Survival and Grief

        Today is the third anniversary of the sudden death of my youngest son, who was 12 1/2.    He was well, and died following a wonderful Thanksgiving Day in which he played a rigorous game of soccer with older teens. The following morning, he was well, got up, spoke to us about Christmas shopping and getting a cat, and then walked into the bathroom, collapsed and died. Despite rapid CPR and an emergency helicopter ambulance, we never revived him.  Nothing was found on autopsy, and so the presumptive cause of death, is a spontaneous arrhythmia (or heart rhythm disturbance) of unknown cause.  There has been talk of the possibility of a disorder known as Long QT Syndrome, but Daniel was never ill, and therefore never had an EKG. This will therefore forever remain as a theoretical possibility, and no more.  The sudden loss of a healthy child, due to presumed heart rhythm disturbance, and NOT a heart attack,  has been occurring more and more around the world and is now in the news fairly often.  Our family's faith has been something that has helped us survive this.
            I mention this because it is unreasonable to expect that you and your family will pass through life never being tested by a period of loss and of grief.  Certainly, there are people who seem never to have things go wrong, but most of us do.  Some of us experience great losses and great grief and sometimes multiple tragedies.  I mention this today because in order to be a competent practitioner of preparedness there needs to be some forethought on grief and loss.    Heaven forbid, if a natural disaster, or man-made one occurs, and a member of your family is lost, it will be important to tell yourself that they would not want you to lose your own life, sitting in a bubble of grief and failing to take actions which would ensure your survival and the survival of your remaining family.   It is important to consider for a moment, what you would do should the unthinkable occur.  "Freezing in place" has cost the lives of many as the sit within the shock of the loss of someone,or even when faced with the loss of one's home.
            Please tell yourself that if anything horrible ever happens to someone you love deeply, that you will make the commitment to them, here and right now, to first, get out of harm's way, get help for yourself and other family members, eat and drink, deal with survivor guilt AFTER the emergency, and live to produce a meaningful monument to the loved one you have lost.  Do this now, before the maelstrom of life tears at your resolve to do so.
            One of my ways of memorializing Daniel is to pass along information we learned together which can help other families. Please make your mental preparations for challenges, economic, emotional, political, and others, now.

Why I Believe You Should Consider Owning an AED

Daniel

To those of you who know me well, you know that our youngest son, who had no prior medical history, died almost three years ago now, presumably due to a sudden heart rhythm disturbance at almost 13. (His autopsy was completely clean, and his cause of death is therefore a theory, not a certainty)  Since then, many other young people have experienced a similar passing.  One moment, they may be out on a soccer field, or playing (American) football or basketball, and another moment, they are inexplicably down, breathless and pulseless and require CPR.  Despite rapid CPR that day, and two epinephrine injections, we never got Daniel back.  The one piece of equipment which may have helped us that day is an AED.  An Automatic Emergency Defibrillator delivers a shock which helps to synchronize the quivering of a heart in a near lethal rhythm, hovering near death.  Unfortunately,  there is only a short and narrow band of time in which an AED can be effectively used in a sudden arrhythmic death. Although the emergency helicopter that arrived to render care, had one and used it, it was beyond the narrow band of time in which it was most likely to have been effective.   Of course, I had no idea that I probably needed to have an AED in our home.  I also still have no guarantee that an AED would have worked, because although they help sometimes, they do not always. They are simply the best we have for such a situation.
           First of all, children and teens who die suddenly of a heart rhythm disturbance are not having heart attacks.  (A heart attack, or myocardial infarction, is a clot which forms in the coronary arteries which feed the heart, and normally, these children have absolutely clean coronary arteries.)  What the children or teens of cardiac arrest are experiencing is a lethal heart rhythm disturbance, or lethal arrhythmia.  Sometimes, this is due to a viral invasion of the heart and subsequent enlargement. Sometimes this is due to hormonally causes, as in hyperthyroidism.  Other times, there is eventually identified a pre-existing rhythm disorder, such a Wolff-Parkinson-White Syndrome,  Brugada Syndrome, or Long QT Syndrome.  Other times, a child is simply tapped on the chest inadvertently and this disturbs the rhythm at a crucial part of cardiac repolarization. (This is called commotio cordis)  Many times, as there was in Daniel, there were no prior symptoms, and the child or teen feels just fine. Daniel had no discernible cardiac abnormalities on autopsy done at a major US medical center, and reviewed by other centers since.  Daniel had played soccer the day before.  We did have a family history of heart rhythm disturbances, but this was felt only to afflict the elderly members of our family. No one believed Daniel should have a work up or as much as an EKG, and so, one was never done.
          In the US, one can get an automated AED which is unlike the ones used in hospitals which require very specialized training and certification.  Sam's Club sells one for $1200.    Another reliable supplier of an AED and the education one generally should have to use the AED most effectively is:

      The AED Superstore

http://www.aedsuperstore.com/?adid=1002&content=&gclid=CJaj64r32KsCFUld5Qod-j-HRQ

or simply

     www.aedsuperstore.com

      Although there is no guarantee that Daniel would have survived his first and only cardiac arrest had I owned an AED, I still wish I had. I wish he had been given every chance for survival that day,in addition to the rapid CPR he received and the epinephrine injections.

      In the US, one can purchase an AED for under $1200. and sometimes much less for a used reconditioned device. If you own one of these, it is important that you understand how it is to be used, because although it is automated, it is still important that you use it correctly to maximize the chance of saving someone's life.  The one I have pictured below, can be purchased with a key which instantly turns it to a pediatric device delivering the appropriate shock to a pediatric patient.    In Canada, you would need a prescription from your physician for one of these.  Many government locations have one there.   In Europe, more and more places are getting AEDs.
         Since a fairly large number of cardiac arrests in children due to arrhythmia occur during sporting events and practices, each team should own an AED and it should be available to the coach at all times.   This year, outside Richmond Virginia, a teenage girl's life was saved, as she experienced a cardiac arrest early one morning while walking stairs. Her two school nurses used an AED, saving her life.  Later that day a local hospital identified her cardiac problem and installed an emergency internal defibrillator.  She will be fine.

 An AED in a public place in another nation

The unit which arrived at our home yesterday. It also has a key which immediately renders it effective for pediatric defibrillation. (Yes, even using the identical patches)  It can instantaneously be returned to the adult mode should it ever be required to aid an adult in cardiac arrest.

  

          More information on Sudden Arrhythmic Death Syndromes can be obtained by going to:

                         http://www.sads.org.uk/causes_of_sads.htm

We miss Daniel immensely.  Please consider the possibility of purchasing an AED, if this is a possibility for your family, or for your team, your employer, or for your school.  Ours arrived yesterday. I could finally emotionally process the need to have one here.

Everything we do here on "Rational Preparedness" is dedicated to Daniel and to his memory.