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If we only knew how to prevent Sudden Cardiac Arrest and death.

DrD11
0 Recommendations

Today we know how to rescue an individual,who sustains cardiac
arrest and death. Thanks to CPR,Defibrillators and ICD's,lot of
people are rescued.Still,this population constitutes only 5% of the
total number of persons estimated to sustain S.C.A. and S.C.D.
If we could screen and predict this coming tragedy,we could
prevent a whole lot more such disasters.
I wonder if anything is known in this issue.Something practical
available to the masses(And affordable).
Please do not relate to risk factors,as these are not practical
enough.

Explore topics in this discussion:

Exercise Surgery Sudden cardiac arrest Falls Syncope Anxiety Long QT syndrome Stent Arrhythmia Hydrocephalus Stroke Diabetes Hypertension Memory Brugada syndrome Heart attack Obesity

29 replies

DrD11

Hi Paul.
I absolutly agree, that in the case of Bystander,doing nothing results in nothing.
Reading the narratives in this forum,it saddens me to realize the level of distress you all go through.
Something must be done to motivate the Bystander
to "Pitch in".CPR on a large scale, is an excellent idea.Still more ideas (and tools) are needed.
Idea of a tool that will be available on a level of a gadget,inexpensive,available to anybody,anytime
to tell the person what is going on with his heart
(or someone else) now! There are some tool, today,
on thr market,but these are not available(In concept and affordability)to the masses.
Best regards
Dr.D11

Paul_Pakusch

Everyone....I started writing a private message to Debra, but then decided to make it public so that maybe other people could learn from it as well. Please feel free to respond.

Hi Debra,

Mary and I were both struck by the similarities in SCA situations between you and your husband and us. Since you saved his life, what was particularly noteworthy was your feelings about whether you did enough or not. That has been one of my biggest issues ever since.

Mary's first SCA was on July 15, 2006. We were talking in the kitchen when she suddenly collapsed. I had no idea what was going on at the time, but it was obvious to me that she was unconcious; she had landed on her back, face up, her eyes were in a fixated stare and she was not responding to my screaming her name. As luck would have it, she had fallen right in front of the phone. I immediately picked it up and dialed 911. I was still screaming her name when they answered. We later got a copy of the tape and also met the 911 operator, Julie. Julie quickly calmed me down, got info, and then started giving me directions on what to do until help arrived about 7 or 8 minutes later.

Through all of this, I started feeling horribly guilty that I had passed up so many opportunities at work to learn CPR. I followed Julie's directions, but I didn't really understand what I was doing. I couldn't find a pulse and it didn't look like Mary was breathing. I knew every second counted, but I felt like my slow responses to Julie's commands were wasting time. Mary was turning purple and her hands were starting to curl. I didn't know until later what the curling hands meant, but I knew it wasn't good. In spite of doing everything Julie was telling me to do, I felt like I wasn't doing enough.

Later that afternoon in the hospital, when we still didn't know Mary's fate, I was sobbing uncontrollably and blaming myself for the fact that I didn't do enough. Most of Mary's family and my family were also in the hospital. Many of them tried to console me by telling me I had done everything humanly possible. But I kept thinking, "How could she get to this point? If only I had taken a CPR course!"

When the doctors finally told me what had happened, it was a term I had never heard before: A ventricular arrhythmia followed by a cardiac arrest. I made the common mistake and applied what I thought was the layman's term for it, "heart attack." It wasn't until two days later that I finally understood the difference between a SCA and a heart attack. But I clearly understood from the doctors that her chances of surviving were about 10% and that her chances of recovering from brain damage were about 5%.

Her parents and sisters were also part of these conversations. We were told that I might have to make a decision about pulling the plug. The stories about Terry Schiavo were still fresh in the news and I dreaded whether being put into that position would cause a huge rift among us. Later on, her parents told me they would have supported whatever I decided to do. I told them I would have included them in that decision.

Mary was on a cooling therapy using the Arctic Sun machine. In this therapy, the body's temperature is brought down in order to increase blood flow to the heart and brain. They kept her on an induced coma for almost two days. Imagine my thrill when the night nurse called me at 1:15 a.m. to tell me Mary had woken up!

Even so, her short term memory was shot at that point and she had a lot of recovering to do. She was in the hospital for a total of 10 days and she looked like a bruised pincushion from the IV's and everything else they had done to her. But boy, she looked beautiful to me! They gave her an ICD.

Bringing her home was bittersweet. She had been well cared for in the hospital and I felt she was safe there. It scared me to death to lose that security. Until she had her second SCA a year and a half later and the ICD saved her life, I had a hard time learning to trust that the darn thing would actually work. I got very jumpy when I heard things fall or when she dropped her head down like I saw her do just before she collapsed from her first SCA. At night when she was sleeping, I often watched carefully to make sure she was breathing. On the first anniversary of the first SCA, at 9:11 a.m. (about the time it happened), she was still sleeping so I went in the room to watch her breath.

Emotionally, this has been a hard thing for me. A lot of people tell me, "I can't imagine what it must have been like for you." I agree. You can't imagine it; it's surreal. I still can't believe it happened. Debra, you know what I'm talking about; you probably can't believe you went through it twice. Mary was alone when she had her second SCA and her ICD saved her. Since I wasn't there, it mostly just sounds like a story to me. But unlike the first SCA, Mary remembers the second one. She got "real dizzy," passed out, and then woke up on the floor, disoriented at first. The whole episode was recorded on her ICD and the doctor said it lasted 8 seconds. There was no anoxia involved, so she was able to resume "normal" activities almost right away. Of course, we were both very scared and upset, but they did tell us we would feel that way if it ever happened again.

Debra, it will take time for you to trust your husband's ICD. It will also be very scary to you when he goes to have it tested. But be assured that they do work!

As for me, I have now had enough medical people and emergency responders tell me I saved Mary's life that I am actually starting to believe it. She is living proof that my actions that morning started the chain of survival that brought her to where she is today: Living a normal life, working, enjoying our daughters and their friends/companions, and sharing dreams of doing a lot of travelling together.

DrD11, you made an important point about bystander actions. People need to get over the fear of failure. There is indeed a chance that their efforts at CPR will fail, but failure is virtually a guarantee if bystanders do nothing.

DrD11

Hello Paul.
Hello Mary 1.

In reviewing medical literaturr via Pub Med,you will
some articles dealing with the lack of action by the
Bystander.Except for the "Yuck Factor",there is the fear of failure.Lack of sufficient knowledge,and
appropriate tool,give the Bystander the feeling that the effort will be futile.Avoidance is easy.
I hope that when an appropriate tool becomes available,and utilized in the first"Ten Golden Minutes",more Bystanders will volunteer in ressuscitation.

Mary1

(Just because I believe we can and should find humor in everything...)

I'm glad Paul didn't have that "yuck factor" about the idea of putting his lips on mine! :-)

Paul_Pakusch

DrD11,

It's no problem at all that you barged in. (I just sent a friend request to Debra)

I'm intrigued by this whole bystander stigma. Have you seen the video that came out about a month ago, where a traffic camera caught an elderly man being hit by a car and no one helped him until a cop happened upon the scene? (It's on Youtube, if you want to hunt for it) The video shows people standing around, going about their business, or gawking. But no one helped. I've been around accident scenes where I didn't do anything either, but that was after making sure someone else was helping. Maybe that's the thinking: "Oh, SOMEONE ELSE will take care of this."

Of course, that's not going to work when you're alone with the victim and they're not breathing. Honestly, I don't know how I would have reacted if I saw a stranger collapse like Mary did. Since she's my wife, it was a no-brainer to take immediate action and there was no hesitation when the 911 operator told me to do some mouth-to-mouth. But on a stranger? I think that's what's good about the new hands-only CPR. It takes out the "yuck" factor and may prompt someone to take action.

Debra71508

Paul:

I'd love to talk with you! yes - after his second SCA they gave him an ICD & I am trying to learn to trust it.

My first shot at CPR with his first SCA on 2.21.08 was pretty lame since I wasn't sure what to do & I wasn;t even sure it was a cardiac problem! After he made it through 4 days on life support with a medically induced coma (& made it with no brain damage) I made it a point to read up on CPR. I felt very guilty for not having known what i didn't know. I was not timid in the least on 7/15/08 when he went down & I am sure that it was my hands keeping him alive for that long 10 minutes before the EMTs arrived in the woods. This time - no medically induced coma was needed PLUS he did not code 2 more times in the hospital like he had in February.

I've been telling everyone that there is no reason that an able bodied person over 12 should not know how to do CPR and when to do it. The American Heart Association makes it very plain that if an adult is down & unresonsive you can assume it's SCA and your hands only chest compressions can make the difference. if we insist that all school children know how to read and how to swim why wouldn't we insist they know CPR?

If I can do it, anyone can do it.

DrD11

Paul.
Your note was adressed to Debra,not me,and I shouldn't "Barge in".
Still ,as it appeared in this site,with a space for me to reply,I feel obliged to add my comment.
First,and above all,let me praise your outstanding
deed of saving life, twice!
As a Bystander,you did something that not many
Bystanders do:You went into action.
Literature,mentions the very low response of Bystanders.(~7.7%).The big question is: why?.
The answer?,You can not answer unless you have been in this person's place.
The Bystander,who comes across such a tragedy,
many times:"Freezes".He doesn't know,he hasn't
seen that before,he is afraid that he will fail and
get blame for the failure.He doesn't have enough information to act upon.Calling 911,is one of the solutions.Still when the E.M.T. arrive with the defibrillators,it may be beyond the "Golden Ten
Minutes".This is "Too Late".
It behooves all of us to figure a better way,where the Bystader will know immediately that this person
"Down" has not just fainted but that he is in V-Fib
or other catastrophic arrythmia.It behooves us to
think of something better to include in CPR.
In that moment the Bystander is the Doctor,he is
supposed to save lives.

Paul_Pakusch

Debra, I am Mary's husband, Paul. Maybe I'm too modest to say I saved Mary's life, but everyone tells me that and the results are hard to dispute. She is doing very well today.

I did not know CPR when she collapsed in front of me. A wonderful 911 operator got me calmed down and gave me step-by-step instructions until firemen arrived. Even so, the feelings of helplessness and guilt over passing previous opportunities to learn CPR were very overpowering.

Mary got an ICD while she was in the hospital (does your husband have one?) It took me a long time to learn to trust it until it actually saved her life after her second SCA on December 22, 2007. Knowing that it worked, I feel a lot more relaxed now.

My personal message is to get people to learn bystander CPR. That's the key. I made a video, which you can find on www.youtube.com/flyjupiter. Mary has a TV interview on there as well. We've also been interviewed by the media a few times. There's one on CNN.com. You can find the story if you google "Pakusch CNN".

Debra, We have a lot in common: Her first SCA was July 15, 2006 and it happened just after 9:00 AM. The hospital got their call at 9:11 AM. I would like to communicate with you some more about our experiences.

Lydjahh

Well...my cholesterol is fine. My blood glucose is normal. I don't smoke and I exercise like a fiend. My husband has diabetes, hypertension and hyperlipidemia...and a family history of heart disease..and sleep apnea...and obesity. Which one of us had the SCA?? Go figure. I have not let this ICD change the way I live because if I think too much about my "event", it freaks me out. I am one lucky woman. My hubby of 32 years never worried much about me and now he's almost too protective. I cannot live with fear and refuse to take life seriously. A girl's gotta have her fun! As y'all know, it could all end with a singled heartbeat! Hang in there! Life is a dream!

Debra71508

Mary!

How is Paul doing now? Still twitching? I can't sleep through the night, most nights, yet. I'd love to talk to someone who's been there. My husband (Chris) claims this has been harder on me emotionally than it's been on him. I am not sure he's wrong. I've been having a very hard time with pretty dark thoughts and random anxiety. I'm not normally jumpy or crabby but I've been both lately & I hate it.

As for diet, "let me say this about that" as our former President liked to say: I love to cook fresh, wholesome foods from scratch. It's creative, relaxing and rewarding since you get to eat the results of your efforts. Christopher has had something like 3 servings of french fries in the 10 years we've been together. I've seen him eat fastfood probably once a year. Diet, in his case as with so many others, had nothing to do with it. Although everyone would benefit from a thoughtful well balanced diet, I sometimes think we seek SCA protection from risk in places that are only partly (and sometimes never) related to risk.

You know since all this I have gotten a bunch of my friends to take CPR class & I've sent out the Am. Heart Assoc. video on chest compression only CPR. As a link in that "chain of survival" that you mentioned, Mary, I hope we all help make more links in the survival chains of others. I've got to turn my gratitude outward, right?

DrD11

Hello Mary1.
Your comment hit the point that I am trying to make.
You wrote:"...He was the primary factor in the chain of survival that kept me alive,"
In todays "Chain of survival",we still do not have the
ability of the bystander,who happen to come across a
person"Down",to function as E.M.T.
When one says call 911,it means that defibrillation
will occure when this proifessional arrives with this
tool.Everybody knows the value of "Time lost" "The 10 Golden Minutes".
I wish for everyone who gives care to be able to function as a full fledged Care Giver.
This idea of mine was already published.(see my
Profile in this publication),
P.S.I am not Debra.Just a Guy.

Mary1

Hi Debra,
Your comments caught my attention because you sound so much like my husband from when I had my SCA in July 2006. He never had any prior CPR training, yet he saved my life with the help of the 911 operator (whom we've both met since then!)... Anyway, while I was in the hospital and my family was told I would most likely die or be in a vegetative state, he was furious with himself for not being able to do enough. Even today, with a full recovery, he still won't believe he was the primary factor in the chain of survival that kept me alive.
I had a 2nd SCA last December. Luckily I also had an ICD. But it brought back many bad memories, especially for Paul. I am going to show him your letter. I think you could really benefit from talking to someone who felt as helpless as I'm sure you did.
Take care.
Mary

drjose

Hi,

I went to MIT to get my MS. I am a survivor of the Blizzard of '78. haha.

I also believe that I was saved by the grace of God. I don't know anyone surviving a SCA with 45 minutes of CPR and 5 AED shocks. Maybe I should be in the Guinness Book of Records. :-)

The power of prayers was vital for my recovery. My wife prayed so hard and the prayers' chains were in churches in Jacksonville, Florida, Miami, Atlanta, and other countries.

I thank God every day for this second opportunity to share these thoughts and live better.

Jose

Debra71508

Drjose:

So you have a Ph.d., so does my husband and from MIT - like it matters in the least given all this? YEAH smart dude but he can be an eggplant in 4 or 5 minutes? So can we all?

FACT: My darling husband's risk factors (we know them all and well from family to pre-SCA test of every sort) did NEVER, EVER place him in a high or near high risk group. To this day when you "plug" in my husdand's pre-SCA known risk factors (family hx, smoking, diet, weight, chol levels, exercise patterns) he still falls into "low" risk levels.

YET he had SCA TWICE THIS DAMN YEAR!!!! - 2 times - TWO - (I am still totally freaked about this) in 2008.

February 21 and July 15 and only NOW after the last attack am I begining to get the diff between SCA and "heart attack." The only common factor was that I happened - by sheer dumb luck - I to be there both times and called 911 and did what I could to keep him alive via my lousy but apparently adequate CRP skills as learned from a late 1960's Girl Scout's (God Bless them - i.e., do not be afriad and don't freak out & please be useful & the new Heart Association public service anounncements about Hands Only CPR.)

Hands Only CPR is more - far more- resonable than you'd think when you look at the research behind it.


Both times it was enough but the Grace of GOD - not me, I know since I don't even believe in God -although these events are challenging my prior ideas about it.

Tammy1

I suffered a Sudden Cardiac Arrest October 23, 2007. There has been no diagnosis, no long Q-T syndrome, nothing. I have had syncope for years and then the SCA. I have been researching and studying for the last 8 months. I looked at WPW that has some of my symptoms but then I found a syndrome called Brugada Syndrome that is right on target with all of my symptoms. I think would be of interest for some to look into.
I have contacted him and he has agreed to look at my file. I am having a electro-physiology test soon to be sent to him as well. Hopefully we have an answer soon.
Hope this helps.

DrD11

Hello
You are correct in emphsizing Lifestyle modification.
Doctors are notorious to have little knowledge about nutrition.Therefore,nutrition,is a neglected subject.The public is not less negligent,in not paying attention, to what they eat and why.
Willing to have a "Quick fix",we eat fast,fast food.
When our arteries get clogged,we speed into surgery and then suffer some consequences.
Then we complain:"Why me".
"Stop whinning and do something",somebody said it recently.Prevent,prevent prevent.This is what medicine is now start to turn to.Unfortunately it turn too slow.Someone got to do something about it!

drjose

Hi,

I am not a medical doctor so don't get confused. PhDs also used the DR. before the name and many times I get questions about health that I am qualified to answer.

However, as a SCA survivor, I have found that prevention should include the way we eat, work, streess, exercises, etc.

I se every day that we do not know how to eat well and our children are going in the same direction, we do not exercise well and our children are doing the same. We need to lead by example.

Go to your favorite supermarket and see the families and their shopping carts. My wife says that the secret is to learn to buy food.

Prevention can be done in many ways and I am doing my part by teachig others how to have a better daily life.

Have fun,

Jose

Camping in a Scout reservation as staff of the National Youth Leadership Training Brownsea XXVIII. Back to the woods two months after my SCA, and kept doing it every month. (Yes, we have Internet, cell phone signal, and a brand new AED donated to the camp by St. Vincent's Hospital.)

DrD11

Calcium Scan,is a good test to have.This test answers the question if a plaque is calcified.
It also identifies the existance of the plaque.
Since big part of the plaques are not-calcified,this test does not detect it.(MRI of the heart will detect it).
The "Soft" plaques rupture more easily than the "Hard"Plaques,cauing coronary occlusion.
Let us not forget that Cardiac Arrythmias are the
"Bigger killer" in S.C.A.

MoJo

Since cardiovascular disease can lead to SCA, there is a good screening tool for that disease and it is a coronary artery scan, otherwise known as a heart scan. The scan is non-invasive and measures a person's coronary calcium score--the higher the score, the more likely you are to have a "cardiovascular event", which could be a heart attack, stroke or SCA. For more information see www.shapesociety.org. Costs of scans vary, but in the Baltimore area, they are under $100 at leading hospitals. Not covered by insurance, but well worth the cost to see if you are at risk.

janee

I appreciate and am pleased that there are so many good outcomes. I guess my husband didn't get so lucky and obviously I am still very angry but don't know who to take it out on!! Cooling was not used on my husband and may have made the difference. Also he continued to go into v-fib during the entire night after his SCA. He has gone from being a very kind, caring, concerned man to one who is extremely ego -centric. My Dad died just a year afterwards and my husband was unable to give me any empathy. It is just tuff and I know that there are others like me out there. I am truly sorry for those families and pleased so many of you have good outcomes. As an RN, I hope to never have to help someone in SCA again unless it is in a hospital and controlled setting. I am sure that I would give it my all tho. Good luck to you all.

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