One night, nine defibrillations

Denise woke one night with a pain in her shoulder and what she thought was indigestion. Just 15 minutes later, husband Phil wheeled her into accident and emergency (A&E), moments before she had a cardiac arrest. Over the next few hours her loved ones were left worrying whether she’d survive.

Phil’s still not sure why he woke that night of Denise’s heart attack – perhaps a sixth sense told him something was wrong? One look at his wife’s face confirmed his unease.

“Denise was looking grey and I was concerned straight away. I think it was because I’d woken up and I never normally wake in the middle of the night,” Phil recalls.

The couple had gone to bed around midnight, after enjoying a meal with son Dan and his girlfriend, who were staying for the night. But 58-year-old Denise had woken shortly after.

“I woke up about one o’clock with a pain in my left shoulder and a little bit of what I considered indigestion, which I’d never had before in my life. I took a couple of paracetamol and it got worse,” recalls Denise.

Phil took Denise’s pulse and noticed it was very strong. They waited a few minutes but the pain didn’t settle and when Phil took Denise’s pulse a second time it was suddenly very weak.

“It went from racing to almost non-existent, very difficult to find,” Phil says.

Phil rushes Denise to hospital

Phil recognised the danger signs and immediately drove Denise to Masterton Hospital, which was only a few minutes away. Denise was struggling to breathe, although she still managed to complain about the speed of the driving, Phil remembers with a laugh.

On arrival at hospital, Denise was lucid and tried to walk from the car. But Phil, now suspecting a heart attack, alerted the staff and got a wheelchair.

“I started to wheel Denise through the doors, but just as they opened, she literally went from being lucid to having a seizure and going completely rigid.”

Denise’s legs caught on the ground and she fell out of the wheelchair, so Phil and a nurse carried her to the emergency department.

‘…at this point, she died.’

“She was completely limp, completely blue and I’m assuming at this point, she died. You know her heart had stopped,” Phil says.

The nurse immediately started cardio pulmonary resuscitation (CPR) while the crash team came with the defibrillator. Luckily the on-call doctor happened to be a cardiologist and an anaesthetist was onsite at the time, something that’s not always the case at a small, rural hospital.

“She didn’t respond to the first two shocks, but she did to the third one. The anaesthetist had arrived by then so he intubated her.”. 

Denise’s heart stops a second time

“On the third shock, when her heart started again, I thought that we were over the worst bit. But within half an hour her heart rate went from very slow, to incredibly fast, to nothing. It just stopped again.”

The crash team recommenced CPR. By now, Denise had four lines giving her various medications and was breathing through a ventilator.   

“Over the next few hours, every now and again Denise’s heart would do some strange things. It would race or stop, one or the other. Invariably, when it was racing I was less worried than when it stopped. Over the course of the evening I think she had nine electric shocks off the defibrillator.”

Time to tell the family

Concerned that his parents hadn’t returned from the hospital, Phil and Denise’s son, Dan, arrived at the emergency department. He then collected his sister Ellie from her home nearby, so the family could be together at the hospital to support Denise.

“I think by now the nurses were quite concerned whether Denise would pull through or not. I did overhear a conversation when I went out to get a coffee, there were two nurses chatting privately and they didn’t sound very positive,” says Phil.

“Each time she was on the defibrillator I kept thinking, ‘This is it, she’s not going to come round this time’. Because it happened so many times, you think, ‘Well how many more times can it happen?’ I was also getting concerned about other possible issues with the lack of oxygen and everything else. Although I didn’t realise until much later on how dangerous the lack of oxygen was.”

Denise keeps fighting

The decision was made to helicopter Denise to the cardiology unit at Wellington Hospital at first light. Unfortunately, fog in Wellington and a shortage of doctors delayed take off, but she finally left around 10.30am – much to the relief of the family, who drove to Wellington to meet Denise in the intensive care unit (ICU).

“By the time we got to the hospital, Denise had been seen by the specialist, had a stent put in, and was back in the ICU. It was incredible there – it was one-to-one care with a nurse at the end of your bed and all of this equipment plugged in. Everything you could think of was there – unbelievable service.”

The family were seen by the doctor who explained that the angiography revealed that only one artery was blocked. What’s more, the work the team had done in Masterton meant that there was no significant damage to the heart. However, there was major concern about Denise’s brain function due to the lack of oxygen.

A waiting game

The next few hours were spent watching and waiting. Denise’s body temperature was lowered to aid her recovery and the nurse explained they would keep her sedated but would intermittently lessen the sedation to see what the reaction was.

The first two attempts to bring her around were unsuccessful. Denise reacted angrily and attempted to remove her ventilator and medication lines.

Finally, the following evening, Denise was deemed well enough to be brought around. The family were nervous - this was the moment they’d know if there had been any brain damage. The nurse asked Denise her name and date of birth, and who the current Prime Minister was.

“I can remember thinking, ‘What a stupid man, not knowing that’. So I told him and thank goodness I got it right,” says Denise.

“Then he said, ‘Who is the finance minister?’ Bearing in mind we’d only just moved to New Zealand from the UK six months before, I said, ‘I haven’t a clue who that is,’ and he just laughed.”

When she reeled off her phone number for him, there was a collective sigh of relief. Despite the lack of oxygen, brain damage had been avoided.

The road to recovery

The medical team predicted Denise would be in intensive care for a week and on the cardiology ward in Wellington for a further two weeks, but Denise had other ideas. She was discharged from the ICU after three days and then spent just one night in the cardiology unit before returning to Masterton Hospital by ambulance. Phil attributes the quick turnaround to Denise’s fighting spirit.

“Denise is always like that. Competitive is not the word for it,” says Phil.

She was told she’d stay at Masterton Hospital for a week or two while she recovered. But this merely served as another challenge. The first couple of days she was on a feeding tube because her throat was swollen from the intubation and the CPR.

By the time Friday came, Denise was desperate to eat and drink and was given water to sip to exercise her muscles. In fact, she hardly slept that evening because she kept sipping water. On Saturday, now better able to swallow, she was allowed to eat some yoghurt and on Sunday was given the all clear to go home. The whole episode had lasted just over a week.

Life after a heart attack

Since the heart attack, Denise and Phil have both been anxious about a reoccurrence.

“I think the first fortnight I probably hardly slept at all. I’d just catnap and then just check that Denise was still alive,” says Phil.

While they’re trying not to worry too much, they are taking precautions to lower their risk of future heart events. As well as being more conscious of their diet, Denise has learnt to take her own pulse and, most importantly, she has quit smoking. She says a photo taken of her in hospital surrounded by monitors has motivated her to stay off the cigarettes.

“It’s the thought that Phil, Ellie and Dan had to be sat there, looking at me like that. I can’t put them through that again, that was awful and that’s my key to stopping smoking. After a few weeks I thought I could maybe have a cigarette, but I picked up that picture and thought, ‘Oh no!’, and that was it.”

Denise has some ongoing pain from two fractured vertebrae suffered as a result of either the CPR or the fall from the wheelchair. But she believes it is a small price to pay for her life and she is working with a physiotherapist to improve her discomfort.

Meanwhile, Phil has been seeking out the locations of defibrillators in their community and is talking to his squash group about getting one for the squash club. Should Denise have another event, Phil is under strict instructions to call an ambulance rather than take the car.

Cardiac rehabilitation ‘amazing’

For others who find themselves in a similar situation, Denise and Phil strongly recommend cardiac rehabilitation. They describe the local six week course they attended as amazing.

“We learnt an awful lot. I thought it was great on exercise and on diet, but it was also being able to talk to people who’ve been through that same thing,” says Denise.

 “Anybody who is in the same position, no matter what heart event it is, see if you can go along because it just helps to understand and also helps you to understand what you can do to prevent it in the future,” agrees Phil.

 

 

Shared September 2018

Please note: the views and opinions of the storyteller and related comments may not necessarily reflect those of the Heart Foundation NZ.

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