This narrative is written in retrospect — 5 years after the event. I appreciate that the story is rather long, but I've tried to include anything of relevance to victims and their families, and possibly, to physicians dealing with this dreadful trauma.
My wife, Ngaire, is some 18 years younger than I. We were both previously married and I have two grown-up sons by my first marriage. Ngaire had no children at the time we first met but, at age 29, she was eager to start a family. After years of trying and numerous unsuccessful IVF procedures, at age 35, she finally conceived (naturally).
Nothing could describe the happiness she felt, especially when amnio centesis revealed that our baby would be a girl — just what my wife had always wanted! Her pregnancy went smoothly. She was in robust health — no nausea, no elevated blood pressure, just blissful happiness. Except! Every now and then, she had dizzy spells and almost passed out! And afterwards, she'd complain of a funny taste and smell, that she could never identify. She informed her GP and her gynacologist, who both put it down to her pregnancy and told her that nothing was untoward.
Easter Monday, 16th April, 1990, saw my wife's life-long ambition come to fruition! She went into labour the night before and I took her to hospital early the next morning. Her gynacologist arrived early to check on her condition and the hospital staff could not have been more caring and solicitous. After one particularly severe labour pain, she needed to go to the toilet and, whilst washing her hands afterwards, called out that she couldn't move. The midwife wasn't at all alarmed, but told her just to rest while she recovered. However, the midwife did call the gynacologist, who responded promptly. After a brief report and examination, he asked if she would like to have an epidural block, which was duly administered. The rest of her labour was (relatively) a breeze and, about 2pm, she gave birth to our daughter, Ayesha (a Middle-Eastern name, meaning "woman" or "Princess" as in Rider Haggard's "She"). And what a "Princess" she was: smooth, fair (almost alabaster) skin, and the deepest, dark-blue eyes, you could ever imagine! A very alert and Contentsed baby, Ayesha thrived on the breast and grew into quite a chubby infant.
Then without warning, about 9am, Sunday 10th June, when Ayesha was barely 2 months old, my wife's dream almost came to an end! She'd been awake since 5am for the early morning feed and, being Sunday, had indulged me the luxury of a cup of tea and the paper in bed. She'd just been to the toilet and, while returning to the bedroom, screamed out that she had a "terrible headache and couldn't move her leg!" I jumped out of bed and found her rivetted to the lounge room floor, unable to move! I picked her up and lay her on our bed, where she complained of the "worst headache, I've ever had" and pleaded, "Please don't let me die!" She felt quite nauseous and wanted to be sick, so I raced to grab a basin. After a couple of dry retches, she suddenly went rigid! Her back arched, her eyes rolled back, and she began twitching violently. Her breathing was harsh and sounded like a death rattle! I thought she'd had a stroke, but now know it was a seizure resulting from a burst aneurysm!
I rolled her onto her side, made sure she hadn't swallowed her tongue and, briefly, considered bundling her into the car and racing her off to the local hospital. But then remembered Ayesha!. My next thought was to rouse our neighbours and get some help - but they were away for the long weekend. Finally, I dialled "000" (our emergency number) and recall telling them (and my wife remembers, too - one of the last things she does remember) that "I thought my wife had had a stroke and could they send an ambulance urgently." The ambulance arrived within about 10 minutes, but it seemed to me to be an eternity! My wife was in a coma, so they administered oxygen and said they'd take her to the Royal Brisbane Hospital. Ayesha was due for another feed and fortunately we had some formula - she took to it like a duck to water. Meanwhile, I'd phoned Ngaire's mother and asked whether she could look after Ayesha while I went to the hospital. Poor lady, she was so upset that, when she arrived, she parked her car almost at right angles to the kerb.
I arrived at the hospital nearly an hour after the ambulance had taken Ngaire away. I was told that my wife had been taken to X-ray and that a doctor would see me shortly. "Shortly" turned out to be nearly 2 hours later, when they bustled me into intensive care. My wife had had another seizure in X-ray and was in a bad way. They were waiting for the neurosurgeon to arrive before they were willing to commit to a diagnosis. Then came the inevitable form-filling and personal details. Almost as an afterthought, I told the doctor that my wife had suffered a fractured shull from a discus, when she was a teenager. He didn't think that that was very relevant. Then I told him that, many years ago, my wife's mother's sister had died, aged 42, from an aneurysm in the brain, as had her brother, aged 32. THAT, he said, was VERY RELEVANT! I think my wife's mother already knew and was prepared for the worst.
I stayed with Ngaire in intensive care, while she lapsed in and out of consciousness. Surprisingly, during her waking moments, she could remember her name, address, birth date, the current Prime Minister, etc. The neurosurgeon arrived and, after examining my wife and her scans, took me aside to inform me that she'd suffered a subarachnoid hemorrhage from a large aneurysm on her right carotid artery and also from a mild stroke. The prognosis was not good! She was partly paralysed down her left side and he considered she had a less than 50-50 chance of surviving to the next morning.
I returned to my wife's bedside and just held her hands and watched the monitors. Her pulse rate was around 95. Then suddenly, it dropped to about 50 as she suffered another seizure! Her supposedly paralysed left hand almost broke my thumb off, the seizure was so violent. The nurse packed ice around her head and the neurosurgeon was recalled. They told me there was nothing I could do and to go home and rest. I arrived home about 7pm exhausted, and told Ngaire's mother the worst.. Ayesha was asleep, but would probably wake for an 11 o'clock feed. Grandma, too, was exhausted, so she went home. I decided that, for our baby's sake, I had to remain strong, so I cooked and consumed a lonely meal. After feeding and changing Ayesha, I showered and went to bed. Surprisingly, I slept soundly, reasoning that if Ngaire took a turn for the worse, the hospital would phone. Otherwise, my best option was to get a good night's sleep. Like clockwork, Ayesha woke about 5am. I changed her nappy and fed her - she seemed to like the formula. Then I phoned the hospital. Ngaire's condition was unchanged - still critical and in intensive care!
Our families and friends rallied round. I was almost constantly on the phone. My sisters and sister-in-law came over and looked after Ayesha, while Ngaire's mum and I went off to the hospital. Ngaire was conscious for a while and wanted to know what was wrong with her. When told, she observed, Aneurysms! People die from them, don't they?
I saw the neurosurgeon again. He told me that they had to stabilise Ngaire's condition before he could operate, but he wanted to move her to the Mater Private Hospital as soon as she was capable. He phoned me that night to say the time was right. He would move her the next day and operate on Wednesday, but he needed me to sign an approval for the administration of Nimodipine, which was still an experimental drug in Australia, but had been in use in the US and Germany for about 2 years. I asked if he also needed my consent for him to operate, but he said no. It would be negligent of me NOT to operate.
On the Wednesday morning, the neurosurgeon explained what he was about to do and quantified the risks. My wife's aneurysm was a giant one, nearly 2 inches in diameter. He proposed to place a metal clip across the neck of the aneurysm and seal it off. However, the operation would take about 4 hours and almost 2½ hours to reach the site of the aneurysm. If it should burst while he was placing the clip, he would be "blind" and my wife would probably not survive. It all depended on whether the neck was narrow or wide.He rated her chances of NOT surviving the operation and the post-operative stress at about 40%. And even if she survived, he could NOT GUARANTEE that she would NOT end up as a vegetable or partially paralysed. In any event, her recovery was likely to be slow and could take 2 years or more. I've had better odds at the racetrack, but understood there was no choice. In her favour was that she was young and healthy and had every incentive to live for her young baby daughter! He suggested I go home to be with Ayesha and he would phone me as soon as he had news.
Despite the support of relatives and friends, the next 3 or 4 hours were amongst the longest I can remember and, when the phone rang less than 3 hours into the operation, I feared the worst! BUT THE OPERATION HAD BEEN A SUCCESS!! The neck of the aneurysm turned out to be a VERY wide one (about 1 inch) and the neurosurgeon had to use the largest clip in his kit. Otherwise, everything had gone smoothly! I raced into Ayesha's room and picked her up and hugged her and cried from relief. Her mummy was ALIVE!
When I visited Ngaire that night in the post-operative intensive care ward, she looked like a "refugee from an Apache raid". More than half of her long black hair had been shaved off and a quarter section of her skull removed and replaced. It was only then, that I appreciated the seriousness of the operation. She spent the next 2-1/2 days in intensive care, before returning to the ward. That was when the long haul started!
Ngaire was partially paralysed down her left side. The side of her mouth drooped; she had difficulty talking; she needed assistance to walk; and her left hand twitched violently and unpredictably. Mostly, she had to be spoon fed - like a baby. Many were the cups of tea and coffee she threw over herself and she gave a whole new meaning to a "tossed salad". The previous 8 days had been wiped from her memory for ever! Unlike her previously calm and collected demeanour, Ngaire had become extremely irritable and agressive - not an uncommon outcome, according to her neurosurgeon.
That week was amongst the most difficult I can remember! The hospital decided it would be good therapy for my wife to see her baby regularly, so my day was spent looking after Ayesha's needs, paying 2 visits a day to the hospital, washing, cleaning and bathing, cooking meals and answering innumerable phone calls from concerned relatives and friends. I usually got to eat dinner around 9pm. To cap it all, I had Exam Papers to correct, usually between 10pm and 2am, such were the demands on my time. The saving grace was that Ayesha (as though she knew and understood) decided to sleep THROUGH THE NIGHT - from 5pm to 5am!
Ngaire spent the next week on drips and drugs, especially anti-epileptic drugs. She was having 2 sessions of physiotherapy a day, trying to get her mobile again. Mostly, she just wanted to sleep! Her neurosurgeon was encouraged, but thought she should spend 3 or 4 weeks at a Rehabilitation Centre. No way! In her most agressive tone, Ngaire refused pointblank! ""And who will look after you?"", questionned the neurosurgeon, "You can't be left alone at any time and you cannot drive a car under any circumstances!". "HE WILL!", was her swift response, pointing to me. "Then who'll look after the baby?" was the next question. "HE HAS and HE WILL!", was her equally emphatic reply! Fortunately, my employer of some 25 years had been very understanding and generous and had granted me compassionate leave, so I did!
Ngaire was released from hospital, just 2 weeks after her first seizure! I was awed by the realisation of my responsibilities: nurse, surrogate mother, cook, cleaner and amateur psychologist, but nothing could have made me happier than having her home again!
During her stay in hospital, Ngaire was finding it difficult to watch TV, mainly because she couldn't see it very well. Her eyesight slowly degenerated until, about 2 weeks after her operation, she saw a flash of red in her eyes and became effectively blind in both eyes. It was back to the neurosurgeon, then to a neurologist, more tests and scans, then off to an opthamologist. Apparently, my wife was suffering from Terson's Syndrome, in which the pressure of the bleeding in the cranial cavity forces blood into the eyes, where it congeals, effectively putting up a dark blanket. The opthamological registrar at Royal Brisbane assessed her vision at less than 5% and commented that it was the most severe case, he'd ever seen. When I questioned him further, he responded that most patients who develop Terson's Syndrome are dead! I was completely humbled!
The ensuing months were miserable. Effectively blind, still partially paralysed and still suffering from uncontrollable twitches, Ngaire was a functional cripple. Unable to see or look after her baby, unable to read or watch TV, unable to cook or do any housework, she became extremely depressed! I did what I could to assist. I purchased an exercise bicycle to assist her physical recovery. I borrowed "talking books" from the library. We went out to dinner and visited friends. I rigged up our computer screen to display large yellow on black letters and dictated articles for her to type. By this means, she managed to type an entire issue of the Australian Journal of Educational Research. But her tears were frequent, her frustrations debilitating.
The opthamologist was hopeful that her sight might recover naturally but, after four months, there was no improvement. Finally, he referred her to an eye surgeon - a hearty, jovial man built like a gorilla with large hairy hands, but we'd heard wonderful reports about his skills. He explained that the operation involved removing the vitreous gel from her eyes and replacing it with sterile saline solution. It was a delicate operation and he had to be careful to avoid any retinal damage. But the chances of success were very high. And so, five terrible months after her anurysm, the eye surgeon operated on her right eye. The following morning, they removed the bandages and Ngaire COULD SEE AGAIN!! I took Ayesha to the hospital and her joy at being able to see her baby again, brought tears to my eyes. The hospital asked whether we'd allow them to write a story about Ngaire and take a couple of photos for their in-house magazine. We had no objection.
What we didn't know, was that a reporter from the local newspaper (a Murdoch-owned, News Limited publication) was also at the hospital. They decided that they would also like an interview and photos — a "human interest" story, they called it! Ngaire's story was front-page news the next morning, in syndicated newspapers throughout Australia! Then it was the turn of the radio stations and the "women's magazines". Interview after interview, photo opportunity after photo opportunity! It was my wife's, so-called "ten minutes of fame"!
Three months later, the eye surgeon operated on her left eye with equally spectacular results! Ngaire could once more see out of BOTH eyes. About a month later, she returned to work, half-time — just nine months after her aneurysm! She worked half-time until the end of the year, when she returned to full-time work and has worked full-time, ever since — defying all the medical predictions!
Five years on, I call her "Number 99", after the TV program "Get Smart"! Not because she bears any resemblance to the TV character but because, within 12 months, she was 99% back to normal! I know that she will never be 100%, but I could care less. I now know that, given good medical care and the right sort of help, support and encouragement, it IS possible to rebuild a life out of potential tragedy! Our daughter has now turned five and is about to commence primary school. She is beautiful, intelligent and an absolute delight, and more than fulfils her mother's wildest expectations!!
Forgive me for the length of my story, but I've long believed it to be a tale of courage, determination and commitment, from which others, in similar circumstances, may gain inspiration! From what I've gleaned from various doctors and from reading, the odds of her being able to resume a normal life within 9 months of her aneurysm were about 1 in 100 (or less).
In retrospect, I believe that the epidural block during labour saved my wife's life and probably that of our daughter's! I am also of the opinion that the exertion of labour enlarged the aneurysm to such an extent that it pressed on some vital part of her brain, causing temporary paralysis in her legs. Without the benefit of the epidural block, I am convinced that the aneurysm would have burst during childbirth - to what end, I can only conjecture!