Monday, September 15, 2014

Must Read:I Found Patrick Sawyer Dead- Doctor Who Survived Ebola Opens Up

  
For many who were infected with the Ebola disease, it marked the end of their lives.
However, one doctor, who contracted the disease from Liberian-American, Patrick Sawyer, lived to tell the story.
Dr. Ada Igonoh, who worked alongside late Dr. Ameyo Adadevoh at First Consultant Medical Center in Obalende, Lagos, has opened up about her ordeal.
Excerpts below:

On the night of Sunday July 20, 2014, Patrick Sawyer was wheeled into the Emergency Room at First Consultants Medical Centre, Obalende, Lagos, with complaints of fever and body weakness.
The male doctor on call admitted him as a case of malaria and took a full history. Knowing that Mr Sawyer had recently arrived from Liberia, the doctor asked if he had been in contact with an Ebola patient in the last couple of weeks, and Mr. Sawyer denied any such contact. He was admitted into a private room and started on antimalarial drugs and analgesics. That night, the full blood count result came back as normal and not indicative of infection.
The following day however, his condition worsened. He barely ate any of his meals. His liver function test result showed his liver enzymes were markedly elevated. We then took samples for HIV and hepatitis screening.
The following day, the results for HIV and hepatitis screening came out negative. As we were preparing for the early morning ward rounds, I was approached by an ECOWAS official who informed me that Patrick Sawyer had to catch an 11 o’clock flight to Calabar for a retreat that morning.
 He wanted to know if it would be possible. I told him it wasn’t, as he was acutely ill. Dr. Adadevoh also told him the patient could certainly not leave the hospital in his condition. She then instructed me to write very boldly on his chart that on no account should Patrick Sawyer be allowed out of the hospital premises without the permission of Dr. Ohiaeri, our Chief Medical Consultant. All nurses and doctors were duly informed.
During our early morning ward round with Dr. Adadevoh, we concluded that this was not malaria and that the patient needed to be screened for Ebola Viral Disease. She immediately started calling laboratories to find out where the test could be carried out.
Dr. Adadevoh at this time was in a pensive mood. Patrick Sawyer was now a suspected case of Ebola, perhaps the first in the country. He was quarantined, and strict barrier nursing was applied with all the precautionary measures we could muster.
On the morning of Wednesday 23rd July, the tests carried out in LUTH showed a signal for Ebola. Samples were then sent to Dakar, Senegal for a confirmatory test.
The following day, Thursday 24th July, I was again on call. At about 10.00pm Mr. Sawyer requested to see me. I went into the newly created dressing room, donned my protective gear and went in to see him.
At 6:30am, Friday 25th July, I got a call from the nurse that Patrick Sawyer was completely unresponsive. Again I put on the protective gear and headed to his room. I found him slumped in the bathroom. I examined him and observed that there was no respiratory movement. I felt for his pulse; it was absent. We had lost him. It was I who certified Patrick Sawyer dead.
I informed Dr. Adadevoh immediately and she instructed that no one was to be allowed to go into his room for any reason at all. Later that day, officials from W.H.O came and took his body away. The test in Dakar later came out positive for Zaire strain of the Ebola virus. We now had the first official case of Ebola virus disease in Nigeria.
It was a sobering day. We all began to go over all that happened in the last few days, wondering just how much physical contact we had individually made with Patrick Sawyer.
On Friday 1st of August, my temperature read a high 38.7c. As I type this, I recall the anxiety I felt that morning. I could not believe what I saw on the thermometer. I ran to my mother’s room and told her. I did not go to work that day. I cautiously started using a separate set of utensils and cups from the ones my family members were using.
On Saturday 2nd of August, the fever worsened. It was now at 39c and would not be reduced by taking paracetamol. This was now my second day of fever. I couldn’t eat. The sore throat was getting worse. That was when I called the helpline and an ambulance was sent with W.H.O doctors who came and took a sample of my blood. Later that day, I started stooling and vomiting. I stayed away from my family. I started washing my plates and spoons myself. My parents meanwhile, were convinced that I could not have Ebola.
The following day, Sunday 3rd of August, I got a call from one of the doctors who came to take my sample the day before. He told me that the sample which was they had taken was not confirmatory, and that they needed another sample. He did not sound very coherent and I became worried.
They came with the ambulance that afternoon and told me that I had to go with them to Yaba. I was confused. After all, my contact with Sawyer was minimal. I only touched his I.V. fluid bag just that once without gloves. The only time I actually touched him was when I checked his pulse and confirmed him dead, and I wore double gloves and felt adequately protected.
The ambulance door opened and a Caucasian gentleman approached me but kept a little distance. He said to me, “I have to inform you that your blood tested positive for Ebola. I am sorry.” I had no reaction. I think I must have been in shock.
My parents called. My uncle called. My husband called crying. He could not believe the news. My parents had informed him, as I didn’t even know how to break the news to him.
Every morning, I began the day with reading and meditating on Psalm 91. The sanitary condition in the ward left much to be desired. The whole Ebola thing had caught everyone by surprise. Lagos State Ministry of Health was doing its best to contain the situation but competent hands were few. The sheets were not changed for days.
The floor was stained with greenish vomitus and excrement. Dr. David would come in once or twice a day and help clean up the ward after chatting with us. He was the only doctor who attended to us.
There was no one else at that time. The matrons would leave our food outside the door; we had to go get the food ourselves. They hardly entered in the initial days. Everyone was being careful. This was all so new. I could understand, was this not how we ourselves had contracted the disease? Mosquitoes were our roommates until they brought us mosquito nets.
Later that evening, Dr. David brought another lady into the ward. I recognized her immediately as Justina Ejelonu, a nurse who had started working at First Consultants on the 21st of July, a day after Patrick Saywer was admitted.
 She was on duty on the day Patrick reported that he was stooling. While she was attending to him that night, he had yanked off his drip, letting his blood flow almost like a tap onto her hands. Justina was pregnant and was brought into our ward bleeding from a suspected miscarriage. The news that she had contracted Ebola was broken to her the following day after results of her blood test came out positive. Justina was devastated and wept profusely – she had contracted Ebola on her first day at work.
My husband started visiting but was not allowed to come close to me. He could only see me from a window at a distance. He visited so many times. It was he who brought me a change of clothes and toiletries and other things I needed because I had not even packed a bag. I was grateful I was not with him at home when I fell ill or he would most certainly have contracted the disease. My retreat at my parents’ home turned out to be the instrumentality God used to shield and save him.
I researched and found out all I could about the strange disease that has been in existence for 38 years. My research, my faith, my positive view of life, the extended times of prayer, study and listening to encouraging messages boosted my belief that I would survive the Ebola scourge.
Ebola can be likened to a multi-level, multi-organ attack but I had no intention of letting the deadly virus destroy my system. I drank more ORS. I remember saying to myself repeatedly, “I am a survivor, I am a survivor.”
Shortly after Justina came into the ward, the ward maid, Mrs Ukoh passed on. The disease had gotten into her central nervous system. We stared at her lifeless body in shock. It was a whole 12 hours before officials of W.H.O came and took her body away. The ward had become the house of death. The whole area surrounding her bed was disinfected with bleach. Her mattress was taken and burned.
To contain the frequent diarrhea, I had started wearing adult diapers, as running to the toilet was no longer convenient for me. The indignity was quite overwhelming, but I did not have a choice.
I kept encouraging myself. This could not be the end for me. Five days after I was admitted, the vomiting stopped. A day after that, the diarrhea ceased. I was overwhelmed with joy. It happened at a time I thought I could no longer stand the ORS. Drinking that fluid had stretched my endurance greatly.
On my 10th day in the ward, the doctors having noted that I had stopped vomiting and stooling and was no longer running a fever, decided it was time to take my blood sample to test if the virus had cleared from my system.
They took the sample and told me that I shouldn’t be worried if it comes out positive as the virus takes a while before it is cleared completely. I prayed that I didn’t want any more samples collected from me. I wanted that to be the first and last sample to be tested for the absence of the virus in my system.
The following night, Dr. Adadevoh was moved to our isolation ward from her private room where she had previously been receiving treatment. She had also tested positive for Ebola and was now in a coma.
We all hoped and prayed that she would come out of it. It was so difficult seeing her in that state. I could not bear it. She was my consultant, my boss, my teacher and my mentor.
She was the imperial lady of First Consultants, full of passion, energy and competence. I imagined she would wake up soon and see that she was surrounded by her First Consultants family but sadly it was not to be.
Two days later, on Saturday the 16th of August, the W.H.O doctors came with some papers. I was informed that the result of my blood test was negative for
My recovery after discharge has been gradual but progressive. I thank God for the support of family and friends. I remember my colleagues who we lost in this battle. Dr. Adadevoh my boss, Nurse Justina Ejelonu, and the ward maid, Mrs. Ukoh were heroines who lost their lives in the cause to protect Nigeria. They will never be forgotten.
Early detection and reporting to hospital is key to patient survival. Please do not hide yourself if you have been in contact with an Ebola patient and have developed the symptoms.
I don’t claim to have all the answers to the nagging questions of life… All I know is that I walked through the valley of the shadow of death and came out unscathed.

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