Surgery only option for man with elephantiasis
ANTON du Plessis’s life changed when he contracted elephantiasis two years ago, a condition that sent his weight spiralling to 252kg, forced him to give up his job as a boilermaker, and effectively left him bedridden.
His hopes for a healthier future lie in gastric bypass surgery, which may bring his weight back under control. But he’s number 13 on a provincial waiting list for the operation, and doctors have told him that it’s unlikely to be scheduled before 2013.
“We can’t go on like this,” said his wife, Welma.
Elephantiasis is a disfiguring and painful disease, which results when an infected insect transmits a parasite into the skin of the human it bites. This causes tissue swelling, skin thickening and fluid retention, and in men, also extremely uncomfortable genital swelling.
The disease has affected Du Plessis’s movement, his heart, his body temperature, and so much more.
While the pain and occasionally the swelling can be treated, there is no cure or vaccine for the infection.
Du Plessis, 32, of Brackenfell in Cape Town, takes pills three times a day, but in the past month the infection has spread to his stomach and genitals.
Gastric bypass surgery would essentially zip-tie part of his stomach, so that he would be able to ingest only 50ml of food – rather than the typical three litres – before feeling full. While the reduced calories would avoid more weight gain, it would not address the disease itself.
Dr Shawn Williams, Du Plessis’s primary doctor who referred him to the Tygerberg Infectious Disease Clinic for the bypass surgery, said the obesity was exacerbating Du Plessis’s condition.
“If he lost weight, his condition would improve,” said Williams, who has been treating Du Plessis since late 2010.
“But he can’t lose weight because he can’t exercise. It becomes a vicious circle. But there is only so much your kidneys and other organs can take. Gastric bypass surgery would not help his disease, but it would help preserve his life.”
In the early stages of the disease, Du Plessis was treated with a Lympha Press, a machine that essentially “milks” tissues infected by elephantiasis.
Williams said Du Plessis could undergo major surgery to remove all the soft tissue around the muscle of his infected leg, which would then be covered with a skin graft. But the surgery was expensive, and the outcome often poor.
Meanwhile, Du Plessis is worried that he won’t live long enough to make it to the top of the waiting list. And the financial stress the family are under doesn’t help either.
“I can’t do what I did before, and I can’t go and look for work,” he said. “It’s a hell of a stress. I am not giving excuses. I am at a wall.”
One of the hardest things is that he has nothing to do.
“I am bored. I sit here on this couch and watch TV all day. I sleep here at night. I can’t go out and walk around. I can’t do anything.”
More than 120 million people are infected with elephantiasis, with about 40 million disfigured or incapacitated by it, according to the World Health Organisation (WHO) online. About 30 percent of those infected live in Africa, with others in southeast Asia and other tropical regions.
In 2000, the WHO began a programme to eradicate elephantiasis by 2020, and in the first decade of its existence the Global Programme to Eliminate Lymphatic Filariasis, more than 2.8 billion doses of medicine were delivered to a targeted population of 845 million people, according to its progress report.
By 2009, 19 countries that required mass drug administration had not yet received it. Of these countries, 15 are in Africa. The WHO reported that many of these countries were difficult to get to because of active conflict and fragile infrastructures.