.....if it makes you feel better
By
Dr Chukwudum Cj
□
She is a 26year old.
At the age of 22 she came with chronic diarrhoea preceeded by flu-like symptoms ; and was diagnosed of HIV but she refused the diagnosis and rather attributed the symptoms she was manifesting to "spiritual attack ".
Fast forward 4years: she came in again in a critical state: profoundly weak and breathless with PCV of 6g/dl; anorexic[also has odynoohagia], cachexic, marked weight loss, abdominal distension associated with drenching night sweats; and acute watery diarrhoea with associated mucoid and blood stained excrement.
Following proper physical assessment and laboratory investigations she was diagnosed
as having RVD stage lV [full blown AIDS, with CD4 of 67cells/micro liter] with
- Disseminated TB
- Esophageal Candidiasis
- Chronic diarrhoea due to malabsorption
- PCP
We set to work to resuscitate & stabilise her:
-4 units of blood, transfued in tandem over 4days
- IV fluids[ drip ] enriched with vitamin B'complex
- Vitamun A, Zinc, Selenium, Fluoranum [ also imodium when necessary ] in addition to the "traditional" flagyl and ORS to take care of the malabsorptive diarrhoea
- Septrin for PCP was with held until the PCV apprciated
- Fluconazole for the Candidiasis
Etc
In a weeks time the improvement in her state was remarkably phenomenal; her appetite was back to normal, diarrhoea completely ceased, breathlessness and profound weakness resolved .... she could smile, laugh, crack a few jokes. She was happy, the whole family was happy!
But we knew that we had to address the 2 monster culprits [ HIV and TB ], else she was going to embark on another roller coaster ride down a steep hill, in a car without breaks, headed for the rocks. A fatal crash was imminent!
To prevent IRIS [ Immune Reconstitution Inflammatory Syndrome], we enrolled her in DOTS and started anti-kochs [TB Drug] using the RIPE regimen [ Rifampicin, Isoniazid,Pyrazinamide, Ethambutol] under cover of pyridoxine. She was to take this for 2 weeks before commecement of HAART [ Highly Active Anti RetroViral Therapy I.e HIV drugs ].
We had done our part, but then this all important part of the treatment depended on her judicious adherence to the medications!
Just when we thought we were winning the battle, RELIGEON reared it's ugly head again!
She was going to get spiritual help. And no, she dosent believe she has TB let alone HIV .... some diabolic elements from her village were after her, and she was going to get to the root of it.
All counselling and pleas fell on deaf ears .... she demanded for and was discharged AGAINST MEDICAL ADVICE.
3 months later I was on call in the A/E [ Emmergency section ] , I received a consult and went to see the patient. Behold it was my 26year old friend, presenting in a manner similar to the way she presented 4months prior ... only this time arround twice as bad.
One would have thought that by now common sense would have cleared the thick fog of superstition created by RELIGEON in her brain. But nah .... she was still irrational and delirious from OVERDOSING with the "opium of the masses" !
She said[ No, not her .... the mum rather; because she herself was too weak and breathless to talk! ] she had been ill for the past 3weeks, and seriously so ..... but why didn't she collapse until the eve of her final exams...???? That the simple answer is that their enemies were at work again!
My simple answer was this .....
" Stop bullshitting yourself about these imaginary heinous creatures you call enemies! Cos you are your own enemy! You are the one that refused treatment, you are the one that didn't seek medical attention when things started going south ..... you and you alone! So stop blaming it on God or the Devil .... cos neither had anything to do with this! The only thing they did was allow you to live on borrowed time, cos this was inevitable and should have even happened earlier!"
[ Those may not be the exact words .... but the contents are pretty much the same ]
□ Morals ...
- The "opium" of Religeon in itself may not be bad, but senseless addiction to it without proper knowledge and information dulls the senses and blinds one from reason.
- It is high time the African started tackling his problems head-on without recourse to the supernatural; & taking responsibility for his actions instead of waiting for God to come down & wipe his ass for him.... and blaming it on the devil when things go awry!
- Like always, denial of a problem only creates a momentary euphoric illusion of wellbeing, one that vanishes when the stings of reality sets in.
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