In the midst of last summer's heatwave, 48-year-old Michael Cates found hypothermia to be his best option for surviving the effects of a life-threatening cardiac arrest.
On July 16, Michael was getting ready to leave for Pershing Elementary School to begin his shift as custodial supervisor. Michael's wife, Christina, and daughter Mariah were inside, beginning their own routines.
|When Michael Cates' heart stopped beating, doctors at BryanLGH initiated hypothermia protocol, pumping cold saline into his body to drop his body temperature below 93 degrees for 24 hours.
But what was shaping up as a typical Friday morning suddenly changed. Michael's enlarged heart had given him problems off and on for years; this time would be the worst.
He grabbed the arm of the love seat to brace himself. Christina asked him if he was feeling dizzy. He said, "I think so," so she told him he'd better sit down for a minute. She walked into the kitchen and soon sensed something was very wrong by the way their 10-year-old daughter cried out, "Mom!"
Michael's head had fallen against the back of the couch, his eyes bulged and rolled back in his head, and his chest was pressed out away from the back of the couch. His body appeared very stressed. Air was leaving his body, so Christina called 9-1-1 and sent Mariah to a relative's nearby home for help.
Michael's heart had stopped beating. The emergency dispatcher told Christina - who had CPR training - to begin cardiopulmonary resuscitation. A nephew and Christina stretched Michael out on the floor, and the dispatcher explained the new breath-to-chest compression ratio and the importance of letting the chest rise and fall in between compressions.
Michael's heart didn't begin beating again until paramedics shocked his heart back into rhythm. An ambulance whisked him off to BryanLGH East.
Michael has little memory of how those measures helped him. "Christina had me sit down; the next thing I knew, it was four days later," he said with a smile. "I only know what she and my doctor told me went on."
Pulmonologist Doug Fiedler, MD, notes that restarting a person's heart after cardiac arrest is only half the battle - the bigger problem is damage to the patient's brain cells, which begin dying soon after blood stops circulating to them.
At BryanLGH, the medical team explained to Christina that Michael's brain had been deprived of oxygen for more than seven minutes during his cardiac arrest, so brain cells already were beginning to struggle, endangered by toxins given off by suffocated cells.
The team suggested Michael would benefit from hypothermia protocol. It involves pumping cold saline into the aorta to drop body temperature below 93 degrees for 24 hours. This creates a stable environment to help vital organs survive.
"Cooling the body reduces the amount of re-profusion injury to the brain," said Dr. Fiedler. "The brain is the most delicate organ in terms of possible damage from being deprived of oxygen. Once a brain cell dies, it doesn't come back; so by slowing the metabolism, we reduce the amount of oxygen the brain needs."
After the 24-hour chilling period, Michael remained unresponsive. His doctors wouldn't be certain if the treatment had been effective for at least 48 hours. Less than 10 percent survive such cardiac arrests, and no one knew how much of the old Michael remained.
Christina kept the faith, praying for her husband's recovery, as did many others. She reminded him that Sunday was their anniversary and gently chided, "Don't try to get out of it; you need to wake up."
Michael opened his eyes the next day. He was back, sharing his sense of humor and thankful to be surrounded by family and friends.
"I was pretty out of it from the medication, I guess, but I'm so grateful to be here," he added.
Michael also received an internal defibrillator to address his heartbeat issue. Now he's back at work and back to his duties as a church officer. He also returned to BryanLGH to thank his care providers and share his story with the local media. "I can't express how well I was treated here," Michael said. "All of the nurses and doctors were great, and the intensive care manager, Mona Reynolds, was inspirational for my family."
He concludes by noting, "Never take life for granted, because you can be gone in five minutes. I'm blessed to be here, and I'm feeling great."