Tuesday
evening we were down by Philadelphia picking up a new bed for Heidi
when both our cell phones went off at about the same time -- rarely a
good sign. Chris's dad, who lives in Pittsburgh had gone into cardiac
arrest and there was very little information about his condition.
Jim and his sister go for a walk each day at a nearby park. After Tuesday's walk they get back in the car, as they're leaving the park he suddenly slows the car and slumps over the wheel, unresponsive. His sister got the car stopped and bystanders pulled him from the car and called 911. A nurse happened to be in the park and walking nearby. She initiated CPR until the park police arrived. They had an AED (defibrillator) which shocked him twice and got a pulse back on him. Once the ambulance arrived they were only 5 minutes away from the closest hospital.
When we got the call at 8pm Jim was unresponsive and on the vent in the ED. Fast forward about 8 hours and we made it to Pittsburgh around 4:30am on Wednesday. By this time he was still unresponsive, but in the ICU and still alive. On the plus side he was physically fine otherwise -- his heart, lungs, kidneys, all his major systems were functioning very well. He'd been working hard in the last year to improve his health. He'd lost a hundred pounds, got a hip replacement, his diabetes and pressure were well under control. Unfortunately in almost any cardiac arrest the brain suffers damage as a result of oxygen deprivation, it's just a matter of how long and how much. There is no test that can predict the results or even determine what the damage or chance of recovery is. And 24 hours in things were looking very bad for him.
Wednesday and Thursday there wasn't much change, an improvement in responsiveness to stimulus -- but no purposeful movement. Eye opening but no focusing, posturing but nothing in response to voice, no following commands. Thursday afternoon the neurologist said the words "hypoxic ischemic injury to both hemispheres of the brain." He said he did not believe Jim would be lucid again, but that with these cases you needed to wait the full 72 hours to get a good picture on recovery. We broached the topics of "Do Not Resuscitate" orders and other unpleasant decisions that may arise. Our realm of experience told us that the chances of anything more at this point were slim at best, so we were prepared for some very difficult times. But we readily agreed to give him the full 72 hours before making any decisions at all.
When we got to the hospital on Friday morning we walked in expecting little change. Instead Jim heard Chris's voice and turned his head and looked directly at him. He was able to indicate yes and no, blink his eyes, and squeeze my hand on command. When the neurologist checked him tonight, he passed all the early tests. The overly serious neurologist actually smiled and said, "Some people just get lucky."
Yesterday he was even clearer, though he does appear to favor his left side. He was able to form words with his mouth, primarily "Take it out!" (Meaning the endotracheal tube) Today he could hold up two fingers with each hand, an indication of fine motor control and very good sign. He has no memories yet of the last week, both the arrest and the medications contribute to short term memory loss.
It's still a really long road ahead and we won't get a clearer picture of deficits and care needs until next week when he's extubated. But it looks like he may pull through intact and the kids will still have their grandfather. Chris's sister got me a flight home yesterday afternoon so that I could be with my kids and he wouldn't have to drive 12 hours round trip. I have to go back to work tomorrow night as it is. Because ya know ... there's no rest for weary, unless you're dead and even then you can't sleep. ;)
Jim and his sister go for a walk each day at a nearby park. After Tuesday's walk they get back in the car, as they're leaving the park he suddenly slows the car and slumps over the wheel, unresponsive. His sister got the car stopped and bystanders pulled him from the car and called 911. A nurse happened to be in the park and walking nearby. She initiated CPR until the park police arrived. They had an AED (defibrillator) which shocked him twice and got a pulse back on him. Once the ambulance arrived they were only 5 minutes away from the closest hospital.
When we got the call at 8pm Jim was unresponsive and on the vent in the ED. Fast forward about 8 hours and we made it to Pittsburgh around 4:30am on Wednesday. By this time he was still unresponsive, but in the ICU and still alive. On the plus side he was physically fine otherwise -- his heart, lungs, kidneys, all his major systems were functioning very well. He'd been working hard in the last year to improve his health. He'd lost a hundred pounds, got a hip replacement, his diabetes and pressure were well under control. Unfortunately in almost any cardiac arrest the brain suffers damage as a result of oxygen deprivation, it's just a matter of how long and how much. There is no test that can predict the results or even determine what the damage or chance of recovery is. And 24 hours in things were looking very bad for him.
Wednesday and Thursday there wasn't much change, an improvement in responsiveness to stimulus -- but no purposeful movement. Eye opening but no focusing, posturing but nothing in response to voice, no following commands. Thursday afternoon the neurologist said the words "hypoxic ischemic injury to both hemispheres of the brain." He said he did not believe Jim would be lucid again, but that with these cases you needed to wait the full 72 hours to get a good picture on recovery. We broached the topics of "Do Not Resuscitate" orders and other unpleasant decisions that may arise. Our realm of experience told us that the chances of anything more at this point were slim at best, so we were prepared for some very difficult times. But we readily agreed to give him the full 72 hours before making any decisions at all.
When we got to the hospital on Friday morning we walked in expecting little change. Instead Jim heard Chris's voice and turned his head and looked directly at him. He was able to indicate yes and no, blink his eyes, and squeeze my hand on command. When the neurologist checked him tonight, he passed all the early tests. The overly serious neurologist actually smiled and said, "Some people just get lucky."
Yesterday he was even clearer, though he does appear to favor his left side. He was able to form words with his mouth, primarily "Take it out!" (Meaning the endotracheal tube) Today he could hold up two fingers with each hand, an indication of fine motor control and very good sign. He has no memories yet of the last week, both the arrest and the medications contribute to short term memory loss.
It's still a really long road ahead and we won't get a clearer picture of deficits and care needs until next week when he's extubated. But it looks like he may pull through intact and the kids will still have their grandfather. Chris's sister got me a flight home yesterday afternoon so that I could be with my kids and he wouldn't have to drive 12 hours round trip. I have to go back to work tomorrow night as it is. Because ya know ... there's no rest for weary, unless you're dead and even then you can't sleep. ;)
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