Friday, July 17, 2015

UNDERSTANDING PREVENTIVE HEALTH

As a child growing up in a fairly remote village, I followed my mum a couple of times to the local maternity centre at the delivery of my younger ones for routine child immunization. One thing I noticed which I clearly remember till date is mothers giving their babies Paracetamol syrup prior to their baby’s immunization. I watched with so much curiosity with many questions in my mind but I was too little and naive to voice say these things out yet I lived with them for years.

When I started my career in 1997 in the hospital, I saw it happen again and I asked a Matron colleague of mine who took time to explain to me. It was then I realised, mothers actually give this medication prior to immunization to prevent their babies from having high temperature. I was so amazed when I imagined the level of awareness and poor educational levels of those women I saw in the village. What these mothers were involved in can be relatively seen as a preventive health approach to health (proactively preventing increased body temperature in infants). It simply means taking proactive actions to prevent possible ill health, sickness or disease before it comes.

What those mothers understood even in that poorly informed level is that their babies can avoid the pain of suffering from high body temperature if they are given paracetamol prior to vaccination. My question is why couldn’t the mothers leave the babies to just take the vaccines without necessarily giving them those medications? Even the Mothers need peace of mind. When their children suffer from increased body temperature, the mothers also suffer discomfort.

This was just to build a foundation on what this column will be focused on within the time or period we have at our disposal. Preventive health is indeed the new frontier in healthcare delivery; it is the new world order in both saving healthcare cost and achieving improved healthcare outcomes. We grew up to meet our healthcare professionals enjoying the conventional curative clinical care, the business the health professionals had with patients was just to listen to patients’ complains, examine their physical clinical presentations and either recommend them for further laboratory investigation or outright drug prescription. 
  
In modern day healthcare services, the complexion of healthcare delivery has greatly changed even the treatment pattern. The focus now is overall wellness, wholeness of body, mind and soul. This is where interaction and patient engagement has placed patients at the centre of quality healthcare delivery team. The rule is, we do not want you to be sick before you come to your healthcare professionals, even when you have questions, go to them and seek medical clarifications.

There used to be a level of reserved disposition among practitioners towards patients, but this has long changed because we must talk with our patients, answer their questions and clarify bothering medical issues they may have in their mind.

The role of the healthcare professionals have transcended beyond just caregiving but to health education, health awareness and health promotion. The patient needs to get informed, the patient needs to know what to do to maintain good health, he needs to know the food type suitable to maintaining good health and possible ways to modify life style in the midst of available health risk exposure.

Preventive health has been recommended as the most cost effective form of healthcare delivery. Let’s look at Hepatitis B which is a viral disease that has a violent effect on the liver, you will agree with me that it is easier, safer and most cost effective for us to get an early screening and take the vaccination if we come out negative. The highest cost you may get this screening and the three course vaccination will be between N5, 000.00 – N7, 500.00, but the average cost of having a six-month treatment outside the pre-treatment test falls within the neighbourhood of N500, 000.00 - N750, 000.00. There is no guaranty that the virus will be totally out within this six months, you might need about a year, two years, 6 years or longer therapy to totally get rid of this viral infection.  What this tells us is that the cost of immunising yourself against Hepatitis B virus is just 1% of the cost of having a six-month therapy.

In any balances you may weigh this from; it makes a whole lot of economic sense to embrace Preventive health in our overall quest to maintaining an improved and quality life style. Curative Medicine is still very much in practice and in use but we need to free spaces in our healthcare facilities through Preventive Health approaches to allow those who really need those clinical environments access to curative care as recommended.

Organisations, families, governments and health insurers are financially bleeding in their health funds because of the sole reason of waiting till we get really sick before we seek medical help. This is wrong; we need to seek Medical help in form of Medical advice even when we are not sick. We need to have thorough engagement will our healthcare providers, if they are not talking to us or providing answers to our questions they cannot be the kind of healthcare providers we really need.  

The most important approach to healthcare delivery in 21st century is “Caregiver-Patient Engagement”. This has another twist is preventing medical errors and ensuring patients safety.

We will be looking at most of these issues in details as time permits us subsequently. Stay glued to us here, we will surely be back.


I can be reached at ehi@ohsm.com.ng

Thursday, July 2, 2015

PROLONGED USE OF HIGH HEELS SHOES COULD CAUSE RESTLESS LEGS SYNDROME (RLS)



There is an issue of recent growing concern to me, most especially in the area of Ergonomics and health risk which is my focus area.


I do not know if you have noticed the indiscriminate use of shoes with incredibly high heels amongst ladies of all ages of late, this has got me really worried on the possible health outcomes. Most alarming is the prolonged use of such high heels shoes in work places ranging from 5 - 8 hours continuous use. This is where the troubles lies.

How many of us have heard of the term RESTLESS LEGS SYNDROME (RLS)? According to a publication of the National Institute of Neurological Disorders and Stroke, "Restless legs syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them". It is classified as a movement disorder, as individuals are forced to move their legs in order to gain relief from symptoms.

Although there are other factors responsible for this disorder but one of the factors indicative of this disorder is the use of high heel shoes predominantly amongst women. Men are all not together left out, studies have also shown that men are also in the habit of wearing shoes with heels such as Sanchos Boots.

I am most worried the way we get our feet traumatised in our quest to be seemingly look fashionable, elegant and perceived glamorous yet in our most discomfort mode. Every part of the body has a scientific process of use and management and you cannot afford to violate these processes without suffering the naturally prescribed consequences which you cannot appeal.

You must have heard of the term Cumulative Trauma Disorder (CTD), this is very applicable to this high heel shoes habit. We either pay now, or we pay later because you have continuously traumatised your feet and this has great consequences which awaits you in future. You may not have an immediate consequence but because this habit persists over a period of time, the possibility of suffering from RLS will be very high. But remember, this has to do with frequency of exposure and duration of exposure to such risk. This talks about how often you get involved in the use of high heels shoes and when you use them, how long do you stay on them (do you use them 5 days in a week and you are on them for 8 hours stretch in each of these days). I would rather think RLS is avoidable if we wear relatively flat shoes or shoes with very low heels more often, especially during work hours or at work.

We have heard of a number of crashes as a result of such high heel shoes in workplaces, it is more frequent when climbing or walking down the stairs. When you look at it closely, it causes organisations downtime through man-hour loss and RLS induced absenteeism, extra health cost and psychological tension amongst colleagues. The person who wears these shoes is not also left out because he or she lives to suffer the immediate pain and the cumulative long term health effect and consequences.

This can also be linked to insomnia. During my online course on Behavioural Medicine at Karonlinska Institutet Sweden, i realised one of the most predominant causes of lose of sleep is pain and this is most times taken out of focus by some Physicians while we continuously overwork ourselves trying to figure out ways of dealing with the lack of sleep without recognising the root cause. When you stay on these high shoes for longer hours, you are bound to go through pain just like an employee who has spent a whole day working in a workplace that is ergonomically dysfunctional. This continuous body pain in affected locations may not allow you have a good night rest because of pain and discomfort, you wake up in the morning feeling more tired than you were before you went to bed. Most times, even feel too tired to go to work and even when you manage to go, the law of circadian rhythm sets in. Because you had sleep disruption, you are at work and yet battling with heavy eyes and urge to sleep. This in turn does not allow an employee to be optimally productive and again leads to presenteeism (you are present at work just to be seen but in the real sense, you are productively absent).

This has a huge adverse effect on both the employee and the employer alike. The employer is not earning the expected production contribution of the employee and the employee when appraised also will not like the outcome of the appraisal and could jeopardise the position of the employee's continuity in the organisation.  

In as much as we love the fashionable and elegant look you seem to portray from the use of these sets of high heel shoes, we are more concerned about your feelings and look in your old-age. That is what sustainability is all about, so long as the high heels shoes and the fashionable look it gives to you cannot be sustained till old-age, then it is unhealthy and unsafe and not worth continuing with. Your feet should be able to function well all through your days at least, without necessarily going through pressures which we are imposing on them today.


It does not matter how long this has gone on, when we make a deliberate and honest decision to discontinue in this act or habit, restoration sets it and you will begin to have your legs back. I think it is worth giving a shot.

This is just a concern expressed in my own honest understanding but i hope it helps all the same. No harm intended at all.

I can reached at ehi@ohsm.com.ng