Patricia Ingle is beating the odds

THINK of all the phrases you never want to hear, and chances are this one will be right at the top of your list: “I’ve done all I can, but I don’t think she will survive.”

Patricia Ingle is beating the odds

These were the words given to the parents of Patricia Ingle at the height of her acute illness regarding the miracle girl who fell into physical paralysis, who was locked in but brought back to life (kind of) by Ashlee Simpson. Her tale has so many twists it warrants a book, so it’s just as well Patricia intends to write one.

This is not a sad story, despite the desperate hours, days, and weeks spent by Patricia’s family worrying about whether she would live or die. As she sits in the Clarion Hotel in Cork City in her wheelchair, dressed in black tights, purple shorts, and a T-shirt which bears the legend ‘Genius At Work’, the 24-year-old Limerick woman is a bright, engaging, and attractive symbol of a refusal to ever give up.

Back in the summer of 2008, Patricia, from Farnane near the village of Murroe, had finished secondary school at Scoil Carmel and began work at PetMania in Limerick, a job which reflected her love of animals and her hopes to undertake some training as a pet groomer. Then something very strange happened. While cleaning out the parrot cages in the store, she contracted a rare airborne brain infection, Chlamydia Psittacosis, which can be transferred from birds to humans.

She fell ill, and then in hospital in Limerick came close to death, before being rushed to Cork University Hospital (CUH) for emergency neurosurgery. She was ‘locked in’, with little prospect of ever emerging from a state of complete paralysis, yet she did, and in a way which has amazed experts. As one medic in the Oxford Centre for Enablement put it: “I’ve seen your scans — you’re not supposed to be here.”

Speaking in a loud but clear whisper, Patricia says life is now looking good. “I’m fine,” she says. “I am seeing more of me and I am seeing my personality the way it used to be.” On some of the detail of her heart-stopping flirtation with death, she says, “It is incredible to me. I actually can’t remember.”

Going back to Aug 2008, Patricia spent her spare time walking her dog, Coady, going out with friends, and driving around in her green VW Polo. Having cleaned a cockatiel cage at work she began feeling unwell. This was the incubation period and no one could have foretold what would happen next. “I was throwing up,” she says. “I had a headache and I was very dizzy.”

Her mother Annette picks up the story. “She had a few trips to her GP and she had to go down to him and he said we may as well go to the hospital [Mid Western Regional Hospital].

“When Trish was sent home from hospital the first time she had to stay in bed and the doctors said she would get better, but she didn’t.”

They took her back into hospital on Sept 2 because she was not improving; in fact, her health was deteriorating. What came next left an indelible mark on all their lives.

“Sept 3 was the worst day of our lives,” Annette says, while her father Pat says: “That Wednesday when I went up with Trish and Annette I knew something was wrong — she wasn’t talking back and things like that. I was getting very anxious about it.”

Patricia remembers complaining about the heat and in hospital the family asked nurses for pain relief for their daughter. “Her eyes just rolled into the back of her head,” Pat recalls. “She was screaming with the pain.”

Patricia remembers that someone had to get a fan as more attention was focussed on her. Pat says: “I have lost the memory of most of that day.” Annette feels the same. Kiera says: “I got a phone call at home and I was told I had to come out and that things were not looking good for Trish.”

Now in the ICU, having collapsed and requiring resuscitation, Patricia’s condition had worsened alarmingly. By the time Kiera made it into the ICU “there were tubes everywhere — I didn’t recognise her at all”.

It quickly transpired that what Patricia needed was neurosurgery due to raised intracranial pressure, the brain stem having fallen into her neck, so she needed to be taken to either Beaumont in Dublin or CUH. The delay in transferring her pushed Patricia to the edge, but an anaesthetist intubated her and opened her airways, a vital intervention.

An ambulance rushed Patricia to CUH, and she was taken in to surgery. Pat says: “When surgery was finished the surgeon came out and introduced himself to us. He said ‘I’ve done what I can, but I don’t think she will survive’.”

Luckily, the Ingles were still “in denial”, according to Kiera. “I refused to believe that,” she says. “I didn’t dwell on it.”

The family was told they were not going to recognise Patricia when they saw her. Sure enough, tubes obscured her face and Kiera noticed that one side of her head was shaved. “I was thinking, ‘OK, she’s going to hate that’.”

Numerous meetings followed, and every time the family wanted to see Patricia they had to ring a bell. “We knew Patricia was in dire straits,” Pat says. He asked nurses what was going on and one of them told him to prepare themselves for bad news. “The machine was going to be switched off,” Annette says. Patricia interjects: “Because of all this happening and me not remembering it, I think I am a zombie.”

“We were going into the meeting and we looked at everyone’s face as we came in, the doctors and so on,” Kiera says. “The doctor was saying ‘my intention was to come in and say we should turn off the machine, but there was some slight signs of activity in the brain, and so we can’t turn it off’.” This was a relief, but Patricia herself sums up what had happened at this point in time: “Locked in.” Nevertheless, Annette saw it as a victory. “She was still alive. I didn’t care what way she was going to be.” When the doctor was leaving he crossed his fingers so the family could see.

The flickering of life in her brain did not mean the end to the hourly medical drama. As Pat recalls: “These few days every 30 minutes Patricia was being resuscitated. Every time we went in to visit her we were being asked to leave every 20 minutes. Alarms were going off. The alarm was something I’ll never forget. That was happening for four or five days.”

Annette: “Every day when they [the doctors] were coming into her they would say ‘we’ll give her another while’. They were telling us they were going to go and operate on Trish to take off some of her skull cap to relieve the pressure. So we filled in forms for that. Two hours later they came back in and said they will not do that.” Patricia says “they never treated this before”.

All the while, Trish was in a coma for up to six weeks and according to Pat: “We were living in the waiting room.” Annette says: “We never went home.” Pat was shaving in the toilets and likens the experience to the Tom Hanks character in the film The Terminal, who lives in an airport. They eventually switched to the accommodation at Brú Columbanus near the hospital.

Maybe in one sense it was lucky that Annette had been made redundant just two weeks before Patricia fell ill from her job as an assembly electrical operator. Pat’s employers at the ESB were able to give him time off from his job as an electrician.

All other aspects of family life stopped, and the vigil at CUH continued unabated, waiting for signs of life. Kiera was the first to spot a “little flicker on the eyelashes”, but the medical staff was not convinced.

Annette says: “They would say, ‘it’s involuntary, it’s not Trish’, and we would say, ‘it is Trish’.” One Sunday the family saw her eyelids open up a little and called for the nurses who suctioned her. That tiny fluttering was exhausting for Patricia, who says now: “That was so much work for me.”

Having fallen ill in early September, by late November and early Dec 2008 there had been few signs of progress. “The nurses were fantastic,” Pat says. “They would be watching Trish all the time for signs.”

When asked when she first realised that she was coming around, Patricia says: “Maybe when you put the earphones on my ears.” She looks at Kiera, who knows exactly what tune was playing at the time. “Funnily enough, it was ‘Outta My Head’,” Kiera says. “Patricia had liked Ashlee Simpson before she got sick.” Music was accompanied by visual stimulation through a TV in the corner of the room. Pat says: “When she opened her eyes I thought we were over the worst of it but when she opened them there was no blinking, so they would dry up and get infected. Then her eye swelled and later there were blisters on her eyes.”

An eye doctor would apply drops that seemed to turn her eyes orange and yellow. At one point plasters were placed over the eyes but underneath they were not healing sufficiently, leading to talk that they may have to be tacked shut. Thankfully they then began to recover. The emotional toll was relentless. “I remember always coming over and looking at her and telling her it was going to be OK,” he says. “Then I would be out in the car park crying for an hour.”

Patricia still had to be resuscitated at least once a day, months after she first fell ill, but one day she began blinking slowly. She could sometimes sleep for three or four days, but doctors insisted the TV stay on. Patricia’s memories are of the blue eyes of the speech therapist, or a spot on the ceiling she would focus on. Slowly, communication began, with one blink for yes and two for no, a method employed to gauge the level of pain she was experiencing at any time.

That December she could shake her head a little and by Christmas she was able to be moved out of the ward. “It was my first time out of the ward to see the Christmas tree,” she says with a smile. Her parents were still unsure of her future health, and Patricia jokes about a photograph of the Christmas tree trip, “it shows that the stress turned her hair grey”.

That her devilish sense of humour had returned was comfort to the family, illustrated when Pat would put a teddy bear on her knee and she would repeatedly tilt it off. Contrarily, doctors would ask her to do something and she wouldn’t oblige, only to do it once they had left the room. It entered the realm of black comedy when she was asked once about Annette ‘is this your mother?’ and she responded ‘no’. Annette didn’t see the funny side at the time, but at least they can laugh about it now.

Following a transfer, Patricia spent eight months in ICU in Limerick and according to the family when they departed for Limerick they were told speech therapy and occupational therapy would be available to them — except it wasn’t. Pat took up the cudgels, and ultimately it paid off when the family secured occupation and speech therapy for Patricia.

The incentive for greater physical movement had come when Kiera managed to get Patricia to give a small squeeze to a rubber ball. “That’s what they were looking for,” Kiera recalls. “For something on command.” Even now, Patricia can’t help but make a joke. “I made it look involuntary,” she smiles.

While back in Limerick, the family was still in the dark as to what had happened to Patricia, and when one member of staff at the hospital “let it slip” that they had been contacting nursing homes to see if they would be able to cater for Patricia, Pat and Annette were furious. “There was no way Patricia was going to a nursing home or a care home,” Pat says.

The family had previously had no intention on engaging a solicitor, but their anger with the nursing home plan led to them making contact with Susie Elliott of Cork-based firm Ernest J Cantillon. She, in turn, ran a battery of tests and eventually established that the initial illness had been psittacosis.

Then began the process of “fast track” litigation, with Patricia Ingle v Petmania Ltd, O’Keeffe’s of Kilkenny Ltd, and the HSE concerning employer’s liability and a medical negligence action. Patricia attended every day at the High Court. In Jun 2011 the case was settled on an interim basis with a periodic payment made by the HSE, with the family returning to the High Court this month for an assessment hearing to continue the private arrangement of periodic payments, something without a legislative basis due to the Government not fulfilling a 2009 commitment.

All this after a remarkable 1,069 days in hospital, during most of which she actively wanted to return home. The family say in Mar 2009 they were told there was no medical reason for her to be there, but the first time she was eventually allowed home was Christmas, when the temperatures were well below freezing and snow was falling.With virtuoso timing, the electricity went and the house’s power supply was coming from a generator.

Candles were lit and the lights were put on the tree and at 7.45pm the electricity came back on. “It was amazing,” Patricia says. “I was amazed that this was happening. I felt so lucky. There were pillows saying ‘welcome home’.”

Despite her obvious mental strength, there are still moments of reflection. “Maybe I would say ‘why did this happen to me? But what comes, comes.”

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