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LIVING With SCD(Sickle Cell Disease). - Health (6) - Nairaland

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Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 9:52am On Nov 16, 2020
tonyson010:


Congratulations dear. grin grin

Thank you✌️✌️
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 9:56am On Nov 16, 2020
tonyson010:


Success my dear. Read through and it has been an amazing and emotional story of your life.

Wow!!! Am out of words!

We all are survivors in many different ways. Working in hospital( Med Radiographer ) have made me meet lots of people who have been battling and surmounting different health challenges which don't have immediate cures. Everyday becomes a miracle.

Thank you for being committed to giving some people hope and courage to live on.
You're right. No one is actually created perfect we al have something we're living with. But then this avenue here is where I have been able to make my voice heard. Thanks for stopping by Sir

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 9:59am On Nov 16, 2020
EatforHealth:



Hello darling sis. I just came across this thread and I am so amazed at the level of your energy. I can relate with every issue that is being discussed here, and I won’t mind contributing my bits in terms of information (especially on the aspect of nutrition), although I am scarcely online but more frequent on WhatsApp

I drew some inspiration from Abali1, now Abali 2020, right here on Nairaland and I wouldn’t know if you have come across him before. If you haven’t, please do so and perhaps follow his post threads

I would love to have some discussions with you at the level of getting people informed and provision of assistance in terms of information. You may reach me your through the number on my signature

Congratulations on the new feather on your cap too!

God bless you so much
You're contribution in any way is welcome . We'll be glad if you can give us tips partaining to warrior nutrition.
I'll check out d Abali thread you also mentioned.

Thanks so much.
Glad u stopped by.

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by tonyson010(m): 7:02pm On Nov 18, 2020
Fhunkhy1:

You're right. No one is actually created perfect we al have something we're living with. But then this avenue here is where I have been able to make my voice heard. Thanks for stopping by Sir


Keep it going.

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 9:15pm On Nov 22, 2020
Saw my mom during the weekend at a family gathering. I've missed her but I'll rather stay back in school because I don't wanna fight with her which is unavoidable if I go home.
The weekend was long and I came back home with cramps and Crisis.
Didn't go to church today coz I needed to rest well.
I'm good now.
Peace ✌️✌️✌️

PS: I know this post is disjointed, I'm really sorry.

2 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 12:31am On Nov 25, 2020
Hi.
I'm still awake , are you?
Remember that insomnia post I made sometime ago, this is what it's really about.
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 7:35pm On Dec 03, 2020
Hydration Helps; how to incorporate hydration into daily routine.(PART 1).

It is incredibly important for those of us with sickle cell to stay hydrated.

Drinking water promotes healthy blood flow and reduces the chance of our red blood cells sickling and sticking together.

It keeps our blood cells supple so they can move more freely within our blood vessels.

If we don’t drink enough water, our blood cells become stickier and struggle to move through the body.

This could result in the blood cells getting stuck and lead to a crisis.

It is recommended that we drink approximately 2 to 4 liters of water a day for optimal blood flow. However, maintaining this daily intake can present a challenge.

Following are my tips about how to incorporate water into your diet and make it less of a chore:

1. Make it manageable: Drinking 2 to 4 liters of water a day may seem daunting. I find that it’s less of a challenge when I break it into smaller amounts throughout my day.

For example, instead of facing up to 4 liters each day, I think of it as four to eight bottles with 500 milliliters each. That way, I can see myself accomplishing the goal.

I also aim to drink most of the water in the morning and afternoon so that toward the end of the day, I am uninterrupted by frequent toilet visits.

( to be continued.)

Source: https://sicklecellanemianews.com/2019/11/06/staying-hydrated-daily-water-intake-tips/
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 8:52am On Dec 26, 2020
With greetings of peace and prosperity, I’m wishing the very best for you during this special time. May you enjoy all the best now and throughout the coming year
Wishing you and your family health, happiness, peace and prosperity this holiday season and in the coming New Year.
May the magic of Christmas fill your heart all year long.

I cherish you �

3 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Holysholay: 2:53pm On Dec 27, 2020
Hi Fhunkhy1,

My daughter was disgnose with SCA a year ago (she was 8 months at dat time). We were at d hospital for a week (Emmanuel Med Centre, Osogbo.

Based on my search on nairaland, dioscovite seems to b the best supplement for d management of SCA and she has being taking dioscovite daily til today.

Although we hav never slept in any hospital til today since she started taking dioscovite, however, she sometimes experience swollen legs/hand with pain and malaria which often vanishes in 3 days after treatment with ibuprophen or lonart as the case may be.

Now my questions is: The malaria/pain she sometimes experience, is it same as crisis most people talk about here?

Moreover, can i meet u at osogbo nd ask u many questions pls. I reside around Dele Yes Sir Area, Osogbo.

She has malaria yesterday nd she s better now, i m considering placing her on paludrin (daily), cos malaria seems to b her major challenge, want to see if there re side effects to continous intake of paludrin, d reason for my presence here today

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 2:04am On Dec 28, 2020
I am in a considerable amount of pain right now. I'm home with my family. My younger sister is fast asleep beside me as I type, same as mum and dad in their room.
Pain is centered in my ankles, knees and hands.
Rating the pain right now, I'll say 4\10 ,so it's still manageable.
It even feels odd to think of waking any of them up you know.
I'll manage.
I always do.

Good morning �
Peace ✌️✌️✌️

2 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 2:21am On Dec 28, 2020
Holysholay:
Hi Fhunkhy1,

My daughter was disgnose with SCA a year ago (she was 8 months at dat time). We were at d hospital for a week (Emmanuel Med Centre, Osogbo.

Based on my search on nairaland, dioscovite seems to b the best supplement for d management of SCA and she has being taking dioscovite daily til today.

Although we hav never slept in any hospital til today since she started taking dioscovite, however, she sometimes experience swollen legs/hand with pain and malaria which often vanishes in 3 days after treatment with ibuprophen or lonart as the case may be.

Now my questions is: The malaria/pain she sometimes experience, is it same as crisis most people talk about here?

Moreover, can i meet u at osogbo nd ask u many questions pls. I reside around Dele Yes Sir Area, Osogbo.

She has malaria yesterday nd she s better now, i m considering placing her on paludrin (daily), cos malaria seems to b her major challenge, want to see if there re side effects to continous intake of paludrin, d reason for my presence here today

Malaria is amongst the things that can trigger crisis but it is not crisis. I figure that she's probably around 2 years plus or 3 years so she can't really verbalize the pain.
For her age, the swollen hands and legs is a sign that she's in pain ie having crisis so please treat as urgent when you see that.

Paludrine is a drug taken as a prophylaxis for Malaria and is among b routine drugs usually recommended for warriors.. for her age,I'll ask that you see a doctor so that he can recommend a dosage for her age.
As per side effects,I don't have any on my part.
You can as well place her on folic acid ( one tablet daily)

I'm not in Osogbo at the moment ma'am but I'll find a way to let you know when I get back there.
Please keep her hydrated and warm ma, she'll be fine.
Thanks for being here ma and thank you for taking care of us..

2 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Holysholay: 9:28am On Dec 28, 2020
Thank you for this. Kindly drop a message for me using holysholay04@gmail.com wen you are around. I m not always on nairaland. Thank you

Fhunkhy1:


Malaria is amongst the things that can trigger crisis but it is not crisis. I figure that she's probably around 2 years plus or 3 years so she can't really verbalize the pain.
For her age, the swollen hands and legs is a sign that she's in pain ie having crisis so please treat as urgent when you see that.

Paludrine is a drug taken as a prophylaxis for Malaria and is among b routine drugs usually recommended for warriors.. for her age,I'll ask that you see a doctor so that he can recommend a dosage for her age.
As per side effects,I don't have any on my part.
You can as well place her on folic acid ( one tablet daily)

I'm not in Osogbo at the moment ma'am but I'll find a way to let you know when I get back there.
Please keep her hydrated and warm ma, she'll be fine.
Thanks for being here ma and thank you for taking care of us..
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 9:46am On Dec 31, 2020
Good morning & Happy Last Day Of the Year �

I'm really excited �. The year has been a really an unusual one but we made it through all odds.
COVID broke out....
ASUU also struck....
But in all I'm grateful, I can say I had a good business year for starters, I enjoyed amazingly good health as I didn't have cause to get hospitalized, I also started friendly relationships with individuals who have help me in way I didn't expect and to crown it all I passed my midwifery professional exam.

ISN'T GOD JUST TOO FAITHFUL??

So To mark the last day of the year, please share with me what you are thankful for in the year 2020 despite being a warrior and what your 2020 has been like.

Peace ✌️✌️✌️

3 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 10:46pm On Jan 11, 2021
Compliments of the season FAM.

I'm sorry I'm just signing in here for the year. Let's put the blame on my department that decided to release exam timetable that stated that exam starts on the 4th of January and ends on the 11th. I had to travel ASAP back to school on the 2nd.

So for the first time in my whole life (I wrote out New year Goals) and it's been really exciting , I kinda have this inner push or energy to get them achieved; I guess that feeling is what people call being goal oriented. I'll let you know as it unfolds but know that one of my goals Is to buy a water bottle and achieve drinking at least 3L of water daily.. yay grin
This year i feel like i might be ready for a new relationship,I really should stop pushing these men away àbí. I've been meeting new people and I think I'll start referring them to this thread when it's time to discuss genotype issues. It will save me the stress of shalaye to every Tom, Dick and Harry.

By the way, I need answers to this question:

When is the right time to tell someone you like(the opposite sex) about your genotype?
First Date ? When you're already dating? Few days to marriage?
When exactly?

Peace ✌️✌️✌️

4 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 1:51pm On Jan 31, 2021
It dropped.
It finally stopped.
That stubborn tear I've been fighting since the day before dropped.

It's my birthday today guys �.
Yay!
But I'm not happy, I've been Moody and sad since this day seems to be approaching.
I even did a photoshoot to ward off the feeling of sadness I've been feeling concerning my birthday.
This is one of those days I don't want to exist but Damn, I'm still grateful to GOD.
I'm grateful for being alive Lord.
But why do I feel like this?
Could it be because I'm lonely and don't have no one to fuss over me ?

Another one dropped!

Could it be because I'm not getting anything that I want from life yet?

Or Could it be simply because I'm just ungrateful?.


I need someone to talk to, the tears are becoming a heavy downpour right now..
08143505458.

3 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 5:54pm On Feb 05, 2021
*Frequently Asked Questions about SICKLE CELL DISEASE.*

Sickle cell disease (SCD) is a group of inherited red blood cell disorders. Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has SCD, the red blood cells (rbcs) become hard and sticky and look like a C-shaped farm tool called a "sickle". The sickle cells die early, which causes a constant shortage of red blood.
*Q* : Why do SCD patient's have pain?
*A*: Sickled red blood cells cannot pass through small blood vessels, they get stuck and clog the blood flow. This results in pain in the areas where blood is not getting to.

*Q* : Why do SCD patients take Folic acid?
*A* : Sickled cells get destroyed easily and Folic acid help make new red blood cells.

*Q* : Why do some SCD patients have big tummy?
*A* : Blood gets trapped in the spleen and the liver whereby expands rapidly. It can presents with weakness, fast breathing, shock and abdominal pain.

*Q*: What should sickle cell patients avoid?
*A* : Strenuous exercise, extremes of weather (cold or hot), cold water, dehydration

*Q* : Why do some sickle cell patients have a give away look?
*A* : This is called 'sickle cell habitus'. They have long thin extremities, prominent forehead or bossing of the head, big tummy, yellowish tinge of the eyes, prominent bone in the upper lip, etc. These features are as a result of rapid breaking down and production of rbcs, repeated blockage to blood flow by sickled cells, reduced oxygen supply.

*Q* : Why do SCD patients have frequent infections?
*A* : Their immunity is low. They have abnormal white blood cells that can't fight infections very well. Also, reduced blood supply and oxygen supply puts them at risk of having frequent infections.

Sickle cell patients do well when they follow instructions ; take a lot of fluids, eat healthy, take fruits and vegetables, take enough rest and do moderate exercise.

They should also have a positive mind set to life and a good support system.


Copied

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by Hotbutt(f): 12:20pm On Feb 06, 2021
Hello. Just saw this thread and stumbled on it. From the title of this thread it shows most people here are Sickle Cell or Living with Sickle Cell Disease. But you all don't have to be like this now. People are getting Cured from Sickle Cell daily while others are getting their GENOTYPE CONVERTED from SS, SC to AA. And it is true.

Have you all not heard of Phytoscience Stem Cell Therapy And How it works. It works by Regenerating Healthy Cells And Repairing The Damaged Cells (Sickled Cells) in the body.

As a Nurse, I have put some of my numerous Sickle Cell Anaemia Patients on the Therapy and they are fine and healthy today. One good thing about it is once any Sickle Cell Patients starts the Therapy, all Crises will automatically stop. Continous usage brings conversion. Yes. There have been cases.

Please Be Informed. The world is Evolving And This is a Breakthrough in Science taking over the world.

I have done my part. Believe it or not. It is working. Believe me or not, it won't add to my Name.

They even have a thread here on the Health Section. Please get in touch with them and be saved. A Friend of mine died 10 years ago due to Sickle Cell. If this Therapy was discovered then, my friend wouldn't be dead today. I Love You All

Click this thread to know more about it and how it works.
https://www.nairaland.com/6330207/sickle-cell-sc-childs-genotype#97889849

Their Health Page on Facebook is this
https://m.facebook.com/Your-Health-107826354087027/?ref=bookmarks

Watch the testimony of how a Sickle Cell Girl Who Used The Therapy, Got Cured And Her Genotype Changed From Sickle Cell (SC) to AA


https://www.youtube.com/watch?v=7wXAK3-LZGw

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by oxypressPlus: 2:33pm On Feb 06, 2021
Hotbutt:
Hello. Just saw this thread and stumbled on it. From the title of this thread it shows most people here are Sickle Cell or Living with Sickle Cell Disease. But you all don't have to libe like this now. People are getting Cured from Sickle Cell daily while others are getting their GENOTYPE CONVERTED from SS, SC to AA. And it is true.

Have you all not heard of Phytoscinece Stem Cell Therapy And How it works. It works by Regenerating Healthy Cells And Repairing The Damaged Cells (Sickled Cells) in the body.

As a Nurse, I have put some of my numerous Sickle Cell Anaemia Patients on the Therapy and they are fine and healthy today. One good thing about it is once any Sickle Cell Patients starts the Therapy, all Crises will automatically stop. Continous usage brings conversion. Yes. There have been cases.

Please Be Informed. The world is Evolving And This is a Breakthrough in Science taking over the world.

I have done my part. Believe it or not. It is working. Believe me or not, it won't add to my Name.

They even have a thread here on the Health Section. Please get in touch with them and be saved. A Friend of mine died 10 years ago due to Sickle Cell. If this Therapy was discovered the n, my friend wouldn't be dead today. I Love You All

Click this thread to know more about it and how it works.
https://www.nairaland.com/6330207/sickle-cell-sc-childs-genotype#97889849

Their Health Page on Facebook is this
https://m.facebook.com/Your-Health-107826354087027/?ref=bookmarks

Watch the testimony of how a Sickle Cell Girl Who Used The Therapy, Got Cured And Her Genotype Changed From Sickle Cell (SC) to AA


https://www.youtube.com/watch?v=7wXAK3-LZGw

@Fhunkhy please comment on the veracity of this testimony.
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 11:49pm On Apr 24, 2021
Good evening everyone.
Tonight 8s one if those nights so I really don't know what to say.
Lemme try some diversional therapy.
I developed interest in two things recently
1) learning to write
2) learning a New language.

Writing is one hell of a task I must say.. kudos to every writer out there. It hasn't been easy combining words and making them into phrases,then sentences.
Just so you know, I'm still at the stage where everything i write is trash even to me.
Concerning the language, I chose German for many beneficial reasons.

My induction ceremony is slated to hold next month.. please pray along.

Thanks for reading

Sleep well
Peace ✌️

2 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 11:27pm On May 13, 2021
The pain started about 30 minutes ago, though I've been feeling unwell since evening.
I'm home �, Dad and Mum in the next room and my little sister beside me.
I have pains in my back, chest, lower limbs and a headache.
I'll be fine . I know that but I need this pain gone befoe I start crying... I'm restless and can only express my pains in groanings.

I won't Wake anyone.. it's my sister's birthday tomorrow so I won't spoil her night with this.
I'll bear this alone.
Again

Good night
Peace✌️✌️✌️

3 Likes

Re: LIVING With SCD(Sickle Cell Disease). by MariamAlheri: 11:46pm On May 13, 2021
Fhunkhy1:

The pain started about 30 minutes ago, though I've been feeling unwell since evening.
I'm home �, Dad and Mum in the next room and my little sister beside me.
I have pains in my back, chest, lower limbs and a headache.
I'll be fine . I know that but I need this pain gone befoe I start crying... I'm restless and can only express my pains in groanings.

I won't Wake anyone.. it's my sister's birthday tomorrow so I won't spoil her night with this.
I'll bear this alone.
Again

Good night
Peace✌️✌️✌️

Hello dear,

I just stumbled on your thread and I must commend you for keeping it going since years ago. You're a strong lady, I can't even imagine the amount of pain you're feeling right now.

But I just want to say it is well with you. The Lord continue to be your strength. I'm sending you lots of warm hugs, you're in my prayers.

Take care.

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by VictorIfe(m): 4:57pm On May 17, 2021
hello funky, hope you good now? stay strong
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 1:17pm On May 18, 2021
I'm much better now guys, though still on meds. Thank you so much MariamAlheri and VictorIfe,

2 Likes

Re: LIVING With SCD(Sickle Cell Disease). by MariamAlheri: 8:59pm On May 19, 2021
Fhunkhy1:
I'm much better now guys, though still on meds. Thank you so much MariamAlheri and VictorIfe,

You're welcome dear.

How're you doing today?
Re: LIVING With SCD(Sickle Cell Disease). by MariamAlheri: 9:00pm On May 19, 2021
Fhunkhy1:
I'm much better now guys, though still on meds. Thank you so much MariamAlheri and VictorIfe,

You're welcome dear.

Hope you're doing great today too...
Re: LIVING With SCD(Sickle Cell Disease). by punisha: 7:49am On May 21, 2021
Fhunkhy1:
I'm much better now guys, though still on meds. Thank you so much MariamAlheri and VictorIfe,

I tried mailing u...
Goof to know u r better now.
Kindly reply when u are free to do so.
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 3:06pm On May 24, 2021
FIVE WAYS TO MANAGE A MILD PAIN CRISIS AT HOME.

TIP 1.
�DRINK LOTS OF WATER!
Hydration is cardinal during a crisis as it helps to unclog the sticky and clogged red blood cells that have blocked and are preventing oxygen and blood flow to the affected area. One should at least drink 8 glasses of water. Remember to avoid cold fluids.

TIP 2.
TAKE THE PAIN MEDS BEFORE IT GETS BAD.
�I know no one wants to rely on pain meds whenever you start to feel signs of a crisis or mild pain but it's better to take a painkiller once you start to feel pain. From my experience,it's better to stay ahead of the pain than waiting for it to progress to a full blown crisis that will require hospitalization.

TIP 3.
STAY WARM.
�It's important to keep every part of the body warm, especially the legs, hands and chest. Always put on warm clothes and blankets even if you don't want to. Staying warm helps the blood vessels not to constrict, allowing easy blood flow.

TIP 4.
DO THINGS TO KEEP YOUR MIND OFF THE PAIN.
It's important to try to keep your mind off the pain because it helps lessen the pain. There are many ways you can distract yourself. You can try reading your favorite books, listening to music has been found to be effective because Music not only helps with the easiness of the pain but it also provides a beautiful distraction and relaxation. Also catching up on your favorite TV shows or movies can help keep you entertained and distracted.

TIP 5.
GET SOME REST.
�I know it's not easy getting some sleep when in pain but try to get some rest whenever you can. Remember with Sickle cell, our bodies works ten times harder than everyone else's so let your body recover and don't feel guilty about it. Don't rush the process and just gain your energy back.

�N. B
These tips are for a mild crisis,sometimes they may help and sometimes the pain may increase to a more intense and severe pain which may require hospitalization to help control and avoid any damage to the affected area.
(Copied)
..............................................................
Thank you so much Punisha.. I appreciate your concerns..

A good news update is coming soon.. I'm excited..

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by Peppe66: 8:09am On May 26, 2021
Fhunkhy1:
FIVE WAYS TO MANAGE A MILD PAIN CRISIS AT HOME.

TIP 3.
STAY WARM.
�It's important to keep every part of the body warm, especially the legs, hands and chest. Always put on warm clothes and blankets even if you don't want to. Staying warm helps the blood vessels not to constrict, allowing easy blood flow.


Great one!
I think staying warm can really help with such pain. This article
https://blastahenriet.com/blogs/journal/the-wheat-bag-effective-natural-pain-relief
has some really great tips on heat therapy for relieving pain.
Cheers!

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by hampan95: 8:12am On May 26, 2021
Totally agree!
Heat is everything for an easy pain relief.

2 Likes

Re: LIVING With SCD(Sickle Cell Disease). by Tobichuks08: 9:22am On Jul 07, 2021
.
Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 7:31pm On Jul 09, 2021
PAIN OF A WARRIOR

Everyone they say feel a pain
But some pains turn to gain
How do we explain the bane
Some even say its a feign
We still put on a grin
Coz its a pain of a warrior
But only a few understands

Oh! you who call us lazy
Let me get you busy
Ask Zandy how she felt
When the leg ulcer split
Ask Radeyo, how he endured the maim
Ask my Twinnie the true definition of priapism
We won't forget to remind you of Justezy
A man who died and resurrected for kidney failure
Come to CSS, and have a clearer experience
How pains creep in like a thief at night
And disappear like a volatile gas

We all keep holding our shied and armour
Even if its an horror
No matter the terror
We will get an honour
By keeping our hopes high
Despite all the odds
Coz we definitely know
Its a pain of a warrior
And only the few understands.
©Sheriff

1 Like

Re: LIVING With SCD(Sickle Cell Disease). by Fhunkhy1(f): 10:15am On Sep 07, 2021
Dear warriors,

Emotionally, I know this battle gets overwhelming at times�. But I'm here to tell you we can't give up! All our past efforts will be wasted if we now give up. What will be the use of all the times we've fought with our last breath and won?

We've always been winning and I'm sure we can do it again and again. Though it's not easy but that's what we're made to do. We're conquerors... We can't give up! It's not allowed at all.

So please, give it your all. When you feel overwhelmed, take a rest and start again but never give up cos it's not over until it is over. Utilize the strengths around you when you are weak. Also, don't forget to be someone's strength when they need it. And lastly, sickle cell got nothing on us cos we're WARRIORS!*

FIGHTING!�

#cpd

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