text: Dr. Sylvester Ikhisemojie
  In discussing matters of health concern, it is often the case that we focus a lot on things which contribute to good health practices and the outcome we all want. However, there are certain situations in life in which difficult choices have to be made to sacrifice one or more organs in order that life can continue with as little discomfort as possible. Sometimes, these problems are as a result of hideous injuries where there is no possibility of salvage and sometimes, they result from disasters like cancer. At any rate, it is important to appreciate here that the loss of such organs does not mean the end of life, but rather an opportunity to adjust to the new realities so that a second chance can be obtained. In the paragraphs below, we shall be looking at some of these organs and the conditions that might cause the radical decision to do away with them.
  One common organ that many people have lost and have carried on living normally without is the appendix. It is usually surgically removed once it becomes inflamed and begins to cause a lot of abdominal pain, fever and vomiting. The functions of that appendage are not fully understood and there is no evidence to indicate that the people who no longer have it are missing something.
  Another organ that can be done away with in similar circumstances of pain, infection and fever is the gall bladder. In addition, it may harbour stones which would add to the likelihood of pain and it can actually cause a lot of misery to those who have these features. As a result of that combination, the convenient thing offered most patients is the removal of the organ with little or no ill-effects.
  The other organ that many people have lost and carried on living without is the spleen. This is called a lymphoid organ whose major role in the body is the filtration of particles from the blood. These particles may have to do with red blood cells that are deformed by disease or invaded by parasites like the malaria parasite, plasmodium. It is also a frontline organ of defence for the body and an important part of the immune system. However, in certain situations such as the tropical splenomegaly syndrome seen in people with frequent attacks of malaria or in people with the SS and SC genotypes, the organ may be removed to improve the quality of life. With adequate care using antibiotics judiciously and providing vaccination against some common forms of bacterial infections, people who have had their spleen removed live normally.
  One surprising organ we can live without is the stomach. The operation to remove the stomach is known as gastrectomy and it may be partial or total. The total gastrectomy which is the removal of the entire stomach is the more profound one and it is the only choice when a person has got a particularly aggressive form of stomach cancer that is still limited to the walls of the organ. The survivor of such a terrible disease condition is then compelled to eat small meals at frequent intervals of two hours or four hours to avoid some of the more challenging side effects of having lost the stomach. That is known as the dumping syndrome when the alimentary canal is presented with a sudden influx of a large amount of food at once. Dizziness, sweating, abdominal pain, vomiting and diarrhea can occur as a result and this is all very distressing for the patient who would then also lose weight.
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  The same is true of the large intestine or colon where conditions like its total involvement by Hirschsprung’s disease seen in children or Crohn’s disease can pave the way for such radical treatment. In either case, the entire colon can be removed surgically and normal life can actually go on with profound changes in the frequency with which food is eaten. It is thus possible to live without the large intestine. That is not true for the small intestine where some of the most important things to do with digestion and absorption of nutrients take place.
  The sex organs can also be lost with no significant changes in the pattern of life except for the psychological import of it. This is particularly true in situations where the choice to lose such organs was determined by a disease condition rather than a voluntary one. Accordingly, men who develop cancer of the penis will often have to have the entire penis removed. The necessary provision for them to be able to urinate normally will of course be ensured but sexual intercourse is a lost attribute. The same is not true for women who lose their womb either because they have endometrial cancer or they develop huge fibroids that necessitate the removal of the uterus. Since the vagina is spared, sex is still possible without any ill-effects.
  When there is bladder cancer, the entire urinary bladder can be removed and an artificial pouch can then be created using small intestine as a holding bag for the urine. Usually, such people lose their ability to regulate their urine and often have to time it using some kind of warning device. With time, they are able to time it almost precisely with practice and maturity. In children, this is a challenge always.
  The eyes are something we can also do without. As terrifying as it looks here, there are millions of people across the world who have lost their sight and live healthily with their adversity. When the loss involves one eye, it is almost like both eyes are present. When it is both eyes involved, certain challenges are inevitable but good health can be preserved. When people like Steve Wonder are considered, it can be appreciated that so much is possible even without the eyes being able to see normally.
  Another such organ is the kidney whereby normal living is possible with one organ only. There are many situations which can make this particular situation happen. Cancer of the kidney is one such condition and so is multi-cystic kidney. In either condition, it is usually normal to excise the diseased kidney so as to protect the individual from further damage. The remaining healthy kidney can carry on the work of filtering the blood of its impurities in a normal way. There may be some increase in the individual size of its cells just as a form of adaptation. This enables the lone kidney to continue its work and to take up the extra workload being left behind by the removed kidney.
  Finally, the lungs are another organ which the body can comfortably live without even when one is removed. Cancer in one lung, tuberculosis that has destroyed one lung or a lung crushed as a result of an accident are some of the common reasons why one lung might be removed. Normal breathing could be slightly more difficult at the beginning but over time, the remaining lung develops an increased ability to cope with the extra load that is required. At 82 years, the current Pope Francis has had one lung since his teenage years and that has not slowed him down in any way.
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  Questions and answers
  Dear doctor, I was diagnosed with high blood sugar three weeks ago with a reading of 250mg. I was placed on Gluformin 500mg two times a day. I stopped drinking sodas and beer and I was drinking only water and sugar reducing tea. This morning, the reading was 96mg and I did not take the drugs. My question is should I stop taking the drugs or reduce it to one daily? Thanks and God bless. 0803xxxxxxx
  No sir, you must not stop taking the drugs on the strength of one reading alone. Even among people who do not have diabetes, the blood sugar levels vary so much usually within a normal band. What you are expected to do is to respect your doctor’s prescription to a large extent and have the dose changed at the routine follow-up visit to the clinic. When you stop the medication suddenly like you are proposing, the sugar level is likely to go straight back up. Secondly, the decision to reduce your drug use has to be taken by your doctor based on what he knows of your condition, not by you. That is part of the reasons why you must see them at intervals.
  Dear doctor, kindly let me know the side effects of using sildenafil tablets. Can I be using it every day? Many thanks sir. 0816xxxxxxx
  Sildenafil is a drug which acts by relaxing the muscles within the blood vessels of the penis. Because it can similarly affect blood vessels elsewhere in the body, it can cause stuffiness in the nostrils, headaches and palpitations, an awareness of the heartbeat. It can also upset your stomach and may colour your vision by making it seem bluish. Besides that, it can also cause your vision to be blurred. Muscle pain and back pain have also been known to occur. If you can handle all these side effects at once, because some people will not suffer from them, you can use the medicine on a daily basis.
  Dear doctor, God bless you for your good works. Please I am a boy of 13 years and my erections are always facing up, pointing to my body. What is wrong? Secondly, I release sperm with my urine whenever I defecate. Sir, please what is wrong? My erections are quick and frequent. 0808×××××××
  You are still young and just getting into your teenage years when the dramatic changes of puberty will begin to occur. The surge in producing testosterone is responsible for the quick and frequent erections. Now, you are also more likely to be very much attracted at this age to new things relating to sexual awareness which would make you to fantasize. When this happens, you can also have frequent and quick erections. The erections will be strong, so much so that the penis will be so erect that it can bend upwards as you described. Over time, as it gets heavier, it may not bend towards your body but may be parallel to the ground. On the whole, there is nothing wrong with you. The sperm released with the urine is probably a consequence of having wet dreams during which you could ejaculate. Some of that will come out with the urine and even some adults can experience such things.
  Dear doctor, about a month ago I had a little pain by the right side of my penis where there is hair and it swelled with associated pains sometimes. In the night, it will go down. Please what is this, what caused it and what is the solution to it? Sir, there is no money for hospital and I do not usually read newspapers. Thank you and God bless you. 0803×××××××
  It is likely that what you have is a hernia, what many people call “haainia”. I do not know how old you are because you did not say but the important thing you need to know is that hernias are dangerous and when they develop, they ought to be treated. That treatment will involve hospital visits and eventually an operation without which you could find yourself in big trouble one day at a time and place when you are least prepared. At least, start by getting to see a doctor for confirmation before discussing how much the treatment is likely to cost you.
  Dear doctor, thanks for your articles and the explanations you provide in your column. Sir, after the sallah break my stomach disturbed me: I went to the toilet a couple of times but the stool was watery and not much. Now, I am better but I feel pains in my anus? What could have caused this sir? 0807xxxxxxx
  Thank you very much for your kind words. There are several possibilities for the pain you feel in the anus: the first is that the upset stomach you had may have been caused by an infection brought about by a food infection. Or perhaps by taking several different types of food at the same time, the entire mixture upset your stomach. The other possible cause is that you could actually have sustained a tear in the anus as a result of increased pressure there. If it is an infection, it is probably a self-limiting one which would resolve on its own, especially because you have started to feel better without any form of treatment. When it does, the pain in the anus will also go. If it is a tear, that too will heal as long as your stools remain soft but not hard.
  Dear doctor, I am over 53 years of age and I have fibroids which I have been coping with for some time. My doctor says that when I enter menopause, it will shrink. At 53, I still menstruate. Is it normal? 0805xxxxxxx
  Good day madam. The menstrual cycle varies widely in many people. As for the menopause, it is a range actually and may be as early as 45 years and as late as 55. At 53 therefore, you are very fine. As for the fibroids, since they have largely not disturbed you till now in the manner of heavy menstrual bleeding or pain, you should be patient as your doctor says and allow the menopause come.
  Dear doctor, thanks for the great work you are doing. My wife has had a bad cough for nearly one year now and there has been no letup despite visiting several hospitals to see different doctors. The worst part of the problem is that the cough is dry most of the time. Occasionally, it produces some whitish sputum. What do we do about this problem now? 0802xxxxxxx
  Thank you very much for your kind words. This sort of cough may be due to an allergic condition or may be due to some underlying problem that is not necessarily within the chest. I am convinced that not enough has been done to determine the nature of this problem and I would advise that you go to a bigger hospital where a team of doctors can see you and hand you a proper evaluation. If you do this, the cause of the problems you currently face will become clear and a genuine treatment can be found.
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