- Associated Press - Saturday, January 7, 2017

BOZEMAN, Mont. (AP) - Nicholas Rennspies remembers waking up really excited to get his ski pass at the Big Sky Resort.

He rode to the top of the Swift Current lift with his roommate, got off and bent down to strap on his snowboard.

Then Nich’s heart stopped.

He keeled over, landing in the snow at a weird angle, looked back in panic toward his roommate and died for the first time.

That was the start of a race to save a life - a race that challenged first Big Sky’s Ski Patrol and then teams of Montana paramedics, air flight staff, hospital doctors and nurses from Bozeman to Missoula. All worked to bring a 28-year-old outdoorsman back from the brink of death, back to his family.

“The only reason I’m alive today is because of the Big Sky Ski Patrol,” said Nich, sitting with his brother Erich at Dave’s Sushi restaurant in Bozeman, one day after getting out of St. Patrick Hospital in Missoula.

Nich gently patted the healing incision near his heart, where the doctor had just implanted a pacemaker, reported the Bozeman Daily Chronicle (bit.ly/2htwbJM).

Together the brothers pieced together the story of what happened on Dec. 7, the story of a remarkable rescue that gave the Rennspies family the gift of Nich’s life.

Ten minutes

Big Sky is a big, sprawling resort that calls itself “the biggest skiing in America,” boasting more than 5,800 acres of skiing terrain.

It has one of the largest ski patrols in the country, with 104 professional patrollers, said Bob Dixon, ski patrol director for 35 years. There are another 140 volunteer ski patrollers, said Dave Benes, assistant patrol director.

“It’s just a lot of ground for them to cover, a lot of steep, advanced expert terrain,” said Chelsi Moi, resort spokeswoman.

Had Nich fallen almost anywhere else, farther from help, his story might have ended badly.

Luckily for him, the ski patrol has a posting station right at the top of Swift Current lift. Nich’s roommate Rob Lovell quickly got the attention of patrollers Sam Keesler and Tim Gaar, who’d been warming up soup and spooling rope.

Keesler, a patroller for three years, and Gaar, a five-year veteran, had never faced a life-and-death situation like this.

“It was my first time seeing something like that, it was shocking,” Keesler recalled.

Yet everyone on the patrol team was “fresh out of training,” said Steve Emerson, who runs the patrol’s medical program. For three or four days at the start of the season, ski patrollers get intensive training on emergency medical procedures.

“The training takes over,” Keesler said.

Finding no heartbeat and no breathing, the two patrollers made the critical decision to start CPR. They used a bag valve mask to push air into Nich’s lungs and compressed his chest 100 times a minute to keep blood pumping.

The emergency call of an unresponsive adult male went out over the mountain. This was not a drill. Patrollers quickly determined the fastest way to deliver the AED, automated external defibrillator, stored at the top of the Powder Seeker chairlift, a point from which it can quickly be brought to much of the mountain.

In all 10 or 12 patrollers arrived, bringing the defibrillator by snowmobile and the red ALS bag with advanced life-support equipment and medications. Among the first were Noah Ronczkowski and Scott Patch, said Dan Sheil, a paramedic ski patroller for 17 years and Big Sky Fire captain.

They tore open Nich’s jacket, attached defibrillator patches to the upper right and lower left side of his bare chest and the machine delivered a shock.

After about six or seven minutes of CPR, Emerson said, the patrollers saw their patient’s chest expand - he was trying to breathe on his own. It was a good sign, but there was no time to waste. Ronczkowski remembers thinking, “Hurry up and go!”

They wrapped the unconscious patient up in a toboggan and skied him down the mountain, with ski patrollers at his side watching closely, stopping every half minute to make sure he was breathing, Sheil said.

It all happened fast. From the time Nich went down and the call went out, to the time he was out of the toboggan and into a Big Sky Fire ambulance, Sheil said, took about 10 minutes.

A helicopter from REACH Air Medical arrived at the fire station to fly Nich to Bozeman Health Deaconess Hospital in Bozeman.

Minutes matter, Sheil said.

“They saved his life, absolutely,” he said of the ski patrollers. “It’s a team dynamic, not an individual. It’s everyone knowing their role, their gear.”

The outcome often isn’t positive, veteran patrollers said.

“Everything was in alignment that day,” Sheil said.

“It all went right,” Dixon said.

Dying again

Erich Rennspies, 30, was 800 miles away in sunny Prescott, Arizona, talking with some people about renovating a house, when he got a call from his younger brother’s cellphone.

The voice said his brother had collapsed on the mountain at Big Sky and there was a “Do not resuscitate” request in his phone. Did Erich want them to keep trying to resuscitate his brother?

“‘What are you talking about? F - ing bring him back!’” Erich said.

“I fell to the ground, I couldn’t stop crying,” he said. “I drove 20 hours straight, through blizzards, going 80 mph” to reach the Bozeman hospital.

Two years apart, they had grown up fighting like brothers, but became close four years ago when their dad, “Stormin’” Norman Rennspies, a former Air Force fighter pilot, was killed.

When Nich was born, the family had been stationed at an air base in England. Doctors there tested the newborn and thought their heart monitors were broken, Erich said.

At age 10, Nich had a routine health check and was told, “‘Wow, you’re having a heart attack right now.’”

Doctors diagnosed L-Transposition of the great arteries. The brothers said it meant that the top and bottom chambers of his heart beat out of sync. They said he would need a pacemaker someday, or he might only live to age 13 or 18.

At first his parents didn’t want to let him outside, Nich said. “Eventually I told them if I’m going to die I want to die outside. I want to do fun things.”

Despite the cardiologist’s advice, he played football and baseball, ran track, snowboarded and skied - without any problems with his heart muscle.

“We just thought I’d grown strong enough,” Nich said.

He loved hiking and rock climbing in Glacier National Park, fell in love with Montana and discovered Big Sky. There he has been a self-professed ski bum for the past six years, bartending and serving in restaurants when not enjoying the outdoors.

Shushing down the mountain feels like “flying,” Nich said, and he likes being part of “a great community of good people.”

Their dad’s death had been “real rough,” Erich said. So when he first saw Nich lying in a Bozeman hospital bed hooked up to tubes, like their dad, he couldn’t go into the room.

Their mother, Patsy St. John, a high school teacher in Arizona, said she was at a training meeting when she got a phone call from Big Sky, saying her son had collapsed and asking if she wanted them to continue to resuscitate him.

“Yes!” St. John said. “Do everything!” Told his heart had stopped, “I didn’t believe it because he’s so healthy.”

In a blur, she found a flight to Bozeman, thanks to pilot friends, and arrived by midnight.

She found Nich in a coma, induced by Bozeman doctors to reduce swelling in his brain from the loss of oxygen. They had cooled his body down to around 37 degrees to protect his brain and organs. Bozeman doctors Andrew Sullivan and cardiologist Dane Sobek treated Nich.

“He was ice,” his mother said. “It was pretty hard to see.”

But, she added, “I was very impressed by the Bozeman protocol. That pretty much saved his life. That and the ski patrol. Every minute without oxygen going to the brain can cause brain damage.”

St. John sat all night by Nich’s bed, held his hand, kissed his forehead, talked to him and played music in hopes it might reach him.

Then, his heart stopped again. “He codes,” she said. Forty people rushed into the room and she was rushed out. The medical team brought him back to life, still in a coma.

One of the worst moments, St. John said, was “seeing my son hooked up to the intubator, all the tubes coming out, and being frozen. The worst was when the doctor and social worker sat me down and said there could be serious brain damage.”

The best moment was when the doctor started bringing Nich out of the coma. “Squeeze my hand, squeeze my hand,” his mother kept saying. And finally, he responded.

As the doctor pulled the tube from his throat, Nich woke up for the first time since his collapse.

“I was extremely confused,” he recalled. “I said, ‘What just happened? I just bought my ski pass?’”

His aunt and uncle had come from Seattle, and his cousin Matt had driven all the way from New York. Big Sky friends came to the hospital, too.

Cousin Erin Scot started a GoFundMe web page to raise money for medical bills, because Nich has no health insurance. Erich guessed his bills could come to hundreds of thousands of dollars.

Doctors told Nich he’d need a pacemaker to regulate his heartbeat, but he stubbornly resisted. Erich said he had to talk his brother into it 50 times, saying his heart would have one beat instead of two weird beats. He showed pictures of “all the cool dudes,” like Elton John, who have pacemakers.

Finally Nich agreed to the pacemaker. The hospital prepared to fly him to Missoula where a specialist could implant the lifesaving device.

On the gurney waiting to board the medical plane from Bozeman to Missoula, his eyes rolled back and he coded again, his mother said. Again they had to shock his heart. It stopped working a fourth time during the flight to Missoula, Erich said, either stopping or fluttering super fast, without making proper contractions to pump blood.

“I definitely died and came back,” Nich said. “I remember a few times, I floated away and then - boom - I came back and thought, ‘What was that?’”

For Nich the worst part was waking up and “seeing the fear and worry in everybody’s eyes.”

Lots of people were praying for him, Erich said.

“I always felt someone was watching over me,” Nich said. “I’ve had a lot of close calls. It’s definitely something I’ve always felt.”

Whether climbing mountains, or having a close call on an adventure to Guatemala, getting hit on the head by robbers, he said, “something has always given me a little push in the right direction.”

A precious gift

The brothers like to talk about the humorous side of the trip to Missoula.

For two days at St. Patrick Hospital, Nich was hallucinating.

“He went streaking buck naked down the halls,” Erich said, smiling. “All the nurses wanted to work with him after that.”

“I thought they were testing me to be an astronaut,” Nich said. “I remember when they told me they weren’t testing me to go to outer space, I felt really sad. I thought I was going to the moon, literally.”

He talked about seeing Clydesdale horses and badgers chomping their teeth.

“Now we were really worried he had brain damage,” Erich said.

Nich became combative at times and tried to escape the hospital. “He doesn’t remember any of that,” Erich said.

Everything changed when the cardiologist, Dr. Simone Musco, implanted the pacemaker. It took about 90 minutes.

“The doctor asked, ‘How do you feel?’ ‘Pretty good actually,’” Nich recalled. “Everything was normal after that.”

The next day he had a psychological evaluation and was released from St. Patrick. Erich drove him back to recover in Bozeman and Big Sky.

“I feel a lot more humbled, and a lot better than I have been,” Nich said. “I feel I’ve got a lot more oxygen.”

He wants to keep traveling and enjoying life, Nich said. “They’re so short and fragile. Making the most out of what we have is what Erich and I try to do.”

“Be kind to everybody,” Erich added.

“You’ve got to enjoy your life more,” Nich said.

“‘Cause girls like it,” Erich said and laughed.

The brothers and their mother said they are grateful, especially to the Bozeman doctors and Big Sky Ski Patrol. “They killed it,” Erich said.

“The people who helped my son really did a good job and need to be thanked,” St. John said.

One lesson she took from this close call is that all the men in her family need to get their hearts tested. Her own dad died of cardiac arrest at age 30, coming home from Vietnam. About 325,000 Americans a year die a sudden cardiac death.

“It is precious,” she said of life. “I feel Nich was given a gift. We all were.”

___

Information from: Bozeman Daily Chronicle, https://www.bozemandailychronicle.com

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