https://health4naija.com/questions-to-ask-before-surgery-in-resource-limited-settings/ Visit the site for a PDF download of the questions listed below.


When life throws us some curveballs, we might be presented with surgical options to resolve medical conditions.

Some conditions present as urgencies and emergencies requiring immediate surgeries and some are elective procedure which can be scheduled at a time convenient for you and your surgeon.

When there is a surgical emergency, you may not have much time to ask detailed questions, however, we recommend, if the surgery is elective- meaning planned and scheduled, that you should try to get as much information as you can and if you are not satisfied you should seek a second opinion.

In both instances of Emergency and Elective surgery, your surgeon will discuss indications (the reason for the surgery), the procedure (exactly what will be done, how long it is expected to last, whether you will be under general or local anaesthesia), and complications (what could possibly go wrong) and this is all considered important before you provide informed consent – informed because you have been told and indicated you have understood all of the above- with your signature for care to proceed.

With current medical and technological advances and the entrants of foreign practitioners in Nigeria’s healthcare system, it helps to be informed about your surgical care to ensure that you are getting the best possible treatment options.

The doctor you see should introduce him or herself to you. You should also be given an introduction packet with the Doctor’s full name, credentials, official address, and where licensed.

Here are some questions that would help prepare you for surgery.

You might be given a packet that answers most of the questions listed below.

Feel free to print out this list to take to your appointment.

What is the indication for surgery?
Have all other non-surgical treatment options been offered?
How do I best prepare for surgery?
How many of such surgeries has the Surgeon done before?
How long would the surgery typically last?
Who else would assist you- the Surgeon-to perform the operation?
What type of anesthesia will be used? Who will provide the anesthesia?
Where will you perform the surgery? Is the healthcare facility accredited or approved by the MDCN?
Does the healthcare facility have 24-hour electricity?
What kind of complications have you seen during surgery for this condition?
Would I need to receive a blood transfusion before or during or even after the surgery?
How do you avoid such complications?
How do you treat the complications should they occur?
How long will the hospital stay be?
What is the cost of the surgery and post-op care?
When will I be able to return to usual activities like driving, work, etc?
When do I follow up for care? What are the wound care instructions? Who will remove the stitches? Who will change the wound dressing?
What is the long-term side effect of this procedure?

Written by Dr. Onuoha with Dr. Doherty.

Copyright 2018, Health4Naija LLC. All Rights Reserved.

This site serves to provide information for Education. You should seek the attention of your Medical provider for any health matters.

COVID-19 vaccines have been shown to reduce the severity of coronavirus (SAR-CoV-2) infections and hospitalizations.

Many pharmaceutical companies have made various COVID-19 vaccines. To put an end to the pandemic, people are being encouraged to accept the vaccine when offered.

Many high risk groups such as frontline health workers and older adults have been vaccinated during mass vaccination campaigns going on globally.

For the World to return to business as usual, countries need to achieve herd immunity, which translates to 70% of population vaccinated. This herd immunity reduces person-to-person transmission of the Coronavirus.

COVID-19 Vaccine

The first COVID-19 vaccine to be approved by the FDA was Pfizer-BioNTech in December 2020. This is a Messenger RNA (mRNA) vaccine. This vaccine is given 2 doses 3 weeks apart.

The mRNA works by stimulating T-cell mediated immune response and the production of antibodies. The mRNA works in the cytosol which is the fluid within the cell after which the cell degrades the mRNA. The mRNA does not enter the nucleus of the cell or alter the DNA of the cell. In response to the mRNA, the cells make spike protein, that block the coronavirus from infecting the cells.

The second mRNA vaccine approved in USA was by Moderna. This vaccine is given as 2 doses, 4 weeks apart.

The first dose of the mRNA typically has very few side effects with mostly pain at the injection site, that can last for up to 3 days.

The second dose of mRNA is more reactogenic, and can cause fever, fatigue, body ache and pain at the injection site. Symptoms typically resolve with rest, hydration with water, and tylenol or paracetamol.

People who have had anaphylaxis from components of the mRNA vaccine would be advised to seek counsel from their provider and avoid taking the mRNA vaccine.

Long term safety data is not available for the mRNA vaccine because this is the first time mRNA technology has been used to make vaccines. The technology to create mRNA vaccine has been studied for 20 years. During the COVID19 pandemic, pharmaceutical companies were able to accelerate clinical trials by simultaneously working on different processes to produce the vaccines.

The non mRNA vaccines for COVID-19 have been made using traditional vaccine manufacturing processes as we have seen for the various existing vaccines. We know that vaccines are safe. People have received vaccines for various bacterial infections; examples of which are tetanus and pneumovax vaccines, and vaccination against viral infections such as influenza, polio and smallpox vaccines as examples.

Vaccines have been around since the first smallpox vaccine was produced in the 1790s. Since that time, advances in medicine and science have allowed vaccines to be safely produced. We know vaccines work and prevent disease.

The third vaccine approved by FDA is by Janssen COVID-19 Vaccine by Johnson and Johnson. This vaccine works through inactivated virus particle which primes the body’s immune system to fight off the coronavirus. It is a one time injection.

In the UK, the AstraZeneca COVID-19 vaccine was approved in December 2020, as a 2 dose injection given 4 to 12 weeks apart. The vaccine is made using inactivated virus particle.

There are many more vaccines that have been approved in different countries.

Currently, over 300 million vaccines have been given globally across over 110 countries.

Link to post: https://health4naija.com/covid-19-vaccine/

Colon cancer is one of the preventable cancers when found in its precancerous stage (before it becomes cancer).
To understand this, imagine a bud of a plant that flowers, this is the process of colon cancer, it starts off as a small polyp which looks like a bud and matures over a 10 year period into full-blown colon cancer.
Here is a write up explaining about the options to screen for colon cancer.

Key points: Screening starts at age 45 years in most people.
In families with a history of colon cancer, screening should start at age 40 years.
Colonoscopy is the gold standard test for screening.

Article
Colon cancer is the growth of abnormal cells in the colon. These abnormal cells are harmful and can spread to various organs causing damage.

Types of polyps
A colon polyp can lead to cancer, it takes about 10 years to transform from a bad polyp to full blown cancer.

Hyperplastic polyps are good polyps that do not transform to cancer.

Adenomatous polyps are bad polyps that can be defined by their histological appearance as tubular, villous, or tubulovillous. These polyps can transform into cancer and are removed during colonoscopy.

What is a screening colonoscopy?
The purpose of a screening colonoscopy is to identify polyps in people without any gastrointestinal symptoms. When polyps are found, they are removed during the colonoscopy. Depending on the type of polyp a repeat colonoscopy may be done in 3 years, 5 years or 10 years. The gastroenterologist will best advise as to the frequency of the colonoscopy.

A screening colonoscopy is generally performed starting from age 45 years in black people and every 10 years if normal up to age 75 years.

Screening colonoscopy is offered to people at age 40 years if there is a family history of adenomatous polyp or colon cancer at age 60 years or less in a first-degree relative.

Screening colonoscopy is also offered at 10 years younger than the earliest diagnosis of cancer in a first-degree relative. For instance if a parent had colon cancer at age 50 years, then their offspring should start screening colonoscopy at age 40 years (50 years minus 10).

There are hereditary syndromes that predispose a person to colon cancer, these are genetic conditions, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer. In these genetic conditions, screening would start at much earlier ages.

Other conditions that cause an increased risk for colon cancer include inflammatory bowel disease (ulcerative colitis and Crohn’s disease) and primary sclerosing cholangitis (a condition of the bile ducts).

What is a diagnostic colonoscopy?
If a person has gastrointestinal symptoms, such as rectal bleeding, weight loss, low iron, abdominal pain, pelvic or rectal pain, or change in bowel habits and a colonoscopy is performed, the term is called diagnostic colonoscopy. A diagnostic colonoscopy is done at any age.

In a patient who does not have any gastrointestinal symptoms having a colonoscopy, the term is called screening colonoscopy, and this is determined by age and family history.

Are there any other things to know?
Yes. A colonoscopy is a procedure performed by a gastroenterology with an anesthesiologist administrating sedation. There are risks with this procedure as well as over-diagnosis and under-diagnosis. There are anesthetic risks also.

The adenoma detection rate is a rating of how effective the colonoscopist is to detect polyps. A low adenoma detection rate means that the colonoscopist misses adenomas. While a high adenoma detection rate means that the colonoscopist is good at finding polyps.

I don’t want to have a colonoscopy. Are there other ways to screen?
Colonoscopy is the gold standard test because it is possible to remove a polyp or polyps during the procedure whereas polyp removal is not possible with the other testing methods listed below. If any of these tests is abnormal then a colonoscopy will need to be performed.

Fecal immunochemical test (FIT) every year
High-sensitivity guaiac-based fecal occult blood testing (FOBT) every year
Barium enema every 5 years
Flexible sigmoidoscopy every 5 years
Ct scan colonography/ virtual colonoscopy every 5 years
Where can I find a colonoscopist in Nigeria?
Major teaching hospitals in Nigeria have Gastroenterologists.

Private hospitals also have Gastroenterologists.


How can I prevent colon cancer?
Let’s review the risk factors for colon cancer, these are

Poor diet, including consumption of processed and red meat, alcohol, and low consumption of nonstarchy vegetables and fruits;
Lifestyle factors; smoking and sedentary lifestyle.
In fact, we have often heard that sedentary lifestyle or sitting for prolonged periods has become the new smoking.

By modifying these risk factors, we may be able to reduce our risk for colon cancer through healthy eating and lifestyle.




Disclaimer: This post is for general health education. Kindly consult with your doctor to determine what is best for you.

Source: https://health4naija.com/colon-cancer-screening/