Dr. Abayomi Ajayi: Pioneering Technologies for Better Lifestyle for Nigerian Women

Dr. Abayomi Ajayi: Pioneering Technologies for Better Lifestyle for Nigerian Women

Medical Director of Nordica Fertility Centre, Dr Abayomi Ajayi, is saddled with the task to help improve the quality of life of the Nigerian women. In line with that objective, he recently spearheaded the procurement of a lifesaving technology, the High Intensity Focused Ultrasound new machinery which treats women with fibroids without going through the knife. Dr. Ajayi, who has always been a pioneer in Nigeria when it comes to women’s health, has proven once again to be ahead of the game with this novelty, being the first not just in Nigeria but in the West African sub-region. In this exclusive chat with MARY NNAH at his Ikoyi office, he assures that with HIFU in Nigeria, the lifestyle of women would be improved and their lifespan lengthened

What is about HIFU that makes it the talk of the town at the moment?

The High Intensity Focused Ultrasound (HIFU) is not totally new because it has been around in other parts of the world for about 20 years now but it’s completely new in Nigeria, in fact it is first of its kind in the West African sub-region.

As the name suggests -an ultrasound is sound but it is beyond what you can hear, that is why it is called ultrasound. It’s not within the hearing range of human beings.

Actually, what it does is to converge and convert sounds into heat and thereby burn the fibroids and the blood supply of the fibroids. But because it is focused, it only burns where you direct it. So you focus the beam on a particular point and it burns the fibroids there.

What are the benefits of this technology?

We are able to treat fibroids, adenomyosis, and solid tumours. In some places they are using it for some forms of cancer treatments. You don’t need to cut, you don’t need to transfuse blood and you know that in this environment, when we do fibroid surgery there is usually a lot of blood loss and so on. Most of the accidents that come from fibroid surgery come from two things: either paraesthesia or blood loss. But in HIFU, you don’t need any form of anaesthesia, because you don’t cut and you don’t lose blood. And then your recovery period is so short because by 48 hours later, you are good to do anything you want to do but we would usually say, rest for about 48-96 hours.

But you don’t stay in the clinic more than two hours after the procedure. You are good to go home as soon as you are done. The period that you use to recover is so fast that it looks like you have done nothing. And also because there is this condition called adenomyosis, which looks like a fibroid and sometimes it is what the doctors actually see and they think they are seeing a fibroid. Sometimes it is so difficult to differentiate between the two. And so this is a treatment that can also take care of adenomyosis at the same time as fibroid. So, it is a very good thing for people who have been suffering from adenomyosis.

You see some women have done two to three surgeries and within the space of two years they have done another one and on and on. Most of the time, it’s probably not the fibroid they are dealing with – in their cases, the fibroids are adenomyosis. The difference between fibroid and adenomyosis is that in fibroid, there is a capsule, so when the doctor does surgery, he can remove it from the capsule but in adenomyosis, there is no capsule at all, so the doctor can cut and he will not see anything to remove because adenomyosis is Endometriosis into the muscles of the uterus.

So in other words, in adenomyosis it is like the patient is just bleeding into the muscles of the uterus, so the doctor is not going to be able to remove anything. But HIFU is actually able to burn this off. With HIFU, we don’t remove fibroid, we burn it. You lie down on the bed and in about two hours you are told to stand up and that’s it! Nobody actually touches you to say they are cutting you.

Considering that a lot of Nigerian women have suffered severely from fibroid, why is HIFU just arriving in Nigeria?

The technology itself has gone through so many transformations and it is not particularly a very cheap technology. We had to hold our breath to be able to procure the machine but the advantages right now from all that we can see, is something that we really need in this environment. Fibroids are probably the commonest tumour that happens in women, especially in their reproductive age group, so when we knew that women in our environment stood about 80 percent likelihood of having fibroid by the time they were 50 years old, we felt it was something that should be brought here.

Aside from that, so many things are also happening that makes it very important for us to have it now. We read that 4,528 Nigerian doctors left Nigerian shores. So definitely, the number of doctors and qualified hands are reducing, so we need something that is more invasive and of course COVID-19 is around here and so surgical, except for emergencies are going down. So it is just a very good point to bring HIFU to Nigeria.

Can you tell us the cost implications of this technology?

I don’t talk about cost, I only give people an idea… the technologies is not particularly very cheap but what we have done is to try and bring it down to the level of what it will cost you to do surgery for fibroids in a hospital in this area so that cost will not be an issue for you in deciding whether to use HIFU or not. This is like us trying to make people see that this thing works. And right now, we have treated quite a number people as of today and all of them have been very happy with themselves. So we do not think cost is so much of an issue, especially now that Naira is losing value every day. So, we think it is something that is fair, especially compared to when you look at this technology in other parts of the world and how much they are charging for it and how much we are trying to charge. It is very affordable.

How many cycles do one need to go through before one gets a successful result? Most people will do it only once and are successful but then it depends on the number of fibroids you have and where they are located. But the majority of the people have only one section and they are good.

Who can use HIFU?

Almost everybody can use it but we cannot use it for women that are very obsessed because the pathway where the sound needs to pass through might be too deep and therefore, it might not be as effective as we want it to be. What we do is that we take a cut off of about 120kg, we don’t want to do HIFU on women above 120kg. But once you are able to lose weight to 120kg, you can do it. The next set of people we cannot use HIFU for are those that have passed through tummy tuck because the anatomy there might be a little bit distorted. So, we really don’t want to do HIFU for them. Apart from those two sets of people, almost everybody can do HIFU.

How safe is this procedure?

It is very safe but then, there is no technology that doesn’t come with side effects. Three main things can go wrong when you do HIFU but we take steps to prevent them.

The first thing that can happen is skin burns. That is why we don’t like to take people with scars on their abdomens. So, we don’t like taking people who have done tummy tuck because the scars on their tummies may absorb so much energy and then they would have skin burn.

The second aspect, which we don’t like to take but which we can still take but then we just need to be very careful with, are people who have had previous surgery, especially the vertical incision but people who have had the bikini (low transverse) incision can do HIFU. For them but for people who have had vertical incisions, we pick them carefully and do the assessment to ensure that they have a good pathway for the sounds to pass through so that nothing is at risk.

Thirdly, the intestine can be hot when you have this procedure and that is why we take preventive measures to ensure that it is safe for you before we can take you on. We have the rudiments for preparing the intestine when we want to do the procedures. So we empty your stomach of gas before you do the procedure because gas is a very bad transmitter of ultrasound.

Another thing is nerve injury for some people but this is also very preventable and that is why we do not allow patients to sleep, so that if they are having pains in their legs, they let us know. Usually because of the heat that is being transmitted to the fibroids, they could affect nerves. So, if you are having pain in your legs, you can let us know so that we can stop and change direction which the waves are coming through and then we can prevent nerves injury.

But these are very rare complications and these are just the only things that can possibly go wrong when you have HIFU. So HIFU is a very safe procedure that majority of the people when they do it, they are asking you if we have started when we are telling them to stand up and that we are done with the procedure.

Fibroids are sometimes a major cause of infertility in some women and they go to get rid of it because they want to get pregnant. Can one get pregnant after HIFU?

Sure, they can! Unlike surgery where you cut through the muscle, with HIFU, it is the fibroid itself that you target, so the muscles of the uterus are intact. But we would do an assessment before we give them that go ahead because there are a lot of people out there who apart from having Fibroids, are also having infertility. So what we tell them is that the Fibroid alone rarely causes infertility, so the first thing is to do a proper assessment for infertility before we even start treating your Fibroid.

For example, HIFU will take care of the Fibroid but will not take care of low or zero sperm count, which is a major factor that prevents fertility. But for the uterus, it is going to be good after the HIFU procedure and you don’t need to do a Caesarean Section after HIFU is carried out on you. If we cut into your uterus, we tell you that your delivery is by Caesarean Section and it is compulsory but with HIFU, you don’t need C&S.

Is there an age limit for the treatment?

Anybody can do HIFU as long as you have Fibroid.

This technology is not cheap like you mentioned earlier, so what informed your decision in bringing it to Nigeria, investing so much to ensure that Nigerian women have access to it?

First, Fibroids are very common and a lot of women are afraid of surgery because they think it puts their lives at risk. Truth be told, when you look at the records of complications coming from Fibroid surgeries all over Nigeria, you see that it is pretty high, it is as much as about 60 to 80 per cent. That is one of the reasons we need a method that does not require blood transfusion.

So, we think this has a lot of advantages for Nigerian women especially as pertaining to quality of life. Those are some of the reasons that made us say, it was better we have this technology in Nigeria.

Now, I must tell you that I have been following this technology for about 10 years now. I have followed it through all the stages of development until we got to a stage where we said this technology is ripe enough to come to Nigeria because it needs very little in terms of manpower and complications, so it is just the right technology for this kind of environment.

That means Nordica is a pioneer for HIFU in Nigeria.

We have only three of this kind of machine in Africa. One is in South Africa, one is in Egypt and here in Nigeria, we are the third.

How do you feel being a pioneer of such a life-saving technology in Nigeria?

I don’t feel anything. For us, it’s a good thing that we can contribute to improve the quality of life of Nigerian women. When we talk about healthcare in Nigeria and Africa, as a whole, it’s sad because there is not so much investment in healthcare. So, anything we can use to make our lives and healthcare better, I think is a welcomed development# Dr. Abayomi Ajayi: Pioneering Technologies for Better Lifestyle for Nigerian Women

Medical Director of Nordica Fertility Centre, Dr Abayomi Ajayi, is saddled with the task to help improve the quality of life of the Nigerian women. In line with that objective, he recently spearheaded the procurement of a lifesaving technology, the High Intensity Focused Ultrasound new machinery which treats women with fibroids without going through the knife. Dr. Ajayi, who has always been a pioneer in Nigeria when it comes to women’s health, has proven once again to be ahead of the game with this novelty, being the first not just in Nigeria but in the West African sub-region. In this exclusive chat with MARY NNAH at his Ikoyi office, he assures that with HIFU in Nigeria, the lifestyle of women would be improved and their lifespan lengthened

What is about HIFU that makes it the talk of the town at the moment?

The High Intensity Focused Ultrasound (HIFU) is not totally new because it has been around in other parts of the world for about 20 years now but it’s completely new in Nigeria, in fact it is first of its kind in the West African sub-region.

As the name suggests -an ultrasound is sound but it is beyond what you can hear, that is why it is called ultrasound. It’s not within the hearing range of human beings.

Actually, what it does is to converge and convert sounds into heat and thereby burn the fibroids and the blood supply of the fibroids. But because it is focused, it only burns where you direct it. So you focus the beam on a particular point and it burns the fibroids there.

What are the benefits of this technology?

We are able to treat fibroids, adenomyosis, and solid tumours. In some places they are using it for some forms of cancer treatments. You don’t need to cut, you don’t need to transfuse blood and you know that in this environment, when we do fibroid surgery there is usually a lot of blood loss and so on. Most of the accidents that come from fibroid surgery come from two things: either paraesthesia or blood loss. But in HIFU, you don’t need any form of anaesthesia, because you don’t cut and you don’t lose blood. And then your recovery period is so short because by 48 hours later, you are good to do anything you want to do but we would usually say, rest for about 48-96 hours.

But you don’t stay in the clinic more than two hours after the procedure. You are good to go home as soon as you are done. The period that you use to recover is so fast that it looks like you have done nothing. And also because there is this condition called adenomyosis, which looks like a fibroid and sometimes it is what the doctors actually see and they think they are seeing a fibroid. Sometimes it is so difficult to differentiate between the two. And so this is a treatment that can also take care of adenomyosis at the same time as fibroid. So, it is a very good thing for people who have been suffering from adenomyosis.

You see some women have done two to three surgeries and within the space of two years they have done another one and on and on. Most of the time, it’s probably not the fibroid they are dealing with – in their cases, the fibroids are adenomyosis. The difference between fibroid and adenomyosis is that in fibroid, there is a capsule, so when the doctor does surgery, he can remove it from the capsule but in adenomyosis, there is no capsule at all, so the doctor can cut and he will not see anything to remove because adenomyosis is Endometriosis into the muscles of the uterus.

So in other words, in adenomyosis it is like the patient is just bleeding into the muscles of the uterus, so the doctor is not going to be able to remove anything. But HIFU is actually able to burn this off. With HIFU, we don’t remove fibroid, we burn it. You lie down on the bed and in about two hours you are told to stand up and that’s it! Nobody actually touches you to say they are cutting you.

Considering that a lot of Nigerian women have suffered severely from fibroid, why is HIFU just arriving in Nigeria?

The technology itself has gone through so many transformations and it is not particularly a very cheap technology. We had to hold our breath to be able to procure the machine but the advantages right now from all that we can see, is something that we really need in this environment. Fibroids are probably the commonest tumour that happens in women, especially in their reproductive age group, so when we knew that women in our environment stood about 80 percent likelihood of having fibroid by the time they were 50 years old, we felt it was something that should be brought here.

Aside from that, so many things are also happening that makes it very important for us to have it now. We read that 4,528 Nigerian doctors left Nigerian shores. So definitely, the number of doctors and qualified hands are reducing, so we need something that is more invasive and of course COVID-19 is around here and so surgical, except for emergencies are going down. So it is just a very good point to bring HIFU to Nigeria.

Can you tell us the cost implications of this technology?

I don’t talk about cost, I only give people an idea… the technologies is not particularly very cheap but what we have done is to try and bring it down to the level of what it will cost you to do surgery for fibroids in a hospital in this area so that cost will not be an issue for you in deciding whether to use HIFU or not. This is like us trying to make people see that this thing works. And right now, we have treated quite a number people as of today and all of them have been very happy with themselves. So we do not think cost is so much of an issue, especially now that Naira is losing value every day. So, we think it is something that is fair, especially compared to when you look at this technology in other parts of the world and how much they are charging for it and how much we are trying to charge. It is very affordable.

How many cycles do one need to go through before one gets a successful result? Most people will do it only once and are successful but then it depends on the number of fibroids you have and where they are located. But the majority of the people have only one section and they are good.

Who can use HIFU?

Almost everybody can use it but we cannot use it for women that are very obsessed because the pathway where the sound needs to pass through might be too deep and therefore, it might not be as effective as we want it to be. What we do is that we take a cut off of about 120kg, we don’t want to do HIFU on women above 120kg. But once you are able to lose weight to 120kg, you can do it. The next set of people we cannot use HIFU for are those that have passed through tummy tuck because the anatomy there might be a little bit distorted. So, we really don’t want to do HIFU for them. Apart from those two sets of people, almost everybody can do HIFU.

How safe is this procedure?

It is very safe but then, there is no technology that doesn’t come with side effects. Three main things can go wrong when you do HIFU but we take steps to prevent them.

The first thing that can happen is skin burns. That is why we don’t like to take people with scars on their abdomens. So, we don’t like taking people who have done tummy tuck because the scars on their tummies may absorb so much energy and then they would have skin burn.

The second aspect, which we don’t like to take but which we can still take but then we just need to be very careful with, are people who have had previous surgery, especially the vertical incision but people who have had the bikini (low transverse) incision can do HIFU. For them but for people who have had vertical incisions, we pick them carefully and do the assessment to ensure that they have a good pathway for the sounds to pass through so that nothing is at risk.

Thirdly, the intestine can be hot when you have this procedure and that is why we take preventive measures to ensure that it is safe for you before we can take you on. We have the rudiments for preparing the intestine when we want to do the procedures. So we empty your stomach of gas before you do the procedure because gas is a very bad transmitter of ultrasound.

Another thing is nerve injury for some people but this is also very preventable and that is why we do not allow patients to sleep, so that if they are having pains in their legs, they let us know. Usually because of the heat that is being transmitted to the fibroids, they could affect nerves. So, if you are having pain in your legs, you can let us know so that we can stop and change direction which the waves are coming through and then we can prevent nerves injury.

But these are very rare complications and these are just the only things that can possibly go wrong when you have HIFU. So HIFU is a very safe procedure that majority of the people when they do it, they are asking you if we have started when we are telling them to stand up and that we are done with the procedure.

Fibroids are sometimes a major cause of infertility in some women and they go to get rid of it because they want to get pregnant. Can one get pregnant after HIFU?

Sure, they can! Unlike surgery where you cut through the muscle, with HIFU, it is the fibroid itself that you target, so the muscles of the uterus are intact. But we would do an assessment before we give them that go ahead because there are a lot of people out there who apart from having Fibroids, are also having infertility. So what we tell them is that the Fibroid alone rarely causes infertility, so the first thing is to do a proper assessment for infertility before we even start treating your Fibroid.

For example, HIFU will take care of the Fibroid but will not take care of low or zero sperm count, which is a major factor that prevents fertility. But for the uterus, it is going to be good after the HIFU procedure and you don’t need to do a Caesarean Section after HIFU is carried out on you. If we cut into your uterus, we tell you that your delivery is by Caesarean Section and it is compulsory but with HIFU, you don’t need C&S.

Is there an age limit for the treatment?

Anybody can do HIFU as long as you have Fibroid.

This technology is not cheap like you mentioned earlier, so what informed your decision in bringing it to Nigeria, investing so much to ensure that Nigerian women have access to it?

First, Fibroids are very common and a lot of women are afraid of surgery because they think it puts their lives at risk. Truth be told, when you look at the records of complications coming from Fibroid surgeries all over Nigeria, you see that it is pretty high, it is as much as about 60 to 80 per cent. That is one of the reasons we need a method that does not require blood transfusion.

So, we think this has a lot of advantages for Nigerian women especially as pertaining to quality of life. Those are some of the reasons that made us say, it was better we have this technology in Nigeria.

Now, I must tell you that I have been following this technology for about 10 years now. I have followed it through all the stages of development until we got to a stage where we said this technology is ripe enough to come to Nigeria because it needs very little in terms of manpower and complications, so it is just the right technology for this kind of environment.

That means Nordica is a pioneer for HIFU in Nigeria.

We have only three of this kind of machine in Africa. One is in South Africa, one is in Egypt and here in Nigeria, we are the third.

How do you feel being a pioneer of such a life-saving technology in Nigeria?

I don’t feel anything. For us, it’s a good thing that we can contribute to improve the quality of life of Nigerian women. When we talk about healthcare in Nigeria and Africa, as a whole, it’s sad because there is not so much investment in healthcare. So, anything we can use to make our lives and healthcare better, I think is a welcomed development.

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