Meet Alyse Milstead. She has been no stranger to the medical world since birth. She was born with congenital heart defects, which required numerous surgeries, medical implants, and infections. Alyse was born with Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), and Ebstein’s anomaly of the tricuspid valve. She had her first open heart surgery at the age of 11 months. Since that time, she has had five other open-heart surgeries, five pacemakers, and endocarditis, twice. Despite the hardships of childhood and early adulthood due to these heart issues, Alyse has made the best of her life. She is happy and very thankful that she has been given the chance to continue living.
October 11, 2024
On this day, Alyse went about her normal routine. She went to work her normal hours, stopped on the way home to get the family some supper, and did all the normal nightly routines that the family has. After laying their 4-year-old daughter down to bed, Alyse and her husband also went to bed. It was a cool night in the small community of Sugar Loaf in the northern part of Alexander County.
October 12, 2024
0047hrs
In their residence, Alyse and her husband Wesley were asleep in their bed. The nightmare that was about to unfold would change their lives forever. Wesley woke up to a “thud” and called out to his wife, “Alyse, are you alright?” to which she did not respond. He then got up and found his wife lying on the bedroom floor, gasping for air. When he turned Alyse over, he found that she did not have a heartbeat. Wesley immediately began Cardio-Pulmonary Resuscitation (CPR). He knew he needed to get help, so he paused CPR long enough to call his mother and instruct her to call 911 to get help on the way.
0049hrs
Frantically, Leigh (Wesley’s mother) called 911. Leigh told the dispatchers that her daughter-in-law was reportedly not breathing and attempted to give the address and phone number where she was located. While doing so, there were issues with hearing some of the information. After gathering all of the necessary information, the dispatchers at the Alexander County 911 Communications Center called Wesley’s phone to confirm exactly what was transpiring.
Wesley answered the phone in a panicked, horrified state but was able to relay the information needed for the dispatchers. After obtaining the appropriate information, Brian Williamson, the dispatcher who answered the 911 call, started instructing Wesley on how to perform CPR. Wesley was performing CPR in a thirty-inch area between the bed and the wall of the bedroom. It was a very small space for Wesley since he is 6’ 6” tall, but he made it work. All the while, their 4-year-old daughter, Evie, was sitting on their bed, awakened by the commotion. Ryan Crankshaw, another dispatcher, was alerting all emergency services of the call. As the minutes ticked by, the desperation and tiredness in Wesley’s voice was heard as he counted 1, 2, 3…23, 24, 25. He would repeat that over and over with dispatcher Williamson. Dispatcher Williamson continuously encouraged him not to give up.
While Wesley was doing CPR, he stopped quickly to turn on the porch light and unlock the door for first responders. He was concerned the first responders would not be able to easily find or access the house without doing so. He went back in and moved his daughter to the living room. He continued CPR, and he was so tired that he had to rest his head on the wall while continuing to count 1, 2, 3, and so on. Shortly thereafter, his mother, Leigh, arrived on the scene. She was terrified. All she knew to do was to comfort Evie and Wesley, and pray.
The first help arrived on the scene minutes after dispatch. It was Alexander County Sheriff’s Deputy, Sergeant Brandon Caudle. When Caudle arrived on the scene, he knew to move Alyse to a bigger area where CPR could be better performed. After moving her lifeless body, Caudle relieved Wesley and began CPR. Caudle continued until Alexander County Emergency Medical Services (ACEMS) Crew 3 arrived on the scene, approximately one minute later. Several volunteer firemen from the Sugar Loaf Volunteer Fire Department arrived to assist. Paramedic Justin Kerley and Paramedic Josh Welker would lead the care for Alyse. The on-duty EMS supervisor, Paramedic Brennan Moore, arrived a couple minutes after the crew.
Crew 3 immediately found Alyse, pulseless and not breathing. CPR was continued, and during a heart rhythm check, it was found that Alyse was in a deadly heart arrhythmia, Ventricular Fibrillation. In an attempt to correct this, Alyse was defibrillated, CPR was resumed, and lifesaving medications were administered. The paramedics also placed a breathing tube to ventilate and suction her airway. They would continue this cycle for over thirty minutes. After the seventh defibrillation and the eighth medication administration, the paramedics did one more heart rhythm check and found that Alyse had a heartbeat. During the time of treatment, Alyse would also suffer from seizure-like activity.
At 1:16 a.m., Leigh would call Alyse’s parents to let them know what was going on. Ronnie and Donna, who live in Kings Mountain, were scared. They did what any mother and father would do – they got dressed and started on what would be the longest two-hour drive of their life. Their drive was spent praying, attempting to call others to pray, and posting on Facebook for people to pray. No one was answering the phone due to the time of morning, but the post on Facebook caused her phone to start receiving comfort and prayers from others. “God, please don’t take my baby,” were all the words that Donna could muster up and speak. Leigh would remain on the phone with them updating them on what was going on.
With every update that Leigh gave she would add, “They are still working on her.” Every time she said those words it felt as if another knife was plunged into the hearts of Ronnie and Donna. Desperation filled the air with every update given. They knew those words meant that Alyse still had no heartbeat. They knew the longer she went without a heartbeat the lower her chance of survival. Leigh could hear everyone working in the bedroom, words so clear and crisp as if she were still present in the room, “I still don’t have a pulse,” and a few minutes later, “I have a faint pulse; no, I lost it.” Then, “I have a pulse.”
Alyse now had a pulse. It was faint, but present after 34 minutes of resuscitation efforts, which doesn’t include the time Wesley was doing CPR on his own. Alyse was immediately loaded in the ambulance with a volunteer fireman driving and all three paramedics in the back continuing to care for Alyse. Leigh remembers the somber moments when Alyse was rolled past them in the living room area, not knowing if they would ever see her alive again. She was transported by emergency traffic to Atrium Wake Forest Baptist Health – Wilkes Medical Center for more definitive care.
Wesley, Evie, and Leigh would follow them, not knowing what they would find after arriving at the hospital. While following from a distance, Wesley made a frantic call to his pastor. Pastor James answered the call, and Wesley told him that Alyse was gasping for air and they didn’t have a heartbeat. Pastor James rushed out of his house to head to the hospital.
After arriving at the hospital and entering the doors, Wesley remembers there was no commotion other than what was being done to treat his wife. A staff member of the hospital escorted everyone to the family room. Only the pastor knew what that room meant. In his head, Pastor James knew that the room was used when a family member had passed and a doctor was coming in to tell them. He kept those thoughts to himself, but in his head, he was saying, ‘Please don’t put us in that room.’
Prior to the arrival of Alyse at the hospital, Charge Nurse Kendall was already preparing her staff and directing them on what each of them was to do upon the ambulance’s arrival. After Alyse’s arrival at the hospital, Nurse Kendall helped to keep everyone calm and updated, and was especially attentive to little Evie. Nurse Kendall was an angel to the family. One of the emergency room doctors came into the family room and informed them that they were doing everything they could to save Alyse’s life. He informed them that she was very sick. They remember him saying she had experienced cardiac arrest, her heart was in v-fib, her lungs had fluid in them, and on top of it all, she was positive for COVID.
After sitting in that room for what seemed like an eternity, a nurse came in and said that Alyse could have two visitors. Wesley and Pastor James went back while Leigh stayed with Evie. Alyse was gray in color, and her blood pressure was very, very low. She was on a ventilator, had multiple IVs, and various monitors going. Fluid was being suctioned from her lungs. Wesley informed staff that Alyse’s pacemaker leads were old and they were anticipating a pacemaker replacement in the near future and that all of her care has been done at Atrium Health Carolinas Medical Center (AHCMC) in Charlotte. The staff started to make the phone calls needed to get an accepting doctor and helicopter transport.
Pastor James, along with Youth Pastor Matthew, who had now arrived, would spend time praying over Alyse and the family. Upon the arrival of her parents, they were escorted back to be with Alyse as well. There were so many emotions going on, from tears to prayers to hand-holding to telling her that she is a fighter to saying they are all there for her. By now, staff had finally been able to get her stabilized enough for the transfer to Charlotte.
Staff informed the family that the helicopter would be there in 20 minutes, as they began to prep her for the flight. Those 20 minutes, which seemed like forever, were also short because it was time to kiss her and tell her goodbye. The family followed as Alyse was taken to the helicopter and watched as she was loaded. Nurse Kendall was with the family the entire time. Watching the helicopter lift off seemed like an eternity, but they watched, prayed some more, and cried, not knowing what they would find when they got to Charlotte.
While gathering belongings, they sat in silence for a while to try and absorb what all had happened. Pastor James prayed over them before they would start their journey to Charlotte. Alyse was admitted to the Cardiovascular Intensive Care Unit (CVICU). While knowing she had COVID, she was also found to have double pneumonia. Even though she was on the ventilator, she was trying to breathe on her own. Alyse woke up several times attempting to pull her breathing tube out, which would then require more sedation medications. An echocardiogram was done showing that only 15% of her heart was functioning. One of her valves was leaking more than before, but her pulse was good, and her heart was pacing at 100 percent.
On Sunday, 10/13/24 at 9:22 a.m., Alyse was taken off the ventilator. On Monday, 10/14/24 at 9:36 a.m., Alyse sat up for the first time in the bed and then in her recliner. On Tuesday, 10/15/24 at 4:40 p.m., Alyse walked around the unit for the first time. She was tired at the end, but she did not stop one time. More echocardiograms and pacemaker checks were done. Alyse’s heart function increased from 15 percent to 43 percent. This was very good news. Alyse showed signs of short-term memory loss; however, the doctors said this was very normal and that it should improve over time. Her nurses in the CVICU (Jonathan, Katie, Cameron, and Ian) were wonderful and took such great care of Alyse, her family, and her friends. The staff at AHCMC were amazed at how fast she was recovering and how far she had come in such a short time. Dr. Alegria, the cardiologist, and Dr. Bryant, from pediatric cardiology and electrophysiology, talked with the family. Doctors discussed wanting Alyse to heal before more surgeries. After six weeks of healing, the plan will be to go back and take a close look at her heart and valve with the idea of replacing her pacemaker, implanting a defibrillator, and looking at the valve to see if the leaking has decreased.
Alyse was moved out of the CVICU on 10/16/24 and into her own room on the heart floor. Since she had seizure-like activity at the house during the event, the neurologist came in to do an assessment and ordered an EEG. The doctor did see some short-term memory loss, but the EEG did not show any seizure activity. On 10/17/24, Alyse was fitted with a life vest that she must wear all the time except to shower, and someone will need to be near her when she isn’t wearing it. After receiving instructions on the life vest, Alyse was discharged to go home.
After being discharged from the hospital, Alyse visited Alexander County EMS Station 1, where she could meet the crew that took care of her. It was a meeting filled with tears, hugs, and appreciation. Pictures of the moments were captured during the visit, and the memories will last a lifetime.
In emergency services, a patient’s outcome is rarely known. Some hospitals will give updates when requested, but EMS crews rarely get to meet the patients again. Then there are patients like Alyse, who want to thank EMS for a job well done. Praise for a job well done means the world to anyone in emergency services.
This story also serves as a reminder that learning CPR is imperative to saving a life. While major strides have been made since every student in public schools is eventually taught the valuable skill, many people still do not know what to do when faced with this situation. Thankfully, there are people on the other side after dialing 911 who will be there to assist with whatever emergency one is facing.
