18 side-effects of living in Mozambique


1. You eat piri piri sauce with everything…

Because there aren’t any other options. And because it’s just so damn good.

2. …but you can’t see any more prawns.

Delish, but there’s only so many you can eat. Unless of course…you have them with piri piri sauce.

3. You pray before boarding an airplane.

If it ever arrives. Or leaves.

4. You request time off from work to go to the bank.

Because it takes at least a 1/2 day to stand in line.

5. You’ll never appreciate a good beach anymore.

Because nothing lives up to Bazaruto. Or Cuirimbas. Or Inhassoro. Or Barra.

6. You are obsessed with checking Facebook, email and the news a week before an official public holiday.

To find the official announcement of a dia de tolerancia. After all, you’ve made travel plans
assuming there’ll be one. Or two.

7. You are conditioned to drive your car without your arm/elbow leaning out of the window.

Because that’s against the law.

8. You check online references to see whether your local restaurant isn’t accidentally involved in rhino horn trade.

The struggle is real.

9. You start singing, clapping and dancing at a work conference and expect everyone to join in.

Just to get into the right mood.

10. You think Laurentina is better than Heineken…

Because it is. Maningue nice!

11. …but you’re suspicious of artisanal beer.

Because it might be poisoned with crocodile bile.

12. You have a can of coke in the backseat of your car.

In case a cop pulls you over for no reason and won’t let you go unless you give him ‘something’.

13. You use capulana fabric for everything.

Clothes, table cloth, towel, picnic blanket, curtains, bag, washing basket, car shade, baby carrier, headband, wristband, pillow case, bed sheets. The possibilities are endless.

14. You understand why the building guards wear gloves and a hat at 20C.

It is a little chilly, isn’t it?

15. You aren’t surprised that funerals can be fun…

There may be some drinking and dancing to please the spirits of the afterlife and ensure a smooth transition for the deceased.

16. …and a great occasion to catch up with people.

Because everyone you’ve ever known and their mother will be there.

17. You aren’t afraid of hugging the person next to you on the bus.

So that you won’t fall off.

18. You know that in the end, whatever may happen, we stand together.

Estamos juntos!


18 side-effects of living in Mozambique - travels

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Hepatitis B

What is hepatitis B?

Hepatitis B is a virus that causes liver disease. Hepatitis B virus is found in the blood and body fluids of infected people. People infected with hepatitis B virus can spread it to others.

You can be infected with hepatitis B virus if you

  • Have sex with an infected partner
  • Share needles, syringes, or drug preparation equipment with an infected person
  • Share personal care items such as razors, toothbrushes, or medical equipment, such as a glucose monitor, with an infected person
  • Get cut with a sharp instrument or have a needlestick injury in a health care setting
  • Touch the blood or open sores of an infected person

Early symptoms of hepatitis B can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice (yellow color in the skin or the eyes).

Some infected people develop chronic (lifelong) hepatitis B. The long-term health effects caused by chronic hepatitis B infection can cause people to die early from liver disease and liver cancer.

Who is at risk?

Hepatitis B occurs in nearly every part of the world but is more common in some countries in Asia, Africa, South America and the Caribbean. This map shows the worldwide prevalence of hepatitis B virus infection.

Although the risk to most travelers is low, medical tourists (people who travel for medical purposes) or people who need emergency medical care while traveling may be more likely to get infected.

What can travelers do to prevent disease?

Getting vaccinated is the best way to protect against hepatitis B. Hepatitis B is a routine vaccination that infants in the United States receive at birth. The hepatitis B vaccine is over 90% effective at preventing infection and has been routinely recommended for infants since 1991. The vaccine is given in 2, 3, or 4 shots and the series of shots is usually completed by 6 months of age.

The hepatitis B vaccine is also recommended for unvaccinated travelers of all ages going to countries where hepatitis B infection is common. The vaccine is given in 2 or 3 doses. Check if Hepatitis B vaccine is recommended for your destination.

If you trip is soon, talk to your doctor about accelerated dosing and ask about getting the combination hepatitis A/hepatitis B vaccine.

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel. Avoid contact with other people while you are sick.

If you need medical care abroad, see Getting Health Care Abroad.


Cancer Care Decisions for Older Adults

Cancer treatment can be more challenging and complicated for older adults. This is because older adults are more likely to have chronic health conditions, such as diabetes or heart disease. Even when you are healthy, your body will most likely respond differently to treatment than a younger person’s body. For example, older adults are more likely to have serious side effects from chemotherapy.

But age should not be the only factor in your treatment decisions. Cancer treatment can help people of any age. This article helps you think about making treatment decisions.

Why your decisions matter

In the past, doctors sometimes made decisions without talking with patients. Today, the situation is different. Your health care team wants to know your concerns and answer your questions. They also believe that you have the right to make your own decisions. Working with your health care team to make a treatment plan can help you feel more in control.

What to consider

Before making any treatment decisions, talk with your health care team about:

The type of cancer, if it has spread, and how far

All your treatment options, and the risks and benefits of each one

Any other medical conditions that might cause problems with treatment or increase your risk of side effects

How cancer treatment can affect your physical health, emotional health, and lifestyle

Thinking about your personal situation is also very important. You might want to consider:

Possible emotional and social challenges. Who can help with your care and provide emotional support? If you live alone, will you feel lonely or cut off from other people? How can you get support during treatment?

Financial challenges. Older adults are more likely to have a limited budget, live on a fixed income, or both. But costs of treatment vary based on several factors. And there are resources to help people with the costs of care. Ask your health care team about ways to get financial help with cancer treatment.

Also consider what your life will be like physically, emotionally, and socially. These factors put together are called quality of life. Think about each of the areas listed below:

Ability to keep taking care of yourself, do usual activities, or live independently

Your ideas about a dignified or peaceful death

It is important to talk honestly with your health care team about what quality of life means to you. Sometimes, managing side effects from treatment can make an important difference in your quality of life.

Your cancer treatment goals

Your cancer treatment goals depend on many factors. For example, the type of cancer and whether it has spread will factor into your goals.

Living longer, even with cancer

Having fewer symptoms from cancer and side effects from its treatment

Maintaining physical and emotional strength

Having a certain quality of life

Your goals might be different from a younger person’s. For example, a healthy younger person's goal might be to cure the cancer even if treatment is very difficult. Some people are able to have aggressive treatment. This might not be true for you.

Depending on your age and general health, you might care more about feeling well than curing cancer permanently. This might be especially true if you have a chronic health condition or you feel that your quality of life is poor.

But if you are very healthy and enjoy many activities, you might want aggressive treatment. You might have plans many years in the future. If so, you might want your health care team to do everything possible for a cure.

If you and your family do not agree

Family members, friends, and caregivers might have different ideas about your treatment. They might want you to have more aggressive treatment. Or they might try to keep you from having certain treatments.

If this happens, your health care team can help you talk with your family and friends. Sometimes, it is best if your family and closest friends meet with you and your doctor to talk about the best treatment plan. Remember that you always have the right to make your own treatment decisions.

Cancer treatment options for older adults

You may have just one type of treatment or a combination of treatments. The main cancer treatments for people of all ages are:

Chemotherapy or targeted therapy

How cancer surgery can affect older adults

Like other treatments, surgery has risks. The risks can be higher when you are older because your body does not always work as well as it did. Before surgery, you and your doctor should think about the following:

Heart function. Surgery may make heart problems worse. It is important to consider your heart function before you have surgery. Older adults have heart disease or an irregular heartbeat more often than younger people. Also, your heart might not tolerate changes in blood pressure as well. This can happen during surgery.

Kidney function. Surgery can involve many drugs. You might also get a lot of fluids to keep your body working. Your kidneys need to process the drugs and fluids. If your kidneys do not work as well as they used to, surgery can cause problems.

Liver function. As you get older, less blood flows to your liver to help it work. Your liver breaks down drugs. If it does not work as well as it should, you are more likely to have a reaction to the drugs needed for surgery.

Lung function. As you get older, your lungs do not hold as much air. And they might not work as well to move air in and out of your body. If you have a lung condition such as emphysema or chronic obstructive pulmonary disease (COPD), you may have problems recovering from anesthesia. This includes medications you get before and during surgery. Lung problems raise your risk of getting pneumonia after surgery, which can be very serious.

Considering surgery risks and benefits

It is important to talk with your health care team about the risks and benefits of cancer surgery. If surgery is risky for you, talk about other treatments.

If you have any health problems, or your doctor is concerned about the risks, you may need to have other tests done before your surgery. These may include blood tests, electrocardiograms (called an ECG or EKG), lung function tests, and x-rays.

You might also want to see a type of doctor called a geriatrician. This is a specialist who cares for older adults. This doctor can check your general health and talk with you about surgery risks and benefits.

Planning for after surgery

Talk with your health care team about the care you need after surgery. Depending on your health, you might need different care than a younger person. Ask if you might need:

Recommendations for help in your community

Planning for your after-surgery care is important. Having a detailed plan makes a successful recovery more likely.

How chemotherapy can affect older adults

Unlike surgery, chemotherapy can take a long time. Doctors often give chemotherapy in many treatments spread over a few weeks or months. Then, you might take a break and have more treatments later. Even with breaks, having many treatments can lead to longer periods of weakness. If you are an older adult, chemotherapy might affect you differently than someone younger. For example, older adults have a greater risk of physical side effects from chemotherapy, which can affect your quality of life.

Side effects of chemotherapy

Unlike radiation therapy and surgery, chemotherapy affects your whole body. This increases the risk of side effects. Older and younger patients have similar side effects, but older adults usually get them more often. Sometimes older adults with cancer go to the hospital because of a reaction to chemotherapy.

Fewer blood cells, also called low blood counts. You may have fewer white blood cells, red blood cells, or a type of blood cell called platelets. Low blood counts increase your risk of infection, anemia, bleeding, and bruising. Anemia is when you have low levels of red blood cells. It can make you tired and cause other problems.

Stomach and digestive problems. These can include nausea, vomiting, diarrhea, and dehydration. Dehydration is not having enough fluids for your body to work well.

Nervous system damage. This can affect a person’s thinking or judgment. It can also increase memory loss, make you tired, and cause nerve damage.

To make these side effects less severe, or less likely, your doctor can:

Check for health problems before you start chemotherapy

Change the dose or type of drug

Chemotherapy and your other medications

Older adults are more likely than younger people to take regular medications for other health conditions. These medications might affect the chemotherapy you receive. Or chemotherapy might affect how your regular medications work.

To help prevent problems, make a list of all your medications. This includes those that are taken without a prescription as well as vitamins, supplements, and herbs. Be sure every medication is listed, even medications that are not taken daily. Share this list with your health care team.

How radiation therapy can affect older adults

Radiation therapy might be your only treatment. Or you might have it in addition to surgery or chemotherapy. You usually do not stay in the hospital for radiation therapy. But you might need to go for treatment often, sometimes every day for several weeks.

Radiation therapy can come from a machine outside the body. Or your doctor may put tiny pieces of radioactive material inside your body, near the tumor.

Considering radiation risks and benefits

Talk with your health care team about:

If you need to be away from home

How to keep a healthy diet during treatment

Depending on your health, your doctor might recommend less intense treatment for a shorter time than for someone younger.

Older adults usually do well with radiation therapy. The side effects depend on the type and dose of radiation therapy and where the cancer is. For example, radiation therapy for prostate cancer can cause different side effects than radiation therapy for head and neck cancer. Learn more about radiation therapy for specific types of cancer types.

Clinical trials

Clinical trials are research studies that involve people. The people in clinical trials volunteer to help researchers learn more about new drugs and treatments.

Because 60% of people with cancer are older than 65, it is very important for research studies to include older adults. Doctors need to learn which treatments work best in older adults. They also need to learn if those treatments might work differently than in younger people. Talk with your health care team about available clinical trials and how they differ from standard treatment.

Other types of cancer treatment

Relieving a person’s symptoms and side effects is an important part of cancer care. This is called palliative care or supportive care. It can be especially important for older adults. This is because older adults can have more side effects, especially from chemotherapy. Or your body may not recover as quickly from surgery as someone younger, which can cause more symptoms.

Palliative care also includes getting all the support you and your family need during cancer. Anyone can receive palliative care at any time. It is important to ask for support when you need it.

Advanced cancer care

Advanced cancer is cancer that doctors cannot cure. It is also called end-stage cancer or terminal cancer. Even though your health care team cannot cure advanced cancer, they can treat it. And you can still have a good quality of life.

Advanced cancer treatment options include:

Standard treatment. The current or most effective treatment available.

Clinical trials. Research studies that test new drugs and treatments.

Palliative care. Care that helps you live as comfortably as possible.

Hospice Care. This is care to help you and your family cope with death and dying. It is available when you are no longer having treatment to cure your cancer.

Understanding these types of care can help you and your health care team plan for your needs, goals, and wishes. Learn more about advanced cancer.

Questions to ask the health care team

After you learn about your treatment options and your general health, you might need more information. Consider asking your health care team the following:

What is my chance of recovery?

What are all of my treatment options?

What is the goal of each treatment?

What treatment do you recommend? Why?

How does this treatment help me?

What are some risks and potential side effects of this treatment?

Will I need to be in the hospital for treatment? Or can I stay home and come to the hospital or clinic during the day?

How long will each treatment last?

How will this treatment affect my daily life? Will I be able to perform my usual activities?

If I am worried about managing the costs related to my cancer care, who can help me with these concerns?

How can I keep myself as healthy as possible during treatment?

If I have questions or problems, who should I call?

What support services are available to my family?


Dosing information

Usual Adult Dose for Rheumatoid Arthritis:

Comments:
-This drug may be used as monotherapy or in combination with methotrexate or other nonbiologic DMARDs.
-This drug is not recommended in patients with an absolute lymphocyte count (ALC) less than 500 cells/mm3, absolute neutrophil count (ANC) less than 1000 cells/mm3, or hemoglobin level less than 8 g/dL.

Use: Treatment of patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response or intolerance to methotrexate.


What’s the Outlook for Stage IV Colon Cancer?

Articles On Colon Cancer That Has Spread to the Liver

When your doctor tells you that you have colon cancer that has spread to other parts of your body, you will naturally have lots of questions, including what it will mean for your future.

Everyone is different. Even if the disease cannot be cured, there are treatments that may help you live longer and with less pain so that your quality of life is as good as possible.

You'll want to work with a doctor who specializes in treating stage IV colon cancer. You can also ask for a second opinion so you feel confident that you understand your situation and options.


Watch the video: 0218 Shadowing Session with Dr. Chowa


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