It started as just an ordinary day but what happened that day in 1981 would be anything but ordinary for Barbara and Kevin Kunz. Witnessing sudden cardiac arrest and then effectively applying a reflexology technique that day would be the source of continual discussion over the years about why this would happen. A second incident (see below) would confirm the decision some forty years later to include the technique as the first test in fMRI research at the University of Minnesota School of Medicine in 2023.
Could a simple reflexology technique serve as a possible addition to medical care for resuscitation from sudden cardiac arrest: the failure of the electrical system of the heart to maintain a regular heartbeat? Sudden cardiac arrest is one of the deadliest killers in the world. Research using brain imaging by fMRI may provide clues.
An Ordinary Day and an Extraordinary Event
“She’s dead, she’s dead,” came the cry from another room. We were making a house call and Kevin was giving a reflexology session to the husband of the house. Suddenly from the bedroom we heard, “She’s dead, she’s dead.” It was caregivers for the lady of the house, an elderly invalid who had been diagnosed with multiple strokes and senile dementia. The caregivers, experienced in caring for older adults with multiple symptoms of aging, thought they were witnessing sudden cardiac arrest.
We rushed into the room as the caregivers rushed out. We found Mrs. Wallace sitting in her wheelchair slumped to one side. Barbara had called 911 on the way, handing the phone to one of the caregivers for address information. Kevin attempted mouth to mouth resuscitation with no results. He said, “I don’t know CPR. What should I do?” Barbara replied, “Do what you know, go for the feet.”
Kevin applied pressure multiple times to the center of the big toe, a reflexology technique traditionally utilized for revival from fainting.
At that point, Mrs. Wallace sat upright in her wheelchair and began moving her feet. Concerned she would injure herself, on the wheelchair foot rests, Kevin reached to move them out of the way. As he did so he asked, “Mrs. Wallace, Mrs. Wallace, do you know who I am?” She replied, “Yes, you’re a jackass.”
From the other room came the sounds of laughter from the caregivers. They knew she was back; she always talked like that.
The rescue squad had been delayed, unable to find the house. The house had recently been repainted with house numbers removed and not replaced. It took responders ten minutes to respond to the call. When they arrived they found nothing wrong with Mrs. Wallace. Later after an exam at the hospital, she was pronounced healthy for a woman of her years. She lived another two years.
Curiously enough, the previous weekend, we had started to watch a program about how to do Cardio-Pulmonary Resuscitation. The program ended by saying, “ And next weekend we’ll show you how to do it!”
We never saw the second half.
Sudden cardiac arrest is a leading cause of death among adults over the age of 40 in the United States and other countries. Some 350,000 individuals experience sudden cardiac arrest outside of a hospital every year in the US. Nine out of 10 die. The survival rate is 1% worldwide and close to 5% in the US. For those receiving CPR, the survival rate is 5% out-of-hospital and 15% in-hospital.
When we tell these stories, people ask, why does this keep happening to you? We do not know how to explain it. But here is an example of our experience.
A Not So Ordinary Day in Ireland
It was a few days into our visit to our friends Michael and Deborah in a remote village on the west coast of Ireland. During a late night / early morning conversation, Michael suddenly stopped breathing and moving. While the absence or presence of a heartbeat was not confirmed at the time, he did not respond to shouts and gentle slaps on the face. He showed no signs of life.
Kevin applied pressure ten times to the center of the left big toe and moved on to apply pressure to the right big toe. A faint sound of inhalation came from Michael. At the seventh pressure contact on his right big toe, he sat up, alert and conscious, and said, “Barbara, Kevin, Deborah, why are you all standing over me?”
He was up and moving within minutes.
Michael was later diagnosed with Brugada Syndrome. The only symptom of this condition is sudden cardiac arrest. Brugada is a genetic condition where abnormalities in the heart’s ability to beat regularly lead to a high risk for ventricular fibrillation. The only known medical treatment is caution, little or no strenuous exercise and an implantable cardiac defibrillator.
Looking back, we remembered that Michael had greeted us at the Galway airport with the story of the testing he was undergoing for a heart problem. His 25 year-old nephew had collapsed and there were concerns that a genetic abnormality family could exist.
We celebrate his survival from the above incident, every year.
A worldwide problem
Sudden cardiac arrest is the leading cause of death for young men under the age of 40 after accidents in the Philippines. Brugada incidence is particularly high in Southeast Asia where legend has it a young man will wake up early in the morning, cry out and die. In the Philippines it is known as bangungut (“to rise and moan in sleep”), in Japan this is called “ pokkuri” (sudden and unexpectedly ceased phenomena) and in Thailand they name it Lai Tai (death during sleep).
A high number of occurrences of Brugada Syndrome has been discovered in Ireland and studies continue at a Dublin hospital.
How deadly is sudden cardiac arrest?
“… the number of people who die each year from SCA (Sudden Cardiac Arrest ) is roughly equivalent to the number who die from Alzheimers disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicides combined.” http://www.sca-aware.org/about-sca
A Call for Research: The Potential of Reflexology Applied in Response to Sudden Cardiac Arrest
Could reflexology provide an adjunct technique for one of the world’s leading causes of death — sudden cardiac arrest? The goal of CPR, Cardio Pulmonary Resuscitation, is to maintain oxygen flow to the brain following cardiac arrest. Lack of oxygen to the brain results in unconsciousness and death. What if there were multiple ways to re-establish the heart beat? How could research be instituted to test the potential for this natural defibrillator?
We hope to find an understanding of possibilities to answer this question with further analysis of brain images collected during Neural Pathways of Applied Reflexology. Such analysis could show regions of the brain activated by application of specific reflexology techniques to the specific reflex area of the big toe.
After all, pressure to the bottoms of the feet communicates the level of one’s activity (i. e. running or walking) to the brain. The cardiovascular system responds to this information and if needed, creates changes in the rate at which the heart beats. Areas of the brain beyond those related to feet were shown to be activated during preliminary data analysis of Neural Pathways. Could these other areas demonstrate that the stimulus of pressure applied to the feet activates areas of the brain relevant to the beating of the heart?
(Note: We encourage anyone in a similar situation to call for emergency help. With Michael, we were in a foreign country and did not know how to call paramedics. We also did not know CPR.)