A CT scan of a patient's neck (not the writer's) reveals a thyroid tumour (Photo By BSIP/UIG Via Getty Images)
A CT scan of a patient's neck (not the writer's) reveals a thyroid tumour (Photo By BSIP/UIG Via Getty Images)

I ignored my health after my second child – and regret it



After giving birth to my second child last year, life became overwhelmingly busy. Shower times were cut, friendships were put on hold, multitasking became a sport and any personal errands – such as haircuts and manicures – were non-existent.

A month after giving birth, I felt great and cancelled all upcoming health checks. Not only did they seem unnecessary at that point, but also an inconvenience for myself and my two children. Basically a waste of time and effort.

Instead, play dates were planned and family trips were booked to give them an unforgettable childhood they would probably forget by their next birthday. It was not until months later that I realised I had fallen into the same trap so many mothers fall into when it comes to neglecting their own health, particularly after back-to-back pregnancies.

And I should have known better. Two years ago, while working as a full-time reporter at The National, I wrote a story about this very issue.

Doctors complained that women continued to prioritise their family’s health over their own. They said it was difficult to persuade some women to return to the hospital for postnatal check-ups. Doctors warned that mothers would neglect their health to a critical degree.

Those who chose to have back-to-back pregnancies were at even greater risk. Dr Bachar Abduh, a specialist in obstetrics and gynaecology at Al Noor Hospital, said women needed a three-year gap between pregnancies for her body to fully recover. Pregnancies with a smaller gap than the three years meant a bigger strain on a mother’s body. Interviews with those mothers who chose to have children a year or less apart revealed that their health deteriorated tremendously with every pregnancy. The shorter the gap the bigger the problems.

Yet somehow all of this was forgotten when it came down to my own pregnancies. I left a mere seven-month gap between the birth of my first and the start of my second pregnancy – and then also failed to show up for my check-ups.

Being in my mid-20s convinced me that age and seemingly good health were on my side. In reality, pregnancy and birth – as incredible as they are – are taxing regardless of age and their after-effects spare no mother.

A few months after having my second child last October, I had a number of symptoms I attributed to hormone imbalance and sluggish post-partum recovery. These included hair fall, swelling and weight loss. Chronic tiredness was also a big issue but for that I had no-one to blame but my nocturnal son. However, other symptoms, such as joint pain and blurred vision, could not be explained. Still, they were not good enough reasons to warrant a visit to the doctor.

At five-months post-partum, my family started to notice my symptoms. All the house drains were blocked with my hair, I seemed to lose more weight with every meal, my swelling hands meant I could no longer open a bottle of water without asking for help from the nearest prey, and, finally, the wedding ring had to come off, something my husband took notice of rather quickly.

After several nudges with babysitting offers from family, I finally got around to seeing a doctor for a routine postnatal check in March. Since most of my symptoms were nothing out of the ordinary, I had blood work done and vitals checked. I was told to go back the following week to review the results and was handed an ultrasound referral to check my enlarged thyroid. I did neither.

After ignoring voicemails from the clinic to come back for the result, the physician called me herself. She first told me off for neglecting my checks and asked that I would come straight back in as there were a number of abnormalities in the results.

My white blood cells were high and my thyroid function was outside the normal range. A later ultrasound found a suspicious nodule in my thyroid gland and Hashimoto’s disease. A second ultrasound and biopsy found papillary carcinoma, the most common type of thyroid cancer.

Although the cancer had been growing for at least a few months, it was only now that my body had noticed and tried to attack it with white blood cells leading to the sudden spike. And as the thyroid regulates the body’s energy levels and metabolism, I had another explanation for the tiredness and weight loss that did not involve blaming my children.

Although this may seem an extreme post-partum complication, it is not uncommon. And while I will never truly know if my pregnancies had anything to do with the cancer, its timing seems to indicate that it was – particularly since research in this field has found that it is a complication in women during pregnancy and the early post-partum period.

According to a paper published in the Journal of Thyroid Research in 2011, physiological changes that occur at those times seem to be the trigger. High levels of oestrogen and the secretion of more thyroid hormones during early pregnancy create a favourable environment for tumour development.

Luckily, it is a manageable cancer and rarely requires any form of chemotherapy. My doctor joked that if I had to choose one cancer then this would be it.

Since the human body can survive without a thyroid, surgery to remove the gland – a thyroidectomy – would be needed and a hormone replacement taken daily after that to compensate. Radiotherapy may be used in treatment in some cases. But of course, as other cancers, neglected and unchecked consequences could be fatal.

I am not the first mother out there to ignore her health. Without adequate support systems to help mothers, I will not be the last, either.

Women have the tendency to conform to societal pressures to come out of the delivery room without a hair out of place and preferably in heels. Mothers are expected to bounce back after giving birth in as little time as possible. All this and the little support in many systems today with short maternity leave, inadequate childcare and cosmopolitan societies meaning few or no family members living nearby to offer help and support, rob women of their health.

More attention is needed to prevent mothers from falling into this health negligence trap. Governments should place women high on their agenda in public health and recognise the obstacles they face at home and work in reaching the proper care they need.

But more importantly, mothers must be aware of post-partum complications when they leave hospital with their newborns. They need to realise that delay in any checks could lead to irreversible complications – even if rare, no one is immune to any of them.

Ola Salem is a former political reporter at The National

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Catchweight 82kg
Piotr Kuberski (POL) v Ahmed Saeb (IRQ)

Women’s bantamweight
Cornelia Holm (SWE) v Corinne Laframboise (CAN)

Welterweight
Omar Hussein (JOR) v Vitalii Stoian (UKR)

Welterweight
Josh Togo (LEB) v Ali Dyusenov (UZB)

Flyweight
Isaac Pimentel (BRA) v Delfin Nawen (PHI)

Catchweight 80kg​​​​​​​
Seb Eubank (GBR) v Mohamed El Mokadem (EGY)

Lightweight
Mohammad Yahya (UAE) v Ramadan Noaman (EGY)

Lightweight
Alan Omer (GER) v Reydon Romero (PHI)

Welterweight
Ahmed Labban (LEB) v Juho Valamaa (FIN)

Featherweight
Elias Boudegzdame (ALG) v Austin Arnett (USA)

Super heavyweight
Roman Wehbe (LEB) v Maciej Sosnowski (POL)

MATCH INFO

Arsenal 1 (Aubameyang 12’) Liverpool 1 (Minamino 73’)

Arsenal win 5-4 on penalties

Man of the Match: Ainsley Maitland-Niles (Arsenal)

Results

Stage 7:

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2. Sam Bennett (IRL) Deceuninck-QuickStep - same time

3. Phil Bauhaus (GER) Bahrain Victorious

4. Michael Morkov (DEN) Deceuninck-QuickStep

5. Cees Bol (NED) Team DSM

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2. Adam Yates (GBR) Ineos Grenadiers - 0:00:35

3. Joao Almeida (POR) Deceuninck-QuickStep - 0:01:02

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Director: Hwang Dong-hyuk 

Stars:  Lee Jung-jae, Wi Ha-joon and Lee Byung-hun

Rating: 4.5/5

THE LIGHT

Director: Tom Tykwer

Starring: Tala Al Deen, Nicolette Krebitz, Lars Eidinger

Rating: 3/5

RESULT

Copa del Rey, semi-final second leg

Real Madrid 0
Barcelona 3 (Suarez (50', 73' pen), Varane (69' OG)

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”