Thursday, July 9, 2015

ARE YOU GUILTY OF ASTHMA?

Consulting room 2.

Bright Monday morning.

She wore a blue cardigan, and sat across the table facing me. At the risk of sounding vain, I dare say she was prim, beautiful and healthy-looking.

She’s been having a very disturbing cough, she complained. I listened carefully as she described the cough, and what she's done so far to make it go away; she's been to several chemists'/pharmacy shops, a private clinic and a public hospital. The cough is recurrent, comes in bouts, worse at night, associated with chest tightness, and comes with cold...


I made notes in her folder and quipped a few questions to guide her clinical history.
When I asked:
 'Do you have anybody in your family with asthma?’
She froze (as in, literally F.R.O.Z.E).          

It was as though I caught her spilling blood of her twin. I'd never seen anyone look that guilty/ embarrassed before.
Momentarily, I was confused. I repeated the question twice or more in the most humane way I could. When she finally found her voice, she stuttered 'Yes. I-I-I...me. I was told I've asthma in a government hospital in Benin.'
'OK. So, why didn't you mention it earlier?'     

She hesitated: 'It's not something I'm proud of'.
'Did you mention it to the pharmacies and the clinics you went to?'
'No.'
I put this encounter beside the experience I've had with other patients or families of patients I've seen with Bronchial Asthma, and I observe a recurring decimal: the feeling of guilt/shame of having bronchial asthma or the subtle/outright denial of same.
Now, if we've not exceeded the limit of your attention span, and you have few minutes more, let’s talk about these:

1. Subtle/outright denial:
Asthma is one of the diagnoses patients and their relatives deny most, especially when it has not manifested in the overt case that even passers-by in the street can identify. It's true that a patient maybe misdiagnosed even in the best clinical settings. The pastors are right when they talk about divine health. However, bronchial asthma exists and it affects humans. You have probably seen a classmate or a neighbor’s child who has it. Most people argue it's never been found in their family from Adam, but then people hardly ever call all their family members to discuss their illness...and there's always a first.

It's wiser to take it head-on like a flat tire in your car and deal with it. Thankfully, it's very controllable, and in some cases, it goes away with age.


2. The shame/guilt
One of the terrible things about hospitals is that if they look hard enough, they’ll  find something wrong with everybody. There's nothing remotely 'more shameful' about having asthma than having malaria. Asthmatics have a hypersensitive airway. In other words, their airway is 'different' from that of most of the population. So, things like dust, smoke, common cold, etc that most people tolerate may tip them into respiratory distress. Hence, lifestyle modification can make a significant difference in their quality of life (reduce frequency and severity of respiratory disturbance). Living in shame/guilt, hiding the condition from close friends, spouse, doctor, pastor, etc is not known to cause any improvement. In fact, it's known to be potentially lethal.

The last time I saw the lady I described earlier, she was leading some young ladies on a course in her community, and I was glad shame/guilt didn't stop her.

Dr Okpara McCoy Emeka
Author of HIDDEN HALOES, blogs @ emekaokpara.blogspot.com
t: @IamRMcCoy

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