Mysterious and hapless bulge

By Gardy Chacha

When Peter Ogech Kianga noticed a tiny lump developing on his left thigh, he never imagined it would develop thousand folds into a humongous mass of dreadful flesh. Then, at the clock of a new millennium in the year 2000, he was an active farmer and livestock keeper, earning a comfortable livelihood a family of five.

As time went by, what initially appeared pimple-sized kept growing bigger, but still, he thought it wasn’t cause for worry because to him, it was just another one of illnesses that pass with time.

However, Mzee Kianga, who hails from Borabu in Kisii, began realising that the growing lump wasn’t wilting off as he expected but instead, it seemed to grow in leaps and bounds, to the point that his trousers stopped fitting.

Whispers of witchcraft

When whispers started going round in the village that he was bewitched, he decided to seek medical help from a clinician in the nearby dispensary.  He was referred to Kisii town’s Level five hospital.

At the hospital, Mzee Kianga met doctors and clinicians who were unable to make out what caused the huge bulge on his thigh and gave conflicting information on what possibly ailed him.

“In my first two visits, after assessment, the medics booked me for a surgery to clear what they described as the lymphatic system of waste, which had accumulated. They removed a lot of waste from the growth,” said Mzee Kianga.

After the operation, to his amazement, the growth continued to increase in size, which prompted him to visit the hospital again several times in order to get the necessary palliatives. However, doctors said they didn’t know what sort of ailment was eating into his health and quarte-genarian vigour. He was forced to resign to the little comfort his homestead provided while the bulge spread throughout his leg to the sole of his foot.

At Kisii Level Five, Mzee Kianga says, the doctors had initially suspected cancer but numerous tests conducted gave negative results to cancer. The father of three says he now suffers not only from the awkward sessile lifestyle the mound of flesh on his leg has brought him, but also the pain he feels through his whole frame is beyond measurable peaks.

“I was farming maize, sugarcane and other crops but now even taking a few steps to the river is something I can’t do. My might has been muzzled, and this mound of flesh feels too heavy. I can’t even lift my leg,” says Mzee Kianga, adding; “Around here there’s nothing much anybody can do but I pray

that some rescue may come for this pain to go away.”

Dr Tang Daudi who works in Nairobi ssuggests that Mzee Kianga could possibly be suffering from Lymph Oedema (Lymphedema), a condition that is characterised by swelling in one or more extremities or appendages that result from impaired flow of the lymph in the lymphatic system.

Amputation

Primary Lymphedema is an abnormality of an individual’s lymphatic system and is likely present at birth (which points to the fact that it is highly hereditary) although symptoms may not become apparent until later in life.

The lymphatic system is a network of specialised vessels (lymph vessels) throughout the body whose purpose is to collect excess lymph fluid with proteins, lipids, and waste products from tissues or all cells in the body. This fluid is carried to the lymph nodes, which filter waste products and contain infection-fighting cells called lymphocytes.

The excess fluid in the lymph vessels is eventually returned to the bloodstream. However, in the case of Lymphedema, the lymph vessels get blocked and hence are unable to carry lymph fluid away from the tissues leading to localized swelling: Lymphedema.

For now, Mzee Kianga can only watch with hope that help will come his way before it’s too late. His wife, Hellen Nyanychama, tends to him with concoctions and drugs she buys from village doctors, when she can. Dr Daudi says Mzee  Kianga can only be helped through amputation because the malfunctioned

lymphatic system is networked throughout the swollen leg.

Symptoms of  Lymphedema

•     The swelling can occur in one or both arms or legs, depending on the extent and localisation of damage.

•     If the swelling becomes pronounced, fatigue due to added weight may occur.

•     Scarring of tissues, leading to a firm, taut swelling that does not retain its displacement when indented with a fingertip.

•     The skin in the affected area thickens and can also become scaly and cracked.

•     Affected areas may feel tender and sore, and loss of mobility or flexibility can occur.

•     The immune system becomes suppressed hence frequent infections and even a malignant tumour of lymph vessels known as Lymphangiosarcoma.