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Dallas Mom Survives Drowning in Bathtub After Sudden Cardiac Death|
DALLAS — Some say it was random luck. Others say it was thanks to a light-sleeping husband.
Marla Sewall uses words like “blessing” and “miracle.”
Whatever you believe that “something” was, it woke Marla’s husband at 1 a.m. on Sept 5, 2011. In the darkness of their bedroom, Cary Sewall sensed something wasn’t right. His wife hadn’t come to bed, and he heard water running. Sounded like the shower was on in the upstairs bathroom, he thought.
He climbed the stairs to the guest bedroom. As he approached the bathroom, he heard the bathtub faucet running. The carpet was wet beneath his feet. When Cary opened the door, water was spilling over the sides of the bathtub. But he didn’t see his wife. He went to turn the water off, and there in the water lay his wife, face up and eyes open. Motionless. Blue. Lifeless.
Marla, a 42-year-old marathon runner and mother of four, had drowned.
Cary pulled her limp body out of the water.
“I was in shock,” he said. “All I knew was I had to start CPR.”
Marla had kissed her husband goodnight around 10 p.m. and decided to stay up late, watching U.S. Open tennis and relaxing after a particularly tough run that day. She was training for the Chicago Marathon and had run more than 30 miles the previous two days in the grueling Dallas heat. She also played tennis that afternoon.
She eventually dozed off in front of the TV. She apparently woke up and decided to take a bath sometime after midnight. But while leaning over to adjust the faucet, she passed out and fell head first into the bathtub. With the faucet still running, the water level slowly rose, submerging Marla while her husband and four children slept.
Then that “something” happened.
“I don’t know what woke me up and told me to check on her,” Cary said. “I don’t know what it was, maybe divine intervention. It’s hard to explain.”
Marla had suffered ventricular tachycardia (a dangerously rapid heartbeat) that doctors think caused her to pass out as she leaned over the tub. V-tach, as it’s often called, is an electrical malfunction of the cardiac muscle that can strike without warning. It interrupts the rhythmic pumping of the left ventricle, which is the heart chamber that supplies the entire body, including the brain and other vital organs, with oxygen-rich blood. V-tach can also rapidly degenerate into ventricular fibrillation, causing sudden cardiac death.
“Ventricular tachycardia can be a highly lethal arrhythmia,” said Dr. Jorge Cheirif, chief of cardiology at Texas Health Presbyterian Hospital Dallas and a cardiologist on the hospital’s medical staff. “It can cause someone to pass out by itself and can also degenerate into V-fib, a malignant rhythm that has to be addressed immediately or the patient will die.”
More than 50 percent of people who suffer this kind of arrhythmia never make it to the hospital. The only way for a person to survive this is to have their heart shocked back to life by a defibrillator, either by paramedics or a passerby using an automated external defibrillator (AED). There’s one more possible life-saver: a bystander administering CPR until paramedics arrives.
Cary was that bystander that night. Alone. House quiet. Children asleep. Middle of the night. He laid his wife on the flooded bathroom floor of their University Park home and immediately started chest compressions and mouth-to-mouth resuscitation.
“After what seemed like an eternity, she began gurgling up some of the water from her lungs, and I heard her breathe,” he recalls.
He broke away to call 911. He woke up the couple’s 12-year-old twin boys and told them to wait by the front door for the paramedics. He raced back upstairs, with the boys unaware what was happening. The couples other two children were still asleep. Dallas EMS soon arrived.
“She was breathing faintly as they put her in the ambulance, but she still hadn’t woken up,” Cary said.
Marla was taken to the emergency room at Texas Health Dallas before being transferred to the hospital’s intensive care unit. Based on the amount of water in the tub and on the bathroom floor, Cary estimated that Marla had been under water for at least five minutes.
“That had us very concerned,” said Dr. Kenney Weinmeister, a pulmonologist on the medical staff at Texas Health Dallas. “We were looking at lung damage from the water (pulmonary edema) and the possibility of serious brain damage, too.”
So doctors cooled her body, called induced hypothermia, to reduce her brain’s metabolic need for oxygen. The procedure includes cooling a patient’s body to 32 to 34 degrees Celsius (about 89 degrees Fahrenheit) for 24 hours. She was kept in an induced coma for a day. For the next five days, she was on a respirator to ease the stress on her lungs.
“We felt very blessed to be at Texas Health Dallas and surrounded by such a wonderful team of doctors and nurses,” Cary said. “There was no other hospital in the world I wanted my wife to be.”
A vigil was held in the waiting room of the Texas Health Dallas ICU. Friends and family waited and prayed around the clock. “It was an unbelievable show of support from our friends and family and everyone in the community,” Cary said. “It was five days of 30 or 40 people at a time constantly there.”
Then five days after arriving at Texas Health Dallas, she was weaned off sedation and taken off the respirator. She immediately began breathing on her own. “We were still worried about brain damage because of the amount of time she had been under water,” said Dr. Richard Dasheiff, a neurologist on the medical staff at Texas Health Dallas. “But soon after she began to wake up, we began seeing very positive signs.”
Doctors and family gave her simple commands to test her neurological function. While early responses were good, she was still groggy from medications. “As the day went on, she was waking up more and more, and we didn’t notice any issues,” Cary said. “By the next day, we were celebrating.”
After a battery of medical tests, doctors spotted what they theorize was the original cause of her passing out and falling into the bathtub: cardiac tests revealed a short episode of ventricular tachycardia in her heart beat. Blood tests also revealed that Marla had low potassium levels, which may have triggered the electrical “storm” that struck that September evening. Her heart likely began to beat rapidly after she fell asleep in front of the TV. Uncomfortable and nauseous, she decided to take a bath to cool down. Then, doctors say, her left ventricle stopped functioning.
“That was the moment when everything stopped,” Dr. Cheirif said. “With every second that passed from that point forward, her life was in the balance. Something had to be done right away.”
She was in need of a miracle, or a blessing, or a hero. Maybe all three.
“What saved her life that night was her husband — who stayed calm and acted quickly, starting CPR without hesitation,” Dr. Cheirif said. “Then EMS arrived on the scene quickly and did their job. And within minutes, she was in an ICU being cared for by a multidisciplinary team of doctors and nurses. The system worked at every step.”
Marla and her husband are on a mission of sorts now.
“We want to raise awareness about the importance of getting trained in CPR and knowing what to do in an emergency,” she said. “It’s everyday people who are most likely to be with someone if something like this happens. There’s usually not a doctor or paramedic standing there when cardiac arrest strikes. For me, it was my husband.”
The Sewalls also credit the care Marla received in the Texas Health Dallas ICU for saving her life.
“We felt like there was an entire team of doctors and nurses caring just for her,” Cary said. “They were totally focused on seeing her get better, and we can’t thank them enough.”
The ICU at Texas Health Dallas features an intensivist program that puts the care of ICU patients under the guidance of board-certified critical care physicians, who directly oversee patient care in the ICU throughout the day — without other responsibilities in the hospital. In 2009, it was the first hospital in North Texas to implement the program.
The Sewalls also say they appreciate the compassionate way clinicians cared for Marla and her family and friends.
“Our ICU nurse, Ben Preda, was a Godsend,” Cary said. “He cared for my wife like she was a member of his own family, and he supported me in some really tough times.”
To prevent another cardiac arrest from a serious arrhythmia, Marla was implanted with an internal cardiac defibrillator, which is a small device under the skin that monitors her heart rhythm. If another electrical malfunction happens, the ICD is designed to deliver a shock to restart her heart into a normal, healthy rhythm.
Today, she’s running again, with no limitation. She’s training for an upcoming marathon and playing tennis regularly.
“I can feel the ICD under my skin,” she said. “It reminds me that miracles happen.”
About Texas Health Presbyterian Hospital Dallas