range of injuries and injury severity.
Level III centres provide definitive care to patients with mild trauma. Having such systems is imperative to ensure proper treatment of trauma patients.
Even for those who survive trauma, disability is a major assault on economic potential and viability. Importantly all this cannot happen with a cash and carry system. Emergencies should be managed under a different model to save life and limb first. Obviously, there is a need to ensure that healthcare facilities will be able to recover their investments in emergency care, and that balancing act needs careful consideration.
Frontline clinicians are often forced to bear the public’s anger for infrastructure deficits they did not create and cannot fix. This is a failure of governance, not a lack of clinical care. Responsibility lies with the policy makers who manage the nation’s resources.
The “No Bed Syndrome” is a systemic disease. It cannot be cured with a directive from the Ministry of Health, parliament or a lecture on ethics. It requires a blueprint, a budget, and the political will to treat this like the menacing threat it is.
It is safe to say that non-emergent healthcare is excellent in Ghana for the most part if you can afford it. However, emergency care is suboptimal. We had a sitting president die from an emergency health issue and a former vice president also die from an emergency. If that is not enough warning, it is clear that anyone can be a victim of an emergency.
If we do not act, the next ambulance driving aimlessly through the streets of Accra could be carrying anyone, including the very people who have the power to fix this issue.
Prof. Jonathan Laryea is a Professor of Surgery at the University of Arkansas for Medical Sciences in Little Rock. Arkansas. He is board certified in General Surgery, Colorectal Surgery and Clinic Informatics.
He is a graduate of the University of Ghana Medical School (Class of 1997)
