The Day

Monday, March 21.  It was around 4 in the afternoon.  I was sitting on the living room floor, playing catch with Sweet Pea and the Wife.  Laughing and having a good time.  We had this day and Tuesday off all together and were talking about things to do on our free day Tuesday.  The phone rang.  I was sitting on the floor and didn't feel like getting up.  The Wife was in the chair and sitting comfortably, but she had worked a night shift the night before and was darn near exhaustion, so she didn't feel like jumping up to answer either.  Until we heard my sisters voice. 

Usually when people leave a message, it is a little breezy.  Not so this one.  We could tell by her tone that something was terribly wrong and she commanded us to call her immediately when we got this message.  Of course by then we were both up and to the phone.

My first thought was something had happened with my mom, as she has been having health problems this last year with her kidneys and dialysis and such. 

"I'm on my way to pick mom up from dialysis.  Dad apparently had a heart attack and is headed for the hospital."

Everything sped up and slowed down at the same time.  With only that information I thought perhaps he had some chest pains and someone called 911.  I've picked up symptomatic people before.  Maybe it wasn't too bad.  Still we started packing up for a rushed trip to Cedar Rapids, three hours away.  I got online and found the phone number for the ED down there and gave them a call.  There was no answer.  That seemed strange, as even in my hospital there is always somebody around to answer a phone.  Within ten minutes my sister called back.

She had talked to a fire medic that had been on scene and been working with the medics on Dad.  The information passed to me was that he had dropped mom off at dialysis and gone to the cardiac rehab gym to do some exercising when he collapsed.  All the fire medic could tell her was that CPR had been started, the medics arrived in just under ten minutes.  CPR was continued.  Dad had been in ventricular fibrillation, or V-fib, and a shock was administered.  One round of epinephrine and amioderone were administered along with a second shock.  An endotracheal tube, or ET tube, was placed down his throat and into his lungs to help him breath.  He was loaded and transported with CPR still in progress.  The fire medic was not too optimistic about his chances.

With that information, the kiddos were loaded in the car, along with the dogs and some hastily packed bags, and we headed out.

As a paramedic, I have been on calls like this.  We get someplace with CPR in progress, work the patient and do what we can.  If we transport at all, we have usually regained some organized heart rhythm, or seen something that makes us think perhaps they have a chance of survival.  But if we've administered the drugs and the shocks and nothing is working, we usually call it in twenty or thirty minutes or so.  ten minutes of CPR before the medics arrived.  They had worked him for another ten to fifteen on scene, and CPR was being continued on the way to the ED.  I was starting to try and wrap my mind around the world without my father in it.

We stopped at a gas station about twenty minutes down the road.  I stepped outside and got hold of the ED.  Mom gave them permission to tell me everything.  My own heart was heavy, as I knew that by this time he was either alive or he wasn't.  And from what I had heard, I did not think he would be alive.

Much to my relief, they had a rhythm back.  He was critical but stable and headed for the cath lab to find the problem and fix it. 

When we arrived in CR, we headed straight for the cardiac intensive care unit.  Dad's room looked like a movie set.  All of the various life support paraphernalia was there, and there was my father.  He was pale.  The vent was pulsing rhythmically, keeping him breathing.  The vitals looked OK.  He was heavily sedated and unnaturally still.  And my heart broke.  It is cliche to say it seemed like a bad dream.  But there is no other way to describe it.

As the day went on, we heard more of the story.  He had collapsed while on the exercise bike.  CPR was started within a minute.  Much of the staff at the dialysis center worked on Dad, doing good quality CPR.  The medics did everything just right.  The ED nurses and doctors did everything just right.  It was a textbook case.  A textbook save for a sudden cardiac arrest event.  The medic in me was proud and thrilled that all had gone well.  But the medic in me also knew that just because we get a pulse back doesn't mean everything will be all right.  The brain dies pretty quickly without oxygen, and sometimes even with good CPR the end result is a person who loses some of their mental faculties. 

I will be forever grateful to those that saved my dad so that I could make it to his side in time to say goodbye if that was the case.  And now it was a waiting game to see if he would wake up, and if he would be close to the same man he was before the day.

More Later