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Defying Death

Story by Kate Vanskike · Photos by Gary Matoso

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Cardiac arrest left physician and researcher Katherine Tuttle, MD, lifeless. But prompt CPR and her commitment to health enabled a full, and unprecedented, comeback.

As a leading kidney disease expert, 56-year-old Katherine Tuttle, MD, follows the dietary and exercise advice she gives her patients. Still, on Easter this year, her heart stopped without warning, resulting in sudden cardiac death—a complete system shutdown—no heartbeat, no pulse.

“The week before I died, I ran 60 miles,” Dr. Tuttle says. “But that wasn’t unusual for me. I’ve been a distance runner and marathon participant for years.”

What had been different in the weeks leading up to that fateful Sunday was her stress load. She worked up to 80 hours a week, keeping up with her clinical practice, oversight of the Providence Medical Research Center and responsibilities as a faculty member of the University of Washington Medical School. She’s also committed to improving kidney disease treatment worldwide, which involves traveling to national and international conferences. In the first three months of 2012, she traveled to Chicago; Washington, D.C.; and India to make presentations. On any weekends she wasn’t working, she traveled to California to care for her terminally ill mother.

“I have always worked very hard; it’s just who I am,” Dr. Tuttle says. “But as I look back, I recognize that I was maxed out on the stress scale. I didn’t want to give up any of my commitments. I wanted to meet all of my obligations and continue with my running schedule as well—and I was just totally exhausted.”

Besides fatigue, other issues surfaced: “On my return trip from India, I passed out on the plane, and when I got home, I noticed my feet were swollen. I thought it was due to being dehydrated or spending too much time sitting on long international flights.”

In reality, those episodes—combined with her exhaustion—could have been indicators that something was not right with her heart. After all, a heart condition called hypertrophic cardiomyopathy runs in her family. It causes a thickening of the heart muscle and is a leading cause of sudden cardiac death.

The Day her Heart Stopped

At 2 a.m. on Easter, Dr. Tuttle’s husband, Andy Boulet, MD, was awakened by a massive seizure taking control of his wife’s body.

“As a spouse, I felt really bad for her and what she was experiencing,” he says. “And as a physician, I was terrified about all the things that could be making this happen.”

When her seizure stopped, he could find no pulse. But after he gave her CPR for five minutes, her pulse returned and she began to regain consciousness.

She returned to normal but agreed to go to the emergency room for evaluation. The pair soon began the 20-minute drive toward Providence Sacred Heart Medical Center & Children’s Hospital. Dr. Tuttle apologized to her husband for the “inconvenience,” then commented that she felt lightheaded.

It was the last thing she said before she went into sudden cardiac death again.

“I felt her pulse stop,” Dr. Boulet says. “I called 911 and hit the gas rather than stopping, because I had to get out to the main road where paramedics would find us more easily.”

After learning it would take 20 minutes for help to arrive, Dr. Boulet pulled his wife out of the car and laid her on the asphalt, where he began chest compressions again.

“It upset me to know the paramedics were that far away. I knew that it wasn’t good for Kathy’s chance of survival, or for her outcomes if she did survive. I also knew the CPR guidelines had changed and was thinking that they better be right!”

He knew what he was up against. “Literature shows that 20 minutes without oxygen to the brain is really pushing it. I was grieving about what was probably going to happen to my wife, while trying to keep my cool as a professional and do what had to be done.”

He did chest compressions on his lifeless spouse for 19 minutes before paramedics arrived and used a defibrillator to shock her heart into action. A second shock restored Tuttle’s pulse, but she still did not regain consciousness.

Beating the Odds

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“I’m eternally grateful that he [my husband] was there, but I also think this is a great reminder that ANYONE can learn CPR.” —Dr. Katherine Tuttle

At the hospital, Sacred Heart’s expert team rushed into action, running tests and ultimately deciding to begin a cooling protocol because she still wasn’t conscious. This process of cooling the body is an effort to protect the vital organs from suffering permanent damage because of lack of oxygen. All in all, cooling and then warming the body again takes about 36 hours. And then begins the waiting to see how the patient will wake up—whether she will be alert and whether she will recognize anyone.

For Dr. Boulet, it was a grueling time of wondering whether his amazing wife would be left with significant disabilities. And would she know her own husband and their 16-year-old daughter?

At last, Dr. Tuttle awoke and a neurologist began to ask her questions. He pointed at Dr. Boulet and asked the patient if she knew who he was.

“My husband, Andy” came a weak reply.

“That was the first time in three days that I felt any relief whatsoever,” Dr. Boulet recalls.

Seven days after her cardiac arrest, Dr. Boulet says, “I knew her functioning level was going to be good. In fact, instead of worrying about whether she could feed herself, I was worrying about her doing too much!”

Dr. Boulet says she’s in the “4 percent club.” Seventy percent of people who have a cardiac arrest outside the hospital die. Of the 30 percent who survive, the vast majority suffer severe neurological deficits.

“We are truly blessed,” he says.

Two Keys to Survival

Dr. Tuttle and Dr. Boulet—like most couples—don’t agree on everything. They don’t necessarily agree on the most likely cause of the cardiac arrest. (Was it stress or a genetic heart condition?) But they wholeheartedly agree on what saved her life and enabled her to return to the work she loves.

“She brought a totally healthy body to the situation,” says Dr. Boulet. “She was physically fit, ate right and took care of herself. That gave her a fighting chance at a full recovery.”

Dr. Tuttle is a runner and a vegetarian. Acquaintances and friends who know that have used it as proof that sometimes a person can eat right and exercise and still not be able to prevent a life-threatening cardiac event.

“They say, ‘Look what happened to you! I might as well go ahead and eat these biscuits and gravy because I can’t really control what happens to me anyway!’ ” she says. “But they’re missing the point. I am here today because I take care of myself.”

Learn from her experience, she says. “If something does happen to you, you have more chance of coming out of it OK when you’re healthy to begin with.”

That said, she wouldn’t have recovered at all if the first lifesaving activity hadn’t occurred: immediate CPR response.

Some say she was lucky to be married to a cardiologist. But both Dr. Tuttle and Dr. Boulet agree that what saved her life was basic life support—which anyone can (and should) learn.

“It’s great that he’s a cardiologist, but he could have been anything other than a doctor and still saved my life,” she says. “I’m eternally grateful that he was there, but I also think this is a great reminder that anyone can learn CPR and basic life support. You don’t have to be a doctor to save a person’s life.”