PS Nalo was bold about his cancer condition

BY DAVID S.O NALO, CBS

On Sunday, 5th February, 2012 afternoon at about 4.00 p.m, I was resting with my family at home. I started feeling some discomfort around my stomach and a general body malaise. I also felt weak and so dehydrated. After a while, I decided to call a doctor friend who accepted my request and came home so I could share with him my experience. Fortunately, after a short examination, he established that I was very sick and there was urgent need to see a doctor on the same day i.e. 5th February 2012.

What warranted the doctor friend to recommend that I need to visit a doctor, was informed by the oral observation that (a) the swelling across my stomach was abnormal; (b) the level of dehydration (c) pale eyes; and (d) the general body malaise. These were purely drawn from oral observation and a few interrogations. Observations further showed general lack of appetite, in the lower parts of the lungs, stomach and swollen lymph nodes along both sides of the neck. These were of major concerns to the friend doctor.

On the basis of these, we did indeed visit Nairobi Hospital and after doing the normal procedure, I was admitted. Indeed the lead doctor observed no variations between the friend doctor and what he found. Consequently, three distinct lines of action were identified for execution the same evening.

First, I was put on IV drip immediately and eventually consumed 15 bottles to regain my water level and kidney functions to manage the high dehydration. The second action was to mobilise a team of doctors to support the process to run special lines of tests relevant to their areas as identified by the lead doctor. This was key due to support needed in these circumstances. Third action was to run a series of diagnostics tests on 6th February, 2012. Therefore, I dedicated 24 hours for this essential service which covered a chest X-ray, lower abdomen scan; Biopsy of the neck gland; the endoscopy; bone marrow test and others including a series of blood tests.

These three actions were executed simultaneously on the 6th, 7th and 8th February, 2012. In the evening of 8th February 2012, and indeed in a total of 24 hours of going through the tests, all tests were done/completed except the biopsy and bone marrow. With most diagnostic tests ready on the 8th February 2012, the doctors concluded that action required to be taken.

Perhaps when public doctors go on strike and demand for better services, they have a point to make. A look at our public hospitals and we should appreciate that much has been done, but the ongoing tension in the public sector, points to the fact that we must sort out the sector. They need laboratory technicians with tools of work, nurses with facilities to perform: this may have not been achieved with some degree of efficiency but with commitment and dedication to the Bill of Rights in the Constitution, these are commitments we have made and should assure the public that we are duty bound to address them with resource limitations.

Back to the diagnostic story, it emerged that they captured similar tests on the allergy and more. On 8th February, treatment started after counseling and necessary consultations concluded between the family and the doctors. The result of the tests revealed that I had “Hodgkin Limforma” an early stage of cancer.

At this stage, expecting to hear more results on “allergy”, and hearing this, I gave Dr. Nyikal a straight look into his eyes without a question – but inside, I was like, “you brought me here to be told that I have cancer?” Quickly, he understood the unstated question but the deep look and his reply was “David, It is manageable”. Indeed he clarified that given all forms of cancer, I will comfortably choose “Hogkin Limforma” because it is manageable and it can be treated. Then I got a sigh of relief. I also learnt that there are several stages of cancer, and we can live with any stage but each must be timely identified, diagnosed and managed.

This is why Kenya needs cancer facilities like yesterday. I challenge our Parliament, the Treasury and Revenue Allocation Committee to view this as a priority for every county if possible or a group of counties clustered together. Between 5th February and 5th March, 2012 the Doctor did not only succeed to run a set of critical diagnostics, but they also did a set of four chemotherapy successfully and the most challenging was the fact that I had to go through chemotherapy treatment when I had not known before and secondly to accept the word “cancer” in my life.

In life, there are several stages of cancer, there are many patients at different stages and can have lived with the disease for many years.

But what is the moral of this story? First many of us do not accept our disease condition, so we live in denial and do not seek medical attention in good time. At times, the access to medical services may simply not be available especially the public Medicare. But even when we do, the diagnostics may not be in time leading to inaccurate or suboptimal results with suboptimal treatment.

This does not help the patient, and the disease may advance, become complex and lead to early death. Many cases of cancer, diabetes etc fall in this category many of which we are victims. Alternatively, the diagnostics may just be narrow and is not broadened enough to capture other potential ailments that need to be captured in the diagnostics – here treatment becomes impossible.

Finally diagnostics can be accurate, broad, including oral and laboratory, the right team and materials and equipment, and hence possibility of accuracy is high thus timely, leading to the accurate treatment and prolongation of life.

When I became ill and got hospitalized in Nairobi Hospital between 5th February and 5th March 2012, little did I know that this would be my experience. I truly learnt that when in doubt of your disease, counseling helps. In the case of the latter, I have learnt that diseases can be identified, diagnosed and treated.

I was also able to meet more than 10 patients of “Hodgkin Limforma” and other forms of advanced cancer who came to give me support in various forms. These people were a major source of inspiration and energy in addition to the doctors. In this context, I thank Prof. Peter Nyong’o, Prof. Ntiba, Mrs. Mary Onyango and Jerry Okungu, at least the few that permitted me to share their own experiences. These people are going about their business as usual but most important they advocate on awareness on cancer. They need all the support and that is why I add my voice to the process.

I advise that it is critical to seek medical attention at the earliest opportunity. Avoid fear to overcome the challenge and move on. Above all, have faith, determination and believe that fear is not meant to stop you from moving on but to enable reorganise your strategies.

I highly congratulate the following team at Nairobi Hospital; Dr. Elly Ogutu; Dr. James Nyikal; Surgeon Baraza; All the Angels (Nurses) and the overall staff.

I wish in a special way to thank the following for their inspirational support and encouragement during the process:

i. Dr. James Nyikal; ii. Dr. Kioko – Kidney Specialist; iii. Dr. Elly Ogutu; iv. Prof. Habinya; v. Dr. Gikonyo; vi. Dr./Surgeon/pathologist Baraza; vii. Dr. Minus (Anesthetist); viii. Dr. Suni, and; ix. Bone Marrow Specialist

The 15 Nurses under their Matron and the continuous improvement teams also deserve special mention.

Finally, it was amazing to be always woken up at 4.00 p.m. by laboratory technicians drawing blood for tests to monitor how I was doing medically and clinically.

In addition, I give special thanks to my colleagues for the moral support, wise counseling, spiritual support and material assistance. Finally, was the powerful spiritual network driven by network of faithful friends that unleashed a new life of hope in me. If you have gone through an experience in life, like the biblical Job (Ayub), and you have nothing to share with others, then you learnt nothing. I learnt something special and I have chosen to share it.

Mr Nalo was the Permanent Secretary in the Ministry of East African Community succumbed to cancer at the Nairobi Hospital on Thursday 13th September 2012