“You are always sick,” someone said to me recently. As if all I do in my free time is walk into laboratories to snack on viruses and think, ‘Oh wow that illness would look good on me, I’ll have some of that. And please garnish each serving with a dollop of complications. Looks good doesn’t it?’
No, it doesn’t. That comment — whether on a light note or not — took me down faster than a skydiver without a chute.
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Three weeks ago, on a terribly cold morning I said to myself, ‘I am a doctor. I can treat myself. What’s a little stomach ache?’ Many medics find it inconvenient and unnecessary to consult a fellow medic for an ailment they feel they are competent to treat. What we forget — and I forgot on that Tuesday morning — is that ‘self-treatment’ removes the objectivity and distance necessary in a doctor-patient relationship. So when I woke up with left lower abdominal pain, I thought nothing of it, took a painkiller and went on my way. If anyone had told me, ‘You will not go back home this evening,’ I wouldn’t have believed them.
As I did the school run that morning, the ache would wax and wane. And I found myself sub-consciously rubbing my lower abdomen to relieve the pain. Still, I thought nothing of it. On the way back, I was stuck in traffic and the still moments in the car had me wondering what was going on in my body. All the same, I got back and headed to the Antenatal clinic to attend to patients.
Every Tuesday I get a chance to share my mind with the world. Through articles like the one you are reading now. No matter what I am doing, my mind is most engaged on Tuesday mornings. As I walk from the parking lot into the hospital I routinely toy around with phrases in my mind. ‘What will my first line be?’ Because a great opening statement can either hook or lose a reader. That day I was going to post an emotive article about my sister and I mulled over it. ‘How will I end this article? What message do I want to communicate?’ My mind was busy and I forgot momentarily that my sides were aching.
At the clinic, each time I got up to attend to a patient, the pain would stop me in my tracks. I had to take a breath before getting up from my desk to walk to the examining couch. I only realised this in hindsight but as I stretched my hand to examine my patients, I was bending over involuntarily. Somehow it made me feel better. Then I would take another breath and inch back to my chair. The pain built up with each patient I saw. ‘Maybe it’s a urinary tract infection.’ I told myself. So I took a break and walked ten steps to the mini lab in the clinic.
“Hi, could I have a urine test?”
The lab technician gave me a quizzical look. The kind that needs justification for such a request. I turned and did a quick sweep of the room and noticed scores of pregnant women seated on a bench waiting to get tested. It was a line of swollen feet, swollen noses and puffy faces.
“I have really bad abdominal pain here.” I pleaded my case while pointing to my left side, “I have even left patients on the queue just to get tested. Please.”
She went on to serve a client who was standing next to me then said, “Here. Take this. Bring the sample right away and I will check for you.”
A few minutes later, we stood shoulder to shoulder as I watched her insert a urine dipstick into my sample.
“Daktari there is nothing here. Uko sawa.”
Have you ever felt disappointed to receive a clean bill of health? Because by that time it felt as if maggots had penetrated through my skin and were now eating away at my insides. I limped back to the consultation room where I tried to see another patient but the maggots wouldn’t let me. A colleague of mine passed by to borrow something and he took one look at me and asked, “Ah! What’s up?”
“Are you going to your private clinic today?” I asked.
“Actually I am just finishing up and heading there. Are you ok?”
“Erm, I don’t know but let me follow you there. Are you driving?”
“Walking.”
“Ok. I will meet you there.”
It took an enormous amount of willpower to get to my car and drive to his clinic less than a km away. Apart from him and God, no one else in the Universe knew where I was. No one knew that when I got to where his clinic is, I found no parking and was forced to park in the neighbouring hospital. Where, there was no parking either. I pulled my doctor card and asked the guard if I could leave my car in a certain prohibited spot. “Sure but how long will you be away?”
“I won’t be long. Fifteen minutes tops.” But when I got out of the car he followed me, as if he knew what was about to happen. “Daktari, I have changed my mind. If you take longer and the CEO finds your car there, it will be my neck on the gallows.” So I had to move my car. I finally got a spot. A safe spot. As if I knew my car wouldn’t be moved for a while. I limped out to the next building confident that I would be back in time to pick my daughter from school.
There is something about excruciating pain that causes temporary insanity. Ask a woman in labour she will tell you. Don’t ask her while in labour though. Wait for the scourge to end. I have been to my colleague’s clinic several times but on that day, I couldn’t remember what floor it was on. I got into the lift and pressed all the buttons going up. The plan was to read the names on the wall as we ascended. The only problem is, when the doors rumbled open, the in and out traffic obscured my small frame and I didn’t get time to read all the names. The craziest thing is I got to 5th floor and still didn’t know whether or not to get off. So I went back down, hissing and growling like an angry cat. I was on that lift for what felt like eternity. I thought I would pass out.
Eventually I got off on 3rd floor and walked up each floor reading the names until I got to his clinic, which was on the 5th floor. My body was covered in a thick coat of sweat. Whether from the pain or from the fatigue, I don’t know. At the reception, I was winded. Could not sit, could not stand still. My head was stooped forward close to my knees. I did not care who was watching. I could feel my mind unfurling and I knew I was about to lose it when my colleague called me in. “Whoa you are not ok.” He said when he saw me.
“No. I am not.”
“What’s up Sue?”
“Paaaaain…” And I remained bent over as if my head was too heavy for my neck. He stood abruptly, helped me to the examining couch and gave me a jab for the pain.
“This might help as I try to examine you.”
“Aaaaargh.” I was now wriggling on his couch, clenching and unclenching my fists. My breathing was quickened and I wanted nothing to touch my left abdomen.
He approached me cautiously and said, “Sue I am sorry. I will be gentle but I have to examine you and perform an ultrasound.”
“Ok.” Fists still clenching and unclenching.
When his hand touched my abdomen, it’s as if a hot iron was placed on my skin.
“Whatever it is, it’s on the left side.” He said.
So he placed his ultrasound probe on my left lower abdomen.
I started twitching while pushing his hand away. I had become the patient all medics abhor. The uncooperative patient.
“Ok. There is definitely something going on, on your left adnexa. It’s just not clear. I can’t see your left ovary either.”
In that brief period the pain ‘seemed’ to wane. I was able to lift off the bed and look up. “So now what?” I ask him.
“I think it would be good to have a Radiologist have a second look. Because you seem to be better, go and get a quick scan and then revert.”
I surprised myself and got off the couch with the remnant of the pain at the back of my mind. I took the imaging request and slowly left his office afraid to awaken the maggots. But when I got to the lift, they were triggered and I remember bending over and saying, “ooooh.” And the one thing I hate doing when I am in pain happened. I started to cry. I don’t like to cry when I am in physical pain. It makes me feel helpless. It makes me want my mummy. Yes, even 30 something year old women still want their mothers. Because they just know how to make things better. Mine unfortunately is in the next room. I called my husband.
I staggered into the lift and let it carry me to the ground floor. Strangers stared at me because my face was streaked with tears. I limped out of the building onto the street. Terra firma. I stood on the road, draped forward like a folded cloth. I was only relieved by the loud engine of my husband’s car. He lifted me into the car and said, “Where?”
I thrust the paper into his hand and he hit the accelerator.
On a normal day, my husband likes to drive as if he is running late. It was not a normal day. He swerved through traffic like a mad man. With each turn he made, my body flopped about because I wasn’t belted. His eyes were half on the road and half on me because I was groaning uncontrollably.
We got to an imaging centre and try as I may, I could not leave the car. He tried to lift me, nothing. I tried turning, I couldn’t. Tried to even step on his hand like an acrobat but the pain had taken over. The pain ruled. “Who are we kidding?” Husband blurted out. “If you can’t get out of the car, how will you even get the ultrasound done. I am taking you to hospital.”
He was back in the car and the trip back was worse than the one before. I was becoming delirious. My palms were cold.
We got to Nairobi Hospital and that, ten paragraphs later, is the reason for this article.
We got to the ER parking and within seconds there was a lady by my side in grey scrubs. She looked at me, her brow furrowed, “Hi. What has happened? Bring a wheelchair,” she said to someone I couldn’t see.
The three of them managed to get me on the wheelchair and ran with me into the ER. When I got there, a nurse appeared by my side. Sister Muteti.
I know the drill. I have worked in an ER before. When an emergency comes in you have to think on your feet. You have to have an octopus brain. To take history from a patient or their next of kin, while doing a physical exam, giving instructions, resuscitating the patient, taking blood samples and staying ahead of the game. It’s worse when the patient is a doctor. The pressure is real.
The doctor — Dr Kogo — asked me several questions. I could tell what her line of thinking was with each question. To her, I was not a colleague. I was her patient and I was sick. She prodded me gently, asking every minute detail down to what I had eaten that morning. But she didn’t just stand there, she and Sister Muteti helped undress me and covered me in a green frock. As she took information from me, she asked them to prepare a potent painkiller. She walked off briefly and came back to put in a cannula and draw some blood.
Now, I have had several IV cannulae inserted in my arm. And I usually have to brace myself for it. Because I was in so much pain, I couldn’t brace for it. But I knew it was coming. I only remember Dr Kogo saying, “I am going to fix an IV cannula and you will fill a slight prick. Then I will take blood samples for investigations in case you need to go to theatre.” She didn’t have to give me this information. Because again, I know the drill. But she did. And by the time she was done fixing the IV I said in a whisper, “That’s the most painless IV, I have ever had.”
She worked with Muteti like they had some form of telepathy. Even in my delirium, I could hear them discussing how to manage the pain. “Give her Tramal-Plasil,” I heard Dr Kogo say. And Muteti would be by my side in a minute. She would push the drug in and then linger, stroking my arm. “Utakuwa sawa. You will feel better after this.” I lay there staring at the ceiling trying to focus on something I could comprehend.
But the pain still ruled. The maggots drank that Tramal like a snack. I was still groaning and even rolling side by side on the bed. This was beginning to feel like a single relentless nightmare.
“Let me add an NSAID,” the doctor would say and Muteti would be quick on her feet. I was not the only patient in that room but I felt as if I was. On and on they continued trying to add painkiller onto painkiller until in total I received five different types of painkillers.
Yes five.
Five until I was lifted onto a stretcher and taken for an ultrasound and the sonographer said the exact same thing my colleague had said earlier. “There is something going on on her left side but we can’t see exactly what it is. There is also a fibroid there obscuring things.”
Throughout the entire scanning process, I wailed. I had reached the end of my rope. I sobbed because the pain was so immense. So excruciating. And no one knew the cause yet. By the time I was being wheeled back to the ER, I was a mess. Muteti, who had wheeled me there with a casual kept telling him, “Don’t push the stretcher so fast. This girl is in pain. Careful! Dont hit the walls, I can tell it’s making her jump.” They wheeled me back slowly, gently. And went over the rumble strips in the corridor in slow motion.
Anyone reading this is probably saying, ‘they were being nice to you because you are one of them.’ But I later came to learn that they didn’t know I was a medic until much later. When I got back, Dr Kogo was informed and she came to see me. “Is the pain better?” And all she saw were hot tears flowing down my cheeks.
She walked away and I thought my tears embarassed her or she was giving me a moment. But she was back a second later with a tissue. She wiped away the tears and said, “Ok let’s go through your symptoms again one by one. We will figure this out.” And even though my sides were burning like hot coal, and my mind was tightly wound like a spring, I cannot underscore the compassion I felt from her, Muteti and the staff that attended to me that day. They even called the anesthesiologist to see how else they could alleviate my suffering.
Eventually the only thing that took away my pain was general anesthesia. I ended up on an operating table where they found my left ovary had twisted on itself. Class at the end. Don’t google.
Post op there was a nurse — Gitonga, who treated me like I had just been extracted from someone’s womb. She swaddled me. Yes swaddled in a layer of blankets and kept a blower heater in between. It felt like I was being hugged. No wonder the baby whisperer swears by swaddling for newborns. It makes you feel secure. She sat there next to me, asking me if I was ok every five minutes and stroking my head as if I was her baby. She only left my side when it was time for me to be wheeled away to the ward.
Afterward however, I had a major emotional dip.
That in the past one year it has been one ailment after another, some — life threatening. That I am currently in a toxic relationship with my body and I can’t walk out on myself. That I am forever swallowing drugs for this illness or the other and feeling guilty that my friends, family and colleagues may think I am a joke.
The climb back up is ongoing.
Still, I must commend the staff of Nairobi Hospital who attended to me. Of course several other people came to my rescue. My colleagues, the doctors who operated on me, the anesthesiologist and nurses in theatre and the wards. But I can’t forget Dr Kogo, Sister Muteti and Sister Gitonga. They exhibited the true spirit of being a light in darkness. Because a little kindness goes a long way when you are at your lowest.
Thank you to the Team.
Ovarian Torsion is a condition that occurs when the ovary or fallopian tube twists on the tissues that support them.
This cuts off the blood supply to the ovary and if not treated promptly can cause tissue in the ovary to die.
The symptoms arise suddenly and are intense. They include: severe pain in the pelvic region, nausea, vomiting.
The sudden pain is often preceded by occasional cramps for several days or even weeks because the ovary twists and untwists itself repeatedly.
Risk factors include: Pregnancy, Use of hormonal medications
Diagnosis includes taking a history and performing a physical exam. An ultrasound typically confirms the diagnosis.
Treatment: Surgery is the only way to treat ovarian torsion.