Thursday, July 2, 2020
Harrisburg, PA, USA

(continued from part 1 of 2)

elow is a story that might interest the reader on how a man I know, here in the United States, took control of his diabetes. I have told this story a lot of times before, in my writings.

Many years ago, as a construction engineering inspector in Maryland, I worked with a project engineer, Mr. Buchanan (not his real name), on two bridge projects. Mr. Buchanan, a Caucasian, had a personal regimen that caught my attention as soon as I joined the project team. During lunch time, when the rest of the engineering inspectors would settle to scrumptious meals with assorted cans of soda(mineral) to wash the food down, Mr. Buchanan would head into the forest and would not reappear until thirty-five to forty minutes later. It took a while before I found out that he used the entire time to walk two or three miles in the forest for exercise.

On return to the office, which was basically a construction trailer, he would settle into his chair, gingerly retrieve his lunch from a small Ziploc bag and slowly start eating. His lunch pack always contained fruits. Because I did not understand what was going on at the time, I saw him as a very strange and miserly man that did not want to spend the money he was making to "live well". Considering that he was very well paid, I did not understand why he could not "eat big" like every other staff on the project team. Mr. Buchanan always wore sunshades and did not smoke. He told me that he quit alcohol several years back.

As time went on, I began to understand that there was a method to Mr. Buchanan's “madness.” The man I saw as a miser was actually the wise one amongst us. He was doing everything possible to live a healthy and long life. The mild-mannered man was working hard to surmount an uphill but winnable health battle that nature had dealt him. It was during a routine conversation with him that it all began to make sense to me. In a somewhat subdued tone, he said to me that he had lived with diabetes for a while. He explained that an attempt to control and even defeat the ailment necessitated several changes in his lifestyle. The changes included quitting smoking, watching what he ate, exercising regularly and wearing shades to protect his eyes.

Mr. Buchanan also stated that he was always in control of his temperament to avoid spiking his blood pressure. No wonder he was so mild-mannered that we all loved him. To him, all the precautions he had been taking had proved fruitful so far. In spite of the number of years he had lived with the disease, he was still free from any of the opportunistic ailments like retinopathy and neuropathy. "Alfred", he had said to me, "the greatest gift any man can ask for in life is to live a life free from diseases. When this is not possible, because of heredity or other factors, the quality of a man's life depends on the effort invested in the upkeep and maintenance of life. I realize I did not ask to be struck by diabetes but since it can be controlled through what I eat and do, I am going to do my best to control it."

From that day on and as the years passed by, Mr. Buchanan's words of wisdom have continued to make sense to me. Mr. Buchanan had a good doctor. The doctor prescribed the right medications, advised him on needed lifestyle and dietary changes. The doctor also followed up with periodic blood tests to ensure that the drugs Mr. Buchanan was taking were not having toxic side effects on his kidneys and liver as is often the case with medications that are metabolized in the liver or kidney. The doctor knew when to change Mr. Buchanan's prescription drugs or reduce the dose to avert liver or kidney damage.

Nigeria has a lot of great and knowledgeable doctors, but to defeat this silent killer of a disease or at least control its effects, Nigeria needs more doctors that are dedicated to patients and not just profit-driven.

In Nigeria, we need doctors that always keep abreast with latest developments in the pharmaceutical industry. We need doctors that do not carelessly prescribe healthful but dangerous drugs without monitoring their patients to avoid liver or kidney toxicity. We need doctors that know when the drugs they prescribe have been recalled so as to warn their patients to stop taking them. For example, one of the drugs that had been used to treat diabetes, in this country and elsewhere, was recalled and doctors instantly sent out information to their patients, warning them to discontinue the use of the drug. I do not think that the information filtered down to all diabetes patients in Nigeria.

It is time for the Nigerian government to declare an all-out war against diabetes, especially in this pandemic era when diabetic patients are very susceptible to morbidity if they contract it. This means earmarking substantial amount of money to make available necessary drugs for treatment. The drugs should be subsidized so Nigerians on the lower rung of the income ladder can have access to them. Also, a substantial amount of the earmarked money should be used for mass education about diabetes and the effect of coronavirus on patients with the ailment. The mass education component of the campaign should include TV, Radio, newspaper and billboard advertisements that address the signs and symptoms of the disease, when to see a doctor, what to expect from a good doctor, lifestyle changes to make once a diagnosis is made, dietary changes and more.

I was almost moved to tears, on my visit to Nigeria in 2019 December, as a friend narrated his ordeal with this ailment and how he was spending a fortune for doctor appointments, lab work and medications. Once I heard the amount of money being spent on lab work, doctor consultation and drugs for the ailment, it became clear why Nigerians at the lower rung of the economic ladder are being maimed, are losing their sights or dying needlessly from the disease. Just to see the doctor, you pay twenty to thirty thousand naira! You go to lab, you pay another fifteen to twenty thousand naira. Then you buy medication that would last only three months and pay another twenty thousand naira. Haba, how can someone on minimum wage in the country, suffering from this awful disease, survive?

I have heard so much about the National Health Insurance program in Nigeria and how those enrolled in the program get some of the medical services at subsidized or reduced rate. But then I hear that only certain Nigerians qualify for it because it is a Federal Government program that only those who work for the Feds or their relatives qualify for. If the NHI program works that well, then the government should broaden its scope to include many more Nigerians and help those with preexisting ailments like diabetes benefit.

Furthermore, doctors should be compelled to get some sort of recertification to continue to treat patients living with the disease. Recertification should include relearning signs and symptoms of the disease. Relearning treatment options that advancement in technology continues to unearth. It must include relearning the necessary lifestyle and dietary changes needed by patients. Most importantly, recertification should include keeping abreast of new and emerging drugs for the disease and knowing when a drug is recalled so as to warn patients. The importance of constantly running kidney and liver tests on patients on diabetes drugs, to know when toxicity has set in, cannot be overemphasized. On the part of the patient, constant visit to the doctor for medical physicals and screening, constant monitoring of blood sugar levels, attention to diet and eschewing those foods that spike blood sugar level, is a must.

A very important component of managing diabetes is exercise, exercise, exercise. Finally, every patient must continually pay attention to what their body is telling them. Keep an eye on the eyes, the hands and feet and report to the doctor if and when any changes occur that could be signs of neuropathy or retinopathy. In this day and age of coronavirus, one must take all safety precautions to avoid contracting it. Wear masks when in public, maintain social distancing, wash hands often, etc.

The war against diabetes requires concerted effort from all and sundry. It requires effort from Nigerian doctors and the certification board. It requires effort from the patients and their families. It requires effort from the government.

May God help us all

(continued from part 1 of 2)

Author of the books- 1. Nigeria: Contemporary Commentaries and Essays

2. Surviving in Biafra: The Story of the Nigerian Civil War