Breath of life

Posted on 25 Feb 2022

Emergency clinical intervention saved a young athlete’s life when he suffered a catastrophic asthma attack.

Marketing executive Luke de Kock (30) celebrates his birthday twice a year. Once in March (his real birthday) and once on 20 October. On that day in 2019, thanks to swift intervention from medical staff at Mediclinic Cape Town, he was bought back from the brink of death following a catastrophic asthma attack.

“I was on my way for a sunrise hike with a friend when I started experiencing a very tight chest,” Luke recalls. As an asthma sufferer since childhood, Luke has always carried an emergency Ventolin inhaler with him. But this time, the pump wasn’t doing the trick. His friend needed to get him to hospital. “Initially I thought we were overreacting, and I didn’t feel that scared – but then I felt my lungs getting smaller and tighter with each breath,” he says. “I felt light-headed, and my fingers were turning blue. I remember thinking – it’s such a beautiful morning. What a pity to have to die now.” Thankfully the friends made it to the emergency centre, where Luke immediately passed out. “And that’s when everything went dark,” he recalls.

Dr Lynne Swarts was on duty that Sunday morning when Luke went into hypoxic cardiac arrest. “Hypoxaemia means low levels of circulating oxygen in the blood and we immediately started chest compressions,” she explains. “Fortunately it wasn’t long afterwards that we got a heartbeat and could start oxygen. We first used a bag belt oxygen mask [rather than a face mask] because he wasn’t breathing spontaneously, and then moved him to Continuous Positive Airway Pressure (CPAP).”

Once Luke had reached adequate oxygen saturation levels, he was moved onto a nebuliser. “We also administered intramuscular adrenaline to treat the shock and hydrocortisone to reduce the bronchospasm and inflammation ,” says Dr Swarts. “As he was getting restless, we then gave him ketamine to relax the chest muscle and calm him down. This was so that we could pre-oxygenate him in case we needed to intubate.”

Luke remembers feeling as if someone was slapping him awake. “I wasn’t sure how much time had passed since entering hospital because I’d been in a total void but I remember wondering why my favourite hiking shirt had been cut on half,” he says. “The doctors who worked on me were high-fiving each other because the resuscitation had been successful. Dr Swarts told me I had given them all quite a scare.”

The fortunate patient spent two days in ICU at Mediclinic Cape Town before being discharged with a clean bill of health. “It has been a huge restart for me and has affected me profoundly,” he ways. “I feel very grateful, humble and happy to be alive – and have realised that is the meaning of life – just being alive is a bonus. I’m living in a world of bonuses and every time someone thinks they’re having a rough day, they should consider all the deceased and celebrate the fact they still have life.”

As Dr Swarts explains, Luke’s cardiac arrest was fairly rare as most asthmatic patients have more warning signs that they’re having a major attack. “There’s usually a slow onset and people usually present sooner,” she says. “Plus this wasn’t a seasonal attack as it was in summer, so it was certainly unexpected.” Luke puts it down to a stressful breakup, a recent bereavement, and a spike in allergies after gardening. Today he’s vigilant about his cardiovascular health. He continues to be an active sportsman – from gym to running, surfing and hiking – and has given up smoking. He now controls his asthma with a daily preventative inhaler.

“Luke went into cardiac arrest within two minutes of arriving at hospital. If he hadn’t arrived when he did, he wouldn’t have made it,” Dr Swarts says. “It was so rewarding when he came into the Emergency Centre with his physician to say thank you. It’s a really nice success story.”

Published in Patients