Lautaimi Faumuina, from American Samoa, underwent free surgery in Hamilton to reduce severe leg swelling.
Surgeon Simon Chong used liposuction, as Faumuina’s lymphoedema was too advanced for microscopic surgery.
Chong aims to bring advanced lymphoedema treatment to New Zealand’s public health system in the future.
It’s been years since Lautaimi Faumuina could lift his leg to walk, and more than a decade since he could fit a shoe on his right foot.
His right leg had become so swollen it was the size of a torso,encased in folds of fat, and the skin had become hard and calloused, overlapping his foot until only the ends of his toes peeked out.
The 55-year-old is here on a medical visa from American Samoa to have the life-changing surgery for free, which will give him back his mobility and allow him to once again wear shoes.
Faumuina developed lymphoedema from a parasitic infection over a decade ago, a common cause of the condition in the tropics.
Over years, his leg swelled bigger because part of his lymphatic system was blocked causing a build-up of fluid and fat.
“I try my best to walk ... it’s a big problem for me. I can walk about 10 metres, [after] only a few minutes I feel I want to sit down because it’s like a heavy bag of sand pulling if I walk,” he said.
Faumuina used a rope to lift his leg onto a bed, could no longer play golf and stopped working in 2012 when he was in his early 40s.
“Bigger and bigger, swollen ... it was really hard to work that’s why I resigned from my job.”
Photo: RNZ / Marika Khabazi
While visiting family in Auckland, Faumuina was put in contact with specialists who help to manage the condition, and surgeon Simon Chong, who has set up a practice specialising in microsurgery to prevent it.
A plastic and reconstructive surgeon, Chong operated on Faumuina’s foot to reduce the swelling with liposuction – the lymphoedema is too advanced for microscopic surgery that can prevent such swelling.
“I don’t think I will ever see another patient in my lifetime in New Zealand who was affected by lymphoedema as much as Lautaimi and his family,” Chong said.
“When I met him, his leg was the size of my torso. He did not walk into my room, he dragged his leg behind him because it was so heavy he couldn’t lift it off the ground and it was unrecognisable as a leg.”
He said others offered to help with Faumuina’s treatment and surgery, and the operation was done for free on Monday, facilitated by Anglesea Hospital in Hamilton.
Chong said advances in medicine meant if lymphoedema was treated early, people need not suffer swollen limbs.
In New Zealand, the condition is commonly the result of having lymph nodes removed in cancer treatment.
“It is part of the cancer journey that doesn’t necessarily end, even when you have beaten the cancer you always have this reminder of what has happened and you never fully return to normal...to the person you would have been had you never had the cancer,” Chong said.
“It’s a life sentence that you carry with you and we think that’s completely unnecessary.”
Chong said the New Zealand health system was simply managing the condition and that needed to change.
He has travelled overseas to train in microsurgery that re-routes the lymphatic system, using thread as thin as hair, with specialists in Sweden and Japan.
It’s the type of treatment that can prevent lymphoedema advancing but until now patients have had to travel overseas.
The Australian Lymphoedema Education, Research and Treatment Programme confirmed nine New Zealand patients had travelled to its Melbourne hospital for treatment since January last year, five of whom had microscopic surgery to re-route part of their lymphatic system.
Chong is a member of the Australasian Lymphology Association and has set up a private practice in Auckland with specialist equipment to treat the condition, within the Auckland Plastic Surgery Group in Highbrook.
“This is something that we can do for New Zealanders this is something that we can bring to New Zealand, educate people, educate the doctors, educate the patient and lift the standard of care to where we think it should be in this day and age.”
Chong said he realised early on that he would need to start this in private practice, because of the challenges facing the public healthcare system.
But he said his vision is that surgical treatment for lymphoedema will one day be available through the public health system.
“I do genuinely believe that those challenges will one day be met and so what we need to do in the meantime is do what we can to build up so ultimately we can pivot the service that we create into the public space so that all New Zealanders can access it.
Chong said his hope is that lymphoedema in New Zealand is a thing of the past because it will be prevented.
“We are just at the start of building a service but we want this eventually to be accessible to New Zealanders nationwide and we do eventually want the skillsets and the operations and the care to permeate and become a part of the New Zealand public health system.”
In the lead-up to the operation, lymphoedema therapist Diane Lacey worked with Faumuina to reduce the swelling in his leg with a combination of massage, exercise and compression garments.
She has helped hundreds of patients with the condition manage swollen limbs and said his leg was the worst she’s seen.
“When I first met Lautaimi, when we went to put the bandages on I couldn’t get my arms around his leg, his leg was so large...just with the bandages on it’s come down a tremendous amount.”
Lacey said having a surgeon trained to do specialist microsurgery to prevent the condition is a huge step forward.
Faumuina hoped to soon be lacing up his shoes.
“Since my leg is getting swollen no shoes fit ... hopefully I look forward to putting back shoes on my leg.”
