Monday, March 26, 2018

Medical questions like you've never heard before!

I knew that when I came here to Nigeria, I'd have to learn a lot of things. I was expecting to learn Hausa, to learn how to ask simpler and more effective medical questions, and to learn how to explain things better to uneducated patients. What I wasn't expecting to learn is how to ask questions like this! Can you figure out what each of these medical questions is really asking?

"When you pee, do ants come to that place?"
                This is an easy test for severe diabetes where the patient's urine is full of glucose.

"When you feel pressed, can you make it to that place before the urine it does drop?"
                I ask this one a lot to determine if she has symptoms of urge incontinence. Since most of my patients' homes do not have toilets or indoor plumbing, and they use the bush or a communal pit latrine, I can't really ask about "making it to the bathroom in time."

"Do you feel like you have pepe in your front?"
                It's another way to ask about dysuria (burning with urination) that is common with urinary tract infections. Also, many women don't know the word "vagina" or "urethra," so we use "your front" or "the place of urine" commonly.

"Do you have a runny stomach?"
                Do you have diarrhea?

"When you get up from bed, your eyes they do turn you?"
                This is a straight up pidgin English way to ask about dizziness or orthostatic hypotension.

"Are you purging?"
                Are you vomiting?

"Do you have heat?"
                This could be asking about fever or pain, depending on their other complaints.

"Have you taken pounded yam today?"
                We always ask this question of our post-surgical patients. They will start by eating a porridge or hot cereal, but when they progress to pounded yam we know they're feeling better.

"Go and drink 2 sachets pure water and one Coke, then come back when you feel pressed."
                This is our way of kicking urine production into high gear when a patient is complaining of urinary leakage but we don't see a fistula. It could be something called a "ureteric fistula" where one of the kidney's ureters dumps directly into the vagina instead of into the bladder. This can be congenital (from birth), or as a result of a cut ureter during an abdominal surgery. If they come back and we see clear urine gathered in the vagina and not the purple dye we put in their bladder, we can confirm it's a ureteric fistula.

"Do you take lots of pepe on your food?"
                This is the first thing we ask when a patient complains of heartburn, yet we know that asking her to reduce the amount of the super hot chili pepper powder she sprinkles on just about any kind of food is like asking a fish to stop swimming!

I bet you've never been asked any of these questions before!

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