CPR and collaborative care helped this cardiac arrest survivor beat the odds

When Bill Joseph got out of bed on October 26, 2020, his day started much like any other: he got dressed, ate breakfast and headed to his job as a maintenance technician for a local city.

Looking back, he remembers that his dogs seemed unusually anxious that morning and that he felt a little dizzy on his way to work, but he didn’t think much of either of these things at the time. Joseph has little memory of what happened next; what he knows about the rest of that day has been pieced together from his family and co-workers.

“Around 2 o’clock that afternoon, my boss and I were moving traffic signal cabinets from one place to another,” Joseph says. “They contain the electronic equipment that control lights at intersections. We stopped for a minute to talk, and I started to reach down toward my knee and then just slumped over to the ground.”

Joseph was experiencing sudden cardiac arrest — a life-threatening emergency where the heart stops pumping blood.

Working together to save a life

Although the terms “heart attack” and “cardiac arrest” are often used interchangeably in everyday conversation, these two health emergencies are different. A heart attack happens when blood flow to the heart is blocked or disrupted by a clogged artery. Cardiac arrest — what Joseph was experiencing — occurs when the heart’s electrical signals malfunction.

“Cardiac arrest is usually due to ventricular fibrillation — an abnormal heart rhythm that begins in the bottom chamber of the heart, says Michael Rome, MD, an electrophysiologist with Pulse Heart Institute.  “When this happens, the heart can’t maintain blood pressure so people collapse suddenly and often die. If a person experiences a cardiac arrest outside of the hospital, their chances of survival are less than 10 percent.”

Joseph defied the odds that day, in part due to the swift action of his boss who immediately began CPR. When emergency responders arrived, they continued CPR, used a defibrillator to restart his heart and rushed him to MultiCare Tacoma General Hospital.

There, the Pulse Heart Institute team was able to stabilize Joseph but his heart was still not effectively pumping blood, putting him at risk for a brain injury.

“It’s common for people who survive cardiac arrest to experience neurological problems afterward because the flow of oxygen to the brain was disrupted,” says Deven Vora, MD, an interventional cardiologist with Pulse Heart Institute.

“One of the things we can do to prevent or limit those problems after a cardiac arrest is to cool the body down to a low temperature for several hours and then warm it back up again slowly, which is what we did for Bill. Keeping the body cool reduces brain swelling and prevents brain cells from dying.”

In addition to protecting Joseph’s brain, the Pulse team also needed to protect his heart. They determined that Joseph had a weakened heart muscle — likely the result of a viral illness —which put him at risk for experiencing an abnormal heart rhythm again.

To prevent that, Dr. Rome surgically placed an implantable cardioverter-defibrillator (ICD) in Joseph’s chest. This battery-powered device continuously monitors his heart, and it if it detects an abnormal rhythm, it automatically delivers an electric shock to correct it, significantly increasing his chances of surviving a cardiac arrest should it happen again.

“One of the great things about Pulse is the coordinated care we provide,” Dr. Rome says. “I think of it this way: I’m the electrician, so I focus on the heart’s electrical system. Dr. Vora is the plumber who ensures that blood flows the way it should. The two of us and our other partners all work together to help patients like Bill get back to their lives and their families. Success stories like his begin on the front lines and wouldn’t happen without that collaboration.”

A badge of honor

Joseph spent a total of 16 days in Tacoma General Hospital and credits his wife as well as his diverse care team for his recovery.

“Everyone was amazing, from the doctors to the techs who did my chest X-rays and everyone in between,” Joseph says. “The nurses in particular took such good care of me. Whether it was making sure my blood pressure was at the right level or helping me go for my first walk, they were determined to help me get better.”

Joseph’s healing process is still ongoing. He experiences tremors in his right hand, has trouble recalling words at times and is being treated for nerve damage as well as post-traumatic stress disorder (PTSD). Ultimately, he was not able to return to his job; however, his experience has inspired him to support other cardiac arrest survivors.

“A lot of problems can crop up weeks or months after a survivor leaves the hospital,” Joseph says. “I’m working with other volunteer members of the Sudden Cardiac Arrest Foundation to put together a comprehensive package of information so that people know what to expect after they’re discharged and where to turn for help.”

When he’s not volunteering, Joseph spends his time beekeeping and playing the guitar, and he encourages anyone who witnesses a person collapse, as he did, not to hesitate on the sidelines.

“I ended up with 14 broken ribs from receiving CPR, and I can still feel the lumps from where they’ve healed,” he says. “I consider them my badge of honor, because without them I wouldn’t be alive today. Even if you don’t really know how to do CPR and you need a 911 dispatcher to talk you through it, you may still save a person’s life.”

For more information about how to give CPR or sign up for a class, visit the American Red Cross.