12 MISSING MINUTES
March 21, 2011 at 6:03 p.m.
Updated March 20, 2011 at 10:21 p.m.
GREATHOUSE'S MEDICAL TIMELINE
Dec. 24 - Hypothermia maintained at 32 to 34 degrees Celsius for 24 hours and then a slow rewarm.
Dec. 25 - Greathouse is sedated and intubated.
Dec. 26 - Greathouse begins to look toward voice and has slight movements in her fingers. Sedation is stopped.
Dec. 27 - Has slow response to command.
Dec. 29 - Extubated and alert to person and place. One of the first things she asked was that she wanted a Budweiser beer.
Dec. 31 - Sits up in chair but still somewhat confused.
Jan. 3 - Greathouse is more talkative.
Jan. 6 - Dr. Oakley puts a heart catheter in Greathouse.
Jan. 7 - Greathouse transferred to St. David's for pacemaker.
YOAKUM - Twelve minutes.
Ruthie Greathouse's eyes dart back and forth, struggling to remember those 12 minutes; they were the 720 seconds the 70-year-old was no longer alive.
"I don't remember anything," Greathouse finally said, succumbing to her own memory.
Greathouse went into cardiac arrest in December, and because of a new hypothermic therapy in the Crossroads, was saved without any neurological damage.
The Golden Crescent Regional Advisory Council has made therapeutic induced hypothermia its regional initiative this past year.
The procedure is used to save cardiac arrest patients by reducing a patient's body temperature to 92 degrees through a cold saline infusion.
Therapy is started once paramedics receive a heartbeat.
Greathouse owes her life to the therapy and the relentless paramedics and doctors who did not give up, she said.
"I'm alive," she said. "That's what they did; that's what you call a miracle."
FROM DEATH, BACK
No white light, no life flashing before your eyes.
The last thing Greathouse remembers was getting ready to soak her feet in some warm water and Epson salt.
Then, she came to in a hospital bed.
Greathouse has come back with a new lease on life and wants to spend more time with her husband, kids and grandchildren.
Though, from time to time, she thinks hard about those 12 minutes she was gone.
"Every now and then I think about it, and then it scares me," she said. "I've been trying to put it all together."
Yoakum EMS responded and after finding a heartbeat, began the therapy.
However, the regional initiative is to push the therapy out from its infant stage, said Suzanne Stone, Citizens Medical Center chest pain center coordinator.
EMS in Goliad, Port Lavaca, Hallettsville, Yoakum, Yorktown, Cuero and Edna and the Victoria, Port Lavaca, Cuero, Edna and Hallettsville hospitals make up the council's region, Stone said.
Yoakum EMS was the first to train for the initiative, which Walter Morrow was instrumental in bringing to the attention of the council.
Morrow, the air medical chairman, saw that other larger cities had the therapy and felt it would be important to have it in the field as well as in the hospital setting, he said.
"It's a therapy that's been proven to be very effective," he said.
In December 2009, Morrow had approached the council with the idea as one of their regional projects.
The idea received a thumbs-up and both the hospital and EMS developed guidelines for patient care.
The council received the funding to provide all the services in the council's region with the in-field equipment, he said.
Morrow knows of Victoria and Yoakum using the equipment in the field.
The equipment is about the size of an ice chest and the saline is kept cool in that. Training took about two hours, Morrow said.
Citizens cardiologist Dr. Robert Oakley is on board with that push - after all, it gave Greathouse her life back.
"This is a disease (cardiac failure) that has a dismal prognosis," he said.
HOW IT WORKS
The procedure has been used at the hospital for about a year but is an idea dating back to the days of ancient Greeks, said Oakley, who has been a cardiologist in Victoria for about 30 years.
Patients who suffer cardiac arrest have a less than 10-percent survival rate and a less than five-percent survival rate without neurological damage.
But with the therapy, this improves outcomes about 30 to 50 percent, or about one in six patients, Oakley said.
"Salvaging one in six doesn't sound that good unless you put it against salvaging less than one in 20," he said. "We can change that. That's a material improvement in outcomes."
The sooner the therapy begins, the better. Paramedics need to first re-establish a patient's pulse. Once that's done, the patient is infused with the cold saline until they reach the hospital.
Once at the hospital, cooling blankets are used to continue bringing the temperature down for the next 24 hours.
The goal: to have the patient go on living life without neurological damage.
Neurological damage is received from cardiac arrest because of lack of oxygen to the brain.
The therapy provided hope for Greathouse.
"If they wouldn't have used that on me, I wouldn't have made it," she said. "I'm sure glad the Lord took his fingers out of his ears so he could hear somebody praying for me."