By Rasha Madkour
Associated Press
Copyright 2007 The Associated Press
MIAMI — Andy Nelson’s heart had stopped, his pupils were fixed and dilated, and he was in a deep coma.
Things weren’t looking hopeful. Even if the staff Florida Hospital staff could get his heart pumping again, chances were good that his brain would be damaged from the oxygen deprivation.
So the doctors put him on ice.
A growing number of hospitals around the country are using hypothermia as a way to protect a patient’s brain during times of stress, decreasing its demand for oxygen by slowing down its systems. This, in turn, can prevent damage from occurring.
Miami’s Jackson Memorial Hospital is part of the budding trend - this summer, it began using cooling pads and IV lines on patients like Nelson. For the past couple of years, it has used cooling helmets on babies who were oxygen-deprived during birth and other cooling methods on stroke patients.
In Nelsons case, his brain didn’t escape totally scot-free from the episode - his wife describes him as having had a warped sense of time and finding him cooking grits at 3 a.m. - but over time, he healed and returned to normal.
His wife couldn’t expect such a positive outcome when she found him face-down in the front yard one morning last year, and later in the emergency room where it took 10 minutes to restart his heart.
Usually if doctors can get a patients heart to start pumping again, the patient immediately wakes up. If they don’t, their chances of recovering diminish.
“I’ve seen patients, when they look this bad, theres usually not a happy ending,” said Tonya Nelson, a respiratory therapist like her husband, recalling his prognosis.
Its in these cases that hospitals use hypothermia.
“It changed our thinking that maybe not all was lost,” said Walter Severyn, a critical care specialist at Memorial Regional Hospital in Hollywood, which has been using hypothermia on cardiac arrest patients for almost two years.
The procedure isn’t used widely enough to have solid statistics, but anecdotal evidence from hospitals like Severyn’s is so far positive.
Of the 16 cardiac arrest patients his hospital has used hypothermia on - patients who were comatose, unresponsive and, in the past, who would have been written off - eight came out of it neurologically intact.
Tonya Nelson figured she had nothing to lose by consenting to the procedure. Only the week before had Florida Hospital in Orlando gotten the equipment. Andy Nelson was to be their guinea pig.
In order to cool his brain, cooling pads were applied to his legs, arms and torso. A humming machine circulated ice water through them, bringing Nelsons body temperature down to about 92 degrees, from the normal 98.6 degrees. Tonya Nelson remembers her husbands body looking pale and feeling “like he was on ice.”
Nelson was kept that way for 24 hours. He remained in a coma for a few days after that, but when he woke up, his wife asked him who the president was - he first said Reagan, then grinned and said “President Bush.”
“That’s when I thought, Oh my goodness, his brain is going to be OK,” Tonya Nelson said.