Coma & The Vegetative State


DEAR PAT:

Pat, help me understand my friend who was involved in an auto accident, has several broken bones, a tracheotomy (done at the scene), has been hospitalized for 7 days, has swelling of the brain which has been drained. Doctors are not saying or doing much until the swelling goes down. I guess he is on a breathing apparatus; he is not awake; he is in a coma. Do swelling and blood clots in the brain mean severe brain damage? Can a brain scan be performed on a swollen brain?

DEAR PAT:

At the age of 18, I sustained a severe head injury when I was hit by a driver in a pick-up truck, and I was as messed up as a Don King hair-do. I was in a coma for 8 weeks, and I really don't remember much of my recovery except that the food sucked. I guess I'm either too stupid to realize the severity of my injury or too stubborn to let it keep me down, because I'm in college now trying to get into the field of cognitive rehabilitation. I'd like any information you can provide on this topic. By the way, the best advice I can give others: NEVER GIVE UP!

DEAR PAT:

My father had heart failure and it took him 20 minutes to bring him back. The doctor gave him medication and he was supposed to wake up in about 10 hours. It has been over 72 hours and his is in a coma. His heart and organs are functioning well and a brain scan showed no signs of stroke. Can you tell me how long it takes to get out of a coma?

DEAR PAT:

My son has a severe brain injury (he fell 35 ft). He postured a lot in the hospital and now he is in a rehab hospital. They had him on Haldol and also had him on Botox. It stopped the posturing, but now he is no longer on the Haldol and he is starting to posture again. Why would he posture? I am trying to get the Doctors to do something quick before it gets so they can't control it. My son is in a coma yet, he has been in one for 2 1/2 months and they think he is improving, but not while he is posturing. Also he fixes his eyes to the right at a certain time of the day some days. He tracks well and responds to sound. Can you give me any encouragement?

DEAR PAT:

My brother fell 20 feet and hit his head while at work. This fall has left him in a coma for 55 days now, and all the doctors have been telling us is to wait and hope. My family and I understand that, But Alan started responding to small commands such as - Give a thumbs up, point one finger, or squeeze my hand if your name is Alan. He has even mouthed "Hi," and told them that he was 28. A week later he started having seizures and is back in the TICU. We talked to the doctors and they say that Alan has fluid on the brain again and that the fluids are not draining. They said they would put a shunt in to help the fluids drain, but they said if they put the shunt in Alan still only has a one percent chance of him being Alan again. Now they are telling us that all the little steps that Alan is making are not purposeful. I am totally confused. I don't understand how one minute they are purposeful and now they are not. I will never give up on the power of God, and the strong will that my brother has. Pat if there is any advice that you could give me and my family I would deeply appreciate it. Missing Alan!!!

DEAR PAT:

I was talking to someone and they told a story of coma that I find hard to believe. This person said that they were hit on the head with a large book from a height of about 10-12 feet. She claims she was in a coma for three weeks. She also claims that she woke up with no disabilities and no need for rehabilitation. She claims to have been back to work within a week of waking up. I do not believe that this is possible. From what I understand, it takes quite a bit of trauma to keep a person in a coma for that long. And sustaining that kind of trauma means that part of the brain were damaged severely. That a coma of as little as a week would cause someone to have months of therapy. That they would have to re-learn a lot of menial tasks including walking, taking care of themselves and basic cognitive functions. Am I wrong in my assumption that all head injuries that lead to a prolonged coma require extensive rehabilitation or can someone just wake up and have no after-affects of a traumatic brain injury?

DEAR PAT:

Our 39 yr. old brother suffered a closed head injury Sep. 11, 1999. He sustained shearing to midbrain, thalamus, and brainstem. He was in a coma for several days following injury and is now what is considered a "locked in" state. As of yet, his left side seems to be unaffected, while he has hemiplegia to right. He has made more progress than the doctor's ever thought he would. For instance, he'll answer yes/no questions using his fingers, and is learning American Sign Language alphabet. His memory doesn't seem to be impaired; he knows his name, age, brother's names, etc. He has also started writing his name on a notepad. Recently, he has started exhibiting somewhat aggressive behavior-pulling our hair, noses, and such. Our question to you is-is this new behavior common with such injuries? Some of the nurses at the Rehab hospital have told us this means he is "waking up", it that true? And, is it possible to recover from an injury to the brainstem?

DEAR PAT:

I have a nephew that has been in a pre-vegetative state for 1 year and 6 months. He is still in the hospital. He hung himself. He also suffers from schizophrenia. The doctors have given up hope of recovery. He can tell when someone is in the room, and likes for you to read to him. Do you know of any other cases like this where they recover?

DEAR PAT:

My brother died from anoxia due to an accident last year after living in a vegetative state for 3 months. Although at first in an ER, he was later transferred to a long-term care facility. I was shocked to see how many young people were there. My questions arise out of sheer curiosity: how many young adults nationwide live in a persistent vegetative state? what percent of them recover? How many facilities exist nationwide that care for young adults in vegetative state?

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