“And I’m so lucky that they did because they continued on and found a bowel obstruction, my bowel had a kink in it, so they straightened that and saved my bowel. I was really lucky because I was minutes off infarction, which would have been death anyway.”
Amy’s husband, John, was told she was “in a really bad way”. While she was in ICU, she had a cardiac arrest and was resuscitated while he watched.
“As if it wasn’t bad enough before that, I wasn’t expected to live.”
Amy Moeke attached to an Extra Corporeal Membrane Oxygenation machine at Auckland City Hospital's Cardiothoracic and Vascular Intensive Care Unit.
She was flown to Auckland City Hospital’s Cardiothoracic and Vascular Intensive Care Unit (CVICU) and attached to an Extra Corporeal Membrane Oxygenation (ECMO) machine. She remained there for nearly two weeks.
“ECMO is a bedside machine used to support patients with a life-threatening illness that stops their heart or lungs from working properly on their own,” says Philippa Neal, Health New Zealand Te Whatu Ora nurse specialist – ECMO, CVICU at Te Toka Tumai Auckland.
“It is the ‘last resort’ treatment which allows the heart and/or lungs time to rest and repair. It’s considered a last resort because patients would usually not be expected to survive without ECMO, which is a highly complex therapy that is not without risk and does not guarantee survival.”
Amy says that, while she was unconscious, it was “really, really hard on my family”. She was also at risk of losing one or more hands or feet.
“My husband and my sister-in-law [Ruiha] massaged my hands and feet and were with me up to 11 hours a day. Lots of my nurse colleagues came up and massaged me and all sorts of things.”
John and Ruiha used mirimiri on Amy, a Māori holistic therapy that promotes healing through physical touch.
“The doctors said there was no clinical proof that it would help, but most people [in my situation] lose limbs. I think that’s really interesting.”
Looking back, she realises she was picking up things that were going on around her.
“It’s definitely true that you can hear things.”
She vaguely remembers being flown back to Tauranga, and was in Tauranga Hospital when she finally regained consciousness.
“When I woke up, everyone was so happy and I was like, ‘Why are you so damn happy?’ That’s when the hell began for me. That was awful. My body was racked with excruciating pain – it was horrific.”
She found that her memory of the four weeks before her surgery had gone and she was “like a baby”.
“I eventually started to wake up, the pain was excruciating. I had nearly lost my hands and feet, due to lack of oxygen. It was the worst time of my life. It was an extremely rough three months of rehabilitation in hospital. I had to learn to walk, talk and use the bathroom again. Even brushing my teeth and hair was a major task due to weakness.”
She had other ongoing health problems and has been in hospital again since she returned home.
She now wants to thank the Te Puke community for rallying around the family at the time.
Amy during her extensive rehabilitation.
Amy’s son Taimana, who was 6 at the time, is at Fairhaven School and her daughter Saphire, now 16, is at Te Puke High School. ”I think it was The Daily [Charitable Trust] that filled our freezer up. I’ve had to gain a lot of snippets of things and I’m only really just starting to comprehend, but the schools put food in place for my kids for lunches and as a community, mainly in the schools, the pastoral care parts of the schools came together and really wrapped themselves around my family.
“The high school and Fairhaven primary were fabulous.”
She also has two adult children, Lily and Jasmine, and three grandchildren.
“One of my grandchildren was due and I felt there was a really strong reason for coming back to my body. It sounds really bizarre but, when you die, it’s so peaceful – there’s no reason to come back but I knew my daughter needed me.”
“I definitely saw loved ones and saw people I didn’t expect to see.
“My husband’s uncle and his adopted mum, who have passed, were there to collect me – it was the strangest thing. It was nice of them to be there, but it wasn’t who I expected.
“It definitely concreted my belief in the afterlife. It was very peaceful.
“The one thing I took from it was that time is really man-made. On the other side it doesn’t really exist as we feel it here. What was a blink of an eye for me was two weeks for my family.”
She says she feels now that it wasn’t her time and it was her choice to “come back”.
“When I did decide to come back I went through some horrific things. Some would say it was the drugs because I was on a lot of drugs, but the only way I could describe it would be going through purgatory to get home. All the horrible things you understand about purgatory were definitely things that I saw and that caused quite a bit of post-traumatic stress.
“You are literally in between two worlds of life and death and you are trapped in your body and your mind. Whether it’s in your mind or not, it’s horrific. You can’t move away from it, can’t get out from it, it’s going around and around.
“But I would say I wouldn’t change it, because it’s going to make me a better clinician. I’ve been an empathetic nurse but I’ve always believed there’s going to be some purpose for it. I’m not sure where I’m going to land after this but I’m sure there’s a greater plan for me.”
She says one major lesson she has taken from the experience is that people worry too much.
“We really want a new car, want the spa pool, a new house, and we work, work, work to try and get it – then all of a sudden, when you’re in that death spot, none of that matters. The only thing that mattered, and I remember it really clearly, was I just wanted to be with my family. I didn’t care what that looked like, I didn’t care if it was in a shack – I just wanted to hold them close to me.”
Amy making some improvement and getting outside.
Amy thinks it will be another year before she can work again and says it has taken her until now to begin to come to terms with what happened.
“It took me a long time to piece everything back together – I think it was the trauma.
“There’s been a lot of rehab and I’m only just feeling like it’s only now I’m able to grasp this stuff. I don’t know what it all means and I’ve no answers.”
Neal says that, like all patients who need ECMO, Amy had a life-threatening respiratory condition in which her lungs were unable to perform the process of gas exchange, resulting in critically low oxygen levels. “The ECMO machine provided time for her lungs to be treated. The most common scenarios where ECMO may be required include bad pneumonia, high-risk heart and/or lung surgery or organ transplantation and other life-threatening conditions such as severe lung damage from trauma or shock.
“It’s only used after all other life support treatments have failed, and in patients who have an extremely high chance of dying. It is used to provide more time for a patient to be treated and their vital organs to recover.”
Technological advances and training for clinical teams have improved the surl outcomes.
“However, use of ECMO does not itself guarantee survival.”
■ ECMO has been used in New Zealand since 1993 and, since that time, its use both here and internationally has continued to expand. Its use within the adult population increased during the H1N1 pandemic in 2009. The ECMO service continues to be run through Te Toka Tumai’s CVICU and Starship’s PICU, with a total fleet of eight machines and an additional one used when retrieving a patient from somewhere away from Auckland.
