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Article Category: PeopleCare

KevinCare

Surviving sudden cardiac death—and living life to the fullest

Published on January 24, 2023

Last updated 01:40 PM January 08, 2024

Doing good CPR is critical to save someone from cardiac arrest.

There aren’t many people out there who can say they survived cardiac arrest at 30. Kevin Miskewicz can.

According to the American Heart Association, more than 90% of people who experience an out-of-hospital cardiac arrest die. Those who survive often have permanent neurological disabilities. But Kevin’s story has an incredibly fortunate ending, thanks to the highly coordinated work of his medical experts at Wellstar.

Recovering from cardiac arrest is something Kevin will never forget. It lives forever as a piece of his health history—one that includes a dedicated healthcare team—and his wife, who was the first to save his life.

There aren’t many people out there who can say they survived cardiac arrest at 30. Kevin can.

CPR to the rescue

Kevin woke up on Labor Day 2017 at 5:30 AM to take the dog out. Pausing to adjust the thermostat as he came in, he fell, knocking over a lamp.

He was in cardiac arrest.

With no symptoms and no known pre-existing condition, this was unexpected, but that didn’t stop his wife, Andrea, from jumping into action.

“If it weren’t for me knocking over a lamp when I passed out,” said Kevin, “she would have never woken up and saved my life.”

In addition to calling 911 and unlocking the door for the paramedics, Andrea performed CPR for 10 minutes.

“Kevin’s wife doing good CPR was critical,” said Dr. Arthur Reitman, the interventional cardiologist who was a vital part of Kevin’s treatment team at Wellstar Kennestone Regional Medical Center. “More than five minutes of poor blood flow to the brain can result in permanent irreparable injury from which a patient is unable to recover.”

Coordinating multidisciplinary care to save a life

When paramedics arrived at Kevin’s home, he had no pulse and was not breathing. As the paramedics performed their lifesaving work, he technically died two times.

The ambulance took him to Wellstar North Fulton Medical Center, where he was initially assessed and treated by Dr. David Jacoboff. The interventional cardiologist implanted an intra-aortic balloon pump to stabilize him. Then, he transferred Kevin to Wellstar Kennestone for highly specialized heart care.

When Kevin arrived at Wellstar Kennestone by helicopter, his heart function wasn’t strong enough to support his body. Dr. Reitman and a team of doctors including a cardiologist, a pulmonologist and critical care doctors worked in tandem to put Kevin on an advanced life support system called veno-arterial extracorporeal membrane oxygenation. Better known as VA-ECMO, it took the heart “offline” so it could heal. The technology removed unoxygenated blood from his body, oxygenated it and pumped it back in for the next three days.

“Very few places in the state—only four or five hospitals—have the technology and specialized training to put a patient on ECMO,” Dr. Reitman explained.

Kevin’s wife doing good CPR was critical. More than five minutes of poor blood flow to the brain can result in permanent irreparable injury from which a patient is unable to recover.

- Dr. Arthur Reitman

Interventional cardiologist, Wellstar Kennestone Regional Medical Center

Preventing sudden cardiac death in the future

Dr. Reitman worked closely with Dr. Rajnish Prasad, Wellstar medical director of cardiovascular critical care services and Dr. Bryan Piedad, Wellstar electrophysiologist, to decide which treatments would give Kevin the best life moving forward.

Despite an extensive workup, there is no known cause for Kevin’s cardiac arrest. And there’s a chance it could happen again. If there’s ever a “next time,” Kevin’s doctors want him to survive.

“A defibrillator is meant to protect the patient once they leave the hospital,” said Dr. Piedad, who implanted the device. “Because Kevin was so young, we elected to put in a subcutaneous defibrillator—it’s implanted around the heart rather than inside it.”

The defibrillator constantly reads and interprets Kevin’s heart rhythm, preventing a future episode of sudden cardiac death by shocking the heart muscle if needed.

Kevin continues to follow up with Dr. Piedad once a year to make sure everything is looking good, to get his defibrillator checked and occasionally replace the generator.

“Dr. Piedad is one of the most brilliant people I’ve ever met!” Kevin said.

Kevin also initiates a weekly transmission of data between his defibrillator and the Wellstar electrophysiology device clinic to help the team monitor his heart.

Understanding the bigger picture

There still isn’t any link that doctors—at Wellstar and other healthcare facilities—can say caused Kevin’s cardiac arrest.

Cardiac disease is often exacerbated by certain risk factors like cholesterol, obesity or diabetes/insulin resistance syndrome—none of which Kevin has. A genetic disorder is another possibility.

“Many people believe there are genetic disorders that have not been discovered yet that may predispose patients to cardiac arrest,” said Dr. Piedad. “His genetic testing is negative, but it doesn’t detect what hasn’t been discovered.”

That’s why Kevin is extra careful with his own daughter. Born after Kevin’s cardiac arrest, she got her first annual EKG when she was just three weeks old.

 

Returning to life as normal

After two weeks in the hospital, including six days in a medically-induced coma and eight in the intensive care unit, Kevin was finally ready to go home.

“In walks Dr. Reitman,” Kevin remembered about discharge day, “and he said, ‘It’s nothing short of a miracle that you’re walking out of here!’ That stuck with me. I’m incredibly grateful for the care I received and the quality of care at Wellstar.”

Years later, Kevin said it feels like it never happened. He’s returned to doing what he loves most—traveling. The next big trip on the calendar is all for his little girl—their family of three is heading to Disney. Then, it's off to Europe for their next adventure.

“I remain extremely grateful that I’m here today,” Kevin said.

Learn more about our integrated and collaborative heart care program.

Tags

Bryan Thomas Piedad Arthur Brian Reitman Rajnish Prasad
David Jacoboff North Fulton Medical Center Kennestone Regional Medical Center PeopleCare Heart Care Pulmonary Care
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Monitoring Your Lung Health with Cancer Screenings

Lung cancer screening can detect cancer earlier—even before symptoms show up. Earlier-stage cancers are more easily treatable. If you are at increased risk of developing lung cancer, you could benefit from regular low-dose CT scans to monitor your lung health.

“Finding lung cancer early leads to better outcomes, and screening with CT scans is recommended as the only proven way to minimize delay in diagnosis,” said Wellstar Thoracic Surgeon Dr. Daniel Fortes.

Our team has built one of the country’s largest and most comprehensive screening programs. Wellstar has been designated as a Screening Center of Excellence and Care Continuum Center of Excellence by the GO2 Foundation, an organization that supports lung cancer patients and educates about screenings and care. We’re also a designated Lung Cancer Screening Center by the American College of Radiology.

Evaluating your lung cancer risk

The United States Preventive Services Task Force has revised lung screening guidelines. You may qualify for screening if you are 50 to 80 years old and smoked for 20 years. If you are a former smoker, you may qualify if you quit less than 15 years ago.

“Those who are current or past smokers of cigarettes are more likely to develop lung cancer,” Dr. Fortes said. “However, while smoking is the leading risk factor for lung cancer, a large number of lung cancer patients have never smoked—1 in 5 women and 1 in 10 men diagnosed with lung cancer were never smokers.”

You may also be at increased risk of developing lung cancer if you have been exposed to radon, asbestos or other agents such as uranium or arsenic, according to the American Cancer Society. Previous radiation therapy in the lung area, such as chest radiation for breast cancer treatment, can also increase risk. Additionally, be sure to discuss your family history with your provider—siblings and children of people who have had lung cancer may have a higher risk of developing it.

Screening for lung cancer is not a one-time test, but a process that involves a periodic evaluation of your lungs over time to look for newly emerging cancer. CT scans can detect nodules that are compared over time for changes in size. 

“For those who are at high risk for lung cancer, it is best to have nodules and lung health evaluated by a team of physicians specializing in lung cancer care so the appropriate decision can be made of continued observation versus the need for early intervention,” Dr. Fortes said. 

Depending on the findings, some patients may have more or fewer exams. If findings are suspicious for lung cancer, your care team will contact you to discuss your screening results.

How do I schedule a screening?

An order from your physician is required to get a screening. Contact your primary care team or a pulmonologist to talk about screening and when it may be right for you. Once an order has been obtained from your physician, call (470) 793-4AIR (4247) to schedule your appointment.

What if my scan shows a lung nodule?

Your care team will support you at every step of the screening process. If you have any questions about your results or your screening plan, contact your provider over the phone or using the secure messaging feature in MyChart. You can also call our cancer care team at (877) 366-6032 to learn about our care options.

All lung screenings are initially interpreted by a radiologist. A team of physicians who specialize in the diagnosis and treatment of lung cancer will review findings that are suspicious for cancer. Once the physicians complete their review of your images, your results are posted within three to five days to your MyChart account. Results will be communicated with you and your physician via MyChart or mail within one week.

If a lung cancer is suspected, our team will call you to answer your questions and arrange next steps. You will then meet with a physician specializing in lung cancer treatment.

Patients whose screening shows a lung nodule may feel concerned. However, you should not be overly concerned if your report indicates you have small lung nodules. Most people who meet eligibility for screening will have some. Nodules are very common—at least 50% of people have them by the time they are 50 years old.

Learn more at wellstar.org/lungcancer.

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Close up of man’s hands working on vehicle engine.

PeopleCare

BillyCare

William “Billy” Gerace, a retired man in Mableton, found himself progressively restricted by severe emphysema. Dependent on oxygen, it was tough to find the breath and the energy to work in his garage. Then he found out about BLVR, a procedure that would change his lungs—and his life—for the better. Now he spends his days breathing new life into classic cars. Billy’s story highlights the power of expert care and leading-edge treatments at Wellstar, and our commitment to help people get back to doing what they love.

 

Slowed down by an oxygen tank

For Billy, the simplest of movements became Herculean tasks. The man who loved tinkering in his garage found himself slowed down by an oxygen tank and dependent on his wife, Patty, to help him move it from room to room. 

“I couldn’t walk 20 feet without the hose on my nose,” Billy said. “I couldn’t go from the living room to the kitchen without oxygen. That’s how bad it was.” 

Billy suffered from emphysema, a severe type of chronic obstructive pulmonary disease (COPD). The inability to work in his garage on his collection of vehicles—including a '69 Corvette convertible—was heartbreaking. 

“I’d have to do five minutes’ worth of work—then catch my breath,” he remembered. “It took me a very long time to do anything. A project that would normally take an hour took two days. I had to sit dormant most of the time.”

Billy had managed this condition for years with prescription medication and pulmonary rehabilitation, but in the final months leading to his procedure, he had the impression that his life was fading with every gasp of air.

 
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Highlights

Make Lung Health Your Habit

Whether you’re running a marathon or simply running errands, having healthy lungs helps you to live comfortably and do the activities you enjoy.

Lung health is an important part of overall wellness. It’s best to prevent health issues before they start, and Wellstar experts will partner with you to personalize a plan to keep your lungs healthy. 

Book an appointment online to check in with a clinician about your lung health and follow these tips to breathe a little easier.

Don’t smoke or vape

If you are a smoker, keep in mind that there are both short-term and long-term benefits to quitting. One to nine months after the last cigarette, your shortness of breath should decrease. Within 10 years of quitting, a former smoker's risk of developing lung cancer is 30% to 50% below that of a person who continues to smoke.

Also, if you don’t smoke, do not pick up the habit. Nicotine is highly addictive, even more so than many other drugs including narcotic opiates, according to Wellstar Pulmonologist Dr. Hitendra Patel.

Dr. Patel said that vaping is gaining popularity, especially among younger people. However, vaping irritates a person’s airways and increases their risk of asthma.

“Nothing but air should go in and out of the lungs,” Dr. Patel said. “Any other chemical or substance, or inhalation of smoke of any kind, is going to be detrimental and harmful.”

Wellstar Primary Care Physician Dr. Jignesh Dholaria said misinformation about vaping is common.

“People have the notion that vaping is somehow safer and that it doesn’t have the same chemicals that cigarettes do,” Dr. Dholaria said. “We’re seeing a lot more harmful effects from vaping just because we don’t always know all the chemicals that are in these vapes. That has caused a lot more lung-related injuries.”

Get your exercise and sleep

While staying active is a critical component of overall wellness, it’s especially important to keep your lungs in top shape.

“As you’re breathing in and out, getting rid of carbon dioxide and inhaling more oxygen, that helps your tissues, which helps you feel better overall,” Dr. Dholaria said.

Even if it is raining—or if pollutants are especially high that day and you’re worried about lung irritation—there are ways to get your steps in. Dr. Patel recommends going to an air-conditioned shopping mall or store to get some exercise if being outside is not an option.

“Continuing to exercise to the fullest of your body’s ability is an important step of maintaining whatever lung health you have,” Dr. Patel said. “If you start with healthy lungs, staying on an exercise program and regimen is vital.”

Balance that exercise with some rest, too. Dr. Patel, who is also the medical director of the Wellstar sleep program, said being well-rested can ward off sickness, including some respiratory illnesses.

“If you don’t sleep well, that means your immune system is not going to function as well as it should,” he said.

Try breathing exercises

In addition to getting your sleep, some relaxation and breathing techniques can have benefits for both mental wellness and lung health. 

Dr. Patel recommends “4-7-8 breathing,” which involves inhaling for four seconds, holding your breath for seven seconds and then exhaling for eight seconds.

Benefits of breathing exercises may include lower stress and anxiety levels, lower blood pressure and better sleep.

Manage your asthma

If you have asthma, know your lungs and avoid the environmental triggers that cause the condition to flare up, Dr. Patel said. Common triggers include pet dander, seasonal changes, allergens like perfume and smoke inhalation. 

Asthma can also run in families, although there is often no specific reason why a person develops asthma, Dr. Patel said.

“Sometimes people underestimate how bad asthma can be,” Dr. Patel said.

If you have asthma, see your primary care physician to monitor your lung health. Pulmonologists specialize in caring for people’s lungs, and they often collaborate with primary care clinicians to create personalized plans to manage their patients’ asthma.

Ask your care team about screenings

Early detection is key in cancer treatment, but many lung cancers present in later stages, Dr. Patel said.

“In that area in the middle of the lungs and the middle of the chest, there are no pain fibers or pain sensors in there,” Dr. Patel said. “If a tumor occurs there, patients don’t know it. They don’t feel it, and it doesn’t hurt them.”

Lung cancer is sometimes found when it spreads and causes complications, Dr. Patel said.

If you are at increased risk for developing lung cancer, ask your care team about screenings. You should consider screenings if you are a current or past smoker. Visit our lung cancer screening page to learn more about if screening, which involves low-dose CT scans, could benefit you. To keep up with your lung health, find a Wellstar physician near you.

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