A very emotional day for me…..

A 43-year-old lady came to the surgery complaining of tummy pain.
I asked all the usual questions and then proceeded to examine her tummy.
I knew instantly that she was pregnant though the tummy was still small.
‘You are pregnant,’ I said to her.
Wide eyed in shock, she shook her head vehemently:
‘That’s not possible!!!’
‘That’s not possible’ she repeated, ‘we have been trying for a baby for many years without success…..there’s NO way I could be pregnant!!!’
But she was pregnant as a simple test of her urine confirmed.
‘No way!! Can’t keep it’ she declared, ‘I want it removed.’

She was almost hysterical with shock.

‘What the f….!!’ she swore angrily.
‘Ok, take it easy.’
I tried to calm her down.
‘You don’t have to decide right now. Go home and think about it and come back in two days to see me, ok?’
‘Let me know what you want to do then.’

She was back two days later.
‘I will keep it,’ she sighed deeply.

Fast forward many months later, as I made my way through the crowded surgery waiting room, I heard someone calling me.

‘Doctor, doctor….’
I turned round and saw a stranger smiling at me with a baby in a buggy.

I smiled back, unsure who it was.
‘Don’t you remember me?’ She asked.
I shook my head apologetically.

With a few words she reminded me of our encounter.
With excitement she announced ‘This is the baby….I’ve had my gorgeous son!!!’
And it was indeed one of the cutest babies I had ever seen. The lady looked like a new woman, so visibly happy.

‘Thank you so much doctor,’ she enthused, giving me a warm hug, ‘Thank you so much!!’

We hugged tightly oblivious to the gaze from all the patients in the waiting room. I tried so hard to hold back tears of joy that pushed at the back of my eyes.
It was one of those defining moments when you decide that despite all the stress (and I can tell you that being a doctor is VERY STRESSFUL!!!) encounters like this make it worth it.

Adaeze x

 

All in a doctor’s day….

adaeze-profilepicjuly15Yet another emotional day for me…
Saw my very last patient at 7.45am. I was supposed to finish work at 8am having worked overnight.
I am tidying up when another name pops on the screen.
It is a young girl in her early 20s with painful period.
That should be easy, I think as I call her through, already dreaming of my warm bed.

So she tells her story of having a really painful period past three days. Both paracetamol and ibuprofen haven’t helped.

So I asked all the usual questions and then requested her to lie on the couch for examination.

Now this lady is big.
However when she lay down, her tummy was BIG. Very Big!
I placed my hand on it and looked at her.
‘Did you say you are on your period?’ I asked.
‘Yes and it’s been really painful.’

‘I think you are in labour,’ I replied.
‘You are pregnant.’

‘What? That’s not possible??! I have been having my periods.’

But a urine test confirmed she was indeed pregnant.
She sat there shocked.
She was adamant that she didn’t know.
She cried a little bit.

‘We need to get you to the labour ward’ I said gently.
‘You will need someone with you.’

She was here studying. Her parents were across the globe in the US.
‘What of your friends or flat mates?’

She wasnt keen to call anyone. I contacted labour ward and sent her over.

Fast forward 24 hours later, I call her to see how she is doing.

‘I have had my wee girl. It’s the cutest baby ever’, her voice tinkled down the phone.
I was genuinely happy for her.

Her flat mate was with her and her mum was on her way over to meet her unexpected grandchild.

I smiled as we chatted.
Forget UNI for the moment.
Forget how she was going to cope.
Forget all the upheavals this lovely addition to the world may bring.

It was heartwarming to know mother and child were both well despite not having any antenatal attention, no pregnancy vitamins, no preparation at all for its arrival.
It’s one day at a time.
All in a doctor’s day…

Adaeze x

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ABC of the ‘3 parent baby’ technology.

3 parent baby, sexual wellbeing, The world reacted with horror when the news of the ‘3 parent baby’ was approved in UK Parliament last week making the UK the very first country to authorise this.

It is understandable that there would be such a reaction. People distrust science when it comes to reproduction. It was the same reaction with In vitro fertilization (IVF) yet today so many families have benefited from it. The success of IVF now means that many couples who otherwise would be childless can now enjoy the bliss of having their own babies.

Now science has moved on to ‘3 parent baby.’

However I want to explain the so called ‘3 parent baby’ in a way non-medical people can understand. This is not science playing God at all.

But first some terminologies:3 parent baby, sexual wellbeing network

Mitochondrial diseases: The mitochondrion is the”power house” of the cell. It produces the energy required by our cells to function effectively. It also helps the body detoxify waste products amongst many other functions.

It is because the Mitochondria are such an important part of our cells that when they malfunction, it causes a whole range of diseases known as Mitochondrial Disorders.

Some disorders related to malfunction of the Mitochondria include Blindness, Autism, Diabetes, Myopathy (muscle problems), Bipolar disorder, Dementia, Epilepsy, Stroke, Parkinson’s disease and many others.

Many of these diseases are passed on from mother to her child because the child gets its mitochondria from the mother. So if the mum passes on defective mitochondria, the child will then be affected by these mitochondrial diseases.

So how does the 3 parent baby work??

Mitochondrial donation means that those with defective Mitochondria can get a good one from donors.

The baby still has the entire DNA from its own father.

It still has the entire DNA from its own mother.

However the defective Mitochondria from the biological mum are replaced with functioning Mitochondria from a donor. This donor Mitochondria make up only about 0.1% of the total DNA in the baby.

I have simplified the process to help readers understand. Details about the procedure can be read in medical articles such as here.

So, do these donated mitochondria mean that the child has 3 parents??

If you got a kidney from a donor, does that make the donor one of your parents??

So we can see that the term ‘3 parent baby’ does not really mean what it says and is simply creating fear and mistrust in the public.

However this is a new technology and long term studies will be needed to ensure that it is safe just like studies are needed and are ongoing concerning IVF babies and many other scientific breakthroughs. We just do not know for now how safe Mitochondrial donation is even though the Human Fertilisation and Embryology Authority (HFEA) has suggested that the technique is “not unsafe.”

You can read why one scientist opposes mitochondrial donation here.

But for now it looks like a major breakthrough which hopefully might  alleviate and even eliminate mitochondrial diseases and the suffering and anguish of families affected by them.


Dr Adaeze Ifezulike is a Family Physician/GP based in Aberdeen. She is a Finalist at the UK Sexual Health Awards 2015 and for her book ‘Understanding Contraception: A guide for black ladies’ she has been nominated ‘Author of the Year’ at the Women4Africa Awards.

Celebrating the Sexual Wellbeing Network (SWB) community!

We welcome the 1000th member of the SWB community. You are what the blog is about. You make it all worthwhile!
As a way to celebrate, we are featuring the comments of the SWB community on different topics featured on this blog. No one knows it all. Your input helps the whole community learn and expand our understanding.

Sexual Wellbeing Network

Sexual Wellbeing Network

Thank you! Enjoy the comments below and have a fabulous Christmas!

On Female Condoms:
”I think where the emphasis should be placed most should be on the effectiveness of these toys, do they do the job? Are they capable of protecting the woman from unwanted pregnancies, contracting the HIV virus and other STDs, without reducing the fun and intimacy of sex? How much does it affect the users psychologically? Is it acceptable to both man and woman? These questions, to my own understanding, are more important than the looks of the toy, after all, once they are inserted in place, you only feel and never see them until the act is over and done with. If this is the case, I will encourage our women to please heavily arm themselves with it at all times, since prevention is better than cure” – Ilouno

On HIV:
”There is no gainsaying the fact that societal pressures, family disharmony and loss of values contribute a great deal to the pervasiveness and sexual indiscretions, that exposes couples to this most embarrassing scourge of our time, and it takes more than just self control to curb it. The message still remains; ‘Zip up or use condoms’,’one man one woman’, as fidelity and faithfulness to one’s husband, wife or girlfriend remains one sure way of keeping the numbers down.” – Ilouno

”Mma needs to tell her husband about her HIV status because, think about it, how long can she keep the secret? And what if keeping it secret leads to her infecting others in some way – her husband or children? If her husband loves her enough, he’ll stand by her after the initial shock” – Asanwa.

”Fidelity in marriage is so important. Temptations may occur but they must be discussed with one’s spouse to allow for fortification of any lose ends by prayer and increased efforts to meet each others’ needs. This also allows for accountability” – Kay.

”Marriage should involve openness and freedom to broach even the most difficult subjects. She needs to tell him. No one should bear this alone! She may be reluctant because this would bring up the almighty ‘infidelity’ which could lead to accusations and counter accusations or disintegration of the marriage. Nevertheless, knowing the truth sets you free so she needs to broach the subject in a non-confrontational manner” – Nkirum

”I have had the opportunity as an adherence counsellor in the HIV clinic and most times its shocking how we Africans especially perceive HIV. The funniest and most ridiculous I ever heard was that it was just like malaria that would go away after a few medications or perhaps someone from their village was after them (spiritual attack). The challenge is that most people do not take the time to acquire the necessary information on health issues and in this case know for sure their status but would prefer to sit on the fence all in the name that ‘what I don’t know won’t kill me’. That is just clear cut ignorance and foolishness” – Amie.

”Faithfulness, faithfulness, faithfulness! how can you know that your spouse is faithful? O Lord help! Only the regenerated in heart can be faithful. Please good people, if you ever suspect your spouse, call a round table conference!!!” – Joy.

”Being faithful is not enough but it boils down to being faithful to a faithful partner. There is hope for everyone irrespective of the trauma such revelation can bring. Whatever way one gets HIV doesn’t reduce the trauma, suspicions and all that.” – Honey

”This is a very touching story but unfortunately one that repeats itself often. Many of us are in denial. We believe we are too careful to ever be infected. We make sure we are not exposed to all the risk factors and therefore we are fine. The truth is it could befall anyone. We may be able to control all risk factors under our control, but what about the ones that are beyond our control? We may trust our partners but some human beings have dual personalities and can change: only God never changes. Being informed is the best weapon and exhibiting responsible behaviour” – Ubong

On Injecting Drugs:
”We need to equip our youth as little moments of pleasure and experiments can bite one in the bum in years to come” – Kay

On Educating Teenagers:
”Not until my son was taught how to use condoms in a health class, I couldn’t have imagined there was a proper way to do it. Like most Black parents, I was initially upset about the need for a teenager to be exposed to that aspect of life but when I realised he will one day use it, then I felt better he learns to use it the right way from the experts rather than from someone or somewhere else. We need to be better informed to protect ourselves and our loved ones” – Engee.

On Testing for HIV:
”Many Africans believe that what we don’t know will not kill us. He is just trying to hang it on something to avoid the test. I however believe that as more people see the benefit of early detection, they will offer themselves for screening without being asked. Almost all of us were in this same situation before we got some awareness. It is ignorance to say the least, as it is in his interest if he knew better.” – Engee

”Most ignorant people like Dike would not want to know their status forgetting that awareness is the first step towards a solution. I personally believe knowing one’s status is very important!!!” – Bels

”To be honest, if I believe I don’t have HIV and hepatitis, then I will not be willing to have the tests. Taking the tests brings its own high blood pressure. Just waiting for the results can freak you out, even though you know it will be negative. So I would not recommend hastiness in agreeing to take these tests. The human body can be funny – someone can be very healthy till they’re told they have a sickness… then they start actually feeling sick! So in such cases, to know or not to know… that is the question!” – Jetmum

”I think it is important to know your status even if you believe you’re not at risk. The reason why people frown at getting tested might be because they believe only promiscuous people get infected by the virus. Another reason could be the fear of having the virus” – Omorewo

On Challenge to Men on Contraception:
”I totally agree with men asking their partners what contraceptives they intend to use and both parties agreeing on what to use. It takes two to tango and there’s no reason to suggest to the other to take care of her body while you take care of yours. That goes against the essence of marriage/partnership. So please MEN, take on the challenge” – Stef

”A very objective and well thought out challenge to our men. Dear Man, my prayer is that you rise up to the challenge” – Elsie

”I equally challenge women to take control of their bodies and do what they can to protect themselves. After all, abortion or unwanted pregnancies all happen in their bodies… not to talk of diseases! Take charge of your bodies and live life to the fullest.” – Jetmum.

”I feel to an extent it is joint responsibility, but on the whole every human being is responsible for their own body. And so a greater part of the responsibility lies on the woman when it comes to contraception. We have to look after our bodies, women have to consider the fact that they could get pregnant or catch a disease and have to explicitly make sure they are protected from this. It would be nice to think that someone else can take responsibility, but except in the case of children (who have no business engaging in sexual activity anyway) and incapacitated people, the ultimate responsibility of every capable adult lies on themself” – Sisbee.

On Sterilization:
”I am Nigerian who schooled and lived in UK for some years. I have two lovely kids and honestly they are my best gift from God ever. I had a vasectomy five months after our second child. I am very normal, my home run is awesome, my erection and ejaculation is superb and I also know that I can have a reversal if the need arises but truth be told even after the marriage broke down I have no regret, (in the UK cost of reversal is less than £3000 now). I am not keen on remarriage and even if I find love again and remarry, I can adopt a child or two if necessary or do artificial extraction and insemination if I don’t want reversal. Why did I do it? I just didn’t want more than two kids in a wobbling and very rocky marriage and I felt it is ungodly for me to be having more kids under the situation. I prefer action to complaints particularly when I knew she was not willing to have a long lasting contraception procedure so I did and am still happy I did” – Segun

”Call me old fashioned, but I wouldn’t advise my “future” husband to get sterilized. It still feels foreign to me. I’d rather go for something easily reversible, although I am sure easily reversible contraception methods may not be as effective as sterilization and other contraception methods in its family. But it is a risk I’d rather take” – Debbie

”Well, for me, women are at the receiving end always. It should be ‘making’ a decision not ‘settling’ for one. Amina wants to be a good wife, mother, and woman but she is not happy taking this step. What is this man ready to put into this decision? The woman is a soil that is always ready to grow d seed but d man needs to provide d seed. Make a decision that will bring smile on both Amina and her husband. I am not against her decision but there are other ways out. Make the man understand that he can’t eat his cake and still have it” – Kemi

”I am black and have been sterilized. I don’t have to worry about getting pregnant anymore. Everything has remained the same for me and even better as I enjoy sex more. I can’t be bothered about what anyone thinks about my decision as it is my life. I have the number of children I want and that is it for me. Recently a lady lost her life while trying to abort a fifth child. She couldn’t bear to have another. Women have to take the decision if their darling husbands have refused. I believe that more women and men will opt for this procedure as they become more enlightened and better still as they get the assurance that sex life remains intact and in cases like mine even better” – Engee.

”As far as I’m concerned sterilization is better than having to abort another unwanted baby! Sterilization should be promoted and shouted from the rooftops in Africa. Once you’re sure you are done, you shut the gate and get on with life… that’s it! – Jetmum

”I think its all a matter of choice. However, I will not choose sterilization. Other options like IUD are available which many have used including yours truly and can enjoy marital bliss without the awkwardness of always reaching for a condom. As an African woman, permanent sterilization is a no no!. But as I said earlier, it still boils down to one’s choice and beliefs!” – Zuzu.

”Personally I still feel sterilisation (male & female) is a bit extreme. I know other methods might not be as effective but Amina could try Implanon in the meantime while the couple buy time to make a permanent decision” Ofon.

“In my own opinion, I think sterilization is unnecessary. There are many other types of contraceptive that Amina and Baako could choose from which would give them the desired result. It’s obvious that Baako is not happy with the issue of sterilization, then let Amina who thinks there’s nothing wrong with sterilization go for it. After all, woman can be sterilized too!” Yemisi

”My view on male sterilization might be a little bit different. I am an African lady and would never advise my husband get sterilized even though he has said he wouldn’t mind. My reason is this; no one knows the future, I do not pray for a terrible one but things happen. Hence, I would rather go for a reversible contraceptive method” Omorewo

”I think male sterilization (which apparently is a simpler procedure than a hysterectomy and female sterilization) should be promoted more amongst black people. The statistics are clear and in fact in men just don’t want to hear it at all which I think is sad because it is an easy solution to these issues. One school of thought however is this: our society is generally notorious for male promiscuity even among some of the married folk. I may be speaking for some women when I wonder if sterilisation would increase this problem as the risks are reduced” KC

On Withdrawal Method.

”As a black man with a strong Christian background, I still find it difficult to believe we need any form of contraception. I would rather exercise the self control withdrawals. This I know would sound strange to some but I believe its also an option for those who can” – John Bull

”Hmm I’m actually amused by the confidence with which Mr Bull is recommending withdrawal. Sounds like the catch is for men to pride themselves in the ability to control themselves. I think this may work until you are absolutely sure you don’t want more children. People may manage the odd mistake that yields one child but if there are multiples in your genes, please don’t follow Mr Bull oh!!!” – Kayce.

On Abortion:
”Quite shocked at Amina’s abortion number: two already! She must be emotionally affected by that. She would need support. But I’m also surprised people do not consider implant or even injection (for female). I mean it’s stress free and free lol” – Ange E

”It’s sad that though we know abortion is murder, we continue in it and help people to abort children. Let me repeat…ABORTION is MURDER. We have walked so far away from God and His statutes that ‘modernism’ is now the order of the day. No matter how we look at it the guilt of abortion in whatever religion stays with the woman all through her life. Do not have a hand in it, nor propagate it. When those children are murdered in the womb, they scream silently. You may not hear it. But God does” Olive

”Interesting……want to see what their decision was at the end. Abortion……….hmm! Its killing a God-given life so that’s not an option in my opinion” – Pearl.

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