SERVICE OFFERINGS
|
Chronic diseases management
Chronic disease is a lifelong ailment that requires long-term medical care. If not diagnosed or treated early, chronic disease can become overwhelming and affect your quality of life.
Management and Care of Chronic Conditions
Chronic disease management is the medical care of the following chronic conditions:

Hypertension
Hypertension is classified as high blood pressure when high blood volumes push against the arterial walls. Chronic high blood pressure can increase the risk of stroke and heart disease. Dr Okeke will encourage you to eat healthily, exercise and cut out bad habits such as smoking and eating high cholesterol or highly salted foods. Your blood pressure (BP) will have to be monitored closely-at home, in the office or at school. Blood pressure lowering medications may be needed in moderate to severe cases to achieve BP control.
Diabetes
Diabetes is a serious ailment that affects the way the body converts food to energy. As a result, the body is unable to produce or use insulin effectively. Insulin is a hormone that assists in the breakdown of blood sugar and conversion of it into energy. Typical symptoms of diabetes include frequent urination, increased thirst, weight loss, hazy vision and a prickling sensation in the feet and hands. Sometimes, diabetes may present as recurrent sores on the skin or oral or vaginal thrush. It is important to meet with your dietician to help manage your eating plans so you can cut out foods that elevate your blood sugar. Dr Okeke will discuss diabetic medications or insulin shots with each of his patients, depending on their diabetes type. There are two main types of diabetes: Type 1 Diabetes, called Insulin Dependent Diabetes Mellitus, and Type 2 Diabetes, called Non-Insulin Dependent Diabetes Mellitus.
Eczema
Eczema, also referred to by the medical term “atopic dermatitis”, leads to red, itchy and dry skin. Eczema could arise from an allergic reaction to wool fabric, cleaning products, pollen, dust, mould, fragrances, chemicals, and arid and cold air. Moisturising the skin daily and following a healthy skincare routine can help prevent future breakouts. However, controlled medicated ointments can be applied to the skin to prevent itching and repair damage to the skin’s surface.
Autoimmune disease
In autoimmune diseases, the body’s immune system mistakes healthy body cells for foreign invaders, which leads to the body attacking its own tissue. There are about eighty types of autoimmune diseases, such as rheumatoid arthritis, psoriasis, lupus, thyroid disease, and diabetes to name a few. These diseases wreak havoc on healthy bodily tissue. Typically, autoimmune conditions cause joint pain, swelling near the affected regions, fever, tiredness and swollen glands. Management of autoimmune diseases includes keeping blood pressure low and monitoring your cholesterol and glucose levels. While most doctors recommend immune suppressants to control an overactive immune system, these types of medications can increase your risk of infections.
Arthritis
Arthritis means inflammation within the joints which may affect several regions simultaneously. Prevalent forms of arthritis include rheumatoid arthritis and osteoarthritis. Osteoarthritis leads to the gradual decline of the cartilage covering the bones' tips, whereas rheumatoid arthritis arises from the immune system’s attack on the joints.
Treatment with anti-inflammatory agents for arthritis aims to relieve pain and improve your quality of life. However, if the pain is severe, Dr Okeke will refer you for joint repair, joint fusion or joint replacement surgery. Rehabilitation and exercise programmes from physiotherapists, bio-kineticists and occupational therapists are usually part of the multidisciplinary treatments for arthritis.
Asthma
Asthma is a lung disease that must be managed through medication and healthy lifestyle choices. Bronchial asthma develops when the airways begin to swell and mucous build up in the passageways. Treatment for asthma aims to help the patient continue living normally by taking prescribed bronchodilator inhalers or anti-inflammatory medication.
Thyroid disorders
The thyroid gland controls your metabolic processes and manages to regulate weight and temperature. The thyroid can secrete the thyroid hormone in excess or deprive the body of this hormone. Hypothyroidism leads to the limited secretion of the thyroid hormone, causing fatigue and weight gain. In contrast, hyperthyroidism increases the production of the thyroid hormone, causing an overactive heartbeat, hand tremors, sweatiness or weight loss. In severe cases, the eyeball may become enlarged, and the sufferer struggles to close the eyelid. This is called proptosis or exophthalmos. Treatment of thyroid disorders involves the use of synthetic thyroid medications prescribed by the doctor after reviewing your thyroid function test results.
Anxiety
Chronic anxiety can prevent you from getting that promotion you have always wanted and socialising and enjoying life. Typical symptoms of anxiety include dry mouth, palpitations, sweating, muscle tension, and difficulty breathing. A combination of psychotherapy and anti-anxiety medication can help relieve symptoms.
Depression
Depression is an uncontrollable form of deep sadness and hopelessness. Depression instils self-loathing and poor self-esteem. In addition, previously inherited chronic disorders can worsen depression. However, Dr Okeke can manage symptoms successfully through antidepressant medication, a referral to a psychiatrist and healthy lifestyle changes. Counselling and psychotherapy from a clinical psychologist are important aspects of non-pharmacological management of depression.
Panic disorders
Panic disorders are characterised by a sudden onset of anxiety and fear. Naturally, panic is to be expected in the event of danger. However, persistent panic in everyday situations requires medical care. Dr Okeke aims to treat panic disorders by reducing the number of panic attacks you experience through prescription anxiolytic medications and a referral to a therapist.
Insomnia
Insomnia is classified as sleep deprivation over a long time. A lack of sleep can reduce your energy levels and prevent you from functioning optimally. Chronic insomnia lasts longer than a month and could be a result of stress, mental health disorders, excessive intake of caffeine and nicotine or a change in the usual schedule. Dr Okeke will help manage the condition through prescription medications that can help you fall asleep. Teaching patients good sleep hygiene may be all that is needed to resolve insomnia.
Obesity
Obesity occurs due to excess body weight as a result of uncontrollable eating habits, poor diet and a lack of exercise. Obesity lowers self-esteem and contributes to several health-related conditions such as diabetes, heart disease, hypertension and certain types of cancer. Treatment involves making healthier lifestyle choices, following a diet prescribed by a dietitian and exercising daily. Appetite-suppressant oral medications and newer injectable treatments could be useful as adjuncts to lifestyle changes and diet caloric restrictions.
Insulin-resistance
Insulin resistance occurs when muscle, fat and liver cells do not respond well to insulin. As a result, cells are unable to extract glucose from the blood for energy. Instead, the pancreas secretes more insulin for cells to store glucose. The best way to treat insulin resistance is to exercise, follow a healthy diet, maintain a healthy weight and take prescribed medication to lower blood sugar levels.
Menstrual disorders
Menstrual disorders lead to pain during menstruation, heavy bleeding (menorrhagia), lack of a period (amenorrhea) and infrequent menstrual cycles (oligomenorrhea). Premenstrual syndrome leads to menstrual symptoms developing before the menstrual cycle. For menstrual disorders, Dr Okeke will prescribe non-steroidal anti-inflammatories and oral contraceptives to control abnormal menstrual bleeding and dysmenorrhea.
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) affects a lady’s hormones. PCOS arises from an increase in male hormones. As a result, a hormonal imbalance disrupts a woman’s menstrual cycle. Infrequent periods cause infertility in women. In addition, facial hair, baldness and acne may develop. Oral contraceptives are often taken to alleviate PCOS symptoms.
Epilepsy
Epilepsy is a condition that, if left undiagnosed and untreated, results in seizures. A seizure occurs due to an abnormal change in the brain’s activity. Epilepsy is characterised by recurrent seizures (more than two) in a limited space of time. Anti-seizure medication is taken to reduce the number of seizures experienced.
FAQ
Certain genes can contribute to obesity, diabetes, heart disease, Alzheimer’s disease, depression and rheumatoid arthritis.
Insulin is required for type 1 diabetes. Without insulin, your blood sugar will rise. As a result, diabetic ketoacidosis (DKA) can occur when acid accumulates in the blood as a by-product of the producing energy from other non-sugar nutrients in the body. Diabetic ketoacidosis is a diabetic emergency that needs immediate hospital care.
Anti-epileptic medicines are taken to prevent seizures in epileptic patients. However, if the epilepsy is caused by a tumour in the brain, surgery may be needed to cure or control the frequency or severity of the seizures.

ADDITIONAL SERVICES
Additional services available at Milestone’s Family Practice include:
Early antenatal care and sonars
Women's Health, pap smears, contraceptive pills, patches and implants, as well as intrauterine devices insertions and removals
Minor surgical procedures
Minor fracture and sprain management
Corporate and general medical checks
Intravenous fluid rehydration therapy, iron infusions, vitamin injections and jet fuel therapy
The family physician views his or her
practice as a “population at risk”.
Prof. Ian McWhinney