I was driving Adam to school when the call arrived. He had to be there by 7:00am for his diocesan cross country run. Donna called, sounding hysterical but saying “Something terrible has happened to Lauren but don’t let Adam know”. I had just pulled up so it wasn’t hard to stay calm for a second and wish him luck. At first, I thought Donna must have been overreacting. However, it was obvious that something serious was wrong, so I started the drive back home. I called Donna back but Rochelle answered the phone in confusion. I could hear Donna talking in the background, but I couldn’t really understand what she was saying. She said she would call me in a minute. The two or three minutes before she called back seemed like forever. The first thing Donna said was “I think she’s dead, the ambulance is here”. I nearly had an accident trying to get to the side of the road. I was supposed to be running a training workshop that day, so I had to call someone to either run it or cancel it. Once I had made that call, I seemed to get every red light coming home. At each light I checked that it was safe to cross and then crossed regardless. I am sure that I went through at least 6 sets of red lights between Old Windsor Road and home.
My heart nearly stopped as I turned into our street and saw two ambulances outside our house. They were taking Lauren out to the Ambulance as I pulled up. Naturally, Donna wanted to ride in the ambulance, but they said no, as they needed all the room they had to keep working on her.
As we drove to the hospital, Donna explained how she had gone back to bed after seeing Adam off. She rarely does this, and it almost certainly helped to save Lauren’s life. At 6:50am Donna heard a noise like the dog being sick. She got up to stop him from vomiting on the carpet and realised that it was Lauren not Scrappy who was making the choking sounds. Donna screamed for Karl to call the ambulance. Karl did that and then when they asked about CPR he clicked into action and started administering it to Lauren. He thought she stopped breathing and they called the ambulance again. The ambulance arrived at 7:02 and her heart was not beating. They had to administer shock to her four times to get her heart started and according to their records, she didn’t have a regular rhythm until 7:16.
When we arrived at Emergency, only a minute or two behind the ambulance, Lauren was already surrounded by about 8 people all doing different things with her. Although they welcomed us to stay, it seemed that wherever we stood we were in the way. The ambulance paramedic (Erica) came to us and told us how great Karl was and made the point that whatever happened, Karl had given her all the chance she had. Karl wasn’t there at the time but it was so good for us to hear that. It was only then that I realised how hard that must have been for Karl. Later that day, the Cardio Professor from Westmead who saw Lauren made the same point to Karl directly. I could see a huge burden being lifted from Karl as he said that and I was so glad that Karl had heard it directly from the professor.
The first thing we were told was that Lauren was being transferred to Westmead but soon after we discovered what would continue to be the case for almost a week. Plans change by the minute in ICU. Apparently there were no beds available at Westmead so they were moving her downstairs to Blacktown ICU. They assured us that this was good as she would get just as good care at Blacktown as she would at Westmead. Naturally, we were sceptical and anxious, but as we were powerless, we just followed along.
We were all taken into a conference room where a doctor - there may have been others there as well, it was all a bit of a blur to me except the person speaking – explained that they had been in touch with Westmead ICU and discussed their plans and they were in agreement. Clearly this is an issue for many people as they went to great pains to reassure us that they were working with Westmead. The doctor explained that Lauren had potentially had no oxygen to her brain for at least 25 minutes and that it didn’t look good. Although they gave us a glimmer of hope, they made it clear that the worst was more likely. The doctor (Krish) explained this technique of lowering the body temperature of hypoxic injury patients for up to 24 hours. We were in such a daze, that although we understood what he was saying, we were not capable of challenging it. They asked us to go and get lunch – we were shocked to find that it was already lunchtime – while they got Lauren organised.
After what seemed like hours, we were taken into a room and there was Lauren with tubes hanging out every orifice on her body, unconscious and packed in ice. I mean this literally, There were bags of ice under her arm pits, in her groin and all along her body. It took about 5 hours for her body temperature to drop to their goal of 33o. She wasn’t shivering because she was being fed a paralysing drug and a sedative through the tubes in her chest. At one stage I counted 11 different drugs being pumped into her at the one time.
Lauren remained packed in ice until about 9am the next morning. At that time they took the ice away, but they did nothing more to warm her, as it was important that this happen slowly. They continued to keep Lauren under paralysis during this time to avoid her shivering. Shivering would raise her body temperature too fast. It took almost as long to warm her body as it did to cool it and it was probably about 2pm before she was back to a normal temperature.
Lauren was connected to a monitor which measured her body temperature, pulse, blood pressure, oxygen saturation and breathing. It was fascinating to see the balance. She started to develop a fever and then her blood pressure went up. They introduced a different sedative which also helped to lower her blood pressure. It became a balancing act to keep all these measures at their right level.
During all this time, Lauren had one to one nursing and we wouldn’t have made it through that time without the support of these wonderful nurses. There was ‘Kiwi Sandy’ who was the most gentle and lovely person. She has a daughter with Downs Syndrome, so we discussed the trials of early intervention and Downs. ‘Red headed Sandy’ who was a neat freak and set about cleaning up the room when she started her shift. She was always looking for ways to make things better and all the other nurses called her a philosopher. I had some enjoyable conversations with her, but didn’t really get into philosophy. Another nurse that we had was Danielle. She was a real ‘no nonsense’ nurse but with a heart of gold. When Lauren had been in hospital for a week, Krish tried to get Lauren breathing on her own so that they could avoid the trachie and Danielle was on shift. She worked so hard through her shift trying to get Lauren to breathe on her own enough to avoid the trachie. When Lauren couldn’t keep her lungs clear of phlegm and we had to tube her again, Danielle was struggling to hold back her tears. I guess she had a good idea of what Lauren would go through with a trachie and wanted to avoid it.
On about day 5, they eliminated all sedation except for Propofol. This is a sedative that has a very quick effect and also comes out of the bloodstream very quickly. This allowed them to turn off the sedation and very soon afterwards try to guage what sort of reaction they were getting. We had a couple of signs of squeezing our hands but nothing too conclusive. The doctors had been sending us out of the room and doing this regularly but were not getting good results and one night, a registrar, PK asked us to stay while he tried this. Instead of asking Lauren to squeeze his hand, he asked Donna to ask. Lauren squeezed her hand. She also followed several other instructions. This was our first sign that Lauren might make a good recovery.
The next day, during a period when the sedation had been turned off, Lauren squeezed both Donna’s and my hands and then reached out her arm towards Donna. She was also making eye contact – or so it seemed to us anyway. The signs we were getting were definitely positive, but then we got a devastating blow in the form of an EEG (brain scan) which indicated that Lauren had suffered ‘severe to moderate’ brain damage. The specialist did add that what we were seeing in her responses seemed to contradict that. Throughout the next couple of days we continued to see evidence that she had some brain function, but she was very groggy so it was difficult to get more than a squeezed hand and a wriggled toe.
On the Monday 10 days after Lauren had been admitted, she had the dreaded tracheostomy. This was a tube inserted in a hole in her throat that helped the nurses gain access to her lungs to clear them out. Once the trachie was in, they were able to stop sedation and within 24 hours we were seeing lots of signs of good brain function. She started trying to write, and communicate with us in other ways. On the Wednesday morning, the nurses decided she was well enough to go outside, so they packed her up and moved her outside for a while. It was at this time that she really started to show positive signs. She asked us questions like “What hospital am I in?” “When can I go home?”, “When can I get this thing out of my neck?” and many more. Her fine motor skills had really deteriorated and it was very difficult to read what she wrote. Each sentence tended to start off reasonably legibly but as it continued it got worse and worse until it was totally illegible. This mostly happened when she had written “Can I please have a …”. No matter how hard we tried, we never seemed to be able to read the important bit. I guess it is testament to her determination, that she never took a short cut. She always wrote full sentences. Of course, now, she has progressed from a whiteboard marker to a pen and her writing (though still messy) is far more legible. She is writing constantly.
Update 1/1/2005. Lauren recovered well from her operation. She had a defibrillator implanted and left hospital on 17th June, in time for her birthday. Lauren had a small roadblock when she went back to hospital to have her defibrillator checked and found that the lead had moved and wasn't working effectively. She had to go back under general anaesthetic to have it reseated. Lauren went back to school in early August and started swimming at the end of September.
She is continuing to improve, and despite all the problems this year she still managed to achieve satisfactory results in her School Certificate exams.
