When he stopped breathing, his dog called out for help

On a Friday morning in late February, Ken Walsh and his wife, Nicole, sat on their couch in East Brunswick, New Jersey, having coffee and talking about weekend plans.

Their dog, Indiana, a 6-month-old Australian Shepherd mix, sat on the floor at Ken's feet. She was a happy, friendly dog who loved walks. She was especially attached to Ken, often curling up by the door after he left for work.

The morning chat lasted so long that Nicole realized she was running late for work. She jumped up to finish getting ready.

On her way out of the room, she heard Indiana uncharacteristically growl and whimper.

She turned around to see Ken seemingly making funny faces at the dog. Then she realized that Ken was shaking. His jaw was clenched. His eyes fluttered but he didn't appear to see anything. She thought he might be having a seizure.

Nicole called 911.

Ken, 31, had gone into cardiac arrest. He was no longer breathing.

Nicole cried as she waited. Indiana curled up in a corner and stayed quiet.

By the time the ambulance arrived, Ken's skin had started to turn blue.

"How long has he been like this?" an EMT asked.

Nicole had no idea. To her, time had stopped.

As the house filled with first responders, Indiana quietly went upstairs.

EMTs performed CPR on Ken. When the compressions failed to restore a sustainable heartbeat, they used an automated external defibrillator, or AED. It worked.

As they rode in the ambulance to the hospital, EMTs asked Nicole about Ken's health and whether he used drugs.

Not only was he healthy, Nicole said, he was a lifelong runner. And, no, he'd never used drugs.

At the hospital, doctors placed Ken in a coma, providing a gentle atmosphere for his brain and body to heal from the trauma. Nicole, meanwhile, stayed with her parents, as did Indiana.

Indiana usually slept in a crate in Nicole and Ken's bedroom. Now Nicole placed her on the bed.

"This isn't permanent," Nicole said as Indiana curled up next to her feet.

Ken was taken out of the coma after three days. Nicole waited for him to regain consciousness to see how the cardiac arrest affected him – whether he'd return to his old self.

He was confused at first, but that was to be expected. Over the next few days, he showed no cognitive deficits.

Doctors couldn't find an underlying reason why Ken's heart stopped. To prevent it from happening again, he received an implantable cardioverter defibrillator, or ICD. The device monitors his heart rate and if it ever detects an abnormal rhythm, it can jolt it back to a safe beat.

After a week, Ken was transferred to a different hospital for physical therapy and cognitive testing. The only deficit therapists saw was a weakness in his left arm and hand, which improved with physical therapy.

When Ken was cleared to go home, he looked forward to returning to work the next month. He also planned to attend cardiac rehab to test his physical limits in a controlled setting.

But this was March 2020. The arrival of the COVID-19 pandemic shut down in-person activities. He'd have to figure something out for himself.

The obvious choice? Running, if his doctor thought it would be OK.

In high school and college, he ran cross country and track; he was captain of his college team. His first five years after college, he ran six marathons. Although he'd ramped down the training and competition, he still enjoyed running with friends.

At this point, he could only walk. Even that was taxing. The idea of walking Indiana scared him; what if she pulled or ran? He also feared his heart stopping again.

"Sometimes I would cry while walking," he said.

Nicole worried too. For the first few months, she was afraid to let Ken out of her sight. She put her trust in the ICD.

Two months after Ken left the hospital, his doctor cleared him for light running.

"As long as you're smart about it," the doctor said. "Always bring a friend and your phone. Start slow and don't be a hero."

Ken's running buddies were happy to slow their pace for him. Gradually, he managed to run farther and faster.

"Not only was running my mental therapy, it was one of the few feelings of normalcy during the pandemic," he said.

On Feb. 28, 2021, a year to the day of his cardiac arrest, Ken ran his own solo half-marathon, looping through his neighborhood until he reached 13.1 miles.

"Running that half-marathon felt liberating," he said. "I felt like running was finally changing from fear to fun."

That run inspired him to join the American Heart Association's 2022 New York City marathon team as part of the event's charity partner program.

During the marathon, someone recognized his AHA jersey and fist-bumped him.

"I had a stroke 18 months ago," the man told him. "Thanks for all you're doing."

"It was a cool moment," Ken said.

As he approaches three years since his cardiac arrest, Ken has had no other heart issues. He downloads data from his heart device to his cardiologist every three months and gets checkups twice a year.

Ken now exercises almost every day, including running and walks with Indiana. His enthusiasm for fitness has inspired Nicole to walk more as well.

As for Indiana, she never had to relinquish her "temporary" sleeping arrangement.

"She's earned her spot on the bed," Ken said.

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.

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