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Health Essentials

Medical challenges that may fall below the radar

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Children

Your Health is Your Responsibility – Take Control!

It is important that we do everything possible within our power to ensure that we stay healthy. Having the appropriate knowledge is very important in our quest to remain healthy so that we can do more of the things we enjoy. Some conditions have a way of escaping our memory and we occasionally need a reminder.

Rhesus

Independence Day is just around the corner and over the past few years I get very anxious in March; when countries are so blessed but we do everything possible to mess up then you really wonder what else we expect of the Almighty.

Let us look at some easy to forget medical conditions and hopefully the engagement will ease my March anxiety.

  1. Pregnancy complications of Rhesus Negative mothers
  2. Bell’s Palsy or Facial Palsy
  3. Post Partum Blues or Depression
  4. Underperformance in school children
  1. Pregnancy complications of Rhesus Negative mothers
    1. This is a potentially serious condition but easy to correct. Could this be the cause of the poor pregnancy outcomes or multiple abortions you are experiencing?
    1. If a woman is Rhesus (Rh) Negative and carrying a baby who is Rh positive, then the mother’s immune system will see the baby’s red blood cells as “foreigners” and will make antibodies to fight and destroy the baby’s red blood cells. This may not be a problem with the first pregnancy but subsequent ones are at risk since the antibodies would have built up significantly.
    1. This process of antibody production could occur when an Rh negative mother has a miscarriage, ectopic pregnancy and induced abortion. It is IMPORTANT to know your blood group – O negative, A negative (and all the ones that are followed by a negative), will need to alert your health care giver when pregnant.
    1. If you are Rh negative, it is important that to protect your babies, you are given an injection called Rhogam (this is no advertisement), which is a type of vaccine. It should ideally be given when your pregnancy is 28 weeks old and then repeated within 72 hours of delivery if baby is Rhesus positive.
    1. There may be some issues with Rhogam but the benefits outweigh the downsides.
  • Bell’s Palsy or Facial Palsy
    • This is not a STROKE but seek immediate medical care since you may not know what it could be heralding. Bell’s palsy is a sudden weakness of the face causing one half to droop. Your smile is one sided and your eye on one side resists closing.
    • It may occur at any age. The exact cause is unknown but it affects a nerve controlling muscles of the face. It is sometimes considered to be a reaction that occurs after a viral infection such as a common cold and may occur also in pregnancy.
    • Bell’s palsy is often temporary and most people experience total recovery within six (6) months. Rarely it may leave permanent tell-tale signs and may recur in a handful of people also.
    • One may experience increased sensitivity to sound on the affected side, headaches, pain around the jaw or behind the ear on the affected side. There may also be abnormal production of tears and saliva. Seek medical care.
  • Post Partum Blues or Depression
    • We all expect a new addition to a family to bring excitement and joy but sometimes it may cause depression. Post partum depression is not a character flaw or a weakness and with the right intervention at the right time and with good family support, you can enjoy your baby.
    • Post partum blues is a milder form of post partum depression. In some cases one may even develop post partum psychosis after you have your bundle of joy. This is in no way a thesis to scare you away from childbirth but rather to make you aware so that you can take the appropriate steps quickly once you are confronted with the situation. Always SEEK prompt medical care, there is no point “waiting to see.”
    • One may often experience some of the following; loss of appetite, inability to sleep, intense irritability and anger, overwhelming fatigue, lack of joy in life, difficulty bonding with baby, feeling of shame, guilt or inadequacy and even thoughts of harming yourself or your baby. Avoid diagnostic greed, do not wait for many symptoms before seeking help, you are better off seeing a professional and being declared okay than to wait until things become complicated.
  • Underperformance in school children

Quite often, children may not be performing well in school and we unfortunately resort to the cane, screaming at them and heaping insults on them without finding the root cause. We will be complicating matters and eventually set the stage for rebellion in addition to poor or underperformance in school. We need to consider the following (other reasons or causes exist) before drawing conclusions and as parents or guardians, our input is extremely important.

  • Poor Nutrition
    • Food is fuel for the body and the brain can never perform appropriately without the proper “fuel”. We need to ensure that children eat a balanced meal before going to school. Hunger or poor meals could distract a child at school and prevent him/her from understanding what the teacher may be imparting. Check the meals and you may realise you have a straight As child!
  • Poor Eyesight/vision
    • The child may not be doing well simply because he is unable to read from the board. It may only need a simple test of vision to correct this.
  • Hearing Challenges
    • Certainly if the child has a problem with hearing, he may miss so many things discussed in class or even hear the “wrong” things. Your guess in such a situation is as good as mine.

So the next time your child finds himself/herself at the bottom of the class check the above and get medical assistance, you may be hosting a genius. I believe you are aware that some children will bloom late and at that point there is just no way to stop them, even the sky limit cannot limit them.

The drill remains the same, you will cope better with all the above if you stay healthy – exercise often, eat right, drink adequate amounts of water and get enough sleep hours.

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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/ Mobissel

(dressel@healthessentialsgh.com)

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Dr. Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy, fitness nutrition and corrective exercise.

Thought for the week – “Lack of sleep may predispose you to many diseases including a STROKE. Jump into bed an hour earlier and sleep a stroke away. You cannot be healthy during WAR or VIOLENCE, let’s all pray and work towards PEACE in our WORLD”

References:

  1. www.mayoclinic.com
  2. www.healthessentialsgh.com

By Dr. Kojo Cobba Essel

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Health Essentials

Identifying the geriatric giants & taking appropriate steps

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An elderly woman suffering from headache
An elderly woman suffering from headache

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.

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“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:

  1. Impaired Intellect/ Memory (e.g. Dementia)
    1. one of the major battles we need to deal with is challenges with memory
    1. Exercise, adopt the Mind Diet, build a great social network and enjoy time outdoors
    1. Keep reading and solving puzzles for as long as possible
  2. Instability – leading to much feared falls
    1. A good reason to indulge in Balance Training and Core Strengthening exercises from today
    1. Ensure your home is safe; avoid clutter such as cables crisscrossing floors, toys etc. These are all trip hazards and should be avoided
    1. Many healthy, happy and fun-loving older adults have died soon after a fall with its attendant complications.
    1. Do whatever it takes to avoid falling
  3. Immobility (opening the doors to pressure sores, joint stiffness)
    1. 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.
    1. Make sure you passively or actively move joints daily.
  4. Incontinence (urine, faeces or both)
    1. This is one of the reasons older adults prefer to stay at home and avoid going out to meet friends etc.
  5. Iatrogenic Disorders – adverse effect of medication
    1. 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.
  6. Inappetite – this may result in poor nutrition
    1.  This may also be linked to loss of teeth thus making chewing very difficult or limited.
    1. 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:

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  • 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)

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*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

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Health Essentials

Why Ghana’s ‘no bed syndrome’ is a policy failure, not a clinical failure -Part 2

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Kwabena Mintah Akandoh -Minister of Health

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.

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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.

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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.

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He is a graduate of the University of Ghana Medical School (Class of 1997)

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