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Cheri Amelon has no idea if it was an out-of-body experience or just a bad dream. All she remembers is the unnerving sensation of holding her husband's hand while hovering in the air above a woman in distress.
"I just kept saying, 'We've got to help that girl!,' Amelon says.
"Then I realized that girl was me."
Amelon—, a 42-year-old mother of three—recalls nothing else from her "sudden death" on May 7, 2007.
She and husband John are still shaken by what she experienced: Cardiac arrest (no heart beat) leading to "clinical death" (no breath, no pulse).
Even though cardiac arrest is nearly always fatal, Amelon survived and appears to be recovering fully with no long-term memory loss.
Alix Ashare, MD, a critical care specialist who directed Amelon's care in the Medical Intensive Care Unit (MICU) at University of Iowa Hospitals and Clinics, says a fortunate series of events led to Amelon's remarkable outcome.
"John Amelon saved his wife's life," Ashare says. "His use of CPR and his '911' call made everything else possible." The 911 call brought paramedics from the Iowa City Fire Department to the Amelon's home, where three jolts from a defibrillator restarted her heart.
"After those fortunate events, we were able to minimize brain damage by using Arctic Sun® technology to induce hypothermia," Ashare says.
The Arctic Sun® system pushes cold fluids through hollow pads that hug the patient's body, thus lowering the body temperature and diminishing a damaging inflammatory process that occurs naturally when blood flow is restored.
UI Hospitals and Clinics is one of a relatively few hospitals nationwide using "cold therapy" to preserve brain function in select patients with cardiac arrest. The system also can be used for other conditions, notably liver failure.
"Cheri Amelon fit the profile perfectly for induced hypothermia following cardiac arrest," Ashare says.
"We were surprised and pleased by her recovery, given the fact she arrived in a comatose state with posturing (an involuntarily pulling of the arms toward the head). Posturing is usually an ominous sign of significant brain injury."
Steven Hata, MD, medical director of the Surgical Intensive Care Unit, says the cold therapy technique mimics the experiences of people who survive lengthy accidental submersions in frigid water.
"Even if the heart recovers after cardiac arrest, many patients sustain brain damage because of lack of blood flow and oxygen to the brain," Hata explains. "Rapid cooling limits damage to the brain cells so those cells don't go on to die."
In Amelon's case, she emerged from her comatose state and began to recover following induced hypothermia over a 24-hour period. During a two-weeks hospital stay, UI Heart and Vascular Center cardiologists placed a stent to keep open an artery that was 80 percent blocked. They also diagnosed a heart arrhythmia and implanted a defibrillator that will automatically shock her heart should it fail again.
"We feel really fortunate she ended up at University Hospitals," John Amelon says. "It was the best possible place for her to be."
Cheri Amelon continues to recover at home but says she and her husband deeply appreciate everything people did on their behalf.
"We have so many other people to thank, too—rescue workers, family members, and friends from church. Someone above was looking out for me!" she says.
For questions about UI's comprehensive heart care services, patients and family members should:
For consultation or referral, physicians should contact UI Consult.
Cold therapy's promise
UI anesthesiologist Steven Hata, MD, stresses that body temperature management for cardiac arrest is still investigational. Clinical trials show that cardiac arrest patients with induced hypothermia are more likely to have better neurological outcomes. "In one study, more of those patients were discharged from hospitals to their homes or rehabilitation centers, compared to discharge to nursing homes for those whose body temperatures weren't lowered," he says. "Our hospital's own experience with a half dozen patients over the past three years is encouraging."
—Michael Sondergard
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