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Death of the First Lady of Nigeria By Stephen K. Odaibo
To learn that the first lady died following liposuction surgery is not only disturbing and distressing but agonizing as well. Liposuction is generally an outpatient procedure aimed essentially to aspirate excess fat from the anterior abdominal wall and sometimes the upper thigh. Liposuction is not recommended in women with abdominal fat apron; rather a formal surgical excision of fat and excess skin with abdominoplasty should be carried out. Liposuction is reserved for those with taut abdomen and because both procedures are attended by much bleeding it is imperative that any blood loss in excess one litre must be replaced and the patient transfused with blood, failing which the resultant hypovoleamia leads to shock and possible death. To give you a rough idea, for every 2 litres (2kg.) of fat aspirated, the patient loses one litre of blood. Liposuction is thus suitable for those with humps and pumps just below the umblicus as diet and exercise with discipline are best for some.
For most women and men above 50years of age who wish to maintain stable body weight, one meal a day will suffice. For those who cannot stand one meal a day, that same meal can be split and taken twice. The omitted meals are replaced by non-sugary fluids like tea or coffee. A fast once a week with prayers is also recommended. Men store fat inside the abdomen and such visceral fat are very dangerous and lead to myocardial ischaemia and endocrine pancreatic insufficiency and in expressed circumstances, sudden death.
In effect, liposuction and abdominolipoplasty have attended postoperative complications. Following the procedure, bleeding is stemmed by the application of abdoninal binder or skin strapping. The greatest danger I find is from pulmonary fat embolism especially at night and if it occurs unrecognized leads to death before dawn. Patients can also die from adrenaline toxicity which is incorporated in the local anesthetic agent used to infiltrate the skin prior to fat aspiration. Those patients admitted to hospital who remain immobile and are not given intermittent pneumatic compression of their lower extremities, may develop deep vein thrombosis and if this propagates, it leads to pulmonary embolism and death at night if it passes unrecognized. Death often occurs at night because the staff complement on night duty is thin for adequate coverage. A local private night nurse should be recruited in such circumstances. It is important that a thorough and assiduous preoperative evaluation of the patient is carried out to correct any premorbid conditions. This cannot be done in a hurry. Preoperative physiotherapy and breathing exercises are essential and mandatory, followed by early postoperative ambulation.
For an important personality like the first lady, an advanced party of Nigerian surgeon to the hospital where the surgery took place would discuss the implications of the surgical procedure they plan to use and be present at the operating theatre at the time of surgery and to make sure that she is not included in any new randomized surgical research trial. Some overseas hospitals are not as meticulous as you may think especially when she is addressed as that black lady and not as the first lady at least for her monetary worth. What I am trying to say is that all that glitters is not sarcoidosis. Nigeria must have faith in their surgeons.
Taking a roll of surgeons in West Africa some years ago, I found that there were more surgeons at the University of Ibadan alone than the entire country of Ghana.
Negligence must not be ruled out as a cause of death and I recommend that a post-mortem examination on her remains and a coroner's inquest when she arrives the country. An investigative panel must be set up to look into her death which touches not only Mr. President and her family but every Nigerian as well. May her soul rest in perfect peace.
Look not up unto thine things only but unto the things of others also. For if ye salute your brothers only what reward have ye. Make someone happy today and every day,
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