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Documented: November 2011
As the school nurse at Pocopson Elementary in West Chester, Sue Davis, 66, also leads CPR instruction for the entire Unionville-Chadds Ford School District. When teaching CPR, she always stresses what she calls the critical "chain of survival" after a cardiac event: call 911, start CPR, use an automatic external defibrillator, get right to the hospital for early intervention. Little did she know that on the evening of February 19, 2011, that chain would help save her own life after cardiac arrest, thanks to her husband Larry's ability to stay cool through some incredibly challenging circumstances.
As Sue and Larry recall, a powerful windstorm had knocked out their electricity and phone service that winter day. As evening fell, they decided to go out for dinner and a movie. After the movie, Sue started feeling some pain in her shoulder, but she thought nothing of it and didn't mention it to Larry. Returning to a cold, dark house, the couple bundled up in layers and went to bed. By 10:30 pm though, Sue was having lasting chest pain and weakness in her arms. She alerted Larry, who grabbed their high-powered flashlight, led her into the bathroom to take an aspirin, and said they should drive to the Emergency Department at The Chester County Hospital.
"I definitely was not thinking 'heart attack,'" Sue says. "My lipid profile is perfect. I exercise three to four times a week. I eat a vegan diet with some fish. And my Body Mass Index is in the 20th percentile. I do have some family history of cardiovascular disease, but in my mind I was doing everything right."
As Larry sped down their long driveway, he thought the car was making a strange noise, so he threw it into reverse and returned to the house to call 911 on his cell phone. This turned out to be a fortuitous decision, given what happened next: Sue lay down on the couch and complained of increasing pain and dizziness, then went into full cardiac arrest.
"As I was talking with 911, I went over to check on her and watched her eyes roll up into her head," Larry recalls. "I cannot even explain what it felt like to see her die like that. I was in shock, but I told myself not to panic. I knew I had to concentrate."
Propping the phone between his ear and shoulder and securing the flashlight under his other arm, he listened as the 911 operator instructed him how to perform CPR. (Larry now jokes about the irony of the fact that Sue, despite being a CPR instructor, had never taught him to do it!) He told the operator their street address and then just kept pumping away on Sue's chest, even after the call accidentally disconnected and he lost contact with 911.
"I am a manager with DuPont and I work with a lot of diaphragm pumps," Larry says. "So the one thing going through my mind was just to keep that pump going." He knew he could not stop performing CPR in order to call 911 back. Sue's life depended on him.
But then another thought occurred to him: With all lights out in the area, it would be difficult for the ambulance to find their house, which is located in a wooded and somewhat isolated area in Chadds Ford. When he caught sight of what looked like ambulance lights out the window, he stopped the CPR and ran outside to signal with his spotlight. The headlights flashed back, and he quickly returned to Sue's side to continue CPR. By this time, Sue had already been in cardiac arrest for 10 minutes.
Within moments, paramedics from the Longwood Fire Company took over. As soon as they had Sue in the ambulance, they initiated a process known as therapeutic hypothermia. They used ice-cold intravenous saline to begin cooling Sue's body to about 92 degrees F (38 degrees C). For certain patients in a coma after cardiac arrest, inducing hypothermia for about 24 hours can give the fragile brain tissue time to recover gradually. Research has shown that patients who are cooled after arrest are more likely to survive with their brain function intact. Once Sue arrived at The Chester County Hospital, intensivists Ian Butler, MD, and Don Emery, MD, continued the cooling while cardiologist Joseph Lewis, MD, worked quickly to open the vessel blockage that had caused Sue's heart attack.
"I remember Dr. Lewis coming out and spending time with me, showing me everything he had done, and explaining that Sue had about a 50/50 chance of coming out of the coma," Larry says. "Even then, she was likely to need six months to a year of rehabilitation. She might never be the same again. I knew that going without oxygen to the brain for as few as six minutes could have devastating effects."
The next couple of days became an anxious waiting game for Larry, as Sue was kept in hypothermia for 24 hours and then gradually re-warmed. He was soon joined by their son, Eddie, who flew in from California; Sue's brother from South Carolina; Larry's family; as well as their close friends. Larry notes that an especially calm and comforting presence was ICU nurse Clarissa Hake, RN, CCRN, who remained by his and Sue's side throughout the entire ordeal.
"I have been to a lot of hospitals, but this was so different," Larry marvels. "The attention and concern for us was incredible -- from Clarissa, from the doctors and from the entire clinical team. What they did for both Sue and me was just amazing."
On the third morning, Larry and Clarissa were at Sue's bedside when she opened her eyes. They discovered she could follow orders to open and close her eyes and to squeeze their hands -- with a reassuringly firm grip, no less! Sue had trouble talking because of a paralyzed vocal chord, but Larry says he gained real hope when he heard her first words: "I'm having a little difficulty articulating my words." Sue immediately recognized her family members, although she had no short-term memory; in fact, she would re-greet them every time they walked into the room, which led to some amusing moments. But Larry felt hopeful for her full recovery and was encouraged by the cautious optimism of Dr. Butler.
Within just a couple of weeks, Sue was out of the Hospital and on to Bryn Mawr Rehabilitation for five days of speech, physical and occupational therapy.
"I think I surprised everyone there," Sue says. "They could see my diagnosis was 'post-anoxic encephalopathy' -- oxygen loss to the brain -- but here I was jumping out of bed on my own and doing a great deal for myself."
In the weeks that followed, Sue continued her therapy and started cardiac rehabilitation at The Chester County Hospital's Fern Hill Medical Campus. She returned to her job after just two months, and she now uses her own story to help her CPR students understand the critical importance of the "chain of survival." Over the summer, she and Larry took their annual vacation to Maine and visited their son in California, where Sue climbed a 9,000-foot peak near Lake Tahoe.
Sue has no memory of the night of February 19 or the immediate days that followed, but Larry certainly will never forget it. Sue credits Larry's ability to remain cool under pressure, along with the Hospital's cooling therapy and fast action to treat her blockage, with saving her life -- not just her ability to function physically, but the quality of her life as well.
"Sue's full recovery has been a miracle," Larry marvels, "and we're so grateful."
By Kristine M. Conner
Last Updated: 10/11/2012