Turn your lights down low, I need to see your liver

Once again to the north

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.

Blog - From measuring liver stiffness to stiffneckedness

The pickup talk

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.

Petition: Death release him!

Clicking to save the world

Quite recently, I have become rather concerned about the insidiousness of online petitions and their power to force issues onto the agenda demanding serious action.

The whole idea that we can at our keyboards and click our way to world peace and the Nirvana we have also dreamt possible and attainable is now so trendy, it is beginning to lose its purpose.

Now, I have signed a few online petitions, even gone out on protests to back what I am petitioning for, however, I am not one to sign all petitions that land in my mailbox for whatever cause, no matter how serious and endearing that cause might be to others more fully persuaded of that cause.

To be persuaded

I need to be persuaded and engaged, I need to see the goal and understand the need, it is important that we see what is achievable and what is just following the crowd.

Yet, there are causes that I will support because they are close to my heart, those to do with rights, with children, with justice when deserved and the last one I felt so strongly about was the petition to Selfridges Manchester to remove the anti-homeless and reprehensible studs they installed on the low-lying ledges of their shop windows.

However, three recent petitions have got up my nose that seem to tend towards malevolence than beneficence.

An adjunct to justice?

The petition against Ched Evans who having been convicted of rape and having served his sentence was not allowed to return to his footballing career because some people did not think he had served his punishment enough. Besides going to prison and his still protesting his innocence, the petitioners who amassed in their hundreds of thousands creating a wall of online protest that appeared to force the hand of more reasonable people unwilling the challenge public opinion.

What is uncomfortably insidious about this development is where the petitions appear to tag on an extra punishment beyond the justice system, the keyboard warriors completely abstracted from reality, yet effective in their petitioning numbers. You wonder, when is a punishment or a crime effectively served if petitions can grant unregulated public opinion the ability to impose new sanctions?

Like reality television, the power of the subjective and emotional without clear access to the facts has now become part of our daily life, and much as it is helping some people, it can also dramatically ruin lives too.

Entertainment trumps the punch

The second petition that is giving me great concern is the one imploring the BBC to rescind the suspension of Jeremy Clarkson who co-hosts the Top Gear show.

I am no fan of Jeremy Clarkson, his manner, his attitude or his activities much as his antics can be entertaining and still be a pitiful display of boorish kidulthood. There are reasons why the BBC chose to take the very dramatic action of suspending their ‘Golden Goose’ as Top Gear is probably the most syndicated television show in the world.

Like many who have signed the petition and the keyboard warriors are close to a million, we all do not have access to the facts and detail of what prompted the suspension. The said ‘fracas’ suggests Jeremy Clarkson allegedly attacked his television show producer for not providing the refreshment or food he wanted.

Consider the producer, for once

Jeremy Clarkson is a lumbering creature and no one can explain what the producer might have felt in terror or humiliation at being ‘attacked’ for not doing what was expected of him. The dispute could have been handled in a more gentlemanly manner if Jeremy Clarkson were ever a gentleman, and I have never been convinced he ever was.

Yet, for the popularity of his show, the producer has become inconsequent and a nonentity, whilst Jeremy Clarkson is to be excused and forgiven the actions that led to his suspension, because our entertainment matters more to us than the minor act of a probable fist connecting to the body of another lowly person who brings no glee into our well-adjusted lives. According to the petitioners and the following is global.

As a consequence, the producer might become a pariah and even lose his job because it is attached to the now suspended Top Gear show. Is there any justice in this world?

Death release him

Which brings me to the last petition and there is not much I can say to the fact that Sir Terry Pratchett died on the 12^th of March, 2015 after almost eight years of suffering from Alzheimer’s disease.

Over 21,000 have signed a petition asking Death to give Sir Terry Pratchett back, I guess that is a petition I can sign up to, seeing we are coming into the Easter season. Honestly! That is what the petition craze has become.

Essential Snobbery 101: Anticipated Consideration

A window on our world

This morning, as I got on the train to work, I was offered a view on society that had brought expectations and personality into focus.

Expectations of others and the personality of people, both of myself and the other person involved in the incident. It got me thinking about how things are changing and why some things have come to stay.

Feet off

The schoolboy who could be no more than 12 years old was sitting on a 3-seater, his bag and classical musical instrument case occupying the whole space, and then he had his shod feet on the seat in front of him.

Nothing particularly annoys me as much as people who put their feet on seats, especially where there are clear signs that feet should not be put on seats. Besides, even if they do take their feet off the seats, it is not like they make an effort to clean off the dirt they might have put on those seats.

So, I motioned with my cane and intensified that with a scowl for him to take his feet off the seat. I brushed it off and took my seat. Hardly a minute after that, he decided it was too much for him, so he moved to another seat in the train carriage.

As he settled in that seat, I said to him, putting his feet on the seat was anti-social behaviour, and it was important that he knew that, even if he did not like the fact that it was being pointed out to him.

Anticipated consideration

Yet, in that little encounter was a whole set of narratives. A public school-educated boy who had exercised a sense of entitlement in a public space without what I might call ‘anticipated consideration’ and, when challenged, expressed rebellious dissent by moving away.

Anticipated consideration is when, as in this case, you know that you do not put your feet on seats others might want to use, and you do not occupy more seats than you have paid to occupy, especially when the train or vehicle is still at a major boarding port, like a terminal train station. It is having consideration for others long before it is demanded of you to consider and adjust.

Rebellious dissent, however, is the case where, rather than acknowledge that you are wrong with contriteness and apology, you take evasive action to avoid proximity with the challenger of your behaviour.

The fear of challenge

I dare say, we now live in a society where, sadly, many young people will not brook any scolding or correction, and those who dare challenge bad behaviour run the risk of coming to harm by such people lashing out in aggravated resentment. We have a delicate balance to manage between wanting right and yet being fearful of demanding things be done right.

The question is, if as a society we, for the fear of retribution, maintain silence rather than challenge anti-social behaviour, what kind of society will we have?

The other nuanced narrative is in assumptions and appearances, as this young man was a day student at a public school in Hale, there are general expectations of behaviour and conduct. Whilst entitlement is drilled into their psyche, comportment has a particular importance because it moderates behaviour in polite society and defines the quality of integrity, which is what you do when nobody is watching.

Maybe I was a bit harsh

Much as I would like to explore this further, it is best left for now, because it will reflect on not just the school, but on the parenting too. Suffice it to say that having a classical instrument case does not necessarily suggest one has class or has been schooled in the decorum that pertains to performing for sophisticated audiences.

On my part, I thought about my attitude to anticipated consideration and my acceptance of the inconvenience of rebuke when I have been wrong, and I might have been a tad sterner with the schoolboy because he could easily have been one of my youngest sons.

When I was his age, I would never have done what he did, and surely, as another black man, yes, we shared the same racial profile, we are a lot better behaved than this, especially if we have the benefit of a privileged education.

Thought Picnic: Don't leave your youth behind

Riding through life

Being a passenger in a taxi cab is becoming a story of life and experiences seen through the keyhole of conversations that could last anything from 10 minutes to 30 minutes. I have heard of a death, a graduation, two operations, holidays, a retirement and many other tales of interesting careers before they took up driving.

The other day, I was picked up by a completely new driver from the firm that offers the service and in the process I found myself going through recollecting episodes and remembering names of the many others who have picked me up.

To think that I got to ten was quite revealing and yet from teacher to tearaway, policeman to cricketer and any other profession, I have found people who are everyday lovely and interesting people.

The end of one venture

On Friday, I bookended the taxi driving career of a man who had retired at 55, took to being a chauffeur and taxi cab driver and just 6 weeks after he turned 65, he decided his hackney carriage licence which comes up for renewal today should expire. He is going on to other interests you take up in retirement – going on holidays with his wife.

Whilst I somewhat lamented the change and the fact that the interaction with many strangers will end, he recalled his first job where he picked up two young ladies, how memorable that was and how for the conversations we used to have, my being his last passenger before he returns the car and waves goodbye to a decade of driving will be memorable too.

Embracing youth

What fascinated me is the way many people who are much older embrace change and sometimes embrace change faster, enthusiastically and better than the youth. The couple I bought my apartment in Amsterdam from, some over 13 years ago were in their late 70s, they had bought that apartment off a plan uncompleted after 25 years of living in Eindhoven in their early 70s and spent 3 wonderful years in Amsterdam.

She, the wife was the chairperson of the resident’s / owner’s association in a block of 63 apartments in a 19-storey apartment block. They left Amsterdam for an idyllic riverside serviced convalescence apartment in Arnhem. A place they bought off the proceeds of selling their Amsterdam apartment to me.

A state of the mind

What struck me was the youth adventure of doing something new and living happily in the present, unburdened by their past whilst lacking any apprehension for the future. Youthfulness is rarely a function of the chronological age, it is more a state of the mind.

That, I think is the wonder of youthfulness and it is infectious at any age if you allow yourself that freedom.

“Youth is a wonderful thing. What a crime to waste it on children.” George Bernard Shaw and as it happens, I did visit his house at Ayot St Lawrence in the 1990s. He died in 1950 at the age of 94.

The above quote is a better version than the more commonly quoted, “Youth is wasted on the young,” and I saw it on one of the boards outside the Bachelor Inn in Dublin, last year.

#NigeriaDecides: It is a part of a campaign - Anything but the truth is what we need

Enough of it

Yesterday evening, after watching as many sickening lying tweets pass my timeline that veers from exaggeration, through embellishment to outright falsehood, I had to react to one particular one about Transparency International.

The tweet suggested Transparency International data made a comparison between the present and a period 8 years before Transparency International came into existence. For the record, Transparency International was founded in May 1993.

The worst comes forth

Now, I would have ignored the tweet as noise, but the person who I have not met before, however, respect as a 'journalist' who runs a newspaper as an Executive Editor is someone I respect for reasons difficult to explain since we have never met. The fact is people project a personality on social media that you grow to like and generally follow and engage.

What has bothered me is this electioneering season in Nigeria has brought out more of the worst of than the best of people. The propaganda with sensationalist headlines has reached a crescendo that the whispering truth and facts have been lost in the cacophony of the malevolent.

Desperate times

The air is rife with conjecture and conspiracy, the opinions rock perspectives like a small boat tossed about in turbulently rough seas, we are literally left at the mercy of the hope that we still have our wits about us to be breathing for the wish for discernment and discrimination is long far gone.

All I can say is these are desperate times, the chaps in charge, in a Nigeria that was barely functioning to its potential would have hardly scraped entry-level management, but they have found themselves holding Nigeria’s purse strings.

With literally untrammelled power, wealth and opulence beyond their wildest dreams, these people are not going away without the dirtiest political battle for office Nigeria has ever witnessed.

Their being in office supports the most aggrandised company of gluttonous pigs with their snouts in trough of the national largesse, the prospect of change is fearsome and terrifying for them because not only will they go hungry, they risk incarceration for their heretofore excused and celebrated criminality.

It is a part of a campaign

Indeed, we have a Nero who fiddles as Nigeria burns, thinking like the man in the street that has never left the street, he pardons the corrupt, elevates the questionable, excuses the inexcusable, utters the intolerable, celebrates the reprobate and redefines corruption with platitudinous acceptance. He does not give a damn.

With that kind leadership, it is no wonder that when I challenge someone about tweeting lies and creating tales represented as fact, I am told, "It is a part of a campaign."

That is the danger we face in Nigeria, "It is a part of a campaign." Anything goes, without consequence because reputations count for nothing if your patron is in charge to give you the semblance of normalcy and success whilst offering the delusional Utopia of everything is well in Nigeria.

They promptly take credit for the successes of others despite them and even more rapidly apportion blame to others for the failures they are responsible for.

"It is a part of a campaign." That is one thing I will remember of those who abandoned principle, virtue, honesty and truth for political expediency. I am beginning to lose my respect for people I once respected, but "It is a part of a campaign."

Thought Picnic: The Red Hot Chilli Pepper of Crazy

Peppered in life

The joys of capsicum delight are best expressed in another interesting Yoruba saying that I will attempt to translate thus, “A life without eating chilli peppers is a flimsy life.”

I would guess that is as good an old wife’s tale as any that instructs one should try hot chicken broth for colds amongst many other similar spicy remedies.

We use the scotch bonnet (ata rodo in Yoruba) a lot in West African cuisine as well as the cayenne pepper (tatashe in Yoruba), but I will not be mistaken to notice that back when I lived in Nigeria we used a lot more scotch bonnets for our stews than we will attempt to use here in Europe. The ones grown or imported are somewhat spicier.

Scales of spice

However, this little write-up is caught up in the picture above, which came from a packet of Nando’s crisps. I could not help but notice the Peri-ometer scale, which in a way indicates the spiciness of their products.

Whilst I am not a fast food fan, I have been a patron of Nando’s from when they opened their first outlet at London’s Earl’s Court probably in the late 1990’s, if I remember correctly and now, my choice of easy cooking without the class of an a la carte restaurant is between the preferable Vapiano and Nando’s.

On the Peri-ometer scale and there are many representations of it, I do like this one because I do remember when I visited my friends’ aunt in Kaduna at the age of 9, she cooked for us, dark yam flour pudding (amala) with stew.

This is mental

Eating with hands, I dipped into the pudding and took bite-sized bit that I first touched to the stew and then to my mouth, when all hell broke loose. It was a case of “I need my mum.” Not only was my tongue and mouth on fire, I was close to spontaneous combustion as the hotness of the chilli in the stew.

I cried, I drank lots of water and then settled for a bowl of cornflakes as my friends lapped up the stew as if they could use it for eye salve. They belonged off the Peri-ometer scale.

However, today, when I go to Nando’s, their fare does not seem to be hot enough, besides the fact that chicken needs to be cooked and dry to keep me from being nauseous. The piri piri sauce made from dried chilli peppers called African bird's eye chilli helps a lot and I have my chicken at the Peri-ometer scale where “I need my head examined.”

Which is no surprise, because I guess I am crazy and to write a blog about a crisp packet, I probably do need my head examined too.

From measuring liver stiffness to stiffneckedness

Probed from the side

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.