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The Greatest Health Risk to the Ghanaian Working Class

Try to not think “I don’t have the time to read this”. You may be right, but l think you should. These few minutes (maybe a little more than a few minutes) may be a lifesaver.

For the typical busy working adult, the routine is often predictable: jump out of bed often by an annoying alarm, rush through breakfast if there’s time, hop in a car, battle the traffic and all its stress, and then off into a busy work day.

We work all day. We often get home late and completely exhausted. We then mindlessly gobble down our dinner, much too late for any meaningful digestion. Most of us sit down to catch our breath from the day, only to fall asleep in our chairs after a few minutes of TV and then stumble into bed. 

Just when we’re beginning to relax, that alarm goes off again. We wake up once more, and do it all over again. I know this lifestyle because it has been my life too. 

Work is good. We need that to survive and to do all the beautiful things we love to do for ourselves and our families with the money we earn. It is also that and many other reasons, that we need to maintain our health in good condition to function optimally, and to perform our life duties, whatever they may be.

I would like to use the analogy of a car to explain a few points first, so stay with me, and come along for the drive. 

Supposing l told you that the human body, is like a car in many respects, would that surprise you? The comparisons are endless. For instance, foggy car headlights remind me of foggy eyesight, which in many ways is cataracts. l see worn out tyres and l think, worn out joints or osteoarthritis. Fuel pump, filters, the car engine, etc. All of these remind me of similar functions in our body.

And just like the car, we too have many parts, most of which have the potential of grinding the entire car to a halt if not serviced properly and timely. The breakdown might occur suddenly, even without warning.

Every car owner understands the importance of paying attention to subtle changes in sounds or the feel of a car, to pick up the early warning signs that something is wrong. Prompt attention to these, particularly the check engine light, can avert some catastrophic events from happening and grinding the car to a halt.

Just like a new car, a young person can keep going for years, all things being equal, without much trouble, but as we get older, things change and little things begin to matter.

When we’re young and functioning at our optimum, it is easy to ignore general health maintenance, but here is where we have the most chance of significantly decreasing future risks of malfunctioning as we age. The rationale is so we don’t find ourselves facing certain major medical conditions that could have been totally preventable, if attended to on time. 

People sometimes say things like “oh, he/she had a stroke (or heart attack) out of nowhere “. We know it is not always totally “out of nowhere”. It is often after months or years of ignoring little things just like the check engine light. These things often culminates into a major event. 

Old people diseases are taking young people’s lives. The risk is even more so when there’s family history of diseases such as hypertension, diabetes, heart disease, certain cancers, often with genetic predisposition.

In such instances we need to pay even more attention to those risk factors and manage them,  if we want the body to serve us for many more years and with less risk of malfunctioning. While we cannot change our genetic heritage, we can and should make every effort to live healthy and prolong the duration of our life engines.

That being said, what needs to be done? What do you and I need to do to live a bit healthier, a bit longer? Here are a few thoughts.

1. Food/nutrition: l read somewhere “people today are digging their graves with a fork and knife”, or something like that. I will add hands, spoons and whatever tools we eat with. The point is, when it comes to health, what we eat is high on the list of things to prioritize. 

When we think “good food”, for most people, it is often the unhealthiest meals that tend to come to mind. Foods that may be too sugary, too salty, too fatty, and too large in portions. Unfortunately, that is what’s considered as evidence of “the good life” to a large portion of Ghana’s population.

Don’t get me wrong, food is a good thing and serves as the fuel for our engines. But eating too much of the wrong foods also clogs our system, making us unhealthy. Over time, we malfunction. Here, l am talking of red meats, fatty foods, excessive alcohol, too much salt, high carbohydrate or high-sugar foods that are eaten too frequently and often in high amounts. 

Rather, you should try eating more green leafy vegetables, wholegrains, nuts, fish and less of the fatty, starchy, processed and/or sugary foods. This makes for a better function.

The keyword here is moderation. 

The idea is to make changes that affords us some comfort food but less of them overall.  Based on a person’s specific medical history, even closer attention might be required. For example, fruits are good, but fruits also contain lots of sugar and may not be a healthy choice for a diabetic, for instance. 

Reaching for fast foods because we’re too busy may sound convenient, but in the long term, it does us more harm than any good.

When it comes to food, it’s good to remember this: 

  • if it’s not considered good for you, but you must surely eat some, then we must eat a lesser amount at a time and less frequently. 
  • if it’s considered healthy, then we should go for that as the staple.

Again, think “moderation”. Even healthy foods eaten in excessive amounts may have with them some unexpected adverse effects. Someone once said, “always eat until 3/4 full, then stop”.

2. Hydration/fluids: Notice l did not say “water”, even though water is the best, cheapest and most accessible form of hydration? Other liquids and beverages (not alcohol but rather fruit juices, soups, etc.) can also hydrate. Conscious hydration, particularly in our hot climate, is essential to replace fluid lost to the environment and for body maintenance.

Taking in adequate fluids a day is important for our internal organs to function well. Water serves as a transport medium for food and nutrients to our organs. Water also help the body function appropriately and to detoxify itself. Excess food or toxins are excreted in water as urine or in stool.

On a hot day when we’ve been sweating a lot, or on a bad day when we lose more fluids through illnesses such as diarrhoea or fever, we will need even more fluids. Here, the goal is to get into you enough fluid for our regular daily maintenance requirement and even extra that day. These will go to replace ongoing losses as a result of these acute events, and helps to avoid dehydration.

When we become dehydrated, our body organs suffer. Some such as our kidneys begin to malfunction and shut down. If such injury is not corrected on time and the assault to the organs continue, then an acute and potentially reversible injury can progress into a more serious form, many of them even resulting in irreversible damage.

3. Exercises: An area where we often fall short is regularly exercising. We are often in jobs that keeps us sitting for most part of the day, every day. We come home, then sit even more to watch the news or our favourite TV programme until we go to bed. We’re often too tired for anything else.

Exercises, even moderately, improve blood flow, blood pressure, help control blood sugar, lowers blood cholesterol and improve overall health. It helps in decreasing risk factors for diseases such as diabetes, heart attacks and strokes. Exercises improve our mood by the release of endorphins, hence the name “the happy hormones”.

So yes, we’re happier after a jog and we also tend to sleep better at night. The right exercises improve endurance, bone strength, muscle strength and balance. These become very important as we age. A poor balance can result in a fall and a possible broken bone/hip, which can then initiate a period of immobility or being bed ridden. A cascade of other medical events can then arise as ripple effects of that immobility.

Exercising for 30 to 45 minutes for at least 5 days a week, has been proven to improve overall health and survival. A practical way is to get in about 6,000 to 10,000 steps a day.

Remember, start slow and listen to your body when you exercise. If something doesn’t feel right, stop and make time to speak with your doctor.

…more about the doctor visit in a minute.

4. Sleep: A good sleep like good nutrition needs no introduction in regards to its benefits. There’s a reason why the sun goes down at night, even nature agrees, our bodies need to shut down and rest. Sleep allows the body to recuperate and rejuvenate itself. A good sleep of at least 6 hours a day should be something we can all aim for.

Of course, lying in bed for 6 hours is not the equivalence of 6 hours of sleep. Conditions like sleep apnea, often manifesting as loud snoring at night, with repeated choking sounds and awakenings, decrease the effective sleep time significantly. This often result in tiredness even in the mornings when we just woke up from “sleep” and hence easily fall asleep during the day, even when we need to be alert.

Whilst this snoring might result in teasing by family members, the comedic aspect is not the concern. It may be the sign of a real and serious health problem of sleep apnea. This must be properly diagnosed and appropriately treated to decrease significant associated risk of morbidity and even increased risk of mortality without such treatment.

5. Controlling weight gain: Culturally, weight gain may be seen as a sign of affluence. Medically however, excessive weight gain says something very different. It says we might be eating too much. It says we might be eating the wrong foods, which sits too much and does not move nearly enough. 

To a doctor, excessive weight gain doesn’t say rich at all. It says a person is at higher risk of a multitude of diseases and therefore likely very unhealthy.

There are countless studies to support that maintaining a healthy weight significantly improves outcomes and overall quality of life. A low fat, low carbohydrate/low sugar diet, smaller food portions and moderate regular exercises as tolerated is often the recommendation to help achieve a healthy weight. 

A body mass index (BMI) of between 19 – 25 is considered the ideal body weight for a person’s height. Again, moderation – eat in moderation , drink alcohol moderately if any, and at least do some form of moderate exercises on a regular basis.

6. Smoking: I might need to check recent statistics, but it is my belief and hope that most of our Ghanaian community are non-smoking. Nicotine is bad for you – full stop. This is as firmly stated by surgeon/medical generals everywhere.

Smoking increases risk of lung infections, results in poor oxygenation, causes chronic lung diseases such as emphysema, and increases risk of a myriad of cancers, as well as strokes and heart attacks. I am yet, in all my years of practice, to find one true health benefit of nicotine to warrant its use.

If you smoke, then l would recommend you quit smoking. If you don’t, just know that you’re not missing anything significant, except the diseases it’s associated with.

7. Have Good Fun: Remember “all work and no play……” They say the most important things in life are free. Love, laughter, joy and l will add, fresh air. These are free and good for you. Sure, air conditioners are good but it is also good to get outside into the natural air sometimes.

Find something you love doing that is not work related and do it sometimes. Music, dance, sports, painting, taking a stroll with your kids, photography, hiking, excursions to the countryside, etc. These are inexpensive forms of relaxation, often free.

Some may seem like a waste of time and money but some of the world’s greatest ideas have been discovered not when a person is stressed out in a lab or the boardroom, but when they were, rested relaxed and having fun.

When you let go of all the things on your mind, sometimes, new things get a chance to come it. This is why companies now organize R&R (rest and relaxation) retreats for their employees. They realize that this tends to increase their employee’s productivity.

So go on and try it. Do something fun this week, something that makes you feel like a kid again. You’ll be better for it. 

8. Medical Checkups: This to me is one of the most important messages from this piece. Again, l go back to my car analogy because l feel it is easier to and helps explain this point. For any car, regular checkups for servicing, oil changes, tyre alignment and others are important.  Timely changing a worn out car part can save a lot of high cost repairs down the road by avoiding costly breakdowns. 

Our bodies are similar in that respect. Except, of course, we can’t change all our body parts like a car. This then is the more reason to pay much more attention to its maintenance. When something doesn’t feel right, it might be time to see the doctor, even if you just had a physical. It might  end up being nothing serious but do you not remember how good it feels when the mechanic says “it’s nothing much, l just tightened a few knots and bolts and your car is good to go”?

It’s the same thing. 

Sometimes, that doctor’s visit is just for peace of mind and reassurance. On the other hand, should it happen to be something significant, then as the saying goes, “a stitch in time, saves nine”. Being afraid of what the doctor will say will not make things go away if in fact there is a problem. Rather, an early evaluation might mean early intervention and disaster averted.

In an era of technology, it is now even possible to have a virtual physician visit via telemedicine if we’re “too busy” for a trip to the doctor’s office. Here, one can get virtual consultation for some form of clarity as to what could be going on. It is always preferable however, to get a physical face-to-face evaluation. Nothing beats a hands on assessment of a patient. 

For those with an existing medical diagnosis, a regular checkup ensures that your medications are doing exactly what they’re meant to be doing and that they’re not causing some other harm. For the healthy ones among us, at least one annual routine checkup to make sure we are really as good as we feel is the right thing to do.

There are lots significant medical conditions that can be managed by making simple adjustments in our lifestyle, if we start sooner than later. The few hours for a doctor’s visit, the simple tests, these tiny lifestyle adjustments: these are the simple things that save lives.

It is my hope that even as our intellectual health improves and excel, our physical health is not neglected to suffer as a result. 

Anyways, the opinions expressed here are just that: opinions. They are the opinions of a private healthcare professional and a fellow working class member. It is our personal opinion based on personal observations and working experiences and should not viewed as a replacement for any specific instructions given by anyone’s regular physician based on their specific healthcare needs.

As always, thanks for reading.

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Gladys Kodjoe, MD, is an Internist with a specialty is Internal Medicine. She did her lnternal Medicine residency at the Cleveland clinic health system in Cleveland Ohio, following which she’s worked for hospitals in Nevada, North Dakota and North Carolina.