Infertility Part 2

Hello. I have run out of excuses for being AWOL for sometime. Please just accept me the way I am.

Today I will conclude the infertility topic and hopefully I will be more consistent. Thank you very much.

   Baba Oloye was a big man to the core. Mere looking at him you could guess as much. He was huge, fat and had a big pot-belly which was as pendulous as that of a pregnant woman. He had money and he bragged about it. His business was booming and everyone was lobbying for his attention. Anything he wanted, he got. "Owo lo ma je" was his favorite phrase. He even paid for the title given to him in his town.

Whatever money could buy, Baba Oloye had. He had many 'tear rubber' cars, state of the art facilities. He built so many houses as if to release a statement to people that he was rich. Women were at his beck and call, throwing themselves at him at the slightest opportunity. The fact that he had four wives did nothing to deter them. Many of them were trying to be wife number five.

There was however only one thing that eluded this man. He had no child to call his own. He always had children in his house because he believed in the Yoruba adage that says "ori omo lon pe omo wa'ye" none of his wives had ever conceived.

He had been nonchalant about the child issue. He had always believed the problem had to be from his wives. Only women could be barren. After all he had "passed a lot of pregnancy tests" when he was much younger though he did not have money to afford a family then. He would just have to marry another wife. Daz all. Even his mother had advised him as much. Probably his wives were witches who had vowed not to give birth on earth. He had visited his prophets and babalawos who have promised him that he would soon be a father. He just had to offer some sacrifices and give a lot of alms. They would help him ward off the evil spirits preventing the children from coming.

He however got the greatest surprise of his life when he had accidentally bumped into his ex-wife Asake whom he had sent packing with the help of his mother due to her childlessness so that he could marry his latest wife. Asake was heavily pregnant!!!  He could not believe his eyes. Could he be seeing correctly? He had been told that Asake was "Ako Aja" ( male dog). How come she was pregnant. He had tried to dodge her but she saw him and sarcastically showed him her baby bump and told him God had blessed her. He felt as though the ground should open and swallow him up.

That got him thinking. How could it be. He could not count the number of girls that he had impregnated while in school in those days. He had insisted they aborted the pregnancies. He was not ready then both financially and emotionally to have children. He was too smart for those girls who wanted to trap him with pregnancy. He was 100% "kampe". He could never be barren. But what was preventing his wives from getting pregnant. Could it be....... God forbid bad thing. But how come even Iya Biliki who was said to be giving birth like a pig had not even conceived since he snatched her from her husband over six years ago. Na wah o.

All these thoughts were driving him crazy and he decided to see his doctor. At least "make he no come die before death go come sef" . He had seminal fluid analysis done and when the result was out it was just as he feared, he had low sperm count. Low sperm "kini" . The doctor however gave him a ray of hope. He would need further tests and if it was due to infections, he would be treated and he could start having children. However, if nothing could be done, there were many other options offered. That was when he calmed down. At least, " owo lo ma je".

DISCUSSION

As earlier discussed in part 1, 33% of infertility is due to male factor. The following are the risk factors for male factor infertility.

• Complete absence of sperm (azoospermia)
• Low sperm count (oligospermia)
• Abnormal sperm shape (teratozoospermia)
• Problems with sperm movement (asthenozoospermia)
• Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead
• Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation (semen not coming out)
• Problems with erections or other sexual problems
• The most common cause of male infertility is varicocele. A varicocele is a varicose vein found in the scrotum. The extra heat caused by the vein can lead to low sperm count and impaired sperm movement.
•  Current or previous infection of a sexually transmitted infection

Risk factors for male infertility include: 

• History of prostatitis or genital infection

• Testicular trauma or torsion

• History of precocious puberty (puberty occurring at a young age) or delayed puberty (puberty occurring at an older age)

• Exposure to toxic substances or hazards on the job, such as lead, cadmium, mercury, ethylene oxide, vinyl chloride, radioactivity, and X-rays

• Cigarette or marijuana smoking

• Heavy alcohol consumption

• Exposure of the genitals to high temperatures (as in wearing nylon pants)

• Hernia repair

• Undescended testicles

• Prescription drugs for ulcers or psoriasis

• DES taken by mother during pregnancy

• Mumps after puberty 

.  age (over 40 , men too have biological clocks)

Symptoms of male infertility.

There may be no obvious symptom.

Diagnostic tests

• A general physical exam by a urologist
• Semen analysis
• Specialized semen analysis, including genetic testing of the sperm (looking for the presence of antibodies) and evaluation of immobile sperm (to see if they are dead or alive)
• Blood work to check hormone levels, usually of Follicle stimulating hormone and testosterone but sometimes also Luteinizing hormone, Estradiol or prolactin
• Genetic karyotyping if recurrent miscarriage is a problem
• Ultrasound
• Post-ejaculatory urinalysis (urine testing), to check for retrograde ejaculation
• Testicular biopsy
• Vasography

Treatment

Includes:

• Treatment with antibiotics, in cases of infection
• Surgical correction, in order to remove a varicocele, reverse a vasectomy, or repair a duct obstruction
• Medications or fertility drugs to improve sperm production

In cases where the above treatments are unsuccessful, or when the cause for male infertility is unknown or untreatable, Sperm donation, In Vitro fertilization treatment, or Adoption may be suggested.

INFERTILITY

Hello friends. Let me greet you in the words of KWAM1.'s song: "E ku atijo, se daadaa ni?/2x, se alaafia le wa gbogbo ile nko o." Hope you are all fine. It feels wonderful to be able to meet you here again.

Today I am writing about a very broad topic called infertility. Getting married and having children almost immediately is the dream of almost all newly weds  of African descent and I pray that God will bless us all with fruitful children whenever we are ready to have them. Amen.

Below is a fictional story about family battling with infertility.

 Mr Aye was a gentleman to the core. Handsome, intelligent, hardworking and cool headed. He was every woman's dream. He worked at one of the commercial banks in the country as an accountant and earned a good income. He was comfortable by all standards. But he was unhappy, very unhappy.

    He was turning forty and was beginning to have mid life crisis. The cause of which was the fact that he had been married for 15 years and was childless. He had married his best friend and sweetheart immediately after the youth service year. He did not know what the problem was. He had tried to make sense of it all to no avail. Why was this happening to them. He had never committed fornication not to talk of adultery. He neither drank nor smoked. He tried to be upright as much as possible. The same applied to the wife. She had been a virgin until their wedding night. So, why him. God why him.

He had friends who had been "original bad boys" and many ladies who had aborted countless times yet got pregnant whenever they wanted. Na wah o. If not for the fact that he really loved his wife and was scared to death of having a polygamous home, he had been tempted to marry a second wife. 

A few years ago, his mother had stormed into the house bringing in one dirty looking girl like that to him to marry so that he could have children. It was disgusting. It had been a sorrowful day. Was marriage all about having children? His wife had cried her eyes out but his mom did not even mind her. She had even labelled her a witch for making him disobey her. He had to be tough on his mother that day and banned her from coming to his house. Now no one visited them. They believed he had been bewitched by his wife.

They had prayed and prayed. They had fasted so much that they both came down with ulcer. They had visited so many men of God but nothing was happening. Someone suggested that they visited a gynecologist but what would they see a doctor for. They had never committed abortion and they did not have any problem with their reproductive system. So, which miracle would a doctor perform for them. They believed that God would answer them in his own time.

But he was still unhappy. He prayed he wouldn't have to wait as long as Sarah and Hannah did. He prayed his miracle would come soon. Amen.

DISCUSSION 

Introduction

Children are a gift from God and they must be seen as such. However God has also blessed our world by giving us medical education to be able to examine, investigate and treat or counsel people when these gifts of God are not forthcoming. We should not see the doctor's visit as a taboo to our faith.

 

Infertility means inability to conceive or to carry pregnancy to term. it is a common problem of about 10% of women aged 15 to 44.

There are two types of infertility:

• Primary infertility refers to couples who have not become pregnant after at least 1 year having adequate sex without using birth control methods.
• Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable. 

Having adequate sex means having sex at least three (3) times a week with one day in between. It is not for one to have sex on three consecutive days for example Monday , Tuesday, Wednesday. No. It will be on alternate days eg Monday, Wednesday, Friday etc. 

 Couples not having adequate sex are not considered to be infertile. A woman also has to know her ovulation cycle well. She must have sexual exposure at least for 3 days before and after ovulation. The sperm has a life span of 72 hours while the ovum lasts for about 24 hours.

I have to say this. As funny as it may sound some people may not know how to have sex. I have seen a couple married for years and claimed to be having adequate sex and yet unable to conceive. The consultant later found out that they woman still had her hymen intact! They had been having coitus interfemoris. I have also seen some who were having anal sex not intentionally but because they do not know how to perform the act. These set of people are not considered infertile. Let me also mention here that a man with erectile dysfunction may not be infertile.

CAUSES OF INFERTILITY

Many physical and emotional factors can cause infertility. It may be due to problems 

 in the woman (33%), the man (33%) and by both sexes or due to unknown problems (33%), approximately. 

We shall discuss female factor infertility as it is the most common. Majority of the causes can be treated when diagnosed.

FEMALE INFERTILITY

Female infertility may occur when:

• A fertilized egg or embryo does not survive once it attaches to the lining of the womb (uterus)
• The fertilized egg does not attach to the lining of the uterus
• The eggs cannot move from the ovaries to the womb
• The ovaries have problems producing eggs

Female infertility may be caused by:

• Autoimmune disorders such as antiphospholipid syndrome (APS)
• Birth defects that affect the reproductive tract
• Cancer or tumor
• Clotting disorders
• Diabetes
• Drinking too much alcohol
• Exercising too much: weight below 50kg
• Eating disorders or poor nutrition
• Growths (such as fibroids or polyps) in the uterus and cervix
• Medicines such as chemotherapy drugs
• Hormone imbalances
• Obesity
• Older age:>35 years
• Ovarian cyst and poly cystic ovarian syndrome (PCOS)
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted infection, abdominal surgery or endometriosis
• Smoking
• Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal (reanastomisis), previous uterine surgery or procedures causing asherman's syndrome, or tubal surgery following ectopic pregnancy
• Thyroid diseases

We shall continue next time with male factor infertility . Thanks a lot. Please share as this may be beneficial to someone. Bye for now.

References

. Pictures from google.

. WebMd

. Medicinenet 

INFERTILITY

Hello friends. Let me greet you in the words of KWAM1.'s song: "E ku atijo, se daadaa ni?/2x, se alaafia le wa gbogbo ile nko o." Hope you are all fine. It feels wonderful to be able to meet you here again.

Today I am writing about a very broad topic called infertility. Getting married and having children almost immediately is the dream of almost all newly weds  of African descent and I pray that God will bless us all with fruitful children whenever we are ready to have them. Amen.

Below is a fictional story about family battling with infertility.

 Mr Aye was a gentleman to the core. Handsome, intelligent, hardworking and cool headed. He was every woman's dream. He worked at one of the commercial banks in the country as an accountant and earned a good income. He was comfortable by all standards. But he was unhappy, very unhappy.

    He was turning forty and was beginning to have mid life crisis. The cause of which was the fact that he had been married for 15 years and was childless. He had married his best friend and sweetheart immediately after the youth service year. He did not know what the problem was. He had tried to make sense of it all to no avail. Why was this happening to them. He had never committed fornication not to talk of adultery. He neither drank nor smoked. He tried to be upright as much as possible. The same applied to the wife. She had been a virgin until their wedding night. So, why him. God why him.

He had friends who had been "original bad boys" and many ladies who had aborted countless times yet got pregnant whenever they wanted. Na wah o. If not for the fact that he really loved his wife and was scared to death of having a polygamous home, he had been tempted to marry a second wife. 

A few years ago, his mother had stormed into the house bringing in one dirty looking girl like that to him to marry so that he could have children. It was disgusting. It had been a sorrowful day. Was marriage all about having children? His wife had cried her eyes out but his mom did not even mind her. She had even labelled her a witch for making him disobey her. He had to be tough on his mother that day and banned her from coming to his house. Now no one visited them. They believed he had been bewitched by his wife.

They had prayed and prayed. They had fasted so much that they both came down with ulcer. They had visited so many men of God but nothing was happening. Someone suggested that they visited a gynecologist but what would they see a doctor for. They had never committed abortion and they did not have any problem with their reproductive system. So, which miracle would a doctor perform for them. They believed that God would answer them in his own time.

But he was still unhappy. He prayed he wouldn't have to wait as long as Sarah and Hannah did. He prayed his miracle would come soon. Amen.

DISCUSSION 

Introduction

Children are a gift from God and they must be seen as such. However God has also blessed our world by giving us medical education to be able to examine, investigate and treat or counsel people when these gifts of God are not forthcoming. We should not see the doctor's visit as a taboo to our faith.

 

Infertility means inability to conceive or to carry pregnancy to term. it is a common problem of about 10% of women aged 15 to 44.

There are two types of infertility:

• Primary infertility refers to couples who have not become pregnant after at least 1 year having adequate sex without using birth control methods.
• Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable. 

Having adequate sex means having sex at least three (3) times a week with one day in between. It is not for one to have sex on three consecutive days for example Monday , Tuesday, Wednesday. No. It will be on alternate days eg Monday, Wednesday, Friday etc. 

 Couples not having adequate sex are not considered to be infertile. A woman also has to know her ovulation cycle well. She must have sexual exposure at least for 3 days before and after ovulation. The sperm has a life span of 72 hours while the ovum lasts for about 24 hours.

I have to say this. As funny as it may sound some people may not know how to have sex. I have seen a couple married for years and claimed to be having adequate sex and yet unable to conceive. The consultant later found out that they woman still had her hymen intact! They had been having coitus interfemoris. I have also seen some who were having anal sex not intentionally but because they do not know how to perform the act. These set of people are not considered infertile. Let me also mention here that a man with erectile dysfunction may not be infertile.

CAUSES OF INFERTILITY

Many physical and emotional factors can cause infertility. It may be due to problems 

 in the woman (33%), the man (33%) and by both sexes or due to unknown problems (33%), approximately. 

We shall discuss female factor infertility as it is the most common. Majority of the causes can be treated when diagnosed.

FEMALE INFERTILITY

Female infertility may occur when:

• A fertilized egg or embryo does not survive once it attaches to the lining of the womb (uterus)
• The fertilized egg does not attach to the lining of the uterus
• The eggs cannot move from the ovaries to the womb
• The ovaries have problems producing eggs

Female infertility may be caused by:

• Autoimmune disorders such as antiphospholipid syndrome (APS)
• Birth defects that affect the reproductive tract
• Cancer or tumor
• Clotting disorders
• Diabetes
• Drinking too much alcohol
• Exercising too much: weight below 50kg
• Eating disorders or poor nutrition
• Growths (such as fibroids or polyps) in the uterus and cervix
• Medicines such as chemotherapy drugs
• Hormone imbalances
• Obesity
• Older age:>35 years
• Ovarian cyst and poly cystic ovarian syndrome (PCOS)
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted infection, abdominal surgery or endometriosis
• Smoking
• Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal (reanastomisis), previous uterine surgery or procedures causing asherman's syndrome, or tubal surgery following ectopic pregnancy
• Thyroid diseases

We shall continue next time with male factor infertility . Thanks a lot. Please share as this may be beneficial to someone. Bye for now.

References

. Pictures from google.

. WebMd

. Medicinenet 

SEX AND PREGNANCY

This is an excerpt from my book on pregnancy. Happy reading....

SEX AND PREGNANCY

......Again, if two lie together, then they have heat:but how can one be warm alone? Ecclesiastes 4:11(KJV)_

These are the words of the bible not mine.

 Sex in pregnancy is a very big issue. It has caused so much trouble in many homes. That is why I feel it should be addressed.

  Let us be judges for one moment. Lets us listen to different sides of the same story.

First scenario:

A Man complains that he dreads his wife being pregnant because he would be starved of sex. His wife tells him that the reason was because she didnt want her baby eating the husband's sperm. The man knows she is lying and he is frustrated. He wonders why his wife is denying him of his God given right!

Second scenario:

A woman complains that her husband keeps disturbing her for sex. He  has it too easy. That is why he can even think of sex in the first place. She is in pains, uncomfortable. She can not sleep well. Instead of her husband to be helping out by giving her a total body massage, he is thinking of having sex. Can he not see what she is going through?

We have to understand that humans are sexual beings. The fact that you are pregnant does nothing to reduce your husbands desire for you. Some men are even more turned on by the sight of their pregnant wives!

  You may have lost your libido due to the pregnancy but he has not lost his. If you do not want him in the arms of someone else try to work around this issue by talking about it. Let him understand how you feel. You probably had a rough first trimester, a better second trimester and a dragging third trimester. You may be irritable and even hate the sight of your husband but try and see things from his point of view too. He is suffering though in silence.

  You must know that sex is visual for men. Temptations abound all round for him. The only reason he is asking you for it is because he is not looking for it else where. An average man has a sexual cycle of 30 days only. It is hard for men to be celibate for more than 30 days. This is not his fault. It is human nature.

  As a general rule, a good sex position for pregnant sex is one where:

-both partners are physically comfortable

-the position allows for the kind of sex and physical contact you want to have

-both partners avoid putting pressure on the uterus, or a partner’s full weight on a pregnant belly.

Beyond this, figuring out pregnancy sex positions requires some creativity, a sense of humor, and often lots of pillows. It may also mean abandoning penetration if it isn’t working, and finding other ways to please each other and please yourself.

You are advised to try out new and creative sex positions comfortable for you. This will add some spice to the whole act. Let it not be like a chore. a lot of foreplay will go a long way to help out. 

 While many women have reduced libido, a lot of women also have high libido. If you do, do not feel awkward. Discuss with your spouse. You can also try out new sex positions. 

The following pregnancy sex positions may be useful for you.

-The spooning sex position can be very comfortable as there is no pressure on your abdomen and you have lots of movement. Your partner can position themselves behind you at different angles to allow for penetration. Avoid lying on your right side in this position.

-The side by side sex position allows for more equal physical contact than spooning, but penetration can be a bit trickier. You can cross your legs over each others and this may help. As with spooning, this position can be very comfortable as no one is feeling the weight of the other partner’s body.

-The woman on top sex position offers the benefit of you being in control of the depth and angle of penetration. Later in the pregnancy you may find this position more tiring, and if balance is a concern you may prefer a lying down position, but others find this the ideal position.

-The rear entry sex position is said to be good for g-spot stimulation and can be a comfortable change as it’s a position you aren’t in that often. This position can either be done on a bed, or modified as a version of the next sex position.

-The edge of the bed sex position offers many possibilities for greater comfort during pregnancy. You can lie on the bed (on your side, or briefly on your back) at the edge of the bed and your partner can be off the bed, either on their knees or standing up. Combined with the rear entry position, you can be off the bed on your knees (with a pillow underneath them) and rest your upper torso on the bed, with your belly off the bed.

   Sex on the whole is healthy in pregnancy except when otherwise indicated. There is a hormone called Relaxin. In the male, it is produced in the prostate and is present in human semen.In the female, it is produced by the corpus luteum of the ovary, the breast and, during pregnancy, also by the placenta, chorion, and decidua.Its function is to mediate the hemodynamic changes that occur during pregnancy, such as increased cardiac output, increased renal blood flow, and increased arterial compliance. It also relaxes other pelvic ligaments. It is believed to soften the pubic symphysis which makes the delivery process easier. Sex has its advantage after all!

 Women with history of bleeding in both previous and present pregnancy should consult their doctor to decide whether sex is safe for them or not.

Long time no see

Hello. Guess what? I am back!!!

How are you guys. Hope you are very fine. I am so sorry for being AWOL. It was due to reasons beyond my control.

I however have good news. God gave me a beautiful bundle of joy about a month ago who has been keeping me a little busier than usual. I pray for all those seeking the fruit of the womb that God will bless them and grant their heart desires. Amen.

I sure hope to be able to post more interesting health topics soon. I hope you will be there to read,share and advice me on how to do it better.

Thank you very much.

Love you lots.

Breast cancer..... Must it be a death sentence?

We bless the name of The Lord for His grace and mercy. It is by His grace that we are not consumed. All glory and honor be His forever.

I am going to discuss the issue of breast cancer today. It is a disease that is becoming rather common and leading to unnecessary death. Having breast cancer shouldn't be the end of the world if the right thing is done.

The story I am about to share is fictional though it portrays the usual attitude of a lot of patients in Nigeria to a diagnosis such as cancer of the breast.

Mrs Williams was a very beautiful woman. She was very elegant. Even at 50 years she could still make heads turn. She had won so many pageants as a youth. She had so many trophies and prizes to show for it. Just two years ago she had been the face of a popular magazine. God had been so good to her. She was happily married with three children, all grown now and working. She had a good job with a robust retirement package. Life was good! She hardly a fell ill. She couldn't even remember the last time she was in a hospital. 

So, she hated the fact that her husband forced her to come today. She hated the smell of the hospital as well as the arrogant doctors and nurses who seldom had good news for one. While she had been making love to her husband two days before, he had noticed a small lump in her breast and had been so worried that he made her come to the hospital.

She was later ushered in to see a doctor. Surprisingly, the doctor was very nice and examined her thoroughly. He then explained to her that he needed to take sample of  the lump for cytology as well as some other tests. She had a Mammogram done, samples of blood were drawn from her and the doctor used one very long needle to take some samples from the breast. It was a harrowing experience. She was glad when the whole thing ended. She was asked to come the following week for the result.

How she survived the past one week was a miracle and she was back again for the result. The doctor's face was too grim for her liking. Was he not the one that was so nice the previous week? He sat her down and told her he had some the test results. He said the mammogram and the Fine Needle Aspiration Cytology tests he did showed that the lump was cancerous. He went on to explain what breast cancer was, the progression of the disease and the treatment modalities. He said he was happy the cancer was discovered at an early stage. There was a good chance that with surgery, all the malignant cells would be removed.

Mrs Williams' face turned white. Did she hear this man right? Her whole world was crumbling. Did he just say surgery? These doctors are terrible o. Cutting someone's breast lo pe beyen. Emi ko! She couldn't wait to get out the office. What nonsense. She was so angry. It was her husband that made her eyes to see this rederede. If he had not made her to go for check up, she wouldn't have heard such. Lump that she would just put ori (Shea butter) and everything would melt away.

SIX MONTHS LATER

 

The Surgery outpatient department of the hospital was filled to the brim. People were packed on the wooden benches like sardines. Different odors oozing out of different individuals. But there was one distinct odour. It was the smell of decay. It was as though there was a dead dog nearby. Air freshener couldn't do the magic of neutralizing this smell. It was terrible. And it was coming from the one and only Mrs Williams. People passing by her always covered their noses while those that were polite held their breaths. It was as though she was dreaming. She, the once gorgeous woman was now a smelly old woman. All thanks to her fungating breast disease.

She had been devastated a few months ago when she had been diagnosed of breast cancer. She was offered mastectomy ( removal of breast tissue). Who in her right mind would allow them to cut off her breast? So she had turned to the herbal doctors who gave her things to rub on the breast and drink. They told her that she had been attacked spiritually. Won so l'ata ni oyan ni. It was an attack. They told her she would excrete it out which she did or thought she did. When that did not work, she had turned to deliverance pastors and Islamic clerics to gbona . They collected huge sums for saraa (alms). But there was no solution. Instead her case worsened. When the odors did not allow people to breathe again in the house, she decided to come back to the hospital. 

The nurse called her case file and was allowed into the doctor's office. The doctor, after interviewing her and conducting an examination subjected her to further tests like CT Scan, X-ray, full blood count and a repeat mammogram. Because of the complications she presented with, the tests were done urgently and the result were discussed with her. The situation was grave. The cancer had metastasized to different parts of her body. The cancer cells were found in the other breast, lungs, liver. She had really deteriorated and needed radical treatment with surgery, chemotherapy, radiotherapy. Her 10 year survival rate was 5% ( this means that if 100 people had the same, only 5 would survive up to 10 years). She was doomed and death was knocking. She humbly submitted to the doctor's orders and was placed on admission.

As she was wheeled into the Female Surgical Ward, there was only one thing on her mind........ If only she had known, she would have had the surgery six months ago. It was a grave and costly mistake  and she wished she could turn back the hands of time.

DISCUSSION

Breast cancer is a cancer of the breast tissue. Though it occurs mostly in women, it can occur in males. When it occurs in men, it is usually more fatal.

It is not deadly if it is detected and treated early. The survival rate for early detection in advanced countries is about 80-90%. But the reverse is the case in Nigeria. It is not usually detected early and when it is, most patients do not accept the offered treatment leading to deaths in 90% of cases.

RISK FACTORS

There are some identified risk factors to developing breast cancer as the cause is not known. They are:

- Being female

- Genetics: if a first degree relative has it, there is probability of having it too

- Older age: from 45years though it is now seen in younger people

- Prolonged exposure to the female hormone Estrogen as in early menarche( age of menses), late menopause, lack of childbearing.

- Lack of breastfeeding

- Obesity

-  Lifestyle: alcohol consumption and smoking

SYMPTOMS AND SIGNS

The following are the symptoms and signs of breast cancer

- Lump: this is the first symptom. The lump is different from the normal breast tissue. Not painful initially.

- Nipple changing position or shape or becoming inverted

- Skin puckering or dimpling ( of the breast)

- Rash on or around a nipple 

- Nipple discharge 

- Pain in part of the breast or armpit ( this is a later symptom)

- Swelling beneath the armpit or around the collarbone. 

- A wound may develop on the breast in much later stages.

SCREENING

This should be done by every healthy woman to allow early detection. The screening methods are:

- Self breast examination: this should be done the week after menses. Divide the breast into four quadrants (segments) and feel for any lump.

- Clinical examination: done at the hospital by the doctor

- Mammography: in the US, it is recommended that women ages 50-74 have a mammogram every two years.

- Genetic screening 

- Breast ultrasound

- Magnetic resonance imaging

SELF BREAST EXAMINATION

1. Stand in front of a mirror that is large enough for you to see your breasts clearly. Check each breast for anything unusual. Check the skin for puckering, dimpling, or scaliness. Look for a discharge from the nipples.

2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward.

3. Next, press your hands firmly on your hips and bend slightly toward the mirror as you pull your shoulders and elbows forward.

Do steps 2 and 3 to check for any change in the shape or contour of your breasts. As you do these steps, you should feel your chest muscles tighten.

4. Gently squeeze each nipple and look for a discharge.

5. The breasts are best examined while lying down because it spreads the breast tissue evenly over the chest. Lie flat on your back, with one arm over your head and a pillow or folded towel under the shoulder. This position flattens the breast and makes it easier to check.

Use the pads of the fingers of your other hand to check the breast and the surrounding area firmly, carefully, and thoroughly. Some women like to use lotion or powder to help their fingers glide easily over the skin. Feel for any unusual lump or mass under the skin. Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover the whole breast, take your time and follow a definite pattern: lines, circles, or wedges.

The important thing is to cover the whole breast and pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone, and all the way over to your shoulder. 

PREVENTION

- Maintaining healthy lifestyle: diet and exercise

- Breastfeeding

- Drinking less alcohol and reduction of smoking

- Prophylactic bilateral mastectomy in women who have breast cancer genes

TREATMENT

 You must see a doctor for diagnosis and treatment. These include:

- Surgery: lumpectomy ( removal of a part of the breast), mastectomy( removal of the whole breast) with or without nipple sparing reconstruction

- Chemotherapy: use of cytotoxic drugs

- Radiotherapy: use of radiation. Given after surgery to destroy the microscopic cancer cells.

- Immunotherapy

CONCLUSION

Death should not be the end result of this disease if proper care is taken. I admit that such a diagnosis is very hard to accept but early acceptance would lead to early treatment which would make it possible to eradicate most of the cancer cells. This will improve survival rates as well. It is important to note that cosmetic surgery can be done to repair the breast with implants and nipple reconstruction which will make the breast to look good.

PLEASE NOTE

 Much younger women who have breast lumps should check it out at the hospital. Usually, younger women have a benign form of lesion called Fibroadenoma. This may need excision. Please do not hide such.

Thanks very much for reading. You can share with your friends. Who knows? Someone may need it.

 

Childhood Obesity....... What Is The Way Out

Hi friends. Happy new year. May this year usher in God's blessings like never before. Amen.

Yesterday, I had an encounter with a baby who was just 6 months but weighed 11kg. The child was being nursed exclusively on breast milk. He was yet to be weaned into the family diet. I wowed because it meant that his weight for age was 2x normal. The expected weight at six months is about 6kg. And a year old child is expected to weigh 10kg. So you can understand why the child's weight wowed me. As a physician, I really did not know what to do. I could only imagine all the complications of obesity that he child was at risk of. I could not even share it with the mother because I did not have a solution for her. Would I tell her that she should not feed the child if he was hungry. No! I could not do that. Would I want starve a six month old baby. What offence did he commit. And to think that he has not started eating solid foods. How would dieting work? I could only hope that the baby loses the weight as he grows older. Maybe when he starts crawling, standing and walking.

Below is the picture of world's most obese toddler who weighs 19kg at 18 months. On a lighter note, one would almost shit in one's pant to carry him. Lol.

This really got me thinking because most mothers want very big babies. They feel it s a thing to be proud of. This occurs especially in the affluent. People brag about how well fed their children are. It's not bad thing to feed our children well. Children must eat balanced diet. I then went down on memory lane. What were we eating in our days? I remember days of akara and ogi, moinmoin and eko, asaro with efo riro, amala, tuwo, egbo(corn meal), ekuru etc. We ate well then. The foods I earlier mentioned contain the right amount of carbohydrates, proteins, vitamins, fruits and vegetables. And here we are today bouncing in health. But what do we give our children nowadays? Indomie, Spagetti, Bobo, Ice cream, meat pie , Burgers. All the things that we did not eat, we want our children to eat. Because we can afford it abi. 

If we do not feed our children appropriately, our eyes shall see the things that our parents eyes did not see. Now we have juvenile DIabetes Mellitus, early onset Hypertension( seen now in young people of about 18 years), Early onset osteoarthritis etc. I am sure none of us wants this. So, let us do the right thing by feeding our children only on BALANCED DIET. 

 

Thanks very much for reading. This is just food for thought. CIAO.