On October 15, last year, Esther Kinuthia received a blood transfusion of nearly two pints at a hospital in Kerugoya, Kirinyaga County. What happened next changed her life...
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She had gone to the facility ahead of a surgery called turbinoplasty: an operation to reduce the size of swellings (turbinates) on the side wall of the nasal airways.
The previous day, October 14, her haemoglobin (Hb) levels had been tested and it was eight. Normal Hb for a healthy person should be 12 or higher.
“The Ear, Nose and Throat specialist who was to operate on me said I get transfused for surgery to be performed later when my Hb was back up,” she says.
Since high school, Esther had suffered from allergic reactions instigated by anything from dust to strong smells. Even her speech was affected: she speaks in a muffled voice: what others may call ‘speaking from the nose’. Her breathing is often affected and she has to breathe through the mouth.
“I also experience slight headaches and some discomfort,” she says.
The surgery was not a life-and-death situation, she admits. It would have qualified as an elective process.
“I sought the ENT specialist’s expertise and he conducted a scan which showed that I had enlarged turbinates,” she says.
“The surgery was to reduce the turbinates and give me a more normal breathing and speech,” Esther narrates.
She accepted the ENT specialist’s view that she undergoes transfusion. “The first pint went in without much occurrence,” Esther says. “But there was a problem with the second pint.” First, she felt hot flashes stroke through her body like electric current.
“Please stop the blood: there is something wrong,” she told the hospital personnel who arrived at her bedside when she pressed the panic bell.
The man did not stop the blood, telling her that it was the right blood and that the transfusion would go ahead. She rang the bell a second time when the discomfort was unbearable. The hospital staff who came suggested that they inject her with something to stop the reaction she was feeling.
After receiving the injection, almost immediately, Esther passed out. By the time she was regaining consciousness, the second pint was almost over.
“That’s when I called ACK Mt Kenya hospital, where I work as a nurse, to tell them what had transpired,” she says.
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Her expertise as a nurse came in handy. She says: “I knew that transfusion should not feel the way I was feeling.”
At ACK Mt Kenya, she says she was treated to counter effects of the transfusion and discharged to go home and rest. The day after discharge, she noticed that her abdomen was distending – like she was in early stages of pregnancy.
“I was not really alarmed because there was no pain,” she says.
On October 21, she started spotting blood. Earlier that month, on October 9, she had completed menstruation but still, she did not feel like it was a cause for worry. “After all, women can experience double menstruation in a month,” she says.
The red bulb flickered for her on October 23 when the bleeding increased abnormally and she was having dizzy spells.
“I went back to ACK Mt Kenya Hospital where I was treated with medicine to stop the bleeding. And it did stop,” she says. She went home for a few more days but on October 27, she was forced to head back to hospital as bleeding resumed, this time round, almost profusely.
“The bleeding was so bad. My stomach was still swollen. And I went to hospital before anything worse happened,” she says.
On that day, her Hb level had dropped to six. This was dangerously low. A doctor prescribed transfusion but Esther was already doubtful of blood transfusion after the October 15 incident.
On October 29, still admitted at the hospital, Esther was taken for an ultrasound scan. “The scan revealed that the blood was coming from the endometrium – the lining of the uterus,” she says. For some reason, her endometrium had filled up with blood.
Esther was told she had endometrial hyperplasia, a condition in which the endometrium (the lining of the uterus) becomes abnormally thick.
“I did a pregnancy test and it was negative,” she says.
The bleeding was not arrested. And by October 30 Esther was in bad shape. She could not stand on her own let alone walk.
At 2am, the next day, her Hb had fallen to for, sparking panic by medical personnel to get blood for transfusion. “But there was no blood,” she says. Her handlers had called hospitals and blood banks but there was no blood that could be safely transfused into her body.
Esther’s blood type is O-negative which makes her a universal donor – she can donate blood to anyone, really. However, she can only receive blood from an O-negative donor. As such, not many donors are available to donate to her.
By daylight, at 7am, Esther says she was pale white – having lost a lot of blood. By 7.30, faced with no option, Esther’s doctor told her that he was going to do explorative surgery to find the tissue that was bleeding and cut off leakage.
But it would have been foolhardy to wheel a patient in Esther’s state into surgery in the absence of blood for transfusion. Nonetheless, Esther was prepared to go into theatre as her doctor, an obstetrician and gynaecologist, had asked.
“At that moment, I concluded that I was dying. There was no way he could save my life. The odds were against me,” she says.
Esther was given medicine to boost her blood in the meantime. But time was of essence.
Her doctor had called for peer advice. “The first consultant to arrive looked at me and told the gynaecologist that the only way he would ever know the cause of the bleeding was through a post-mortem,” Esther says.
She was struggling to maintain consciousness but she heard those words. They confirmed her worst nightmare: dying on the surgical table.
Two other consultants went into the theatre and gave their verdict: “No hope.” Not deterred, and willing to risk it, the gynaecologist gave Esther consent forms for her to sign as he got ready to operate on her.
Her veins were collapsing and her pulse was faint. But the doctor found a line for blood transfusion just in case blood came from somewhere.
“I told him not to bother much because I knew I was going to sleep and I would wake up either in hell or in heaven,” she says.
As anaesthesia took effect, Esther resigned to fate. When she woke up, she was in great pain: from her lower abdomen.
“The doctor told me that I was neither in hell nor in heaven; that I would be taken to a general ward,” she says.
How was her life saved? Apparently, she says, O-negative blood was found as the surgery progressed — allowing the surgery to proceed with relative ease.
The doctor had gone into her abdomen and cut off the bleeding tissue, stopping the blood from leaking further. Esther today holds that gynaecologist in high regard. She believes he saved her life — even when his peers had ruled out such a possibility.
She learnt a few lessons from this ordeal. To start with, she says, it is important for doctors and medical professionals (herself included) to be more careful with their words as they handle critical patients.
“On your death bed you don’t really want to hear someone pronounce your death while you are still alive,” she says.
On that surgical table, feeling her life ebbing away, one thing plagued her mind.
“What will happen to my children?” she wondered. She had made peace with death. But it greatly bothered her that her two children would have an uncertain future without their mother.
She says: “My love for my children grew immensely afterwards. I now understood just how death is a whisker away.”
She has learnt to appreciate friends — especially the ones who were by her side, mourning, sad, yet supportive as she was fighting for her life.
“I have grown fonder of my family as well,” she says.
Esther suspects that something went wrong that October 15 — the first time she was transfused.
As it is, the turbinoplasty never happened. Esther still wishes that her turbinates would be corrected.
And the fact that the whole experience was sparked off by a corrective procedure — to improve the quality of life — she is astounded by the nature of human beings to seek things in life that may seem important yet those same things may cost us our lives.
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