Friday, December 24, 2021
Christmas Tidings!
Thursday, December 23, 2021
Much ado about nothing
Michael - Thursday
I have a friend who says you should never go to see a doctor
– they always find something wrong. She’s a medical practitioner herself and
has spent more time seeing doctors than she’d choose to, so maybe she has a
point.
The first chapter of my story starts with a visit to my new
GP to have a couple of skin issues dealt with and a prescription renewed. Since
he’s a thoughtful and careful doctor, he asked me about my general health. I
mentioned that my heart occasionally went into what I’d been told was an
ectopic rhythm—a sort of double beat—that only I had noticed despite a plethora
of ECGs and even a visit to a cardiologist some years ago. It seems to occur
after too much wine (which does happen from time to time but I don’t consult
doctors at that point). Although they never
said so, the doctors probably suspected that the problem was more
in my head than in my heart.
Normal ECG Mine was different...I guess... |
Nevertheless, my GP whipped out his stethoscope, listened for a few moments, and then muttered that he did hear something unusual. A resting ECG was called for. He considered the printout seriously for rather more moments and then pronounced that I was in atrial fibrillation, atrial fib to its friends. In atrial fib the upper chambers of the heart do their own thing without reference to the beats of the ventricles, the lower chambers responsible for the real pumping work. That didn’t strike me as a good idea at all, but he explained that this condition was not uncommon and that if one was going to have a heart complaint, this was the one to have. That struck me as a little like saying that if you're going to be poisoned such and such a substance is the best to use. His recommendation was that (a) I should immediately start on blood thinners because atrial fib can cause blood clots and thus strokes, and (b) that I should see a cardiologist as soon as he could obtain an appointment for me.
In the next chapter, I visit one of the top cardiologists in
this area who practices at a cardiac unit in a town called Mossel Bay about an
hour and a half drive along the coast from Knysna. (That’s regarded as a
ridiculous amount of time to travel in this part of the world although taking
that sort of time to reach a hospital in the same city wouldn’t be unheard of in many large cities.) The
cardiologist did a suite of ECGs and ultrasounds and followed that by
pronouncing the good news and the bad news. The good news was that I was no
longer in atrial fib implying that it was episodic and could probably be
controlled by drugs. This avoided needing a procedure like cardiac shock
treatment. I was glad of that. However, the bad news was that the stress
ECG had revealed an abnormality in the ventricle beats at high heart rates. This
could indicate coronary artery disease. He prescribed an angiogram which could
be used to obtain a complete picture of the arterial blood flow around the
heart and to insert stents to open the blood vessels if needed. And if stents
were inadequate, they would have all the data they’d need for the bypass
operation.
I thought about my friend’s comment. I’d visited my GP to sort
out a few small lesions on my face and the way things were going I was going to
end up with a heart transplant. Seeing my lack of enthusiasm, the cardiologist was at pains
to point out that the procedure was quite standard nowadays and very seldom led
to serious problems such as a heart attack on the table. For some reason this
didn’t increase my enthusiasm one iota.
Normal coronary arteries Mine did look like this...I guess... |
I have only good things to say about the hospital, the nurses, and all the staff who were efficient, responsive, and considerate. Even the food was good. And I didn’t have a heart attack on the table. I was awake for the whole process and actually managed to whip up some interest in the processing issues involved in the amazing images of the vessels around my heart that I was seeing in almost real time. Best of all, my arteries were all in good shape. I left the hospital the next day with a huge sigh of relief.
In the final chapter, we jump five days from the angiogram to
last Saturday when I start developing a sore throat, stuffy nose, and
headaches. Let’s face it. Hospitals are not great places to be in the middle of
a covid wave, let alone our latest omicron-driven one. Hospitals are full of
sick people. That’s why they go to hospitals in the first place. Despite the
efficiency and care I mentioned earlier—to say nothing of the patients having
covid tests before admission—one is exposed to doctors and nurses who work with
patients, including covid patients. They are taking that risk every day.
By Monday I was no better and coughing a bit. I was also—to use Caro’s wonderful word—quanked. I was supposed to visit Stan at his place in
Cape Town and have Christmas lunch with him and two other friends. That was no
longer a possibility unless I was cleared by a covid test, and I was pretty
sure what the outcome of that would be. In fact, by that stage, I wasn’t too
concerned about the outcome. I wasn’t desperately ill, I wasn’t getting worse, my
oxygen level was fine, and I’m fully vaccinated. There’s even some belief that
omicron is a great covid immunity “booster” in its own right, and while new covid cases
in South Africa have rocketed, hospitalizations and deaths have hardly
increased.
So I tried to get a test. It turned out that because of the pressure on testing, I needed to be referred by a GP. My new GP was away. My previous GP had recently died. I began to wonder if they only tested people who were not likely to have covid i.e. those wanting to travel overseas or being admitted to hospitals. What does that do to the statistics?
It took me two days before a friend’s GP kindly gave me a
phone consultation and signed off on the form. His comment was that omicron was
so contagious, and so mild in practice (if you were vaccinated), that I really
shouldn’t bother about whether I had it or not. Everyone would get it sooner or
later anyway and almost all of them would be fine. Nevertheless, I had the test.
It was negative.
Happy Holidays everyone!
Wednesday, December 22, 2021
The Face Of Literacy in Africa
Wed--Kwei
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Twenty-year literacy rates, sub-Saharan Africa (World Atlas) |
- Poverty, obviously, is the major factor, relating to literacy in a chicken-and-egg fashion. In much of SSA, people are too poor to send their children to school, because, make no mistake, school fees, tuition and books are rarely free.
- Child labor, a politically loaded term because it’s sometimes used in the sense of indentured servitude. In the SSA context, however, children may be asked to help their parent(s) or other relative(s) with their trade, whether it be farming or other livelihood.
- Generational illiteracy means the passing down the inability to read from parents to offspring. An illiterate parent will not have personal knowledge of the advantages of being able to read in the world at large, and they may not realize what their kids are and will be missing.
- Government inadequacies lead to problems of distribution and supply, particularly to remote rural areas. In his article, Tony Read (an appropriate surname indeed) of the World Bank Group writes, “. . . despite decades of funding by governments and DPs [development partners], few low-income SSA countries have been able to establish sustainable systems for providing textbooks and other essential TLMs [teaching and learning materials] on a regular basis.
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Aguiyi brothers, Confidence (L), Evans (R) and me (Photo: Kwei Quartey) |
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Young students clamoring for books (Photo: African Rural Volunteers) |
Monday, December 20, 2021
The Nadir of the Year
Only today isn’t just any other Tuesday—Tuesday 21st December is Dōngzhì, meaning the most extreme low point of winter.
Traditionally, Dōngzhì is the festival celebrating the Winter Solstice and marking the shortest day and longest night of the year—at least for those in the Northern Hemisphere. Here in Singapore, we’re just one degree north of the Equator, meaning our shortest day is only eight minutes shorter than our longest.
This year especially, there doesn’t seem much to have a festival about. Omicron has arrived with over twenty imported and three (all airport staff) local cases. This means social get- togethers will remain limited to 5 fully vaccinated / pre-event tested individuals and the travel, hospitality and service industries will continue to suffer with their staff and their families bearing the brunt. And across the causeway up North, our neighbours in Malaysia are suffering the aftermath of flooding with over 20,000 people displaced, thanks to ‘the worst in one hundred years’ monsoon rains.
I have such happy memories of my year end school holidays that I’m especially sorry for today’s schoolchildren as this situation drags into another year. What kind of memories are these kids going to have?
Galapagos 1991
Annamaria on the go
When this Post launches, I will be arriving at Munich Airport on my way to Florence to spend the holidays and the winter months with my loved ones in Italy. I know! I am an incredibly lucky person.
This past week, however, has been a challenge, and as I start to write today – Sunday the 19th, I have just returned home from a root canal operation. Yes, on Sunday morning. And just 12 hours before my plane takes off. Since Wednesday, I have had three dental appointments, along other unexpected complications. The world seemed to sending me every negative message it could think of. I pinned my hopes on my Covid rapid test. If it also turned out negative, I knew I was meant to take this trip.
I admit that I was a nervous wreck when I showed up at the dentist office at 8 o'clock this morning. But just as the dental surgeon was beginning to drill, the music system in her office played Louis Armstrong and Ella Fitzgerald, singing "Cheek to Cheek." Readers in my age category will understand why that song made me laugh. It begins "Heaven, I'm in heaven…" in Louis's unmistakably marvelous voice. Hearing those words, so appealed to my ironic sense of humor, it made me forget my worries!
Perhaps, given my trials and tribulations this week, you will forgive me if all I have to offer today is remembrances of a trip from my past – one of the most memorable of my life. It comes with some advice at the end. But first take a look at what my dear departed David and I experienced 30 years ago in a place that felt like the Garden of Eden: