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Making The Most Of Your Sleep Time

The first time I heard the word “agoraphobia” was during my Psychiatry posting as a medical student. Asides the tendency of medical students to associate the symptoms of a disease they are studying to themselves, what is referred as Medical Student Syndrome or Medical Student Disease, it was interesting to note that it was the opposite of “claustrophobia,” a word I learned much earlier from novels.

I was thrilled to be putting a name to the fact that I hated open spaces. Not typical agoraphobia, but I hated a person entering or exiting my room and leaving the door ajar. It made me feel exposed, in an uncomfortable way.

Over the years, as I grew, I learned to also sleep with the lights off; how “adults” (are supposed to) sleep.

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I noticed of recent though, that I slept most times with the lights on and more worriedly, did not seem to care as much if I was sleeping with my door ajar.

These made me wonder. “What is it that has made me let my guards so low?” 

It was a source of concern to me.

It made me think, “Could it be that I am developing poor sleep hygiene?”

I know some may be wondering if that is even a thing – sleep hygiene. Well, I also remember from my Psychiatry posting, that one of the first things you do while managing insomnia (inability to initiate or maintain sleep) is to educate the patient on behaviors that may help them get to sleep faster or sleep soundly.

By the way, I am sleeping soundly. I simply thought that we might sleep/rest better if we practiced a better sleep hygiene.

With the increasing demands of adulthood and generally making a handsome living, we get to sleep less on most days. When we get a chance to sleep we should optimize it.

Some things you could do to improve the quality of your sleep:

1. Obey your body clock

The body has an alternating sleep-wake cycle controlled by an internal “clock” within the brain.

If you get up at the same time every day, soon, this strict routine will help to “set” your body clock and you will find yourself getting sleepy at about the same time every night. This may require you set an alarm for the first few days/weeks.

Also, note that staring at the clock in your bedroom or watching the minutes tick away while trying to sleep, can increase stress, making it harder to sleep – the reason you should turn your clock’s face away from you.

When your body signals you to rest, obey. Don’t say, “let me write a few more lines,” “read a few more pages,” or “watch a few more scenes,” do what it asks – go to bed. Likewise, do not go to bed when your body is not tired. You will be reinforcing bad habits, like laying awake. This is the time to put in the “extra” work.

2. Improve your sleeping environment

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A higher quality of sleep is assured if your bedroom feels restful and comfortable. This is where the “adults” win. A dark room does help you sleep better. It signals to your brain: it is time to sleep.

If your mattress is too hard or too worn, a quality sleep is less assured. The aches from sleeping on a mattress that slouches upon laying on are enough to rob you of the rest you hoped to get. Invest in a good mattress.

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I read a post on Facebook. A friend was complaining bitterly about a church situated close to his home that would not let him sleep. This was as a result of the loud and discordant sounds emanating from their speakers. If this is you, too, then getting earplugs would do you a world of good, since you cannot chase them away – even though you would have loved to. Keep in mind that the added stress of cursing does not make the prospects of a quality sleep more assured.

Make sure the room is at a right temperature; increase the temperature of your air conditioner or open up your windows, as the case may be.

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You would want to reserve your bedroom exclusively for sleeping where possible, so your brain does not associate your bedroom with activity.

3. Avoid drugs that influence the brain activity, by either stimulating or depressing it.

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Such would include caffeinated drinks such as coffee, coke, and also cigarettes and alcohol.

Taking a warm, milky drink instead can help you sleep faster, as it contains a sleep-enhancing amino acid.

Although alcohol may help bring on sleep, after a few hours it acts as a stimulant, increasing the number of awakenings and generally decreasing the quality of sleep later in the night.

4. Relax your mind

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Ease the transition from wake time to sleep time with a period of relaxing activities an hour or so before bedtime.

Take a bath (the rise, then fall in body temperature promotes drowsiness), read a book, watch television, play some music or practice relaxation exercises.

Avoid stressful, stimulating activities — doing work, discussing emotional issues. Physical and psychologically stressful activities can cause the body to release the stress hormone, cortisol, which is associated with increasing alertness.


There are also a number of other measures you may adopt to enhance the quality of your sleep, such as exercise – exercise promotes restful sleep if it is done several hours before going to bed, having light meals for dinner and taking balanced fluid – not too little for thirst to arouse you from sleep or too much to be awakened by a need to use the bathroom.

Did you know taking afternoon naps reduces the quality of your nighttime sleep?

I know some persons go to sleep soon after they hit the bed, whereas, for some others, it is a tug of war. I hope the latter find this post useful.

Love,

Annie.

 

 

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Culture and Travel Life in Medicine

First Outing As A Doctor x Practicing In My Village

When it was confirmed I was listed as one of the doctors and was going to travel, my excitement knew no bounds. The joy in my heart must have rung louder than a grade six murmur. The prospects of clerking in Igbo, and most importantly treating my own people was too exhilarating to keep calm.
Having trained in Rivers state, interacting with people from its various tribes, and even doing a compulsory one-month rural posting in a community in Rivers state – Kegbara-Dere, sometimes having a colleague who is a native act as an interpreter, and learning a few of their language to get by, this was much-welcomed opportunity.
As we approached the venue for the outreach, my aunt who was with me in the vehicle worried about my proficiency in Igbo; if I would be able to communicate effectively with the villagers.
I did not hesitate in letting her know how grounded I was for this. I boasted: “We have been effectively trained for this. One of the things you have to get right in medical school is the ability to communicate with your patient – whatever their level of education was. That included finding ways to surmount the barriers of language and religion also.” By the time I had gone on to lecture her on the expediency of passing the counselling station in the exam, and explaining a patient’s medical condition in the simplest of terms, she was forced to believe more in my ability.
I alighted the vehicle feeling comfortable in my ordinary attire, no white coat or stethoscope to give me away as a doctor, when to my uttermost amazement some other person alighting from a motorcycle greeted me, Doctor.
Poker-faced, looking down at my bag to crosscheck that my ward coat and stethoscope were safely tucked in, I stared back in his direction blankly, wondering what gave me away as a doctor. After he settled the bike guy, he repeated his greeting, as if to erase any doubt I had, concluding that I probably didn’t recognize him. The doctor who was to become a partner and a potential friend explained that we had the same Alma Mata and he knew me while we were in school. He was some classes ahead of me, had seen me a couple of times in the library and was currently serving in my village. Small world.
In no time, the patients were ready to start seeing the doctors, and the doctor and I were initially positioned in different consulting rooms.
“I mere añunu?” I started. The only Igbo Isuikwuato I was sure of.
The elderly woman began her compliant. At some point, I wanted to plead with her to stick to basic Igbo but decided against it.
When I had gotten all of her complaints and had an understanding of her condition, I proceeded to prescribe her medications.
One thing I didn’t do was fake knowledge where I would have used some guidance. That would be grave and foolish of me. So, I asked questions and sought clarifications when I needed one. If that made me seem “incompetent” or not schooled enough, that was your thinking.
“Better be humble and learn more, than prideful and kill innocent persons,” I admonished myself.
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Shortly afterward, we were joined by an older doctor who had been in practice for years. He was from my village and owned a hospital in a neighbouring town. I gave up my consulting room to share space with the other doctor who was serving in my village.
At intervals, my aunt came to check on me; to be sure I had no difficulty communicating with the patients and help if I had one.
I reassured her that I was doing fine, with a smile. The other doctor was from Akwa Ibom and didn’t understand a lot of Igbo. My aunt helped out when I was busy, and I took on the task of interpreting when I was less busy. I was too happy to.
He understood some words. When they said ishi/isi, he knew they were talking about their head… So, headache. When they said ukwu, they were referring to their waist. And so on.
The majority of the patients complained of headache, waist pain, leg pain, and general body pain. And of course malaria. This was to be expected considering their major source of livelihood is farming, my village is hilly, and the major age group of the presenting population elderly.
Children also came. If you have treated malaria, then the other most likely complaints were cough, ukwara and its accomplice, catarrh, mmiri ukwara.
Everyone that presented to the health center was dewormed.
Among the mpas and mmas, hypertension, as expected, was predominant and a few accompanying or isolated cases of diabetes.
There were few other random cases, and patients were referred to the General Hospital, and to be followed up when there was a need.
It was obvious some came for a refill of their medications, which was OK. That was why we were organizing the free medical outreach, everyone should make the most of the opportunity.
Of particular note was a certain old man, who looked vaguely familiar when he stepped in. On interaction with him, I asked him if he knew my grandpa and he answered in the affirmative, recounting some fun memories with him.
I was more than impressed when he took out a small note, where he had beautifully written down his complaints. I had to show my partner, he didn’t seem as impressed as I was, but I was and made sure the old man knew I was. He smiled and said he used to be a teacher. I scribbled his name on a paper and made a mental note to ask my uncle or granny when I got home.
I also met some other persons who knew me as a child or knew my family, and when they tried to place whose child in particular I was and were told “nwa Moses, Ada ya,” I could see them wearing the happiness in their hearts on their faces. Their own daughter was treating them. And I, too, found satisfaction and inexplicable delight and gave them my best.
We were joined by another doctor, who is from my village and works at the General Hospital.
His family is based in Port Harcourt, but he has a love for community medicine and enjoys working in the village to give back to his community. A lot of persons attested to his humanitarian and selfless service to the community.
The three of us soon got along and by the end of the second day, the last day of the outreach, we were heartily retelling stories of medical school. I didn’t realize how exhausted I was at the end of the day until I lay to sleep, but one thing was certain: The joy in my heart had no match, and my people were more than happy, blessed.
Tired, but surely excited, I managed to pose for photos at the end of the day:
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*I mere añunu? – How are you? (in my dialect)
*Mpas and mmas – Fathers and mothers (the elderly)
*nwa Moses, Ada ya – Moses’ child, his first daughter
Love,
Annie (or I should sign off with my Igbo name, Chioma? 😁)
Ps – This outreach was part of the infamous August Meeting, the annual meeting Igbo women attend in their village. Isn’t it cool that it has evolved to become an avenue these women seek ways to give back to the community? Shout out to the Onicha Amiyi-Uhu women of Isuikwuato local government area, Abia state. Onicha Amiyi-Uhu to the world! ❤
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Dear Younger Me

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Yesterday, I was given the honour of speaking to some teenagers and children about their health. When I was first called, I was not given a specific topic. The caller just said, “You know teenagers now… You can speak to them on anything that applies to their health.” Then she suggested topics like HIVSTDs, the regular things, and made me promise I would be able to make it. I was away at the time she called, but would be back by the time and so I assented to her request, still leaving room for a possible change of mind.

I thought about these children and what I could possibly teach them. “If it were women, then I could tell them about breast cancer, cervical cancer, and their cohorts,” I worried. At another end I thought that HIV, STDs as the caller suggested were worn-out topics; they have heard those a hundred times over. Then personal hygiene was too mundane. “What’s that?” I mocked the idea. “Bathe twice a day, brush your teeth, wash your undies… Oh, please! They don’t need me to tell them those. They should know those already,” I continued to struggle about what to teach them.

I even took up some teen devotional plans on my bible app, to find some ideas. Are you wondering why I was looking in my bible, rather than my textbooks or online to find what to teach the kids about their health? I did wonder, too. Especially as they were in a camp organized by a church, and surely would have had several persons talk to them about “their spiritual life.” Won’t they? To answer that thought, I reminded myself that: I am first a child of God, before a doctor. Then, isn’t every Word of God God-breathed and profitable for instruction, for conviction, for correction, for training in righteousness [learning to live in conformity to God’s will, both publicly and privately–behaving honorably with personal integrity and moral courage]? Wasn’t that what I desired for these children and teens, above all? If so then, it was not out of place to look there for inspiration and guide.

I, however, could not still reach a decision on what to teach the children and teens. I was almost reaching an impasse and frankly thought about calling the organizer to cancel. That was a day before the event. I had thought about it all week but had not taken the necessary steps to cancel. While having my bath the night before the D-Day, I thought about myself in my teenage years,“What did I wish I knew more about?” I also knew I could not pass over any opportunity to speak to young children. That would be doing too much harm to the younger generation; a decision I could not live with or forgive myself for taking.

“We owe it to each to tell our stories.”

Ideas started forming in my head. I knew just where to start and how to continue from there, trusting the Holy Spirit to guide me with the right words. Are you still wondering if I am talking about their health? Yes, health, their “social health.” As defined by W.H.O, health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. I was very much in tune, unconventional, maybe, if you like. I was going to talk to the teens about sex; making responsible decisions about it, having and owning their values – positive values, and of course all the in-between: menstrual cycle, contraception, unplanned pregnancy, in addition. Things I was not taught. I was going to be honest with them, open about it, and available to answer their questions, using my own story.

When I got to the venue, trepidation began to creep in. I ministered to myself: “I have the Holy Spirit, the Holy Spirit gives me boldness. I am bold and not timid.” It was my first time deciding to be very open with my story. I was always going to tell it, put it in a book, and tell of how God gave me grace and helped me! Oh, don’t think it is a sanctimonious story of me or one of a wanton child saved by grace. It is simply my story, of how life happened to me, and how life can happen to anyone. All the more reason I would be doing a great disservice to the younger generation, by not sharing my story with them. I may not have had someone teach me, but I can be the one to teach others.

I mounted the stage, looking into the familiar faces of some children I had always known growing up, some of whom had fast grown into teenagers and ‘young adults.’ And some not too familiar faces, too. It was my home church, which meant I grew up in their midst. Had always been among them. Still among them, even though more away than with them presently. So, they knew me. Most of them knew me.

After building on this premise, I began to teach them. And somewhere along the line, I got candid with them, about details of my story which was unknown to even some relatives. It came as a shock. My youngest brother was in their midst, I saw him look up in a mix of emotions I can’t clearly tell. I didn’t back down or flinch, I plunged ahead. It was the debut telling of my story; unplanned and unrehearsed. At some point, I was not sure if I clearly communicated it to them. I didn’t let that bother me. I would get better at this, I encouraged myself. There is still the book. I did my best to answer their questions; I made them feel comfortable to ask and pointed out that I was available to answer any questions, even beyond the meeting. I was not sure how I felt when I got back home, but I had one prayer as I left my house and all through the while I spoke to the children and teens: “God, please, use me to preserve some destinies here.” I can rest in the promise that God answers prayers.

If you could tell your younger self everything you have learned so far, so they could be one step ahead, where would you start?