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How I contracted spinal TB while treating a patient
Nurse Naomi Wanjiru who had TB of the spinal cord is now fully healed. PHOTO | SARAH OOKO
Just as other health care workers, when trained as a nurse, you learn to put your patients first. You always think about their wellbeing and ways of making them feel better. That’s nursing.
But sometimes tables turn and you end up on the receiving end — an ironical scenario of the health worker becoming the patient or the giver becoming the receiver. That is the story of my life.
In 2010, just three years into my nursing career, I was excited to get a promising job opportunity at Engineer District Hospital in Nyandarua.
I was posted there to work as a tuberculosis (TB) nurse in the hospital’s Comprehensive Care Unit (CCU) and I was glad to serve the approximately 20 TB patients that came to the facility daily. I talked with them, assessed their condition, listened to their concerns and advised on how to cope with the illness.
I was enjoying my work and everything seemed fine apart from the slight backache I began having six months into this new job.
But I had a ready solution. Pop a few painkillers. They seemed to do the trick. They numbed the pain and allowed me to go about my duties normally. Back pains are normal. It’s nothing to worry about. I know it will get better, I kept telling myself.
I shared the case with my colleagues and they assured me the pain was nothing serious and would probably be as a result of me pushing myself a little too hard at work. “Just take it slow and that pain will subside,” they said.
Incessant coughing
All these proposed solutions failed to provide a permanent remedy. The pain became intense and wouldn’t go away even as I kept increasing the dose of painkillers.
At some point, I couldn’t walk. I got worried and eventually decided to see a doctor.
An X-ray and MRI scan revealed that I had TB of the spinal cord. The bacteria had eaten up sections of my spinal cord, hence the intense pain and mobility struggles.
Most people are aware of open or pulmonary TB which affects the lungs. Once the TB-causing bacterium lodges itself deep in the lungs, the bug compromises its functionality, thereby causing incessant coughing that is a major symptom of the disease.
As soon as the TB bacterium gets into the body, you can’t tell where it will attack. Most of the time, it goes to the lungs. But other times, the blood transports it to other parts of the body like the spine, as was my case.
Actually, TB can affect all parts of the body except the nails and hair which have dead cells. So people can get TB of the spine, womb, eyes, brain and even bladder.
When the disease affects any other part of the body other than the lungs, it is referred to as extra-pulmonary TB.
Watching TV After my diagnosis, I immediately began the recommended six-month long TB treatment. As parts of my spine had severely been damaged by the disease, I was given a corset to support the back and advised to have complete bedrest to facilitate full recovery.
I went back home and would lie in my bed watching television from morning until evening for almost one year. I even had a catheter inserted in my body to pass urine as I couldn’t stand up to go to the toilet.
This was a stressful experience but I was able to go through it by the grace of God and overwhelming support that I got from my family. My son was only 10 years old then, but he would do almost everything in the house for me.
The fact that my employer was still paying my salary was also very helpful. I am happy that they stood by me during that low moment of my life. After completing the six month treatment programme, I went back for review. The drugs had not cleared the TB, I was heartbroken.
I began the second-line treatment course for TB for another two months which involved numerous injections and more bed rest. Gradually, my condition improved and after a year away from work, I was able to resume my duties at the hospital. But I had to wear a corset and use crutches to support my back and aid her movement.
Sh1.2m surgery
In early 2013, after three years on crutches, I travelled to India for a special surgery. Doctors removed sections of my spine that had been destroyed by TB and replaced it with metal plates to support my back.
The surgery cost Sh1.2 million, money which I had raised through the support of friends and family.
I stayed in India for a month. When I came back, my condition had improved. After just three weeks, I was walking well and back to my old healthy self. I thank God for my complete recovery.
The experience put me in the world of my patients and I was able to identify with some of the challenges they go through.
Having TB made me to realise how stigma hurts so much. No one wanted to come near me lest they get infected. Some would come to the house but sit far away from me. Yet, if you have extra-pulmonary TB, you cannot transmit it.
With lung TB on the other hand, people cough and emit TB germs which spreads the disease from one person to another. But when on treatment, the chances of spreading are lower.
I also had to deal with some of the side effects of TB treatment. For instance, I have been suffering from memory lapses but I am now on medication to rectify that.
Even though I know that I got TB from one of my patients, it never crossed mind to blame them for my predicament nor become bitter with my job. The experience strengthened my resolve to serve them even better.
Open windows
My plight also brought new changes to the hospital. The Centre for Health Solutions (CHS) Kenya in partnership with the United States Centre for Diseases Control (CDC) revamped the TB unit, making it well ventilated and equipped to prevent health workers getting infected. This should be replicated in all hospitals across the country.
What happened to me should never happen to anyone else. Care-givers should know how to protect themselves from TB infections while at work.
Open windows to ensure that the clinic is well ventilated. If a TB patient is coughing too much, they should cover their mouth and nose with masks. I would also like to discourage Kenyans from self-medication like I initially did with the pain-killers. Had I consulted the doctor early enough, I would have saved my spine from extensive damage.
Due to my commitment to eradicate TB, I won the prestigious Kochon prize in 2015. It is an annual honour to award individuals or organisations that have made a significant contribution in the fight against TB.
