Around the start of the sugar cane crushing season I started training back at Tweak Fitness – the only place to be… with Louise Doughty and phoh! does she push me hard or what! But that’s what I want, I don’t want to be this nice piece of ass (for a lack of a better phrase). I want to be strong! I want to get shredded and create a piece of art.
It’s incredible what you can achieve with your body if you put your mind to it. Before my accident I didn’t take much notice, half the time I couldn’t keep track of my period – but now I have educated myself through the internet and reading and have started living consciously… with everything.
The other day I wore bikinis for the first time since I was 17! And you know what – my body looks better than what it did at 17! I am so incredibly proud of myself – This hasn’t been a year long adventure for me, it has taken five years. FIVE YEARS – People usually get to ten months and give up. What can I say – The only reason I’m still here is because I have a bloody HARD head!
It is the best feeling deep down FINALLY being happy in my own skin.
Today I am not in a very good head space, and that reflected in my workout. Louise pushes me hard, but I want to be pushed hard. At the moment, I am trying to be the most positive person that I can be but that is all slipping away very fast with everything that’s going on. Working out is the only thing, I feel, that keeps my mind from going back to dark places. BUT – that will be a forever journey for me living with a brain injury. Thankfully, we are about four weeks away from the end of the sugar cane crushing season -alleluia! This season was hard, for everybody, it’s definitely not like it was 10 or 20 years ago – the sugar is just not there, lack of diversification etc.
Today was one of those days where we finish all of our sets, but I didn’t want to stop, I had so much built up anger that I could have pumped out another three hours – I didn’t want it to end. Louise is helping me create a machine – and you know why I want to do this, I will prove all those chaps wrong, the people that say “there’s no way she can’t do it!” I told Louise, that I will be her little guinea pig and we are going to create something awesome! This is the only thing, that I feel, is for me at the moment, the only thing that keeps me from going bat shit crazy.
Since having my accident, I have proven everyone wrong, with everything and it makes me feel powerful – NOT invincible. The reason I push so hard is because there is always somebody worse off! Check out this video of Andy, this bloke is incredible!
Here are some other articles I have written in the past about this topic:-
I’ve decided to change the direction I’ve been writing lately to a subject I am extremly passionate about – my hometown – Ingham. The small town (that is rapidly growing) is situated approximately 110 kilometres north of Townsville and 1,437 kilometres north of the state capital, Brisbane. The town is positioned about 17 km inland within the Herbert River floodplain where Palm Creek drains the low-lying lands. The North Coast railway line passes through the town, which is served by the Ingham railway station. The Bruce Highway also passes through the town.
So there’s a bit of a geography lesson for you… haha I actually learn’t something at school – sorry that I gave you guys a hard time (teachers).
Ok – moving on… Ingham has been my hometown my whole life… Well – except for when I left school and hated everything… You know – that rebellious phase most of us go through, well… some of us. The suborn, hard-headed, independent little shits seem to be the ones who go far – look around. There’s no need to bring up anyone’s past, BUT, we all have a past. Ingham is the sort of town where some people forget their past and are possibly the most judgmental people you will find.
Ingham is the sort of place where there is more positives than negatives. Look at the support the town gave my family and I at the time of my accident, and still 6 years later they will lend a helping hand when need be. The 4 kids that live next door to me have become part of our family. My boys just love them – to the point my two year old yells out talking to them through his bedroom window – everyday… People need to change their perspective on the world. I would love for my boys to grow up here, to continue to build the empire their father and I are trying to build. What’s here in Ingham at the moment is unacceptable!
I’m not leaving the town the way it currently is – I want better for my boys. The best way to be in life to get what you want is to get out there and work bloody hard for it! That’s what I’m doing… Me – who suffers 24/7 chronic pain. I don’t want your pity… I want you to join forces with me to turn this town around! I love being busy! Being busy means I’m not focusing on the pain.
Optimism is a happiness magnet. If you stay positive, good things and good people will be drawn to you. – Mary Lou Retton
The place where there is more sticks of cane than people – yeah Ingham! My hometown, the place where the sugar industry is 8th largest sugar industry in the world and the place where if you stop to talk to every person you know in Woolworths, you will never leave! We have a population of 4,357 people in Ingham according to the 2016 census.
My hometown is the best. We are located in the Herbert River Valley just north of Townsville and just south of Cardwell. We have an awesome 360 view and some of the best barramundi in the world. Our local beaches, the Great Barrier Reef, Wallaman Falls, Hinchinbrook Island, Mungalla Station, Tyto Wetlands, Mercer’s Lane Mosaic, Broadwater National Park, Tyto Art Gallery, Crystal Creek, the must-sees are endless! I have lived in this district my whole life and to date I have never seen Mungalla Station – But I hear Jacob Cassady is doing amazing things for our tourism industry!
I love Ingham, because it is a small town with a passion for all that is homegrown, sustainable and community-oriented. We are famous for our Sugar Cane Industry, our fishing (The brainwashing started in grade 5 from my teacher, Mr Gori), our wog culture, our amazing art and music scene. Ingham is actually home to some wonderful musicians – Joe Geia, Paul Tabone, just to name a few. It’s got a rich history and is also a bit rough around the edges.
I love where I live because of the combination of the laid back lifestyle and the amazing fishing spots. I remember somewhere at the start of 2013, I was asked to go fishing and the fish were going crazy! I was put in charge of making sure we stuck to bag limit. We were fishing for barramundi and mangrove jack that both have a bag limit of five – so ten of each fish… awesome I can do that! Yeah – no. One of the others checked when we got back to the hut and there were 10 jacks and only 9 barras! 9! You had one job missy!
You can drive 20-30 minutes from the main street of town (yes – we have one main street) to almost anywhere in the district. Pretty much any delays to the traffic in this town is due to a derailment (bins full of sugar cane come off the line – sugar cane everywhere!).
Certainly your attitude about where you live makes a huge difference. Ingham is the sort of place where you can walk up to a complete stranger up the street and ask them where anything is – if they can’t tell you, chances are they weren’t born here!
My great grandfather Bertie Peri, who’s Italian name was Giovanni Batista Peri (John the Baptist) came out in 1920 when he was only fifteen when he wanted to come out to Australia, but being so young he needed a guardian to travel with him.
Mr Pino Cominadi (whose descendants are still in the Ingham district, as is nonno’s) was his guardian and they came over to Australia together and their first job was cane cutting on the Adam’s and Blackburn family farms at Macknade in the year 1920.
The residents in the Ingham district at the time consisted of a few maltese a few spanish but mostly those with Italian heritage. Those who became cane cutters out at Halifax ended up living in a barracks together. Many stories have come from the Adam’s and Blackburn families especially how nonno loved Mrs Blackburn’s corn brisket and when nonno got married, he took his wife – Carmelina Toirrisi to the local butcher’s and he made sure his wife could make corn brisket like Mrs Blackburn did every Saturday. Still to this day, corn brisket became tradition amongst many families. In 1924,
One famous story of nonno’s was how Halifax at the time was busier than Ingham And the cane cutters all flocked to the area and had barracks to live in out there. One day nonno was riding a horse into Ingham when he came across a big suitcase in low grass and he didn’t know what to do, so he hid it better in long grass and didn’t say anything.
He came back to his home, It was a Saturday and he didn’t let on about his findings. On Sunday morning, he made an excuse that he had to go back into town to visit somebody. All the other cane cutters were asking why he had to go back to Ingham so soon after his return.
He said he had to go and went and picked up the big suitcase he had hidden in the long grass which proved to be quite a challenge to get on the back of his horse. He tried many different ways, pulled it up a tree even, and he finally got it up on the back of his horse and he took it into the Ingham Police Station.
When he got there, there was a man sitting there – once he saw nonno he ran towards him, he was a travelling salesman who had lost his suitcase. Nonno took it into the Police Station and they worked out the case belonged to a Mr Stevens – a commercial traveller.
Mr Stevens wanted to take nonno for a beer but nothing was open – Mr Stevens never forgot how nonno found his suitcase. He knew if he took his suitcase back to where he was staying with all his cane cutter mates in the barracks, they would want the stuff he had in his suitcase so he hid it.
I love sitting with my nanna and listening to the stories she has told us from when we were young… I think secretly she was impressed that I remembered some of the story… I love my nan and don’t have much free time but when I do I take the boys to see her. We have always been and will always be close.
In our house – our big boy when he turned one would carry on until we turned harvesting videos on and he would sit on one of his tractors or his harvester and would not move! Probably the reason why he drove nonno’s harvester last season. Dad was playing around with his GPS – next minute the harvester started moving. It was hilarious! Our German Au Pairs were amazed how he could tell them exactly what was happening and what everything is.
Sugarcane has been my life – since the day I popped out. Essentially sugar cane is the main industry that fuels our town. I’ve recently been researching the production process and things like that… I’ve got an idea, but I can’t explain it – so I teach myself, the internet is the most powerful tool in the world you just need to know what you’re looking for.
sugarcane is a tall tropical perennial grass that grows to between 2-4m high. It’s used to make heaps of different processed foods, drinks and things like molasses and golden syrup. The biofuel ethanol can also be produced from sugarcane which can be used as a fuel for vehicles in its pure form but is usually blended with gasoline to improve vehicle emissions.
Sugar cane has heaps of nicknames like sugar bush, sticks, there are so many different things we call it. Sugar cane needs 1.5 m of rainfall each year if not more or access to irrigation to survive. Sugar is made in the leaves of the sugarcane plant through a natural process called photosynthesis. Photosynthesis occurs when a plant, using energy from the sun, transforms carbon dioxide (CO2) and water (H20) into oxygen (02) and glucose (sugar).
The plant absorbs water through its roots and oxygen from the air through the pores in its leaves. Sugar is created when this process is combined with the help of a substance called chlorophyll. Chlorophyll is green and gives plants their colour. It allows plants to absorb the sun’s energy more readily. In the same way that animals store fat, the sugarcane plant stores energy that is doesn’t need. This extra energy is sugar and it is stored as sweet juice in the plants’ stalks.
When ripe, sugarcane stalks are harvested (the fun part!) and taken to a sugar mill and converted into raw sugar. In the Herbert River district we have two sugar mills – Victoria and Macknade Mill. Victoria mill produced 3330 million tonnes of sugar in 2007 being the mill that produced the largest amount of sugar in Queensland.
In Australia, sugarcane can be seen growing along 2,100 kilometers of coastline between Mossman in far north Queensland and Grafton in northern New South Wales. Because of their proximity, many cane growing families spend their weekends outdoors riding motor bikes/quads and fishing. Cane growers go out of their way to manage the land so it is still in excellent condition for their children and grandchildren to enjoy for many generations to come.
I miss the days were we would burn cane in the Herbert. Black snow (ash) everywhere! I still remember the smell… I wouldn’t let mum wash my shirt for a week after it… #Farm kid. There is nothing better than growing up on a farm! I remember finishing my homework so quick so I could go mowing, ride the quad bikes/motorbikes or go and chat to dad in the shed. I remember my old headland bomb – cheers uncle Micky! My cousins and siblings helped me paint it – I strolled off to the shed – noone there, it’s all good, a drum of John Deere green paint, i’ll take that! We painted it with rollers and ended up banging it up pretty bad.
I can’t remember if I got away with murder or I just didn’t listen… You know – a regular teenager! I made friends with the kids that lived out my way and we used to run amuck. I remember one had a go kart OMG – so. much. FUN. Dad still has the same quad that we have had since 1997 – It’s never been rebuilt and it still has the original tires. I don’t know how it’s still alive – we flogged that thing… Good ole Honda.
Since my accident my friends circle has changed dramatically! It went from being friends with the wild ones, the bad asses because let’s face it, they are the fun ones, to being friends with doctors, ambo bearers, firies, solicitors, accountants, financial advisors, business people – you name it.
I’ve become friends with the doctor in charge on the morning of my accident, I asked him if he would write me a piece about what he was confronted with on that morning, he obliged and this is his story – Mum, do not read this! You will be an absolute mess and I don’t want to do that to you!
It’s 5am and the phone rings.
“Hello, doctor? There’s been an accident, a patient is coming in after an accident with a head injury, they’re GCS 3, and the other doctor wants you to come in.”
“Yes, of course, I’ll be there as soon as I can.”
I am, of course, not ‘on call’ for the night, but this sort of event needs anyone available to help.
My wife and I have been living in Ingham for 9 months. I’m not popular at the hospital with the other staff because I tend to tell it like it is, which in the healthcare setting can cause friction.
Whenever we get a call like this, the mind starts racing. Do we know the patient, particularly likely in a small town? What injuries could they have? How are we going to manage them? What are we going to walk into? Will they even make it to hospital? Often we get the call, race in only to find that the person has died before arrival.
The physical act of getting dressed into a pair of scrubs and driving allows the fog of sleepiness clear. I think of a line from a medical book, ‘Cautionary Tales’ which reminds us to slow down, drive properly to a call out so as not to cause another accident. I slow down, just as well! Some idiot has thought that 5am is a great time to wheel their bloody motorbike out onto the middle of the road, when it’s as foggy as all hell and visibility is shot to shit. I narrowly avoid them.
Wouldn’t that have been great… one severe injury becomes two, and takes out the doctor going to help the first one…
I arrive at the hospital, not five minutes later, right in front of the ambulance, the adrenaline already pumping.
The paramedics bring the patient in. Their condition is as said over the phone, GCS 3, with a probable head injury, having come off a quad bike.
The GCS is the Glasgow Coma Score, which is an assessment used to guide how severe a head injury is. 15 is a normal person, and 3 is the lowest you can get, meaning the person is completely unresponsive with no external signs of any brain activity; common medical knowledge and medical research gives such persons almost no chance of surviving such injuries.
Yet, the way people in this situation present, they often appear remarkably intact from the end of the bed, with almost no external sign of injury. That is the case here, a young girl, quite pretty actually.
“What’s the situation?” I ask.
“We’ve been called out to the scene, quad bike injury, we think there’s been alcohol involved. Head injury, GCS 3 on arrival. We think her name is Amy Aquilini.”
They say this because having someone’s name and date of birth becomes important for us to arrange retrieval to a larger hospital, and so that we can give a name to the person. Also, if the worst should happen the police will need to attend the hospital and this information can help them get an identity and make the dreaded trip to the family to inform them.
We’ve put this information onto the whiteboard. I am the most senior doctor on the ground and so this is my scenario to run.
The management of someone in this situation is driven very much by a system and protocol to run through, and follows an ABCDE format.
A is for Airway. Airway compromise, meaning that the person cannot move air into and out of their lungs, is very common in this situation, but right now Amy has a clear airway.
B is for Breathing, the action of moving air into and out of their lungs. This is currently being controlled by the paramedic, who is using a device called a Bag Valve Mask over the face, to provide ventilation. I listen to both sides of the chest, and hear air moving in and out equally. This is important, because what we call a ‘tension pneumothorax’ can occur, where the lung space becomes occupied with so much air that nothing can move in or out, and it can kill within minutes.
C is for Circulation, the beat of the heart pumping blood to the body. We check this by measuring heart rate and blood pressure and by looking at the person. These are often well maintained in young, fit and healthy people which proves to be the case here. The heart rate is high, which is to be expected in this situation.
D is for Disability – given the story of a head injury, some form of compromise to the brain function seems entirely likely, and this assessment refers to the person’s conscious state among other things. It reminds us to be wary for an injury to someone’s neck. The GCS is 3, move on.
E is for exposure. When someone has a serious head injury it is not uncommon for other injuries to be present. Amy’s clothes are removed completely. This is no time for dignity. There are some bruises to her right shoulder and arm, but no signs of injury to her chest, abdomen or pelvis. By the time the night is through I will have done things like check for nerve injury to the rectum, and to help the nurse insert a catheter into Amy’s bladder. This was not in the brochure…
I’m then on the phone to retrieval services to arrange a helicopter to retrieve Amy from Ingham to Townsville, where she will get the care she needs. They’re on their way.
It’s about this point where a difficult situation becomes much worse – where everything turns to shit.
The paramedic, who until now has been admirably managing to provide ventilation through the bag-valve mask, tells us that they are starting to struggle to move air in and out.
This can be due to any number of things. Sometimes it is because there is swelling in the mouth or voicebox because of injury, or bleeding. Sometimes it’s because the stomach contents are regurgitating up, which can also be life-threatening – this is literally someone ‘choking on their vomit’ and it’s how Bon Scott from AC/DC died. Whilst I am sure that someone like Amy would consider that fact somewhat cool, it’s not really what we’re aiming for.
I must take over. There’s me, the other doctor, and a couple of nurses. In the big smoke there would be a team of probably at least 15 people to look after this situation. Oh, well!
We need to secure the airway, which means inserting a breathing tube. This is called a Rapid Sequence Intubation and it is one of those things that raises the hair of even the most experienced emergency doctor.
I ask the nurses to get things ready, as I’m busy trying to ventilate Amy. We need the tubes themselves; a laryngoscope (this is a device that pushes the tongue back and allows us to insert the tube), other pieces of equipment that help guide the tube directly into the voicebox, and drugs that will allow us to insert the tube by inducing complete anaesthesia (no pain or awareness) and paralysis, so that the muscles and reflexes don’t prevent the tube going in.
This team is very much unpracticed in this sort of procedure. I am by far the most senior person on the ground with the most experience here, but I’m only three years out of medical school.
The KISS principle applies here – Keep It Simple, Stupid! There is a simple trick to this procedure called the 3/2/1 rule, to simplify the drugs used, based on body weight. 3micrograms per kilogram of Fentanyl, a potent painkiller. 2milligrams per kilogram of Ketamine, a potent agent that induces anaesthesia. Finally, 1milligram per kilogram of Suxamethonium, an agent which blocks a chemical that causes muscle contraction, therefore paralysing her. Similar agents are used in poison darts, another useless fact.
Amy is now completely paralysed and her life is in my hands. If we have made the wrong decision, or if this procedure doesn’t work, she will die right here.
I insert the laryngoscope, which has a video camera attached to improve visibility – we need every little bit of help we can get. I can see her vocal chords. I ask for the tube, but it’s too big. I specifically asked for the smaller size! OK. “Hand me a bougie.”
“What’s that, doctor?”
Fuck. Me. Dead.
Now I have a paralysed patient, who cannot breathe for herself, and I cannot breathe for her without a breathing tube, and this is not the time to tell me that you don’t know what a standard piece of equipment is.
“OK, on the trolley, 20 metres away, to the left of the defibrillator, is a long piece of blue plastic. Please bring that to me right now.”
This direct instruction works better than assuming people know what things are and how to set up for this procedure, as they really should in this situation. I recognise that by far the most important thing to do is to remain calm, and even. Shouting like they do on TV is guaranteed to kill someone, literally, from lack of oxygen.
Amy is blue at this point, from lack of oxygen. Keep in mind that her oxygen levels were low and her breathing was in peril before we started. In the big smoke and in an operating theatre this would have been done in a carefully controlled environment, with a perfectly well patient, with doctors and nurses who do this every day. The odds are stacked up against us.
The bougie arrives. I put the laryngoscope in again. I put the bougie in, which thank Christ sails right through the vocal chords. I ‘railroad’ the tube in over the top of the bougie, and straight through the vocal chords. We attach the breathing bag and I start pumping furiously – we need to get her oxygen now! Amy’s chest starts to rise, and fall, and within a minute her oxygen levels have returned to normal. She is lovely and pink again.
We can hook her up to the breathing machine, finally.
We have fixed the immediately life-threatening problem. It’s funny how the mind works. I remember every single bit of the intubation itself as if it was yesterday, but only patches of what we did before and afterward.
At this point, the retrieval team of expert doctors and paramedics arrive. They’re surprised in a good way at what we’ve managed to achieve. They transfer Amy to their ventilator. The sun is up now. I remember the sunrise. A new day, new hope?
I remember the retrieval doctor barking instructions after a line had become kinked and it appeared as if Amy had no recordable blood pressure.
I remember Amy’s family, particularly the moment Allen – or Amy’s dad, as we knew him then – leant forward to give Amy a gentle kiss on her forehead. That moment stuck out, and to be honest I thought that would be their last kiss goodbye, so sick Amy was.
Did I talk to the family? I can’t remember. I remember going home for a rest, then heading into work that afternoon. Naturally, we debrief. “Back then” the best way to keep up with what had happened to our patients sent to Townsville Hospital was to ‘stalk’ the blood test results. Amy’s treating doctor was a general surgeon and often this means that the person is likely to be a candidate for organ donation. This, at that time, was not unexpected and is what happens to the vast majority of people who have this injury. One medical journal I read even said there was no chance of survival!
I heard that when Amy had to be re-intubated in the Intensive Care Unit a few days later, the team there struggled – with many multiples of doctors and nurses over and above what we had in Ingham, more resources, and in a much more controlled environment – my boss at the time said that was a testament to the job we had done for Amy in our ED.
Then, the news articles. The vigils in Ingham. The recovery, over months and months, that happened, was nothing short of miraculous. The role we had played paled in comparison to the work done by the massive team at Townsville Hospital – but by the same token she probably wouldn’t have made it there if we hadn’t stabilised her. We talk about a ‘golden hour’ in trauma where if injuries and complications are assessed and treated the person has a fighting chance. We caught Amy’s ‘golden hour’.
I followed from afar, not wanting to intrude further on what was an extraordinarily difficult time for the family. Then, some months later, Allen came in to see me for an unrelated matter and we got to talking about Amy. I mentioned that I was there that night.
Then Amy came in to see me, and seeing her alive, well, and chatting to her in person was one of the most amazing experiences of my life, and certainly the most rewarding of my medical career.
Since then, I have thankfully transitioned out of being one of Amy’s medical practitioners to being able to see her and her family socially – never often enough!
Her wedding day remains one of the best of my life. Seeing this amazing young woman, radiant and beautiful on her special day, and knowing that if not for what I’d done she may not have been there, is something that I will carry with me forever.
Medicine can be a tough gig, a demanding marriage partner. It separates us from our family, and takes the best years of our lives, our weekends, our sleep, and sometimes our sanity. At times I wonder whether it has been worth the sacrifice, as I am sure most doctors do at some stage. Then I think of Amy, and I know that it’s all been worth it.
I believe in you.
This was written by Stephen Dick, Doctor in charge.
We had quite a small wedding on the Tablelands, North Queensland but I wasn’t going to stand for Stephen and his wife not being part of the guest list! We don’t catch up half as much as any of us would like to, life is just crazy at the moment! But that doesn’t mean their not always in my thoughts. Hats off to Chrissy for being a doctor’s wife – I couldn’t do it! But then I think I married a farmer so that’s pretty much the same thing, just with a massive reduction in wages! Haha, I make myself laugh at the places my thoughts take me.
I’ve decided to post this as there are a lot of rumours going around about that morning, but that’s what comes with living in a small town, people can be real assholes! I want to make people understand that my accident was a major life changing event for me, my family and really, the Ingham community. I believe it will open a lot of people’s eyes to how bad I actually was, and to Aquo’s golden hour!