Rheumatic heart disease

by Sunday News Online | Sunday, Feb 26, 2017 | 1419 views

Andrew Phillip Cowell

RHEUMATIC heart disease is a “. . . cardiac inflammation and scarring triggered by an autoimmune reaction to infection with a group a streptococcus”.

Rheumatic heart disease often affects children at a very early age, as young as five years, and they then need to go onto a monthly regimen of Benzathine Penicillin injections, not a nice prospect at all for a small child. The good news is that a significant number of patients experience a resolution of their heart valve problems five to 10 years after their initial bout of Rheumatic fever. For some patients, however, the painful derriere and double ultracillin shot will remain a monthly reality till around age 25. The injections can help ward off infective endocarditis, a potentially fatal cardiac disease.

Let me now concentrate on the injections themselves, and how to take some of the sting out of them. I’ve always prided myself on being a brave patient, and oh Gosh! I’ve had so many shots — you name them! Anti-tetanus; flu shots, pethidine injections; vitamin B 12 shots (quite painful, but I just love the incredible energy boost they give!) and intravenous shots, like ceftriaxcne (for Bronchitis, 2015) and I.V Penicillin (through a drip following a hernia operation in Mutare (in 2007) and I have taken them all without flinching.

On Thursday, 7 July I’d come bounding eagerly into the clinic, carrying a flu vaccine. Wow! I went into the treatment room, took the jab eagerly and really enjoyed it, it made me feel so good. Yet, exactly two months later on Wednesday, 7 September, I was a quivering wreck on entering the surgery. The oral treatment I’d been on was taking ages and the time had come for me to take off my trousers and take those two big injections like a man, not a sissy. By the way I’d had a good breakfast that morning, an essential if you are going to get an ultracillin jab, and I’d been to the toilet, to prevent any possible gassy, liquid or solid “accidents.”

I was now face to face with my cute nurse with a big needle and syringe in her hand. I said an amusing prayer — I won’t repeat it here, but it undoubtedly helped me to relax. I was aware too of various friends (including some from the Baptist Church) who were praying for me and that helped too. Without any more ado my pants were off and I was lying face down on the couch (An important point: take the shots lying down, rather than standing up, you’ll be more relaxed. If you feel like it cross your feet — it’ll make it more difficult to tense your gluteal muscles. Don’t even think of looking over your shoulder — that needle is big!)

“Are you ready Andrew?” the nurse asked.

“Sure, go ahead,” I replied and felt the needle going in deep into my ample right buttock. This is the crucial moment. No getting away from it, that precious, cleansing white stuff does burn, but if you keep your gluteal muscles relaxed it will just be a moderately painful, but quite bearable experience. If you tense up it will be agonising — hence all the grandiose horror stories one hears about these injections.

Then I got 4ml in my left cheek and before I knew it the “agonsing ordeal” was over and I could get dressed again, and be on my way smiling — a bit sore, but by no means in agony. (The usual practice is to give 4ml in each buttock, which is much more pleasant for the patient, 8ml may be injected into one buttock, but it is much more painful, and the penicillin may crystallise while being injected. The 4ml per cheek, rule is better, all around for service provider and patient alike).

So please guys and girls if you must have the ultimate injections, please don’t be a cry baby, take it like a real man or a real lady. I’m not being hard — after all I’ve been a practicing social worker for 32 years but I do believe that we must “quit ye like men” (and women) and be strong.”(to quote my old Milton School Motto) and face the challenges life throws at us even if this particular challenge can involve having a sore rump.

For post injection care walk as much as you can to prevent stiffening of your gluteal muscles. You may like to carry a cushion with you, in case sitting is uncomfortable for a few hours after the shot (I had my injection at noon, and did use a cushion that afternoon) (riding in a kombi could be decidedly painful — avoid that if you can).

I’ll tell you something however, — an hour after getting my two shots I was floating in penicillin and felt great. I was actually glad to have got the injections. True, my hind-quarters were bruised for nearly a week but that’s not too bad.

Now, for those of you who may have to endure monthly shots till you are 25, I hope that I’ve given you some tips that will make that less painful. Yes, you will have a sore butt once a month, but even that isn’t so bad now, is it? And you’ve got the other 29 days of the month to enjoy life as much as possible.

Thanks everyone for bearing with me this far and keep happy and healthy.


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