By KEVIN J. DONALDSON
Special to Crossville Life
Decisions. We all have them to make each day. Some are significant, but the majority aren’t anything resembling a life and death circumstance.
Earlier this year, a Cumberland County (TN) man had one of those rare life and death calls to make, and he made the right one.
Walt Hitch, director of the University of Tennessee Research and Education Center, located between Crossville and Monterey, had a very close brush with death on April 22.
“I went to work that day, and had come home for lunch,” Hitch said. “I had started on a bowl of soup, and then didn’t feel so well.” Hitch, already a heart patient, soon recognized what he thought were the symptoms of a heart attack. “I told my wife (Aretha) I didn’t think I could wait, and she said, ‘Where do you want to go?’ I said Cookeville (Regional Medical Center).”
“I took my aspirin like they tell you to,” Hitch said, and his wife soon had him in the car headed down the road to Cookeville. “I think we may have broken a few speed limit laws along the way,” Hitch said.
“Aretha reminds me daily that she saved my life,” he said with an appreciative laugh.
Mrs. Hitch dropped her husband off at the CRMC emergency room, where the staff quickly jumped into action. While a staff member asked the appropriate questions to determine exactly what was wrong with Hitch, “I got to feeling really bad,” he said. At some point during this time, Hitch recalls he heard a nurse say, “This doesn’t look good,” and he was wheeled back to the emergency room.
Nurses continued to ask Hitch questions about how he was feeling, and he remembers seeing Dr. Stacy Brewington, M.D., a cardiologist with Tennessee Heart, walk in about that time. He also remembers nurses asking his wife to leave, but after that point, he remembers very little.
Hitch’s heart stopped. He was having a heart attack, called a Code 37 in statewide Emergency Medical Services (EMS) radio talk and also used at CRMC for that same designation.
“Code 37 sets the nurses into action, the doctors into action, even the lab personnel into action,” said Dr. Brewington, who performed the stent procedure on Hitch. “We’ll have the (heart) catherization lab waiting when they arrive at the emergency room, stopping the heart attack and restoring blood flow to the heart. That translates into better survival and less damage to the heart.”
The next lucid memory Hitch said he has was waking up the next morning. “The nurses asked me if I was sore, and I asked ‘Why?’ They told me they had to do chest compressions to get me back.
“I didn’t know how close I came to the end,” he said.
Quick action
From the time Hitch and his wife arrived at the emergency room to the time when Dr. Brewington placed a stent at the blocked point in the artery, stopping the heart attack and restoring normal blood flow, was 34 minutes. “That’s amazing to me,” Hitch said. “The process Cookeville Regional has put in place is just great.” A stent is a small mesh tube used to treat narrow, weakened or blocked arteries.
“The national goal for what is known as the ‘door to balloon’ time is 90 minutes, and we’ve been able to reduce that time to around 35 to 40 minutes here,” Dr. Brewington said.
Hitch estimates that counting the drive time from his home, and the Code 37 process at CRMC, his saving stent was in the blocked artery in less than an hour.
“I had no heart damage from the heart attack, due to how quickly it was dealt with,” Hitch said. “I don’t know how you can get that done any faster. Tennessee Heart and Cookeville Regional work seamlessly together.”
Hitch spent Tuesday through Friday at Cookeville Regional, with one night in the cardiac intensive care unit.
“There were a lot of people involved in saving my life,” Hitch said. “Obviously, my wife played a huge part in this, as she reminds me, along with all the folks in the emergency room, the cath lab people, Dr. Brewington, and the nurses on the 4th floor. They all played a part.
“I believe in God, and I am a Christian,” Hitch said. “I believe He works through people, and He worked through a lot of people that day.”
Hitch did his cardiac rehabilitation in Crossville, under the guidance of Dr. Brewington and Tennessee Heart. “I have a good support group,” he said. “My wife continues to make sure I am eating right and exercising. I’ve undergone a big change in diet, eating a lot more fish and chicken. I still eat some beef,” he said smiling. The Plateau Research Center is known for its studies in beef, pork and a wide variety of fruits and vegetables.
Hitch said he’s dropped about 20 pounds since the heart attack. “My kids don’t let me have anything I’m not supposed to.”
Hitch said he would recommend Tennessee Heart and CRMC for anyone dealing with heart-related issues. “The reputation is there, and I can now give a personal testimony to how good they are,” he said.
Big strides being made
Dr. Brewington said the American Heart Association started a public awareness program several years ago on the importance of the “door to balloon” time. The death rate due to heart attacks started leveling out in 2005, Dr. Brewington said, and by 2010 had started to decline.
Tennessee Heart and Cookeville Regional started working with local and area EMS groups on developing the Code 37 protocol “to improve the care for patients who are suffering a heart attack,” Dr. Brewington said. The program has helped CRMC cut the recommended national “door to balloon” time to less than half at their facility.
“Treating a heart attack quickly helps tremendously in restoring blood flow, resulting in decreased damage to the heart tissue,” Dr. Brewington said. “It can change someone who might have a weakened heart to someone who has a strong heart, after suffering an attack.”
Quick intervention also reduces the need for future procedures and creates shorter hospital stays, he said.
There were considerably more steps in the old heart attack treatment protocol, Dr. Brewington said. Now, a Code 37 can be activated by an emergency room doctor, and EMS personnel can start the protocol, too.
It typically takes 15 to 20 minutes to get all the involved personnel ready to do a heart cath when a patient “hits the door at the ER,” Dr. Brewington said. With enough EMS notice on the Code 37 when patients are being transported by ambulance, the lab can be ready on arrival. As Hitch and many others have found out, every moment is precious in those situations.
“About 95 percent of the time, we can stop a heart attack with balloons and stents,” Dr. Brewington said.
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Dr. Brewington is in his 10th year with Tennessee Heart, made up of a group of 11 physicians and 40 support staff members, and affiliated with Cookeville Regional Medical Center.
Tennessee Heart serves over 38,000 patients, with that number growing annually and expanding geographically.
“We have a state-of-the-art facility where you can get your EKG, stress test, echocardiogram and nuclear cardiac studies, provided by Cookeville Regional, without leaving the building,” a group spokesperson said.
Tennessee Heart can be contacted at 931-372-0405 or at 888-391-0048. For more information about the Heart and Vascular Center at Cookeville Regional, visit www.crmchealth.org.
