Family wants to keep life support for girl brain dead after tonsil surgery #8

[K_Z]

Sorry to trouble you, but could you or someone else provide a link to the comments of "Dr. G" referenced in sentence two above? I'm looking for a way to help a friend understand why I'm so insistent that there is no recovery from brain death and that pretty much would put in pretty raw terms. It sounds similar but not identical to something else I had read. Thank you.

I'm not nore, and I don't have a link for Dr. G., but this article is easy to read, and quite clear about the changes in the brain that occur in brain death with prolonged ventilation. It's beautifully written by a procurement and transplant surgeon. (Warning- may be disturbing to some readers.) I have linked this here before.

http://www.vqronline.org/essay/dead-enough-paradox-brain-death

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.”

And this article discusses hypoxic ischemic encephalopathy (HIE), and the subsequent liquefaction of brain tissue in "respirator brain" situation (prolonged ventilation in a brain dead person).

Severe and protracted HIE damages the cortex, deep nuclei, and brainstem, resulting in brain death. If such a patient is put on the respirator, the brain (under normal body temperature) undergoes an enzymatic autodigestion which may end in liquefaction. The term" respirator brain" that has been applied in such cases is misleading because the autolysis is not caused by the respirator. The term "non-perfused brain" is more accurate. Because circulation is arrested and all metabolic activity ceases, the non-perfused brain does not show any reactive changes (inflammation, macrophages, gliosis), only autolysis. Imaging reveals hypodensity due to edema and disintegration of brain tissue without enhancement.

http://neuropathology-web.org/chapter2/chapter2aHIE.html

This picture, from the above article, demonstrates no blood flow to any brain structures within the cranium.

http://neuropathology-web.org/chapter2/images2/2-nonperfused.jpg

Causal factors in the development of “brain death” in respirator patients were analyzed in the present study. The syndrome, as manifested in the cases studied, is characterized by irreversible deterioration of nervous system function, with deepening coma and loss of electroencephalographic activity and, pathologically, by severe brain edema and softening, often with diffuse liquefaction necrosis.

http://www.sciencedirect.com/science/article/pii/S004681777380067X

 

[SailorMoon]

Jahi's surgery was not "routine". Besides a tonsillectomy, Jahi's surgery included other procedures. The scope of the surgery has been discussed several times, and medical professionals have described in detail the delicate nature of the surgery. Additionally, Jahi might have had underlying medical conditions that put her at greater risk than a well child undergoing the same surgical procedure.

Okay, then I'll restate - I could not imagine my child going in for ANY surgery, medical procedure, what have you, and not waking up. I would want to hang on. That's my thought right now. There but by the grace of God go I. I just think it would be hard to let go, but that's me and my personality. Just expressing how I would feel if I were my child. Not wanting to argue.

 

[Linda7NJ]

Okay, then I'll restate - I could not imagine my child going in for ANY surgery, medical procedure, what have you, and not waking up. I would want to hang on. That's my thought right now. There but by the grace of God go I. I just think it would be hard to let go, but that's me and my personality. Just expressing how I would feel if I were my child. Not wanting to argue.

I can certainly empathize with that feeling!


Sent from my iPhone using Tapatalk

 

[Nore]

Sorry to trouble you, but could you or someone else provide a link to the comments of "Dr. G" referenced in sentence two above? I'm looking for a way to help a friend understand why I'm so insistent that there is no recovery from brain death and that pretty much would put in pretty raw terms. It sounds similar but not identical to something else I had read. Thank you.

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nrdsb4, Hi! I heard this by watching Dr.G. she has mentione it many times during autopsies. She is Dr.Jan Garafaglia of Orlando Fla.. I will go to her site and get a link. She handled the Caylee Anthony autopsy. She is the head M.E.. I figured there may be a difference because shes' on life support. The Doctors statement was in a newspaper article. this surprised me as they insisted she have it. The article appeared after she was removed from the hospital. We are learning a lot from this case. We could use Cindy here, she's a nurse of decomposition. ROFLOL..

 

[BetteDavisEyes]

Okay, then I'll restate - I could not imagine my child going in for ANY surgery, medical procedure, what have you, and not waking up. I would want to hang on. That's my thought right now. There but by the grace of God go I. I just think it would be hard to let go, but that's me and my personality. Just expressing how I would feel if I were my child. Not wanting to argue.

I didn't suggest that you were being argumentative. I'm realistic about the facts regarding Jahi's surgery and whether or not her family truly understands the gravity of the situation. Their loved one is brain dead and will not recover. I'm a person of faith, but I don't believe in miracles. I do believe that G-d doesn't give us burdens that are beyond our ability to cope, and that is what I hope and pray for with regard to Jahi's mother and family: That they will eventually have the courage and strength to let go of their loved one and know that Jahi is with G-d.

I didn't want to lose my beloved Dad when I was only 20 years old, nor did my dear mother want to be widowed with five children so early in life. But, that was reality when my dad had lung cancer and died at age 43. My siblings and I and our mother had to deal with the situation at hand, grieve for our loved one, and move on with our lives. Presently, my siblings and I are confused and saddened that our youngest family member has multiple myeloma with a prognosis of 9-12 months. Loss isn't easy for anyone, but it's part of life. Jahi's family is having difficulty letting go. I understand and appreciate this and know that G-d will give them courage and strength to do so when they are ready. lease:

 

[ca2james]

Okay, then I'll restate - I could not imagine my child going in for ANY surgery, medical procedure, what have you, and not waking up. I would want to hang on. That's my thought right now. There but by the grace of God go I. I just think it would be hard to let go, but that's me and my personality. Just expressing how I would feel if I were my child. Not wanting to argue.

I understand how hard it is to watch a loved one to go in for surgery and die afterwards. It's a traumatic shock to the system, to suddenly be faced with this terrible, unexpected loss, and I understand wanting to deny the truth of the matter and wanting to find someone to blame. I imagine these feelings are intensified when that loved one is your child. I empathized with the family's feelings.

Then came the lawsuits, the press conferences, the organised marches and calls to the hospital, the demands for a feeding tube, and all of the lies. It's one thing to be privately grieving and in denial and it's quite another to try and force others, including the hospital, to share in that denial. I understand that grief motivated some of the family's actions but as those actions went on (and on, and on), the family seemed less stricken by grief and more money-hungry and wanting their 15 minutes of fame.

I feel like the family attempted to use and manipulate the sympathy they had. Of course a grieving person will do things that seem unreasonable or crazy but this family went well beyond reasonable limits. At this point I have a very small amount of sympathy for the mother as she's lost her child, but I'm definitely not on the family's side and I do not support their actions in any way.

 

[BetteDavisEyes]

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nrdsb4, Hi! I heard this by watching Dr.G. she has mentione it many times during autopsies. She is Dr.Jan Garafaglia of Orlando Fla.. I will go to her site and get a link. She handled the Caylee Anthony autopsy. She is the head M.E.. I figured there may be a difference because shes' on life support. The Doctors statement was in a newspaper article. this surprised me as they insisted she have it. The article appeared after she was removed from the hospital. We are learning a lot from this case. We could use Cindy here, she's a nurse of decomposition. ROFLOL..

:lol: :lol: :lol:

 

[Nore]

Hi,
hard to say what program it was on. This will give you a lot of answers. Dr.G. is still the Chief Medical Examiner at Orlando morgue. She is highly respected for her work. Hope it helps. She speaks between autopsies of many different things, it is at this time she spoke of decomp.. :loveyou:






http://index.about.com/index?q=Jan+Garavaglia+Bio&qsrc=6&o=4554&l=sem

 

[CHERIE.T]

where did my post go, ?lol

any word on her body's condition?

 

[Elley Mae]

----------
nrdsb4, Hi! I heard this by watching Dr.G. she has mentione it many times during autopsies. She is Dr.Jan Garafaglia of Orlando Fla.. I will go to her site and get a link. She handled the Caylee Anthony autopsy. She is the head M.E.. I figured there may be a difference because shes' on life support. The Doctors statement was in a newspaper article. this surprised me as they insisted she have it. The article appeared after she was removed from the hospital. We are learning a lot from this case. We could use Cindy here, she's a nurse of decomposition. ROFLOL..

bbm
:seeya: Thank you for my morning laugh that I love to start off my day with.

 

[Nore]

We have the snow again. Ice underneath it. I cant take it anymore. cold temps on top of it. We must have at least 8 or 9 inches. Lord have mercy!!lease:

 

[ca2james]

5 Questions: David Magnus on understanding brain death -

http://med.stanford.edu/ism/2014/february/5q-magnus-0205.html

I particularly liked this:

It is important that these lines {between life and death} be drawn in ways that are medically and philosophically defensible. Imagine if we decided that parents could decide when their children are mature enough to be allowed the status of adulthood. Some 40-year-olds would never get to vote or make decisions, while some 10-year-olds would. Instead, we draw a clear boundary at age 18. If a religious minority decides that patients are adults at age 13, it does not follow that the law should be different for them. Similarly, there needs to be a bright line drawn by professionals who can reliably and accurately distinguish between life and death, as we distinguish between child and adult.

 

[ca2james]

This article shows why defining brain death is so important (and why it should perhaps be called something else). Sometimes I wonder if the people who write articles like this are deliberately trying to twist words around to confuse their readers. I can't see such a tactic working, but what so I know?

Of brain death and climate change

http://www.lifesitenews.com/mobile/news/of-brain-death-and-climate-change

 

[wendiesan]

I posted more information on the thread dedicated to the Munoz case, but thought it might be relevant to what is being discussed on this thread.

On December 28th, Robyn Benson, who was 22 weeks pregnant, suffered a brain hemorrhage and has been pronounced brain dead. A C-section has been scheduled for the end of February (if all goes as hoped) at the 34th week of the pregnancy.

http://globalnews.ca/news/1130112/a...in-dead-b-c-woman-kept-alive-until-baby-born/

Dr. Randy Wax, section chief of critical care at Oshawa, Ont.’s Lakeridge Health, hospital head for organ donation, was asked to comment on the critical care which Robyn receives 24/7. There can be no guarantees of success, the body could shut down at any time.

'...“The body isn’t meant to function for prolonged periods of time after the brain is dead,” Wax said."

Mods please snip if it's too off topic.

 

[CHERIE.T]

I keep hoping I'll come here and read that she's been laid to rest. I guess her heart could beat indefinitely.

 

[killarney rose]

I've been reading al the threads about Jahi and have not posted yet. But at this point I need to voice my opinions. First, I think she should have been let go when she died. I agree with all of you.

However, these threads have turned into nothing but pure speculation about where she is and the condition of her body. It is for that reason alone that I believe in MHO it Needs to be shut down until we have real news such as an update from her her caregivers, or news that her heart has finally stopped. Again, it is MOO that this has turned into nothing but gossipy speculation (this last photo just enforces that opinion). We have no idea whether this is a person or a movie prop, nor if it is a person, the condition of the body at autopsy.It completely disrespects the memory of a beautiful little girl who should have long been laid to rest. I've seen threads closed for less. I think this one had long ago run its course.

 

[Elley Mae]

Christopher Dolan, the family's attorney, has said a medical malpractice suit is expected, but he declined to comment for this story.

http://www.mercurynews.com/ci_25042493/jahi-mcmath-is-it-safe-have-tonsil-surgery

In addition, he said, post-tonsillectomy bleeding has not necessarily been linked to poor medical procedures.

"The cause of secondary bleeding is unclear and presumably occurs without specific provocation and therefore cannot be prevented," he said.

Inpatient tonsillectomies carry a higher risk because they may be combined with other procedures, as in Jahi's case, and may involve patients with additional health issues. For instance, Baugh said, a very young child, or one with a pre-existing medical condition, such as diabetes or asthma, usually is treated on an inpatient basis.

 

[al66pine]

....these threads have turned into nothing but pure speculation about where she is and the condition of her body. It is for that reason alone that I believe in MHO it Needs to be shut down until we have real news such as an update from her her caregivers, or news that her heart has finally stopped. Again, it is MOO that this has turned into nothing but gossipy speculation ....who should have long been laid to rest. I've seen threads closed for less. I think this one had long ago run its course.

BBM SBM

Respectfully k'rose, discussing events and possibilities, or as you say, speculation, is the nature of W/S, imo.
Even w Jahi's fam not speaking to MSM or SM, in the meantime, ppl here post and link informative articles that
help the non-med-knowledgable, esp me, understand more about Jahi's situation and med issues we could encounter ourselves.
Undoubtedly this thread is spurring ppl to discuss adv. care directives, med. power of atty, and
what they would and would not want under various circumstances, etc.

I hope these discussions also lead to folks drafting and signing adv. directive, med/healthcare durable power of attorney documents approp for their individual circumstances.

JM2cts and I may be wrong. :seeya:

 

[Karmady]

Christopher Dolan, the family's attorney, has said a medical malpractice suit is expected, but he declined to comment for this story.

http://www.mercurynews.com/ci_25042493/jahi-mcmath-is-it-safe-have-tonsil-surgery

In addition, he said, post-tonsillectomy bleeding has not necessarily been linked to poor medical procedures.

"The cause of secondary bleeding is unclear and presumably occurs without specific provocation and therefore cannot be prevented," he said.

Inpatient tonsillectomies carry a higher risk because they may be combined with other procedures, as in Jahi's case, and may involve patients with additional health issues. For instance, Baugh said, a very young child, or one with a pre-existing medical condition, such as diabetes or asthma, usually is treated on an inpatient basis.

Just in case others read this and go "he said WHAT?!?!" like I did...Baugh is the one who said the stuff after the link NOT Dolan.

 

[Elley Mae]

Just in case others read this and go "he said WHAT?!?!" like I did...Baugh is the one who said the stuff after the link NOT Dolan.

Oh I did not mean for that to appear that way. So sorry. :truce: