The last thing Andrew McLean, 43, of Moultonborough remembers is walking in to the Emergency Department waiting room at Speare Memorial Hospital. The next thing he knew he was waking up in a hospital room at the New England Heart Institute at Catholic Medical Center (CMC) in Manchester—two days later. How he got there is quite a story, and one he has been told a few times since his journey began on April 23.
A self-employed carpenter, Andrew explains he wasn’t feeling well that Tuesday morning as he traveled to the job site in Waterville Valley. He started having shortness of breath and tightness in his chest. While worried, he wasn’t panicked. His colleague and friend Rick Stachecki took one look at him and felt differently, insisting he be immediately driven to the ED at Speare.
En route, Rick called Andrew’s wife, Debi. She says, “Andrew got on the phone and sounded okay. I said I would meet them there after I picked up lunch for our daughter Reilly. At that moment, neither of us realized how much trouble he was in.”
Brenda Joyce, the health unit clerk sitting at the triage window in the ED, saw Andrew round the corner into the waiting room, then collapse face down on the floor. She immediately sprung into action, sounding the alarm and a Code Blue (cardiac arrest) was called. Rick again called Debi to make sure she was on her way to Speare. Things weren’t good.
Respiratory Therapist Paul Punturieri picks up the story after responding to a second Code Blue that was called. “I hadn’t seen a case like this in 30 years,” notes Paul. “When a second Code Blue was called I knew it wasn’t good. He had numerous cardiac arrests and was defibrilated (shocked) many times. CPR continued with the helping hands of many responders under the direction of Dr. R. Patrick Broadwater.”
“It was a total team effort,” insists Dr. Broadwater. “Here we had a young man with no other comorbidities (presence of any other diseases or disorders), and when is wife and young daughter walked in, it made us even more determined. We tried everything. “
It was like a scene from a popular television medical drama when Debi and Reilly, age 11, arrived. “They instructed us to talk to him and hold his hand,” recalls Debi. “There were so many people packed in to a very small room trying to help him.”
Paul says Andrew finally came out of cardiac arrest and they were able to get a heart rhythm on him. After being put on a portable ventilator, he needed to be transported to the New England Heart Institute at CMC for treatment as soon as possible. Unfortunately, neither the DHART helicopter nor the ones out of Boston or Maine were flying that day because of safety reasons related to a low cloud ceiling. Compounding the situation was the fact that neither of the primary ground transport services were available either. That’s when Paul knew he would be joining the transport team from Warren-Wentworth to get Andrew to CMC.
Paul continues, “The bed Andrew was on in Room 7 was side-by-side with the transport gurney needed for the ride down to CMC. No sooner had we gotten him on the gurney, then he went into cardiac arrest, and again had to be shocked multiple times. Finally we got him stabilized and into the ambulance.
They were on their way to Manchester . . . or so they thought.
“Somewhere between Exit 24 and Exit 23 southbound on I-93 he went purple from the neck up,” Paul continues. “We did CPR all the way back to Speare. After reviving him for a third time Dr. Broadwater found a pulse and Andrew resumed a rhythm. He had been stabilized again. We tried for a helicopter . . . still not flying.”
Andrew went back in the ambulance and Paul notes he took him off the ventilator and manually “bagged” or ventilated him all the way to Manchester, saying, “He responded much better to that approach.” Five hours after first collapsing at Speare, Andrew arrived at CMC and was immediately taken to the catheterization lab.
By the time Debi arrived at CMC they had found Andrew’s main artery 100 percent blocked and a secondary artery 75 percent blocked. While the clot busting medicine given to Andrew at Speare had definitely made a difference between life and death, he wasn’t out of the woods yet. Debi tearfully recalls that the doctors at CMC were worried about organ failure and neurological damage, saying, “They told me he only had a 50 percent chance of making it through the night.”
It was at that moment, as Debi recounted the graveness of the situation, that she and Andrew were overcome with a wave of emotion, realizing what they have both been through. Andrews recalls none of this, but says, “They keep telling me I’m the luckiest man alive.”
While in a medically induced coma, Andrew had two more cardiac arrests overnight. Additionally, to preserve tissue and prevent organ damage he was put in a state of therapeutic hypothermia. Debi says the plan was to keep him that way for 48 hours, but his body wasn’t tolerating it and they had to begin raising his body temperature after only 24 hours. They also began lowering his medications to bring him out of the coma.
Candee Adams is an occupational therapist with Choice Physical Therapy working at Speare, and a friend of Debi and Andrew. Speaking on the phone with Debi Wednesday evening, Candee knew they had prepared her for possible issues associated with Andrew’s brain being without blood and oxygen for extended periods of time. She went down to visit with them at CMC after work on Thursday evening. Andrew recognized Candee and attempted to ask about her son. She says, “He had passed the first test.”
Andrew remained at CMC until Tuesday, April 30. On May 4, he celebrated his 43rd birthday. With a stent put in one artery and a regime of medication therapy to address his heart disease, of which there is a family history, Andrew was also prescribed cardiac rehabilitation. Cardiac Rehab Exercise Physiologists Craig Johnson and Rachel Kindl say Andrew was in pretty good physical shape—because of his active lifestyle—when he began his rehab on May 16. Their goal was to push his limits, give him confidence he would be okay, and get him back to work. He graduated from Cardiac Rehab on June 7.
Looking back on it all, Debi says the community support has been amazing, “Everyone in the room that day—they are our neighbors and friends.” She ends with a realization and acknowledgement, “Speare kept Andrew alive. They wouldn’t give up on him. ”