Helen Watson is facing stomach reconstruction surgery on Monday after an operation in Turkey went wrong. Photo / Jimmy Ellingham, RNZ
By Jimmy Ellingham of RNZ
A Manawatū woman is days away from a full stomach reconstruction five months after a weight-loss operation in Turkey went wrong.
Since returning home and falling unwell, Helen Watson endured almost two months in hospital and half a dozen smaller operations.
While she hopes Monday’s surgery signals the start of her recovery, her battle for compensation has stalled as the Turkish clinic that performed the operation denies it is to blame.
At her Feilding home, a feeding tube attached to her stomach, Watson is steeling herself for an all-day operation.
“It’s now starting to hit how surreal this whole thing is. I’m scared. I’m not going to lie to you – I’m really scared. I’m really nervous about it.
“I’m just kind of pushing people away because I don’t want them to worry for me. It really sucks that this has happened to me.”
Watson paid about $5500 for the operation at the Medicana clinic in Istanbul because she knew she would not get on the public waiting list in New Zealand as she did not have an illness such as diabetes.
Instead her weight hit 80kg, which in her small frame was classed as obese, after she came off a cocktail of drugs she took for years after a car crash.
A gastric sleeve operation performed privately in New Zealand could cost $40,000, which was out of her financial reach and why Watson looked overseas.
But now she does not know what life will look like.
“I don’t know what my body is going to do and how well it’s going to heal or what other complications are going to arise later on. I may not be 100%,” she said.
“I’m just sitting on the fence for this and letting my body do what it’s got to do.”
Her New Zealand surgeon previously told RNZ it was hard to know exactly what went wrong, but it could be a problem with a staple.
A statement from Medicana said it categorically denied failures with the surgery.
“As documented in the clinical report, the laparoscopic sleeve gastrectomy was performed in accordance with internationally accepted standards, with no intraoperative complications and no evidence of leakage at discharge,” it said.
“Post-operative follow-up communications indicate the patient initially reported feeling well and did not raise medical concerns until after undergoing procedures at an external facility abroad.”
Watson denied this, saying she realised straight away something was wrong.
But Medicana said when she was discharged there was no clinical evidence of leakage or complications.
“Medicana does not accept that there is evidence demonstrating surgical error. Medicana stands by the integrity of its surgical and post-operative processes.”
Medicana said there was no basis for compensation, although it was “open to reviewing any independent medical documentation that may be provided” and to communicating with Watson through “appropriate medical and legal channels to review any new clinical evidence in a professional setting”.
Medicana representatives were travelling to New Zealand next month for routine business reasons, and Watson said she would like to meet with them.
She said Medicana had also made legal threats about her speaking out.
“There’s a lot of things that need to be fixed. I’d like my money back, absolutely. I’d like my flights [paid for],” Watson said.
“I even sent them an email asking them for my money back and my flights. My brother-in-law helped me with that letter. Then they came back and said they wanted to sue me.”
Medicana said it sought legal advice in New Zealand about Watson’s public allegations, but had not initiated legal proceedings.
Watson had thought about engaging a lawyer in Turkey, but that came at a cost.
With medical tourism growing, Auckland surgeon Dr Richard Babor said it had reached the point where there was almost always someone in Middlemore Hospital with post-operation problems from overseas surgery.
“We’ve seen increasing numbers of people show up on our acute workload here at Middlemore Hospital.
“Some of them have relatively minor post-operative issues that are easy to sort out. There is a small proportion of them who have quite serious complications from having had surgery, both in Turkey and in Mexico.”
New Zealand’s system was picking up the pieces when something went wrong, although for most people getting on the public waiting list for weight loss surgery was impossible, he said.
“Here at Middlemore Hospital we do about probably 100 a year, which is a very small number compared to the number of obese people who are in our population, and it’s even quite small compared to the number who are referred to us for surgery.
“We’ve got quite strict criteria that the patients need to satisfy.”
Health NZ previously told RNZ about 500 people a year got bariatric surgery through the public system, where aftercare is included.
Babor said hospitals had been approached by medical tourism organisations to see if they would look after returning patients, but he said this was not possible because of limited resources.
“We can’t run a service that does aftercare for some people who are doing surgery in Turkey or Mexico or Thailand or India, or wherever it is.
“We would be overwhelmed and we wouldn’t be able to do any surgery on our own patients. We’d just be providing a follow-up service.”
Babor said no official numbers were kept about people affected by overseas surgery going wrong, but it was something bariatric surgeons talked about and would consider.
Watson did not use a medical tourism operator, organising her trip to Turkey herself, but growing numbers of people were paying for organised trips.
Vanessa Warren owned Total Transformation Tours, which took clients to Mexico for bariatric surgery. She said after research, and 20 years of experience in bariatrics, she found a clinic and surgeon with a good reputation and thorough after-surgery care.
“Any surgery is going to potentially have complications – whether it’s New Zealand, Mexico, anywhere, there’s potential for complications.
“So, one thing I do like about the surgeon that we use is she does a double leak test so that she makes sure that nothing is leaking during surgery and then the day after.”
Warren encouraged people to research overseas options thoroughly, saying cheaper was not always better.
Her company provides aftercare for 12 months as part of its package and she accompanies clients on the trips and monitors them after their operations, and wouldn’t take a group greater than five people.
“People would definitely prefer to do it in New Zealand, but it’s just not a reality anymore... I do feel very sorry for people who have had bad experiences overseas.”
Warren said having weight-loss surgery overseas was viewed differently to other operations, such as dental ones.
“It’s a very hot topic and everyone has an opinion about it, and there’s a lot of judgment out there for people.
“I think we need to remove a bit of that stigma. We have to be realistic that people can’t afford healthcare in New Zealand, so they are looking overseas.”
The Accident Compensation Corporation said it might cover treatment injuries from overseas operations if an injury met its criteria, and that any cover was decided on a case-by-case basis.
– RNZ