Wini’s Story: Chronic Illness, Palliative Care

In her role as the nurse in school at Pocopson Elementary located in West Chester, Sue Davis is 66 and also teaches CPR instruction throughout the district of the Unionville-Chadds Ford Schools. When she is teaching CPR she always emphasizes the crucial “chain for survival” following a cardiac event such as calling 911, starting CPR and using an automated external defibrillator, and getting to the hospital to receive prompt intervention. She didn’t realize that on Feb 19, 2011, this chain could save her own life following cardiac arrest due to her husband Larry’s capacity to keep cool during very difficult conditions.

On the way, Sue and Larry remember, a fierce storm had knocked out their power and phone service on a cold winter day. As the evening grew darker the couple planned to go out for dinner and watch a film. After the film, Sue started feeling some discomfort in her shoulder, however, she didn’t think much of it and didn’t even mention it to Larry. After returning to their dark, cold house The couple wrapped themselves in layers and headed to sleep. However, by 10:30 pm, Sue was having lasting chest pains along with weakness in her arm. She called Larry who grabbed their flashlight with a high-powered power source and led her to the restroom to get an aspirin and suggested they go towards The Emergency Department at The Chester County Hospital.

“I certainly wasn’t thinking of a heart attack,” Sue says. “My profile of lipids is perfect. I exercise between three and every week. I consume a vegan diet, with a little fish. My Body Mass Index is in the 20th percentile. There is a family history of heart disease, however, in my head, I did everything in the right way.”

As Larry drove down their long driveway, he realized that the car was making a weird noise, so he decided to throw the vehicle into reverse and drove back home to call 911 from his cell phone. It turned out to be a lucky decision, considering what transpired the next day: Sue lay down on the couch and was complaining of pain that was increasing and dizziness. She then went into cardiac arrest.

“As I was talking to 911 I went to look her over and observed her eyes swell upwards into her skull,” Larry recalls. “I am unable to explain the feeling it was like to witness her dying like this. I was shocked however I told myself not to get scared. I knew that I needed to focus.”

Placing the phone between his shoulder and ear and placing the flashlight on his arm, he listened to the 911 operator taught him how to carry out CPR. (Larry is now joking about the irony that Sue even though she was an instructor of CPR instructor, hadn’t taught him how to do it!) He gave the operator his street address and continued to pump his chest even after the phone was disconnected accidentally and it was impossible to contact 911.

“I manage at DuPont and I am working with a number of diaphragm pumps,” Larry says. “So the main thing that was on my mind was to keep that pump running.” He knew he would have to quit performing CPR so that he could call 911 again. Sue’s life was in danger.

Then a second thought came to him: with all the lights off within the vicinity, it could be difficult for an ambulance to locate their home which is situated in a wooded, but somewhat isolated part of Chadds Ford. When he saw the lights of an ambulance from in the windows, he stopped CPR and ran out to signal his flashlight. The headlights flashed back and he swiftly returned to Sue’s side to carry on CPR. At this moment, Sue had already been in cardiac arrest for about 10 minutes.

In a matter of minutes after that, paramedics of The Longwood Fire Company took over. When they found Sue inside the vehicle, they started an operation known as therapeutic hypothermia. They utilized ice-cold intravenous fluid to cool Sue’s body until it was around the temperature of 92° F (38 levels C). In certain patients who are in a coma following cardiac arrest inducing hypothermia over the course of 24 hours could give fragile brain tissue the time to recuperate slowly. Studies have shown that patients who are chilled following an arrest tend to live with brain function intact. After Sue was admitted to The Chester County Hospital, intensivists Ian Butler, MD, and Don Emery, MD, continued cooling, while the cardiologist Joseph Lewis, MD, was quick to clear the blockage in the vessel which led to Sue’s cardiac attack.

“I recall that Dr. Lewis coming out and visiting me for a while and demonstrating what he’d accomplished as well as explaining to me that Sue had a roughly 50% chance of waking up of a coma,” Larry says. “Even at that moment, it was possible that she would require anywhere from between six and a year of rehabilitation. She may never recover. I knew that being deficient in oxygen for the brain in as little as 6 minutes could result in devastating consequences.”

The following couple of days turned into a nervous wait for Larry and Sue, because Sue was kept warm for 24 hours before being gradually warmed up. Soon, he was with their child Eddie who came in from California Sue’s brother who was from South Carolina; Larry’s family and close family members. Larry mentions that a particularly serene and comforting appearance was ICU nursing assistant Clarissa Hake RN and CCRN. was by his and Sue’s side throughout the incident.

“I had been to many hospitals however this one was unique,” Larry marvels. “The care and attention to us were amazing from Clarissa as well as doctors and the entire team of clinicians. What they did for Sue as well as I was incredible.”

On the third day, Larry and Clarissa were by Sue’s side at the time she opened her eye. They noticed she could follow their instructions to close and open her eyes, and also hold their hands — and with a firm, reassuring grip and no less! Sue was unable to speak due to a paralyzed vocal cord, however, Larry believes he was given an elated feeling when he heard the first word she spoke: “I’m having a little trouble articulating my words.” Sue immediately recognized her family members however, she was unable to recall her short-term memory. In fact, she would greet them each time she walked into the room, leading to some funny moments. However, Larry was optimistic about her complete recovery and was inspired by the optimistic outlook that was expressed by the doctor. Butler.

In just a few months, Sue was out of the Hospital and was transferred to Bryn Mawr Rehabilitation for five days of physical, speech as well as occupational therapy.

“I believe I wowed everybody there,” Sue says. “They were able to see that my diagnosis was ‘post-anoxic epilepsy which is a loss of oxygen to the brain but I was able to get out of bed and do an amazing job to help me.”

In the following weeks, Sue continued her therapy and began cardio rehabilitation at the Chester County Hospital’s Fern Hill Medical Campus. Sue returned to work within a matter of two months and is now using her own personal story to assist her CPR students appreciate the crucial significance of “the “chain that is essential to survival.” In the summer she along with Larry enjoyed their annual trip in Maine along with visiting their son California and California, where Sue reached a peak of 9,900 feet close to Lake Tahoe.

Sue doesn’t have a memory of that night on February 19, and the following days however Larry definitely will not forget the event. Sue is grateful to Larry’s ability to keep cool even under pressure, in conjunction with the Hospital’s cooling therapies and swift action to relieve her blockage as the reason for the saving of her life. It was not only the ability to perform physically as well but its quality of life, too.

“Sue’s complete recovery has been an amazing experience,” Larry marvels, “and we’re extremely grateful.”

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