BRIEF ILLNESS: SUDDEN DEATH
Dr. Martin Akpan
With a heavy heart but with total submission to the will of God, we announce the sudden transition into glory of our beloved father, husband and uncle, Chief Elder A.B.Z, age 45, who died after a brief illness. He is survived by a wife, two children and aged parents…’
The pattern is familiar. And the attendant pathos contagious and gripping. These days, hardly a day passes without the airwaves being clogged with obituaries of people who “died after a brief illness”. Recently, a cousin of mine obviously disturbed by the rising incidence of “brief illness”, walked into my consulting room and demanded to know what we (doctors) were doing about it. And sensing a palpable expression of helplessness on my face, he quickly suggested a comprehensive health initiative by the Federal Ministry of Health to “stem the spread of this national epidemic”
Like my cousin and other countless other concerned compatriots, I am worried about the rising profile of sudden death and near heroic status accorded this “monster” by our people through elaborate and expensive burials today.
However, I want to state straightway that there is no single, recognized entity called “brief illness” which is responsible for sudden death. The term brief illness which is the lay Nigerian contribution to the medical lexicon is only an attempt by the laity to explain the unusually short duration of the illness that usually precedes sudden death. There is a whole gamut of clinical conditions known to hasten up or cause sudden death. And all these shall be highlighted in this discourse.
There is no gainsaying the fact that the problem of sudden death is on the increase. And the rate of increase is so alarming that thorough appraisal of the situation has become imperative. At a one-day symposium recently organized by the female doctors in the state under the auspices of Medical Women Association of Nigeria (MWAN) to brainstorm this problem, there was an unanimity of opinion that as far as sudden death is concerned, our modern lifestyle maybe our greatest undoing. And yet, whenever sudden death strikes, we are quick to point an accusing finger at witchcraft and other devilish forces instead of blaming it on our “westernized” lifestyle. I do not pretend to be unaware of these forces. My only grouse is that in most cases, our approach to these issues has been largely simplistic and pedestrian.
Sudden death is the death which occurs within a few minutes or hours in an otherwise healthy person. Symptoms may not precede its occurrence.
Causes of sudden death are many and varied. In adults, these include electrocution, epileptic fits, dissecting aneurysm (rupture of ballooned blood vessel), head injury and some obstetric and gynecological problems such as ruptured ectopic (extra uterine) pregnancy, uterine rupture, placental rupture, uterine inversion and bleeding. Others are cot death in babies and anaphylactic shock occasioned by drug reaction and insect stings.
But by far the most dramatic cause of sudden death in adult is coronary heart disease, which may present either as myocardial infraction or angina pectoris both of which are characterized by gripping symptoms of varying degrees. Whatever the clinical type, the pathological basis remains basically the same: That is the deposition of cholesterol (fat) in the lumen (cavity) of the coronary (heart) blood vessels causing their narrowing or occlusion and the eventual reduction of blood flow into the heart. This is where our lifestyle plays a contributory role. In the past, coronary heart disease used to be the “Whiteman’s disease”. Not anymore.
Today, we share the Whiteman’s “burden” because we have elected to “import” and impose the Whiteman lifestyle into ourselves and onto our hitherto Arcadian milieu. We have abandoned wholesome traditional delicacies in the favour of fatty foods of the west. The result is an increased incidence of heart disease which is further aggravated by other lifestyles and other factors such as high blood pressure, lack of exercise, soft (as supposed to hard drinking water), emotional stress, nicotine from cigarette smoking, coffee drinking, low calcium content of drinking water and increased intake of salt. Other risk factors include diabetes mellitus, obesity (overweight), drugs and diet.
With regards to diet, it must the emphasized that animal fat in pork, yolk, meat, sausage, whole cream milk, as well as saturated fat in palm oil, coconut oil, palm kernel oil, and butter are rich in cholesterol and are less protective of the heart than fish, chicken, margarine, olive oil, skimmed milk, egg white and turkey which contain polyunsaturated fat.
In conclusion, this column believes that a return to the Africanness in lifestyle and deity preferences would drastically reduce the incidence of sudden death and raise the life expectancy of the average Nigerian. Besides, we advocate: regular moderate exercises, sufficient rest, blood pressure monitoring, avoidance of smoking and saturated fat and reduction of weight as some of the requisite safeguards against “brief illness” and sudden death.