The Tribune

By DR KENNETH D KEMP

WHEN two people choose to marry and unite their lives into one, they make a legally binding contractual commitment to be together and love one another from that day forward, in sickness and in health. It is a solemn vow that they pledge in front of a priest or wedding officiant and a congregation of friends and family. But I often wonder, if people could look into the future and see the trials that they’ll endure as a couple, if they could see the sickness as well as the health, would they still be as readily forthwith in reciting those very same vows.

Late last year, I recall reading about a husband who filed for a divorce from his wife of 14 years, five days after she suffered a spinal stroke and became paralysed from the waist down. He, like many spouses across the world, forgot or ignored the solemn vow made at their wedding and instead added to the national divorce statistics, which remain staggeringly high each year. But for others, like the patient discussed in today’s report, the answer is easy. She and her husband have been married for 50 years and despite their medical setbacks, have supported and loved one another unconditionally every day since their wedding. She’s asked me to refer to her as Mary and this is her miraculous story.

At age 23, Mary had no medical problems but began experiencing intense recurrent migraines that lasted between 24-48 hours. Each episode was more debilitating than the last. Eventually, she was evaluated by her general practitioner and he advised her to take pain meds and switch her birth control pills, which did little to alleviate her symptoms. A cold shower in fact offered more, albeit temporary, relief than her prescription medication. With no successful remedy at her disposal, her migraines persisted off and on for the better part of 10 years.

Then one day Mary developed a migraine more severe than she’d ever experienced and it lasted unabated for three weeks. It was a constant and intense pounding sensation on the right side of her head. She was nauseous and had extreme sensitivity to light even at its dimmest setting. Her neck felt painful and stiff and her arm was notably weak. She went back to her family doctor but he refused to prescribe a stronger medication than she was already taking. The pain was severe and relentless. Then the vomiting began. She knew something was seriously wrong. So, with her husband at her side, she saw another physician for a second opinion. That doctor discontinued her current medication and prescribed something else. But, based on his examination, he also advised her that her condition appeared neurological so he referred her to a neurologist for further testing.

Mary admitted to her neurologist that she’d been having mood swings and emotional outbursts often directed at her husband and the people she loved most in life. He sent her for an MRI and the results were positive for a partially ruptured giant brain aneurysm. By this time, she could no longer open her right eye because the blood began to pool within her brain and had compressed the nerve that controlled eye movement. Her situation was precarious. She was immediately referred to a specialist hospital in the US to not just save her sight, but to save her life as well. She had to have open brain surgery, which was nearly nine hours long. Mary was semi-conscious during the procedure and recalls hearing when the doctors alarmingly noted whenever her blood pressure began to drop. Despite the risk and complexity, her surgery was successful, her vision today remains intact and she hasn’t experienced any migraines as severe since that time.

Apart from undergoing routine gallstone surgery several years later, Mary remained relatively healthy until one day she wasn’t. She started having excruciating back pain that radiated down her right leg, often leaving her writhing in agony. Her family doctor prescribed oral anti-inflammatories and referred her for physical therapy but given her last ordeal, she opted to get a second opinion at the same hospital in the US where she had life-saving surgery. Before leaving, however, her husband began experiencing episodes of vomiting, weakness and fatigue, swelling in his feet and ankles and considerable pain in his abdomen. His doctor referred him for a colonoscopy and without warning, he was diagnosed with Stage 3 colon cancer. Mary could barely stand up straight some days but summoned the strength to support her husband as he endured a vigorous and potent treatment protocol of chemotherapy and radiation. Following this, he underwent surgery to remove his entire colon.

While tending to her husband, Mary’s back pain became progressively worse. She ignored the pain as best she could and personally cared for her husband with the same gentleness that he displayed during her life-threatening illness. Despite her efforts to remain strong, there were days when she cried hopelessly, in unadulterated physical distress, desperate for any relief. Two years later, once her husband was stable and able to take care of himself, she finally underwent spinal surgery. But, in a cruel twist of fate, her surgeon accidentally punctured her Dural sac, which is a membranous sheath that encompasses the spinal cord. So instead of alleviating her pain, it became exponentially more intensified. The puncture ultimately had to be patched but she lived in constant pain, significantly more excruciating than before her surgery, and so crippling that she could now barely walk. Following revisional surgery by another neurosurgeon, her pain is now mercifully much more manageable but has never resolved entirely.

A few years following this surgery, Mary began experiencing fainting spells. While ambulating she often collapsed without warning and whenever she awoke, it felt like her entire body was spinning uncontrollably. She was afraid that she had developed another brain aneurysm but to her surprise, she was diagnosed with a sinus infection. Her prescribed medication never helped and she saw three other doctors subsequent to that and they also failed to determine the precipitating cause of her fainting.

While at home getting out of her car, Mary by chance and without great expectation, consulted with her neighbour who happened to be a family medicine specialist. She quickly dismissed the notion that Mary was suffering from sinus and informed her that the symptoms were near definitive for a heart abnormality. A local cardiologist examined her and as her neighbour suspected, an EKG revealed that she had a very low resting heart rate of 29, when normal is 60-100. A pacemaker was implanted the following day and immediately after placement, Mary felt like she got her life back and not once since has she fainted.

Over the years and with each medical issue, Mary and her husband have taken their problems in stride, honouring and clinging to their initial vow to support one another in the best and worst of times. Her take home message is to pay attention to the signs that your body gives and to never be afraid to get a second and sometimes third opinion. She says to trust your instincts when something is not right. You know your body better than anyone.

Mary hopes that other couples preparing to enter into marriage appreciate that there will be 100 reasons to leave but all you need is one good reason to stay. Married or not, we can each learn a lot from this story about love, strength, loyalty, faith and courage, which even to this day consistently remains among the highest attributes of man.

This is the KDK Report.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.