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William beats Schizophrenia to find true meaning of life

Rachel Raditsebe

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To a casual observer, Thuto William is no different from you and me. He talks normally, walks just like the next person, and seems comfortable around people. He wasn’t always like this.

“Growing up, Thuto would be energetic and very excited in one moment, only to go flat and expressionless the next,” shares his mother, Reginah William. She adds, “When he was like that, he would be completely expressionless, locked away in a world that no one can reach”.

Thuto’s mother, who has witnessed these mood changes in the 27-year-old for the last 12 years, says for or a long time, Thuto would be withdrawn and just stayed in the house not socialising. William has schizophrenia, a mental disorder characterised by a breakdown of thought processes and a deficit of typical emotional responses. Common symptoms include auditory hallucinations, paranoid or bizarre delusions, or disorganised speech and thinking. It is accompanied by significant social or occupational dysfunction. It is something Thuto will have to live with for the rest of his life.

“It got so bad that I became suicidal. All this time, I had no idea what I was suffering from. Thoughts of ending my life constantly filled my head and I contemplated and evaluated the easiest and most effective ways of taking my life,” William shared.

Gloomy as it was around that time he had the presence of mind to reach out for help and took himself in at Sbrana Psychiatric Hospital in Lobatse. He was 15 years old then and doing his Form II at Ipelegeng Junior Secondary School in Lobatse. “The initial triggers include feeling low and wanting to withdraw and spend time with myself. This later deteriorates to scary thoughts, and then I start seeing things that other people cannot see,” he says.

To counter this, he takes medication and makes a point of keeping the company of people he is familiar with, and who understand his condition. “I can’t party or take alcohol like many of my peers, so I don’t even put myself in such situations” he says, adding that keeping busy also helps to keep the relapses at bay. William says that his life is gradually gaining some normalcy. “I can confidently say that as unfair as life seems, it is also a gift and we should enjoy it and live it to the fullest.

“Yes I don’t enjoy the so called finer things like alcohol, drugs, sex and I struggle to keep romantic relationships. But there is much more to life that I can do like travelling and experiencing the world. It was not easy conquering my demons, but with the help of a psychiatrist and medicine to manage this condition, it is not all gloom and doom.

Schizophrenia, like many other forms of mental illness, is not a death sentence; and can be managed through medication and therapy. I live a full life. Of course, I have good days and bad days. The medicine also has its side effects, like stiff neck, shoulders, feeling shaky and can make you lose hope because they stop you from thinking, but this is the least of my problems.“This condition has taught me that life is truly precious, that we should take advantage of every moment we have. I love travelling and experiencing the world which has also proved to be very good for my head space, I laugh more, I am generally happier, and I make more time for my friends and family,” William explained.

According to Mental health expert, David Mangwegape, schizophrenia is a long-term mental disorder in which a person is unable to differentiate fantasy from reality. “Schizophrenia is caused by a combination of genetic and environmental factors. Dopamine, a chemical found in the brain, is low in people with schizophrenia,” he said in an interview. This is where the genetic disposition comes in. However, not every genetically predisposed person will manifest schizophrenia.

According to Mangwegape, some environmental stressors can cause a trigger. These include traumatic events that lead to emotional trauma, the use of street drugs, and other psychological stressors, such as a stressful relationship, financial difficulty, work and school-related stressors. According to World Health Organisation (WHO), schizophrenia affects about one in every 100 people. The condition is most often diagnosed between age 15 and 35, and can affect any gender but is more frequent in males than females. A schizophrenic attack is gradual. It can begin with withdrawal, followed by other symptoms, such as hallucinations.

Schizophrenia is treated with a combination of medication to reduce the symptoms and therapy appropriate to each individual.“The earlier the treatment, the faster the recovery and the lesser the future relapses,” Mangwegape says. He adds that many people are living with schizophrenia and leading nearly normal lives.

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Mental Health Series

The effects of dagga on mental health

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Recently the South African Supreme Court legalised the private use of dagga. Individuals are allowed to consume dagga in private and also grow for private use. The judgement brought mixed reactions on the issue and further fuelled the debate on dagga.

There are those who have used this judgement to the detriment of their own health. The crux of the matter though is that adverse effects of dagga cannot be underemphasised as far as mental health is concerned. Dagga use is quite popular amongst the youth which ostensibly explains the prevalence of dagga related disorders amongst them.

Effects of dagga are instant upon use. When dagga is smoked, it gets into the blood stream and then blood –brain barrier. This results in depressed brain activity, the end result being production of a dreamy state manifesting as delusions or hallucinations.

Delusions are altered thoughts whereby one may think he is a president when the reality is he is not. Hallucinations on the other hand is when an individual has distorted perceptions of reality like seeing a lion when it’s not there!

Others effects include:
paranoia,
panic attacks
anxiety
Impaired coordination and balance
Impairment in learning and memory

Various research studies have shown that heavy use of dagga facilitates the development of schizophrenia and substance use disorders. The amount of the drug used and the age at first use often place an increased vulnerability to develop these disorders. This explicitly explains why there are many youth who are having substance use disorders in our country.

Those using dagga may develop amotivational syndrome which basically means they have lost the willpower to do meaningful activities in life! This is basically the stroke that breaks the camel’s back, as other mental health problems may manifest from this.

Those whom are already diagnosed with mental health disorders can have symptoms of their conditions worsening when they use dagga. Depression and anxiety are often made worse by use of dagga. The false perception that taking dagga has a calming effect often predisposes those having mental health problems to take it in order to deal with their illness burden.

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Sun Health

Lymphedema Management Part II Post Breast Cancer

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Lymphedema can occur to individuals who have had breast cancer treatment with radiation and/or surgical intervention with or without lymph nodes removal usually in the arm pit.

Lymphedema is a special type of swelling that occurs when there is excessive build of fluid that is rich in protein that is to become lymph due to an impairment in the transport of this fluid anywhere enroute to its final drainage site in the neck.

Lymphedema management is divided into two phases: Phase I Congestive/acute phase whose goal is to achieve the greatest decrease in volume of lymphedema and Phase II Maintenance phase, whose purpose is long term maintenance to ensure sustenance of goals achieved in Phase I.

Components of Phase I are, a) patient education about the condition, self management strategies. The patient will be advised to avoid certain medical procedures to be done on the affected side, e.g. blood pressure readings, pricking to withdraw blood.

These procedures especially the pricking will result in minor injury which in a normal functioning system is insignificant. The normal bodily response is that the body will respond as there is injury with insignificant swelling.

In the case of someone with risk to lymphedema this can be a trigger to full blown swelling, b) Meticulous skin and nail care to keep fungal infections and cellulitis at bay, c)Manual Lymphatic Drainage (MLD).

This is specialised manual (hands-on) technique whose purpose is to improve fluid removal from congested (swollen) areas where there is impediment of flow to using alternative routes to de-congest the areas.

For example, if there is lymphedema in the right arm from right partial mastectomy (breast tissue removal) with eight lymph nodes removal in the right arm pit. The alternative routes to drain) the right swollen hand/arm is to re-direct fluid to drain into the left armpit, right groin and maybe right breast bone areas.

Following this during a treatment session, d)multi-layered Compression Bandaging is used. Here special bandages are used which come in different sizes. Which technique to use when bandaging is influenced by the degree of swelling and staging of lymphedema.

The bandage system is tighter at the wrist and progressively becomes looser towards the arm. This creates graduated compression which facilitates fluid to flow from the wrist towards the armpit.
Initially the bandages are worn 24hrs/day at a time.

If there are wounds which is not as common when compared to the leg(s) preference is to co-treat with nursing care for them to manage the wounds while I manage the swelling concurrently. Immediately the patient does, e) therapeutic exercises to further drainage of fluid from the wrist to the armpit.

This phase I duration can be anywhere from three weeks to eight weeks and more if needs be. During this time the patient is taught to self bandage, gentle self manual lymphatic drainage, prepared for wearing and taking off of compression garments.

Phase II: Maintenance phase, this is initiated when there has been maximal limb (arm size) reduction in Phase I. The patient is fitted into a compression garment. This can either be custom made or off the shelf. Compression garment may be arm sleeve, glove with or without fingers.

The compression garments come in a variety of compression (Class I to IV). The therapist advicss on the compression garment class. Most patients use compression Class II and III. Ideally the patient is encouraged to wear the compression garment all the time.

From time to time there will be a relapse, that is, swelling starts and Phase I will need to be initiated. There are a number of treatment approaches that can be taken. Factors influencing choice include cancer disease stage, type of cancer, location of lymphedema, patient mental status.

It is not just lymphedema that needs to be treated. Other things to treat include scarring, pain and decreased function. If you suspect you have lymphedema bring it to the attention of your oncologist who will refer you to someone trained to manage this condition.

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