One morning late in August 2023, Ingvill Mjeldheim Holter stands in Møllendal chapel rehearsing for a funeral. She will sing in the chapel, as she has done countless times before. – I was really looking forward to that assignment. It probably sounds a bit strange to look forward to singing at a funeral, but sometimes you get a repertoire that you just think oh, this was a bit of fun. A little different. “I did it my way” by Frank Sinatra stands for turn. Towards the end of the first verse, Ingvill continues. Then it feels as if something in the head is bursting. A claw grabs hold of the neck, crawls up the left side of the head and squeezes. It is an absolutely unreal pain she feels. It can’t be a normal headache then? The head throbs. Ingvill becomes nauseous and his vision stings. She can no longer stand upright, so she lies down over the grand piano. The organist calls 113. When every second counts The pressure from the note when she sang Sinatra triggered a very serious internal bleeding. A third of those affected by this die. A third survive, but need help for the rest of their lives. And then you have the last third with those who are lucky, like Ingvill. Where you can only get away with luck without serious late effects. On that August day in 2023, Ingvill suffered a meningeal haemorrhage. – We take it for granted that we will be allowed to live, that we will be allowed to grow old, and that if something happens to us, we must get help. But sometimes life happens. I have understood my own mortality. Ingvill Mjeldheim Holter From Møllendal chapel, you can see straight into Haukeland hospital. So the ambulance was there within three minutes. The paramedics did some quick tests to determine the severity. Ingvill could speak, remember, walk and had not fainted. They therefore decided to go to the emergency room. But one of the paramedics was not satisfied with the tests. He raised his finger in front of her eyes and moved it from right to left. All Ingvill had to do was follow the finger with his eyes. – I couldn’t move my eyes to the left, says Ingvill. It was then clear to the paramedics: Ingvill had a meningeal haemorrhage and every second counted. Only ten minutes passed from the time the meningeal hemorrhage occurred at Møllendal Chapel and until she met twenty health personnel at the emergency department at Haukeland University Hospital. Rapid emergency response is absolutely essential for those with a meningeal haemorrhage. That’s how short the road is from the chapel Ingvill sang in, and to Haukeland hospital. Photo: Karoline Forberg / news – It is typical that, especially as a young person, you brush the seriousness away and think it will pass. You don’t want to be a bother. But such a mindset can be the difference between a patient’s life and death. Ingvill tells her story to make others aware of the symptoms of meningeal haemorrhage, so that more people can have the same “luck” as her. – That’s what all the nurses at Haukeland said too: so, you have no idea how lucky you’ve been. The fact that they said that to me actually meant a lot. Because then it is a little easier to understand that you have been lucky, says Ingvill. What is a meningeal hemorrhage? – Around 20 per cent of those who get a meningeal haemorrhage die before they get to the hospital, says neurosurgeon Christian Helland. A meningeal haemorrhage occurs when an aneurysm (aneurysm) on one of the blood vessels in the meninges bursts. – It is a form of stroke where a blood vessel on the surface of the brain bursts, and it bleeds into the fluid space in which the brain lies and bathes, says Helland. LHL states that around 500 people are affected each year. But Helland gives us new figures from a Norwegian study, which show that we are now down to 250 affected a year. It is not known exactly why the decline has occurred. But one theory is that fewer people smoke, says Helland. Neurosurgeon Christian Helland says that around 2 per cent of the population has one or more aneurysms. Photo: Karoline Forberg / news There are several types of meningeal haemorrhage. Some are triggered by a head trauma, while others happen spontaneously. Ingvill’s case was the latter. – You can be at the gym, sleeping, eating, cooking, then suddenly you get an acute headache, says Helland. It is not unusual or necessarily dangerous to have such a bulge (aneurysm). Because even if you have such an arrangement, it does not mean that one day it will burst. It’s all about coincidences. And no doctor today can predict whether an aneurysm will one day burst. – If you see an aneurysm in a CT scan, it is not necessarily the case that we remove it, says Helland. Often the probability of the aneurysm rupturing is lower than the probability of the risk of removing it. – Sometimes we make the wrong choice and do not remove an aneurysm that later ruptures. And it’s very stupid, but the truth is that it’s a lot about coincidences, says Helland. On 29 August, Ingvill suffered a meningeal haemorrhage and was sent to Haukeland hospital. Around 25 health personnel were waiting for her. The first stop was the emergency room. She was put straight on morphine for the pain, and sent on to the neurosurgery department. The next day they operated on the brain. Ten percent must have open surgery directly in the head. But with Ingvill, the surgeon went in from the groin with a wire in the blood vessel, and all the way up to the brain. That’s why she doesn’t have a scar on her head. “Smile” is written on the wall in one of the stairwells at Haukeland hospital where Ingvill started to train again. One step at a time. After 3.5 weeks, Ingvill could go home. The body was tired and broken down, but today she does not feel any lingering injuries. She is one of the few. Making the right choices Kåre Nesheim has been in the ambulance service for 23 years. He has experienced at least five meningeal hemorrhages throughout his service. – The challenge with meningeal bleeding is that it can look like other things. So being sent to the emergency room when you actually have to go to the hospital can be decisive, says Nesheim. He agrees with both the nurses and Ingvill that she has had pig luck. An old photo from Kåre Nesheim’s younger days in the ambulance service. Photo: Private Many years ago, Nesheim was present when a young lady collapsed at Bergen Storsenter. Since she had convulsions, it looked like epilepsy. But a young doctor happened to be at the center and saw that it was a meningeal hemorrhage and not epilepsy. Because of the young doctor, the lady was sent to the right place and survived. – The young woman was on the operating table within ten minutes. So it’s all about luck, says Nesheim about the story that has made a big impression on him. Nesheim lists these symptoms: A sudden severe pain, often on one side of the head The pain often spreads to the neck Pain so intense that nausea and vomiting can occur One pupil is often larger than the other The pupils do not react to light Pulse rate below 50 , but very powerful Lethargy, can lose consciousness Several times Nesheim brings up the importance of having the “Help 113” app. Life took on a new meaning At the beginning of August this year, Ingvill turned 40. It’s not something she takes for granted. – I’m actually a bit moved. I remember when I rolled into Haukeland, I just had to trust that they do what’s best for me, and we’ll take things accordingly. The man from Bergen, who has been smiling and laughing throughout the heavy conversation, suddenly gets a more serious look on his face. – I wasn’t afraid. It became so clear to me that … I cannot take my life for granted. And if it ends now when I’m 39, that’s what I got. I was quite satisfied with all the years I had, thought Ingvill when she arrived at Haukeland hospital. Flowers from the big fortieth anniversary celebration. Photo: Karoline Forberg / news There is a before and after Ingvill. Today, she does not take life for granted. Not that she feels she did before either, but her outlook on life is different. Nothing is taken for granted. And little trifles that she could get hung up on before, now bounce off. – I am really just enormously grateful. Grateful for life and not least grateful for the wonderful neurosurgery department at Haukeland. Everything from nurses and doctors, to those who take out the rubbish from the room. Everyone there is equally important and I appreciate each one. The first times she had to sing again after the incident, she was anxious. But as a professional singer, she had no choice. So today she sings again with full voice and confidence. – Singing is my second language. It’s so important to me, so I decided that if I’m going to live my life, I just have to live it the way it was before the meningeal hemorrhage. So I’ll do it, says Ingvill with both tears and a twinkle in his eye. No matter how deep and serious the conversation becomes, it doesn’t take long before Ingvill finds a positive twist on it and gets his smile back. Photo: Karoline Forberg / news
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– I have understood my own mortality – news Vestland
