Wellness & Fitness

A health scare and 18 crucial tests for middle-aged men


A doctor shaking hands with a patient.

I have a good 29 years left to live. If I’m lucky. I will be 75 years old then. After that, it doesn’t matter much to me if I kicked the bucket.

What I don’t want is to live long enough for someone to spoon-feed me. Or wash me. Or some stranger with breath to shout in my remaining good ear, “It’s me, Kim, your son!” I want to go when I’m still not too bowed, still dignified when nobody is addressing me as a child.

I’m also aware that all these aspirations and needs - how/when we go - doesn’t matter in any way, what matters, what we can control is how we live now.  And to live well now, as a middle-aged man, is to make very difficult choices that all seem to involve avoiding things that I absolutely can’t live without, like chapatis. Many times I have asked myself; what’s the point of living if I can’t eat chapatis? Why bother?

Talking of middle-age. Three weeks ago I arrived from New York on the Kenya Airways’ 15-hour direct flight. A day later my calf started throbbing. Now, I’m not those men who have to wait until they are on their deathbed to see a doctor. I go to the hospital at the slightest provocation.

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I did a scan and the radiologist pointed at the monitor at what he insisted was not a foetus and said, “this is a blood clot, Mr Biko. Yes. I’m. Sure.”

Turns out I had deep vein thrombosis (DVT). If it sounds serious, it is. It can be deadly. A large clot can travel to the lungs making it collapse, resulting in heart failure and sudden death. This is called pulmonary embolism.

Anyway, I developed this clot on my right calf, never mind that I had worn compressor socks throughout the flight. I’m now on blood thinners indefinitely.


A patient sits on an examination table and listens to the doctor’s diagnosis. The betrayal of the body starts slowly in middle-aged.

My point is, the betrayal of the body starts slowly in middle-aged; the hangovers are unforgiving, the morning after playing basketball you feel like someone tried to pass you through a grinder, if you are tall, your back starts announcing itself more, everything you eat seems to gather around your waist. And you no longer approach sex with the rigorous athleticism you used to.

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Talking of sex - which invariably means talking about testicles. Globally, prostate cancer ranks as the second most frequently diagnosed cancer among men. It accounts for a quarter of male cancers and last year, 642 cases were reported in Kenya. Most of these men live in Nairobi. This is according to the National Cancer Institute, an independent agency under the Ministry of Health.

Prostate examination

So at my age (46) it seems prudent to do annual prostate cancer examinations, particularly this month of prostate cancer awareness. Lucky for me, this isn’t the terrible 90s (and 2000s) when a prostate examination involved the intrusive Digital Rectal Exam where doctors said, “take a deep breath, Mr Biko,” before he inserted a gloved lubricated finger in your rectum to feel if your prostate is enlarged.

Today, there is a PSA (Prostate Specific Antigen) blood test which checks if the protein your prostate produces when it grows is a lot or not. I try to do this test annually, as recommended for men over 40 years of age.

Other crucial tests

Even better than doing this test, I learned that Aga Khan University figured men my age and all age groups can benefit from more comprehensive 18 tests.

These include complete haemogram, fasting glucose, lipid profile, stool occult blood (check for colon cancers), blood group and RH factor, prostate-specific antigen, Vitamin D, HIV, urine routine, liver function test, serum urea, electrolytes and creatinine, serum uric acid, thyroid stimulating hormone, ECG (for the heart), chest X-ray, nutritional therapy consult and dental consultation. You need a full morning for this.

I was advised not to eat anything after 9 pm until the next morning after the test. (Fasting glucose test measures blood sugars after an overnight fast). At their Executive Clinic you get your blood taken by Jane Muchemi in the laboratory, your chest and lungs X-rayed by Caroline Ndegwa, your teeth examined by Dr Fatema and finally your results presented to you by Dr AzamKhan Mohamed. Women professionals run that place.

Finally, the results

When my results came out, Dr AzamKhan said, “your cholesterol levels are simply stunning. The best I’ve seen of a man your age.” OK, she didn’t say that, but that’s what she should have given that I had passed these tests with flying colours.

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“Does your family have a history of diabetes?” The good doctor inquired, looking at my results from her computer. I said no, but my grandpa died of high blood pressure and my maternal grandmother died of bone cancer.

“Do you smoke?” She asked.

“No.” I said.

“Do you drink?” She asked

“Occasionally,” I said. She looked up and I quickly changed my answer, “Well, twice a week. Whisky.”

“How much?” She pressed.

“On Thursdays, maybe 120ml, that’s two doubles and on Saturdays 300mls,” I answered.

“Do you mix it with soda?” She asked and I was slightly insulted that she would imagine I’d be the kind of chap who mixes his whisky with soda like a greenhorn. “No, neat.” I said, sitting up.

She peered at something on the screen. “Are you currently on any medication?”

“Blood thinners,” I said.

“You have a clot?”

I told her about my trip and our history of blood clots. My poor mother died of pulmonary embolism. My brother had clots in his lungs two years ago, survived by the skin of his teeth. “Second time it’s happening to me,” I sniffed, as if reporting a crime, “last time was four years ago. Same leg.”

“You are at risk, then,” she said. “You need to stay on thinners because a third time might be fatal.”

My test results were very normal, she said. She commended me for taking good care of myself.

“You are leading a healthy lifestyle,” she said. “Now, just try and build some muscle and exercise for 150 minutes every week.”

Not enough muscles

I thought she was crazy. I swim for 40 minutes twice or thrice weekly. Once in a while, I will attempt an 8km run in Karura Forest or cycle, if my partner isn't getting lost in the forest because she doesn’t trust the yellow signage that leads cyclists. All that, it turns out, isn’t 150 minutes weekly and isn't enough.

“That means a 30-minute exercise five days a week,” I asked her incredulously. She nodded and said encouragingly, “You can do it.” I told her I wasn’t making any promises then went to the next and last stage of this exercise.

There, in a small white room, I did a body composition analysis. This is a machine you step on barefoot and it brings back results of your total body water, muscle mass, fat percentage, muscle mass, bone mass and physical ratings amongst other things. My fat percentage was at 23.6 percent when the desirable was between 11-22 percent.

“So, are you saying I’m fat?” I asked Wanjiku Njenga, the nutritionist.

She laughed. “No, you are not fat.”

“So the machine is a liar.” I said.

Borderline fat

Anyway, according to the machine, I’m on the fat side. You wouldn't tell if you saw me, though. I need to build some muscles, and turn the flab that was around my midsection and a bit on my arm into muscles.

"At your age, you need more weight-training to restore your muscles,” she advised me. “And watch your carbohydrates.” (Thank God she didn’t malign the name of chapatis).

Back to the gym

I’ve joined a gym. The last time I was in a gym was four years ago. I’m currently writing this with extremely sore thighs and legs after my first gym session yesterday where this instructor called "The Beast" threw me right into the deep end with leg training.

The only thing we can control now as middle-aged men is our happiness and our health. Physical and mental. That requires a lot of tough decisions. It requires taking care of our business, our obligations and prioritising ourselves. What I refuse to do is stop eating chapatis. I don’t care if that’s what will kill me.

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