It began on the night of the 15th of November 2009……
Mike Phillips (Che’s dad) received a telephone call from one of Che’s friends. She told Mike that Che had been involved in a bad motor bike accident and that he needed to contact the Southport Hospital immediately. Mike fumbled around trying to find the number, called the hospital and was told someone would call him back. It was at that point that Mike broke down uncontrollably. He couldn’t breathe and his head was in a spin. He felt powerless and waiting for the hospital to call back felt like an eternity.
In-fact Mike waited less than 10 minutes when the second-in-charge at the hospital called to tell him that Che had an extensive brain injury and they could not regulate his blood pressure. They told Mike to come down now. His wife Katina, youngest daughter Maddy and step-daughter Susannah all piled into the car. Katina drove as Mike’s mind was working at an erratic pace with all sorts of thoughts streaming in and out as they drove from Cooroy to the Gold Coast.
They arrived at ICU on the first floor where Che’s girlfriend Niki Evans was already waiting. Also there was Che’s Mum Irida, her sister and her brother- in-law. They all burst into tears knowing that behind the firmly locked doors was Che. Irida and Mike’s new family had always had a close relationship. Here they now were all bonded for the same person.
They paced the floor and engaged in awkward conversation trying to console each other. The doors finally flew open and the doctor-in-charge told them that Che had left cerebellum and frontal lobe damage and it was likely that his brain-stem had also been damaged. The words “Diffuse Axonal Brain Injury” rang in Mike’s ears. He immediately knew what this meant, but was not prepared right now to consider the real ramification of these words.
Diffuse Axonal Injury (DAI) is one of the most common and devastating types of brain injuries. This means that damage occurs over a more widespread area than in focal brain injury. DAI, refers to extensive lesions in white-matter and is one of the major causes of unconsciousness and persistent vegetative state after head-trauma. It occurs in about half of all cases of severe head-trauma. The outcome is frequently coma with over 90% of patients with severe DAI never regaining consciousness. Those who do wake up often remain significantly impaired. In simple terms, the medical staff told Che’s family that he may never wake up. The family were told Che had a small chance of making it through the next 24 hours, and a 20% chance of any recovery.
Shortly after receiving the news on the expected extent of Che’s injuries the family were met by a social worker who inquired about using Che’s organs in the event he did not last the night. No-one present that night can ever explain the sadness and loss they all felt at that moment. There was no consoling one another or pretending that the situation was anything but dire. Everyone felt sick and could not find any comfort. The family left and found a motel close to the hospital where they all bunked down for a sleepless night. Che’s mum stayed at his bedside that night.
At 10 am the next morning the family met the doctor in the Intensive Care Unit. The prognosis was not good. Che had bleeding on the brain. If this continued it would mean the doctors would need to open his skull to release the pressure. Whilst this was a scary prospect, the fact that Che’s brain was swelling was in-fact a positive sign as it indicated brain activity when the assumption had been that he was brain dead. He was now on total life-support with the machines keeping him alive and a total of 17 tubes coming out of his body. Compounding all this news was the fact that there were other families with loved-ones in exactly the same predicament. Some died whilst Niki and the family waited outside. Everyone secretly wondered if Che would be next.
The family were later to learn what had taken place prior to arriving at the hospital. If not for the following set of circumstances, Che would not have made it through day 1. On that Sunday afternoon Che and his friends were riding their bikes on a leisurely ride in the Gold Coast hinterland. In front was Sam Stefanaras, followed by Che and Sam’s girlfriend Sarah. To this day the only thing they can piece together is that a car with a trailer attached may have come around the corner on the wrong side of the road and Che moved to avoid a collision, going over a 40 metre drop. Sam immediately turned around to find a car and trailer parked and Che over the cliff.
Sam started to descend with the driver telling him it was too dangerous. Sam replied “bugger that, he is my mate” and started to slide down the steep embankment. The driver followed. Sam found Che with a gigantic boulder on top of him. Sam removed it and carefully placed Che in the recovery position, then checked his pulse and breathing. The other guy started to drag Che up the cliff. Sam shouted at him to “leave him alone, don’t move him!” The driver clambered up the cliff and left the scene. To this day no-one knows whether he was at fault and no-one has ever come forward to claim responsibility. A rescue helicopter was sent, however the over-grown, heavily treed area did not allow a rescue to occur. An ambulance was called and after over 2 hours a line was formed to transport Che back up the hill, by passing him from person-to-person. He had very shallow breathing and the paramedics continued to bag him as the stretcher was passed from man-to-man up the cliff.
When they finally reached the ambulance it had a flat tyre. Che was now critical and as time was of the essence, the ambulance drove over 30km on a flat tyre. An emergency doctor was there and inquired as to what had happened. As soon as she realized it was a motor bike accident she literally opened Che up to inspect his spleen, which had ruptured. If not for this quick response, Che would have bled to death within a matter of a few minutes. Along with broken ribs, Che had a major head injury.
Each day just seemed to bring more things for Che’s family and Niki to worry about. As they faced and managed each crisis, another appeared. Che was struck down with a chest and nose infection from his feeding tube. Then within a matter of days Che experienced what is known as “storming.” This is a reflex action of muscles contracting, followed by massive muscular cramping leaving him in a painful twisted state. The medical opinion was that storming was not a good thing, suggesting extensive neural damage. However, some literature suggests that storming is the brain’s attempt at trying to reconnect.
Che was strapped to the bed to prevent him pulling out his nose tube. He would twist his upper body to get to his hand. Again he was strapped around the chest. It was devastating for Che’s family to watch, but his movements and attempts to remove his tube gave them some hope that he had some brain activity. The hospital staff informed Che’s family that it was a reaction rather than any conscious thought, but they weren’t convinced. Whilst the family didn’t agree with the medical staff’s assessment, they couldn’t fault the nurses or doctors whom they describe as ‘simply fantastic’. They allowed them to assist in the daily routines of washing and assisting Che. This made them feel like they were doing something towards Che’s recovery. It was during this time that the doctors conducted a tracheotomy designed to enable Che to breathe through the throat rather than the nose, in an attempt to reduce the risk of infection and increase the oxygen to the body.
At times the family and Niki believed the medical staff thought they were all quite mad. They played (Bach) baroque music, with a 60 beats per minute beat pattern, which someone had read activates the left and right brain. They moved his limbs, massaged him, read to him, talked about the things he loved; surfing, running and athletics. They played his favourite music. There was nothing they wouldn’t do just to get some sort of response.
Che was in a coma for 41 days and Niki and the family literally tried everything that they had read and researched on a non-stop 24 hour family-roster.
After 3 weeks in ICU they finally moved Che to ward 7 where Niki and the family continued to work with him. By now Che’s eyes were open but the next step was to initiate a response to touch, pressure and talking. This would take quite a while. Finally, on Christmas Day Che responded to nurses touching his hand.
A week or so after Christmas Mike started holding up numbers in front of Che saying “Number 1” and pointing to the card. Then he held up the next card and said “Number 2”. Mike held up the card that said number 4 and said… “4 Che, number 4, son.” Then the most incredible thing happened. Che looked at Mike and said “what are you playing at Dad?” Mike had a mixture of tears and laughter at this point. The family looked at each other … they recall that the next words that were uttered were “HOLY SHIT!” The medical staff, were to put it bluntly …..”Gob Smacked.”
Che now weighed in at only 52 kgs, down from 68 Kgs only months earlier. This was further compounded by the risk of infection through the feeding tube. The doctors wanted to insert a peg, a tube into the stomach through which Che could be fed, by-passing the nose tube. They all knew the risk attached to this and wanted to avoid this at all costs.
The family were told that the peg could be avoided if they could get Che to move both his tongue and lips and also swallow. So after another family meeting it was decided that they would take in some condensed milk and plaster it over Che’s lips, day after day. Much to their delight Che started to move his lips and tongue. Excitedly the family beckoned the staff to watch as they made Che perform this new trick. The medical staff looked at the family and said “OK” we can avoid the peg. They were ecstatic. These small changes just gave everyone some hope, slow as it was.
Che was fed Omega 3 oils by his family. However, in their enthusiasm to get Che well, they overdosed him on the oils leaving him with muscle cramps and diarrhoea. The dose was subsequently lowered, but the regime of providing Che with Omegas continued.
The physiotherapists began tilting Che’s bed, followed by sitting him in a wheelchair preparing him to walk. The family took turns wheeling him around the gardens. It was at this time Che’s speech began to slowly improve.
In a strange twist, a young girl called Lauren, who had been at Uni with Che doing the same Physiotherapist course, was his hospital Physio. It was in-fact Lauren who got Che to take his first assisted steps. It was a very emotional time for all whom were present that day.
Che then transferred to “D” block where the Physios began the real work.
Che starts to remember ….
My first real memory I think started when I entered the wheelchair. The doctors told me my short-term memory was most affected and suggested that I would not remember my girlfriend. Niki arrived and I said “Hi Niki, great to see you.” Well, that is what I tried to say. Whilst internally I felt like I knew what was going on, getting the words out or finding the right words to say was near impossible. These times were incredibly frustrating.
After leaving the Southport hospital I was sent to B.I R.U. (Brain Injury Rehab Unit) in the Princess Alexandra Hospital in Brisbane. Here I underwent intensive Physio, Occupational Therapy, Speech Therapy and my days were spent learning basic living tasks. The days were long and my activity could last for over 6 hours with me collapsing exhausted at the end of each day. I spent the next 3 months here completing these exhaustive workouts.
These times were interspersed with some small outings with my Mum who had rented a small unit across the road from PA Hospital. I can remember the short-term memory was still a bit of an issue. My Mum would spend hours making me the most incredible meal and about 10 minutes later I would say, “Mum what’s for dinner?” Poor Mum, she had put so much love and effort in and I would have forgotten that I had the meal only a few minutes later. We laugh now, but at the time I could see the sadness in her eyes.
As I continued to improve so did all my bodily functions. Being only 27 years old I asked my dad whether he thought having sex would be an issue. At the next family and Doctor meeting, my dad asked the doctor, “ So Doc, Che wants to know if there is any reason why he can’t have sex?“ I remember looking across at Niki who had her head buried in her hands, with a bright red glow radiating from her face. The doctor replied, “I will talk with Che and Niki when you all leave.”
I still had a long way to go and after leaving PA Hospital I went back to Cooroy with Dad to complete my recovery. My Mum moved back up the coast as well to assist. I now had my sisters, brother, step-sister and Step-Mum all pitching in to help. How lucky was I to have such a brilliant family all pitching in to help in all sorts of ways.
My Step-Mum was just terrific. Katina is the most wonderful woman and she spent all her time making meals, cleaning and supporting the whole family. My maternal Mum (Irida) also visited on a regular time schedule and did intense cognitive work with me. Being a former school teacher positioned her well to do this work with me. Mum played games, produced puzzles, read to me, made me read, re-introduced me to music and guitar playing. We remembered songs, sung together and completed maths problems.
My Dad (Mike) took 12 months off work teaching exercise science to students at TAFE and dedicated the next year to my physical recovery. Dad worked in with Sue Keays, a well- known and well-respected Sunshine Coast Sports Physio. Together they took their respective roles, Sue measuring my muscular improvement and central and peripheral nervous system recovery and dad supplying the innovative exercise routines. They would both study the latest research into Brain Body Pathways and neuro-science. We all discovered lots of new ways of doing things. For me I had completely remembered my entire Physio training, none of it was lost.
Dad would start with simple isolation limb movements, branching out into functional movements, strength and power. Because the standard routines were not easy dad would invent new ways of doing old exercises, modifying them as he went. Sue Keays continued to monitor my range of movement and strength changes. We were a formidable team!
My dad taught me to surf as a youngster and our aim was to get me back on a board with my half-sister Madi, also a mad surfer. We all worked on the skills to make this happen. Today I am back on my surf board and heading back into my Career as a Physio. l have renewed my driver’s licence, l’m back running and writing up my thesis titled “Assessment of Range of Movement in Professional and Recreational Surfers.”
To all my family, my Mum Irida, my Step-Mum Katina, my step-sisters, Cassie, Madi, Rachael and Susannah, my brother Gareth and his wife Barbara, my Dad Mike, my incredible and beautiful girlfriend Niki (who never left my side), my Uni friends (who supported me) Sam Stefanaras and his girlfriend Sarah. I cannot thank you all enough. I have the best family ever and without each and every one of them, my journey back would not have been possible. I thank you all from the bottom of my heart.
I am now back doing what I love, surfing every chance I get. I have learnt the most important things in life are the simple ones; excellent health and a supportive family. And, I have promised my family that never, never, ever again will l ride a motor bike!
John Hart concludes …..
Che had the incredible talents and perseverance of his Mum, Dad, girlfriend Niki and extended family to support him. The fact that he was an elite athlete before the accident (1996 Australian Cross Country Champion and the youngest Sunshine Coast Rugby Union player for the first 15) and had a good intellectual cognitive base, all contributed to this young man’s incredible journey back to near perfect health.
I have personally worked with many ABI clients and I have never seen such a remarkable recovery. Che is truly a lucky, talented, unique individual.
Stay tuned guys for the release of Che’s thesis on Surfing.