Terminator versus Defibrillator
There is a battle being waged against an enemy whose ranks continue to swell. He has been with us for quite some time, and, although we fully expected to see a retreat due to our vast arms’ superiority, his legions continue to muster on the horizon. His all-volunteer army targets “everyday Joe’s and Joanne’s,” whose body armor will not protect a corps ravaged by obesity, high cholesterol, elevated low-density lipoproteins (LDL), essential hypertension, diabetes, atherosclerosis, and coronary artery disease.
Our last stand is imminent, and no prisoners will be taken in the ultimate sacrifice to our vanity and disbelief. We were warned of the “Terminator’s” coming, and, yet, we chose to live the “good life” and forget that the inevitable was already on hand.
Now, only one thing stands in the way of our immediate demise. A secret weapon! Research and development has provided us with a fully affordable system that can even the score, and reduce the commissions of real estate agents dealing in cemetery properties. The “Defibrillator” is here, and perhaps we have a chance, after all.
Heart failure, our worthy but utterly ruthless foe, represents a major public health problem in all industrialized nations. Dress a developing world’s population in the trappings and vestments of the modern world, and it, too, will find itself naked to the onslaught. Each year in the United States alone, heart failure infiltrates our unsuspecting, elderly troops, to the tune of almost 1 million hospital admissions and 50,000 deaths. Its incidence and prevalence is on the rise, and they are likely to increase still further as our population ages. So, let the “baby boomers” beware! No solace can be taken in a contemporary “Lili Marlene,” “Radio Free Europe,” or “Radio Saigon.”
The current battle plan and medical logistics are particularly important to me, as my father was a victim of the “Terminator” on March 30, 2004. As he lay in my arms at home, and I observed first hand his rapid breathing and heart rate, wheezing and gagging, pale color of his skin, and, finally, dilated pupils and respiratory and cardiac arrest, all in a matter of minutes, I knew I was in trouble. Years of medical experience vanished at that sight, and I felt totally impotent at that moment. They say that hearing and touch are the last things to go, when someone dies. As his muscles became flaccid, I jumped into action. It was a losing battle, however, as I had neither the drugs nor instrumentation for advanced life support, as my basic life support (CPR) technique was rusty, as I knew that it would take more than six minutes for the paramedics to arrive, and as I was fully aware of the fact that even if I succeeded in resuscitating my father at home, the current medical literature suggested that there was a 75% chance that he would not make it anyway. If I had only possessed an automatic external defibrillator (AED) yesterday, I might not feel so much guilt today. “Defibrillator” might not have evened the score, but it would have leveled the playing field.
Sudden cardiac arrest kills an average of 930 people every day, and, while CPR (two lung inflations for every 15 chest compressions, and a rate of 100 compressions per minute) is an essential stopgap measure until the paramedics arrive, it usually takes longer than we would hope and pray. Severe cardiac arrhythmia or arrest without CPR within the first 4 to 6 minutes has a poor outcome even if defibrillation is later successful. The “Terminator” will inevitably triumph, when life support is not instituted within the first 8 minutes of arrest or ventricular fibrillation. Once anoxic encephalopathy (brain damage from lack of oxygen, or hypoxia) sets in, the point is mute. The patient will never be the same, and the “Good Samaritan” or family member will curse both the day he or she was born and the so-called “successful” resuscitative effort.
On September 16, 2004, the U.S. Food and Drug Administration (FDA) agreed for the first time to allow consumers to purchase AEDs, like the Philips HeartStart Home Defibrillator for $1,495, online at amazon.com, for example. It does not take a lot of know-how to use a home defibrillator, but speed and easy access to it are of the essence. “Defibrillator” must act within 5 minutes of the skirmish, in order to vanquish the “Terminator.” Shocking the heart back to some semblance of normality within that limited and precise timeframe can quadruple the chances of survival. Had “Defibrillator” been available to me on March 30, 2004, I would not feel so much guilt right now. The memories of my poor father’s demise and his ghost will haunt me forever, but the brand new portable AED in the trunk of my car will stop the “Terminator” in his tracks the next time he decides to pay a friend, family member, or innocent pedestrian a visit. That will be my “shock and awe!”
Our last stand is imminent, and no prisoners will be taken in the ultimate sacrifice to our vanity and disbelief. We were warned of the “Terminator’s” coming, and, yet, we chose to live the “good life” and forget that the inevitable was already on hand.
Now, only one thing stands in the way of our immediate demise. A secret weapon! Research and development has provided us with a fully affordable system that can even the score, and reduce the commissions of real estate agents dealing in cemetery properties. The “Defibrillator” is here, and perhaps we have a chance, after all.
Heart failure, our worthy but utterly ruthless foe, represents a major public health problem in all industrialized nations. Dress a developing world’s population in the trappings and vestments of the modern world, and it, too, will find itself naked to the onslaught. Each year in the United States alone, heart failure infiltrates our unsuspecting, elderly troops, to the tune of almost 1 million hospital admissions and 50,000 deaths. Its incidence and prevalence is on the rise, and they are likely to increase still further as our population ages. So, let the “baby boomers” beware! No solace can be taken in a contemporary “Lili Marlene,” “Radio Free Europe,” or “Radio Saigon.”
The current battle plan and medical logistics are particularly important to me, as my father was a victim of the “Terminator” on March 30, 2004. As he lay in my arms at home, and I observed first hand his rapid breathing and heart rate, wheezing and gagging, pale color of his skin, and, finally, dilated pupils and respiratory and cardiac arrest, all in a matter of minutes, I knew I was in trouble. Years of medical experience vanished at that sight, and I felt totally impotent at that moment. They say that hearing and touch are the last things to go, when someone dies. As his muscles became flaccid, I jumped into action. It was a losing battle, however, as I had neither the drugs nor instrumentation for advanced life support, as my basic life support (CPR) technique was rusty, as I knew that it would take more than six minutes for the paramedics to arrive, and as I was fully aware of the fact that even if I succeeded in resuscitating my father at home, the current medical literature suggested that there was a 75% chance that he would not make it anyway. If I had only possessed an automatic external defibrillator (AED) yesterday, I might not feel so much guilt today. “Defibrillator” might not have evened the score, but it would have leveled the playing field.
Sudden cardiac arrest kills an average of 930 people every day, and, while CPR (two lung inflations for every 15 chest compressions, and a rate of 100 compressions per minute) is an essential stopgap measure until the paramedics arrive, it usually takes longer than we would hope and pray. Severe cardiac arrhythmia or arrest without CPR within the first 4 to 6 minutes has a poor outcome even if defibrillation is later successful. The “Terminator” will inevitably triumph, when life support is not instituted within the first 8 minutes of arrest or ventricular fibrillation. Once anoxic encephalopathy (brain damage from lack of oxygen, or hypoxia) sets in, the point is mute. The patient will never be the same, and the “Good Samaritan” or family member will curse both the day he or she was born and the so-called “successful” resuscitative effort.
On September 16, 2004, the U.S. Food and Drug Administration (FDA) agreed for the first time to allow consumers to purchase AEDs, like the Philips HeartStart Home Defibrillator for $1,495, online at amazon.com, for example. It does not take a lot of know-how to use a home defibrillator, but speed and easy access to it are of the essence. “Defibrillator” must act within 5 minutes of the skirmish, in order to vanquish the “Terminator.” Shocking the heart back to some semblance of normality within that limited and precise timeframe can quadruple the chances of survival. Had “Defibrillator” been available to me on March 30, 2004, I would not feel so much guilt right now. The memories of my poor father’s demise and his ghost will haunt me forever, but the brand new portable AED in the trunk of my car will stop the “Terminator” in his tracks the next time he decides to pay a friend, family member, or innocent pedestrian a visit. That will be my “shock and awe!”
Copyright 2005, Albert M. Balesh, M.D. All rights reserved.
In memoriam, Chiffie J. Balesh, July 18, 1911 – March 30, 2004.
posted by Dr. Al at
7/08/2006 07:52:00 PM
2 Comments:
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