Anxiety is a weight.
It sits on your chest and bears down regardless of whether you are lying down,
sitting, or standing. Anxiety also signals that the issues of life, though
measurable in the brain, are situated in the chest cavity where your heart and lungs
reside.
For instance, when
you feel confident, you are likely to beat your chest rather than slap your
head. Slapping your head, it turns out, is an act of self-deprecation in
recognition of one's silliness or foolishness. Anticipation can create anxiety,
and nothing quite causes that feeling of foreboding like the hours just before
a long-scheduled medical procedure.
Lessons from a
Previous Encounter
With hindsight, two
years ago, after a multiparametric MRI scan, the consultant sprang a biopsy of
my prostate gland on me without first reviewing the results or explaining the
reasons. Even so, I was quite well prepared for the encounter.
I asked questions,
demanded answers, and only acquiesced to the procedure once I was convinced of
the need. The importance of reading up on your medical situation is paramount.
A Portmanteau of
Procedures
Tomorrow, I am going
for an Oesophagogastroduodenoscopy. I could have sworn that is not a word, but
welcome to the world of medical terms that suggest a portmanteau of activities.
The word reminds me of German, where portmanteau words are joined up with the
letter "S". I would suppose, with medical terms, it is the letter
"O", much like when I had that inguinoscrotal abscess last month.
In summary: I am
having an endoscopy that will reach down through my oesophagus, past the
gastrointestinal junction, to the first and shortest section of my small
intestine. I have not deigned to measure that in miles, but it feels like a
long way down to places never before visited, rather like the first landing on
the moon.
Why This Procedure Is
Necessary
This is pursuant to
an investigation that presaged my visit to A&E after a choking incident
which impacted my ability to swallow anything, including fluids, for hours. I
was eventually discharged about five hours into my hospital attendance, after
managing a sandwich and a drink. Taken alongside a history of choking events
going back decades, and three such incidents since that discharge, this
procedure is necessary.
Herewith, the cause
of my anxiety: without a chaperone, I can only elect for the most basic
palliative, which would be a numbing spray to the back of the throat, rather
than a sedative.
Finding Peace
I believe I shall be
fine. I suppose it is just part of human nature to be slightly concerned at
that kind of invasive activity, and it is not helped by a mind full of others
recounting their own endoscopic odyssey.
Shalom! Peace to my
mind, peace to my soul, peace to my thoughts, peace through it all.
Since I last wrote on my blog, there have been experiences and victories, none to great celebratory aplomb, but all to be grateful for.
The colonoscopy procedure is as uncomfortable as it gets, though nowhere near other health or therapeutic challenges I might have faced before. To say I was not apprehensive would be to deny my reality as it lay before me.
All procedures come with risks and some can be quite serious, ending in fatalities, for that is just a possibility. It is one of the reasons why I was not keen on sedation, that itself would have required having someone with me for 24 hours to ensure any turn was immediately addressed.
Rather, I opted for Entonox, a medical combination of nitrous oxide and oxygen, commonly known as laughing gas. I did at one time in the midst of the discomfort begin to laugh too.
A mile of tubing
Arriving at the hospital a fortnight ago, fully evacuated for internal examination, I noticed that MoviPrep had in just under 16 hours had me shed 5 kilograms. That is nominally the weight of stuff moving through your digestive system, depending on your kind of appetite.
I changed into a hospital tunic, and we were advised to bring a dressing gown and slippers, we did the formalities of questions, waivers and gagging orders, exculpating the hospital from loss of many things including life and then the rather affable doctor came round to see me, assure me of the ease of the procedure, what would be done and that I did not need to worry.
The room in which I was invaded by instrument and curiosity barely held the bed, the equipment and three seats for the staff attending to me, I got comfortable and was offered the breathing apparatus that was left for me to regulate how much I wanted to inhale to attain the delirium to banish the discomfort.
After a digital insertion, the procedure began, a probe with a camera and lights travelled the whole length of my large intestine, it was like they had travelling a mile, from whence a total of 21 biopsies were excised by pincers that looked like pliers in a mechanic’s workshop. The discomfort mainly came from the air that was passed into my entrails to help increase visibility and navigation through my system. I felt like a balloon at one stage.
All well and good
All they viewed was on a monitor that I had one of the best views of, it was interesting to learn that the appendix was not as close to the end of the colon as I thought it was, it was at the other end, at where the colon first descends. The vivid red colour of my innards was a view of something I would never have contemplated seeing in a lifetime or without a career in medicine.
On the way out, which took much longer than the insertion process, a polyp was excised for laboratory analysis an in just about 50 minutes we were done.
For all my discomfort, I was considered a good patient and was soon wheeled out to the recovery room where other patients, some of whom I had chatted to before the procedure were recovering too. One of them had had 7 colonoscopies before the one he was going to have on that day, a veteran of sorts with just enough comforting words for a first timer.
In recovery, I was offered some tea and a sandwich as I had been nil-by-mouth for over 24 hours. The effects of Entonox are supposed to leave the body in under 10 minutes. However, from the bloating and the biopsies, there is quite a great risk of internal bleeding and infection, so care must be taken after that procedure.
Just over an hour after the procedure, I was ready to leave the hospital, I called a taxi cab and returned home to recuperate fully for the rest of the day. After this, the advice is not to fly for at least a week, or better still 2 weeks.
I think I am feeling a lot better after that encounter to the tunnels of life, the somewhat short recovery time is, in reality, longer from the experience, not necessarily the trauma.
It is called MoviPrep, and that is what it is, lots of movement and the extreme preparation of the bowels. They want to have a look and need a complete evacuation exacerbated by MoviPrep which is an experience you can hardly wish on anyone.
The preparation starts the day before the colonoscopy procedure and there are protocols to follow for a morning appointment or an afternoon appointment. As I am scheduled for a morning engagement, I was to stop the ingestion of any foods after 9:00 AM on the day before and embark on a starvation diet or mainly clear fluids.
Taste is not an option
Early in the evening, I mix up the first batch of MoviPrep, the taste of which is most vile, a witch’s brew that could well serve as an emetic as it is a prescribed laxative. I learnt it was best taken chilled and through a straw. Have a few cans of fizzy drink to hand to drink after every sip of the MoviPrep concoction, this to replenish fluids and deal with the aftertaste.
No gastronomic skill was expended to make MoviPrep palatable and if I know beforehand, I properly would have asked for a preparation without Aspartame, the artificial sweetener that has been known to give me migraines.
Not working for me
Meanwhile, there was a visit to the hospital today to consult on the new medication that has not abated in its side effects of insomnia, flatulence, constipation and unexplained aches in the joints and the groin. I took a 44-page litany of my daily experiences to the consultation, I have been on this drug for 44 days.
It would take a couple of days to come to a decision, but we can agree that after over 6 weeks, this is not working for me. I would rather return to my trusted pills to which I have an affinity developed over 8 years.
Dressing and address
The visits to the evacuation receptacle have been frequent all evening, in the double figures as I prepare to bed for the next day. The second batch was taken some 4 hours after the first meant I had consumed 2 litres of MoviPrep and much more in fizzy drinks.
I guess the next conversation would be something along the lines of I as a receptionist announcing, the colon would see you now and the visitors coming in and going deep.
The hope is Entonox would make the passing of tube and time a forgettable experience. Bathrobe, slippers and magazine, packed for the day out. I have forgotten, I am hungry.
The video that
sensationalised the proceedings and attracted much commentary.
Courtesy of
Channels TV.
Update
These are two
additional video Courtesy of Channels TV where the Chairman of the House
Committee on Finance was interviewed.
Part 1
Part 2
For the time he was allowed to talk beyond the biased obstreperous interviewing technique of Harriet Agbenyi, a better picture of the reasonableness of the committee to the unreasonableness of the Finance Minister playing to the gallery exploiting the subjectiveness of Nigerians is evident.
Videos unlimited
When the second video was released in December, many jumped on it and excoriated the chairman of the House of
Representatives Committee on Finance, Dr. Abdulmumin Jibrin for disrespecting the honourable Federal Minister of Finance, Dr. Ngozi Okonjo-Iweala.
Whoever stitched
together the second video was no doubt up for mischief and enough mischief was wrought
by it. However, from the get-go, I was of the opinion that the Minister was
haughty, wrong and troublesome, whilst the committee gave all due consideration before they came to the ruling that she should leave to return on another day.
This new video [The topmost one on this blog] corroborates my views, and I hope that viewers of both videos [The first showing the beginning of the engagement and the second showing how it ended.] which offers a more complete view of that engagement would review and reflect dispassionately and without sentiment.
Once we extricate
ourselves from the gender and age politics, yes, the Minister is female and 22
years older than the Chairman, which could mean a lot in the Nigerian setting,
and concentrate on institutions, process and procedure, we would be better
informed of the fundamental issues.
The synopsis
The Minister was invited to appear before the House Committee, she was given the floor and with excuse seeking pity and whatever else, she said she was very ill, implied her colleagues might be fatigued, for they had not slept for days and offered to tackle the questions from the Committee almost half-heartedly because of her condition.
The committee
sympathetically considered her condition, gave her the questions they were to
ask her and advised her with all due courtesy to return at another time, two
weeks hence.
The Minister took umbrage at this and questioned process and decorum of the Committee as the Chairman containing his exasperation and possible anger, told her she cannot face a gruelling grilling by the committee in her condition.
This after earlier letting her know that the Committee was as flexible as to make the maximum allowances for understanding that the Minister’s health was paramount, and they would have postponed in consideration of that.
The exchanges
degenerated, the Committee ruled, the gavel came down, the session should have
ended there and then but the camera kept rolling and that was theatre for
Nigerians.
Separation of Powers
Broadly, we have a system of government
in Nigeria that practices Baron de Montesquieu's theory of the separation of powers.
An Executive presidency with a cabinet of ministers, a National Assembly – the Legislature
comprised of the Senate and the House of Representative and the Judiciary.
Again, somewhere
between the theory and the practice, the Legislature has oversight of the government
and has powers into invite or summons the Executive about issues relating to
governance, budgets and much else. The graphic below captures the general idea
of what we should expect of the arms of government.
Source Wikipedia.
Now the event
That lays the
groundwork into the how and the why of the Minister appearing before a
committee of the House of Representatives.
As far as the video is concerned, the Minister was late in appearing before the committee, that is the first slight and show of disrespect to the House Committee that the Chairman overlooked without comment, and the Minister did not apologise for.
Then when the Minister was given the floor to speak, rather than address the serious matters of the days head-on, she had a more important human limitation, she was unwell and her colleagues were seriously fatigued, she would do her best, but implicitly, the Committee should have consideration and not grill her, or words to that effect.
Open book test
The Chairman, by
observation decided that the gruelling activity of appearing before the
committee should not be taken lightly, they had prepared 50 questions already,
but seeing the condition of the Minister, the committee was willing to let her
attend to getting well.
Meanwhile, here was an open-book test, take the 50 questions away, answer them and the Committee would invite you at a later date to discuss.
At which point the
Minister for whatever reason contemned and impugned the Committee about orderly
and respect, as she perked up, she was suddenly well, ready and able to face
the Committee.
After the gavel
The Committee
Chairman, overruled her, made a ruling and the gavel came down. The Minister
should have packed her sheaves of paper and left because the session was at
that time over, the Chairman said as much to her but she laid into the
committee, suggested she had been disrespected and much else.
In my view, if we
are to have strong institutions in Nigeria, it is important that all arms of
government appreciate where they stand in the scheme of things. The Minister of
the head of her ministry but answers to the legislature on matters concerning
her ministry.
In that setting,
the committee orders the proceedings and whoever appears before the committee
should clearly respect and submit to the primacy of the committee in their
deliberations, decisions and rulings.
Once the gavel came
down, there was nothing else to discuss, the manner in which the gavel came
down of no consequence, the reason why the gavel exists in the committee room
is to maintain order, in process, proceedings and rulings. End of story – the rest
is idle banter.
This uppity minister
That the minister decided to escalate the matter into a histrionic fit as depicted in that video is unfortunate and the chairman did well to make her understand that she cannot countermand the ruling of the committee.
In the process, it
appeared the Minister was badly treated, but when we watch both videos, it is
clear that the Minister simply pushed the matter to the point where it
degenerated to – that sadly defines the unfortunate mess of a jumble of
separation of powers we operating in Nigeria.
I stand by my original premise, Dr. Ngozi Okonjo-Iweala in that setting was unprepared, uncouth, rude, wrong, ill-disciplined, ill-tempered, melodramatic and disrespectful, and all that as someone unwell.
That the executive
when appearing before the legislature had to be handled in that way is order
that has grown into a storm in a teacup – the committee prevailed, just as it
should, anywhere that system of government exists in the world.
It was like
entering a bazaar of the bizarre. My engagement extended just a few weeks ago
had someone asking if I still required the privileges I had to do what I was
brought in to do.
Immediately, I
replied ensuring my manager was copied in that the privileges are essential to
fulfilling my role – that should have been the end of the story.
Apparently, that
was not the case, as the week began, I noticed that certain ordinary things I was
once able to do, I could do no more.
Lose to lost
Sometimes you
ignore the little issues because at the time, the situation is not as
significant as to warrant further investigation, some other things I needed to
do, I could do all because I was still registered with the environment.
However, yesterday,
I decided to check why exactly a restriction came into place only to find out
that literally all my privileges had been revoked without notification.
This is the sort of
unnecessary frustration of activity and productivity that one sometimes
encounters in the workplace that it borders on an atrocity.
Find the wind
Usually, on occasions
like this, you settle into forensic mode, obtain earlier requests, approved
implementations and compare those with the current state of play before the
matter gets escalated up the chain for a speedy resolution.
Speedy it had to
be, but not before the email church of scores of meaningless power plays that
fail to grasp what needs to get done until someone up there bellows and
suddenly there is someone to assume responsibility to resolve the issue with
alacrity.
Just two hours
later, things seemed to return to normal but it would tempting fate to want to
determine the how and why of the loss of my privileges apart from the apparent
lack of processes to ensure that such events do not happen willy-nilly.
Room to bloom
Where you find you
are about to fume and fulminate, you take 10 sharp breaths, type with
consideration without letting go of the piece of your mind you desperately want
to express and allow the system to adjust itself as the responsibility chain
that depends on your services sorts out the politics to get the technical
issues resolved.
As you drum the
desk with your fingers, don’t forget that you are still charging for the time
you have been made idle by forces within the organisation that should have been
facilitating your greater productivity.
Bureaucracies are a
strange life form, a system of well laid out processes that never seem to
engage clockwork efficiency of alacrity or urgency.
Like mold, it takes
away fervency or freshness leaving a footprint of lethargy, inertia and boredom
as time ticks away as if it has no function of measurement than an abyss of
nothingness clawing in darkness.
Those who people it
Yet, agents and
agencies desire the omnipresence of bureaucracy to ensure that those who depend
on it are introduced to the fact that they are powerful, they have
responsibilities and they move on a whim except when coerced from above to do
what could have been done long before without fuss.
Yet, we wait,
almost helpless, almost hopeless and almost listless that a time will come when
bureaucracy moving as it might be at a speed that makes drying paint look
instantaneous, bureaucracy will finally respond to why it was put in place to
fulfil all righteousness and to give the needlessly engaged a sense of purpose.
Complicate the simple with ease
You have to ask why
what is seemingly easy to do is made unnecessarily complicated, inscrutable and
impossible to action immediately, if not for each little person in the
bureaucratic workflow to engage in the power-play of self-importance to the
detriment of the organisation at large.
Nowhere was it
self-evident than when I visited two banks to open accounts. In the first, I had
to book an appointment for the next day, go through tens of questions, sign
forms to the point that my fingers bled ink into the cuneiform of my signature
and yet will wait days to be able to access the account for business.
The second just
required a walk-in on a Saturday afternoon, I was seeing an advisor in 10
minutes and within 30 minutes, I had a bank card and my account was live for
transactions, just like that.
It goes without
saying that there is probably a century of history between the first and the
second bank which is nimble, modern and streamlined to eliminate the encumbrance
of bureaucratic time-wasting pretending to back-office operations.
Times change but not for that
What seems
well-oiled to whoever set up that system does not really fit into the generally
instantaneous gratification that we all have acquired through the shortness of
attention spans that has become our way of life by reason of competition for
our skill and subservience to some greater or lesser cause.
There might be use
for mold as there is use for bureaucracy if you are part of it rather than
depending on it.
One learns patience
before aggravation, calm before disquiet and acquiescence before complaint when
faced with immotile bureaucracy, we are forced to find the kind of inducement
that will set a bureaucracy off like an avalanche towards the solution – by which
time, a lesson is learnt, no improvements are made and the next person down the
line succumbs to the throes of that wonderfully tortuous wringer called
bureaucracy – it is just the way we have always done things, you are told.
Another long day at work, it started at 7:00AM, a simple change that should have ended in 2 hours had us clutching at straws well after 3:00PM.
Whilst we did not have full knowledge of the multi-faceted system, it was quite difficult to guide the troubleshooting systematically.
A lot of people are a lot more computer savvy than I am, I concede that but sometimes the background from which you have come into Information Technology can be of interesting significance.
Very few people I know have come from an engineering background and there is a particular discipline and rigour that is lacking from other fields in terms of deduction, analysis, building and dismantling components of systems, abstraction and other nuanced thought processes about inputs and expected outputs at different stages.
It is almost a frustrating exercise in trying to align the thinking and analysis but I have learnt to adapt, interject the conversation with pointers that might well be breakpoints somehow the picture begins to take shape and hopefully begin to make progress, the key to keeping it moving is keeping it calm and collected.
Anyway, in the end, we deduced where the problem was and were soon close to resolution.
No intrusive procedures
As the day grew to a close the call I was expecting arrived, my treatment advisor called to inform me that after conferences between my medical consultant, the neurologist, the laboratory and the they review of the results, the invasive procedure will not be required.
Treatment commences tomorrow morning and I can rest easy that I do not have to challenge the preponderance of medical opinion just because I asked that they review their original conclusions.
It was a nerve-racking experience for me but I think I had the right premise, the consideration that I am the one most affected by the decisions made, it is my body; researching the condition and the available options to get clued in about what the suggestions are and engaging the medical personnel to review the seemingly unfavourable option for a more comfortable situation.
I rarely read motivational books, I have always felt they were like snake oil remedies, people who might have found ways of making life work for thems who suddenly think their shoes will fit everyone else who tries them out and then readers would begin to walk the paths of success their motivational book mentors have charted.
Again, I have always been amused by amulet peddlers who have love potions, lucky charms, money spinning wheels and whatever incredible schemes, you never see them in contagious love, they are always down on their luck and if they could spin money the only positive end of that should be doling it out to charity to lift the ones who lack rather than looking for new ways to swindle the gullible.
Seize the day
In ways, I have charted my own way, learnt my own lessons, experienced my own life to the full and whatever regrets I have; they have become part of my own little narrative that confers a sense of uniqueness on my own tale.
Maybe, I heard this somewhere before, it might have come from the book of Proverbs something about seizing the day, the refusal to allow others create your agenda without consulting with you first and then trying to impose the situation on you.
Hear me out again
This morning I called my treatment advisor and remonstrated strongly about the course of treatment that had been left in limbo yesterday, the serology tests and results are indicative when compared to research findings that the intrusive procedure might not be necessary and an aggressive course of treatment should be commenced.
She probably did not understand me or comprehend my argument and premise the first time so she called again to fully understand what I was saying.
My medical history puts me in an at risk category, the less aggressive form of treatment could result in treatment failure that we might have to review in a year’s time when we could by the preponderance of statistical information of such situations address the matter with the accepted course of treatment that guarantees treatment success within 6 weeks.
It was now left to her to discuss this with my medical consultant and agree a comfortable set of choices I can subject myself to.
With me or no way
Meanwhile, the neurological department called and offered me two time slots demanding I attend tomorrow morning. Now, hardly 30 minutes before, I had been asked to standby for a major change taking place at work to allow for a colleague to attend hospital, I had agreed to that arrangement, I could not renege on that setup to the inconvenience of that carefully arranged schedule.
My work life gives me a sense of purpose just as my medical requirements allow for me to have the ability to fulfil my obligations – the medical condition is not life threatening but it needs attention, however, not of the urgency being urged on me.
The conversation with the neurology department went along the lines of the neurologist can only see me tomorrow and so I had to make the time to which I retorted, the neurologist should first consult me and we align our schedules to the convenience of both parties.
I was just not available
They were adamant but then if the patient is not available it would be interesting if they would send the police to come and get me; now that would be comical to the extreme; they just could not see me tomorrow and I made that quite clear – go back to the neurologist and let us plan a date for next week. My hospital is not a court, they should check my availability first.
They are probably not used to patients talking back, this patient is patient but not supine and it so transpired that they allowed themselves to appreciate my situation and we would now meet at 10:00AM on Monday morning, in fact, I was first asked to choose any time slot in the whole of next week but I deferred to their making that choice and I can make the necessary adjustments to my calendar.
First, it is my body
How is that for consideration, respect, resolution and basically not allowing yourself to be pushed over?
My medical consultant now has to be speak to a good few people and we just have to wait and see if I have to challenge the concert of medical opinion singing from the same sheet, knowing what is best for me despite the fact that it is first my body before it becomes a medical curiosity and if that is my last fight, it would have been well fought.
