Chronic Diseases Chronicles: All About High Blood Pressure

Everybody knows someone with high blood pressure (BP)…father, aunt, colleague! It is quite common to hear “I visited my GP and had a BP check”. What does it really mean? What are those values we hear 120 over 80 (millimeters of Mercury)? How does BP impact our daily life?

How does the heart work?

The heart is the pump that allows the blood to flow in and out towards the rest of our body (heartbeats). This is done through the blood vessels which are :

  • Arteries(red): blood with oxygen flows in,
  • Veins (blue): blood without oxygen flows out

 These pipes have flexible walls that get stiff as time passes. Similar to limestone in water pipes, arteriosclerosis depots can accumulate into blood vessels thus limiting flexibility furthermore.

What happens when blood vessels become stiff?

The stiffer the blood vessels get, the less adaptable they become to change in blood flow such as during exercise or stress. At an advanced stage, if the pressure inside fragilized vessels is too high, it might burst with blood flow leaking out, or it might get obstructed by all deposits. Both lead to health complications which we commonly hear of:

  • Stroke if it happens in arteries irrigating the brain, or
  • Heart attack (myocardial infarction) if in heart muscle vessels (coronary arteries).

These two examples are sudden health issues requiring immediate transfer to the hospital.

Where does high BP fit into this

When blood pressure is slightly high over the years, it puts constant pressure on arteries’ walls and arteriosclerosis develops with poor blood flow to organs. If the leg, the kidneys, the eyes, etc are not well irrigated, they will suffer from lack of nutrients and oxygen. This will decrease their functioning capacity progressively leading to permanent organ damage and failure.

Risk factors

There are a few other factors that are known to accelerate this process. These are called cardio-vascular risk factors and include :

  1. high blood pressure (over 140/90 mmHg)
  2. smoking (active or passive)
  3. diabetes (any type)
  4. lack of physical activity
  5. obesity (BMI > 30 km/m2)
  6. genetics (male gender, female gender over 50, ethnicity e.g. Indian subcontinent)
  7. diet & cholesterol levels
  8. age
  9. socio-economic status

Few factors are certainly not modifiable such as age, gender, or ethnicity, but we have the ability to influence many others. Increasing our weekly physical activity such as regular walks has been proven to decrease blood pressure. This is easy to implement and inexpensive. All efforts should be made to stop smoking. It is a major contributor to reducing the quality of life due to organ fatigue because of high BP.

How can you help?

Ask yourself the right questions: Do I know my BP numbers? Does it run in my family? Do I know someone facing health issues due to high BP such as cardiovascular diseases (stroke, myocardial infarction, other organ damage)? What about my cardio-vascular risk assessment? Am I facing a risk of health issues?

You should also request your family doctor to assess your cardiovascular risk using a score risk chart. It will inform about the risk of getting a cardiovascular health event in the 10 coming years, and what might be done to reduce this risk.

Chronic Diseases Chronicles: What to do if you are a chronic patient with Covid-19 risk around?

Here is the WHO guidance about people living with a chronic illness during these coronavirus pandemic times:

“People of all ages can be infected by the new coronavirus (COVID-19), with the risk of becoming severely ill increasing after the age of 60. People with pre-existing non-communicable diseases (NCDs) also appear to be more vulnerable to becoming severely ill with the virus.”

These NCDs or chronic diseases include:

  • Cardiovascular diseases (e.g. hypertension, persons who have had, or are at risk for, a heart attack or stroke)
  • Chronic respiratory disease (e.g. COPD, Asthma)
  • Diabetes
  • Cancer
  • Mental illnesses- it has been shown now that people having obesity (BMI – Body Mass Index > 30) are at greater risk for several reasons

Tips for people living with chronic illness:

  1. Care for your health – your health is your most precious asset that requires your full attention. Every action to care for yourself such as healthy eating, doing regular exercise, making sure you have enough sleep, will contribute to keeping you healthy.
  1. Make sure you have enough medication and any other medical supply needed for your care for a few weeks. You might confirm supply access with your local pharmacist or health center.
  1. Follow recommendations of social distancing (with confinement in many countries), keeping a distance of 1-2 meters with another person. Wash your hands with soap and warm water many times a day, stay away from people having cough/flu symptoms.
  1. Take your treatment regularly, not skipping any prescribed dose.
  1. Drink enough water – it will help medicines to get smoothly absorbed and circulate in the blood to reach their target action.
  1. Listen to yourself, as you know yourself best – be attentive to your body signals and make sure to react fast enough if you feel anything is unusual.
  1. Monitor your health – carry on the regular health checks you are used to performing, such as Blood Pressure monitoring (BP check with home device), blood sugar monitoring, peak flow measurement, use of pain scale for pain monitoring, etc.

If you feel unwell, don’t panic:

  1. Assess yourself – take your temperature, make a list of symptoms you are feeling, give yourself rest.
  2. Call your primary care provider for advice, don’t wait too long to call.
  3. Don’t rush to hospitals or clinics as they might be overwhelmed with cases and you might put yourself at risk of contracting an infection.
  4. Follow medical guidance you receive from known health professionals, the internet might not be the best information source.
  5. If you feel anxiety, voice it. This is as important as physical illness and must be tackled right away.

It is important to seek help early enough to allow health professionals to take the best care of you and your health.

Following these health tips and steps will make you your first care provider as you know yourself best, caring for yourself 24/7/365!

T1International: People living with  T1 Diabetes’ voice

T1International: People living with T1 Diabetes’ voice

 

I was born in 1982 in Nairobi, Kenya to a single mum. I lived in one of Nairobi’s biggest ghettos called Dando (Dandora). For the first five years of my life, I had the care-free joy of being healthy and surrounded by a community. In 1987, I started showing signs of sickness. My mother ran to the community dispensary where she was told I was showing signs of a disease they could not understand, so I was referred to the biggest hospital in the country. My mother was so scared she literally ran with me to the hospital, where I was diagnosed with type 1 diabetes.

That is where my life with type 1 diabetes began. I was admitted to Kenyatta National Hospital, and for a year doctors fought to control my blood sugar levels. I was discharged and my mother had to learn to inject me. To me, injections were a pain I had to live with and it was not easy living with diabetes as a young girl. It was hard for my mother because of the financial constraints that managing diabetes came with.

I was using what they called Lente insulin, which was also known as pig insulin. I was injecting it up to four times a day, put on a special diet, had to do regular blood sugar tests. My mother almost went crazy because of all the financial aspects of managing diabetes. It was not cheap. Living in the ghetto, fighting a condition I couldn’t understand made me stand out in the crowd. From an early age I learned to get used to my so-called “special life”. I went through school and tried to feel like a normal child.

Cate advocating for people with type 1 diabetes in various settings

Over the years, I continued to learn and understand my condition, and to manage it the best I could. It was scary when I attended my monthly review clinics and had to go through a counselling session, where I was told about diabetes complications. I was told I could lose my limbs, I could have a miscarriage, and the list went on and on. I asked myself, ‘‘What life sentence was this?’’ I got angry at diabetes and ended up going through the motions at times.

My mother I was a strong pillar. She accepted who I was and wanted me to take life easy, but life was not easy for me. I had to get a job as soon as I graduated from college because I had to contribute to my expensive health needs. Growing up I always heard people that say diabetes was a disease of the rich. ‘‘The rich?’’ I thought. I kept wondering where the richness was in me. At times I had to borrow money to buy my insulin, and I missed my clinics because I couldn’t afford the consultation fees. I came to see that diabetes affects both the rich and the poor.

For a long time, I never saw any awareness programmes in my community. Even people who were looking for information about diabetes were often given the wrong information. That’s when I decided to start advocating about diabetes education, accessibility and availability of insulin and diabetic supplies. I also wanted to create awareness about diabetes and encourage people to go for screening.

Cate at the NCD Forum Kenya

Recently, I was an ambassador for a youth team in Nairobi that participated in the County budget allocation public forums. We advocated for the inclusion of Non-Communicable Diseases (NCDs) in the 2017/2018 budget. I was surprised to learn that the government was doing little to support people with type 1 diabetes. I learned that NCDs were not even mentioned in the budget. I am happy to say our advocacy was successful in that NCDs were highlighted in the budget. However, no money figures were allocated to NCDs, but the fight is not over yet. I believe with continued advocacy, we will get there.

I later learned about T1International. I loved what they were doing, so I decided to join in their advocacy programme as a volunteer to learn more about diabetic rights and needs globally. I like to hear about the experiences from different people in different countries, which has helped me with my own advocacy in my community. Being part of the T1I team has given me courage to stand out and talk freely about our rights and about our needs.

I am now facing some major diabetes complications. I have low vision disability and End Stage Renal Disease (ESRD), which have brought more complications due to kidney failure. I also have what they call brittle bone disease. I have dislocated both my hip joints and am on a wheelchair. I can no longer work because of my health. Taking care of all these conditions with no personal income is frustrating but I have not lost hope. I am trying to raise enough funds to cover the costs of hip replacement surgery and treatment. I am not as strong as before, but I made a promise to make the lives of people with diabetes more comfortable. If I don’t get the help I need, at least I know my advocacy will help someone in Kenya with diabetes to get better medical care, affordable diabetic supplies and 100% government support.

 

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