Monticello athlete out of hospital after cardiac arrest

The Monticello Magic basketball team will have to do without one player this year. Senior Adam Thielen, 18, won't be back on the court.

At a North Memorial Hospital news conference Wednesday morning, Paul Thielen spoke for his shy and recovering son.

"In his own words, you know, what's more important, sports or living?"

The 3 sport athlete suffered cardiac arrest during a game last Friday. Collapsed at his bench, Adam owes his life to spectators who knew how to use and Automatic External Defibrillator (A.E.D.) to reset his heart. His dad was there.

"The only thing we were thinking of was bring him back. That's about all that was going through our mind."

Adam was rushed to Monticello Hospital where he was stabilized, then, moved quickly to North Memorial in Robbinsdale, where doctors, led by Emergency Physician Marc Conterato, hurried to protect Adam's brain by using what must be medicine's "coolest" procedure.

"What we've learned in recent years is if we can cool them down relatively quickly, take the patient's core body temperature down to about 90 degrees Fahrenheit (89.3 degrees) and keep them there for about 24-48 hours and slowly re-warm them, we can markedly improve patients' outcome and minimize or completely alleviate any sort of brain injury."

In Adam's case, a thin probe covered by narrow balloons filled with chilled saline solution was inserted into the femoral vein of the teenager's left leg. It stayed there for 48 hours.

"24 hours after his cardiac arrest, Adam was being re-warmed and by the time he was finished being re-warmed and taken off this machine," Dr. Conterato noted, "he was awake, alert, following commands, able to be extubated (have his breathing tube removed) and is now neurologically completely back to normal."

Conterato says the "Coolgard" machine has been used 38 times at North Memorial since October of 2006. It has been used to cool patients with conditions like Adam's, to lower temperatures of persons with high fevers and to raise the temperatures of persons suffering from hypothermia.

North Memorial currently has 2 of the $26,000 devices and is ordering a third. The Robbinsdale medical center is also planning to equip all of its ambulances with bags of chilled saline.

When Kevin Everett of the NFL Buffalo Bills suffered a severe spinal injury in the first game of the 2007 season, about 2 liters of chilled saline was injected directly into his circulatory system intravenously. That was done while Everett was in an ambulance before he even left the stadium. The procedure, which is still controversial in spinal injury cases, has been credited with saving the athlete's chance at walking again. Once Everett was at Millard Fillmore Hospital in Buffalo, he was put on a "Coolgard" machine, like the one used for Adam Thielen.

Dr. Conterato says the Twin Cities are ahead of most American cities in using the cooling protocol. "Every hospital in Minneapolis uses a form of therapy to chill the patient after cardiac arrest."

Cardiac Electrophysiologist Dr. Douglas Hodgkin insists that initial reports that Adam suffered a "heart attack" were wrong. He says Adam's heart didn't stop. On the contrary, it was beating so fast that it could not pump blood.

"A heart attack's more of a plumbing issue. You have typically, a blockage in an artery. So, what he had was a cardiac arrest. It was purely an electrical problem. So, either sudden cardiac death or cardiac arrest, that's what we would call it."

There will no more basketball for Adam Thielen. Dr. Hodgkin says the teen has a "primary arrhythmic problem" syndrome called "Long Q.T." It affects just 1 in 100,000 people his age.

"Unfortunately, many of these primary arrhythmic syndromes, the patients are at high risk if they exercise. So, really the safest thing is to avoid competitive sports."

That is not to say that Adam Thielen cannot live a full life and pursue his dream of sports management or even coaching. Dr. Hodgkin explains.

"In order to treat this and try to prevent further arrests, what we did is put a defibrillator in. We that did yesterday (Tuesday). Everything went very well. It's an implantable cardiac device. It's kind of like the A.E.D. that was used externally only, of course, it is always with him. It's like a Paramedic in the pocket. So, if he has an arrhythmic event, this device acts instantly, within seconds. You don't have the delay that you would have waiting for the defibrillator externally to show up."

The reportedly shy young man shunned the spotlight today, skipping the news conference about his recovery. His father says Adam intends to contribute to his sports teams from the sidelines.

"Adam has never been one to have the light shine on him anyway. So, he's just happy to help out and he'll get through it."

Since conditions like Adam's can be hereditary, Dr. Hodgkin says it is important that his siblings be screened, even though they, like Adam, have shown no prior symptoms.

Unfortunately, Dr. Hodgkin says it is "hard to know for sure what the best screening approach is. The current recommendations are just really history, physical , take a family history. What I would say is, if somebody is going into competitive sports, it is good to have a detailed physical and history taken, including the family history. Those are very important."

Adam Thielen left North Memorial Wednesday afternoon to complete his recovery at home. He expects to be back at school soon. All of Monticello High is eager to have him back.

Paul Thielen took time Wednesday to thank all of those in the town who offered support. Of course, the family is extremely grateful to the men who used the A.E.D. last Friday night, as well as the staffs at the hospitals in Monticello and Robbinsdale.

"The care has been phenomenal."

By Allen Costantini - 3/5/08

By Allen Costantini, KARE 11 News

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