Letting Sleeping Dogs Lie - By: Fatima DAMAGUM | Dailytrust

Letting Sleeping Dogs Lie

A while back, some extended family members and I were having a conversation about family genetics and health. The gist centred around diabetes, hypertension and obesity- the deadly triad- that are increasingly becoming common among us. An aunt of mine who was quiet throughout the discussion suddenly blurted out:

‘You see, that is why I don’t go for any test. What you don’t know won’t kill you. It is when you go snooping around that the doctor will find something. Let sleeping dogs lie!’

I was about to protest when I realised some of my cousins were nodding their heads in agreement. Their argument was that ‘unnecessary’ screening was a scam. If you are destined or genetically predisposed to have diabetes for example, you will certainly get it, so why not wait until you get it first? The treatment is all the same, they reasoned.

This line of reasoning, sadly, is very common. Even among medical circles, the argument over the futility of carrying out an annual or periodic medical check-up, is one that has continued to linger. Whenever I read or hear about people preaching ‘let sleeping dogs lie’ in other words, ignoring a problem in hopes that it will go away, I marvel at their optimism. Is it in this Nigeria, where our public health care system is still in its infantile stage, that we are willing to do ‘wuju- wuju’ with our health?

You people joke too much, Wallahi!

Come closer, let me tell you something. Gone were the days when it was only the elite that went for medical check-up. You do not have to travel out of the country for something as simple as a periodic medical examination. A medical ‘check-up’ as Nigerians fondly call it- is a periodic (or annual) series of physical examination and screening tests carried out by a doctor in order to ensure that one is healthy. An annual physical exam lets you and your doctors assess how you are doing health-wise regardless of whether you are feeling symptoms of illness or not. It can also help you assess which areas of your health need attention so they don’t cause bigger issues later on. The tests carried out are based on age, sex and risk factors which are tailored to the specific individual. For example, a woman with a family history of breast cancer might have to have more frequent tests than a woman without a family history of breast disease.

In my humble opinion, the importance of going for an annual physical examination, especially in this era, can not be over-emphasized. To all those who argue about its relevance in this environment, I will give you three reasons.

Firstly, the aim of having an annual physical examination and screening tests is primarily to detect risk factors as well as for early detection of diseases. So, yes, the first reason is that doing these tests help in early identification of diseases. During the examination, the doctor usually takes a detailed history which will help in identifying risk factors in the individual e.g. family history, weight, cigarette smoking etc.

For clarity, let me give an example with two hypothetical patients- ‘A’ and ‘B’.  Both are fifty-five-year-old men. Patient A comes for his annual check-up and is found to be hypertensive. The doctor manages him and prescribes medication. He may not have symptoms, but the fact that his hypertension has been detected early means that his blood pressure will be controlled and prevent him from developing complications. Now, compare him to patient ‘B’ whose first hospital visit is through the emergency unit. His wife finds him unconscious in the bathroom and when examined, he is diagnosed as having a stroke due to his undiagnosed hypertension. He is admitted into the ward and treated accordingly. While the first patient might have spent only a day in the hospital, the second patients might spend weeks or even months in the hospital, incapacitated. One condition, two presentations. Which would you rather be?

The second reason is that prevention is cheaper than cure. Whenever people argue about ‘unnecessary testing’, I tell them the story of my friend’s mother who was treated for cervical cancer. We will call her mama X. Mama X has never had a pap smear in her life. At the age of forty-nine, she started having irregular vaginal bleeding and was diagnosed with early stage cervical cancer. She was advised to have a hysterectomy (surgical removal of her uterus) so as to prevent the spread of the cancer. Mama X refused. Her husband and children supported her decision. They said ‘it was just a temporary infection’ that would go away. She was given medication and the bleeding stopped, temporarily.

Two years later, my friend called to ask if I knew where they could get a particular anti-cancer drug at a cheaper rate. Apparently, her mother’s condition had deteriorated and surgery alone was no longer an option. She was on chemotherapy and each intravenous (IV) medication cost about N25,000 at the time and she needed up to twelve doses. This would be followed by radiotherapy which was another expensive route.

All this wahala could have been prevented with a surgery that cost less than N30,000 at the time. We need to understand that it is significantly cheaper to prevent a disease than it is to treat a complication. How can we compare the price of antidiabetics that costs less than N4000 for a month to the cost of dialysis for life? We do not need to be economics professors to do the math- prevention is cheaper, simpler and more effective than cure.

The third reason is the benefit of hindsight. As humans, we are blessed with the ability to reflect and think back to see the pros and cons of what had already happened. If one were to do a random sampling of all the patients in the stroke ward in any general hospital today, I bet you all of them would tell you that they would check their BP and blood glucose regularly if they were given a second chance. They would not wait until they wake up one morning with their mouth twisted to one side. They would visit the hospital regularly and not joke with their medication. Those with cancer would have wanted it to be detected earlier so they can have higher chances of survival. Those who are blind with glaucoma wished it was detected earlier so that their blindness could be delayed. If only…

This year, let us make the decision to be deliberate about our health. Go for your annual physical examination. Do not wait for illness to come first.

Do not let sleeping dogs lie- wake them up abeg!

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