Thursday, May 26, 2005

Land below the Wind...

I just got back from Kota Kinabalu in Sabah, the Land Below the Winds. I had been there for more than 3 weeks . I had to go there , a 2 and a 1/2 hour flight by air from Kuala Lumpur airport on the 1st of May because my husband developed some severe infection and fell ill while at a meeting there. His symptoms were fever with rigours and a falling platelet count. Initially diagnosed as Dengue, all tests were negative and one day before he collapsed , his blood film was postive for a mixed Malaria infection. Later it was discovered one of the types was Plasmodium Knowlesi which is a rare type but very fuliminant.
Little did I know that the infection was so fulminant that he would deteriorate into septic shock in a few hours of the diagnosis !By that time he had been febrile for only 4 days.
That he is alive today is thanks to the skills of some specialist doctors as well as some very sophisticated instruments and I think the prayers of many people!

Here is something I wrote to a friend:

Indeed it was very difficult but I never gave up hope and what helped me very much was that the anaesthetist Dr Lilly Ng who managed him when he was in septic shock never gave up on him even when the odds were stacked against him . I have a great deal of respect for people like her , she almost did not sleep for 2 days adjusting the dose of the inotropes he was put on to maintain his BP. Had she slept his BP may have dropped and he would be lost to me and to all.It was like walking a tightrope , if she gave too much his heart would give out and the vasoconstriction would have its own adverse effects and too little the BP would drop to beyond recovery. At one point she had put him on 4 inotropes and had pushed the respirator to 100% oxygen with a peep of 18 and she had said at that point , my back is to the wall, if he does not respond , I have no more room to negotiate.I think at that point , all we could do was to pray....I had sat for hours,my eyes rivetted to the monitor recording his vital signs.

I am still trying to understand the significance of what happened, how my husband was hovering on the brink of death , when he collapsed , he was 2 minutes away from being brain dead , because he developed a severe ARDS ( Adult respiratory distress syndrome) and turned blue! Dr Lilly Ng leaped into action . She was at his side when he collapsed, coughed out blood streaked phlegm and then turned blue.She intubated him, bagged him and then hooked him onto the respirator in a matter of minutes , on the wrong side of the bed for her..she had to reach across to do it, there was no time to move to the other side.

He had 4 organ failure:
The repiratory system
The circulation
The blood system( thrombocytopaenia and haemolysis of red blood cells)
The kidneys ( went into renal shut down for 10 days , is recovering now)

He is still in hospital but gradually getting better.
I am trying to write down what happened , in the hope of finding the meaning of it all.

I have so many questions and no answers

Why did he have to fall sick so far away from home? It is as if he went there to get admitted to hospital because he never attended the meeting. But I also got to know a whole new way of being ..the Malaysians in East Malaysia were a lot more gentle and easy going that the ones here in West Malaysia. They ate more vegetables, their food had much less spices and salt and their drinks were less sweet. Their lives were not so stressed. The ICU nurses were most amazing. They were working with very sick people , surrounded by an atmosphere of the very ill and the dying and they worked efficiently quietly and skillfully and calmly . Most of all they were more caring and compassionate. All of the nurses and most of the doctors were shining examples of the medical profession at their best.
Why did he have to get a very rare infection? Where did he catch it?( He was in the jungle 2 weeks previously but the P Knowlesi has an incubation of only one week). Why did he also get a rare complication: optic neuritis..his vision was severely imparied when they finally took him off the sedatives and muscle relaxants they put him on when they put him on respirator. The prognosis for this condition is hopeful and he is slowly recovering his vision.
Why had it turned so fulminant ?( In most people Malaria is not dangerous)
Why was he so near to death and then now recovering in half the expected time? ( The anaesthetist Dr Tai and Dr Ng told me they did his Apache score and he scored in the 80% fatality but she also said that my husband is not a statistic and I hung on to that part of what she said).Dr Ng and Dr Tai had brought with them( from Kuala Lumpur) a very powerful and also potentially dangerous drug Active protein C , tradenamed Xigris. It was only to be used when the Apache score was very high , like it was for my husband. The drug cost RM 50,000 for the 2 vials. I think this was the time I was most grateful that my husband is a senior administrator ( Medical) in the government health ministry earning chicken feed in terms of salary .The Director General of Health sent 5 specialists to Kota Kinabalu to consult with the doctors there on management and they kept an ongoing communication after they went back to Kuala Lumpur..a fine example of telemedicene.I did notice his blood pressure stabilised and they could take him off all 4 inotropes within 3 days . He was put on the Xigris within the first 24 hours of the crisis.

Some of these questions will never be answered..but what I am asking myself is how did I fare and how will it change him and change me and change the family , my life and his life ..for sure something like this changes people.

Here are several things I learnt though:

I met some extremly caring people who were very sincere
Doctors perform very well and cooperate very well together in a crises and start arguing and disagreeing when the crisis is over.
It is difficult to accept help gracefully sometimes and very difficult to deal with well meaning people who kept coming . I think I have to learn to just be quiet and tell when I wanted to be alone.
Next time I visit very ill friends I must make the visit very short, speak little and pray a lot for their healing
People said I was strong but I think I was not strong , I was hopeful , maybe foolishly so , but it helped to have hope.
I learned of my capacity to deal with crisis and also my lack of capacity ( ie I could see my strengths and weaknesses). I found myself picking on a member of my family . A lot of things got resolved in the process..It was illness and it brought out unhealthy dynamics in my immediate family ie my children and myself and the best part is that it healed a lot of old festering feelings within me and within them.
I realised how connected energywise I was to all my loved ones. I had felt where his worse problem was, my chest felt warm for most of the days he was critically ill with ARDS and totally dependent on the respirator.. At one point I felt a headache and all this time I kept doing healing for him , sometimes by zikr, sometimes with my breath and sometimes by touch .A CT scan later showed he may have had an ischaemic stroke but there were no other symptoms except a weakness in the left arm which is resolving. 3 of my children and my sister in law could also feel the heat in the chest and the pain in the head.
There were so many groups praying for him I was amazed. Prayers were held in many parts of the country and by people of many faiths , Muslims, Budhist, Hindus and Christians. We have many friends and belonged to many groups. I really learned the power of prayers.
Planeloads of friends , colleagues and relatives took the flight to KK to see him..I was completely amazed!Perhaps I never knew how beloved my husband was.I was seeing a side of him I did not know.

I learned to sharpen my skill at transmitting homeopathic remedies by sending thought waves of the remedy. I could feel which were the remedies needed and could also feel at which potency they were needed.


I had this anonymous comment on this post:

So many words being said but none thanking Allah. "There were so many groups praying for him I was amazed. Prayers were held in many parts of the country and by people of many faiths , Muslims, Budhist, Hindus and Christians. We have many friends and belonged to many groups. I really learned the power of prayers" Do you mean prayers from any person of any religion are equal in the estimation of Allah?

My answer
I did not need to say Allah because Allah is on my mind all the time as I wrote this. The miracle that happened was a blessing from Allah, why did I need to say it since I felt it flowed throughout the writing?Who answers the prayers if not Allah? Why does it have to be mentioned? For the God conscious , Allah is present with them in every word written .
As for people of all faiths praying. I am not the person to judge if they are equal or not in Allah's estimation. I have never put myself on the same level as Allah and have no knowledge of it.
Anyway just for your information experiments done (by non Muslims scientists ) concluded that praying for people who were sick in the hospital found a statistically significant improved cure rate over patients not prayed for. It was a double blind study to find out about the power of prayer. Here is one URL for you to check on it: