Family wants to keep life support for girl brain dead after tonsil surgery #7

[joypath]

I don't think that the body will heal while on the vent- just continue to decompose. The hormones aren't
there without the brain for healing.

I do wonder if the family did something and they think that healing will happen and hide whatever happened.

BBM: At the initial insult to the human body, the "repair process" will continue while oxygenated blood is circulating. The mitochondria of the cells are "programed" to "do their thing"...thrombocytes to aid in clotting, leukocytes to attack bacteria/or virus, osteocytes as fat metabolism & lymphopoiesis, etc....BUT this activity will NOT go on forever as brain stem function is needed to coordinate. At this point given the anecdotal documentation of Heidi Flori, M. D. (http://media.nbcbayarea.com/documents/HeidiFlori.pdf) , the slow deterioration of Jahi's body is occurring over time since that 1/2/2014 evaluation. My humble opinion.

Given the repair process occurring during the CHO stay, there's a strong probability that little if any evidence of healing would remain as it was on the soft tissue (vs the "remodeling" healing of bones (http://depts.washington.edu/bonebio/ASBMRed/growth.html , Bone remodeling - Wikipedia, the free encyclopedia), or an external scar of tissue harder tissue (that not bathed in liquid/or autolytic enzymes) (http://www.stomawise.co.uk/types-of-stoma/external-scar-tissue)

I'm believing that the INSURANCE carrier of CHO will provide a settlement, HOPING that they don't but......

 

[Nore]

RSBM: Poor little Jahi's brain has not had blood supply since 12/9/13.

--------
Hi, the way it was told to me when the brain is dead once it is dead the blood may start flowing again (as my sons did) but with the brain dead it will not respond. The brain is "gone" so to say. My sons was 5% infarction. It was a very important part of the brain stem, thus he was a quad.. The rest of his brain was crystal clear which Jahis' is not. Hers is completely dead. he played games with his daughter (my Amy) responding correctly with his eyes. If the brain is totally dead there is no response. So her heart will beat, machine will breathe, maybe tissues mend but she cannot get well. She cannot think for herself as her brain is dead. The neurosurgeons at Cleveland Metro General explained it to me along with his Doctor.The rest of the body functioned fine as that part of HIS brain was alive, This poor child God Bless her, she is gone if not for that machine. :seeya:

 

[K_Z]

(I kind of feel like we have discussed this many times already, but since there are some folks new to the discussion here, I'll link some info once more. I'd like to recommend the old threads as a great source for new readers looking for more info.)

This is a really fascinating discussion by a physician who is also an organ procurement surgeon, who is a woman, and a mom. The whole article is lengthy, but worth the read, IMO. Very thought provoking and poignant.

http://www.vqronline.org/articles/2005/fall/chen-dead-enough/

There is a belief in medicine that the pathologist has the final say and that in death there is truth. The truth in brain death is mind-boggling. While normal brain tissue is firm, a brain that has been dead shows progressive autolysis, a form of biological self-destruction. “It will almost be like soup,” Dr. Harry Vinters, chief of neuropathology at UCLA, recently explained to me. He is the co-author of a major textbook on the pathology of the brain and has performed almost a hundred autopsies on the brain-dead. “It really depends on how long they have been on the ventilator. If they have been on the ventilator for two days, then the brain is grey and softened. But if, for example, a family has had difficulty deciding what they want to do and the patient has been kept on the ventilator for two to three weeks, then there’s tremendous autolysis. The brain gets very swollen, soft, and mushy.” The nerve tissue can become so friable that fragments of brain from the head will break off and float down the spinal column. “Sometimes I’ll be looking at a slide of the spinal cord,” says Vinters, “and I’ll see fragments of cerebellum floating around in the specimen.”

It's also worth mentioning that the brain meninges will contain the deteriorated brain tissue, so unless there is some trauma, it's unlikely there would be leakage from the nose or ears. Someone upthread questioned that.

Suffice to say that the body that remains on the ventilator will undergo a progressive, and relentless deterioration in all body systems. Some areas will deteriorate and fail faster than others. Jahi's body from Dec 12 onward has not received the type of aggressive support that, for example, a brain dead pregnant woman might receive. We can expect her organ systems to be in worse shape than, say, the woman in Texas who is brain dead and pregnant.

Dr. Fiori's statement to the court from about 10 days ago illustrates what Jahi's body's condition was at that time. We have no rational reason to believe that there is any improvement from the time of that report. (Link to the report at the beginning of this thread.)

 

[Madeleine74]

K_Z,

I read, with great mirth, your extraordinary efforts to "revive" your teen daughter to arise and clean her room and attend to other sundry tasks.

I believe I have found the diagnosis for this condition and sadly the prognosis is poor: selective hearing.

My dog (RIP) suffered from this syndrome and my cat is afflicted too. I understand it started in the teen population in early Egyptian times and spread from there and then jumped to canid and feline populations.

Symptoms include: turning of the head away when one's name is called, feigning deafness, feigning incomprehension of the native language, pupils slightly dilated yet hidden under heavy lids, feigned sleep escalating to feigned coma, inattention, to name a few.

 

[Yoda]

There has been a whole bunch of editing going on with the wiki link on brain death since this fiasco started.

See history:

http://en.wikipedia.org/w/index.php?title=Brain_death&action=history

Looks like people have been trying to purposely alter it or vandalize it. (I don't know the proper term to use when this happens)

BBM. Troll it?

Griefing.

"Griefers are similar to trolls, with the main difference being that griefers will sometimes act in groups, in the form of tag team editing, to deliberately ridicule content on Wikipedia with which they disagree, to ridicule and harass editors associated with that content, and to interfere with the normal workings of the project. "

Oh the things I've learned from Minecraft ropeller:

 

[Yoda]

(I kind of feel like we have discussed this many times already, but since there are some folks new to the discussion here, I'll link some info once more. I'd like to recommend the old threads as a great source for new readers looking for more info.)

This is a really fascinating discussion by a physician who is also an organ procurement surgeon, who is a woman, and a mom. The whole article is lengthy, but worth the read, IMO. Very thought provoking and poignant.

http://www.vqronline.org/articles/2005/fall/chen-dead-enough/



It's also worth mentioning that the brain meninges will contain the deteriorated brain tissue, so unless there is some trauma, it's unlikely there would be leakage from the nose or ears. Someone upthread questioned that.

Suffice to say that the body that remains on the ventilator will undergo a progressive, and relentless deterioration in all body systems. Some areas will deteriorate and fail faster than others. Jahi's body from Dec 12 onward has not received the type of aggressive support that, for example, a brain dead pregnant woman might receive. We can expect her organ systems to be in worse shape than, say, the woman in Texas who is brain dead and pregnant.

Dr. Fiori's statement to the court from about 10 days ago illustrates what Jahi's body's condition was at that time. We have no rational reason to believe that there is any improvement from the time of that report. (Link to the report at the beginning of this thread.)

I know we sometimes have media only threads for a case, but this situation calls for a medical reference thread. JMO

 

[Isabelle]

Ok so when these medical experts who have been quoted in various articles claim that Jahi's body is "looking bad" and "will continue to deteriorate over time" what exactly are they referring to?

According to the nurses on this board, Jahi's body will essentially stay intact as long as her cells are receiving O2 and CO2 is being removed from her system. Is it safe to assume Jahi could still be on a ventilator 6 months from now with little physical breakdown because her cells are being mechanically oxygenated?

Over time muscle will breakdown due to non-use, contractures will occur. Fatty layer will break down leading to a greater chance for bedsores. She cannot move and tube feedings, IVs will provide maintenance barely. This is breakdown, not the same as decomposition.

 

[ArianeEmory]

There has been a whole bunch of editing going on with the wiki link on brain death since this fiasco started.

See history:

http://en.wikipedia.org/w/index.php?title=Brain_death&action=history

Looks like people have been trying to purposely alter it or vandalize it. (I don't know the proper term to use when this happens)

It actually looks pretty calm to me, compared to other controversial pages I've followed. And the higher-level editors can lock a topic for anonymous editing when the trolls start getting nuts. (e.g, pages related to the Holocaust often get locked, Paul Walker's article got locked when it was still being determined if his death was a hoax, etc.)


Sent from my iPad using Tapatalk HD

 

[Wolfie]

I know we sometimes have media only threads for a case, but this situation calls for a medical reference thread. JMO

This might be a good idea, but it might be hard to keep up with since these threads move so fast.

 

[joypath]

(I kind of feel like we have discussed this many times already, but since there are some folks new to the discussion here, I'll link some info once more. I'd like to recommend the old threads as a great source for new readers looking for more info.)

This is a really fascinating discussion by a physician who is also an organ procurement surgeon, who is a woman, and a mom. The whole article is lengthy, but worth the read, IMO. Very thought provoking and poignant.

http://www.vqronline.org/articles/2005/fall/chen-dead-enough/



It's also worth mentioning that the brain meninges will contain the deteriorated brain tissue, so unless there is some trauma, it's unlikely there would be leakage from the nose or ears. Someone upthread questioned that.

Suffice to say that the body that remains on the ventilator will undergo a progressive, and relentless deterioration in all body systems. Some areas will deteriorate and fail faster than others. Jahi's body from Dec 12 onward has not received the type of aggressive support that, for example, a brain dead pregnant woman might receive. We can expect her organ systems to be in worse shape than, say, the woman in Texas who is brain dead and pregnant.

Dr. Fiori's statement to the court from about 10 days ago illustrates what Jahi's body's condition was at that time. We have no rational reason to believe that there is any improvement from the time of that report. (Link to the report at the beginning of this thread.)

BBM: and to add a decomposition synopsis:
To begin with, when your HEART stops beating, your body's CELLS & TISSUES STOP RECEIVING OXYGEN (O2). Brain cells are the first to die -- usually within three to seven minutes. (Bone and skin cells, though, will survive for several days.) Blood begins draining from the capillaries, pooling in lower-lying portions of the body, creating a pale appearance in some places and a darker appearance in others (livor mortis)(Livor mortis - Wikipedia, the free encyclopedia)
About three hours after cardiac death, rigor mortis Rigor mortis - Wikipedia, the free encyclopedia-- a stiffening of muscles -- sets in. Around 12 hours after death, the body will feel cool, and within 24 hours (depending on body fat and external temperatures), it will lose all internal heat in a process called algor mortis Algor mortis - Wikipedia, the free encyclopedia. The muscle tissue begins to lose its stiffness after about 36 hours, and within about 72 hours of dying, the body's rigor mortis will subside.

In this case, O2 is being provided via the vent mechanism thus an individual STILL WITH O2 circulating is NOT "decomposing" in the classic sense but the human body will begin deteriorating.

Think a balloon on a helium cylinder but the balloon has a pinpoint leak at the tie lip. One can pump/push helium & the balloon stays inflated but "wimpy" (deteriorating) 'til the tank runs out, THEN the balloon sags & goes limp, falling off (decomposing)

 

[Nore]

Can't remember anything from Flori re skin changes. Her bowel sloughing may be due to severe hypoxia/anoxia at the time of her cardiac arrest. And some of the skin changes could be due dependent edema and breakdown bit has nothing to do with decomp.

-------------
Hi Isabelle, Flori did mention she is becoming malodorous. That is not good, not good at all. I must mention I feel so sorry for the Nurses caring for her. I know people will say oh that is their job but I personally think this is above and beyond:loveyou:

 

[Minette]

K_Z, thank you for reiterating what brain death actually means. I just can't get past the thought of what is going on inside Jahi's skull. Sure, she might look OK on the outside but all that is left is a mindless body. They cut holes in her throat and abdomen and are pumping stuff into her while her brain liquifies. I just find this unspeakably horrifying.

And I know some people think her soul is still tied to her body but to me that would be even worse--I visualize (and I'm sorry but I'm an artist and I think in imagery) a little bird trapped in a vessel sinking into water frantically beating its wings against its prison but being held in place by a loving hand trying to give it seeds.

Whew, I guess I needed to get that off my chest. Take that, science brains!

 

[nrdsb4]

OK I have to say it, brain death is not the same as actual death. Read here for explaination: Brain death - Wikipedia, the free encyclopedia She is not going to decompose while on the ventilator, nor is her brain actually breaking down.

BBM

I would never reference Wikipedia as any authority given that it is subject to editing by readers.

Secondly, your last assertion is completely at odds with what I have read about brain breakdown after cessation of blood flow. Consider the quote below referenced by K_Z:

http://www.vqronline.org/articles/20...n-dead-enough/

Quote:
There is a belief in medicine that the pathologist has the final say and that in death there is truth. The truth in brain death is mind-boggling. While normal brain tissue is firm, a brain that has been dead shows progressive autolysis, a form of biological self-destruction. “It will almost be like soup,” Dr. Harry Vinters, chief of neuropathology at UCLA, recently explained to me. He is the co-author of a major textbook on the pathology of the brain and has performed almost a hundred autopsies on the brain-dead. “It really depends on how long they have been on the ventilator. If they have been on the ventilator for two days, then the brain is grey and softened. But if, for example, a family has had difficulty deciding what they want to do and the patient has been kept on the ventilator for two to three weeks, then there’s tremendous autolysis. The brain gets very swollen, soft, and mushy.” The nerve tissue can become so friable that fragments of brain from the head will break off and float down the spinal column. “Sometimes I’ll be looking at a slide of the spinal cord,” says Vinters, “and I’ll see fragments of cerebellum floating around in the specimen.”

If that's not the brain "breaking down," I don't know what is.

 

[katydid23]

Didn't one of the verified nurses on this site say that the tonsil suction device is not normally in an PICU room, and a nurse would have had to bring it to them?

I think this could potentially be a huge problem for CHO. If a nurse handed the suction device to one of the family, then they will likely lose this case in court, imo.

 

[katydid23]

Thank you, Isabelle. I needed a visual of how that worked.

I can't imagine any hospital employee requesting the family or patient use the suction device themselves. What I envision occuring is NW or MW taking it upon themselves to use the suction device for what was a normal combination of blood and mucous while the nurses were out of the room. There must have been a sudden increase in the blood at which time NW fainted and was taken out of the room.

Then only after NW was taken out of the room was grandma allowed to see Jahi. She came in after the fact, imo. I believe she would have stopped NW and MW from suctioning Jahi had she been in the room when they first started.

I think that's why we are getting the info we are from OS and the family has forbid the hospital from releasing info.


Sad all around.

I think this all occured while only NW and Jahi's step dad, MW, were in the room.




Thank you,

But would they know how to use that device and what it was for? It seems so odd to me that layman would grab a medical tool from the wall and begin to use it on a child who was post-op. It makes more sense to me that Grandma might do so, since she would know how to use it and know its purpose. Just pure peculation on my part though.

 

[Zuri]

Most of the ICUs I have seen have individual room with glass doors that can close. I think the rooms are all visible to most of the staff. It may be a 23 bed unit, but I do not believe it would be set up like one big bay with curtains. I could be totally wrong. Infection control is big. There are curtains to provide privacy. JMOO

 

[Marg from Oz]

http://www.latimes.com/local/lanow/...ilator-20140113,0,3203320.story#axzz2qIfdrUJI

eta look at the 9am comment by G

LOL Nearly went blind looking for it. It was on page three.

Sounds like that was the way it went down.

 

[Marg from Oz]

I know this is complete speculation but I have a few questions as to what may happen down the road once Jahi does pass.

Do you think CHO/insurance will settle once a lawsuit is filed?

If they are using this case to "up the ante" of the $250k cap, won't that in essence be a moot point for Jahi's family? The law is what it is at the time of her death - so why would changes in the law affect them getting more $?

What if CHO refuses to settle? What if they take the stance that they are not going to let this be a pinnacle for future lawsuits and fight it every step of the way?

Who will Jahi's family turn to for compensation then? The facility who took her? The lawyer? Stating that they were represented on false pretenses of his desire to increase the cap?

Also - I had read on another thread where someone speculating that once her death certificate was issued her social security # would be flagged as deceased and that any and all medical assistance or coverage would cease. Does anyone know if that's true? And if the state isn't going to pick up any potential bills will the family be responsible for that enormous bill? I guess that of course is assuming that this all won't be covered 100% by "donations" by the facility, doctors, etc.

:dunno:

iirc the death certificate was an interim certificate only. Full death certificate will be issued and registered after the autopsy. Let me know if I'm incorrect.

 

[neesaki]

Interesting article FWIW:

Dr. Paul Byrne, a pediatrician and former president of Catholic Medical Association, says in court documents that he visited Jahi’s bedside and observed her responding to her grandmother’s voice and touch with a squirming movement. That’s another indication that Jahi’s brain is still functioning. Calling her “brain dead”, while her brain is demonstrably alive and working, seems more like a gimmick, similar to how unborn babies and slaves have been called “non-persons”.

http://www.traditionalcatholicpries...on-jahi-mcmath-dr-paul-byrne-and-brain-death/

 

[katydid23]

Interesting article FWIW:



Quote:
Dr. Paul Byrne, a pediatrician and former president of Catholic Medical Association, says in court documents that he visited Jahi’s bedside and observed her responding to her grandmother’s voice and touch with a squirming movement. That’s another indication that Jahi’s brain is still functioning. Calling her “brain dead”, while her brain is demonstrably alive and working, seems more like a gimmick, similar to how unborn babies and slaves have been called “non-persons”.


http://www.traditionalcatholicpries...on-jahi-mcmath-dr-paul-byrne-and-brain-death/

:thud: :thud: :thud: :thud: :thud: :thud: :thud: :thud: