Family wants to keep life support for girl brain dead after tonsil surgery #6

[Linda7NJ]

OK...I just followed the suggestion and looked up assessment by CHO for Brain Death..and NOWHERE did I see any circulations of Blood flows to the brain..and It's just as I have read other places..Mis-informations being spread as facts..There is NO way any such testings would be done..AND no her actual brain matter is NOT decomposing..and I just know that..take that for whats its worth..Far too much judgements have been made by certain spinnings..and I know it's not based on FACTs....IF that was so..Jahi would have been heart/cardiovasular DEAD within 48 hours..We are now weeks later...



Here's what's linked about Brain death..Please point out brain circulations to me...Blood Flow Studies werent done...unless someone can point me to that being done after this date???



http://www.scribd.com/doc/195183111/Children-s-Hospital-Okland-Physician-s-Declaration-Dec-20-2013



NOTE#4 on this evaluations..TYIA:facepalm:

I so wish I could read that on my phone!


Sent from my iPhone using Tapatalk

 

[I Object!]

My brother's ashes were in my linen closet in a Williams-Sonoma bag for over 10 years. I promised him I would spread them in Hawaii. I just got busy, is all. Twice our home was evacuated due to wildfires approaching and both times I made my kids run upstairs and grab their uncle who would have been annoyed to be burned twice. Can't make this stuff up, I tell ya.

I am happy to report I was able to spread his ashes in the channel between Maui and Molokini in April... and I was drinking a mai tai when I did.

My mom's ashes have yet to be scattered. Now I'm wondering, should I make her some soup?

 

[seattlechiquita]

I confess, I giggled over the comment and I saw nothing offensive in it. We are dealing with a tough subject here and handling it with respect, consideration and compassion. But we occasionally need a laugh to keep us from getting to down about such a heavy topic. It is all a part of coping with life, and death is a part of life. Even at my beloved fiance's funeral. We found reason to laugh and I know he would have wanted it that way.

I hear you. I HAVE TO be light about the things we deal with here. I have to, or I would go crazy. And when I die, I hope everyone is laughing at my funeral.

 

[ItsJustaName]

Lack of nutrients was not the sole reason she was in bad shape. She wasn't given nutrients because she was declared brain dead. As per California law, they had a second physician assess her. Then three more. A sixth physician, head of pediatric neurology at Stanford, concluded the same thing. The last being ordered by a Judge, who agreed with all 6 physicians, and declared her brain dead.

CHO followed California law with regard to this patient. In fact, they seemingly bent over backwards to accommodate a family who understandably was grieving but refused to believe physicians.

Lack of nutrients for short periods of time are the cornerstone of gastric bypass surgeries and their success. The temporary lack actually improves the health of obese patients who often have horrible co-morbidities. These patients go months without any real nutrition because A) they don't have the stomach capacity and B) their guts have been snipped and shortened so that any nutrition that DOES make it in cannot be fully absorbed. The only difference is, those patients have healthy, living functioning brains.

I simply don't understand anyone saying Jahi isn't brain dead. If she is not brain dead are all six pediatric neurologists supposed to be mistaken or part of a larger conspiracy?

 

[Quester]

Looking at the financial aspect of this case ...

What are the likely estimated weekly or monthly costs
associated with the type of care JM would now be receiving?

Costs covered by donations? Insurance? ???

What happens when insurance runs out / donations dry up?

 

[Shecky]

I confess, I giggled over the comment and I saw nothing offensive in it. We are dealing with a tough subject here and handling it with respect, consideration and compassion. But we occasionally need a laugh to keep us from getting to down about such a heavy topic. It is all a part of coping with life, and death is a part of life. Even at my beloved fiance's funeral. We found reason to laugh and I know he would have wanted it that way.

The night after my mom died, my brother and I went through her clothes and put on a "fashion show" for relatives in the living room. You should have seen him in her pajamas, singing and strutting. Everyone laughed. No one can convince me her spirit wasn't there and loving every moment! :floorlaugh:

 

[Zuri]

No one on the family's side is playing games..The only reason her body was in such bad shape is because CHO was only giving her fluid via IV....just think about it..If you only drank sugar water or other fluid lacking Nutirents..how well would any body do?...Any Body requires nutrients..Carbs..Proteins..Lipids etc..Once deprived of that..Lose of weight..SO who treated jahi that way for over 4 weeks??? Yep...Now they have a tube inserted to give her needed nutrients..We will see..Regardless of Electrical activities of brain...Her Body could continue to improve...Much against what CHO attempted to deprive her body to maintain....CHO's behaviors totally disgust me...Long time experience in ER and ICU nursing experience..SO get it..COurse..What do I know??:truce:

I have 33 years in ER, SICU, PACU. experience. Working in the ER, especially at triage, I have been told all kinds of things when interviewing a patient, a lot of things that were disproved when all the tests were run and further exam. I have acquired a healthy amount of skepticism over the years when stories did not add up. I have learned a lot on these threads that I did not know before. I have learned the pathophysiology of brain death, neuro criteria etc. For me to assume I know everything would be ludicrous just because of the areas where I worked.

I am not taking the word of an interested party or family member over what I have seen as the norm over 33 years. PICU nurses have one of the hardest jobs on the face of the planet, and I am going to assume they did their job and did their job well. I will not be complicit in accusing CHO of not acting in the best interests of Jahi or children in their care. Until I have evidence to the contrary, I will support CHO. :truce:

 

[AnaTeresa]

bbm I am confused.

My apologies, it was clearer in my head. I meant by "pass away" that Jahi's heart will inevitably stop. Her soul, in my mind, has already passed on.

 

[ferretnurse]

When my son got his molars out recently we were told not to let him suck on anything because the sucking pressure can cause bleeding. He was allowed to drink small sips from a glass the first several hours. Then he was able to have a soft milkshake (again no straw).

He ended up in the ER anyway for continued bleeding. Times have changed since I had my tonsils out (I was 18) - I didn't get a popsicle then either - it was a frozen juice cup that I ate with a spoon.

I wonder if they really gave her a popsicle, and not a frozen cup.

MOO

Mel

I was wondering this too. I had mine out seven years ago, and they gave me one of those water ices with the wood "spoon". I remember being mad that the ice was so hard, I broke the spoon.

 

[Tulessa]

http://www.cnn.com/2014/01/06/health/brain-dead-basics/

Why brain dead means really dead

(CNN) -- A person who is brain dead may appear alive -- there may be a heartbeat, they may look like they're breathing, their skin may still be warm to the touch.
But doctors say there is no life when brain activity ceases.


It's not complicated! 6 doctors declared her brain dead...SIX!

 

[I Object!]

Medical insurance coverage ends with the death of the covered patient. No one is sure what kind of facility (or private home) she's in, so costs are borne by the family (or donors) if fees were charged.

Looking at the financial aspect of this case ...

What are the likely estimated weekly or monthly costs
associated with the type of care JM would now be receiving?

Costs covered by donations? Insurance? ???

What happens when insurance runs out / donations dry up?

 

[ArianeEmory]

Delurk, I am only up to speed on maybe 20% of this case, but isn't the uncle out pulling in media appearances on cable tv? I'm assuming some finances are coming their way, and that plenty of lawyers and whatever are acting on spec for the inevitable lawsuit windfalls.

 

[vlpate]

I made my kids run upstairs and grab their uncle who would have been annoyed to be burned twice.

First laugh of the day! I think you have to have a sense of humor, as our loved ones would probably tell us if they could.

This is one of my problems with Jahi being toted around as if she is going to someday wake up...her dignity is being stolen and there are going to be jokes...not about the funny, sweet, endearing Jahi her family loved, but the dead, rotting, almost faceless Jahi - she deserved better than this.

Dignity for Jahi.

 

[LyndyLoo]

Seems the bleeding is common... really common.
About.com Post Operative Bleeding After Tonsillectomy

Sure..Blood loss or drainage can for laypeople seem like a TON of blood..BUT when a patient loses enough blood to cause Cardiac arrest does NOT compare to that at all..And I have actally watched bleed outs..feeling helpless..its like trying to stop a flood water entering your house..or boat..It's just something that most dont understand..Boat water..House leaks..Bleeding noses....THIS experience IF ever watched by laypeople would be totally flabberghasted....

Blood volume - Wikipedia, the free encyclopedia

Humans[edit]A typical adult has a blood volume of approximately between 4.7 and 5 litres, with females generally having less blood volume than males.[1] Blood volume is regulated by the kidneys.

Blood volume (BV) can be calculated given the hematocrit (HC; the fraction of blood that is red blood cells) and plasma volume (PV):




The body has basically only 4- 5 liters..which basically varies just over I gallon in Jahi case> a 13 year wasnt a BIG HUlk of a person..( actual calulations varies but about BUT cause and affect led to Cardiac arrest.....Think about your purhase of 1 gallon of gas..and visualize that amout circulating in your body that keeps you alive...:blushing:

IF someone starts to bleed out..It doesnt take long to directly affect brain or vital organs....Thus jahi went into cardiac arrest..Lack of blood flows..lack of Oxygen...Doesnt take a PHD to realize any human body will be in DIRE circumstances..This child was in an ICU..Where was the nurses?? ICU means Intensive CARE..monitors..One on one Medical personel THERE....I am just not Buying whats been suggested by those that wish to excuse CHO for how they cared for jahi...Sorry..Too many years of experience tells me different!!

:facepalm:

 

[otto]

If there is no propulsion the feedings could back up into the esophagus and flow out of the mouth and nose and there is a good chance the liquid could enter the airway and lungs. Whether the sphincters at the esophagus to stomach border or the stomach-duodenum border are lax or contracted could make a difference as to whether feeds will pass through. Without any intestinal propulsion it seems the feeds would sit and stagnate/spoil and be further acted on by bacteria and not in a good way. I would think infection of the GI tract would be a high risk to cause rupture/perforation and would cause severe infection.

I did read an article about tube feedings in a person without peristalsis (propulsion) and there is a school of thought that very slow controlled feeds may activate hormones that effect propulsion. Whether this applies in a person who is braindead, not sure. The release/inhibition of many hormones are controlled by a feedback mechanism that requires brain function.

I do not understand how it is possible to deliver tube feedings to Jahi.

I'm beginning to wonder whether it's true, or whether the claim was made to give the illusion that the deceased is not deceased. Dr Flori's report stated that the body had sloughed off the lining of the bowel on January 2. That doesn't bode well for digestion.

 

[DairyGirl]

b b m
:facepalm: :banghead: smh

you took the words out of my mouth. A healthy dead person? Words fail me.

 

[SeekingJana]

Is a popsicle a liquid?

"Sucking" anything (ie use of straws, what one might do with a popsicle) would be discouraged after oral surgery, would that apply here as well?

I would think anything that encouraged gulping or sucking would be out of bounds but im no expert...

I've taken care of children who had extensive nasal and pharyngeal surgeries. The hospital in which I worked, which is a Level One trauma center ( meaning it is a hospital which receives the worst injuries and illnesses from other facilities) did NOT stock Popsicles.

As I have mentioned in another thread, we only had ices. Very very fine frozen juice which was thawed slightly in the microwave and then spooned into the child's mouth when appropriate. ETA: The child was never given a spoon. Either nurses or a parent who had been shown how to feed the ice to the child had the spoon.

Also, someone asked if this type of thing is a " clear liquid". YES. Because when you melt the ices I am talking about ( as well as Popsicles), you can see through the liquid. Hence, a clear liquid.

No child sucked, chomped, or spit anything due to the suction created. If they had to spit, we assisted them to turn their heads and let the fluid drain out the side of their mouths into an emesis basin or gauze, depending upon the age and amount of expectoration expected.

 

[BeginnersLuck]

Sure..Blood loss or drainage can for laypeople seem like a TON of blood..BUT when a patient loses enough blood to cause Cardiac arrest does NOT compare to that at all..And I have actally watched bleed outs..feeling helpless..its like trying to stop a flood water entering your house..or boat..It's just something that most dont understand..Boat water..House leaks..Bleeding noses....THIS experience IF ever watched by laypeople would be totally flabberghasted....The body has basically only4- 5 liters..which is basically varies just over I gallon n Jahi as a 13 year wasnt a BIG Hilk of a person... (of course it depends on Body weight) BUT cause and affect led to Cardiac arrest.....Think about your purhase of 1 gallon of gas..and visualize that amout circulating in your body that keeps you alive...:blushing:

IF someone starts to bleed out..It doesnt take long to directly affect brain or vital organs....Thus jahi went into cardiac arrest..Lack of blood flows..lack of Oxygen...Doesnt take a PHD to realize any human body will be in DIRE circumstances..This child was in an ICU..Where was the nurses?? ICU means Intensive CARE..monitors..One on one Medical personel THERE....I am just not Buying whats been suggested by those that wish to excuse CHO for how they cared for jahi...Sorry..Too many years of experience tells me different!!

:facepalm:

Then you are fully aware of how quickly someone can bleed out in a matter of minutes. She had three surgical procedures. There are major arteries in the area. Medical professionals have posted on how hard it can be to control a bleed in that area and get airway access.

Obviously, they got her heart restarted but unfortunately she lost to much blood and her brain died. You also are fully aware that even the most minor surgery, although this was not, has risks of death. You are fully aware that people die in every hospital across the nation every year due to complications, which cannot all be avoided.

We will not know what happened until we have information from her medical records if it becomes available. A hospital, including all their employees, that treats thousands of children every year shouldn't be bashed based on what this family has said. Her mother passed out during this. How much do you think she can recall? Plus it was shocking for her to see so her recollection may not be accurate.

Here is more about all the good work that this hospital does for children.

http://www.childrenshospitaloakland.org/main/about-us.aspx

It's sad, but it happens and not just at CHO!

 

[K_Z]

I continue to be puzzled why the concept of "no blood flow to the brain" is so very difficult for so many people to grasp and understand-- not just here, but in general society.

Dr. Fisher's report clearly says a rasdionuclide SPECT blood flow diagnostic test was done, with no flow. There is nothing more definitive than that, save doing an autopsy to SEE the dead brain.

When intracranial pressure exceeds blood pressure for long enough, brain tissue dies. The flow scan will show the tracer in the carotids, and not penetrating any tissue inside the skull. The tissue is not just "not perfused"-- it is not in suspended animation, waiting for blood flow-- the brain tissue is dead.

Back in another thread, a very insightful poster (I can't remember who :blushing:-- Donjeta or Beginner's Luck? ) made the analogy that if it was a finger or limb that did not have any blood flow to it for a month, it would be plainly obvious to anyone with eyes what the state of deterioration of the limb is. You can cut off a dead limb, and the person might live. But without a brain, there is no life. No possibility of recovery. At all. Ever. Functional decapitation.

There is also a rather persistent idea in a large swath of the public that when circulation stops to the brain, it goes into a state of "suspended animation". I have read many comments about waiting for "the brain swelling" to go down, and circulation will be restored, the person will wake up, etc.

It is just so puzzling to me how so many people don't have the most basic grasp of what "cell death" means. Is it because we are so urbanized as a society that a lot of people are removed from the realities of anatomy, birth, death, etc? Not to be too blunt, but why don't otherwise rational people realize that human beings will deteriorate and decompose, just like any other living organism? Have most people really never seen any kind of decomposition of a living organism? Just baffling to me.

But then, some first time moms who watch too many labor and delivery reality shows think labor happens in about half an hour! It's like we humans have urbanized and compartmentalized ourselves so much we think we are immortal, and not subject to the same laws of nature and science as any other living thing! Baffling.

 

[Quester]

'Her healing begins today': Family of [JM] say teenager is finally getting
nutrition she needs after being declared brain dead a month ago

http://www.dailymail.co.uk/news/art...tion-needs-declared-brain-dead-month-ago.html