Hypothermia used to save lives

BELLINGHAM — Samantha Hewett doesn’t remember the day she died, but she’s thankful every day that she came back to life.

Late one Monday afternoon last summer, Hewett, 37, was completing her thrice-weekly blood dialysis when, she’s told, she looked at the nurse and said she didn’t feel well.

By the time the words were out of her mouth, she was unconscious.

Her heart had stopped. Doctors at St. Joseph Hospital, where she had been rushed, prepared her family for the worst.

“When the emergency room doctor came out, he said it didn’t look good,” she said her partner, Archie Parker, told her. “Basically, I (had) died. Things weren’t looking good.”

But doctors also recommended Hewett for what’s becoming an increasingly common treatment at St. Joseph for people who’ve suffered cardiac arrest: therapeutic hypothermia.

Studies show that cooling the body as blood flow resumes to the brain can prevent brain damage.

Hewett’s family jumped at the chance for the treatment.

“They were all for it,” she said.

After her heartbeat was re-established, medical staff cooled Hewett’s body and sedated her. They paralyzed her muscles with medication so she wouldn’t shiver and raise her body temperature.

Resuming oxygen flow to the brain is often what causes so much destruction, said Dr. Marvin Wayne, an emergency physician and a champion of therapeutic hypothermia. Reducing the need for oxygen appears to guard the brain against that damage.

The goal is to keep the body temperature between 89.6 and 93.2 degrees Fahrenheit for 24 hours, Wayne said.

Hewett woke up days later in the hospital, asking where she was and what had happened.

She was lucky to have lived at all, let alone with enough wherewithal to start asking questions right away.

Many who survive a sudden cardiac arrest suffer severe neurological damage. Historically, only a small percentage have been able to fully resume their former lifestyles.

Whatcom County is part of a National Institute of Health study of resuscitation techniques that looks at ways to improve recovery for patients who’ve suffered cardiac arrest.

Or, as Wayne puts it, “If we allow more people to be resuscitated, can we save more brains?”

In Hewett’s case, the answer seems to be yes. She said she notices no neurological effects from last year’s heart attack. Doctors told her not to fear another cardiac arrest, and implanted a defibrillator to make sure, she said.

The hypothermia treatment is one of many lucky breaks Hewett got the day her heart stopped.

“I think if I would have been anywhere else, if I would have been home or just out of the house or something, I would have probably died,” she said. “I was very lucky I was so close to the hospital, I was very lucky I was at dialysis with the nurse who knew what this was, very lucky I got put on the hypothermia program. Otherwise, I don’t think I would have made it.”

The experience has made her even more passionate about taking care of her body. A diabetic since 14, she had double-bypass surgery two years ago. Dialysis sessions can wear her out, she said, but she loves doing yoga and spending time at her gym lifting weights and walking the treadmill.

“Most people don’t say that fitness is a hobby for them,” she said. “But it is for me.”

Not everyone has as good an outcome as Hewett, Wayne said. Some suffer short-term memory loss, and some need some assistance later. But those are also people who may not have made it otherwise.

Wayne remembers one man who was slow to wake from sedation. Doctors feared he would remain in a vegetative state. But by the time he left the hospital, Wayne said, he was able to articulate to doctors why he didn’t want to be part of the NIH long-term study of hypothermia treatment.

Hewett has more challenges ahead. She’s getting ready for a corneal transplant to restore sight to one eye that was damaged by an infection. She’s also been on a waiting list for a pancreas-kidney transplant.

But some things she won’t wait for these days.

“I tell everybody that I do love that I love them, every time I see them or talk to them on the phone,” she said. “I don’t put things off as much as I used to.”