Against all odds

After a full day of handyman work on his son’s new house, Rick Pew was hungry. He grabbed a piece of pizza. But before he bit into it, his heart stopped. He collapsed, unconscious. He quit breathing and had no pulse.

The Boise man’s massive cardiac arrest did not kill him on the spot, but pinned him along the border between life and death for a full week. The father of two and grandfather of six should have died. His doctor half expected it. His devout family members were ready to accept it if they must.

But Pew got another chance. He woke up and let the tears flow as he held hands with his family. Talking was hard at first because the tube that had helped him breathe for a week left his throat raw. That was in January 2007. Today, Rick Pew is Rick Pew again, his cardiologist, Dr. David Oakes, said.

Pew and his wife, Lori, and their extended family celebrated the anniversary of his reawakening at Boondocks Fun Center in Meridian. Pew acknowledges he is blessed, and he quit smoking cigarettes, the No. 1 risk factor for heart disease and a habit that stuck with Pew for 34 years.

"Unless he resumes that nasty habit, his prognosis should be excellent," Oakes said.

To his wife’s surprise, Pew joined a fitness club in December and works out almost every night after work. "He has definitely lost 10 or 15 pounds, and he looks healthier," his wife said.

He also is starting to take less medication, under the supervision of Oakes. "Follow-up heart testing shows that his heart is functioning well," Oakes said.

To his family, Pew is a miracle.

"We believe it was God that saved him," Lori Pew said, "that God interceded."

Pew’s dramatic recovery also impresses Oakes. Ninety percent of people in Pew’s shoes would have died, Oakes said. Half of the rest would have suffered brain damage.

Neither Pew’s heart nor his brain appears to have suffered lasting damage. At first, he had no memories of anything that happened during January. Some of those memories have returned, but the week before his near death and the 10 days afterward remain missing pages from his life.

People ask about memories of the near-death experience itself, but Pew doesn’t have any, Lori Pew said. Since his recovery, he has celebrated his 47th birthday and returned full time to his job making tents and awnings. He does not fear another heart attack.

Rick Pew has a sense of humor about the ordeal that he does not remember. He gently ribs his son, Brandon, 26, to keep him from getting too wrapped up in the "what ifs" of being alone with his dad when he collapsed.

During an hourlong interview with Idaho Health, Rick Pew told his son his heart stopped because, "You worked me too long," and because Brandon wanted to eat the pizza without sharing.

This is one family’s tale of what happened when the nation’s No. 1 killer, heart disease, stalked one of their own.

After Rick Pew fell to the floor, his heart squeezed out blood in a fatally weak, haphazard rhythm called ventricular fibrillation. His brain and other organs, deprived of oxygen, would shut down within minutes. Brandon was not in the room when the elder Pew collapsed. When Brandon returned, his first thought was that his father was resting.

"I started trying to talk to him, and he wouldn’t talk back," Brandon said. "I saw him gag on his tongue."

Shaky now, Brandon dialed 911 and tried to do cardiopulmonary resuscitation while he waited for Ada County Paramedics to arrive.

Every second was crucial if his father was to live without permanent brain damage. "Within several minutes, if normal rhythm is not restored, you will die," said Oakes, an interventional cardiologist at the Boise Heart Clinic.

Paramedics arrived within four minutes of the call, restarted Pew’s heart using a portable defibrillator and sped toward Boise’s Saint Alphonsus Regional Medical Center. When Pew arrived at the hospital in a coma, Oakes was very pessimistic about his survival, although Oakes never let the family see doubt. To the family, Oakes was an energetic Superman who all but wore a cape.

Pew had suffered a massive blockage, caused by a blood clot, at the origin of the largest artery of his heart. Doctors call this sort of heart attack a "widow maker" because most victims die fast, the blood supply to a large area of their hearts cut off at once. Many people who survive widow makers have no memories of shortness of breath, chest pain or other symptoms.

By comparison, most heart patients who go to hospital emergency rooms do so because of chest pains or other symptoms. They may have blocked arteries that need to be propped open with stents to minimize heart-muscle damage, but they are not in cardiac arrest. Their hearts have not stopped pumping blood.

Pew’s tests showed he was having a massive heart attack, and every minute counted if he was to avoid irreversible heart-muscle damage.

"When we see that someone has this acute, massive injury to the heart ... we have got to get them into the laboratory as quickly as possible to restore blood flow to the heart," Oakes said.

Because time is so important to saving heart patients such as Pew, some Valley hospitals do not allow interventional cardiologists such as Oakes to live more than 30 minutes from the hospital.

As doctors assessed his condition, Pew’s family gathered at the hospital. After Brandon arrived, he called his wife, Katie, and tried to explain what was happening. "She couldn’t quite understand me," Brandon said. That was because Brandon still was shaken up.

Katie drove Brandon’s mom, Lori, to the hospital. All Lori could think about was missing digits. Because Rick and Brandon had been doing handyman work, severed fingers or toes seemed the likeliest option.

The family met the ambulance as it arrived at the hospital and cried together as doctors came and went with reports about Rick’s condition. They learned he suffered a massive cardiac arrest, even though no one knew he was at risk, and he had never suffered any symptoms.

In a fairly new treatment to reduce brain damage, medical staff packed Pew’s body in ice and cooled it for 12 hours. They gave him medicine to prevent agitation and intense shivering. The medical staff did not let Lori Pew see her husband until the predawn hours the next day, after they had controlled the internal bleeding endangering his life.

"We attend Calvary Chapel, and our assistant pastor, Randy Nurmi, was at the hospital with us during Rick’s first night," Lori Pew said. "After Dr. Oakes came out and told us that Rick was bleeding internally, Randy had us all hold hands and sing, ‘The steadfast love of the Lord.’

"After they got Rick’s bleeding under control, and I was allowed to see him, Randy turned to me and said, ‘I believe you’re going to see God’s hand of mercy.’ "

Throughout the week, what helped Lori Pew hang on were the pastor’s words about God’s mercy and something Oakes had said to the family: "I don’t know why, but I feel good about this guy." Pew was solid and young, said Oakes, who tries not to give families false hope.

After Rick Pew’s first night, doctors encouraged the family to go home and rest. No way. "We stayed 24/7, and as the days went by, they let us take over the waiting room and we slept out there, and someone was always with him," Lori said. The days were a blur of good and bad news as Rick Pew’s condition changed. "We were emotionally drained, physically drained," Brandon’s wife, Katie, 27, said. "We weren’t sleeping. It’s safe to say our world just stopped."

A bright spot was the family, friends and church members who visited, bringing treats or water. Visitors made the Pews laugh, or they just sat, saying little, their presence a comfort when the Pews didn’t feel like explaining again how Rick was doing.

Each day, medical staff reduced Rick Pew’s sedation to see if he was coming out of his coma. Doctors called it a "sedation vacation." They asked him to wriggle his fingers or toes. At first, nothing happened. Then one day he started breathing better than before, and he emerged from his coma.

"I don’t think that my time was done," Pew says of his survival. "And the blessing is that I was whole." Why he survived when others do not is so far unclear to him. "There’s a purpose," Rick Pew said. "But that gets beyond anything I can reason out."