For someone who undergoes annual medical examinations and is declared fit as part of the occupation’s regulations, I asked myself how this could have happened to me. My mind raced through the events that had taken place prior to this, searching for clues as to how this disease could have struck me – but it drew a blank.

As with any autoimmune disease, such as systemic lupus erythematosus (SLE) and multiple scelorsis (MS), my own immune system had, for reasons still unknown today, developed antibodies that had attacked parts of my own body.

As a result, the movement of the affected muscles becomes sluggish. The effect is that a person suffering from MG would experience muscle “weakness” and quite typically, the first voluntary muscles affected are the eyelids (causing droopy lids) and eyes (double vision). When both your eyes cannot be aligned at the same time to look at the same object, you get double vision.

As the mechanisms by which this disease works are still not fully understood, there is no known cure for MG (and other autoimmune diseases). The only “solution” today is treatment to alleviate the symptoms. The best a MG patient can ever hope for is total remission of the disease. Even with an initial remission, it is still possible that the disease will “flare-up” again, leading some to describe MG as a chronic
condition. The prevalence of MG in the United States was estimated to be 14 out of 100,000.

As I lay in the hospital bed, trying to let the reality of this
previously-unheard-of condition sink in, I kept asking myself why it had to be me and why it had to happen at this point of my life? I was told my illness is only ocular MG, the form of MG that is limited to the eyes. Despite feeling dejected about my
condition, I was still hopeful of a recovery. A slight delay in going to America was all the setback there would be to it… or so I thought.


From Bad To Worse
A week after I was discharged, my condition did not
improve. In fact, my double vision started to get worse.
The double images have drifted further apart, and I now
had difficulty merging them together, however hard I
tried. The headaches were also becoming more intense
and frequent. Being accustomed to perfect vision, this
was a difficult reality to accept. The physical attribute
that had landed me an occupation as a pilot was now working against me.

And to make matters worse, my overall condition started to deteriorate to a generalised form of MG. Meaning, the attack was no longer limited to my eye muscles. It had spread to my
right triceps, leaving me powerless to pull the toilet flush with my right hand. It then went on to strike the fingers of my left hand, making them so weak that clenching them into a fist or grasping a cup became difficult tasks. Tasks that I used to perform easily now needed so much effort. On a couple of occasions, my condition became so bad that I experienced difficulty climbing a few flights of stairs.

I became very fearful of where the disease would strike next. In MG, the most critical state that a patient could deteriorate to is myasthenia crisis, which is when the voluntary muscles controlling breathing are attacked.

Without medical intervention, death would almost surely ensue. I wondered if this was the course that I was heading. By now, all my hopes of a fairly fast recovery had dissipated. The reality of the disease had finally sunk in. It became clear that the States trip would remain a dream. Due to the unexpected rapid deterioation in my condition, my doctor recommended that I undergo thymectomy, the surgical removal of the thymus gland.

Although not a described procedure even in generalised MG, thymectomy has successfully “cured” some myasthenia patients. Unfortunately, because the thymus gland is located behind the breast bone area, I would need to have the equivalent of an open-heart surgery to remove it. Even so, patients with their thymus glands removed would still need to be treated with drugs. In other words, the so called “solution”, while promising, had no guaranteed benefits. I was faced with a choice of the devil and the deep blue sea.

Meanwhile, I was started on a long-term course of
corticosteroids and immunosuppressant in the hope that it
would help stop the disease from spreading further. The
steroid and the immunosuppressant would suppress my immune system from producing too much antibodies, including those that were attacking my own body.

The downside was that I would become susceptible to other infections and diseases since the suppression was indiscriminating. I started confining myself at home (or whatever was left of it, as our stuff had already been shipped to America).

Unfortunately, the symptoms did not improve despite the drug treatment. While the weakness in my limbs had somewhat been arrested, my double vision became worse. My left eye, which was my master eye, started to become immobile. The pupil became “stuck” in the left upper corner of the eye. To get rid of the double vision, I had to close my eye, or put one hand or patch over my left eye.

Then my right eye started to get less immobile. In the worst state, a single object would appear as two – one tilted about 15 degree to the left and the other 5 degree to the right relative to the vertical. At the same time, I was also suffering from the side effects of the drugs. I experienced insomnia (clocking about four hours of sleep every day) and developed peptic ulcers, for which I was given more drugs (antibiotics and antifugal solution).

It was about this time that I went into a state of severe
depression. The double vision was so bad that I actually
wished I was blind. The only time I did not feel the severe
pain in the head that accompanied the double vision was when I was asleep.

At the same time, I had deal with many uncertainties. My aviation doctor from the Air Force had told me that I would, in all probability, be grounded from flying for a long while. I couldn’t imagine, given my condition, getting back to work, even if it had been a deskbound one.

Questions plagued me. Will I be asked to leave my job? Who is going to provide for my wife, my parents, her parents? Who is going to be take care of my wife when our child is born? Will I be a liability to her? As if the uncertainities weren’t enough, the fear of the unknown started to encapsulate me.

Vivid images of my mother, who had lost her life to leukaemia 12 years ago, returned . She had not left us willingly. There was, I thought, the look of fear in her eyes when she died. I realised that It was this same fear that I was experiencing. I was fearful of what the next of turn of events might be and of what was awaiting me at the next corner. I was struggling... physically, mentally and spiritually. I have never felt so helpless before. Nothing in my life’s experiences had prepared me for this.

The Turning Point
It was under these circumstances that my wife and I started to attend church. At least if the same eventuality were to befall me, I had given myself a chance to get to know Christ, I thought. All my life, I had chosen to remain a free-thinker, choosing not to be affiliated to or associated with any particular religion.

From my own experiences, I did believe in the existence of God. What I was not sure about was which religion I should be affiliated to or associated with. For many years, I chose to believe that it did not matter.

It did not help that I had come from a secular family. Nor did it help that I had been ingrained, during my formative years, to think that anything that happens in the universe, including life and death, had a perfect scientific, economic or social reason to it. I was, therefore, skeptical about most religions and their claims. But most of all, I was ignorant. I did not put aside time to find out more about the first order questions of life, like, Wwhat we are doing here on earth?” or “What happens after death?”.

So when one of the pastors from the church, whose Sunday service I had started to attend, asked me if I was willing to accept Christ, I said yes. I find it hard to describe how I felt at that moment other than to say that the decision felt right. I wasn’t sure if I had said yes out of sheer desperation due to my medical condition. After all, I had heard of the many real-life miracles that Christ had performed in healing the sick.

I wasn’t sure if I had said yes because I had been touched by the many Christian friends who started to pray for my recovery, despite the fact that I was a non-believer. But I was certain about one thing. I had said yes because I had no basis for not believing in Christ based on the authenticity of the Holy Bible. So I had accepted Christ purely out of Faith.

For someone who regarded religion as a commitment not to be taken lightly, commiting to one was like taking a giant leap forward. However, despite prayers calling for miracle healing, my condition did not improve. I could live with the many side effects of the drugs that I was taking. But to do so without any indication of the symptoms easing was truly very discouraging.

This period of utter discouragement continued for weeks. On one occasion, I was so depressed that I was so tempted to take the easy way out. It felt as if God and Christ had deserted me. Doubts about my Faith began to creep in. It was about this time that an inner voice rang out to me. “If you were willing and able to overcome the hardship that has led to your life (material) successes in the past, why are you so ready to give up on Life?”

It began to dawn on me that I was going through a test of the human spirit! I decided to stick to my faith in Christ, in the belief that God will one day turn things around, no matter how painful and bad things seemed at the time. So I lived day by day, waking up to each day, trying to forget what pain I had gone through the day before, believing that
Christ will heal me in His time. I began to pray to Christ that He might show me some signs of improvement so that I might be encouraged.

For some strange reason, through my daily prayers, my
spirit began to calm down. Despite my condition, I felt a sense of “settledness” and peace in my heart. Because I
had chosen to surrender my life to Christ, I became less
anxious over the things which were beyond my control. I
also became less frightened of the unknown. It was about this time that I started regaining strength in my limbs.

One day, I thought I saw my left eyeball start to move slightly. Wow! In the darkest moments, there was Hope. My spirit was so uplifted. From that day, my double vision started to improve. The double images became upright and started slowly growing closer. I began to pray that God might heal me in time to take care of my wife when our baby came. By this time I was still relatively weak as I had largely confined myself to light duties at home. MG patients have been advised to rest because muscle weakness increases with continued activity and improves after periods of rest.

At about this time, an inner voice again called out to me:
“Get up and run”. Hesitant at first, I decided to make my first
attempt at running. l lasted only five minutes! By the end
of the run, I was totally breathless. My level of fitness appalled me, as I had been a regular jogger before. But I decided not to give up. I was convinced that the more I rested, the less I would use my muscles, and the more they would become susceptible to attack. So, with much conviction, I set out to do better with each new attempt. Steadily, my fitness began to improve. I could feel myself feeling better and getting stronger.

After overcoming much difficulty, I am now able to run 10 km in one hour. Today, I do these runs on a regular basis. This is much more than that I have ever managed to run before I got sick. Isn’t it amazing? With the regular exercise, my
condition improved further. I have come to realise that,
through Christ, God empowers you and I to overcome our difficulties in life. Out of my willingness to surrender to Him, and accept what may come my way, I understood that I still had to play my part. After all, while one cannot direct the outcome, one still has to be responsible for the choices and actions that one makes.

Through Christ, I have learnt to look beyond my own self-pity that had engulfed me during the initial stages of my illness. I was reminded that there are others who had problems that were far worse than mine. In spite of my medical condition, I learnt to be grateful. After all, in many ways, it could have been worse.

One month after I took to running, I was declared fit enough to return to work (albeit a deskbound one). Today, seven and a half months after I was diagnosed with MG, my double vision is almost completely gone, my condition is very much improved, and I have a job in hand. In fact, I’m ready to take care of my wife and our child who was born on 11 Nov 2002. Isn’t life beautiful? God certainly answered my prayers. I had started out accepting Christ not having any reasons not to believe in Him. Today, I’m a Christian who has many reasons to believe in Him. He was with me during my darkest moments, and He gave me Hope when all things seemed doomed.

CHARLES NGOH, 33, currently holds a staff appointment in
MINDEF. Since his diagnosis, he has undergone treatment and is doing well. Charles keeps up his health with regular exercises, and he still runs 10 km once a week. Charles and his wife Sok Peng celebrate the birth of their first child, Natalie, on 11 Nov 2002.