Posts Tagged Paramedics
When I woke up the morning of Tuesday, March 19, 2019 I was feeling great. That day began the best sporting event and for me the greatest time of the year. The first play-in games for NCAA Men’s Basketball’s March Madness 2019 featuring Belmont versus Temple and Prairie View versus Fairleigh Dickenson. What I didn’t know was that just a couple of hours later I’d be dead. Not what you could consider the best start for the day. I’m writing this months later, so obviously I didn’t die. My being able to write this is nothing short of a miracle. An amazing number of interconnected actions taken by a number of equally amazing people who in my eyes are all heroes saved my life.
That day started like most of my days by having coffee and reading. Shortly after 10:30 a.m. my wife and I were sitting talking when I suffered sudden cardiac arrest (SCA). I was literally alive one second and dead the next. SCA is defined by The Mayo Clinic:
“Sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. The condition usually results from an electrical disturbance in your heart that disrupts its pumping action, stopping blood flow to your body.”
My wife knew immediately that I was gone. She called 9-1-1 from our home phone and the dispatcher that answered, after quickly confirming the address she was calling from, instructed her to immediately begin Cardiopulmonary Resuscitation (CPR).
Within a couple of minutes of calling 9-1-1 a police officer arrived at the front door. Fortunately the officer was only a few blocks away when he received the call over his radio. After quickly letting the officer into the house he took over giving me CPR. After five to six minutes from my wife’s call to 9-1-1 paramedics arrived at the house to take over for the police officer.
The paramedics found me unresponsive with no pulse. They attempted shocking me with a defibrillator several times and were unsuccessful restarting my heart. At the same time the paramedics began utilizing a device called the LUCAS 3 Chest Compression System. According to the web site for the maker of the LUCAS 3 it:
“Deliver(s) high-performance, continuous chest compressions with less strain, micromanagement, and risk for the caregiver. The LUCAS chest compression system, provides benefits both to the cardiac arrest patient and the resuscitation team.”
I was incredibly fortunate that the city I live in had equipped the ambulance that was sent to provide assistance to me with the LUCAS 3 and the paramedics were trained in its proper use. Not all cities equip ambulances with this device.
After the initial call to 9-1-1, my wife, a police officer and a team of paramedics working non-stop to resuscitate me finally got a pulse 15 minutes later. One of the biggest concerns of SCA is a lack of oxygen to essential organs, especially the brain. That is why immediately initiating CPR and continually providing CPR until a pulse is found is so critical. The incredible efforts of my wife, the police officer and the paramedic team who together provided me CPR allowed me the chance to survive SCA.
It’s important to understand that 95% of people who suffer SCA in their homes die before making it to a hospital. Those are pretty daunting odds to overcome. The American Heart Association web site states:
“The majority of cardiac arrest survivors have some degree of brain injury and impaired consciousness. Some remain in a persistent vegetative state.”
The chances of surviving SCA and suffering no brain injury is less than 1%.
After finding a pulse paramedics then asked which hospital my wife wanted me to be taken. There are two major hospitals where I live, and both are within 6 minutes from my home. My wife wasn’t sure which hospital would be best as we hadn’t been to either and she asked for input, but the first responders said they weren’t allowed to make recommendations. As my wife was thinking which one to choose someone in the room said the name of a hospital. A few minutes later I was taken from the house, placed in the ambulance and transported to that hospital. As it turned out whoever in the room spoke up provided me a better chance of surviving SCA.
Once I arrived at the emergency room you can imagine that I was receiving a great deal of medical attention. Within minutes of arriving a chaplain took my wife to meet the cardiologist who spoke with my wife about my condition. He informed her that I was in extremely critical condition and the chances of my surviving SCA was minute-by-minute. The doctor was asking her questions to learn about his patient. He was already aware of what had happened and my current grave condition, but what he didn’t know was my prior medical history before SCA and he wanted to understand my quality of life before today. My wife told him that I was the strongest person that she knew and if anyone was capable of surviving SCA it was me. After speaking to my wife the doctor decided to aggressively treat me, and I was moved to a cath lab to check my heart. They found that I had total blockage in one of my arteries which was a contributing factor causing SCA. Two stints were placed in the artery.
While I was in the cath lab another doctor came to see my wife in a small waiting room available for immediate family members. This doctor wanted to talk with her about putting me into a therapeutic hypothermia. John Hopkins Medicine describes the procedure as:
“Therapeutic hypothermia can help only some people who have had cardiac arrest. Some people regain consciousness right after cardiac arrest. These people often do not need this procedure. It is helpful only for people whose heartbeat returns after a sudden cardiac arrest. If the heartbeat doesn’t restart soon, it won’t help. Therapeutic hypothermia can be a good choice if the heart restarted but you are still not responsive. It can raise the chance that you will wake up.”
I had not regained consciousness once I had been resuscitated by the paramedics therefore I was a good candidate for the therapeutic hypothermia procedure. By cooling my body I would have the greatest chance of saving brain functionality, but there were also risks associated with my having the procedure. The hospital that I was transported utilized an internal cooling process that introduces cooled fluids intravenously to cool my entire body to a temperature below 90 degrees Fahrenheit. The procedure would entail keeping my body cooled to that temperature for 24+ hours in an attempt to limit damage to my brain. The other hospital I could have been transported did a similar procedure, but that hospital used cooling blankets and not intravenous fluids. If I had already suffered brain damage the procedure doesn’t reverse the effects, the procedure just helps to reduce further damage.
After suffering SCA everything that could have gone right on that morning did. Taken all together it was the perfect storm for me where literally every minute counts in a SCA timeline.
- I wasn’t alone when I suffered the SCA
- My wife called 9-1-1 and immediately began CPR
- A police officer was only a couple of minutes away and once he arrived he continued giving me CPR
- The paramedics who arrived at my home were equipped with a LUCAS 3 which provided me the best chance to keep pumping blood to my vital organs and oxygen to my brain
- I was only a few minutes away from a hospital
- I was incredibly fortunate that the cardiologist treating me in the emergency room that morning aggressively treated me regardless of my critical condition
- I was transported to a hospital that had a doctor and equipment capable of providing me the therapeutic hypothermia intravenous procedure
I was released from the hospital 8 days after I arrived at the emergency room and my life quickly returned to normal. I have no memory of experiencing SCA. I have no memory of being in the hospital except for the last day. I know the distress that I caused family and friends, but I have no recollection of feeling any pain or discomfort. Based on what I now know I experienced severe pain so having no memory of it is a blessing.
Subsequent to fully recovering from SCA I’ve learned a few things. The cardiologist that treated me had recently joined a practice at the hospital that I was transported. He had moved into the area from another state and had been recruited to join the hospital team due to his medical expertise related to the heart. I was lucky that he was the doctor on call providing treatment to me in the emergency room. Based on my medical condition many doctors wouldn’t have taken the extraordinary steps he did to treat me. I was without a pulse for 15 minutes and the chances of my arriving at the hospital alive were less than 5%. I had a 1 in 5 chance to survive after arriving at the hospital alive. If I was the 1 patient who survived then there was little chance that I would have full brain functionality.
Once my cardiologist decided to have me taken to the cath lab, if I had died, my death would have been recorded against him and his treatment decisions. In a world were scores matter he took a risk with me. A risk that he was willing to take regardless of the outcome. With my cardiologist making the decision to treat me, that allowed the therapeutic hypothermia procedure to be scheduled. This procedure causes the body to shiver uncontrollably and required my being given paralytic drugs to ensure that I didn’t move during the procedure. The cooling process causes intense pain and they also gave me drugs for the pain and drugs to ensure that I had limited brain activity. My prognosis was grave. Family members were told to expect the worse. Family and friends who are medical professionals who fully understood my condition expected the worse.
After 24+ hours the cooling procedure is slowly reversed to bring the body temperature back to normal. The procedure is considered successful if the patient regains consciousness 24 to 48 hours after the body is back to normal temperature. It could take a patient up to 7 days to awake from the procedure. The cooling process began Tuesday afternoon with the warming process starting late Wednesday afternoon. There was no way to know how I would awaken from the cooling. It was possible that I would never regain consciousness and die, it was possible that I could live and be in a vegetative state, it was possible that I could awake with severe brain damage, it was possible that I could awake with some brain damage or I could awake with no brain damage. To awaken with no loss of functionality is unusual.
Between 8 a.m. and 10 a.m. each morning the hospital had asked that family and friends not be present which allowed them to perform patient tasks. My wife stayed in my room each night and she’d go home during those hours. On Thursday morning when she was leaving at 8 a.m. she was told that the earliest I could be starting to awake from the cooling process would be later that day. When she returned a little after 10 a.m. she was told that I was awake and had already been taken off the ventilator. The doctor arrived and asked me the name of the President of the United States, what year it was and my wife’s name, along with a few other rudimentary tasks such asking me to wiggle my toes. I’m told that I quickly and correctly answered his questions and performed the tasks requested. Over the next few hours and days nurses asked my wife if I was acting normal and was this my personality. She responded that it was. I’m not sure exactly why they asked that.
As you can imagine I consider myself incredibly blessed that I survived sudden cardiac arrest. The fact that I survived with zero loss of brain functionality is a miracle. There is no question that the prayers of family, friends and strangers made all the difference.
Those who know me will know that I’m a private person. There are relatively very few people, including friends, who know that I suffered SCA this past March. The only reason that I’m telling this story now is that since I suffered SCA a number of family and friends have gone to their doctors for checkups to see if they have any heart issues. Their rational is that if this could happen to me, someone who most believed was in very good health, SCA could certainly happen to them.
There are a number of simple tests you can take to see if you should make changes in your lifestyle, including diet, exercise or medications to dramatically improve your heart health. One of them is an inexpensive procedure called a heart scan, also known as a coronary calcium CT scan. If you follow that link you’ll learn that Mayo Clinic will tell you that:
“A heart scan, also known as a coronary calcium scan, is a specialized X-ray test that provides pictures of your heart that can help your doctor detect and measure calcium-containing plaque in the arteries.
Plaque inside the arteries of your heart can grow and restrict blood flow to the muscles of the heart. Measuring calcified plaque with a heart scan may allow your doctor to identify possible coronary artery disease before you have signs and symptoms.
Your doctor will use your test results to determine if you may need medication or lifestyle changes to reduce the risk of heart attack or other heart problems.”
As I mentioned, family and friends have taken this simple inexpensive (locally it costs under $ 100) procedure to find out if some changes in your life are needed. Several of those who’ve taken this scan have learned that they needed to take immediate steps because of the results. I wished that I would have known about this scan before I suffered SCA as it would have allowed doctors to properly treat me prior to having my heart stop for 15 minutes.
In the movie The Princess Bride, Miracle Max the Wizard, played by Billy Crystal, had a line saying “Turns out your friend here is only MOSTLY dead. See, mostly dead is still slightly alive.” It’s now easy for me to joke about what happened as my outcome couldn’t have been better. I will be eternally grateful for the actions taken by the 9-1-1 dispatcher, the incredible police officer and paramedics who gave me CPR and got me to the hospital alive, for the two life-saving doctors who treated me at the hospital who provided me extraordinary care, for the nurses and staff in the emergency room, ICU and recovery who cared for me and talked to me constantly while I was unconscious and during recovery leading to my full recovery, to family and friends who were by my side or were aware of what had happened praying for my recovery and especially to my wife who initially called 9-1-1 and gave me CPR until others arrived to help.
I can tell you that surviving SCA and all that I experienced since that day is overwhelming at times. To consider the odds of me surviving and suffering no brain damage is difficult for me to fathom. As you can imagine I’ve gone through a number of tests subsequent to experiencing SCA and my doctor found that I also suffered no damage to my heart which is unusual. For me every new day is a blessing. I’m looking forward to spending a long time with family and friends and I’m looking forward to March Madness in the years to come. That reminds me of the Yiddish proverb, “Man plans. God laughs.”
I would strongly advise anyone who reads this to have a coronary calcium CT or heart scan as soon as you can schedule one. It could save your life.