Seventeen-year-old Ayo Adewemimo was diagnosed of sickle cell anaemia at about age two. The first of three children – all boys – of Hakeem and Gbolabo Adewemimo, Ayo had all the care possible from his parents and medical personnel and coped with the challenges of being a sickle cell patient.

His parents spared no cost or time to make him overcome the trauma that comes with his medical condition. Ayo did not allow his situation to adversely affect his academic life. He also participated in sporting activities, including football and cricket. But his condition changed for the worse five years ago.

Ayo began to experience severe pain, stiffness, shortening in right hip and difficulty in walking. Increasingly, Ayo, then a student of Bridge House College, Dolphin Estate, Lagos, found it difficult to walk. His extracurricular activities began to suffer and he was mostly confined to the same spot. He was diagnosed of hip dislocation.

Ayo recalled: “The sickle cell made me have a lot of pains on my joints and this made me miss classes and school lessons. I wasn’t coping well in school and this led to the dislocation and I started limping, which required me to use crutches. I felt a little bit unsure while in school and among my friends.”

While some of Ayo’s friends and schoolmates helped him through his medical challenge, others would just not care. According to his mother, Gbolabo, “some were a bit mean and he often complained of some of his colleagues not wanting to associate with him because he was limping and using crutches. And they made him feel they were not on the same level. They don’t want to talk to him and he couldn’t take part in sports.”

However, as the boy, who has now graduated from Bridge House College and has the ambition of studying IT Security at the University of Dubai, went through the pains and stigmatisation, his parents and sibling gave all the support, while seeking solution.

Ayo was taken to several hospitals in Nigeria, including the National Orthopaedic Hospital, Igbobi, Lagos. “I wasn’t too comfortable with the arrangement at Igbobi,” Hakeem, Ayo’s father, began. “I wanted something good and something I can be very sure of the result. I spoke to some people. Some said United States, Europe and India. But what took me to India was when I went on the internet to search for surgeons for hip replacement and I came across Dr. Raju Vaishya of Indraprastha Apollo Hospitals, New Delhi.”

Mr. Adewemimo sent his son’s X-ray to Apollo Hospitals as requested and he was told the procedure could be handled. But the boy had to wait for some time. “We had a challenge because they said he had to be of age before they could do it,” Mr. Adewemimo recalled. “The hospital explained that if they do it earlier than that, they will have to do it some other time later and the success rate of the second time is about 30 per cent, which is not even guaranteed. So that’s why we had to wait for him to come of age before we decided to go ahead with it.”

Mr. and Mrs. Adewemimo travelled to India with their son, Ayo, in June this year. The hospital discovered that due to the sickle cell disease, Ayo had developed Avascular Necrosis (AVN) of the femoral head of both hips, with secondary arthritis in the right hip.

In Nigeria, doctors had been apprehensive in performing total hip replacement because the patient was very young. But the doctors at Apollo Hospitals took the risk. On July 15, Dr. Vaishya, who had examined the patient and approved total hip replacement surgery, led the surgery team. According to Dr. Vaishya, a Professor of Orthopaedic Surgery, “total hip replacement was done using uncemented joint components with ceramic bearings and large diameter head. A special care was taken to prevent sickle cell crises during peri operative period, by providing adequate hydration and oxygenation to the patient. The intraoperative and postoperative period was uneventful.”

The preoperative pain of hip arthritis has completely gone after the surgery and now Ayo has started taking his first pain-free steps after a long time. Ayo is now confident that since he has been operated successfully, he is raring to take life head on without any pain and disability in the hip.

Ayo’s case was unique in many ways, especially as he was a young boy with hip arthritis due to sickle cell disease. Total hip replacement surgery at such young age is extremely rare and is often not required. But due to his severe hip problem, there was no better solution than total hip replacement to treat it. “He may require revision THR surgery in future, due to wear and tear of the prosthesis. But still he will be able to lead an active and pain-free life in his youth and prime time of life,” Dr. Vaishya assured.

Mr. Adewemimo was impressed about the way Apollo Hospitals handled her son’s situation even as it was the first case of its kind. “The doctor (Dr Vaishya) was optimistic. And even when they did the x-ray, it was much clearer and revealed the situation to be worse more than he first thought, unlike what they saw in the x-ray we had earlier sent to them. Even at that, he was confident it will be successful and as it were, it proved to be.”

Ayo, who is the one who feels it, said he is on the way to full recovery. His words: “On my leg, after the surgery, I could make some movement which I was unable to do before. Just two weeks after the procedure, I could raise my leg to a certain angle from the foot to the knee and up to the hips. It was much better and I do exercises with much strength. Emotionally, I thank God this has been taken care of and finally maybe I will be accepted more among my peers because then I was limping and some do call me Fela” (in reference to the late Afrobeat King Fela Anikulapo Kuti after his encounter with the soldiers who threw him out of his burning residence in the late 1970s).

In another four months, Ayo should be able to throw away the crutches and walk unaided as he prepares for life in the university. On why he wants to study IT Security, the bubbly young man said he would like to be like Edward Snowden, the 31-year-old American who is credited with the landmark revelation of the National Security Agency’s numerous classified documents to Glenn Greenwald and Laura Poitras, both journalists.

Such an avant-garde proposition by a 17-year-old who is determined to have the world at his feet!

•Photo shows Dr. Raju Vaishya of Indraprastha Apollo Hospitals, New Delhi with Ayo Adewemimo.

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