Bobbi Kristina Brown found unresponsive in bathtub. #2

[jggordo]

I am wondering if the Doctors have not tried to wean BK off the ventilator. Others in the medical profession may have comment on this procedure but from what I have seen happen first hand it is not a pleasant experience. Causing seizure and involuntary body movement. It is not like you see it in movies, IMO. That could be where the eye movement and eyes opening comment by the Aunt came from. To see your loved one helplessly have a seizure and these movements are hard to take and may cause a directive to abort the process. Especially if there are several family members present. All in all it is a very personal and painful process and to observe it is one that you can never unsee.

JMO's

 

[K_Z]

I am wondering if the Doctors have not tried to wean BK off the ventilator. Others in the medical profession may have comment on this procedure but from what I have seen happen first hand it is not a pleasant experience. Causing seizure and involuntary body movement. It is not like you see it in movies, IMO. That could be where the eye movement and eyes opening comment by the Aunt came from. To see your loved one helplessly have a seizure and these movements are hard to take and may cause a directive to abort the process. Especially if there are several family members present. All in all it is a very personal and painful process and to observe it is one that you can never unsee.

JMO's

A person who has no respiratory effort, or who has no ability to have respiratory effort because of a dead brainstem, cannot be weaned from a ventilator at all. They are on "control" settings, not "assist/ control" or synchronized settings, pressure support, etc. They do not assist the vent, nor do they "buck" against the vent breaths.

Also, seizure activity is not an expected part of ventilator weaning. Usually, fatigue is the most prevalent part, leading to weaker effort, and the need to return to vent support to rest the person. People who are not able to have consciousness are not usually able to wean from a ventilator.

 

[K_Z]

And to add to the above, when someone is brain dead, and ventilator support is withdrawn, they usually do not make any respiratory effort at all. The physician will silence the vent alarms, and turn off the vent. (Sometimes they extubate the patient-- take out the oral endotracheal tube-- depending on whether or not the case is potentially one where all medical tubes have to be left in place for the medical examiner.)

The last breath from the vent is the last one. The patient does not struggle, or have seizures, if they are brain dead. It sometimes takes 10 min or more for the heart to stop, and compassionate caregivers turn off the monitor alarms (and sometimes the displays, too, to make the surroundings more peaceful, dim the lights, and make sure family that wants to be there are close, holding their hands, etc).

Thankfully, a brain dead person is unable to feel any distress with this process. But it can be very emotional and difficult for family to see the final stillness of their loved one, and the color drain away, even knowing they are not able to suffer.

 

[passionflower]

so many report it is just a matter of time, how long can a person live with organ failure?
what organs fail first?

 

[K_Z]

so many report it is just a matter of time, how long can a person live with organ failure?
what organs fail first?

It could be that she has developed more cardiovascular instability, blood pressure and heart rhythm difficulties. Kidneys failing, fluid and electrolyte imbalances from probable diabetes insipidis that accompanies brain death (inability to conserve body fluids, etc). Pneumonia that is progressing, etc. Blood clotting issues, inability to regulate temperature.

Could be any or all of the above, plus more. I'm guessing her body has demonstrated more cardiovascular instability, which may be prompting the news reports from earlier today.

How long can someone live with organ failure? Depends on the underlying cause, the age and previous condition of the patient (how healthy or unhealthy), and how aggressively they treat everything. If the underlying cause is brain death, probably not long.

The Jahi McMath situation is unusual, and she was only 13, so her heart was young and pretty healthy. Her cardiac arrest was witnessed, and promptly resuscitated in an ICU, so her heart presumably wasn't damaged badly.

 

[sunflowerchick]

A person who has no respiratory effort, or who has no ability to have respiratory effort because of a dead brainstem, cannot be weaned from a ventilator at all. They are on "control" settings, not "assist/ control" or synchronized settings, pressure support, etc. They do not assist the vent, nor do they "buck" against the vent breaths.

Also, seizure activity is not an expected part of ventilator weaning. Usually, fatigue is the most prevalent part, leading to weaker effort, and the need to return to vent support to rest the person. People who are not able to have consciousness are not usually able to wean from a ventilator.

KZ, while I appreciate your medical expertise, especially on other threads, I wonder how you seem to have such intimate knowledge of THIS particular patient? Have you examined BK? Have you seen the medical records? Do you know first-hand that what you are putting out there as "fact" really is fact? For all we know, BK is sitting in the bed eating breakfast. The truth is we just don't know.

 

[leah]

KZ, while I appreciate your medical expertise, especially on other threads, I wonder how you seem to have such intimate knowledge of THIS particular patient? Have you examined BK? Have you seen the medical records? Do you know first-hand that what you are putting out there as "fact" really is fact? For all we know, BK is sitting in the bed eating breakfast. The truth is we just don't know.

I don't think K_Z has said she has ever examined BK. I think that K_Z is taking time out of her busy life to explain this topic, for those of us that have no medical experience. I for one appreciate it, and look forward to her explaining, I have learned from this, and with that said, thank-you.

 

[K_Z]

I forgot to mention in post 663 that any IV drips and pumps are also turned off, usually before the vent is turned off. All monitors are silenced or turned off, to put the focus on the patient, and not the machines. Turning off the vent and removing the oral ETT is usually the last step.

They will get as much medical equipment off the patient as possible, to humanize him or her, change them into clean gown, clean bedclothes, maybe use a personal blanket on top. Removing the leg pumping "sequential compression devices", taking off most of the blood pressure cuffs or arterial lines, removing nasogastric tubes, pulse oximeters, intracranial pressure monitors, etc.

The nurses usually take great pains to make the situation as peaceful and non-medical as possible for the family, and help the dying patient look as normal as they can for the sake of the family. It's kind of a sacred duty, to shepherd someone's last moments.

Most ICU staff are very compassionate people. Sometimes they will even ask family if they would like to preserve a lock of hair, or take handprints, or last personal photos.

ICU's are busy places, but most staff never forget the humanity and exquisite personal nature of helping people and their families in such a sad time. We hope to make the last memories for the family dignified and peaceful, in contrast to the chaos and uncertainty of the days or hours leading up to the decision to withdraw care. Hope that explains the process better to anyone who is curious, and hasn't had to experience it.

 

[K_Z]

KZ, while I appreciate your medical expertise, especially on other threads, I wonder how you seem to have such intimate knowledge of THIS particular patient? Have you examined BK? Have you seen the medical records? Do you know first-hand that what you are putting out there as "fact" really is fact? For all we know, BK is sitting in the bed eating breakfast. The truth is we just don't know.

Of course, I have no first hand knowledge. I've stated many times that this is my professional and personal opinion from what I've heard in the news. Anyone is free to disagree with me. I kind of doubt BK is sitting up eating breakfast, or the family surely would share that joyous news.

She's only 21 years old. I'd be very glad to be wrong.

The speculation we engage in here is no different from the speculation of the msm, many of whom have printed that she is quite ill, brain dead, and near death. My speculation is not wildly different from that.

Also, please note that in my post you quoted, I used general terms, and not BK's name in particular. I was explaining what it means to wean from a ventilator, and under what circumstances that can be accomplished. If a patient is brain dead, they are physiologically and biologically unable to wean from a ventilator. My explanations are intended to explain the "usual" course of events in an ICU, with a patient in a situation like BK. Such as my earlier post about no permanent tracheostomy being performed after 2 weeks of oral intubation. If they placed a trach, we would be hearing that from some of the family, I'm sure.

 

[katydid23]

KZ, while I appreciate your medical expertise, especially on other threads, I wonder how you seem to have such intimate knowledge of THIS particular patient? Have you examined BK? Have you seen the medical records? Do you know first-hand that what you are putting out there as "fact" really is fact? For all we know, BK is sitting in the bed eating breakfast. The truth is we just don't know.

I highly doubt she is sitting in bed eating breakfast.

 

[kimi_SFC]

KZ, while I appreciate your medical expertise, especially on other threads, I wonder how you seem to have such intimate knowledge of THIS particular patient? Have you examined BK? Have you seen the medical records? Do you know first-hand that what you are putting out there as "fact" really is fact? For all we know, BK is sitting in the bed eating breakfast. The truth is we just don't know.

With all due respect, K_Z has been sharing her vast wealth of knowledge in response to questions, discussion and information that has been released via the media - all of which we have been discussing on this thread since Day One.

As a fellow health care professional, involved in direct patient care and health information technology, your post made me do a double take.

K_Z has done nothing more than educate us, and I thank her for doing so in a superb fashion. I learn something from her every day.

:cow:


Sent from my iPhone using Tapatalk

 

[sunflowerchick]

I don't think K_Z has said she has ever examined BK. I think that K_Z is taking time out of her busy life to explain this topic, for those of us that have no medical experience. I for one appreciate it, and look forward to her explaining, I have learned from this, and with that said, thank-you.

My problem is that many here are now assuming that this is exactly what is going on with BK at this very moment and the truth is we don't know. I appreciate KZ's knowledge of what MIGHT happen or what MIGHT be the situation but the truth is we don't know. Like I said, for all we know BK could be sitting there eating some breakfast. It is wrong to assume she is brain dead or that her organs are shutting down. We don't know because nothing official has been released. KZ can offer speculation and that is appreciated. But it is just that...speculation.

 

[sunflowerchick]

I don't mean to offend anyone. I am just tired of the conjecture about BK's status. Without having some official release from the hospital, the family, anyone, we don't know BK's status and to sit here and speculate in such a negative manner is wrong IMO. With that, I am taking a break.

 

[Mrs G Norris]

Beautiful home, I could get lost if I wanted to, very easily. I don't know but, I doubt if Lomas would be watching every move that Nick was making.

Goddammit, that would only get us a unit here!!! Agree, nice place though

See how the master bath is like a spa, I wonder if she wasn't literally face down, but sort of curled on her side with her face underwater, that would make a bit more sense you know, because by the look of that bath it wouldn't really be possible. Unless she wasn't using the master suite, and was in the other tub .. I think the face down thing is a bit unusual myself.

 

[leah]

Since we have nothing solid, I guess what is left but speculation? I can't imagine the poor girl will come out of this and be fine, and yes, I'm speculating.

 

[katydid23]

My problem is that many here are now assuming that this is exactly what is going on with BK at this very moment and the truth is we don't know. I appreciate KZ's knowledge of what MIGHT happen or what MIGHT be the situation but the truth is we don't know. Like I said, for all we know BK could be sitting there eating some breakfast. It is wrong to assume she is brain dead or that her organs are shutting down. We don't know because nothing official has been released. KZ can offer speculation and that is appreciated. But it is just that...speculation.

I think there is ZERO possibility that BK is sitting up eating breakfast. ZERO.

It is pretty obvious, from what little has been released, that BK was under water for long enough for her brain to swell. That right there is a big problem. And we have been told that she is still on the vent and is still in a coma. So it sounds as though she is probably heavily brain damaged.JMO

 

[tlcya]

It is my opinion that Bobby Brown has zero control over BK's monthly allowance. She is a legal adult. So the fact that he is her father is irrelevant. Unless she herself or a court has named him the guardian of her estate he can't direct her money be spent in ANY way. Even for her health care needs.

Now as her closest living relative, in the absences of a POA for healthcare or a guardian of her person he IS the person her medical caregivers will likely be listening to. He is her next of kin and therefore the logical person to make those decisions. But the money? Nope I feel confident he has no direction or control over even so much as her monthly allowance absent a court order giving it to him. MOO IMO JMO and so forth and so on.

 

[K_Z]

I don't mean to offend anyone. I am just tired of the conjecture about BK's status. Without having some official release from the hospital, the family, anyone, we don't know BK's status and to sit here and speculate in such a negative manner is wrong IMO. With that, I am taking a break.

It's ok. I'm not offended. This is very tough stuff to discuss. I'm a realist, a pragmatist. It's hard for me to engage in false hope, given all we know and have been told, and what I personally know from 30+ years in health care.

I hope you'll come back.

 

[passionflower]

Of course, I have no first hand knowledge. I've stated many times that this is my professional and personal opinion from what I've heard in the news. Anyone is free to disagree with me. I kind of doubt BK is sitting up eating breakfast, or the family surely would share that joyous news.

She's only 21 years old. I'd be very glad to be wrong.

The speculation we engage in here is no different from the speculation of the msm, many of whom have printed that she is quite ill, brain dead, and near death. My speculation is not wildly different from that.

Also, please note that in my post you quoted, I used general terms, and not BK's name in particular. I was explaining what it means to wean from a ventilator, and under what circumstances that can be accomplished. If a patient is brain dead, they are physiologically and biologically unable to wean from a ventilator. My explanations are intended to explain the "usual" course of events in an ICU, with a patient in a situation like BK. Such as my earlier post about no permanent tracheostomy being performed after 2 weeks of oral intubation. If they placed a trach, we would be hearing that from some of the family, I'm sure.

I appreciate everything you have done to educate us hat have no idea what is taking place. We never had to experience this. All my loved ones left us before this phase. My husband and I chose to go to a lawyer years ago for a living will giving our children the permission to let us go. They will never have to make a decision........we hope.

 

[MsFacetious]

Speculating is what we DO at Websleuths.

When a child is missing we don't KNOW what happened because they are MISSING.
When a murder happens we don't KNOW what happened because we weren't there.
When a plane goes missing and is never found, we don't KNOW what happened.
We speculate on what may have happened until we know for sure (if we ever do.)

I do not understand why the sudden objection with speculation.
Unfortunately that is just what we have to do here.
We don't HAVE any facts.

However, I am pretty confident that if BK was recovering... her Dad would share that.
I think if his daughter was NOT dying he would immediately correct that.
Just as he has come out and said certain people don't know what they are talking about.

If she was not brain dead, not comatose, not on a ventilator he would have said that.
He would have come out and said "Her condition has been grossly exaggerated."
Or "She is sitting in bed eating breakfast right now, she is fine."

I don't believe for a second he would allow such grossly incorrect reports to continue.
The LACK of a correction lends credibility to what we have heard about her condition.
For NOW that is all we have to work with. Probability. :twocents: