Mountaineer's long road to recovery
When Heather Rhodes fell 300 metres down ice and rock in the Canterbury mountains, her companions expected to find her dead. She tells Anna Pearson about a remarkable recovery.
Part way up a steep, narrow gully in the Arrowsmith Range, three new friends dug snow stakes into the ice and waited.
Rocks and chunks of ice were hurtling down on the experienced mountaineers. They were turning back, stopping short of their target - the completion of a route up the Jagged-Upham couloir above the Cameron Glacier.
It was a decision based on - ironically, with what was about to unfold - safety.
Heather Rhodes, Vaughan Snowdon and Simon Bell perched together, roped to anchors on a 50-degree slope, for eight hours. The ice, which the trio's mountaineering equipment depended on so keenly, hardened in that time and there were fewer rocks falling. Rhodes and her climbing companions were capable of descending without ropes, but it seemed risky with rocks and ice still showering down from above.
''We thought that if we downclimbed and got hit by something and knocked out we'd fall off, '' Rhodes says. ''And we didn't want that.''
HER STORY OF RECOVERY
Rhodes has just finishing dyeing and blowdrying her hair when she answers the door. She hopes there is no residual dye on her face. She bangs around on crutches, only months after doctors took a piece of bone from her hip and grafted it to her mangled tibia, and offers her guests a cup of tea. Her injuries, sustained tumbling 300 metres on to the Cameron Glacier in November last year, included two broken legs - one a compound fracture, three broken or squashed vertebrae and a severe head injury.
Rhodes also broke her nose. It's the broken nose, she jokes, that is interfering with her ability to walk. Her sense of humour is clearly intact, though, she quickly interjects, it is ''quite bruised as well ... it was much better before''.
The most important thing is that she is alive, living day-to-day in her Spreydon flat, and making tea. Rhodes examines a photograph in her accident file from the day of her fall, which shows her navigating a bergshrund - ''just a big hole'', on the way up.
There's another photograph, from later on, of one of her companions climbing up the Jagged-Upham couloir. It is the same gully where Rhodes, after her climbing party's decision to turn back, used 30 blows of a hammer to anchor a snow stake into the ice.
A trained outdoor instructor, who climbed Mt Cook in 2010 to mark the 100th anniversary of the first woman to climb the peak, she knew what she was doing. Snowdon and Bell used Rhodes' anchor to abseil down, but when it was her turn, ''something happened'' and she found ''a much faster way [down] than the others''.
It took Snowdon and Bell more than an hour to down-climb to where Rhodes lay, without ropes (she had taken them all with her). They did not call out to her, assuming she would be dead. Her helmet had come off and the climbing ropes that had been attached to the anchor were wrapped around her. Rhodes was unconscious and breathing heavily. Her tibia and fibula were sticking out of her right leg, under her over-trousers. The snow stake that she had put so much faith in was lying nearby.
Snowdon and Bell activated a locator beacon, gave Rhodes first aid and put her in a tent to keep warm. The Rescue Coordination Centre New Zealand picked up the signal and helicopter staff spotted the climbers about two hours later. They were unable to winch Rhodes safely, so Bell led paramedics 700m in darkness and deep snow to where his battered climbing companion lay.
Rhodes was in a coma for eight days after being rescued and her memories stop short of her accident by 24 hours. Her grey matter took a hammering on the way down. It took five weeks for her brain to start making new memories after she woke from her coma.
Her family spent hours at her side at Christchurch Hospital in that time, before she was transferred to Burwood Hospital. Her boyfriend did too.
Rhodes does not remember any of it. The last proper memories she has from her adventure before the accident are of hanging out with two other parties of climbers at Cameron Hut, before heading up the glacier with Snowdon and Bell - mountaineers she met through mutual friends just days before - to camp the night.
She has since filled in the gaps through a folder of photographs on her computer, labelled, matter-of-factly, ''accident'', and conversations with Snowdon and Bell.
A brain injury, says University of Otago brain rehabilitation expert Dr Jane Millichamp, is a bit like a burn. A scab forms and the pain goes away, but below the surface, under the skin, the body still has a lot of healing to do. With a brain injury, ''the fastest improvement usually happens in the first six months, but at two years . . . your brain is still doing quite a lot of healing'', Millichamp says.
An individual's recovery is extremely hard to predict, as it is different for everyone and despite the existence of some longitudinal studies, there are still a lot of research gaps.
In the past, ''people died at the accident site or shortly after'', and despite medical and technological advances and an improvement in rapid-response emergency services, such as rescue helicopters, researchers were still working out the best methods for treatment and long-term rehabilitation.
What researchers do know is that brain injuries are extremely common in the western world, with falls and motor vehicle accidents mostly to blame. According to the Brain Injury Association, 90 New Zealanders sustain a brain injury a day. Research shows that between 64 and 87 per cent of prison inmates have sustained a brain injury.
Millichamp says many people who suffer a mild brain injury don't go to hospital, or if they do, they may be told just to go home and sleep it off, despite brain injuries being a serious business. It can take up to four months to recover from a mild concussion, let alone a severe traumatic brain injury, according to a study published in medical journal Neurology last year.
''People beat themselves up with a tyranny of shoulds, such as: ' I should be doing better now. I should be over this in a couple of days'. They try and go back to work and all of a sudden their brain can't tolerate the stimulation and then they can't perform. Too often it just gets worse for them because they don't realise that basically their brain is screaming out for some rest and an opportunity to heal,'' Millichamp says.
Rhodes still struggles with mental fatigue, a symptom Millichamp says can be ''insidious'' and ''debilitating'', but her speech, which was slurred at first, is improving rapidly. She still sometimes forgets where she is going with a conversation, but jokes ''lots of things I complain about, people say, 'I have that all the time'. I am really relieved I feel like [myself] again. My sister reckons I am more laid back than I used to be''.
Rhodes measured 5 out of 15 on the Glasgow Coma Scale in hospital (a dead person is 3), after suffering what is officially known as a diffuse axonal injury or DAI.
DAI is the technical term for what happens when the brain gets ''sloshed'' back and forth against the skull under extreme acceleration and decceleration.
It is in Rhodes' advantage that she is, at 36, ''relatively young'', says Millichamp, with good support from family members and medical professionals.
And if she is cracking jokes, even better.
''Our brains recover and heal and create new pathways in the most amazing ways, but it takes a long time. Rehabilitation is more successful if the injured person is assisted to take small, gradual steps forward rather than huge leaps.''
While Rhodes, who already has a PhD in ecology, is realistic about her recovery, she would eventually like to go back tomedical school after '' dropping out'' in 1996. For now, she is focusing on one day at a time, and ''not doing anything very taxing''.
A series of neuropsychological tests, which are coming up soon, may shed light on when she might go back to work part time.
Rhodes says she is grateful to her family and friends, including Snowdon, who visit regularly and offer to pick up things for her when they are out and about.
''I am obviously fairly gutted to be like this, but you don't spend too much time being gutted. You just get on with life,'' she says.
It would be good to know precisely why her snow stake failed (one theory is a delamination failure of the ice), the cause of her violent 300m journey, '' but we are never going to''.
The reality of mountaineering, Rhodes says, is that '' sometimes it goes wrong ... and there is a high cost to that''.
TIPS FOR LIVING WITH A BRAIN INJURY
- Rest up to give your brain time to heal and recover and take breaks to reduce fatigue.
- Accept help from family and friends and get support from a brain injury association.
- Walk or get some light physical exercise to improve memory and other cognitive abilities.
- Work out your strengths and weaknesses, including triggers for low moods and exhaustion.
- Use a diary to assist memory and plan ahead with a notebook or an iPhone.
- Practice mindfulness or meditation to reduce stress and anxiety.
- Acknowledge your grief and loss and talk with someone close.
- Also talk it over with someone not-so-close, like a GP, psychologist or counsellor.
- Be gentle on yourself and do not subscribe to ''the tyranny of shoulds''.
- Take small steps forward and treat yourself daily.