‘There’s no way I should be here’ — CPR, heroic efforts save UK heart patient

Newswise — LEXINGTON, Ky. (June 7, 2024) – Rob Sprang doesn’t remember anything about Sept. 7, 2023.

He doesn’t remember arriving at Lakeside Golf Course in Lexington for a round of golf with his friends. Nor does he remember standing on the fairway at the fourth hole, waiting to take his shot. He has no recollection of falling to the ground, unconscious and unresponsive.

However, his friends and golfing buddies Tim Worley and Brian Davis remember every excruciating detail.

Rob had a history of cardiac issues. Born with a number of heart defects, he had extensive corrective surgery in 2017, including mitral valve repair, aneurysm repair and a procedure to correct an irregular heartbeat. These issues had never really affected Rob before; an avid triathlete and bike racer in his youth, Rob stays active with regular rounds of golf and traveling the world with his family. He believed his heart problems to be behind him and never gave them a second thought.

But on a late summer day, near the fourth hole of Lakeside Golf Course, his heart stopped.

Standing on the far side of the fairway, Tim wasn’t paying much attention to Rob until he heard Brian calling his name. Looking over, Tim saw Rob flat on his back, barely breathing and unresponsive.

Tim felt his instincts kick him. In a previous life, he was a medic in the Navy, and spent years training for situations such as this.

“In the military you get into stressful situations, especially as a combat medic,” said Tim. “That’s just the job. In the moment, you’re not fearful, you don’t panic – training just takes over. And there’s time to process all that later. You’re just automatic about what you need to do to try to keep someone alive.”

“He’s just the salt-of-the-earth type of guy.”

Tim and Rob have been friends for 15 years, ever since they were introduced by a mutual friend at work. Both work at the University of Kentucky – Rob as the Director of Telemedicine for UK HealthCare and Tim as the Director of Enterprise Telephony. Rob served as Tim’s mentor when he first came to UK. From there, they bonded over their many mutual interests, including golf. Though they no longer work directly together, they still find time to meet up with Brian, a fellow UK HealthCare ITS employee, and hit the links.

Several times a week, Rob, Tim, Brian and other friends get together at one of Lexington’s public courses such as Lakeside. Occasionally, they will hit the road and visit other courses in Kentucky and Tennessee.

“Wherever’s there’s golf, we’ll go,” said Tim.

Tim says Rob has a reputation not just being good at his job, but also being the kind of person people enjoy being around. During his 29-year tenure at UK, Rob has forged many personal and professional connections.

“He’s well-known, well-liked at UK,” said Tim. “He’s got many friends, many colleagues that think very highly of him. He’s my mentor, and he’s just the salt-of-the-earth type of guy.”

“Something just kicked in.”

Back on the course, Tim and Brian rushed over to assess Rob. He had no pulse, so Brian called 911 while Tim started chest compressions. Knowing the clubhouse had an automated external defibrillator (AED), Brian called Lakeside Head Golf Professional Aaron McDowell, who soon came barreling across the course in a golf cart, device in hand.

“To their credit, Lakeside and Lexington Parks and Rec, their staff is trained,” said Tim. “They had the equipment. They knew what to do.”

As Tim and Aaron tended to Rob, Brian multitasked, simultaneously contacting Rob’s family through a mutual friend and directing the ambulance across their location at Lakeside. Since they were in a tricky spot, not easily visible from other areas on the course, Brian alerted other golfers to halt their game and any errant shots that might come their way.

The AED shocked Rob twice, and Tim continued compressions until the ambulance arrived and transported him to the Gill Heart & Vascular Institute at UK HealthCare's Albert B. Chandler Hospital.

“Electrical, not structural – but interrelated.”

During emergency surgery, surgeons installed a pacemaker and an implantable cardioverter defibrillator (ICD) in Rob’s heart to monitor his heartbeat and correct it if it got too slow or irregular. While the exact cause of Rob’s cardiac arrest is unknown, his cardiologist Vedant Gupta, M.D., suspects it was related to his congenital heart defects and prior surgery.

“Most of these arrests are due to scarring within the heart, whether big enough to see on imaging, or microscopic,” said Gupta. “Underlying structural heart disease, prior interventions on the heart are all risk factors for these rhythms.”

Generally, heart problems can be classified as structural – meaning the condition of the blood vessels, valves or tissue – or electrical, referring to the sinus node that generates a signal that causes the heart chambers to contract. When something goes wrong with one system, it inevitably affects the other.

“I think his case is a really important example of how these components are so interrelated,” said Gupta. “We know that one of the biggest risk factors for heart rhythm issues is underlying structural heart disease.”

Rob is grateful for his providers at UK HealthCare for their intervention upon his arrival at the emergency department. But those same providers say their gratitude goes to Tim, Brian, Aaron and the emergency responders for their quick and crucial response.

“Unfortunately, out-of-hospital cardiac arrests have a less than 10% chance of survival to hospital discharge,” said Gupta. “Bystander CPR nearly doubles that chance of survival. His friend responding as quickly as he did was crucial for not only helping Rob’s chances of survival, but also from limiting issues afterwards.”

Looking back, Tim recognizes that Rob’s survival hinged on everybody doing the right thing at the right time. From Tim's emergency training, Brian’s calls to the clubhouse and emergency services and Aaron’s quick response with the AED, everything lined up to give Rob support he needed to keep fighting. For Tim and Brian, it was an emotional day – one that they were sure was going to be Rob’s last.

After the surgery, Rob started taking a medication to reduce the risk of future fast heart rhythms. According to Kristin Ellison, M.D., Rob’s electrophysiologist, the pacemaker and ICD implanted in Rob’s heart are designed to correct irregular heart rhythms by pacing or shock, but they do not prevent them from happening again.

And it happened again.

“I’ll see you in a couple days.”

Rob remembers everything about Nov. 10, 2023.

After his discharge from the hospital, he started rehab at UK HealthCare’s Cardiac Rehabiliation. At his first appointment, he watched his fellow patients walk slowly on the treadmill and pedal at a snail’s pace on the stationary bike.

I can do that, he thought.

He could not do that.

“It was tough for the first few weeks,” Rob said. “After my first heart surgery, I didn’t really commit to the rehab, but this time I worked very hard.”

Three times a week, Rob met with his team on building strength, stamina and new lifestyle habits. After one session, he remembers, clear as day, pushing open the glass door while saying goodbye to the rehab staff, telling them he would see them on Monday. It was Friday; his appointment was early in the morning, before work. He was wearing his backpack, as it was a short walk from the clinic to his office on campus.

“I told everyone, ‘Goodbye, I’ll see you in a couple of days.’”

Then he woke up on the sidewalk.

According to the clinic staff, Rob made it about 50 feet past the door when his heart stopped again; the weight of his backpack pulled him straight down to the pavement. The ICD in his chest shocked his heart back into rhythm. He woke up a few minutes later with his rehab team around him and the sound of an ambulance siren getting closer.  

This time, the intervention was simpler, and the recovery was quicker. Rob’s heart stopped on a Friday. After some diagnostic testing and a tweak of the medication, he walked out of the hospital on Sunday. After a few more rounds at cardiac rehab, he was cleared to travel. Three months later, he was on the ski slopes of Canada.

Physically, he felt great. Committed to getting better, Rob made remarkable progress in the aftermath of a situation from which few people recover. But something gnawed at the back of his mind. It was deep-seated guilt.

“It was hard for me to look at him.”

Rob feels indebted to both Brian and Tim. So much so that he grapples with how it must feel to see your best friend collapse in front of you, unresponsive and close to death.

“It was hard for me to look at Tim,” Rob said. “I just keep thinking, if I’m out playing golf with somebody and all of a sudden, they go down, what the hell am I supposed to do? I don’t know if he ever had to do CPR on somebody in the Navy, and luckily it worked out for both of us, but I have to imagine it wasn’t easy for him. To be that far removed from your training to all of sudden it’s time to go to work is a lot to ask for somebody. Think about what kind of burden that puts on somebody. I can’t imagine your best friend dying right there in front of you.”

For Tim, the concern is appreciated, but unnecessary. It’s just Rob being Rob.

“He kept saying, ‘How are you doing? How do you feel?’” said Tim. “I’m like, ‘I’m fine, man.’ You're the one that went through all this. I’ve been through training. I’ve performed CPR on more than one person. It’s not that you can ever get used to that kind of thing, especially when it’s a friend of yours. But that’s just the kind of person that he is. I don’t think you would ever meet a person that didn't love Rob.”

The concern goes both ways; Tim and Brian both say they now watch Rob like a hawk while they’re out on the course.

“We walk around to try and get some exercise and stay in shape,” Tim says. He probably gets tired of me asking, ‘Are you feeling OK? How are you doing? Let me know if you feel weird.’”

Back at Lakeside, Aaron attributes Lexington Parks & Recreation Department’s dedication to ensuring the health and safety of visitors through rigorous staff training and comprehensive emergency plans.

"Lexington Parks & Recreation emphasizes safety and preparedness,” said McDowell. “We’re trained and ready to respond to emergencies, but that doesn’t make them any less dire. I’m grateful for the opportunity to be trained for when the need arises, and thankful that the quick action of Mr. Sprang’s friends and our staff led to a happy outcome. Rob is one of our regulars, and a big supporter of public golf courses in Lexington. We’re excited to see him continue to tee off and sink putts with us for many more rounds."

Tim also recognizes how vital his training as a medic was to Rob’s outcome, and feels strongly that everyone should take the time to learn CPR and basic life support.

“I’m thankful that even old training is better than no training at all,” he said. “I think it is important for people to have some basic life support knowledge and know how to do some certain things. Because you never know when you’re going to need it. I mean, one minute you’re on the golf course playing golf, and the next minute you’re giving a guy CPR. And that can happen anytime, anywhere to anybody.”

For Rob, the knowledge of that reality is something he is still dealing with. He knows that Tim and Brian could have done everything right, that Aaron and the EMS team could have shown up right on time, and the outcome could still have gone the other way and he wouldn’t be here to share his story.

“You gain remarkable perspective,” he said. “You realize how tenuous this thing that we’re going through is. My life is different. There’s no way I should be here. But the stars lined up and things worked out.”

June 1-7 is CPR Awareness Week. There are only two steps to save a life: call 911 and push hard and fast in the center of the chest until help arrives. If performed immediately, CPR can double or triple the chance of survival from an out of hospital cardiac arrest. Only 40% of people who experience cardiac arrest outside the hospital get the immediate help they need. Learn more about hands-only CPR and how to use an AED.

UK HealthCare is the hospitals and clinics of the University of Kentucky. But it is so much more. It is more than 10,000 dedicated health care professionals committed to providing advanced subspecialty care for the most critically injured and ill patients from the Commonwealth and beyond. It also is the home of the state’s only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, a Level IV Neonatal Intensive Care Unit that cares for the tiniest and sickest newborns, the region’s only Level 1 trauma center and Kentucky’s top hospital ranked by U.S. News & World Report.

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