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

[Herat]

IMO my opinion... If you tossed a brain dead patient into a large room full of unconscious ICU patients it would be incredible hard, if not impossible, for any lay person to single her out.


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And that's why there are highly trained and experienced physician specialists and expensive highly complicated equipement, and validated documented criteria to distinguish the functional levels of "unconscious ICU patients".

If we didn't need this kind of expertise and investigation, I guess we could have the janitors or hairdressers deciding on care and not need all those expensive physicians and ICU nurses.....

I'd like to also point out that there a probably 157,000 medical diseases that are not apparent to the lay person and that's why we have physicians, examinations, laboratory, functional, and imaging testing......

 

[Leilei]

Once JM was released by the coroner's office into the care of the family/new facility, would any impartial medical professional continue to visit JM? To impartially document her condition? TIA

Very doubtful, with the family's seeming distrust of any medical professional who doesn't believe that Jahi is alive. Would love an impartial report, though... well, not "love", but would be interested to see an impartial view into her current state.

I think the majority realize what that state is, though, sad as it is.

 

[BeginnersLuck]

Here is a simple slide show, that explains what takes place in determining brain death.

Criteria of Brain Death

eta: click on the "Criteria of Brain Death" wording at the top of the display, to access the slide show.

 

[popsicle]

IMO my opinion... If you tossed a brain dead patient into a large room full of unconscious ICU patients it would be incredible hard, if not impossible, for any lay person to single her out.


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And that's why there are highly trained and experienced physician specialists and expensive highly complicated equipement, and validated documented criteria to distinguish the functional levels of "unconscious ICU patients".

If we didn't need this kind of expertise and investigation, I guess we could have the janitors or hairdressers deciding on care and not need all those expensive physicians and ICU nurses.....

I'd like to also point out that there a probably 157,000 medical diseases that are not apparent to the lay person and that's why we have physicians, examinations, laboratory, functional, and imaging testing......

I would add that it also depends on how long they have been brain dead. jmo

 

[Linda7NJ]

And that's why there are highly trained and experienced physician specialists and expensive highly complicated equipement, and validated documented criteria to distinguish the functional levels of "unconscious ICU patients".



If we didn't need this kind of expertise and investigation, I guess we could have the janitors or hairdressers deciding on care and not need all those expensive physicians and ICU nurses.....



I'd like to also point out that there a probably 157,000 medical diseases that are not apparent to the lay person and that's why we have physicians, examinations, laboratory, functional, and imaging testing......

Agree totally.

But while many have contributed a wealth of information from a verified medical standpoint and have consistently pointed out the misleading and inflammatory words Dolan has used...

Little has been said to educate and much has been very misleading on the other side as well. ....to the point that some posters believe her body is laying there, a rotting smelly corpse decomposing before her mothers eyes.




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[Wolf Dreamer]

I was wondering about that too, somewhat surprised that nail polish was allowed during surgery, or whether was that applied afterward, after the surgery?

The report from Flori observes that the nurses, amongst other things, had been giving Jahi manicures, so I'm thinking it's been done post-op

 

[threecrazykids]

And that's why there are highly trained and experienced physician specialists and expensive highly complicated equipement, and validated documented criteria to distinguish the functional levels of "unconscious ICU patients".

If we didn't need this kind of expertise and investigation, I guess we could have the janitors or hairdressers deciding on care and not need all those expensive physicians and ICU nurses.....

I'd like to also point out that there a probably 157,000 medical diseases that are not apparent to the lay person and that's why we have physicians, examinations, laboratory, functional, and imaging testing......

I just have to say that you and I must have the same sense of humor because every time I read your references I can't help but laugh.
:floorlaugh:

 

[BeginnersLuck]

Agree totally.

But while many have contributed a wealth of information from a verified medical standpoint and have consistently pointed out the misleading and inflammatory words Dolan has used...

Little has been said to educate and much has been very misleading on the other side as well. ....to the point that some posters believe her body is laying there, a rotting smelly corpse decomposing before her mothers eyes.




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I don't think there is a whole lot of information out there about conditions of brain dead after a month. It would also vary from body to body and what kind of treatments have been used to maintain the illusion.

I have questions about heath hazards to others, concerning bodily fluids, etc.

 

[Herat]

I don't think there is a whole lot of information out there about conditions of brain dead after a month. It would also vary from body to body and what kind of treatments have been used to maintain the illusion.

I have questions about heath hazards to others, concerning bodily fluids, etc.

I have no doubt that from across the room she looks "ok", and her skin feels "warm".

However, once the sacrococcygeal skin starts to break down and get infected, or some oozing of secretions happens, it will become more apparent in an olfactory way that things are not right. I just depends on the particular bacterial or fungal infections going on.

I think most healthcare providers here could agree you can tell from across the room who the person with the gangrenous leg is. I'm not at all saying her skin is like that, but we have multiple senses and you can maybe fool yourself visually, but then touch (body tone and turgor), temperature perception, and smell start to tell you something different....

At some point the family has to accept that they don't get to keep her like Madame Tussaud wax figure or the embalmed and very carefully maintained bodies of Lenin, Stalin, Ho Chi Minh in a mausoleum, either.

 

[Donjeta]

Agree totally.

But while many have contributed a wealth of information from a verified medical standpoint and have consistently pointed out the misleading and inflammatory words Dolan has used...

Little has been said to educate and much has been very misleading on the other side as well. ....to the point that some posters believe her body is laying there, a rotting smelly corpse decomposing before her mothers eyes.




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From Flori's report it sounds to me like there is something going on that could be termed decomposition as things begin to slowly break down. It was mentioned that her skin has started to lose texture and the possible sloughing off of her intestines didn't sound too healthy either. Her brain will not look at all what it looked like a month ago. It is said that brain dead brains liquefy. There might be other cells and tissues dying because of perfusion defects. But if people are imagining that she's already in rigor mortis, collecting flies they would be wrong. The circulation maintains the illusion of life to some degree.

 

[K_Z]

People are free to believe in prayers and miracles but an expectation of a miracle is not a medical indication to continue treatment of a deceased person. It is a religious thing, so perhaps there are churches who'd like to step up and provide this for the people believing that a miracle will happen, but it is not a job for the hospitals.

This quote from a Catholic theology site sums it up imo.

http://catholicmoraltheology.com/what-are-we-learning-from-the-jahi-mcmath-case/

God chooses to resurrect brain dead people very infrequently and there is no brain scan or a lab test that would let hospitals know that He is going to raise Jahi McMath from the dead with any larger probability than any other brain dead person.
JMO.

Very respectfully snipped, BBM and colored blue.

IMO, Donjeta, you are a very, VERY wise person.

Indeed, there is no ICD9 code for "brain death, with expectation of resurrection, NOS".

All my smilies are not working, but you get my vote for best post of the day. (Maybe best post of the thread!)

Thank you!

 

[Quester]

Warning: Don't do Google search for images of "sacrococcygeal" while eating! JMHO

 

[Isabelle]

Not an expert on feeding brain-dead people, but my guess is that it will ultimately do more harm than good.

Agree. Not sure about general decomposition with oxygen provided for cellular activity.

 

[dh109977]

I was thinking back to when my mom had her final stroke. It happened in the nursing home sometime through the night Fri into Sat. She was rushed to the hospital Sat and stayed until Wed when the second set of results came back and said that she had a massive stroke. Her brain was damaged and only her brain stem was functioning. She had a living will so we didn't have the whole ventilator issue. We moved her a different room in the hospital and we were waiting for hospice the next morning. But then I looked at the bag sorry for my incorrect name but the urine bad. It was empty. I asked the nurse when the last time she emptied it was and she said it hadn't been emptied all day. So I said ok so her kidneys are clearly failing. She agreed and we stopped fluids and upped the morphine. Her breathing was so incredibly slow. We had the priest brought in and within a couple hours she passed. So I don't know if that is the norm or if she went fast. But her organs shut down fairly quickly.

So now I have to wonder if the iv they gave Jahi and now the feeding tube where is this all going. Will it just stay inside of her?

 

[Frigga]

Warning: Don't do Google search for images of "sacrococcygeal" while eating! JMHO

Ugh! Thanks for the warning... so at least I wasn't eating!

 

[Frigga]

Sorry if this is a stupid question, but is blood flowing through her body, just not to her brain (artificially, of course)?

 

[Herat]

As long as her heart is beating efficiently (as in not in fibrillation) blood will be circulating throught her body, other than her brain and brainstem. However, it doesn't mean it will be normal. As Dr. Fiori stated to the court, her blood pressure is very labile and is consistently decreasing, so the amount of blood reaching her kidneys, her liver, her bowel, her adrenal glands maybe fluctuating in ways that are causing more and more cellular damage.

We also don't have anything confirmed about the "feedings". As others have pointed out, she could simply have a "banana bag" of fluid with vitamins hooked up to an IV, she could be on Total Parenteral Nutrition, she could be getting "some" fluids through an NG or feeding tube. As K_Z so adeptly pointed out, enteral feedings really seem like the wrong thing to do in a patient whose gastrointestinal integrity and function is very questionable.

However, maybe she's gettin 1 oz q 12 hours and it has three drops of enteral formula in it with saline? Someone could call that feeding or nutrition but it certainly wouldn't meet with appropriate clincial dietetic guidelines.

I wonder if there is a clinical dietician consulting on this?

 

[aprilheeler]

Indeed, there is no ICD9 code for "brain death, with expectation of resurrection, NOS".

ICD10, though...maybe! That thing is huge!

Kidding. But I second your appreciation of Donjeta's statement--I think it was an Atul Gawande article in the New Yorker a few years ago where he said something like if his mom were dying and there was the remotest chance that a treatment would save her, no matter how unlikely, he would want her to have it regardless of all cost and effort, but that that's not how health policy is developed.

Cases like Jahi's remind me that no matter how sound the policy is, no matter how solid the evidence and wide the agreement, there are very few things that have truly universal acceptance.

 

[CHERIE.T]

Christopher Dolan @cbdlaw
Doctors are optimistic that her condition has stabilized and that her health is improving from when she was taken from CHO.


I'm not sure which is scarier, the fact that these "doctors" and others believe a dead person is "improving", or that these same people are allowed to vote. :waitasec:

:dunno:

:loveyou:

 

[Linda7NJ]

I have no doubt that from across the room she looks "ok", and her skin feels "warm".



However, once the sacrococcygeal skin starts to break down and get infected, or some oozing of secretions happens, it will become more apparent in an olfactory way that things are not right. I just depends on the particular bacterial or fungal infections going on.



I think most healthcare providers here could agree you can tell from across the room who the person with the gangrenous leg is. I'm not at all saying her skin is like that, but we have multiple senses and you can maybe fool yourself visually, but then touch (body tone and turgor), temperature perception, and smell start to tell you something different....



At some point the family has to accept that they don't get to keep her like Madame Tussaud wax figure or the embalmed and very carefully maintained bodies of Lenin, Stalin, Ho Chi Minh in a mausoleum, either.

Many of those things happen to non-brain dead but otherwise unconscious too.

I do not believe an honest assessment of her appearance to the lay person has been put forth.

My point was.... both sides of this have painted the situation to deliberately mislead. From Dolans "doing well" to posters here implying she's a visually rotting corpse.


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