Our spotlight is focused on someone whose passion for CVD education is birthed from personal experience and a need to do something different from the norm. When we started The Cardiac Movement, it was important for us to connect with people who had similar goals and Juliet, the founder of The Heart Engine was one of those people. Enjoy this interview as we learned a lot from her and cannot wait to show you what we come up with together.
O: Hey can you tell us who you are and what you do?
J: My name is Juliet Egbule. First of all, I always like to start by saying I’m a Christian and what else….I really don’t like introducing myself to be honest. Professionally, I’m a health and wellbeing physiologist and also a public health professional as well.
O: What prompted you to start the heart engine?
J: First of all, personal experience and it’s something I’ve decided to do professionally as well. I wasn’t necessarily testing the waters, but I was just trying to see how people react to or accept things like cardiovascular disease. To be honest, in Nigeria, there has been a lot of concentration on communicable diseases, but not a lot of people are really focusing on cardiovascular disease. Some people think it’s probably a disease for the rich or that only a selective group of people get it. So, I was only trying to get information out there.
O: I read a couple of your blog posts where you talked about your dad. I have found out that unless people hear a story they can relate to it’s hard to empathize. Care to share a snippet of the ordeal? What caused the hypertension?
J: I think I’ve known my dad to b hypertensive since I was very little, so I’ve been checking his blood pressure since I was 10. I don’t mean the automatic one, I mean the manual one. I had to get trained to do that home because several times he’ll say, “oh, I’m not feeling to well. I’m going to get checked up.” And then, we’ll get a call from the hospital saying that he’s been admitted because his blood pressure was too high. The first time, we went to the hospital with my mum, we were so panicked. When we got there and opened the door, he was sitting there reading a newspaper and sipping on some juice and my mum was like, “I thought this was an emergency.” The Dr. just said all he needed to do was rest because he’s a workaholic. He doesn’t feel ill when he’s at work, but once he steps out of the office, that’s when it happens. He’s an entrepreneur and he’s really worked hard over the years and so, stress is probably one of the biggest things that predisposed him to hypertension. And then, a seeming poor diet (pounded yam like 4-5 times a week.) He also liked meat a lot and growing up, I would always wonder how someone could eat so much meat. Thing is, he never saw it as a serious thing for a long time until one of his doctors told him that he had to put his blood pressure under control.
They gave him a book, I remember that book. I had to stop reading it because it was so scary. It was about sudden death stories. So, they gave it to him to scare him off I think. After that, he started being more careful, taking his medication. That was it really, just taking his medication. There was no follow up care or lifestyle modification. It was just all about the meds.
So, about the particular incident on my blog. I went for NYSC and so, I was away from home for about a year. I was coming home once in a while, but I was away for a while and I couldn’t monitor his blood pressure and medication. I’ll call him and he’ll say he had taken his medication that day, but he wouldn’t take it after that day or the day after maybe because he forgot. I came back to Lagos to start preparing for my masters. I remember that day, I had gone to the salon with my mum to get our hair done. We had deposited some money into my account and I was feeling on top of the world. My mum suggested that we pass by the office to pick something up and then, we saw my dad coming out about 4pm. My dad NEVER leaves work that early except he’s going to the bank or something. So we asked him if he was ok and he just said he was feeling tired. My mum then told me to go with him in the car, but I was like No! Do I always have to go with him everywhere, every time? I’m the youngest, so that was what always happened. Anyways, I obliged. The house is about 10 minutes from the office so he wanted to drive, but I told him to just relax in the back and let the driver do the driving. As we were going, we came to a T junction. The hospital was straight up and the house was on the right. He called the driver’s name (Wale) and asked him to drive to the hospital. Then I looked back and realized that he looked like someone had sucked the energy out of him. His eyes were drooping a bit and he just looked very exhausted. I called my mum at that point letting her know we were going to the hospital.
He rushed to where the nurses where and asked them to check his blood pressure. You know how Nigerians are, they said, “Oga, please where is your card?” While he insisted his blood pressure be checked, I ran to grab the card. I gave them the number while looking at him over my shoulder. I overheard one of the nurses saying they couldn’t find his blood pressure. He had one hand under his chin and they were trying to get his blood pressure on the other hand. At that point, they didn’t know he had slumped. So, when they tried to remove his resting hand, he simply fell over to the ground.
He finally came around and there were no obvious signs of paralysis as he could slowly move his hands and legs. All this happened on the front bench at the reception of the hospital. He eventually got better and was scheduled to meet with a cardiologist where he got his ECG done. We didn’t get a lot of info from the doctor to be honest. I had to start diagnosing what could have caused it. I honestly don’t know if the Dr. knew how to read the ECG, but I knew that I was going to have to do something related to CVD even though I had been accepted for a master’s degree in public health.
I thought it was the end, but 2 weeks after, he woke up with slurred speech which he didn’t think was that serious. Obviously, he didn’t know the warning signs of a stroke because all he said was, “I’ll wait till evening time to see if it goes.” I didn’t want to make them panic, but I had an idea of what was going on. I went on to ask him if he had taken all of his medication and he mentioned that his blood thinner had finished and he didn’t have a replacement. I took an okada and went straight to a pharmacy to get his medication. I gave him the drugs and played some catholic music (we used to be Catholics before, but not anymore) which he likes. I told his cardiologist his blood pressure over the phone and he told me to take him to the hospital immediately, but my dad was adamant about work. After work that day, he went to the hospital and told them that he was talking different (due to the slurred speech), but they told him that is how he always talks. I flared up because here is someone telling you they notice something wrong with the way they are talking and all you say is you cannot see it? Thankfully, the next day it was gone and then, I explained to him what had happened with regards to warning signs of a stroke. After that, I started doing research on how he could reduce his chances because I heard the prognosis in Nigeria was really bad. I think sixty-something percent of people who suffer a stroke end up dying.
O: What did it feel like in the moment when it happened?
J: At that moment, I can’t even explain what was going through my mind. My dad is quite huge and tall, so just imagine your huge father slumping to the floor. It was one of the most terrible things I’ve ever experienced. The first feeling was fear for sure. The devil started bringing up all sorts of ideas to mind. No master’s for you, but then I remembered I was a Christian and then I just started praying. Speaking in tongues better than I ever knew how to. The doctors came and asked me to move and I was like move where? Then, they wanted to inject him with something, but I stopped them because I had to know what he was being given. I had heard stories of people being given medication they didn’t need and so, I wasn’t about to let that happen. All this while, I had forgotten to call my mum. When he was finally stabilized and taken to a private ward, I called her and the thing is, my mum usually doesn’t panic. She is the quiet, but strong one. It takes a lot for her to panic. At that point, she started talking frantically and was about to rush to the hospital when she realized she didn’t have her car.
O: What do you wish you could do more of with regards to your dad’s health? Basically, if you had a chance to change somethings, what would you have done differently?
J: I definitely would have done a lot more to prevent it. After an incident like that, apart from psychological trauma, there’s a lot of trauma to the heart and it takes a while for the heart to recover especially when the person is elderly. Prevention is key for sure. If we had known better, I wish he had a personal doctor who knew his medical history. One that would supervise his medication more closely. Another thing is we would have started lifestyle modifications earlier. Now he doesn’t eat white bread, or drink regular milk. He only drinks soy milk and substitutes a lot of meat for fish. I wish there was cardiac rehab!!! Also, I wish he did more physical activities, but it is very important to know what kind of exercise your heart can take. Some people just hit the gym without knowing that they might be putting themselves at risk.
O: What are your thoughts on the lack of statistics/ statisticians and other health care workers who can provide data on how much CVD is affecting the country as well as providing improve care for patients with CVD?
J: The truth is that there is a lack of public health intelligence in Nigeria. I was writing a policy paper on stroke in Nigeria and I had to read up on an existing policy written by one of the former presidents called the stroke prevention policy. The policy simply stated that they had reduce the cost of testing from 50, 000 naira to 20, 000 naira. That’s all! I’m like that isn’t much of a policy, is it? How many can afford 20, 000? Also, how many people know about this policy as there was no formal documentation of it? I had to get information form newspapers. There was no information on the ministry website either. We have lots of people dying every year from stroke and cardiovascular diseases. There’s much to be done that’s why there is a need for statisticians and other personnel other than doctors. I was in LUTH where I started off as a Dentist although I wanted medicine. I ended up in physiology after my mum asked me if I wanted to look at teeth all my life. I didn’t know what I was going to use it for, but now I do. There aren’t that many diagnostic centers in Nigeria neither are there cardiac rehab centers, so that’s what I want to focus on. Trust me, I’ve been scared off by my lecturers who have urged me to go into MBBS because they don’t think I can practice in Nigeria, but I’ve made up my mind to do this.
O: How has the incident affected you? Any lifestyle changes made as a result?
J: I’ve tried to make personal lifestyle changes. They say hypertension could be hereditary and my dad has had it. First of all, my diet has sort of changed. I cook my own meals even though I’m not a huge junk eater, but when I’m stressed, I can just munch on anything. Now, I’m just trying to be cautious. I don’t have enough time to go to the gym, but I’ve got a resistance band and a yoga ball just to help me. Sometimes, I put on Zumba on YouTube and work out that way. Gradually we are working on that. Honestly, the people I feel bad for are my kids. There will be no coke, no fizzy, nothing at all!!! The reality is that it’s not just about genetics anymore. There are epigenetic factors that can affect how these genes are expressed.
O: What keeps you motivated to continue in this fight against CVD via blogging or going to simply attending graduate school?
J: It’s my vision first of all, it’s my dream. I dream a lot……….. I’m thinking and writing when I’m at work. Sometimes, it’s hard when I come back from work to blog, but it needs to be done. My dad is also motivation for me. He is my cheerleader and number 1 guinea pig. Finally and most importantly God who keeps the dream burning in my heart.
owing the glaring statistics, do you think the government should be involved in the creation of specific care centers such as a cardiovascular health care centers?
Definitely!! The govt. has to be involved. They need to create policies and programs and make them accessible. In terms of hospitals, we only have private specialized hospitals. The Lagos state government “opened” a Cardiac and Renal center recently, but it never actually opened. It was supposed to be state of the arts, but I was reading an article a few days ago saying that the equipment never worked. So, yes, they need to not only set up, but also follow up and make sure these centers are functional and accessible. I think Lagos State does community wide health checks, but it doesn’t cover 10% of the population. There also needs to be more awareness on TV and radio. As well as other media and print. We need to get it in people’s faces about the problem, but also that there is a solution.
What is one thing you want people to know about CVDs and its importance?
CVD can affect anybody and it is largely preventable.
We are thankful for the opportunity to learn and the hope that comes with knowing that many young people are invested in creating a difference in their communities whether home or abroad.