Manawatū woman Helen Watson has spent six weeks in hospital since returning from Turkey, unable to eat, drink or walk. Photo / Jimmy Ellingham, RNZ
By Jimmy Ellingham of RNZ
Manawatū woman Helen Watson has spent six weeks in hospital since returning from Turkey, unable to eat, drink or walk.
She’s endured a further six operations and is now facing massive stomach reconstruction surgery.
Watson isn’t the first person who’s suffered complications from an operation abroad.
Checkpoint last month revealed the plight of another woman who’d spent three months getting fed through a tube due to problems caused by her gastric sleeve operation in Turkey, as warnings about medical tourism grow.
Watson travelled from her Feilding home to the Medicana International Clinic in Istanbul for the same surgery in September.
“When they woke me up, I knew something was wrong because straight away I spewed up blood,” Watson said.
“Even when I got to my room and through my six days there, I was vomiting blood - just vomiting, dry retching. I was so sick.”
Watson decided to head overseas for the operation because at $5500 it was cheaper than going private in New Zealand, even with travel costs on top of that taking it to about $10,000.
She’d have to spend about $20,000 for the operation in a private clinic here, and she didn’t want a lengthy wait on a public list.
She’s now warning people thinking of heading overseas though, to think twice.
After a few days of observations in Istanbul she was on her way home, first with a 17-hour flight from Turkey to Houston, and then the 13-hour leg to New Zealand.
“I had a wheelchair waiting for me in Auckland so they were able to wheel me from the international [terminal] to the domestic, then I could hop on the plane from Auckland to Palmy.
“I was still dry retching and vomiting, even when I got home.”
Days later, as her condition worsened, she went to see her doctor, who immediately sent her to Palmerston North Hospital because she had a life-threatening infection.
She is still there, confined to her bed, hooked up to machines that feed her.
“Even though I’ve still got drains in me I am still in a lot of pain. I’m on morphine. I came off my morphine pump, but I have liquid morphine that goes into my peg [feeding tube],” Watson said.
“It’s definitely taken a toll on me, mentally.”
For years Watson struggled to put on weight while on a cocktail of drugs for injuries suffered in a car crash.
But, as she’s slowly come off these, her weight increased and when she hit 80kg her BMI classed her as obese.
“I do feel quite ashamed, embarrassed that this has happened to me, even though people have said to me, ‘it’s not your fault’.”
RNZ requested an interview with Medicana, including about whether Watson could seek a refund.
In a statement attributed to Medicana Health Group, it said it couldn’t share detailed information about Watson due to privacy laws.
“However, as Medicana Health Group, we would like to emphasise that all medical procedures performed in our hospitals are carried out in full compliance with medical standards and applicable regulations,” the statement read.
“Prior to discharge, all necessary tests are conducted for our patients, and they are only discharged if no complications are observed and their overall condition is deemed suitable for discharge.”
It said all procedures were “carried out meticulously” when treating Watson.
“As the patient’s condition was appropriate and there were no complications or leaks, the patient was discharged with the necessary medical recommendations.
“However, it has been learned that after returning to their home country, the patient did not comply with the recommendations that were clearly explained in detail.”
Watson says she was unwell in Turkey and got worse on return to New Zealand.
Medicana Health Group said: “Furthermore, failure to adhere to the nutrition plan prepared by our dietician, or undergoing any medical interventions without the approval of our physicians after returning to their home country, falls outside our area of responsibility.”
Its team maintained continuous communication with Watson, as it did with all patients, it said.
“The current condition of the mentioned patient has resulted from inappropriate interventions and failure to follow the post-discharge recommendations. There was no error or negligence during the surgical process or the pre-discharge period.”
It dealt with 4.5 million patients a year including many from New Zealand. It said it hadn’t received any negative feedback from them.
Palmerston North Hospital upper gastrointestinal and bariatric surgeon Dr Alexandra Gordon said it was hard to know exactly what went wrong.
Because of a narrowing to Watson’s stomach, she developed a leak above that, but even with surgery doctors couldn’t get through the narrowed area.
Gordon suspected something went wrong with how Medicana applied staples.
“When you make a sleeve your stomach should be a long, narrow tube, but her tube is completely blocked,” Gordon said.
“To be honest, it’s just a mess. I’ve never seen anything as bad as it. Of course, all surgeries can have complications.
“I don’t think that particular severity of complication would happen in someone who’s trained to do sleeves to the standard that we are in New Zealand, Australia and the UK.”
Gordon has tried asking Medicana for Watson’s medical notes, but didn’t receive the information.
Watson faced a long recovery, Gordon said.
She should be able to return home soon, while still using a tube for feeding, but faced another operation in three or four months.
“She’s going to need major reconstructive surgery. Essentially, she’ll end up with almost a total gastrectomy, or completely losing her stomach, and we’ll need to do a Roux-en-Y reconstruction,” Gordon said.
“It’s going to be a very difficult operation because of the infection and inflammation that’s gone on up there.”
Health NZ’s chief medical officer Dame Helen Stokes-Lampard said more people were returning from overseas operations with complications.
“Occasionally they get off the plane quite unwell, but more commonly complications are developing in those first few weeks after the operation.”
She encouraged people thinking of getting operations abroad to research thoroughly and to get personal testimonials.
Stokes-Lampard said there were worrying situations were something was going wrong, but it wasn’t clear exactly what due to difficulties accessing information from overseas.
It was also recommended that people shouldn’t fly long-haul for four to six weeks after surgery.
If an operation resulted in problems it was unlikely patients or Health NZ could recover any costs.
“Overseas clinics are usually not regulated to the same standards or the same way that we have here in New Zealand, so you haven’t got legal comeback when things do go wrong.”
And for bariatric surgery, follow-up support was crucial.
About 500 patients a year could get bariatric surgery through the New Zealand public system.
Stokes-Lampard said Health NZ would love to offer more, and there were clear criteria about who was eligible.
-RNZ