DOCTOR’S NEGLIGENCE Nearly cost me my life

Njoki Kaigai was settling in with her husband in Nairobi after the violent post election clashes of 2007 when her dream of peace and happiness was shattered by an illness that took her to a precipice. She told her story to FAITH MATHENGE-MURIGU.

Thirty-one-year-old Jane Njoki Kaigai, in good health and holding a good job, should have been celebrating Easter of 2009, but that was not the case. A sudden, sharp pain in her belly jolted her peaceful world and forced her to see a doctor. In spite of taking painkillers prescribed by the doctor, the pain didn’t go away. Instead, her stomach became bloated, giving her a feeling of fullness although she hardly ate or drunk. She recounts her experience.

“I was born and brought up in Kiganjo, Nyeri County, the last born in a family of nine. My father passed on when I was a toddler, leaving the burden of my upbringing to my mother and sisters who saw me through school.

The year 2005 was one of double joy for me; I got a job in Kisumu and met Jimmy Kaigai, who later became my husband. Jimmy was working with a security firm in Kisumu. After a short time, I was transferred to Eldoret, which meant seeing Jimmy less often. However, through communication and occasional visits, our love grew and in December 2007, he took me to his rural home in Nyahururu and introduced me to his parents as the woman he wanted to settle down with. It was a very happy occasion.

The 2007/2008-post election violence affected us since it was not safe to remain in our workstations. Jimmy could not go back to Kisumu, but I was lucky because I was transferred to Nairobi. Jimmy’s brother, Paul Ng’ang’a, hosted us at his house in Nairobi, a great sacrifice because he had a family. We rented our own house when Jimmy got a job and we started living together as a married couple.

It was just at the time our lives were starting to assume some normalcy and we were living blissfully in marriage that I started experiencing severe stomach pains. In spite of the discomfort and pain, I visited my sister who lived in Nakuru during Easter of 2009. She took me to the Rift Valley Provincial General Hospital (RVPGH) for a check up. An ultra sound scan and several laboratory tests revealed blocked fallopian tubes. I was booked for surgery and remained hospitalised for two weeks. I had hoped the pain would reduce after the surgery but it didn’t. Doctors told me to patient, as a wound takes time to heal.

I was discharged from hospital but my condition did not improve. I returned to hospital and the doctor who checked me said the wound had healed from the outside but I should be patient as the inside takes a while to heal completely. I told him I felt like there was something moving inside my belly but he assured me everything was okay. I lost a lot of weight because I had lost appetite.

I had a torturous journey as I retuned to Nairobi to resume work. Every bump on the road made me feel like the wound would burst open. My life was extremely difficult, as I could not perform even simple tasks because of the pain. Jimmy’s sister, Emma and my niece Caroline came to stay with us to help me around. After my condition deteriorated, Emma and her brother Paul took me to Avenue Hospital in Nairobi. Various tests and a CT scan showed something that looked like a blood clot inside my belly. I was advised to see a gynaecologist.

After running more tests, the gynaecologist said I required an emergency operation to find out what was inside my belly. It was supposed to be a minor operation but ended up as a seven hours affair. A surgical towel was found in my belly, obviously left there during my earlier operation at RVPGH. The doctors called the condition gossypiboma. Jimmy, who was by this time my husband, told me later he was shown the towel, which was covered in blood and pus. A doctor later explained to me that a surgical towel easily absorbs fluids like blood and this made the surgery very delicate as the surgeons had to ensure bacteria that had already formed did not contaminate the entire abdomen, as this would cause serious health complications.

After the operation, the doctors did not close the wound, as I needed to go back to theatre to repair part of my intestines, which had been affected by the foreign object. I had another surgery after five days and half of my intestines were cut out as they had been badly damaged. This was not the end of my problems. After a few days, doctors discovered the intestines were leaking and the point where they were joined and this required another surgery to correct it. My weight had dropped form 58kgs to 33. I felt like I was dying. I was completely drained.

I was in agonising pain and developed breathing problems after the surgery and remained in the High Dependency Unit (HDU) for some time. I had a low blood count and low blood pressure and there were times I was acting confused. My bill at Avenue Hospital rose to over a million shillings and this added to my worries. Fearing they would never be able to pay the bill, my family asked for an early discharge to curtail accumulating daily charges.

Back at home, my problems were not over yet. One day, in a violent burst of anger, I accidentally knocked the edge of a table and the wound opened. I was back in hospital for another operation to close it. I was weak because my body lacked various nutrients because I was not feeding well. My immunity was also low and this prolonged the healing process. I was discharged from hospital and put on various supplements.

The unconditional love I received from my family has helped the healing process. My in-laws have stood with me and my husband has remained the strong rock I lean on. We have been through this pain together. My faith has been strengthened by my experience. When you reach your end, God shows up. Always remember to pray and declare God’s word over your life because God never fails. I have not fully recovered but I am certainly better and more energetic and ready to face tomorrow.”

(SIDE BAR)

What is gossypiboma?

Gossypiboma or textiloma is the technical term for surgical complications resulting from foreign materials, such as a surgical sponge or blades accidentally being left inside a patient’s body. The term gossypiboma is derived from the Latin word gossypium (cotton) and the Kiswahili boma (place of concealment) and describes a mass within a patient’s body comprising a cotton matrix surrounded by a foreign body granuloma.

Complications include perforation of the bowels, sepsis, obstruction, fistulae or other perforations. Symptoms of the presence of a foreign body may include swelling and pain. Patients are usually re-admitted to hospital if the problem was not discovered during the initial hospitalisation. Re-operation to remove the object is the only option.

Foreign bodies can be left in the body due to failure to do a systematic count of surgical equipment before and after surgery. This may result in missed or overlooked items. The timing for an emergency operation can occur prematurely if the ‘surgical’ team is not communicating effectively. If the team is fatigued after a long operation, there can be counting errors. The risk of a foreign body being retained increases with emergencies and unplanned changes in a procedure. It is therefore important for all members of the pre-operative team to take responsibility to minimise human factors that can contribute to errors in the counting process.

Facts on fallopian tube blockage

Fallopian tube blockage can occur anywhere within the tube. Many things can cause it, but the most common is infection. Surgery to open a fallopian tube blocked at the entrance into the uterus is considered the least invasive surgical approach. Even so, the tubes sometimes close in 81 percent of cases. Therefore, even the simplest surgery only gives a small period when conceiving naturally can occur.

Published in January 2012