A man's routine operation went fatally wrong. Five months later, two of his family members are dead.

For 24-hour crisis support, please call Lifeline on 13 11 14.

On March 3, Pouya Pouladian’s loved ones made the heartbreaking decision to turn off his life support.

The 24-year-old Sydney man had been fighting for his life for two weeks after a routine sleep apnoea operation allegedly went awry.

On Monday, just shy of five months on, tragedy has again struck the Puladian family.

The bodies of Pouya’s 45-year-old mother, Sisi, and 20-year-old sister, Ashley, and their German Shepherd were discovered outside their Greenacre home in an apparent double suicide.

On their front door, a note; “Dear neighbours,” it began, according to The Daily Telegraph. “Please call the police…”

Two women and a dog have been found dead in a car at a Greenacre home. A note was found by neighbors plastered on the front door, alerting them to their location. Their deaths are not being treated as suspicious. pic.twitter.com/vf0jO3Oc67

— Kamin Gock (@kamingock) July 30, 2018

“I have been struggling to breathe properly for years now.”

Pouya Pouladian’s operation was one he had been “desperate” to undergo, as years of recurring sinus problems made it difficult for him to sleep.

Working two jobs to support his widowed mother and little sister, and to fund his dreams of becoming a commercial pilot, the young man turned to crowdfunding to cover the $6000 surgery bill.

On the fundraising page, titled “Can’t breathe!!!”, Pouya wrote, “I have been struggling to sleep and breathe properly for many years now.

“Despite really needing this surgery, I haven’t been able to do it for many years because I cant afford it.”

Tragically, two days after undergoing the long-awaited procedure on February 15, Pouya began vomiting blood, according to The Sydney Morning Herald. Having been discharged that morning, he was rushed back to hospital.

He never left.

The paper reported back in March that the aspiring pilot suffered a massive bleed and cardiac arrest.

The precise cause of his death remains unclear, though the case has been referred to the New South Wales Coroner and was placed under investigation by Sydney Local Health District.

Pouya's death reportedly came six years after that of his father, who suffered a fatal heart attack.

"Words cannot describe what an angel he was."

After Pouya's death, his sister Ashley posted a tribute to him on Facebook.

"He was an amazing and hardworking person who never failed to care deeply for my mother and I. He was truly our inspiration in life,” she wrote.

“Words cannot describe what an angel he was. Rest easy Captain Pouya.”

Today, it is Ashley for whom the tributes are flowing.

"RIP beautiful girl," wrote one friend on Facebook. "Everyone is fighting a battle you know nothing about. Be kind always."

On its website, Beyond Blue notes that while grief can be a risk factor for suicidal thoughts, there are a multitude of complex reasons why a person chooses to take their own life. It offers the following advice to people struggling with grief: "If you notice that depression symptoms continue, or your grief begins to get in the way of how you live, work, share relationships or live day-to-day, then it's important to get support or professional help."

Lifeline: 13 11 14 www.lifeline.org.au
Suicide Call Back Service: 1300 659 467 www.suicidecallbackservice.org.au

For information on how to spot the warning signs of suicidal behaviour or how to support someone with depression, visit the Beyond Blue website.