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www.insideHALTON.com | OAKVILLE BEAVER | Thursday, June 20, 2013 | 20 MacLean's story shows we can all save lives by Dominik Kurek Oakville Beaver Staff naturelifehealthcentre.com 1395 Abbeywood Drive, Oakville 905.827.9968 MASSAGE THERAPY Health "Connected to your Community" Oakville's Cari MacLean is grateful a piece of equipment that helped save her life was available to emergency room staff when she was at death's door. "I stand here today still feeling this sense of overwhelming gratitude that does not go away," said the wife of Hockey Night in Canada anchor Ron MacLean. "Every day I wake up, I am totally thankful for the gift I had that night, the gift of that piece of equipment that just happened to be in the room, thanks to a donation." MacLean spoke before more than 100 people at the Oakville Hospital Foundation's donor recognition event Tuesday. The Foundation is raising $60 million to equip the new Oakville hospital, which will open in 2015. It has collected $51 million. MacLean's story was told by the doctor who saved her life, Dr. Mangesh Inamdar. On Oct. 9, 2012, MacLean, a marathon runner, was taking a warm bath to help soothe the pain of a calf sprain. She began feeling unwell, vomited and had stomach pain. She called 9-1-1 and was rushed to Oakville-Trafalgar Memorial Hospital (OTMH) by ambulance. "When we saw her, she was partly conscious. Her eyes were closed, open only to answer questions," Inamdar told the gathering at the Bronte Harbour Banquet Centre. "The first thing we noticed was that her blood pressure was extremely low. It read 60/20 and that is less than half of what it should be. That is the blood pressure that you get just before going into cardiac arrest." Inamdar said there are a few things that can cause a sudden drop in blood pressure like this, one of which is a pulmonary embolism. "A pulmonary embolism is a blood clot, which originates in one of the calves and dislodges and goes up through the circulation to the lung and ultimately chokes off its blood supply," he said. He said doctors look for two things when trying to diagnose pulmonary embolism. One is calf swelling and the other is pain when breathing. MacLean's calf was not swollen. When asked if she had pain, she said it was from her calf sprain. Nor did she have pain breathing. She said she had cold-like symptoms for a month (sniffles, shortness of breath, couldn't run as far as normal). Her main complaint was pain in the abdomen. These symptoms, Inamdar said, did not support his original diagnosis of pulmonary embolism. He said there were other possibilities -- mass bleeding in the body, ruptured aorta, gastrointestinal hemorrhage, major infection in the lung, fluid around the heart, and more. The doctor checked his patient's oxygen level, done through fingernails using a sensor. MacLean, however, wore nail polish, which blocks Cari MacLean, wife of Hockey Nigh in Canada's Ron MacLean, and Dr. Mangesh Inamdar spoke about Cari's life-saving experience at Oakville-Trafalgar Memorial Hospital (OTMH) at the Oakville Hospital Foundation's annual donor recognition event. photo by Riziero Vertolli ­ Oakville Beaver (Follow on Twitter @halton_photog) the sensor and polish remover did not take it off because it was gel-based. The doctor put the oxygen sensor on the earlobe, but that is notoriously inaccurate. The reading came back as 40 per cent. "Forty per cent is a number that's not compatible with life or would suggest imminent cardiac arrest." Or, he said, the reading was inaccurate. "Here we have Cari, a marathon runner, who suddenly became unwell. She's got a set of symptoms that doesn't quite fit my primary diagnosis. She has dangerously-low blood pressure and a key piece of informa- tion, her oxygen level, I couldn't be sure of." Intravenous medication was used to raise MacLean's blood pressure without success. "If her blood pressure continued to remain that low, she would not even be able to provide adequate blood supply to her own heart. She could go into cardiac arrest at any moment," Inamdar said. "I remember standing by her bedside, looking at her, and thinking my patient is going to die and I don't have a diagnosis. I remember the nurses in the room had begun gently nodding Audiology and Hearing Aid Centre Yes, we have INVISIBLE hearing instruments! Over the last 3 years, hearing instrument technology has advanced so they are small enough to fit deep into the ear canal allowing for use during active sports. This is one of many tiny options available. For some patients, the open fit option is preferred. These miniature options are available in all price ranges of high performance digital instruments. Hear the difference for yourself. 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He said blood tests or a CT scan could be used to determine if it was a pulmonary embolism, but neither was an option as MacLean could not be moved. Treatment for a pulmonary embolism is a blood thinner, a thrombolytic, to dissolve the clot in the lung. "If she had one of the other diagnoses I was considering, for example a ruptured aorta, this thrombolytic could worsen the situation," Inamdar said. "The clock was ticking. She could go into cardiac arrest at any moment now." Inamdar had access to an ultrasound machine. With it, he looked into McLean's belly and found no blood. A check of her heart's surface found no fluid constricting the organ and a look at her heart showed her right ventricle larger than the left. Normally, it's the other way around. "That is a finding that we see in a pulmonary embolism," he said. "Maybe, that calf pain wasn't coming from an injury. Maybe it was from a blood clot. Maybe that prolonged shortness of breath she'd been having could be from little fragments of that clot coming off and giving her multiple, little pulmonary embolisms over time, and maybe just enough fragments came off to partly unclog that vein to allow it to drain so it wasn't swollen, and perhaps that low oxygen level that I was inclined to discard was a real reading." Abdominal pain could have been from low blood levels in the intestine. "I could not deny those ultrasound findings. Those findings gave me the confidence to conclude this was a pulmonary embolism and nothing else. With that knowledge, I went ahead and gave that drug," he said. The diagnosis was correct and MacLean recovered. "That is an example of how a single donation can fundamentally change the course of people's lives." The ultrasound was purchased with the donation of Foundation board member John Platt and his family. "Technology like this helps us make better decisions," said the doctor. MacLean shares her story to encourage people to listen to their bodies and to that voice that tells them to call 9-1-1. The other reason is to show people everyone is capable of helping save lives. "We, too, have the capability of saving lives by giving some money to the foundation to be able to get machines, much like the one that allows me to be here tonight."