HARD TO DIAGNOSE

Silent agony of thyroid disease patients

Thyroid disorder is an autoimmune disease that happens when one's immune system starts to attack a thyroid gland

In Summary

• Hand tremors and eyes bulging out among symptoms of mysterious disease

• Symptoms mimic psychiatric disorder, heart condition and bipolar disorder

Thyroid Diseses Awareness Kenya founder Sarah Katule shows a scar in her neck from thyroid surgery
Thyroid Diseses Awareness Kenya founder Sarah Katule shows a scar in her neck from thyroid surgery
Image: CORAZON WAFULA

Growing up in Machakos county, Faith Mbuva, 31, was an interesting child with an outgoing personality. She never thought she could one day experience suicidal thoughts.

Being a firstborn in a family of five, all she wanted was to be successful in life: drive big cars, own a business, set the pace for her younger siblings, who were looking up to her.

 

But her life took a dramatic turn in 2008, when she lost her mother due to thyroid storm (a severe, life-threatening condition caused by an excess of thyroid hormone). The doctors had done a surgery on her neck and failed to prescribe a replacement pill for her.

 
 

This affected Mbuva to the core. She had never experienced the loss of someone so close to her, and slowly by slowly, she was sinking into depression.

In 2010, Mbuva joined Machakos Technical Training Institute for a food and beverage course, and soon after, she started experiencing massive weight loss, abnormal increased appetite, hair loss, her legs and knees grew weak and started shaking as if she was having a seizure.

She also experienced hand tremors to the extent she couldn’t hold them firm for a manicure process. Her eyes started bulging out, her monthly periods stopped. She was withdrawn.

This was a strange health condition. No one in her family understood what was happening to her. Mbuva was so withdrawn to the extent she could not perform any house chores.

The relatives she had moved to stay with after her mother’s death misunderstood her and thought she was faking sickness. Mbuva said life became so unbearable at home.

She later went to hospital and after one doctor spotted her bulging eyes, she recommended her to do a thyroid function.

The results revealed her thyroid gland was producing excessive hormones, a condition known as hyperthyroidism.

 
 

“For a moment, I was happy what was ailing me had been discovered. I had previously done several tests, which showed I was all well yet I was sick,” she said.

 
Faith Mbuva in an interview with the Star
Faith Mbuva in an interview with the Star
Image: CORAZON WAFULA

LOST HOPE

However, Mbuva’s hope of getting well soon were dimmed after she could not get a specialist physician who could examine her further.

She was told at the facility that she could only see a physician after nine months as he was fully booked. That added to her frustrations.

At that point, she had lost hope and all she wanted was to end her life.

She one evening took an overdose of several drugs in the hope she would die. She was rescued by her sister, who found her in bed unconscious.

Mbuva’s story is no different from that of Winnie Mandela, a human resource officer at an NGO in Nairobi.

Mandela said she got to know about her thyroid status in November 2016 after she started experiencing hand tremors and frequent heart palpitations.

She told the Star her voice also became shaky, especially when talking before people. She could sound nervous, which was sending the wrong signals to people around her. Her workmates thought she was shy.

“I could not hold a glass of water or a cup of tea as my hands could visibly shake and then someone could jokingly ask if I consume chang’aa. For my shaky voice, someone could ask why I was speaking like one who wants to cry,” she said.

Winnie Mandela during an interview with the Star
Winnie Mandela during an interview with the Star
Image: CORAZON WAFULA

Being in a leadership position, she said, it was entirely embarrassing and her self-esteem was hit hard.

“As though that wasn’t enough, I remember in one instance, we were like 100 staff in for a new project. It was a three-day orientation programme. On this day, I accidentally shared a table with the company's CEO over lunch. With the hand tremor, I wouldn’t wish to sit next to such a high-profile person, as I could hardly bring food successfully to my mouth,” she said.

She said it was the longest lunch she has ever had. “In my mind, I was asking myself what my boss would have thought of me. That they hired the wrong person, probably, but I eventually left the table before finishing my food. Feeling useless,” she said.

It was after talking to a sister who had the same condition that she advised her to do a thyroid test, which showed she had an overactive thyroid.

She said at that point, her eyes had literally started bulging out.

“The issue of bulging eyes was a thorn in my flesh. I would walk around but keep thinking everyone is looking at my eyes, especially if I found someone staring at me,” she said.

Radio presenter Monicah Wangui, who underwent a partial thyroid gland surgery
Radio presenter Monicah Wangui, who underwent a partial thyroid gland surgery
Image: CORAZON WAFULA

DISCOVERED BY COLLEAGUE

Monicah, a radio presenter at a local media house, was diagnosed with overactive thyroid in September 2011 after a colleague at work alerted her that her neck looks swollen.

She immediately went to see a doctor at Kiambu Hospital but was referred to Kenyatta National Hospital, where a thyroid function test was done and it found out she had hyperthyroidism.

“I was put on medication for two years but there was no much change and I underwent a thyroid gland surgery at Kijabe Hospital in June 2013,” she said.

Wangui says after the surgery, she thought all was well until the symptoms recurred and after a few tests, it revealed that her thyroid gland was still overactive.

She was later put on a Radio Active Iodine (RAI). This is given as a pill to treat overactive thyroid by gradually shrinking or destroying the thyroid gland.

With destroyed thyroid gland, one has to be on a supplement known as Thyroxine for a lifetime.

“I felt like if my doctors were uninformed about this condition, I would not have to go through surgery then later a radioiodine therapy,” she said.

Despite the month of January being a thyroid diseases awareness month internationally, here in Kenya little has been said and little is known about the condition as millions of women suffer in silence.

Studies show that more women are affected by the disease than men at a ratio of 3:1.

Specialist physician Dr Bernard Gituma during an interview with the Star at ACE medical clinic
Specialist physician Dr Bernard Gituma during an interview with the Star at ACE medical clinic
Image: CORAZON WAFULA

CLUELESS DOCTORS?

In some instances, patients have received treatment for a different ailment as the disease symptoms tend to mimic other diseases.

Dr Bernard Gituma, a specialist physician, told the Star the disease is not easily diagnosed as the symptoms tend to mimic other diseases.

“The disorders many times mimic other medical conditions like psychiatric disorder, heart condition and bipolar disorder, making it hard to diagnose,” Gituma said.

He, however, pointed out some doctors have not been committal enough in picking out and diagnosing the disease.

He said thyroid disorder is an autoimmune disease just like diabetes, and it happens when one's immune system starts to attack a thyroid gland.

Dr Gituma said the problem tends to develop slowly, often over a number of years.

“At first you may barely notice symptoms like fatigue and weight gain, or one may simply attribute them to other factors, but as metabolism continues to slow, one may develop more obvious problems,” he said.

Gituma said it takes a doctor with a high index of suspicion to detect a thyroid condition in a first-time patient.

“We have had cases where doctors have misdiagnosed thyroid disease and put a patient on a cancer treatment or even heart conditions,” he said.

He said since diagnosing a thyroid condition requires special equipment, the government should have it in all major inpatient facilities so one can be tested like any other disease.

“This condition can be easily managed if it’s detected earlier,” he said.