The hospital is an
interesting meeting place of humanity, where our frailty and infirmity meet with a strong will to live, compassion, care, and the understanding used to help us
return to healthy and vibrant lives.
With X-rays came an advancement in
medical research and observation, then ultrasound, magnetic
resonance imaging (MRI), and computed
tomography (CT) scans which all provide a non-intrusive view of our innards
for experts to review and decide some plan of action; if their observations are
indicative of an issue.
The Trafford General
Hospital is the cradle of the NHS and where it was launched just over 75
years ago, arriving early on Saturday morning, I was met with a labyrinthine
range of corridors, first to the main reception and then to the Radiology
department, being the collective term for all these aspects of scanning.
In preparation for it
The aftermath of my
bladder emptying requirement was to prepare for an MRI scan of men’s things.
The call came in on Thursday evening and the speedy arrangement was once again, a bit unsettling. After a series of questions, I was cannulated as the scan was
to be with contrast. The contrast agent which could have side effects is to
help tissue and blood vessels show up more clearly.
Having changed into
hospital tunics, one back to front and the other front to back, I mentioned my
first MRI scan and the poor choice of music, Here Comes The Hot Stepper it was.
The nurse offered me choices and I went to Bach and classical calming music,
good effort and it was soothing.
Closed to noise and
tightness
I was given earplugs, there must be a Nobel Prize for making the MRI scanner silent, this is beyond the one already given for
the discovery of MRI. The cannula was connected, I was strapped down around
my midriff and the music, the scanning and the noise began. I closed my eyes
trying not to think about being in a tube of claustrophobic angst, it did not
bother me.
Time passed quickly
and I was pulled out and asked to wait for 15 minutes; first to remove
the cannula and to observe any contrast agent side effects. I was soon on
my way home, with much time still left of the Saturday morning. The results will form
part of the review to be had soon.
I did not expect today to be as difficult to cope with as the last time I was in hospital to have a FibroScan and it wasn’t.
All sorts of tests needs to be done to check on health of the liver, from liver function tests that are derived from blood tests, through the FibroScan to check for liver fibrosis and today, it was the turn of an ultrasound scan of my liver to check for scarring on the liver.
The instructions for today were not to have had any meals for at least 6 hours before the scans, however, because the appointment was in the morning, it meant I was not suffering as much as when I had to do with meals for 2 hours, but the appointment was for the early afternoon.
After attending one of the many almost pointless talk shop telephone conferences, a forum for the deluge of conversation with the aim of achieving something much longer than if everyone just instinctively and assiduously got on with what they need to do, I got dressed and called UberXL.
The driver arrived and whilst his name looked Turkish, he revealed that he was from Eritrea and there begun a discussion about power crazy leaders whose penchant for war over peace had led to the unnecessary demise of Africans fleeing conflict.
Then, I told him where I was from and where I had lived. When I mentioned the Netherlands, he expressed reservations about how safe Holland was for children because of the Red Light District and the coffee shops.
What we never talk about
First, I gave him some insight into Dutch thinking, the realisation that we are prone to vices and whether legal or not, people will indulge in their needs for sex and drugs, they will also pay for such if they need to. In Holland, the Dutch have provided a ‘safe’ and regulated framework within which prostitution can be practiced and drugs procured legally. He got that.
On the matter of children’s safety, I tried to make a difference between instruction and education, stressing that children need more involved parental education on the realities of life so that children can end up making wise choices.
For instance, I said, if my parents had discussed sex with me and clearly indicated that if I was touched in certain parts of my anatomy, it was wrong and I should come and tell them, it is unlikely I would have silently suffered any child sexual abuse. There are more things effective parent communication on the issues of life and experience that could have been discussed and saved the child the misery of bad choices and worse.
Our different experiences
Parents again sometimes fail to realise that the cultural environment in which they were reared as children and grew up in could be so radically different from that of their wards. Failing to adapt and reconcile might well leave the kids in a somewhat schizophrenic world of home life that has no semblance to street life; their encounters in school, with friends or in social settings. It ends up a disservice to the child and could be damaging in the long-term.
It is no appeal to abandon our traditions, but we cannot recreate little Nigerias, little Eritreas, or little Pakistans abroad and expect them to pass for the new realities of our nostalgic feelings for home than we can pass on to our children. Where we live moves on and where we left has also moved on, we are then caught with fossilised expressions of things that no more exist.
My UberXL driver could begin to see my point, we all reach back to our experiences back home in our childhood and castigate the realities we now exist in because we have refused to integrate at first and then aim to claim cultural superiority of our host cultures, thereby depriving our children of the essential education they need to thrive better than we ever have done here.
Our conversation ended as we drew up to the hospital, each of us having been challenged of the need to take a more liberal view of where we now belong.
The deceptions of receptions
At the main reception, I asked for directions to the X-Ray department, and much as there are many signs to the various departments in the hospital, it is a labyrinthine maze of corridors that taking directions beyond the third left or right turn is bound to get you lost in the morgue.
I found the section reading the signs and submitted my appointment notice to the section receptionist whose fast-talking demeanour completely threw me that I did not get to answer all her questions of name, date of birth and home address. I faltered giving my home address, it was not comfortable.
Then she made a mistake of ticking off the wrong name on the appointments list before properly searching for my appointment and ticking that off.
People like me
I was asked to sit and wait to be called. Most of the seats about 7 abreast per row were in theatre-like formation some 6 rows deep and then the wall to both the right and the front had one long row of seats facing us.
Many of the people occupied the seats in the theatre-like area apart from one middle-aged African woman, from what I could make of her features who sat alone to the right finding spiritual solace in the pages of her bible. Some others had the company of friends or relations as I made to sit amongst the crowd.
Just as I tucked into my bag to retrieve my tablet to make notes of my observations so far, a nurse called out my name. I arrived some 15 minutes before my appointment and was being seen to ahead of schedule.
Quite like yoga
We walked another labyrinth of corridors to the ultrasound equipment room where another nurse was busy on a computer to the foot of the bed. The ultrasound machine was against the wall to the left with the bed between us.
I was asked to take off my coats, pull up my shirt and lie on my back facing up for observation. The nurse then said she had to dim the lights in the room before commencing the ultrasound scans. I quipped in the words of a Bob Marley song, “Turn the lights down low,” to which she said, that was as far as the excitement will get. I remonstrated that she was a spoilsport and we all laughed.
She applied some gel to my stomach having warned me that is was warm, a stark contrast to the gel applied to my sides for the FibroScan that was cold enough to send me into hypothermic shock.
The probe was pressed against my skin and she started taking shots of my liver, from the front, from the right side, from the back and then slightly to the left. I asked if it was kicking, it brought a chuckle to all of us as she answered, it was.
In all this, I was instructed to breathe in, hold my breath, breathe normally and push out my stomach and this went on for almost 15 minutes. I could well have been in yoga classes for all those breathing exercises.
A short story
When we finished, a good deal of gel had smeared my shirt, but it washes off easily, I was told. There was time for an anecdote or short story related to pulling out a yellow plug at the end of the day. It was a short film starring Omar Sharif as a taxi driver taking a passenger to a cosmetic surgery hospital.
They passed by another major hospital that had been closed due to unfortunate circumstances, the case of unexplained deaths that damaged the reputation of a once renowned establishment. People in intensive care were dying overnight and some night doctors were about to be charged, being suspected of murder.
Eventually, they installed video cameras in the intensive care wards and it transpired that at 1:00AM the cleaning lady when into the room with her vacuum cleaner and simply pulled the plug of the life support machine to gain a socket to plug in her vacuum cleaner. The horror!
Hospitals now have tamper-proof plugs for critical equipment or red notices posted that such equipment should never be disconnected.
I left in high spirits after being told again that my liver looks fine, but I will get the full detail from my consultant when we meet at the end of next month. I was home just before noon.
Please pull up your shirt, lie with your back on the bed, then have one arm down your side and the other up and folded with your lower arm under your head and hand down the middle of your back as much as you can stretch.
I was arched like this for just over 10 minutes when a cold gel was applied to my right ribcage and then a pulsing probe pressed again the gap between my ribs to take measurements, 10 of which were successful out of 14.
In another age, this would have been a more intrusive and uncomfortable invasive procedure requiring a biopsy of my liver.
Another amazing gadget
The liver is a big deal in human anatomy and it is presumed to perform close to 500 functions, its critical need within the body cannot be overestimated and yet we abuse it with excess and other vices. It is quite resilient, but it can only do so much.
My visit to the hospital was for a FibroScan, a non-invasive means of measuring liver fibrosis or stiffness. The FibroScan [Wikipedia] is new technology and extensive study indicates it is literally as good as having a liver biopsy whilst covering more area of analysis than a biopsy will offer.
In the end, the only discomfort I had was in the application of the cold gel and the stretching, I did consider having a conversation whilst being probed, but I thought the better of it.
Comfortable and comforted
The letter fixing this appointment is better worded than the original one that invited me to attend a clinic and I was not to have taken any food for at least two hours before the FibroScan. This compared to when I had an ultrasound scan of my liver to check for scarring some 19 months ago which required I had not ingested anything for almost 6 hours.
At the end of the session, I asked the nurse for a basic opinion and she said things looked good, I also asked for explanations of the readings before she wrote them down for me to conduct further research.
Within a healthy range
When I checked the kPa reading against the Liver Fibrosis card; for my condition and health, I found that I was well within the green range, which for me means, any considered deterioration in my liver function can be arrested and even reversed with the right treatment.
The kPa (kilopascal) which is 1,000 pascals is a multiple of the International Standard of Units measurement for pressure.
Before going for these tests, I was not sure of what to expect, but I am happy that on moving my treatment to another hospital, they are keen on learning things first-hand than relying on the aging reports from my other medical interventions.
Now looking forward to the next appointment. Meanwhile, you wonder if there is an instrument for measuring stiffneckedness or headstrongness.
As the FIFA Under-17
World Cup 2013 plays away in the United Arab Emirates (UAE) we find ourselves being ambivalent about the players my other footballing country of Nigeria has fielded. I support England be reason of birth and the Netherlands having lived there for 12 years. [Wikipedia]
We as fans of a
football loving country are always taken by the amazing performance of our
players, as somewhere in our minds we wonder whether the players are really as
young as they state they are.
In 2008, David Moyes, then Everton
manager made this comment
about Yakubu Aiyegbeni,
“He's only 25, albeit a Nigerian 25, and
so if that is his age he's still got a good few years ahead of him.” [BBC News]
Whatever he might
have been alluding to, he created the perception probably long held that some
Nigerian players might well be many years older than the ages presented in
their contractual documents.
Age fraud and overwhelming successes
Age fraud
in association football is well documented in Africa and Asia, Nigeria was
even suspended and sanctioned for fielding over-aged players in certain FIFA
tournaments. [Wikipedia]
Nigeria is the most
successful team in the U-17 World Cup tournament having been in six finals, winning three, followed by Brazil in five finals, winning two, but we must come to a stage
where we are confident that we are playing on a level field without taking advantage of our opponents.
We must be in the
eligible age range and what should show is our football talent and prowess in
our taking the laurels. This however is not to take away from the successes of
teams past and the pride we have in all their victories.
Some science to the rescue
In 2009, FIFA introduced
the mandatory use of Magnetic resonance imaging (MRI) which apparently has 99% accuracy in determining how old a person is up until the age of 17 after which it is difficult for medical expertise to determine the age that accurately. [BBC
Sport]
The MRI system of age
determination checks the grade of ossification/fusion in the distal radius [bones
at the wrist] where fusion suggests the subject is above the age of 17 and
thereby ineligible to compete in the FIFA Under-17 World Cup tournament. [NIH] [BBC Sport]
Many African
countries first rejected this age determination process, but it is the best science could do for countries that have poor documentation processes that have no proper trust or verification systems to ascertain the provenance or authenticity of birth certificates or declarations. [BBC News]
My scepticism is predicated on whether our kind of physiology is catered for and whether the scanners are calibrated to account to possible racial differences in bone structure, environment, diet and other factors. However, this is the best system we have to rely on now.
A poor record-keeping culture
We do not have proper systems to register life births in hospitals or maternity homes, our municipalities have poor record keeping systems for the registration of births, of marriages and of deaths; beyond which there is no centralised archiving system to maintain such information if acquired.
What we have
adopted is a system of swearing affidavits, many of which are taken on
self-recognisance given the weight of a notary public and then rubber stamped
by the judicial arm of government.
These poor archiving
systems permeate all works life; in government, in the private sector and in
academia. There was an instance where a PhD holder from a reputable institution
in the UK had to present all certificates he had acquired dating back to primary
school after a 25-year career, with him approaching 50 to take up an appointment in
Nigeria.
I dare say that
white Africans are far ahead on the record keeping and documentation front; in
another world, they would probably be able to produce enough documentary
evidence to lay claim to anything even if acquired fraudulently by their
forebears.
The fun in record keeping
I watch programmes
on British television like "Who Do You Think You Are?" and I am always impressed with how researchers could trawl through archives going back centuries to piece together genealogies, ancestries and histories. We probably have just the adulterated and sometimes exaggerated or fabled oral histories to go by – we need to pay more heed to record keeping and documentation.
The idea that our
sports ambassadors have to be herded like cattle through MRI scan turnstiles to
determine the ages of the participants is degrading enough, if not disgraceful,
but we brought this ignominious exercise upon ourselves.
We must address this now
The FIFA U-16 World
Championship founded in 1985 and then renamed to FIFA U-17 World Cup has been
running for 28 years. We should have learnt the lessons by now to ensure any
new entrants to the competition have a good paper trail of birth certificates, medical
histories, school reports and other supporting documentation not to have to suffer
the indignities of an MRI scan.
This must be
integral to our health policy, our education policy and other population census
documentation and government planning policies. We need to get to a stage where
the writing on any document emerging from our countries is worth the paper it
is written on and accepted as authentic by any verification or certification
organisation anywhere in the world.
I could remember the day I had a deep biopsy almost 4 years ago when the consultant dermatologist asked one of his understudies to probe the fungating cancer tumours in the ball of my foot and the second toe of my left foot.
The pain was
already unbearable and otherworldly as the woman flooded my foot with
injections of Lidocaine to no effect. After seven shots, I could still feel the
raw pain of cancer, excruciating beyond what words could describe, but the
biopsy had to be done.
So I laid on the gurney, a nurse holding one hand as if I was enacting a sketch of a woman in labour, she asked me to take deep breaths, though I did not have to push, I did ask for an epidural but none was offered.
In the end, I had
some tissue folded into a big pad and put that between my jaws for the firmest
bite force I could muster and gave in to the worst of the biopsy, which ended
after 10 minutes.
Situation to ponder
I was in pain for
another hour after that, it was one of the worst experiences I ever had in my
life, but it was necessary to ascertain the type of cancer I had for them to
determine the course of treatment.
Today, I was to
have another experience that could easily have been happening to the other
gender as I wondered aloud if it would be healthy and speculated about its gender, then remembered we do not gestate.
Before I knew it,
someone was congratulating my wife and I; that left me in a rather tight corner
before I stuttered my thanks and moved on swiftly ere I had to divulge too much
about my warped thinking and complicated relationship arrangements or the lack
of them.
Situation of liver
I was to have an ultrasound
liver scan, and I really was not expecting a foetus to be kicking and grimacing
in my belly.
Preparations for that meant drinking lots of water to have a full bladder and no food for at least 6 hours before the scan. I find water tasteless that I only got half of the two litres I was supposed to drink into my system.
I registered, and within minutes, the sonographer called my name, took me into a consulting room and then asked me to take my shirt off, sag my trousers before lying on the bed.
She applied some
jelly to my belly and used the probe to rub it all over the exposed parts of my
abdomen before I had to take a series of long deep breaths that I held for
almost a minute before I was allowed to breathe normally again.
Situation is good
I could not see the
scans as they allow women to see the ultrasound scans of their life foetuses, however,
we did come up with the idea of projecting the scans onto the ceiling to keep
patients entertained but that might not be possible under the NHS.
Turning onto my
side, my arms raised above my head, she did more scans until she declared that
my liver looks fine. Over time, I will continue to have blood tests and possible
biannual scans – great relief and thankfulness, one cannot afford another major
event for this day.
The 10-fingerprint scan requirement for valid voter registration cards can be waived for those with special circumstances the narrow definition of which would pertain to amputees and those who might have lost fingers and or thumbs leaving them with the inability to provide 10-unique fingerprints from the same person.
Protocols exist to register such persons and there should be accompanying paperwork to describe and explain why the 10-fingerprints could not be captured else that registration is considered grossly deficient and hence void.
Under no circumstances should the fingerprint scanning process be abridged, ignored or circumvented for those who evidently have 10-fingers except in particularly rare circumstances where the whorls are indistinguishable by the system as a result of medically proven ailments like diabetes or high-blood pressure and manually oppressed hands as a result of heavy labour like farming – but that are quite exceptional cases.
Memo for correcting prior registration without fingerprints
On the 20th of January, 2011, INEC released a document entitled Abuse of Special Registration [1] downloadable as a PDF file clearly giving directions as to how to manage the reregistration of those whose original registrations had been voided by the absence of the 10-fingerprint scan.
**** Critical Validation Check ****
You can identify of your Voter’s Registration card is valid by checking that the 5 tiny square boxes aligned vertically on either side of your photograph are all coloured in black for the L (left hand) and the R (right hand).
If any of these boxes are not shaded, your registration is void and you have to return to your original Polling Unit to ameliorate the situation.
Guidelines for re-registration
The guidelines are as follows;
The Assistant Registration Officer (ARO) will check the original voter’s card to ensure that the person is at the right Polling Unit.
Upon confirming that, the ARO will re-register the registrants on the same DDC machine capturing all fingerprints and issue a new Voter’s Registration Card.
The original Voter’s Registration Card will then be destroyed by cutting it through with a pair of scissors.
The ARO should locate the previous registration on FORM EC1A and cancel it with initials indicating the invalidated status.
The registrant’s details are then recorded as a new entry on FORM EC1A.
At the end of the registration period, FORM EC1A and the invalidated Voter’s Registration Cards must be returned to the LGA/State Office.
