TT 174

Go in

Compassion

My Pulpit Message Notes

Go in Compassion

My Pulpit Message Notes are transcribed from the sermon preached at the Nairobi Baptist Church (NBC) Ngong Road on Sunday 23rd October 2022. Preacher: Mr. Mike Njoroge. Scripture: Mark 7:24-37. Topic: Go in Compassion

It’s very interesting that at times we think we have gone through the Bible over and over and think we have read the gospels especially well. But at times there are things we have not seen. For example the Syrophoenician woman may be foreign to us.

In many ways we may not have interacted with the Syrophoenician woman, but even in our own lives there are people who are foreign to us and we have not interacted with them. There are people who are not of the same tribe, gender, or socio-economic status as us and we have not interacted with them.

Today’s passage tells us how Christ goes in compassion especially to people who are unlike us. Both passages have one thing in common, Christ is reaching out to Gentiles and they respond to Him.

Even for us who live in Africa, in many ways we are Gentiles whom Christ reached out to us. We are not the Jews who are originally whom Christ came for and as Paul says in Romans 1:16, “First to the Jews and then to the Gentiles,..”

We are the beneficiaries of Christ’s love as foreigners and so in many ways this passage is going to teach us that as we grow and go, we must go in compassion especially to those who are unlike us.

Have you interacted with people who are unlike you in especially church settings? We get used to people who are like us. After the Service the people we mostly interact with are our friends, family, peo ple whom we share the same hobbies, or investment groups, or go to the same schools with. But what about people who are unlike us? People who do not under stand our language? People who are not of the same socio-economic status as us? How and where is the opportunity for us to show them Christ’s love even as we grow and go?

But that is counter the gospel, for the gospel calls us and recognises our differ ences and calls us to reach out to each and everyone.

The Syrophoenician Woman

The description we are given in the passage of Mark, we can come to the con clusion that this was a woman who was born a Phoenician and within the re gion that had initially been conquered by Syria. This is before the Romans came and took over the world at that time.

There is a similar passage in Matthew 15:21-28 and it is possibly this same pas sage that is given because the similarities go down even to the interactions. In fact, the story in Matthew has more interactions between Jesus and the woman. But in Matthew she is called a Canaanite woman.

In many ways this shows us that it was very counter cultural even as Jesus was talking to her. Jesus had just come from talking about clean and unclean, but here He was speaking to a Canaanite / Syrophoenician woman, a Gentile, someone whom the Jews considered unclean. And the passage in Matthew something happens which is very in teresting. Jesus seems to be ignoring her over and over again and the more she persists in wanting to talk to Jesus, the more the disciples come and tell Je sus, ‘send her away.’

Reflect on the cross because that is where it starts. Without the cross, we are not looking forward to a place where we are all brothers and sisters. Without the cross people who are unlike me are not being called and being saved. Without the cross, then my anger when I am speaking to a mus lim or an atheist and hoping that God just comes and shows them, this is true and they are actually going to hell, my anger is not abased knowing that is only in love that we will be able to reach out to them. The cross is where ultimate compassion was born.

Possibly the disciples were thinking this woman is not like us, so let us send her away so that she stops disturbing the Rabbi. But Jesus is quite interesting in His interactions. In verse 27 he talks to her and tells her, “27 “First let the children eat all they want,” he told her, “for it is not right to take the children’s bread and toss it to the dogs.”

The English have a saying, ‘birds of a feather, grow together’. It is not a wrong saying, it is good one. It is our human nature to flock around people who are like us. But what if God is calling us to reach out to those who do not have the same feathers as us. God is calling us to reach out to those who do not even have feathers so that even they may experience the love of Christ that we have experienced.

I always remember my first interaction with muslims on the topic of prayer. I used to come for Prayer Service and they would ask me, ‘are you going for prayers?’ And I would answer yes. Something about our conversation was a bit off. I would say ‘prayer service’ and they would say ‘prayer’ and it would seem as if we are not interacting well. Later on when I went into a class where I was learning about Islam I finally got to learn that it is because of how they view prayer and how I view prayer that we were talking at cross-purposes.

If I had never interacted with them that is something I never would have learned and possibly now when I go to interact with a muslim friend of mine, knowing how they view prayer enables me to better explain the gospel of Jesus Christ. Sometimes when we interact with those who are unlike us that makes us able to explain the gospel of Jesus Christ much better, much firmer, much easier.

If you are someone who follows current affairs and world politics, there is some thing small and subtly happening where there is a rise is nationalism. More and more people are coming together and telling one another that we as a nation are the best and many times would want to expel those who are not from this nation. If you look in parts of Europe and South America, the elected leaders who are coming along now are people who are giving that kind of vibe of that ‘we are the best nation and only the people who are of our nation belong here and possibly we should seek to see how to get rid, or diminish the influence of those who are not like us.

Jesus here is given a parable. He is speaking in a riddle which the Syrophoeni cian woman understands. In the tradition of those days people used to first give food to their children and if there are any crumbs that are left are given to the dogs. But for the Jews, how they considered dogs is unclean. They would not even give food to the dogs. But for Gentiles, the Greeks like this Syrophoeni cian woman they had domesticated dogs, the pets that we have nowadays. So she understood what Jesus said. First let the children eat then give the rest to the dogs.

Essentially what Jesus was saying is that He had come first for the Jews. So He was focusing first on the Jews then the gospel would expand to the Gentiles. This was the implication that Jesus was giving, but the woman in response, understanding what Jesus was saying said, “Yes Lord”, first recognising Him as Lord, then says “even the dogs under the table eat the children’s crumbs.”What the woman is referring to is that even though she is a Gentile, she is still open to this love that Jesus is giving. That is why Jesus now responds the way He does and says ““For such a reply, you may go; the demon has left your daughter.”

For the Syrophoenician woman, she knew that her only hope was Jesus Christ. This is something that we see regularly throughout Scripture, even in the Old Testament (O.T.). For people who were not Jews and who submitted to Jesus Christ, the moment they believed in God, they were favoured. They were part of the covenant. We see this most effectively with Ruth who tells Naomi, ‘Your people will be my people and your God will be my God.’ In essence she is then treated as one of the covenant God had made with the Israelites on Mount Sinai and gains the favour that God is bestowing upon his people.

My Pulpit Message Notes

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The Healing of a Deaf and Mute Man

Here we see that as Jesus is walking by, He leaves Tyre, goes to Sidon, then down to the Decapolis. They had already been at Decapolis before. In Matthew 5. We see how Jesus went to Decapolis and exorcised a demon possessed man whom nobody knew what to do with. And who was being isolated. The people living there had possibly been there and seen what Jesus had done. Now they are see ing Jesus come again and now they are bringing this man who is deaf and mute.

Something interesting they come and do is they ask Jesus to lay his hands on him. This cannot be the same as them asking Jesus for healing. It is possible that they were not expecting a healing to happen, but all they wanted was for Jesus to lay His hands on that man and for a blessing to fall on him.

To their astonishment “37 People were overwhelmed with amazement. “He has done everything well,” Jesus actually healed the man. As they say, ‘He makes the deaf to hear and the mute to speak’. Even for the people at Decapolis, they were not the Jews, the common people whom Jesus had come for. But they realised that if they submit to Jesus, then Jesus will perform a miracle and that is exactly what Jesus does.

In these two stories we see that people who were not like the Jews, people who are Gentiles come and submit to Jesus and Jesus’ love is so powerful. His com passion goes beyond and even though they were people who were not like Him, essentially a Jew, He still pours out His love out to them.

Therefore how are we called to go and grow in compassion? I see three things that we need to do that will help us in ministry, in giving out the gospel. This gospel is very contagious. As we see in these passages and others in Mark, Jesus tells them, ‘Do not speak of this’, but they cannot help but just speak of what they have gone through.

A few weeks back, Pastor Mokaya preached on how we are beneficiaries and benefactors of love and by virtue of us being beneficiaries of love, we are left with no option but to be benefactors of God’s love. We are left with no option, but with that same compassion that has shone on us to shine upon other people.

But for this passage specifically, speaking of people who are not like us, perhaps we can glean three things:

1. We need to get out of our comfort zone. Jesus within this passage is going in areas which are full of Gentiles. We do not know why some people speculate that maybe He was trying to hide from Herod, having been in the previous chapter been so famous that even Herod is recognising Him and is thinking that He’s John the Baptist revived. But actually, Jesus is going to several places that are designated as places where Gentiles live and Jews do not stay. If we compare these places with the OT there are places who that were outright enemies of the Israelites.

A place like Tyre which constantly came at the Israelites. Sidon, named after the first born son of Canaan, the son of Ham was cursed and that’s why the Canaanites eventually become enemies of Israel. Going out of our comfort zones is what Jesus is asking even as we seek to of and grow in compassion.

I remember in 2019 December, I had the privilege of going to a mission in Marsabit. That was a place out of my comfort zone. Even before we went there were some rumours that maybe there is war going to breakout there. People are fighting, will it be safe? My parents worrying, will it be okay for you to go there?

This was out of my comfort zone in so many ways. First, the place where we slept was totally different from the bed which I have at home. But also the sense of the Service was very different from the one we have here. Even now as I preach there is a timer going on and even if I decide to ignore the timer there is a very big clock staring at me. It’s keeping me within the boundaries of a time frame that I have been given.

But when we were in a church is Marsabit there is no timeframe for a church service. Church service starts and it will end whenever it ends. Also what was interesting for us was that praise and worship took one hour twenty min utes. Here we try and limit to 30 to 35 minutes if we are generous. But they sang continuously unto the Lord. But then also, the preaching of the Word was given only ten minutes. Here when you get to 45 minutes you are really stretching it. There is too much to say from the Word, but there it takes only ten minutes.

This was outside my comfort zone and I would not be able to related to someone from that area if I had not been in that space. To recognise that the reason they only have the Word for ten minutes is that because of literacy levels being low. Not everyone has access and can read this Word. So when I read and quote Scripture you like good Bereans go back and read through to see if what I am saying is true, they do not have that privilege. But the Word of God must still go to people in such circumstances. And the only way we will be able to go out

in compassion is when we go out of our comfort zones. We need to identify which areas we have become comfortable in and see how do we go outside that. For Christians we have a standing mission objective. Every single day is Mission Day for us. Whenever we hear there is a mission somewhere, the first thing we think of is how will we get there? How are the roads? What will we eat? Where will we sleep? But growing and going to people who are not like us causes us to get out of our comfort zone and say, I am doing this for the LORD.

2. We must recognise our biases and prejudices. Getting out of our comfort zones helps with this because there are certain things we do not know are our own biases and prejudices, but a lot of this will call us to be counter cultural to what we are used to.

When COVID broke out in 2020, many articles were written about how throughout history Christians have reacted when plagues hit. One which really stuck in my mind was how when a certain plague, as the people who considered themselves rich, ran away from the cities and went to the hills to hide because they could. The Christians went into the cities and took care of those who were ailing from plagues, some of them to the detriment of their own health and some their lives. These were people who did what was counter cultural. They realised that their biases and prejudices could cause them to be like others, to flee from where the trouble was. But the Christians of old went to where the trouble was. What usually happens is that once the plagues were over, something al ways came along. The Christianity rate rose. Because people who saw Christians coming to them out of compassion in their times of need recognised that this Christianity must be true. In many ways that is the truth at the heart of the gos pel. Christianity is the only religion where God comes to us at our time of need. Comes as a human beings, walks our earth, breathes our air, and suffers the same comforts and discomforts that we go through. He cries at our funerals, rejoices at weddings and ultimately He dies.

Once you see that, why wouldn’t you become a Christian? Once God has done that for us why wouldn’t we become Christians? In the same light, as Christians who are called to go with that compassion, why wouldn’t we go to people who recognise that we are going to them outside of our own biases and prejudices. Why wouldn’t they seek to follow the message that we carry?

3. Let us actually believe the truth of this gospel. In 2008 a British politician and writer came and travelled to African in Malawi. It was during Christmas and he had to write an opinion piece in the times. This is what he labelled it: As an atheist I truly believe Africa needs God. Sampling some of the things he wrote he said, “Traveling in Malawi refreshed another belief. What I have been trying to banish all my life. But an observation I have been unable to avoid since my African childhood. It confounds my ideological beliefs, stubbornly refuses to quit my worldview and has embarrassed my growing belief that there is no God. As a confirmed atheist I have become convinced of the enormous contribution that Christian evangelism makes in Africa sharply distinct from the work of secular NGOs, government projects and international aid efforts. These alone will not do. In Africa, education and training alone will not do. In Africa, Chris tianity changes people’s hearts. It brings a spiritual transformation. The rebirth is real. The change is good.

This is an atheist telling us that our gospel is true. How much more then should we, who take on this Christianity believe that it is true.

One of the reasons I specifically love Holy Communion Service, a day where we come and remember Christ’s death even as we proclaim His coming back, and as we rejoice in that feast, the other thing that I love about this Service is that we come together as both youth and old. Those barriers of age broken down. And this is just a tiny glimpse of eternity. How much better it will get eventually when all tribes, nations come together to proclaim Him as worthy.

But this will not happen if we do not go in compassion to those who are unlike us. If we do not go to those whose feathers do not look like those of ours. If we want a multicultural church which is the vision that God has for us then we must get out of our comfort zones and recognising our biases and prejudices while believing that this gospel is true, go to those who are unlike us.

Reflect on the cross because that is where it starts. Without the cross, we are not looking forward to a place where we are all brothers and sisters. Without the cross people who are unlike me are not being called and being saved. With out the cross, then my anger when I am speaking to a muslim or an atheist and hoping that God just comes and shows them, this is true and they are actually going to hell, my anger is not abased knowing that is only in love that we will be able to reach out to them. The cross is where ultimate compassion was born.

My Life

How to get saved and spend eternity with God

His Love

“For God so loved the world, that He gave His only Son, so that everyone who believes in Him will not perish, but have eternal life.

John 3:16 (NASB)

My response

that if you confess with your mouth Jesus as Lord, and believe in your heart that God raised Him from the dead, you will be saved; for with the heart a person believes, resulting in righteousness, and with the mouth he confesses, resulting in salvation.

Romans 10:9-10 (NASB)

My prayer

Lord God Almighty, thank You for Your love for me. Thank You that You sent Your Son Jesus Christ to die for my sins. Please forgive me for all the sins I have committed against You. I believe that Jesus Christ is Lord and that He died on the cross and You raised Him from the dead on the third day. Please write my name in the Lamb’s book of life. Help me to live a life that is holy and pleasing unto You. In Jesus’ Name I pray and believe. Amen

My Devotional

The Dangers Of Envy

“A heart at peace gives life to the body, but envy rots the bones.” — Proverbs 14:30

It’s easy for the equipment manager to be envious of the franchise quarterback who makes much more money than he does. Perhaps someone works in the concession stand and drives a car that’s loud because it needs a new exhaust pipe, but the car is reliable to get to work every day. When we see others enjoying lux uries that we don’t have, we may be envious and forget that we have good health, steady income, a loving family, a host of friends, a loving God and a home in Heaven.

King Saul was the first king of Israel. He was taller than anybody else in his na tion, blessed with a good family and moved from poverty to wealth when he was anointed king. He could have had a long, prosperous kingdom, but he refused to be content, because he envied the attention and accomplishments of David. When some claimed David was a better soldier, Saul burned inside with anger. He hunted David to the point that he neglected his responsibilities as king, and everybody around him suffered.

When a group of women sang about David after he defeated Goliath, Saul couldn’t stand it. “Saul was very angry; this refrain displeased him greatly. ‘They

have credited David with tens of thousands,’ he thought, ‘but me with only thou sands. What more can he get but the kingdom?’ And from that time on Saul kept a close eye on David” (1 Samuel 18:8-9). Soon thereafter, the Philistines invaded Israel, partly because Saul was so distracted by his envy of the shepherd boy.

Throughout Scripture, we are encouraged to be content with what we have and not to covet what belongs to someone else. Some of our unhappiness results from our refusal to see our blessings and thinking that others have it better than we do. We would please God more and probably be healthier and happier if we enjoyed what we have. “A heart at peace gives life to the body, but envy rots the bones” (Proverbs 14:30).

By Bill Kent, Pastor of Memorial Baptist Church, Sylvania, Georgia | www.sportsspectrun.com | www.sportsspectrum.com|

A Cleveland Browns equipment manager adjusts a player’s helmet. (AP Photo/Amy Sancetta)

My Inspiration

How do you handle the craziness?

By William King | Email: kingwilliam189@gmail.com | image courtesy: truewisher.com

It’s so easy today to allow the busyness of life and all responsibilities to over whelm us. Add to that checking to our phones, text messages, emails, social me dia and the news. I encourage you not to be busy but to be productive. If you’re going to see your dreams and desires come to pass, you can’t just let everything occupy your time.

Busyness does not equal productivity. You don’t want to wear busyness as an important attribute in your life. You want to wear fruitfulness, productiveness. You want your life to be ordered, getting the right things done at the right time. If anyone was overwhelmed with busyness, it was Moses.

Remember that he was God’s man to lead two million Israelites toward the Promised land. He was responsible to hear from God for them and to know where they were to go. On top of that, from morning to evening the people came to him to solve their problems and be the judge of their disputes.

In the midst of this craziness, Moses prayed this important prayer: “Teach us to number our days that we can gain a heart of wisdom” (Psalm 90:12). I can hear the cry of his heart, “God, teach me and show me how to order and prioritize my day.” Moses wanted to see people’s dreams come to pass.

The answer to Moses’ prayer came one day when his father-in-law, Jethro, ob served that Moses was wearing himself out as he tried to solve everyone else’s problems. Jethro said, “You need to set up a system of godly men to help you meet the needs of the people.”

He had to clear the clutter out and rearrange his life priorities. Perhaps you feel a little bit like Moses. Everybody’s asking you for things and you need to fix all the problems. You feel overwhelmed. You need to put things on pause and pray Moses’ prayer. He has ideas to make your life easier.

My Business

Correcting course to accelerate poverty reduction

By Mari Elka Pangestu | https://blogs. worldbank. org/voices/

On End Poverty Day this year, it’s hard to find cause for celebration. The COVID19 pandemic triggered a historic setback, pushing 70 million people into extreme poverty in 2020 – the largest one-year increase in three decades. The war in Ukraine deepened the global economic slowdown, which is now in its steepest decline following a post-recession recovery since 1970. At this rate, nearly 7 percent of the world’s population – almost 600 million people – will still be struggling in extreme poverty in 2030.

Whilst the picture is sobering, it is a wake-up call for us to think and act to cor rect course.It’s important to remember that many of the development challenges we face today did not start with the pandemic. Riding on the momentum to build back better, it’s a good time to review deficiencies of past policies and un derinvestment. We must correct course now across a comprehensive range of policies and step-up global cooperation for a lasting recovery to move towards green, resilient, and inclusive development.

In any crisis, it is the poor that are hit hardest. According to the latest World Bank analysis, the poorest people bore the steepest costs of the COVID19 pan demic: income losses averaged 4% for the poorest 40%, double the losses of the wealthiest 20% of the income distribution. It is the poor who do not have the resources to cope. During the pandemic, strong fiscal policy measures did help to protect poor and vulnerable people, but poor countries were less successful than rich countries. With less to spend, low- and lower-middle income econo mies offset barely a quarter of the impact on poverty.

What may be even more worrying are the long-term consequences of multi ple overlapping crises, which could worsen poverty in the near future if we do not accelerate action. Losses in learning and human capital, as well as climate change are among the most critical.

Losses in Learning and human capital: As a result of prolonged school closures and shocks to household incomes during the pandemic, learning poverty has increased by a third in low- and middle-income countries. This means that an estimated 70% of 10-year-olds are unable to understand a simple written text. Today’s students could lose 10 percent of their future average annual earnings as a result. Youth have also suffered a loss in human capital, in terms of both skills and jobs. Short-term declines in youth employment can lead to more frequent unemployment spells, lower future wages, and increased social unrest. Beyond reducing incomes, the decline in human capital will lead to lower productivity and less inclusion for decades to come, hindering growth, increasing poverty and inequality.

These trends can be reversed if countries act quickly and decisively, guided by evidence on what works. We must keep schools open, assess students and match instruction to their levels, streamline the curriculum and focus on foundations - especially literacy, numeracy, and core socioemotional skills. And we need to create a national political commitment for learning recovery, guided by credi ble measurement of learning. We must not forget to invest in girls’ education – which may well be the highest-return investment available in the developing world.

Climate change: The climate crisis is already here, and it could push an addi tional 132 million people into poverty by 2030. The adverse consequences of climate change—water scarcity, crop failure, food insecurity, economic shocks, migration, and displacement— can multiply threats by exacerbating conflict, re ducing economic opportunities and social cohesion, as well as straining public institutions.

We need to make sure that climate is integrated into development and ensure a well-managed ‘just’ transition towards clean energy sources in a way that pro tects people, communities, and the environment. Developing countries face a triple penalty – they pay more to provide electricity services; they are locked out of economical clean energy projects; and they are locked-in to fossil fuel projects with high and volatile variable costs. We will need impactful programs and proj ects, adequate public policies, and significantly increased funding from multiple sources. Countries need to also invest in adaptation and resilience.

A resilient recovery will depend on a wide range of policies, including fiscal reforms that reorient spending away from subsidies toward support targeted to poor and vulnerable groups, and improvements in efficiency and efficacy. Pri oritizing long-term growth requires appropriate investments in crisis readiness, too. COVID19 showed us how progress achieved over decades can vanish over night when such readiness is lacking. Public investments that support long-run development, such as investments in human capital of young people or invest ments in infrastructure as well as research and development can have a positive impact on growth, inequality and poverty decades later.

We must respond to current challenges in ways that do not further impoverish the poor today and focus on creating opportunities that they can enjoy tomor row.

ood Gift Sells

Entrepreneur

3 questions to ask if you want to build integrity

I was recently reading an excerpt from John Maxwell’s book Developing the Leader Within You. In one of the chapters, he writes about the difference be tween image-building and integrity-building.

I believe integrity is the key to being a great leader. The outward appearance, looking good, and other actions aren’t what make a leader. A leader has to be integrous first and foremost.

How do you put integrity first? John Maxwell had three questions in three areas you could ask yourself. I believe these questions will help you become a more integrity-led leader.

1. Consistency: Are you the same person no matter who you are with?

Leaders with integrity are consistent. They do what they say, do it repeatedly, and they don’t change based on the people they are around. Being consistent is easy to say but challenging to practice.

Watch your actions and thoughts while you’re around others. Do you shift the way you act when you’re around specific people? You may be lacking integrity.

Leaders with integrity make sure they’re the same regardless of who they’re with.

2. Choices: Do you make decisions that are best for others when another choice would benefit you?

Making choices that benefit others is another must. People are naturally drawn to make decisions that are best for themselves rather than the community, espe cially in these me first days.

Great leaders look out for themselves but also realize they are responsible to those they lead. The decisions they make have to keep their people in mind.

Make sure you’re looking out for more than yourself. The people you lead are looking to you to make decisions that benefit everyone.

3. Credit: Are you quick to recognize others for their efforts and contributions to your success?

There are a lot of people who have played into your success. But, do you recog nize those people and the contributions they’ve given?

I think about Michael Hyatt, Dan Miller, Dan Black, Brian Dodd, and others who have poured into my life. They’ve helped me become a better leader.

I try to recognize them as much as I can when I share about my leadership jour ney. They’re the reason I have been successful in what I do.

Who are the people that have helped you become the leader you are, or have helped the business reach the level of success it’s currently experiencing?

These people need to be recognized. Give credit to those who have helped build and shape you and the organizations you’ve worked for.

Integrity takes work

These questions will help you clarify whether or not you’re on the path to being a leader with integrity. I pray that you are.

Remember, integrity takes work. Integrity is doing the right things over and over again. The work of being a leader with integrity is never over.

Keep at it. When you fall short, get back up. Remind yourself of the questions John Maxwell wants you to answer. The more you can return to these questions, the more your mind will be focused on leading with integrity.

www.biblicalleadership.com | By Joseph Lalonde| image credit: istock

My Health

New Treatment For Men With Enlarged Prostate

Image credit: kansashealthsystem.com

By Dr Ravjit Sagoo, Consultant Interventional Radiologist at Aga Khan University Hospital Nairobi

If you are a man over 60 years, you probably have or are likely to have an en larged prostate also referred to as benign prostatic hyperplasia (BPH). This is a non-cancerous increase of prostate tissue which can cause blockage of bladder and urine flow. It is extremely common in middle-aged and elderly men, affect ing up to 50% of men at the age of 60 and 90% of men over 85 years. Here’s what you need to know about this problem.

What symptoms does BPH cause?

Many men with BPH have no symptoms. However, in men with symptoms, the most common include; increased urinary frequency, with voiding small amounts of urine, especially at night, sensation of incomplete bladder emptying after urination, difficulty in starting urination, weak urinary stream, inability to urinate, leading to catheterization, urinary urgency, with difficulty in con trolling urination and blood in the urine.

If I have symptoms, what are my treatment options?

Treatment is only necessary if symptoms become bothersome. Several treatment options are available depending on the severity of symptoms:

Lifestyle changes is appropriate for those with mild symptoms. This includes changes such as limiting fluid intake in the evenings, limiting caffeine intake, healthy eating and undertaking exercise.

Prescription drugs is an option for men with symptoms which are relatively more troublesome and not relieved with lifestyle changes. These includes medications such as alpha blockers and 5-alpha reductase inhibitors which relax the muscles of the prostate/bladder and reduce the volume of the prostate, respectively.

Surgery is reserved for men in whom medical therapy has not resulted in signif icant symptom improvement. There are many surgical options available which vary in their indications, invasiveness, effectiveness, and side-effect profile. Ex amples of surgical options include:

Transurethral resection of the prostate (TURP) – a common procedure in which a scope is introduced into the penis and the prostate tissue is cut away with elec trical current.

Laser enucleation of prostate – in this procedure, the excess prostatic tissue is destroyed by a laser

My Health

Thermal treatments – these procedures destroy excess prostatic tissue using ma terials such as water vapour, microwaves and other low-energy radio waves

Prostatic urethral lift – a needle is used to place implants into the prostate to aid in lifting and compressing the gland, which results in unblocking the urethra Prostatectomy – the entire prostate gland is removed in this operation

Prostate artery embolization (PAE) is a non-surgical treatment for men who want to avoid a traditional surgical procedure (or who are deemed high risk for surgery) in which the blood supply to the prostate gland is blocked off resulting in its shrinkage. The success rate of PAE is over 85% (similar to TURP, a com monly performed invasive operation), with a low recurrence rate long-term. PAE resolves the problem rapidly and, as this procedure involves no open cut, normal activity can be rapidly resumed.

Is PAE an experimental procedure?

No. PAE is an established, minimally invasive procedure and represents a treat ment option for BPH. In the UK and USA, national guidelines recommend that the procedure should be one of the options considered for certain men with symptomatic BPH. It is a relatively new application of a longstanding technol ogy, as embolization has been performed successfully for decades by Interven tional Radiologists to treat a variety of conditions throughout the body.

Where is the PAE procedure carried out?

The procedure is carried out in a Catheter Laboratory (Cath Lab). Patients nor mally need to spend one night on the ward after the procedure, usually being discharged the following morning. Certain patients can be discharged the same evening of the procedure.

What preparation is needed before PAE?

Following a full review and discussion of the treatment options with a urolo gist and interventional radiologist, a CT scan is carried out to look at the pros tate gland and its blood vessels in detail to help determine the most appropriate treatment option. In addition, a urine flow test and a few blood tests may be required in preparation for PAE.

On the day of the procedure, you will be processed for admission where neces sary, you must not eat or drink for 6 hours before the procedure and should con tinue with most of your medications which are normally pre-discussed before the procedure.

What is involved in the PAE procedure itself?

The procedure is carried out by a consultant interventional radiologist (a doctor who has specialised in treating a variety of conditions using minimally invasive techniques under X-ray guidance). Other staff in attendance includes nurses and radiographers.

PAE is performed under local anaesthesia (or very light sedation) and involves no blood loss. A tiny opening (1.5mm) is made in the skin (mostly in the left wrist, but sometimes above the right leg) to allow a very fine tube to be passed into a blood vessel, the tube is moved along the blood vessels until the blood vessels supplying the prostate are reached after which a special substance is then injected to block the blood vessels. All of this is visible on an X-ray screen. The procedure generally takes 1-2 hours to complete.

What can I expect after PAE?

Immediately after the procedure, you will be taken to the recovery area where the nurses will monitor your heart rate and blood pressure and check that you are not in any pain. Once they are satisfied, you will be sent to the ward to re cover further.

Most patients experience no symptoms during the procedure, but a few may experience mild pain, burning or a hot feeling in the urethra or around the anus. The symptoms are easily controlled with appropriate medication. In general, you can get out of bed and start walking 6 hours after the procedure (sooner if the left wrist was used for access).

You are usually able to go home the morning after the procedure (certain pa tients can be discharged on the same evening). We will give you a prescription for painkiller tablets which you can take for 3-5 days (if needed).

Avoid driving for at least 2 days after the procedure but you can return to work after one day.

The prostate will shrink slowly over the following few days/weeks and symptoms continually improve during this time.

Are there any risks?

As with all procedures there are occasional problems that can occur, these in clude;

Infections. There is a small risk of urinary tract infection developing after the procedure, even though antibiotics are routinely given before the procedure. Most of the time, this can be treated with simple antibiotics.

Bruising/Haematoma. This can sometimes occur at the site of access in the up per leg/left wrist, although it is usually self-limiting. Blood in urine. This occurs in some patients but usually disappears in a day or two.

Post embolization syndrome. Sometimes following PAE, you may experience symptoms like the flu. This usually lasts a couple of days and is simply treated with paracetamol and bed rest.

Urinary retention. This is quite rare, however if it does occur, a urinary catheter will be needed for a few days until settled.

Will my sexual function be affected?

Based on studies to date, we know that patients treated with PAE for BPH have not experienced a decline in sexual function (including retrograde ejaculation and erectile dysfunction).

Are there any patients who cannot have PAE?

The presence of urological cancer e.g., prostate or bladder is a contraindication for PAE.

It may not be possible to perform PAE in men with extremely tortuous (twisted) blood vessels leading to the prostate.

My Kitchen

Authentic Chicken Tikka Masala

https://www.allrecipes.com/

Ingredients

¼ cup plain yogurt

2 teaspoons garam masala

2 teaspoons paprika

½ teaspoon freshly ground black pepper

½ teaspoon salt

½ teaspoon cayenne pepper

½ teaspoon ground coriander

1 pound skinless, boneless chicken breast - cut into 1-inch strips

3 tablespoons vegetable oil

1 teaspoon cumin seeds

1 large onion, chopped

3 cloves garlic, minced

1 tablespoon grated fresh ginger

2 green chile peppers, minced

2 Roma tomatoes, diced

½ cup tomato paste

¼ cup water

1 teaspoon garam masala

½ teaspoon ground coriander

½ teaspoon ground turmeric

½ cup heavy whipping cream

½ teaspoon salt, or to taste

½ bunch cilantro for garnish Directions

Combine yogurt, 2 teaspoons garam masala, paprika, black pepper, 1/2 teaspoon salt, cayenne pepper, and 1/2 teaspoon coriander in a large bowl. Add chicken strips and toss to coat. Cover and marinate in the refrigerator for 2 hours.

Preheat oven to 450 degrees F (230 degrees C). Grease a baking sheet.

Place chicken strips on the prepared baking sheet, leaving space between each piece, and bake in the preheated oven until browned and no longer pink inside, about 10 minutes. Remove and set aside.

Heat vegetable oil in a large skillet over medium heat. Cook and stir cumin seeds until lightly toasted and aromatic, about 3 minutes. Add onion; cook and stir until onion begins to soften, 4 to 5 minutes. Stir in garlic, ginger, and green chil es and continue to cook until onion is browned, 15 to 20 minutes. Cook and stir tomatoes, tomato paste, and water into onion mixture until tomatoes begin to break down and incorporate into the onion mixture, about 10 minutes.

Cook and stir 1 teaspoon garam masala, 1/2 teaspoon coriander, and turmeric into the tomato mixture. Mix in the cooked chicken, add cream, and stir to coat. Cover and let simmer for 10 minutes. Season with 1/2 teaspoon salt and garnish with cilantro.

My Sports

‘I am not retired’ Serena Williams say

Oct 24 (Reuters) Serena Williams on Monday said she has not retired from tennis and that the chances of her returning are “very high” after she previously indicated that she would step away from the sport after last month’s U.S. Open.

“I am not retired,” Williams said at a conference in San Francisco while promot ing her investment company, Serena Ventures.

“The chances (of a return) are very high. You can come to my house, I have a court.”

Williams, 41, said she was “evolving away from tennis” in an essay in August and, while she did not confirm the U.S. Open as her farewell event, she was given lavish tributes before each match in New York and waved an emotional goodbye after losing in the third round.

The 23-time Grand Slam champion, who took the tennis world by storm as a teenager and is considered by many the greatest of all time, said not preparing for a tournament after the U.S. Open did not feel natural to her.

“I still haven’t really thought about (retirement),” Williams said.

“But I did wake up the other day and go on the court and (considered) for the first time in my life that I’m not playing for a competition, and it felt really weird.

“It was like the first day of the rest of my life and I’m enjoying it, but I’m still trying to find that balance.”

is a publication of Elizabeth Omondi Consultancy. P.O. Box 833-00100 GPO Nairobi. Tel: 0722 927792. www.elizabethomondiconsultancy.com

Sep 2, 2022; Flushing, NY, USA; Serena Williams of the United States gestures to the crowd after a match against Ajla Tomljanovic of Australia on day five of the 2022 U.S. Open tennis tournament at USTA Billie Jean King Tennis Center. Danielle Parhizkaran-USA TODAY Sports