Doc, will this thing take me out quickly? How much longer till am gone?

I had a patient ask me these series of questions and many more because she could not fathom the diagnosis I was giving her at the of 27 years. She had lost her maternal grandmother to stroke and her dad to heart attack one and half years ago and now this? She could not understand. Because how much was a human being supposed to endure? How much grief and suffering are you supposed to carry around? Was this not enough? How do you even grieve your loved ones in peace, knowing very well the diagnoses that took them out might as well come for you? Funny, very funny. God really does have a sense of humor.

A young woman in her prime years had a high blood pressure reading of above the average high. Her first encounter with a high blood pressure reading was about 8 months ago when she was randomly screened at her church and told to check her pressure regularly, which later resulted in nothing. There was no way. I was probably anxious because of these doctors and their machines and lab coats? Scary. No wonder these days they don’t even wear them. I see them now wearing color coded outfits they call scrubs. You will be in a clinic randomly and see a doctor playing with a child in the reception, laughing with them and some have the audacity of carrying them away because they don’t have the white coat. I mean, things do really change. In our childhood, doctors were the most feared people because that white coat meant you were getting a very painful injection. Again, I am a Kenyan. These things aren’t even that serious. She never checked her vitals ever again. I could read through her minds as these thoughts raced down her mind. However, she described having some occasional migraine that an over-the-counter Zulu MR would have nothing against. Isn’t this what you do yourself? She had some in her handbag, as she never knew when the headache would strike again. There’s literally nothing that you can’t find in a woman's handbag. Want some chips. Check on the inner pocket. Someone will randomly ask for remote batteries and a lady will get in her handbag and voila, there you have triple A eveready batteries. Women are truly a special breed. And that was it. She went on with her life as if nothing happened.

Prior to this diagnosis, she had come in for a different consultation. The reading was an incidental finding that I took time to find out and even lure her deep into her family history. I mean, isn’t that what they are paying me for? Anyway, I figured there was work to do because I would not let another Kenyanese (in the words of Tatu Reginaldah, you will be seeing it here more often. Brace yourself.) wallow in a Non-Communicable- Diseases (NCDs). We needed a strategy, a feasible one for that matter. So we crafted a schedule, she takes her blood pressure readings at a nearest chemist and convey the results to me twice daily on alternate days. Ideally, it was the occasional. “Hey doc, here is pic of my cardiovascular system that you are watching as a hawk.” A witty one, I must say. I was lucky this time. And I would go, “For you Jackie, Anything for you.”

By the time Jackie left this consultation, I had drawn a massive heart to body image and description of what was going on gently. I had drawn the heart, the capillaries — a concrete pipe that drains water on the express way that could get clogged with soil and mud when it rained- you get that visual , right? This was to demonstrate how body fat, again cholesterol is key in Hypertension (HTN) could accumulate in them like the mud and cause resistance in blood flow to lead to HTN. Remember the thyroid gland? Its on your neck. It produces hormones that facilitate your growth. Sometimes, the hormones might increase and cause the HTN. We still had the body image. I hand picked my kidneys. What do they do? They filter out body wastes through blood. How do they do that? Another pictorial and jargon free explanation. Again, drugs and we go on. List out a couple and get a few that Jackie could relate to. Familial history. What can we deduce from that? Here, we already have a clue that there’s a positive family history. It was important for Jackie to acknowledged why and how that is possible.

All that work, doc. you must be kidding. Too much work. I mean. Kumbe, 21st century doctors are different. That was her exact statement. That’s my job. That’s entirely why am here. I understand how vital information is to a patient. They will decide if they will take your medications based on how you said it not even what you said. Once a patient has the slightest idea what’s causing it and how the doctor is helping. My work is done. That’s treatment right there. Its the first step, an empowered patient is happy doctor.

Opening that conversation with her and allowing her to take part in the treatment process unloaded a certain burden off her. Through our Whatsapp conversations, my aim was to answer every question and chat the anxiety away. Deliver key medical advice and assure her throughout the way. You can be sure we covered all my anatomy and physiology classes with her. Where am I taking all the years of medical school knowledge, anyway? Again, how do you tell someone to stop taking salt — okay reduce the amount without giving them a clear explanation as to why? It was easier to explain because remember the kidneys diagram. It came in handy. We did a series of tests and explained to details why we needed this and not the other. We got a specialist on board, a nutritionist and booked her in for a hypertension program.

You, know everyday I appreciate the world we live in today. What a time to be alive? Do you feel it? The world of digital health is here. Its here to augment and challenge the healthcare system. Its one of the ways we can deliver personalized treatment easily, its affordable and gives you the luxury to receive treatment at your convenience wherever you are. Our phone conversations went on for a little longer until the assignment was done on my end. I was confident in her and her journey. Eventually, she purchased a digital watch because that chemist hustle wasn’t made for her, she is a baby girl after all.

Anyway, Jackie called me a few days ago. She said, “Doc do you remember what day today it is? Of course Jackie I do, my job revolves around knowing what day it is so as to schedule treatments, follow up with patients and figure out how many off days and night calls am having that particular week. Which day am I sleeping my life away because a girl deserves that kind of rest. Its that simple, so I can never miss a date. Its the 27th. “Doc today is my third anniversary with HTN, during my first encounter with you my life changed on both good and bad ways but mostly for good. I’m glad I met you when I did.” When the student is ready the teacher will appear. Haha. I almost slotted that cheesy comment in there but I didn’t. I took my flowers and grinned and told her she was welcome. We chatted a bit and got to learn she went ahead to become a HTN ambassador in her work place. She is the HR now. She does those kinds of things. I was happy. Ecstatic even. Partly because, I could not even remember her and its been ages since we spoke. This is my line of work. I meet people of all walks of life, see them in their most vulnerable state and do my best to restore the dignity that they deserve. Some conversation spark and extend outside the consultation room. I’ve attended graduations, rurashios, galas and weddings that I had no business attending but the people in my work? Graceful. Again, what a little life without humor as a Kenyan. For some talking about zakayo, is the icebreaker and the tough economic times later on realize how deep our mental health is being affected.

Cardiovascular diseases are now a global economic burden. Every year 17.9 million people die prematurely. Its imperative to get better treatment, care and prevention to manage this grueling disease. I hope we as health practitioners do right by our patients. May we extend ourselves and gently put ourselves in patients shoes who are hearing the medical jargon for the first time and the only thing they can think about is how death will strike them before its their time. Even google patients. Haha. Touchy. We are visual objects. Patients brains could could use a little art. I hope we incorporate digital tools to assist and mentor our patients as they go through this chronic diseases. I hope patients find us approachable and they know very well they can ask questions. I mean, we are the healthcare system both the doctor, patient and the channel.

The landscape will only change if we equally participate and work towards it. Also, when was the last time you got screened for cardiovascular diseases. The maximum amount a screen would cost is $ 0.14 and is free in most facilities. There’s no excuse people. Get screened, get your body in shape, eat your fruits, try and quit your excessive smoking and drinking habits. Lastly, try to walk sometime. Your body will appreciate you later.