Rick Hansen — with the build of a man who frequently runs and the quick and easy smile of a smart aleck — was running with his usual crowd in the early morning hours of Sunday, June 4.
“Hey, E, look at me,” he said to fellow runner Elisabeth Knierim. He felt as if he were overheated.
Then the 52-year-old man collapsed. And that’s where his runner’s heart, his knowledgeable friends and location all came together to save his life.
‘She’s a hero’
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Lisa Kokotovich and Chris Gleadle were running about a block ahead of Rick and Elisabeth on the group’s planned eight-miler near Memorial Hospital in Belleville. At about mile five, they heard Elisabeth scream and turned back to see a car stopped at Rick’s prone body.
He’s been hit, Lisa thought as she tried to call 911 on her cell.
Elisabeth and Chris rolled Rick onto his back; the driver already had emergency services on the phone. Lisa, who is a nursing instructor at St. Louis Community College–Meramec and had performed CPR countless times during her nine years a nurse in intensive care units, began compressions.
They tell me in St. Louis City, if they get called to a scene and somebody’s down and no one is doing CPR, they know that person is not going to survive.
Michael Lim, cardiologist at SSM Saint Louis University Hospital
Rick had no pulse. Lisa persisted for eight minutes until the ambulance arrived.
On a recent warm morning, standing in the shade at Bellevue Park near where he went down, the now-recovering Rick has a new name for the woman he’s long called “Lisa Lisa.”
“She’s a hero,” he said.
Had he been running alone, as he usually did on weekdays, Elizabeth would not have screamed for help.
Had he not been running with Lisa, professional CPR would have been delayed.
Had he been further from a hospital, further care would have been delayed.
Rick doesn’t dwell on those possibilities.
“Heart attacks can happen anytime, and people can collapse anytime. What translated for this guy is quick action by bystanders,” said Dr. Michael Lim, the past president of the American Heart Association and a cardiologist at SSM Saint Louis University Hospital. Lim is not Rick’s doctor.
“You don’t have to be a nurse” to do CPR and make a difference, Lim said.
According to the American Heart Association, immediate CPR can at least double a victim’s chance of survival. The AHA now teaches a “hands-only” approach, which can be seen online at www.heart.org.
Lim said he works closely with emergency services agencies in St. Louis.
“They tell me in St. Louis City, if they get called to a scene and somebody’s down and no one is doing CPR, they know that person is not going to survive,” he said.
“If there’s a message you can push forward ... (learning and using CPR) would be the one to push for. The other one’s kind of a downer (that fit people can still have a heart attack). I don’t like that message. In all likelihood he’ll recover much better from his heart attack because he was in better shape.”
CPR makes a difference
Belleville police arrived that Sunday morning and offered to take over. Lisa said no. The police told her they don’t do rescue breathing; she said she was a nurse and she was doing it.
She still wasn’t sure what was wrong with Rick, but suspected it could have been a heart attack because of his “agonal breathing,” as if he was laboring to take a breath. She used an Automated External Defibrillator from the police car as well.
“I’m in the street, not knowing what’s going on,” she said. “I’ve done CPR, never on a friend and always part of a team in a very controlled” environment. “It sounds really fast, but at the time it felt like years ... he was without a pulse for a long time.”
How do you tell someone, ‘Your husband may be dead’?
Lisa Kokotovich, who performed CPR on Rick Hansen after he collapsed on a run
Once EMS arrived, directed by Elisabeth and Chris who had ran ahead toward Memorial, they determined he was “flatlined,” Lisa said. They added medicine in the ambulance and continued resuscitation efforts.
“It still hurts; she pushed too hard,” Rick said with a grin of Lisa’s work.
Anyone could have done the compressions had a nurse like Lisa not been there, Lim said.
“If this isn’t your life (if you’re not a medical professional) I don’t think you should think about things in terms of being certified or not. You took the class, you know the basics, keep them in the back of your mind.”
“It’s not going to matter if you’re currently certified or not. You can make a difference in that person’s life,” Lim said. “It’s not like flying planes.”
While Rick was in the ambulance, Lisa had to make a call to Kathy, Rick’s wife, who was on a trip to Florida. It was the hardest call Lisa has ever made.
“How do you tell someone, ‘Your husband may be dead’?”
Rick remembers none of it. He’s putting bits and pieces of that Sunday and the next couple of days together. Rick admits he was a horrible patient at Memorial Hospital. Lisa agrees. She told the doctors and nurses to be prepared to take the breathing tube out quickly because they could expect him to be combative coming out of sedation. He was.
Because of the amount of time Rick was not breathing on his own, Lisa was worried that he would not “come back.”
“His wife kept saying, ‘You saved him.’ And I said, ‘I hope so.’”
It was three days before they would know he was still himself.
At one point, while Rick was unconscious and before they knew he would be well, the doctor mentioned to family and Lisa that Rick had what seemed to be “unintentional movements.”
“I was an ass,” Rick says now, again with a grin, of his time in the hospital. He was ready to leave shortly after waking, when he was still too weak to even walk to the elevator, Lisa said.
He’s brought multiple fruit baskets to Memorial Hospital in apology and appreciation to those who treated him.
Reshaping his mentality
Rick has what they call a runner’s heart, and he and Lisa think that contributed to his comeback. His heart is healthy, but the “pipes” were clogged, he said.
“It’s that runner’s mentality,” he said, of eating whatever one wants. “I’ll just run it off.”
His mentality has changed a bit in the weeks since the attack that left him flat on his back in Memorial for three days. His doctor has cleared him for long walks, but has to wait a few more weeks before he runs again.
He plans to be at the second annual Belleville Main Street Marathon on Sept. 30 to encourage others to learn CPR. He’ll likely have his doctor’s go-ahead to run by then, but doesn’t know whether he’ll tackle the 26.2 miles. He has run marathons before and says his time in last year’s race was a few minutes off. He attributed it to growing older, but now wonders if his body was trying to tell him something.
Risk factors for heart attack come in two forms, controllable and uncontrollable, Lim said.
“If you’re binge eating, eating a lot of snacks” and generally not eating well and not exercising, “that’s something you can change. It doesn’t guarantee the prevention of a heart attack, but it helps.”
Uncontrollable factors include genetic predisposition to high levels of LDL cholesterol and high blood sugars.
“People need to know their numbers, and their numbers are actually silent,” Lim said. “Even if you’re a runner.”
With very little prodding from his wife, Kathy; Lisa; and Rick’s doctor, Rick says he’ll run again after the doctor clears him. He’ll run with partners. “He’s not allowed” to do otherwise, Lisa said. He’ll adopt Lisa’s habit of always having his phone. He’ll lay off the Burger King and Bert’s Chuckwagon, at least most of the time.
“I had to go in once to get my taco fix and feel normal again,” he said, adding that Kathy is watching him as well.
And he’ll encourage everyone he runs with — from their little group of four to the Belleville Running Club — to learn CPR.
What to do when someone collapses
- Call 911. All medical professionals and the American Heart Association say the first thing is to call for help.
- Start compressions. Even if your two-year certification has lapsed, cardiologist Micheal Lim says if a person is not breathing, you should begin compressions.
- Keep going. Lisa Kokotovich did chest compressions and rescue breathing on Rick Hansen for about eight minutes before an ambulance arrived.