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Another Look at the Othello Syndrome

Since the coronavirus lockdown, my High School Alumni WhatsApp group has been one of my favourite pastimes. Over the last four weeks, I have spent some time catching up on chats with my homegirls, and it has been an amazing experience.

About a week ago, I read a personal experience posted by one of the girls on the group, Chinelo. It was a story about her relationship with an abusive partner, and it opened up a whole new dimension to a very much ignored aspect of spousal abuse or Intimate Partner Violence. The overwhelming response to the story from other members of the group recounting their similar experiences got me wondering; how many ladies have been through this, and how many ever got the chance to speak about it? I was also very concerned because I could Identify with Chinelo’s story, it sounded very much like my account but for a few twists.

This made her careless around him to the point that she tested positive to the virus a few weeks later. In her words, “she has no regrets’’. This brought a hot debate on the comments section of the post with some arguing that it was unethical and stupid to fall in love with a patient, while others opined that love was not something that is often planned and can catch one anywhere and happen with anyone. 

So, what exactly is the ‘’Florence Nightingale Effect’’? and what are the principles surrounding such relationships? 

What Is the Florence Nightingale Effect?

The Florence Nightingale Effect (also referred to as Nightingale Syndrome) is a pop-culture reference to the real nurse, Florence Nightingale, who treated her patients with care and compassion. The term originally connoted the care and compassion that nurses were to show their patients, a kindhearted and empathetic relationship, not a romantic one. Over the years however and through over and misuse, some people have come to believe that the term refers to a nurse falling in love with her patient, or vice versa. People have thus come to misuse the term ‘’Florence Nightingale Effect or Syndrome to describe a situation where a nurse falls in love or develops a romantic interest with a patient or vice versa.

Nurses are taught to use compassion, a positive attitude and tender loving care (TLC) when treating patients. Such care has been shown to lead to better responses by patients as well as faster healing times. But nurses must be careful to maintain boundaries, as building relationships with patient that are too close can lead to emotional and even ethical dilemmas. 

Is It Common for Nurses and Patients to Fall in Love?

As a general rule, nurses are able to maintain enough distance from their patients to avoid the problem of a romantic bond forming. Sometimes, however, patients may adopt more amorous attitudes toward their nurses. This may happen if the patient is extremely dependent on the care that the nurse is providing or if the nurse is providing the only perceived positive interaction throughout the day.

So, what happens if a nurse and patient mutually develop strong feelings for each other? In this case, it is the nurse who should establish boundaries and prevent the relationships from moving forward. To act otherwise may put the nurse’s job in jeopardy.

A Romantic Relationship between Nurse and Patient Usually Not Okay

Sue Stewart of NurseTogether.com tackled this issue in an article entitled Should Nurses Have Romantic Relationships with Patients? In this article, Stewart is quick to point out that the National Council of State Boards of Nursing (NCSBN) states that “the nurse should avoid situations where he or she has a personal relationship with the patient.” Developing a romantic relationship while the patient is in your care, therefore, presents an ethical issue.

What Would You Do?

If you are a health care provider, have you considered how you might handle a situation wherein you develop feelings for one of your patients? Has it happened to you, and if not, how have you prevented it? It might help to preempt situations like these and have ready responses for them.

Topics like this are worthy of discussion with other nurses. You may be surprised what you can learn from each other.

When answering the question of whether or not such relationships are acceptable once the patient is no longer in your care, things become a bit murky. A lot depends on your patient’s prognosis and whether or not he or she is capable of providing informed and reasoned consent.

Elisabeth Greenbaum Kasson, a Los Angeles-based writer and editor who covers the collision of culture, technology and business, addressed this topic in her article Dealing with Patient-Caregiver Feelings. She cautions that in the case of patient being treated for mental illnesses, engaging in a romantic relationship is extremely unprofessional and can result in the nurse being charged with a breach of ethics or even a crime in some states.

Sometimes, patient/caregiver relationships do result in long-lasting, true-love scenarios. It is a risky move though. By allowing yourself to become emotionally or romantically tied to any of your patients, you open the door to heart-ache, disappointment and potential loss, so proceed with caution.

We hope all works well for our Kenyan caregiver.

Kembet Bolton

As the world battles through the Coronavirus (COVID-19) pandemic sweeping across continents, physicians and healthcare professionals continue to share  information to help the public stay safe and prevent further spread of the deadly COVID-19.

What is a pandemic? Merriam Webster’s English dictionary describes it as a disease, prevalent over a whole country or the world, or occurring over a wide geographic area and affecting an exceptionally high proportion of the population. This is the situation of the COVID-19 today.

Based on what is currently known about the virus from the Centre for Disease Control and Prevention (CDC), spread from person-to-person happens most frequently among close contacts (within about 6 feet). This type of transmission occurs via respiratory droplets. Transmission of novel coronavirus to persons from surfaces contaminated with the virus has not been documented. Transmission of coronavirus in general occurs much more commonly through respiratory droplets than through fomites. 

Health professionals continue to share Information and sensitize the public on healthy ways to stay safe and prevent infection. Most of this information are being spread through the social media, community outreach, hashtags, and the like. Companies have also made it their responsibility to share updates on COVID 19, while sanitizers, disinfectants and social distancing have become a prevalent part of household and media conversations.

As the infection continues to spread across the globe, and scientists work around the clock for a permanent cure, it has become very important to keep the public updated about the dangers of the virus and the importance of practicing the health tips provided by professionals to prevent the virus, Some of which include:

 Social Distancing: This refers to a set of non-pharmaceutical infection control actions intended to stop or slow down the spread of a contagious disease. The objective of social distancing is to reduce the probability of contact between persons carrying an infection, and others who are not infected, so as to minimize disease transmission, morbidity and ultimately, mortality. This disease control method is most effective when an infection can be transmitted via droplet contact (coughing or sneezing); direct physical contact, including sexual contact; indirect physical contact (e.g. by touching a contaminated surface); or airborne transmission (if the microorganism can survive in the air for long periods). Which makes Social Distancing a suitable preventive measure for COVID 19.

Social distancing is not a new form of infection control. Historically, leper colonies were established as a means of preventing the spread of leprosy and other contagious diseases through social distancing, until transmission was understood and effective treatments invented.

Keep Your Hands Clean: The WHO advises that the most effective way to protect yourself against the new coronavirus is by frequently cleaning your hands with alcohol-based hand rub or washing them with soap and water. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.

Environmental Cleaning and Disinfection Recommendations: Current evidence suggests that the coronavirus may remain viable for hours to days on surfaces made from a variety of materials. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for the prevention of COVID-19 and other viral respiratory illnesses in community settings. It is aimed at limiting the survival of the coronavirus in key environments. 

Finally, what happens beyond COVID-19? I have received several calls and messages from friends, colleagues, and family sharing information about how to stay safe during this pandemic. The messages range from wash your hands, wear a face mask, drink a lot of water, sanitize your hands, and drink a lot of vinegar (please do not do this). I have to ask, will these healthy habits become a part of our lives or do we drop them off and move on when the virus is defeated?

I think not, keeping a clean environment, washing our hands and maintaining a decent social distance in public places should be a part of our lives beyond the pandemic. These habits generally reduce the risk of opportunistic infections which keeps us healthy.

Therefore, while we practice these habits to overcome the coronavirus, let’s remain conscious of our health and make it a lifestyle to stay clean and conscious beyond the COVID-19 pandemic.

 

Boma Benjy – Iwuoha

Women have unique oral health concerns. Changing hormone levels during your menstrual cycle, pregnancy, and menopause can raise your risk of problems in your mouth, teeth, or gums. Health issues such as diabetes can also affect your oral health. Regular brushing, flossing, and dentist visits can help prevent disease in your mouth and the rest of your body.

Oral health is the health of your mouth, including your teeth, gums, throat, and the bones around the mouth.

Oral health problems, such as gum disease, might be a sign that you have other health problems. Gum diseases are infections caused by plaque, which is a sticky film of bacteria that forms on your teeth. If left untreated, the bacteria in plaque can destroy the tissue and bone around your teeth, leading to tooth loss. The bacteria can travel throughout your body and make you sick. Infections in your mouth can also affect your unborn baby if you are pregnant.

How often should I brush and floss my teeth?

Dentists recommend that everyone brush their teeth at least twice a day with fluoride toothpaste and floss once a day.1 Flossing removes plaque between your teeth, a place that you can’t reach by brushing. You can also remove this plaque with tools other than floss. These tools, called interdental cleaners (link is external), include wooden or plastic picks and water flossers.

How often should I visit the dentist?

Most people should go to the dentist once or twice a year.

Your dentist may suggest that you come more often if you have a health problem such as diabetes or a weakened immune system. These health problems can make you more likely to develop gum disease or other dental diseases.

Women are also at higher risk of gum disease during pregnancy. And gum problems and bone loss may happen more quickly in women after menopause. Talk to your dentist about how often you should visit.

How do women’s hormones affect oral health?

Changing hormone levels at different stages of a woman’s life can affect oral health. When your hormone levels change, your gums can get swollen and irritated. Your gums may also bleed, especially during pregnancy, when your body’s immune system is more sensitive than usual. This can cause inflammation (redness, swelling, and sometimes pain) in the gums. Regular, careful brushing and flossing can lessen gum irritation and bleeding.

 

Other causes of changing hormone levels that may affect your oral health include; menstrual cycle, hormonal birth control and menopause.

How does my menstrual cycle affect oral health?

Hormone levels go up and down throughout your menstrual cycle. During ovulation and a few days before you start your period, higher levels of the hormone progesterone may cause swelling in your gums. Your gums may be red and bleed more than usual.

You may also get canker sores more often during your menstrual period. Canker sores are small ulcers that have a white or gray base and a red border. Canker sores are not the same thing as cold sores, which are caused by herpes simplex virus type 1 (HSV-1). Canker sores are inside the mouth. Herpes cold sores are on the mouth and lips. You can’t pass canker sores to another person, but you can pass herpes cold sores to another person.

How does birth control affect oral health?

Pregnancy can make brushing difficult. Some women experience nausea from strongly flavored toothpastes. Switching to neutral-flavored toothpaste may help. During pregnancy, your hormone levels also go up and down. This raises your risk for several oral health problems:

Severe gum disease (periodontitis): Changing hormone levels during pregnancy can make gum disease worse or lead to severe gum disease in as many as 2 in 5 pregnant women. Periodontitis is an infection of the tissues that hold your teeth in place. It’s usually caused by not brushing and flossing, or brushing and flossing in a way that allows plaque — a sticky film of bacteria — to build up on the teeth and harden. Periodontitis can cause sore, bleeding gums, painful chewing, and tooth loss. Women who do not get regular dental care and women who smoke are more likely to have periodontitis.

Loose teeth: The tissue supporting your teeth may loosen during pregnancy since many of your joints and tissues loosen in preparation for childbirth. Taking good care of your mouth can help prevent tooth loss.

Wearing down of your tooth enamel: If you have morning sickness that causes vomiting, the stomach acid that comes up during vomiting can erode tooth enamel (the hard, protective coating on the outside of your teeth). Heartburn, another common pregnancy discomfort, can also wear down your tooth enamel over time if stomach acid is coming up into your throat and mouth. To prevent this erosion, the American Dental Association recommends rinsing your mouth with 1 teaspoon of baking soda mixed in a cup of water 30 minutes before brushing your teeth.

Culled from;

https://www.womenshealth.gov/a-z-topics/oral-health

Shannon Lee Miller Falconetti, is an American former artistic gymnast and cancer survivor, whose survival story shows the beauty of focus and positive mindset. The seven-time Olympic medalist stated that lessons she learned while training for gymnastics competitions helped her endure the rigors of treatment for ovarian cancer. “A huge part of my success as an athlete was that I had the mental game. To get through the toughest moments of treatment I relied on goal setting and keeping that positive mentality.”

Shannon Miller was thirty-three (33) years old when she found out she had ovarian cancer. It was in the fall of 2010 and she had almost skipped her regular women’s health exam. She was a nursing mother to a year old Rocco and had recently founded her company, Shannon Miller Lifestyle: Health and Fitness for Women, and just felt too busy with life and work to go for a checkup. But just as she was calling to cancel the appointment, she had a change of heart.

“In her thought, she was working in the health field interviewing physicians for her weekly radio show talking about early detection, and she thought that she is not setting a good example by skipping her checkups.”  So she kept her appointment; a decision that helped her doctor to detect cancer at an early stage.

While conducting a routine pelvic checkup, her doctor found a baseball-sized mass on her ovary that turned out to be an ovarian germ cell tumor, a rare form of ovarian cancer. Shannon Miller later realized she had actually had signs of ovarian cancer; stomach aches, bloating, and weight loss. But because these are also often signs of much less serious problems, she did not think to report them to her doctor.

She had surgery to remove the tumor and then nine (9) weeks of aggressive chemotherapy to give her the best chance of keeping cancer from coming back. The cancer was at the second stage- it was caught before it had spread to other parts of her body.

Challenge of ever having children again

Before her surgery, her doctor did not know what he was going to find. He had an honest conversation with Miller and her husband about whether they wanted to be able to have another child someday. He asked them about how aggressive he should be about removing the mass and preserving her fertility. “We (the couple) knew the Doctor had to be as aggressive as possible. “We needed to do everything we could to make sure our son had a mom.”

But they also talked to the doctor about all their options. After the surgery which removed one ovary and one fallopian tube, they decided to save eggs before she started chemotherapy.

“I did not want to have any regrets. If you bring an umbrella, it will not rain – that was how she thought about it.”  “We decided we will take advantage of every opportunity available; then if we needed to have a plan B, we were prepared.”

A hard walk

Treatment was tough, both physically and emotionally. Miller’s doctor called it the “hit ‘them hard ‘and fast” approach. She would have chemotherapy five (5) days a week for nine (9) weeks, starting about a month after her surgery. She told herself, “I can do anything for nine (9) weeks.”

But by the end of the first week, she had such severe nausea and vomiting, she was unable to keep even water down and was forced to check into the hospital to receive IV fluids. By week two, Miller’s hair fell out and she experienced severe fatigue and neuropathy, a nerve pain, in her hands.

 

 “Her next true moment was with herself and God in that room thinking, ‘How do I do this?’” according to her. “She kept coming back to the realization that she does not have to do this alone. She had faith, and she had her team around her. She reminded herself that she was not the only one going through this.”

Shannon Miller finished her chemo on May 2, 2011. “She thought she was going to have all her energy back, and that her hair would grow back. She expected to feel better,” stated Miller. “But the neuropathy her my hands was so bad, she could not open a bottle of water. She felt like each limb weighed a thousand pounds and she could barely move herself to get out of bed. When she was in Olympic training 7 days a week, she never felt this kind of fatigue.”

She got help from another cancer survivor, her mother, who helped her understand she would feel better – but it would take time.

Shannon is a survivor

She uses whatever voice she had from her Olympic career to encourage women to keep medical appointments, get more sleep, eat right, get and stay fit, and recognize the signs and symptoms of cancer.

Shannon Miller stated that it took about a year before she felt like herself again. She was still extra tired and taking naps right up until the 2012 Summer Olympics in London where she covered gymnastics for the media. Shortly after she returned home from London, she found out she was pregnant with her daughter Sterling who is now three (3) years old.

Today, Miller travels the country telling her cancer story and encouraging women to take care of themselves, “I use whatever voice I have from my Olympic career to encourage women to keep medical appointments, get more sleep, eat right, get and stay fit, and recognize the signs and symptoms of cancer.”

In June 2014, in honor of National Cancer Survivors Day, Shannon Miller spoke at a cancer survivors’ reunion sponsored by the American Cancer Society and Extended Stay America hotels, which donates hotel reservations to cancer patients whose best option for cancer treatment is away from home. “Extended Stay America does so much for those going through a cancer diagnosis. There is so much involved beyond treatment for patients and caregivers.”  She stated that she enjoys the opportunity to speak to survivors. We are all at a different place in our journey, but we can learn something from every story. Learning more and being around other survivors or reading about them is important because it gives you hope. The more we can do to create awareness the better, so we are catching cancer earlier when there are more options for treatment.”

According to her, “The biggest lesson she learned was how much she needed to appreciate every day.”  “No matter where you are in your journey, you can take that day and do your best with it. She used to fly through life. She did not take time to savor it. She was always a go, go, goes, person. Now she understands the importance of really taking time to appreciate every moment.”

Women can beat this deadly disease by taking note of lifestyles or habits that trigger cancer. Health experts always stress the point that one should live healthily by simply doing the basics of healthy living which will go a long way in avoiding cancer.

By Charles Emekpo

An autoimmune disease is a condition in which your immune system mistakenly attacks your body.

The immune system normally guards against germs like bacteria and viruses. When it senses these foreign invaders, it sends out an army of fighter cells to attack them. Normally, the immune system can tell the difference between foreign cells and your own cells. In an autoimmune disease, the immune system mistakes part of your body — like your joints or skin — as foreign. It releases proteins called autoantibodies that attack healthy cells. Some autoimmune diseases target only one organ. Type 1 diabetes damages the pancreas. Other diseases, like lupus, affect the whole body.

According to experts in the medical field, facioscapulohumeral muscular dystrophy is a disorder characterized by muscle weakness and wasting (atrophy). This condition gets its name from the muscles that are affected most often: those of the face (facio-), around the shoulder blades (scapulo-), and in the upper arms (humeral). The signs and symptoms of facioscapulohumeral muscular dystrophy usually appear in adolescence.

 

Living with this disease just like with many other terminal diseases comes with huge challenges. In this article, we will be reading about a 34 year-old lady who suffers from this terrible disease together her mother and elder sister. Here is her story:

 

My name is Daniela Chiriac. I am 34 years old, and a member of a family of three, including my mother and my elder sister. All of us are suffering from progressive muscular dystrophy. I was diagnosed with Facioscapulohumeral muscular dystrophy in 2010, after a bad episode at work.

 

Unfortunately, none of us escaped this irreversible illness, but we must go forward and fight until the end. The saddest part of my story is that I was the one who has been taking care of my mother and my sister since I was 14 years old when my father passed away, but now I am unable to look after my family and after myself properly as I did for the past 16 years.

 

I am very much aware that this illness has no cure, but I have struggled to provide a treatment which includes many supplements, both natural and synthetic, which have helped fight the illness by slowing the progression. Fifteen years ago, every doctor told me that my sister and my mother would not live more than five more years, but here we are! My mother is 67 and my sister 47 years old at this time (2014).

 

Over the years, I have approached all the foundations/associations that I could find in Romania which fight against muscular dystrophy of any type. Unfortunately, they did not have the funds to help us. Nevertheless, I kept fighting on my own to provide my mother and my elder sister (who is also like a mother to me), a comfortable life and I tried my best to minimise the emotional and financial discomfort, as long as I was able to work.

 

Complications

 

As a consequence of muscular dystrophy and also non-insulin dependent diabetes, my mother has developed many complications, including:

 

  • Muscular atrophy in legs, arms, and muscles of upper and lower back
  • Difficulties swallowing food and periodontitis
  • Weakening abdominal muscles
  • Weak articulations
  • Loss of balance
  • Hepatic steatosis
  • Hypertension
  • Ischaemic heart disease
  • Diabetic neuropathy (also as a side-effect of diabetes)
  • Diabetic wounds
  • Major depression
  • Severe pain (the result of nonresponsive muscles, neuropathy, damage to the bone articulations and internal organ atrophy)

 

 

 

My sister struggles with the following:

 

  • Losing muscle strength and function
  • Affected joints
  • Respiratory difficulties
  • Cardiac muscle affected
  • Liver disorders
  • Pain and muscles cramps

    She also wears knee orthosis to combat knee extension damage and help her walk

    

 

I have been encountering more of these medical problems myself since 2010, but age is still on my side and I still have the strength to look after myself, to help my mother with her hygiene needs every day, to take care of her wounds, to stay in touch with the family doctor, to bathe my sister and to help her to go out for short walks. I was forced by the situation I am going through to accept medication for depression.

 

Living with a rare disease in Romania

 

Medical treatments for the heart condition, hypertension, diabetes, some medication for stomach disorders, and the treatment for depression I mentioned are covered under legislation for the rights of disabled individuals, meaning by the social security system in Romania. No specific treatment for muscular dystrophy exists or is covered by Romanian legislation based on the fact that there is no cure anywhere for muscular dystrophy. In Romania, muscular dystrophy is considered a kind of “luxury illness” with which you can live “in peace,” waiting for it to put you down sooner or later. There is no association/foundation fighting against muscular dystrophy in Romania with help from the state to achieve their goals (at least according to the information I have). Associations are supported by the authorities in Romania if they are accredited and provide services (based on a call for proposals according to the priorities of the Ministry of Work). In Romania, there are two organisations for muscular dystrophy. The situation is the same for other rare diseases where there is no treatment approved.

 

There are some treatments, taken with the common agreement of the doctors following my family’s case, which gave me hope for a better life and improved the medical condition for my mother and my sister over the years. These include coenzyme Q 10 100mg; vitamin E 100mg; glutathione 500mg; Octapower; diabetes supplements; multivitamins and minerals; omegas 3 & 6; vitamin C 1000mg; calcium 500mg; magnesium; bee pollen; and the pain reliever Uteplex (made only in France) which has been very helpful in alleviating the pain. My mother also needs glucose strips but as she is not insulin dependent these are not covered by the social security insurance. Also, all the special bandages and ointments and creams needed for the diabetic wounds that my mother often develops are paid for with our own income.

 

Our income, for all three of us, is approximately 250 Euro per month, with which we must cover everything, including treatments/supplements/glucose strips, as well as bills and monthly costs for the apartment, consumption (water, gas, electricity, et cetera).

 

I need real help to continue my fight because my strength is very low at this time in my life. I feel that my hands and feet are tied and I can’t make any real movements anymore. This is the reason for which I decided to tell my story because I am powerless.

 

 

 

Source: EURORDIS