How CPR Saved My Life


[NOTE: Here's a post from my archives that's been updated. Despite what happened to me, I continue to train and compete…]

Race Season 2009

Okay. So I haven't posted for a while. Not because I've got nothing to say. Far from it. I just don't know quite where to begin...

My 2009 race season hasn't gone as planned. Pre-season training was good and consistent right through from October '08 to April '09. I capped off the pre-season by logging a massive week of hours and miles at the ABA Spring Bike Camp in Penticton, BC.

I don't want to sound immodest, but for where I'm heading with this post you must understand: I'm a fit guy.

I've been racing on the road and track for about the past 10 years. I can hold my own against many riders 20 years younger than me. I can consistently ride 40km time trials in under an hour. My resting heart rate is in the high 40's. I have a body-fat-percentage in the 6% range.

So what gives?

On May 9, an hour into the first race of my season, I got taken out by a crash right in front of me. At 50+kph I had no where to hide and down I went too. I expected to have some road rash, but not much else.

When I stood up all seemed okay, but my bite was all wrong. Later in the ER I'd learn I broke my jaw. I was "looking forward" to a liquid diet for just over 4 weeks. That sucked - pun intended!

The same crash posted a bruise on my left leg, just above my ankle. I didn't think too much of it at the time.

But then after 4 weeks of limping and painful plyometics, I learned I had broken my fibula! (the smaller bone in your lower leg). At least it was well aligned, and I didn't need any further medical work.

As you can imagine, my training got a bit goofed up. But I managed to stay almost on schedule. Power levels were increasing. I competed in another road race and didn't crash — though I did have to avoid a crash that slid across the pavement at 60+kph. I also rode a track meet and finished 6th in the omnium.

I was starting to think my season wasn't going to be too bad after all.

Then the bombshell dropped...

I was all tapered and set to ride in the Banff Bike Fest Stage Race. But then, at about 4:30am on the morning I was to drive to Banff, I awoke with a sharp pain in my chest. It centered on my solar plexus, radiating outwards to both sides. I thought it might be indigestion, but it didn't have the burn of acid reflux.

I stood up, thinking the pain might subside if I changed body position. I managed to walk around my bed. Then I collapsed.

All I can say about what happened next is I'm damn lucky my wife is an intensive care physician. And she was right there by my side. Many times in the ICU Dr. Ella has seen fainting and cardiac arrests. She knows the difference. She's sure my heart had stopped.

I was rigid. My eyes were wide open and staring straight out. She could find no pulse. At first she felt utter disbelief. This couldn't have been happening… But she kept her wits, switched into physician mode and immediately began CPR on me.

One big thump and many chest compressions later I regained consciousness. My first memories were like trying to force my mind awake, like I was deep asleep but knew I had to wake up. And I heard Dr. Ella on the phone to 911. "Why's she calling 911?" I thought.

Quickly I realized something bad had just happened to me.

Now you know why I wanted to tell you a bit in the beginning about the shape I was in. I spent the next 48 hours in the hospital, hooked to a heart monitor, thinking, "What the F... ??" It didn't make sense.

After the continuous monitoring, 3 blood tests (and enough needle tracks to make me look like a heroin junkie), a chest x-ray, an enhanced CT scan, a cardiac ultrasound, a treadmill stress-test and finally a cardiac MRI, we found nothing remarkable.

We proved I was an extremely fit middle-aged man

I had healthy blood pressure, healthy cholesterol levels, and a normal "athlete's heart", i.e., an enlarged but dilated  left ventricle. You see, the left ventricle does all the work pumping blood to your body, so it grows a bit like any other muscle tissue that gets a good workout.

So why the cardiac arrest?

It's important to distinguish that I didn't have a heart attack. That implies a blockage in an artery of the heart leading to death of some heart muscle tissue. My heart is still completely intact with no indications of arterial blockages. But it did stop - hence the term "cardiac arrest".

My recent broken bones could have led to a blood clot thrown into my lungs or heart, but the blood work and many scans ruled that out.

At this point we can only say it was some kind of arrhythmia - an unusual sequence of heart beats leading to stoppage.

Why did it happen? Perhaps this electrical engineer has an electrical problem in his heart. More tests by an electro-physiologist might point in that direction. And there may be a few other genetic scenarios that could explain things. Some genetic testing might provide those answers.

On the one hand it's great to know I'm "healthy". But really, WTF? Something happened and I don't want it to happen again. I don't seem to have an issue while I exert myself, so perhaps my training can remain intact.

I can't expect Dr. Ella to be by my side every moment for the rest of my life. So is there a preventive solution? Sure. An Implanted Cardiac Defibrillator. Stay tuned… I might become the Bionic Bicycling Blogger...

Does this mean anything to you?

Damn right it does. Two things.

First, being an athlete doesn't guarantee you a long, healthy life. A high degree of physical fitness should give you a high quality of life while you're here. But high fitness levels can mask underlying health issues. You might have issues that could have grabbed you from the face of the Earth sooner if you hadn't been athletic.

Don't neglect to get annual physical checkups and blood tests. Work with your family doctor to maintain your health. If you've got small problems that don't seem too bad but don't fully correct themselves, don't ignore them. Keep an open discussion going with your family doctor. As athletes we tend to think we're invincible, that a little rest is all that's needed to get better. That's not always the case.

Second and more important, learn CPR if you haven't already. Dr. Ella is the director of CPR training at the hospital where she works. Until you take a course yourself, she has these pointers to keep in mind. What they teach now is a little different from before:

How To Perform CPR
  1. Make sure the person is lying on their back on hard ground.
  2. Check and double-check that there is no pulse and no breathing. The best place to look for the pulse is to first position the person on their back. Find the point on their jawbone just beneath their ear (it doesn't matter which side, left or right). Then slide your fingers - not your thumb - down onto their neck.
  3. If there is no pulse, then find the bottom of the sternum, i.e. the bottom point where the ribs meet in the middle of the chest. Measure up 1 hand width from the bottom of the sternum. This point will become the focal point of your compressions.
  4. Begin with 1 solid hard fist-blow to the focal point. Really hard!
  5. Start chest compressions on the focal point. Put one palm on top of the back of your other hand and interlace your fingers. Get yourself directly above the person's chest (not reaching towards them at an angle). Begin direct downward chest compressions. Keep your arms firm, and don't let them flex during a compression. Try to compress the chest about 2 inches with each press. Keep a tempo of about 1 compression per second, or slightly faster. Think "1 and 2 and 3 and 4..."
  6. Now here's the BIG difference from what you might have learned in the past: do not stop to administer any mouth-to-mouth breaths. Just keep on compressing.
  7. Call for help and get someone else to dial 911 if at all possible.
  8. After about 1 minute of chest compressions check again for a pulse. If you're still alone at this point, call 911. If you still didn't find a pulse, don't waste too much time on the 911 call. Get back to the chest compressions and just keep going until help arrives or the person starts to come around.
The key difference of not stopping to apply mouth-to-mouth is much like pumping up a bike tire. When you pump a tire it takes many pump-strokes before enough pressure builds to break the valve seal and start getting air into the tire.

With CPR, the concept is similar. It takes many compressions to build up enough blood pressure to get some blood flowing.

The most important thing you're trying to do with CPR is to keep blood flowing through the brain to preserve as much of it as possible. Any time you stop CPR compressions it's like taking that pump off your bike tire. You lose all the pressure gained and all the flow you started. You open the person up to more possibilities of brain damage if their heart ever starts again.

Back On The Bike

I'm back training, doing my best to be ready for the Canadian National Track Championships at the end of August. I'm spending a lot of time second guessing myself, but I will not be defeated by this. If I'm not back racing this season, I'm certainly going to be back at it in 2010!

What Happened Later in 2009?
Read how my story continued at the end of the season. I bagged a couple of medals at the Canadian National Track Championships. But I also bagged a little extra metal in my chest… Read all about it in this post: Bicycling Blogger Restarts With An ICD

Photo "Heart anatomy" by: Patrick J. Lynch

10 comments:

  1. Damn!

    I'm glad that you were ok, you certainly married the right woman. Hopefully this was just a one time freak occurrence; I'm glad that you aren't letting it keep you from riding.

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  2. That is an incredible story Kevin. I am glad to hear that you are recovering. You experience is good reminder to us to be prepared for the unexpected.

    Be well,

    Kamren

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  3. Glad to hear you're still with us and getting everything checked out. Good points on CPR and, while I remember everything from the courses I've taken, not stopping for breaths is different. Why the first big strike? My courses poked fun at seeing that in all the movies.

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  4. Why start CPR with the first big blow to the chest?

    Since you really don't know why the heart has stopped, you may be dealing with a particular type of arrhythmia (ventricular tachycardia) that can sometimes be fixed by the blow.

    The fist-strike won't mess things up any more, so you might as well start with the blow. You've nothing to lose. If it doesn't work, carry on with CPR and hope help comes quickly.

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  5. Kev-

    Amazing story... You are so very fortunate and I'm so glad to hear that you're feeling well.

    Very, very well written and I'm glad you discussed "cardiac arrest" vs. "heart attack". The terms are often used interchangeably in the non-medical community, but they are two very different things.

    EVERYONE should have basic CPR training to the new guidelines. Effective CPR is not pretty; it's sweaty, hard work but it saves lives...

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  6. Wow Kevin, what a crazy scary story!

    Glad your still with us and kicking! Good points on CPR.

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  7. I found the following quote from the great Russian weightlifter Vasily Alexeyev (remember him, with that huge "gut", which was actually a massive wall of abdominal muscle):

    It seems to me that some of the talented athletes lack one thing-- they haven't had an injury. That's right! An injury that will put them out of commission for a year during which time they'll have a chance to weigh everything. I, too, would not be where I am if I had not injured my back. I suffered for a year and a half thinking everything over ... After a misfortune, people pull through and become, if possible, great people -- and sportsmen, in particular. Those who are stronger find their way out and to the top ...

    Here's to hoping I find my own way to becoming a greater sportsman!

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  8. WOW - shook me up just reading about this. Not only does this give one pause for obvious physical reasons, but one's own mortality should give us spiritual reflection as well. Are we secure with what happens next!?!

    Glad to hear you are back in the saddle!

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  9. Kevin,
    Came across your post while looking for other ICD-toting cyclists. My blog is:
    http://v-tach.blogspot.com/
    Glad to know you seem to not be one, judging by the lack of follow up. As a v-tach sufferer I know something of what you went through. If it ever happens again you can sometimes "reset" your own heart via a vagal manouver, like coughing hard, or giving your own chest a thump. As an athlete, you've probably got about 30sec. to figure out that you are either in v-t or arrest and self-administer.
    Best of luck!,
    cc

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  10. Craig (c2),

    Serendipity! Now this is truly bizarre...

    It is time for me to update my blog with full follow-up details of my own latest developments.

    But for now, just know I found your blog a week-and-a-half ago, the day I received my diagnosis. Yesterday, while you were posting this comment to my blog, I was undergoing my very own ICD implantation.

    I don't know what to say right now, other than reading your blog gave me the courage to proceed with my own ICD. But the timing of your comment on my blog is absolutely unbelievable!

    Happy Thanksgiving to you and all my American readers!

    Kevin

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