Ryan Jones does not remember skidding in the snow on May 20, 2016 in Fort St. John causing his chest to slam into the steering wheel and sending him into cardiac arrest.

含羞草研究社淢y first memory was waking up in GF Strong [Rehabilitation Centre] in Vancouver five-and-a-half months later,含羞草研究社� Ryan told Black Press Media.

Now, the 25-year-old Smithers man is at the forefront of a new medical intervention that could save countless lives.

Dr. Mypinder Sekhon, who was a member of the team that treated Ryan at Vancouver General Hospital when he first arrived via air ambulance in the Lower Mainland, said the prognosis was bleak from the start.

含羞草研究社淚n Ryan含羞草研究社檚 case, every textbook and every prognostication would have told you we should stop the life support, that he was going to have a dismal outcome,含羞草研究社� Sekhon said during an interview by telephone.

A life and death decision

At the time of Ryan含羞草研究社檚 accident, Vancouver General had been using a technique called autoregulation monitoring (ARM) for approximately eight months to customize treatments for victims of traumatic head injuries. The procedure involves placing catheters in a patient含羞草研究社檚 brain using an apparatus called a Brain Bolt, which provides critical information that gives the medical team an opportunity to limit or even reverse brain damage, Sekhon explained.

It had never been tried, anywhere, in a cardiac arrest case.

含羞草研究社淩yan sustained a pretty long cardiac arrest,含羞草研究社� Sekhon said. 含羞草研究社淗is heart had stopped for quite some time and even after it had been restarted his body wasn含羞草研究社檛 getting enough oxygen and his brain wasn含羞草研究社檛 getting enough blood flow. We含羞草研究社檝e been using this technology of the Brain Bolt in brain injuries that result from trauma, so when Ryan came to Vancouver General, the CT scan suggested what we feared, that the brain had been damaged and we had never undertaken this type of procedure or monitoring in a cardiac arrest patient.含羞草研究社�

It was Sekhon含羞草研究社檚 colleague, Dr. Don Griesdale, who came up with the idea.

含羞草研究社淎dmittedly, it hadn含羞草研究社檛 crossed my mind before, so we didn含羞草研究社檛 really have much to lose at that point given how severe Ryan was,含羞草研究社� Sekhon said.

But ethically, it was not a decision for the doctors to make, so they took it to Ryan含羞草研究社檚 parents, Donna and Jim Jones.

含羞草研究社淲e were upfront with them, we were not sure it was going to work in his case,含羞草研究社� Sekhon said.

Fortunately for Ryan, his parents were of the same mind as the medical team.

含羞草研究社淥ur thought at the time was, we don含羞草研究社檛 know if this is going to help Ryan, but if it can be part of research that helps other people in the future then absolutely go ahead,含羞草研究社� Donna recalled. 含羞草研究社淭hat含羞草研究社檚 what we said to the doctors.含羞草研究社�

A life-saving intervention

While the hospital had had some success with head trauma patients, they were treading on new ground with Ryan.

含羞草研究社淲e didn含羞草研究社檛 know what we were going to find when we put the catheters in his brain,含羞草研究社� Sekhon said. 含羞草研究社淲hat we found was the oxygen levels were very low, but more than that we established that once we actually augmented his heart function, augmented the lung function, that we were able to increase and normalize the oxygen levels in his brain.

含羞草研究社淲hen he had a great outcome, we started thinking, 含羞草研究社榳ell, can we start to use this in other cardiac arrest patients and can we study it?含羞草研究社�

They did, and the resulting paper has now been published in the May 2019 edition of Critical Care Medicine含羞草研究社攖he official journal of the Illinois-based Society of Critical Care Medicine.

含羞草研究社淲e含羞草研究社檝e done it in about 15 people now in the last year and a bit,含羞草研究社� Sekhon said. 含羞草研究社淓ight of them have survived to full recovery. Seven have still died, so a bit better than 50 per cent.

Sekhon acknowledges it is a far cry from a definitive study, but views the results as very promising.

含羞草研究社淭hese numbers are really, really small, so it含羞草研究社檚 hard to draw any really meaningful conclusions about it, but traditionally the good outcome rate, good being full recovery, is in the single digits, or the high teens,含羞草研究社� he explained.

The research shows some potentially ground-breaking results.

含羞草研究社淭he old dogma has been that in cardiac arrest the [brain] injury that you get is dependent upon the initial time at which the heart is stopped and then after restarting the heart, it含羞草研究社檚 not modifiable,含羞草研究社� Sekhon noted.

含羞草研究社淪econdly, traditional thinking has been we含羞草研究社檙e not able to heal the brain by getting adequate oxygen delivery to the brain and so forth.

含羞草研究社淲hat we found was, by changing various interventions, we are able to increase oxygen levels in the brain after resuscitating somebody, after restarting the heart, so that tells us that the brain is, in fact, not dead and the injury is likely modifiable.

含羞草研究社淪econdly the study demonstrated that currently how international guidelines recommend that we treat people is with a cookie cutter approach. Everybody gets the same management.

含羞草研究社淲hat we含羞草研究社檝e found is there含羞草研究社檚 tremendous differences within patients, in how their management differs, or how the brain injury is different, so instead of a one-size-fits all approach, we ought to move towards individualizing the care, or personalizing the medicine.含羞草研究社�

The paper含羞草研究社檚 authors will soon be taking their findings on the road to disseminate the information to other hospitals around British Columbia, Sekhon said.

A long road to recovery

It has been almost three years since that fateful day, and Ryan Jones has been in rehabilitation pretty much ever since.

From November 2017 to February of this year, he was in treatment at the Watson Centre for Brain Health in Burnaby. Donna said the program there 含羞草研究社渉elped a ton.含羞草研究社�

含羞草研究社淭he brain is so amazing how it can retrain itself,含羞草研究社� she said.

含羞草研究社淗e含羞草研究社檚 pretty good, I wouldn含羞草研究社檛 say he含羞草研究社檚 100 per cent back to how he was before the accident, but he含羞草研究社檚 getting very close and he含羞草研究社檚 making improvements still, they含羞草研究社檙e just not as noticeable as they were when he first started into the recovery phase of it.

含羞草研究社淗e has a tough time with a lot of stuff, but no more than anyone else that has a tough time dealing with stuff, he just has a bit of a disadvantage over someone who含羞草研究社檚 never had a brain injury, because brain injuries are funny things and everybody reacts differently with the symptoms.含羞草研究社�

Physically, Ryan is back to his normal self, he said, playing sports and doing pretty much all the things he did before the accident.

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Mentally, he is a work in progress.

含羞草研究社淚含羞草研究社檒l always have issues, I含羞草研究社檓 sure,含羞草研究社� he said. 含羞草研究社淭he problems for me are definitely memory in general, short- and long-term memory.

含羞草研究社淢y really, really long-term memory is done for. The only time I have my long-term memory recalls is when I含羞草研究社檓 going to Facebook and looking up old photos and stuff like that. Other times when I have memory recalls is when someone will mention a story and, not a hundred per cent clearly, but I will somewhat recognize what they含羞草研究社檙e generally talking about so it含羞草研究社檚 not a full memory, but I含羞草研究社檝e got the idea of it.含羞草研究社�

An undying gratitude

Ultimately, Ryan and his family feel very lucky he got to be the first person to benefit from what amounted to an experimental intervention at the time.

含羞草研究社淚 mentioned to my mom, a week or two before May 20, 2017, I have two birthdays every year now,含羞草研究社� he said. 含羞草研究社淚n my point of view, and everyone else含羞草研究社檚 point of view, I actually did die on that day of my accident.含羞草研究社�

He said recognizing the second birthday is more of an observance than a celebration, however.

含羞草研究社淚含羞草研究社檓 not sure you can call it celebrating,含羞草研究社� he said. 含羞草研究社淚t is a pretty big deal in my life, but it would be a bit weird to celebrate the day of the accident.含羞草研究社�

Donna said it is hard to explain how grateful they are.

含羞草研究社淎t first they told us he was not going to survive,含羞草研究社� she said. 含羞草研究社淭hen it was, OK, if he does survive he含羞草研究社檒l have to live in an institution and be bedridden the rest of his life. We were always being prepared that we were going to have to make a choice whether we were going to continue treating him or not, but we just never gave up and the outcome has been incredibly wonderful.含羞草研究社�

Their gratitude is not just for the medical professionals, who saved his life and oversaw his recovery and rehabilitation, though.

含羞草研究社淭he family really thanks the community [of Smithers] for all the support,含羞草研究社� Donna said.

含羞草研究社淲e had a ton of support from family and friends and co-workers, so we would just like to say thank you to the community for all the support.含羞草研究社�