Medical feature

Lisa Paholke (left) and Cinda Hulskotter are best friends. They got even a little closer a few months ago when Cinda suffered a spontaneous coronary artery dissection while the two were at yoga class. Lisa’s quick response and decisions proved to be life-saving for Cinda.

By Vicki Macklin

Marketing Specialist

HSHS Southern Illinois Division

“She’s my angel.”

That’s what Cinda Hulskotter says of her friend and co-worker Lisa Paholke.

While that may be a common expression when co-workers help each other out, the reason Cinda refers to Lisa by this term is anything but common.

It’s because Lisa literally saved Cinda’s life.

On Tuesday, October 24, Cinda, a Materials Supply Clerk in surgery, and Lisa, a Certified Surgical Tech, were at a yoga class offered at HSHS St. Anthony’s Memorial Hospital through the hospital’s LiveWELL program, which encourages colleagues to take steps to be healthier.

It was the third session that Cinda and Lisa had attended together, and they were finishing up with the class with stretching exercises.

As Cinda described it, “I had done the Pigeon Pose on one side and went to turn over, and I just suddenly couldn’t do anything else. I have taken yoga classes many times before and it wasn’t as if it was a particularly hard class. I just sat there, thinking ‘what is wrong with me?’”

As the class concluded, Lisa noticed Cinda wasn’t doing anything and asked her if she was alright.

“I just felt weird,” Cinda related. “I didn’t feel pain. I rubbed my chest, but it didn’t feel like pain. I just felt like something weird was going on.”

Looking at her friend, Lisa knew something wasn’t right.

“She just didn’t look right,” Lisa explained. “Her color wasn’t good. So I told her, ‘We can just sit here a little while.’ I was a little concerned because of her color and she described having some pain, but knowing that heart issues can have different symptoms in different people, particularly in women, I was concerned.”

As they sat there, Cinda’s color wasn’t getting any better and she still had some pain.

As Lisa was asking Cinda about how she was feeling, Cinda mentioned to Lisa, “You know, I’m really nauseated.

“I don’t know why, but a big red flag went up in my brain,” Lisa continued. “I don’t know if I can say it was one thing, but when she said that, there was something in me that said, ‘OK, that’s not a good sign.’”

When Cinda’s color didn’t return and she was getting “grayer,” Lisa knew there was something wrong. But as she described, “As medical people, we tend to push things like this aside. But I knew we needed to get her checked out.”

After arguing a bit, Cinda finally agreed to be taken to the ER by wheelchair. In route, Cinda was texting and Lisa asked her who she was texting. Cinda told her “Candra,” who Lisa knew was her oldest daughter.

“Cinda said ‘I’m just texting her to tell her I’m going to the ER and to meet me there,’” Lisa recalled. “So we came past the glass windows, and I came to the double doors by Cardiac Rehab. I went to push the button to open both doors, and when I turned around she was in full code in the wheelchair. She dropped her phone, she was tensed up, her eyes were rolled back and I heard what I thought was her last gasp of air. It happened just that fast. “

They were so close to ER, Lisa rushed to the ER door to get someone and realized that she needed to have her badge to get in. But because she and Cinda hadn’t been working, they didn’t have their badges. She pounded on the door, but no one could hear her since the ER was incredibly busy that night.

As Lisa started to think about CPR and trying to start it on her friend, a colleague came out of Imaging who had their badge, so she rushed over to open the door. Lisa brought Cinda in, grabbed ER staff to explain about the situation, and they began to work on Cinda, who had stopped breathing.

Lisa has high praise for the wonderful ER staff and physicians and all they did to save Cinda’s life. In another one of those surprising occurrences, Dr. Subhashish Agarwal, Prairie cardiologist, just happened to be in the ER and helped work on Cinda, with the assistance of Dr. Mark Mitchell, who intubated Cinda so that she would keep breathing.

It all happened so fast, Lisa was kind of in shock. But she recalled when the realization of what had just happened hit her.

“There was a moment that an ER tech came over to me, took me by the shoulders and said, ‘You just saved her life. If she hadn’t been where she was, and you let her leave, and you let her get in her car to go home, she would have died,’” Lisa shared.

“How often do we do that – where we let our lives get so complicated, that we just say, “Hey, hope you feel better, and let them go on their way, and we go ours? But I couldn’t do that. She’s my best friend and I’m so glad I still have her with me today,” Lisa said, holding on to Cinda’s hand.

As the ER staff stabilized Cinda, Dr. Agarwal contacted Dr. Shailesh Nandish at the Prairie Heart Institute at HSHS St. John’s Hospital to prepare him for Cinda to be helicoptered there, even though they didn’t yet know what had caused her condition.

When Cinda got to Springfield, they did a Cardiac Catheterization on her and that is when they discovered that Cinda had a spontaneous coronary artery dissection (SCAD).

According to the American Heart Association, a spontaneous coronary artery dissection is not just a heart attack, but the result of spontaneous tearing in the coronary artery wall. The artery wall has three layers and when a tear occurs, blood is able to pass through the innermost layer and become trapped and bulge inward. This narrows or blocks the artery and can cause a heart attack because blood flow cannot reach the heart muscle.

A SCAD is an uncommon occurrence. Unlike a typical heart attack, people who develop SCAD are often pretty healthy and don’t have risk factors for heart disease, such as high blood pressure and diabetes. While it’s not yet clear on what causes SCAD, a couple of common factors linked to it are women in their 40s and 50s, and high levels of stress.

“I was told it is known as a ‘black widow’ because it gives you no warning,” Cinda said. “The chance I had of making it through this event was 1 percent. You don’t necessarily survive this.”

A SCAD can’t be fixed by a stent, as it might tear, so it has to be allowed to heal itself on its own. Cinda was placed in the Critical Care Unit at St. John’s from Tuesday, October 25, through the following Thursday, November 2. Cinda was very pleased with the excellent care she received there.

When Cinda was released, she was placed on six different medications. She required rest and keeping stress low in her life. Before returning to work, Cinda had a cardiac cath at St. Anthony’s on December 5 and they found the tear had healed.

She was only off work six weeks total. Even her cardiologists were amazed at her recovery.

Watching this unfold in Cinda’s life has taught Lisa that “every day is a gift. Life is very precious. When you wake up in the morning, that day is a gift. Thank God that He gave it to you. I shudder to think if I had let Cinda convince me she was OK and get in her car and go home……”

Cinda is back to planning her daughter’s wedding, which will be in May 2019. Her friend and Guardian Angel Lisa is helping as well. But what Cinda and Candra focused on before with the wedding planning has changed.

“When something like this happens, it wakes everyone up,” Cinda said. “It makes you realize the important things in life. Material things mean nothing.They can bring you some pleasure in life, but they absolutely mean nothing.

“When I was helping Candra plan her wedding before I had this heart issue, we focused on little things that we thought were important in making her day special,” Cinda added. “But now, we see that little things don’t matter. Just the fact that her mother will be there. That is what truly matters.”