A Race to Survival
Story 119

Ryun Harper: He had collapsed, he wasn't moving his left side, and he was actually getting progressively worse. Decisions needed to be made within seconds, or they were going to be made for us. My name is Ryun Harper. I'm an emergency physician.

Charles Crisafulli: November 19th, I think it was 2:00 or 2:30 in the morning, and just suddenly felt the most intense pain I've ever felt, and it was chest pain. I got up and walked into my kitchen, and all of a sudden I was on my back on the floor. Kira, my wife, she heard me and called 911. The Glendale paramedics that showed up said if it's anything to do with the heart, we should go to Adventist Health in Glendale.

Ryun Harper: I get a call that we have a stroke patient and he wasn't able to talk or move his left side. At that time, he had a blood pressure of about 50 over 20. We started him on lots of fluids to get the pressure up. He was kind of in and out, but he woke up long enough for me to ask him if he'd been having chest pain. He nodded, “Yes.”

So I called Dr. Sharma, who was the cardiologist on that night, and I asked him, I said, "What do you think we should do in this situation?" With the pressure of 50 over 20, we couldn't take him to the CT scanner to evaluate him for the stroke because he would've coded on the table with his pressure being that low. I said, "I think our only chance here is to give him thrombolytics now and really hope for the best, because we're really in an extreme situation."

Lance Lee: We really didn't know what to do. His blood pressure was extremely low 50s and 60s, systolic, which is not compatible with human life.

Ryun Harper: We had myself, we had Dr. Lance Lee, Dr. Sanjay Sharma, we had Randall Roberts who came in. So it's like a relay race and everybody has to be on their A game.

Randall Roberts: It's really one of the art forms of emergency medicine these days, to know exactly what test to get and in what order. My name is Randall Roberts, and I am the Chief of Surgery here at Adventist Health Glendale. As it turns out, all of the problems that we were seeing with him and the reason he was so desperately ill were stemming from aortic dissection. As soon as they made that diagnosis, they gave me a call.

Charles Crisafulli: The activity around me, all these people, felt very serious, but it made me feel I was in hands I could trust.

Ryun Harper: He had not only dissected back into the aortic valve, but he also had dissected all the way over to his right common carotid artery, which explains why he wasn't moving his left side.

Randall Roberts: It does add a little wrinkle to my management, because now that very powerful anticoagulant agent is onboard and I'm about to do a big surgery. Chuck's aortic dissection definitely presented a challenge for us. For a certain period of the operation, not only is the heart not beating, but the circulation is completely stopped in order to fully reconstruct his aorta. We have to get the patient down to around 50 degrees Fahrenheit in order to do that safely.

Ryun Harper: Dr. Roberts repaired his aortic valve and he repaired his aorta.

Lance Lee: His surgery went really well. I looked at his CT scan and minor stroke, but overall, his brain architecture looked really good, so I was very encouraged at that point.

Charles Crisafulli: The first thing I kind of have a memory of is the day the respirator came out. That's when I moved to the rehab wing and really started the recovery there.

Randall Roberts: It took nearly four or five days, but eventually he completely woke up and started to follow commands, and we knew that he was likely to have a good recovery.

Charles Crisafulli: For better or worse, the mind is what I had before this entire incident, so I'm right about where I was.

Ryun Harper: The fact that Chuck was able to walk out of this hospital with no significant neurologic deficits is nothing short of a miracle. You just don't see cases like that.

Lance Lee: The decision to treat him with thrombolytic therapy was the most brilliant decision. It's really a touch of God. I think that's probably what saved him.

Charles Crisafulli: Dr. Harper offered to come to our home so we could meet.

Ryun Harper: We sat and had some lemonade in his backyard and talked about what he does and what he's working on now.

Charles Crisafulli: That was just incredible. Looking at that guy who literally saved my life.

Ryun Harper: It just really shows you what you can do and the miracle of medicine, I tell you.

Charles Crisafulli: He'll always be a superhero to me and to my family. Anyone that's been through something that's serious, there's a little worry about, "Can I live my life? Can I live normally? When is something going to pop again?" And Dr. Sharma said the major medical intervention of my lifetime has already happened. We worked hard to put you back together, and you should just live life to the fullest.

Ryun Harper: He's not taking any of his time for granted now. He understands that every day is precious and you definitely need to cherish it.

Charles Crisafulli: We just really treasure moments together, days together. We thought we were lucky moving into a house with this beautiful backyard, but it turns out the luckiest thing about this place is that we were so close to at Adventist Health Glendale. Being close to them and the care that I received there saved my life.