Cardiac arrest - what do you do?
Danville couple learns firsthand the importance of CPR
Danville resident Marty Seaman, 69, died in August. In September, he was back sailing on the Bay.
His wife Dorothy shudders to recall the day, around 2 p.m., she left him sitting on the couch after he'd come home from running errands and been ill. As she walked from the family room she was stopped in her tracks by an eerie sound.
"I heard that rattle - that death rattle," said Dorothy. "I looked at his eyes - nothing."
The situation was dire but the timing was good. Marty had been scheduled for heart surgery the very next day with his Kaiser Permanente doctor at Summit Hospital in Oakland. Because of the impending procedure, their grown sons, Christopher and Mark, had just arrived in town. When Dorothy left Marty in the family room, the sons were right there in the kitchen, working on a stopped up sink.
"Mark said, 'Call 911,'" Dorothy recalled, and the dispatcher told them to get Marty onto the floor. "She said to do 200 compressions, stop, then do 200 more."
Years before, Mark had worked for a company that mandated CPR training for all its employees so he knew how hard to pump - and pump - and pump - and to take a pulse on the wrist or the neck. They told their mother afterward that Marty had gasped at one point.
Dorothy hurried outside to wait for the paramedics, who responded from Fire Engine No. 33 on Diablo Road and Rescue Unit No. 34 on Alcosta.
"They were here quickly," she remembered.
They told the emergency personnel they wanted to go to the Kaiser hospital in Walnut Creek, but the paramedics knew the closest appropriate place was San Ramon Regional Medical Center.
"The paramedics found him to be in cardiac arrest," said Dr. Ramesh Veeragandham, the cardiologist who performed heart surgery on him the next day. "They put an IV in his leg bone to give him medication ... and brought him to the emergency room in San Ramon."
An angiogram showed significant blockage in all three arteries of the heart and they inserted an intro-aortic balloon pump to keep pushing blood through the narrow arteries.
"The concern at the time was, the cardiologist could temporize him from the heart standpoint, but we could not be 100 percent sure of the brain condition," said Veeragandham.
If it had been longer than five minutes with no blood flow to the brain, there could be damage, he explained. When Marty began to show movement in his extremities, they felt there was probably no major damage to the brain.
The next day, Aug. 9, they performed a full emergency four vessel coronary artery bypass, said Veeragandham.
"He tolerated the surgery very well," said the doctor. "Although there was significant damage in the heart we were able to get him through very well."
Dorothy and her sons were relieved to see Veeragandham walk toward them after the surgery.
"He had a smile from ear to ear," Dorothy recalled. "He was delighted."
Six hours later Marty could open his eyes and the breathing tube came out that evening.
"I wanted him to see me and call me by name," Dorothy said, noting her concern about brain damage. "Fifteen minutes after pulling the tube out, he said he wanted me to call his friend and say he couldn't go sailing."
He was released on Tuesday, Aug. 14, and was back playing with his bocce ball team at Sycamore Valley Park on Monday. A few weeks later, he was on the Bay crewing on his friend's sailboat.
Marty does not remember anything that happened around this time, and said he was told the medications may have blocked his memory.
"People were visiting me and we were having conversations, but I have no memory of it," he said.
He also does not recall going "toward the light," as is often recounted in near-death experiences.
Marty said his first symptoms of heart problems had been cramps in his legs a year and a half before. In June, doctors diagnosed the problem as blockages of his leg arteries.
"My family has a long history of heart problems," said Marty, so it seemed logical to him to then question the condition of the arteries in his heart.
Sure enough, an angiogram found blockages although his only sign of heart problems was an occasional upset stomach. He was scheduled for surgery in Oakland at 6 a.m. Aug. 8, but when the surgeon wanted to postpone for one day, there didn't seem to be any harm in it. When Marty and Dorothy returned from pre-op procedures in Oakland on the 7th, their sons had arrived, as a surprise.
The morning of the 8th, the family had a big breakfast together. Then the three men returned the sons' rental car to the Oakland airport, stopping at Costco on their way home and the gas station. By this time, Marty was feeling some uneasiness.
"I remember going to Costco," he said recently, "and handing the keys to my son."
"I stayed home making food," said Dorothy. This resulted in the plugged up sink and the sons being in the kitchen when Marty went into cardiac arrest.
Capt. Andy Swartzell, emergency medical services captain for the San Ramon Valley Fire Protection District, said the three most important factors in saving lives after cardiac arrest are early recognition of what is happening; calling 911 to get an emergency medical response as soon as possible; and performing cardiopulmonary resuscitation - CPR - to keep the heart pumping oxygen to the brain.
"It prolongs the period in which a person can be more successfully defibrillated," said Swartzell.
"One of the most common causes of cardiac arrest is ventricular fibrillation," he explained. "The only treatment is shocking the heart."
Paramedics defibrillate but more and more, Automatic Emergency Defibrillators, designed for use by laymen, are being mounted on walls in public places. The Fire District has formed a partnership with the police and schools as well as the business community to situate AEDs throughout the district and make people aware of them.
"We are working with the Danville Police Department to get one in every police vehicle," said Swartzell, "and we hope to have them soon."
"If you're looking at the nationwide survival rate, despite all the medical advances, the survival rate for someone in cardiac arrest has been dismal, about 5 percent," he added.
With AEDs, the chance of survival rate goes up dramatically, to 12 percent, he said. If people are versed in CPR, and AEDs are available in public places, the survival rate goes up to 12-25 percent.
"Your chances of survival are good in a casino in Vegas or on airplanes or in airports," he said.
Firefighter paramedic John Archuleta of Fire Engine 33 noted that Seattle has made it a mission to provide AEDs, and the city is now known for saving people who go into cardiac arrest.
In case of emergency, anyone can open the AED and follow the instructions, he said. It contains patches to put on the collapsed person's chest, which will interpret the electrical activity and direct the user how to activate it.
"Push it and stand back," Archuleta advised. "It delivers an electrical shock to the heart."
The AED will also instruct whether more shocks need to be delivered.
Archuleta said 911 dispatchers are trained to instruct people over the phone on how to give CPR. But, of course, learning it prior to emergencies is preferable.
"Sometimes CPR will break someone's ribs," he said. "That's the kind of thing you learn in class. Don't panic if it happens; it's normal."
Veeragandham said someone else came into the emergency room in full cardiac arrest about two weeks after Marty Seaman; this person had been experiencing neck pain so was going to a chiropractor.
"These are the lucky few," said the doctor. "There are also hundreds found in bed or, when working, found just slumped at their desks."
"CPR is the single most important life-saving thing for families to learn," he said. "That five minutes can make all the difference in a person's life."
Marty Seaman says the message in his recent experience is that people need to take care of medical problems and not put them off.
"Because I had a doctor's appointment and had tests, I'd scheduled the surgery and my sons were here," he said.
"They saved their dad's life," added Dorothy.
CPR classes are available through the San Ramon Valley Fire Protection District, the Town of Danville, Alamo Parks and Recreation, and Fontaine Fire on Front Street in Danville.
* The Fire District conducts a basic infant, child and adult CPR class from 8:30 a.m.-12:30 p.m. every fourth Saturday of the month at its Administration Building, 1500 Bollinger Canyon Road in San Ramon. The cost is $25 for materials. Eight students to a class; early signup is recommended. Call 838-6620.
* Town of Danville Adult CPR - 1-5 p.m., Jan. 12; $45 residents; $54 non-residents; Danville Library, 400 Front St.
* Infant and Child CPR - 1-5 p.m., March 1; $45 residents; $54 non-residents; Danville Library, 400 Front St.
* Alamo Heartsaver First Aid and CPR offered by the American Heart Association; designed for non-health care professionals who require certification; 1-5 p.m., Sunday, Oct. 21, at Hap Magee Ranch Park. Alamo residents, $27; non-residents, $54.
* Fontaine Fire Inc., 171 Front St., Danville, is a licensed American Heart Association training center. It offers a free non-certified CPR glass at 6 p.m. the first Tuesday of each month. Call 858 9789 for reservations.