Excellence in cardiac — and emotional — care

Have you ever wondered how you would respond during a medical emergency? Would you know what to do, who to call or where to go?

Karyn Cerulli hadn’t really considered any of these things. However, she managed to be the first of many people who helped save her husband’s life when he experienced sudden cardiac arrest early one morning.

Karyn’s husband, Ralph Cerulli, is an energetic, 58-year-old man who has always eaten a healthy diet, exercised and, in general, taken care of himself. After a visit to the gym one day, he felt discomfort in his chest and chalked it up to his overambitious upper-body workout.

The pain stuck around longer than he would have liked, so he made a visit to a local urgent care at the end of his workday and checked in, noting on his registration form that he was feeling chest pains. He was asked to take a seat in the waiting room and sat for an hour and 45 minutes before he ran out of patience and planned to leave. And though he noted that he was experiencing chest pains, no vital signs were checked. The receptionist made no move to stop him.

To this day, Ralph and Karyn wonder how differently things might have gone had they visited a Sharp urgent care or emergency room instead.

Far more than a pulled muscle
Frustrated, Ralph went home to wait for what he assumed was likely a mild muscle strain to resolve itself. However, it was far more than a pulled muscle. Early the next morning, Ralph’s heart stopped beating and Karyn leapt into action.

A change in Ralph’s breathing woke Karyn. She immediately recognized that he was in distress and accidently grabbed the television remote instead of her cellphone to call 911. When she realized her mistake, Karyn screamed to their 23-year-old daughter, Krystina, to call 911 while Karyn started chest compressions on Ralph.

After a confusing start to the call with the emergency operator — Krystina had assumed the emergency was a fire in the nearby canyon because one had occurred earlier in the evening — she ran to her parents’ room only to see her mother performing chest compressions on her father. It was the beginning of a very traumatic week for the family.

“I yelled to Krystina that her father was having a heart attack,” Karyn says. “The operator told us to get him onto the floor, so we pulled him off the bed and took turns doing chest compressions for about 11 minutes. As we switched off doing compressions, I tried to pull our two German shepherds into the backyard because paramedics were on the way and I needed to secure the dogs before I opened the front door for them.”

And then, as Karyn says, “All hell broke loose.”

The paramedics arrived and filled the house. They performed CPR and used defibrillator paddles on Ralph until they had him stabilized for transport to the hospital while the dogs tried desperately to get into the house.

“The dogs destroyed the sliding door in the back,” she says. “They could tell something terrible was happening and just wanted to get to us.”

As the paramedics prepared to leave, they told Karyn and Krystina they were heading to Sharp Chula Vista Medical Center and to meet them there. Having moved to Chula Vista just one year prior, Karyn admits she didn’t even know where the hospital was or whether it was the right one for Ralph’s condition.

However, she soon discovered that, without a doubt, it was.

The Sharp Experience
“From the minute we walked in the door of that hospital, it was amazing,” Karyn says. “We had people greet us at the emergency room entrance and bring us right to the person who checked us in. I was in shock, shaking and fumbling with things in my purse, and everyone was so kind and helpful.”

Soon, Dr. Genaro Fernandez, a board-certified cardiologist affiliated with Sharp Chula Vista, came out to greet Karyn and Krystina. He explained that Ralph had experienced sudden cardiac arrest — when the heart suddenly stops beating — as well as what is commonly called a “widowmaker” heart attack, both of which can have serious consequences, including death.

A heart attack occurs when one or more of the three arteries that run over the surface of the heart become blocked and prevent blood from reaching the heart muscle. When a critical blockage, or occlusion, in the left main artery or at the beginning of the left anterior descending (LAD) artery occurs, the blood supply to a majority of the heart muscle decreases, causing a widowmaker heart attack, which few people survive.

Dr. Fernandez explained that he was taking Ralph to the cath lab, where he would place stents to open the affected arteries.

Terrified of the outcome, Karyn and Krystina headed to the waiting room. As Karyn called friends and family members to share the tragic news, Krystina, still deeply shaken, found she couldn’t sit still and headed outside.

“So, I’m trying to make calls — honestly not sure what I should be planning, travel arrangements for people to come see Ralph or a funeral — while I’m also trying to keep an eye on Krystina because I’m worried about her,” Karyn says. “The security guard sees what is happening and says to me, ‘Don’t worry, I see her. If I see her leave, I’ll let you know. You just keep doing what you’re doing.’ It was amazing.”

Soon, Dr. Fernandez returned with the news that Ralph’s heart was going to be fine. But there was some concern about his brain function because he had been unconscious and without oxygen flowing to his brain for some time, which can cause severe damage. The plan was to treat Ralph with therapeutic hypothermia to lower his body temperature, reduce the risk of brain damage and increase his chance of recovery.

“I was allowed to go up to see Ralph in the ICU and they were starting the hypothermia treatment,” Karyn says. “This was when I met ICU nurse Molly Quillin-McEwan. She sat me down and looked me in the eye and told me she would explain everything that was going to happen in the next 24 hours and encouraged me to ask as many questions as I needed to ask. Then she said, ‘We’re here for you just as much as we’re here for him.’”

Care for the whole family
Over the next several days, friends, co-workers and family members — including Ralph and Karyn’s three other adult daughters, Justyne, Daniella and Victoria — gathered at the hospital. At any time of the day or night, Ralph’s loved ones were either sitting with him or in the ICU lounge.

“The waiting room was right outside of the ICU unit,” Karyn says. “It became a very important spot for us because we had family in and out and other families of patients were there. We all just sort of bonded with one another, which was so helpful during such a horrible time.”

Though Ralph was unconscious for several days, he recognizes that the care he received was exceptional.

“We’re from Boston, which is surrounded by some of the top hospitals in the country and I’ll put this hospital up against any one of them,” Ralph says. “My brother is on the board of one of the Boston hospitals and when he reached out to his contacts for referrals in San Diego, who do you think they recommended? Dr. Fernandez at Sharp Chula Vista!”

Karyn appreciated the excellent medical care Ralph received, but found that it was the little things that helped her get through such a trying time.

“Every single time someone came into his room, they told me who they were and what they were doing and asked if I needed anything,” she says. “They made sure we had warm blankets at night or knew where we could get coffee. They even knew when to push us to go home and take a shower or pet our dogs. They made me feel that it was OK to leave when I was really afraid to step away even for a minute. These sound like little things, but they really do mean so much.”

“They just went above and beyond with everything,” Ralph adds.

The Miracle Man
After a few days, Ralph started to regain consciousness. While he was slightly confused at first about what had occurred, he soon became eager to get home and begin his recovery.

“People were stunned I survived this thing. They called me ‘The Miracle Man,’” Ralph says. “I was ready to get out of there, but everybody — and there were a ton of people in and out all the time — everybody was just awesome.”

And while Ralph wouldn’t wish a similar situation for anyone, he says the experience helped put things in perspective. He is cutting back on his usual long work hours and is not taking anything for granted — prioritizing family and simply being nicer to others.

“You can’t change the beginning of your story,” Ralph says. “What I can do — and what anybody can do — is change what comes next, and for me, the next phase started the day I walked out of the hospital.”

This change includes Ralph’s commitment to take care of his health. He diligently takes his medication and attends a cardiac rehabilitation group at Sharp three times each week.

“We have fun,” he says. “Me and all my 90-year-old buddies get together and it’s great. We’re a fun bunch!” he says.

However, Ralph is not really one to slow down all the way. He was back to working full time as the general manager of a car dealership in Chula Vista just three weeks after his heart attack. But he will continue receiving heart care at Sharp and feels fortunate to have access to the level of care he’s received.

“This is some of the best medical care in the country,” he says. “It just totally exceeded my expectations beyond belief. And I can’t imagine that it wouldn’t exceed anyone’s expectations. It’s just incredible.”

One of the best and darkest times
Now that Ralph and Karyn are a couple of months removed from his heart attack and hospital stay — which Karyn calls, “one of the best weeks of my life during one of the darkest times of my life” — they are committed to making sure people understand the importance of excellence in medical care.

Karyn, a senior vice president and market manager with Entercom San Diego, a media and entertainment company, recently recognized Quillin-McEwan for the care she provided her family with a CARE Award presented by KyXy Radio, an Entercom station. Karyn noted that Quillin-McEwan really touched them during their stay, giving special attention to their daughters and even coming in to check on them on her days off or when she was assigned to other patients.

“As happy as I was to be taking my husband home with me, a piece of me was sad to leave the people who gave us so much care, love and attention from the moment we stepped through the emergency room doors,” Karyn says. “We received the best medical care — they saved Ralph’s life — but equally important, the whole family also received emotional care. We are Sharp for life!”