Susan Salter remembers sitting at the kitchen table, laughing over a YouTube video with her son and his girlfriend while they made dinner on a somewhat unusual Monday afternoon in June, and then waking up in hospital several days later.
It was the unusual part — a series of minor but terrifically lucky changes to the daily routine — that would mean the difference between life and death for the Port Coquitlam woman.
Brant Salter, a 24-year-old plumber at SFU, usually finished work at 3 p.m. but would often wait to leave so that he could pick up his girlfriend, 21-year-old Ashley Gray, from her job as a live-in caregiver for a Port Moody family, at 4:30 p.m.
But on June 22 Gray and Salter happened to have the day off; they spent the day together before Gray decided to pick up Brant at SFU. Instead of going out, they decided to return to Brant and Salter's house early to make dinner.
As Brant got busy in the kitchen Gray sat on the barstool at the counter chatting with Salter, who had her back turned to them as she worked on the laptop at the kitchen table. After showing Brant and Gray the YouTube video Salter turned to writing an email when Brant heard her say, "Oh crap," and then saw her lean forward.
He paused, thinking she was reading something more closely, and waited, but all they heard was a strange gurgling noise; Salter had suffered a cardiac arrest.
'WHAT'S WRONG WITH MY MOM?'
What followed were 18 minutes that seemed to consume an eternity, Gray said, each second suffused with heart-thudding panic.
A 911 operator calmly coached the pair to lay Salter on the floor and immediately begin CPR — 100 compressions, no breaths, she advised.
It had been nearly 10 years since Brant learned CPR during his Scout days; Gray, who was certified two years ago to qualify for her nanny job, relayed instructions from the operator and moved Brant's hands to the correct position.
In the five to eight minutes before the ambulance arrived Brant focused all his energy on those compressions, unaware that he was repeatedly asking, "What's wrong with my mom?" Gray recalled.
Paramedics and fire fighters arrived at the same time, with nine of them eventually crowding into the small townhouse as they rotated two-minute shifts performing CPR on Salter.
Twice they used the defibrillator before she was stable enough to be transported to Royal Columbian Hospital.
"Without immediate help someone in sudden cardiac arrest could suffer brain damage within three minutes; after 12 minutes survival is unlikely," Shelley Parker, Heart & Stroke Foundation
The following days were endless for Salter's family and friends as they waited for the fiery 62-year-old to emerge from a medical coma, not knowing if she would wake up or, if she did, whether there would be significant brain damage.
BC Emergency Health Services attends between 2,400 and 2,800 cardiac arrest calls each year (a heart attack — a blockage of the coronary artery — often comes with early warning symptoms while cardiac arrest — a malfunction in the heart's electrical system — is often sudden and causes immediate loss of consciousness), meaning there is an out-of-hospital cardiac arrest every three to four hours in B.C.
"Without immediate help someone in sudden cardiac arrest could suffer brain damage within three minutes; after 12 minutes survival is unlikely," said Shelley Parker, resuscitation program manager, BC & Yukon, for the Heart & Stroke Foundation. "Bystander intervention is critical because the person having a cardiac arrest can't wait for the fire department or ambulance to arrive."
In fact, performing CPR in the first few minutes of a cardiac arrest can double the chance of survival.
"CPR is critical because it buys time by keeping blood pumping through the body until an AED [automated external defibrillator] can be used," Parker added.
WAKING UP
When Salter woke up — fighting the tubes and restraints — she was, against all odds, just fine.
"If it wasn't for my son and his girlfriend being there I wouldn't have survived," Salter said. "I had no family history, I had no warnings. They're my heroes."
Recovery hasn't been easy though. All of Salter's ribs were either broken or cracked, and her sternum was broken as well, and it was only recently that she was able to sleep lying down in bed.
She takes several medications and was recently fitted with a combination defibrillator/pacemaker device, a new technology that qualified her to be in a clinical study.
There are some memory lapses as well; Salter has only partial memory of a family trip to Whistler two weeks before her cardiac arrest, and less recollection of a weekend in Nanaimo just before that Monday.
And while depression is common among those who have suffered a significant heart attack or cardiac arrest, Salter said she feels some anxiety about the batteries in her defibrillator but is otherwise fine.
"It all feels like science fiction," Salter said as she tries to make sense of what happened.
On any other day she would normally have been driving home from work at that time, and Gray and Brant wouldn't be home until about 5:30 p.m.
But a series of seemingly insignificant shifts from the norm on that late June day have given Salter her life back, and she couldn't be more grateful for every minute of it.
"I'm so lucky it's insane," she said.
BE PREPARED
To help bystanders be more comfortable stepping in to perform CPR, researchers and educators have simplified the steps; the Heart & Stroke Foundation offers a graphic chart on their website (visit www.heartandstroke.com under the CPR/First Aid tab).
The foundation also encourages everyone to be prepared for a cardiac emergency and to take CPR/AED training.
Those who want to learn the technique at home can check out the Family and Friends CPR Anytime product, which includes a DVD and small training mannequin, allowing families to learn CPR together in as little as 20 minutes, Parker said.
"In those first few moments, if you have a loved one who has either drowned or choked or is suffering from cardiac arrest, the more you know in those few moments the more chance you have of saving that person's life before a first responder arrives," added Maria Bekiaris of the St. John Ambulance, BC & Yukon branch.
There are several CPR and first aid training programs available at Port Moody's St. John Ambulance office.
"You never know what's going to happen around you," Gray said of the importance of CPR training. "If you can be the first responder, you can make all the difference."
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