Family wants to keep life support for girl brain dead after tonsil surgery #1

[al66pine]

A sad, sad situation.

Who gets to decide when to end life support when a person is brain dead?
The mother of 13-year-old Jahi McMath, who was declared brain dead Thursday, three days after undergoing surgery to remove her tonsils, said Tuesday that the family should make the call.
"I don't want her off life support because I really feel like she can wake up," Nailah Winkfield told CNN's Piers Morgan.

http://www.cnn.com/2013/12/17/health/california-girl-brain-dead/index.html text and at link, a vid clip from Piers Morgan show.

 

[Kaliste]

I've been following this on the news. It's so sad Not sure if her mom is in shock and dealing with extreme grief of just terribly misinformed. The clip I saw earlier mom said something along the lines of "How can they want us to take her off life support if her heart is still beating?".

It's very sad and I wish her family healing and peace.

 

[Zuri]

A sad, sad situation.

Who gets to decide when to end life support when a person is brain dead?
The mother of 13-year-old Jahi McMath, who was declared brain dead Thursday, three days after undergoing surgery to remove her tonsils, said Tuesday that the family should make the call.
"I don't want her off life support because I really feel like she can wake up," Nailah Winkfield told CNN's Piers Morgan.

http://www.cnn.com/2013/12/17/health/california-girl-brain-dead/index.html text and at link, a vid clip from Piers Morgan show.

I have personally had 2 patients that had complications from a tonsillectomy. Back in the early 80's, an adult female was brain dead as a result of being intubated in her esophagus, not her lungs during surgery. Her family insisted that she remain on a vent because she was just sleeping and would miraculously wake up. While I admired their faith, she had no brain activity and sadly died from multi system failure.

The second patient was more recent. In 2009, a patient had a bleeder that had not been cauterized during surgery and bled a tremendous amount in the recovery room. Per protocol, the anesthesia docs came to examine patient and the surgeon was also notified, who was in the middle of his next case. He sent out messages he would be there as soon as he could which was not going to be soon enough. I put on a hat, gown and mask and walked into his OR telling him he needed to come now. Of course, I was yelled at, but my tone spoke volumes. He walked into the Recovery Room and took one look at the patient and told anesthesia he had an emergency and needed an OR stat. He cauterized the bleeder and the patient was transfused with a pint of blood. He later apologized for not listening to us sooner. Lesson learned.

It sounds as though Jahi was morbidly obese causing the sleep apnea. A tonsillectomy would not fix some of her symptoms that were more obesity related IMO. Parts of this story as reported don't make a lot of sense, but the bleeding and occlusion of her airway leading to low oxygen is certainly probable. Patients that are MO have more surgical risks than other patient populations. I feel very bad for her parents and family that this happened to them and to Jahi. God Speed. JMV

 

[T4Tide]

Every parents' worst nightmare.


There are risks to every procedure...even those we deem minor. It isn't always someone's fault. My heart is breaking for them, especially near Christmas.

 

[LinasK]

The hospital should not be the ones to declare when to pull the plug. :twocents:This should be the family's decision. Maybe she will live years on life support. Cost should not be the deciding factor. Maybe she will spontaneously recover some brain function, we can't know this!!! She shouldn't have died from a surgery that's considered routine. I think the hospital may have a malpractice suit on their hands. I side with this family, she's only 13, and appeared to be a bright girl who was talked into the surgery by her mother, who reassured her nothing bad would happen.

 

[jjenny]

Every surgery has risks, routine or not.
And one can not recover from brain death.

 

[UdbCrzy2]

I knew a family and their daughter had a tonsillectomy and bled to death. There was nothing they could do and she was very young. It's a sad situation to say the least.

 

[Roxye]

I put my Nikel in surgery when he was 11 for not only a tonsillectomy but adenoid removal as well. I knew the risks, but at his age he was still bed wetting and having issues with falling asleep in class. I weighed the odds and thought the best for him was the surgery. I was right.

That being said, if I were this Mom, I can see where she is coming from at this time. Give her a breath, let her deal. She made the same informed decision I made, yet her daughter lost on the odds.

What harm, other then money, would it do, to give them 6 months to deal? Or six months to prove different?

 

[LinasK]

Ironically, my husband had some surgery last summer, and in the recovery room, his sleep apnea surfaced again, and he stopped breathing. The nurse recommended going to a doctor. DH has always had a bad snoring problem. I'd been pushing him lately to look into it, but in light of Jahi's problems, I think I'll just continue to put up with his snoring!!!

 

[BeginnersLuck]

Here is another case where the parents didn't want to take the child off life support. They ended up sending the child home on life support. I'll see if I can find any follow up on this. It was in 1994.

http://www.nytimes.com/1994/02/19/us/brain-dead-florida-girl-will-be-sent-home-on-life-support.html

 

[eileenhawkeye]

Here is another case where the parents didn't want to take the child off life support. They ended up sending the child home on life support. I'll see if I can find any follow up on this. It was in 1994.

http://www.nytimes.com/1994/02/19/us/brain-dead-florida-girl-will-be-sent-home-on-life-support.html

If you can't follow any follow up past the mid-90's, that probably means she never recovered. There would be plenty of articles if her condition managed to improve...I'm looking too, and it looks like the story completely disappeared from the media after '94.

 

[BeginnersLuck]

http://www.apnewsarchive.com/1994/B...t-Failure/id-00b533297e549575b1b1770e4daf1ddf

It looks like this girl died four months later from heart failure.

I suppose the family could take her home then or maybe put her in a nursing facility. Hopefully the shock will wear off and they will make the right decision. It has to be horribly difficult to let go.

 

[BeginnersLuck]

If you can't follow any follow up past the mid-90's, that probably means she never recovered. There would be plenty of articles if her condition managed to improve...I'm looking too, and it looks like the story completely disappeared from the media after '94.

I didn't expect to find any cases where the patient improved. I was just looking for similar situations. I knew there had to be others that didn't want to remove life support.

A hospital IMO, isn't the appropriate place to keep her if the family is not wanting to remove the life support.

 

[BeginnersLuck]

Ironically, my husband had some surgery last summer, and in the recovery room, his sleep apnea surfaced again, and he stopped breathing. The nurse recommended going to a doctor. DH has always had a bad snoring problem. I'd been pushing him lately to look into it, but in light of Jahi's problems, I think I'll just continue to put up with his snoring!!!

I know a lot of people with this problem and they usually go through a sleep study and end up getting a sleep apnea machine to use at night.

 

[SophieRose]

I didn't expect to find any cases where the patient improved. I was just looking for similar situations. I knew there had to be others that didn't want to remove life support.

A hospital IMO, isn't the appropriate place to keep her if the family is not wanting to remove the life support.

About ten years ago a nurse friend told me that at the hospital where she worked were several brain-dead patients on a floor that had been there for years. She said that nursing homes would not take them (I can't remember if it was an insurance problem or what) and therefore they became the responsibility of the hospital. Most of them were foreign-born but had families that visited them regularly, many going everyday. I asked about them in the last year or two and she said that the hospital no longer cares for them but she did not know what happened.

 

[LinasK]

And one can not recover from brain death.

I've personally worked with-in therapy- stroke patients who demonstrated signs of brain recovery 5 years after the onset of their severe strokes- so never say never! Terri Schiavo's husband took her off life support prematurely, she still had a fighting chance.

 

[otto]

I've been following this on the news. It's so sad Not sure if her mom is in shock and dealing with extreme grief of just terribly misinformed. The clip I saw earlier mom said something along the lines of "How can they want us to take her off life support if her heart is still beating?".

It's very sad and I wish her family healing and peace.

If her heart is still beating, she can breath without life support. She may need a tube feeding and other nursing care, but not life support.

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

Why? ... brain dead.

 

[Donjeta]

I've personally worked with-in therapy- stroke patients who demonstrated signs of brain recovery 5 years after the onset of their severe strokes- so never say never! Terri Schiavo's husband took her off life support prematurely, she still had a fighting chance.

You can recover from a severe stroke but not from brain death. Brain death is irreversible by definition. If someone recovered from brain death, he was not brain dead, he was misdiagnosed.

 

[Herding Cats]

If her heart is still beating, she can breath without life support. She may need a tube feeding and other nursing care, but not life support.

Well, not really. Different system, actually. Breathing is controlled by the brainstem, and if the brainstem has died, no breathe-now messages will be sent. If they're not sent, the lungs will not oxygenate the blood, because they're not working. The heart may continue to beat for a time with the vent off, but eventually it will stop working too, without oxygen to work with.

Here's the question *I* have. If there were no machines and no medication, would this little dear one be alive? If no, and all the clinical, established markers are met for brain death are met, then to me, the child's brain is dead. There is no recovery from brain death.

It's a horrible situation, and I've seen a few brain-dead patients during my time as a student nurse. It's a horrible thing at any time, but also to have this happen at Christmas/the holidays? Worse yet.

I have huge sympathy for the family; and I have huge sympathy for the hospital and her Drs and RNs.

And please be aware that brain-death and persistent vegetative states are vastly different...with one, there is still hope. With the other, there is no hope.

I further have concerns about the article. It is written not from both sides, but simply from the family's side. If the family has not given permission for the hospital to 'talk' about the issue, then we won't ever get the hospital's side...and the coroner makes some good points in that over time, it will be harder to determine how and why she bled as she did, as the body will change.

I will post more when I have time, as I'm traveling today and need to get hustling on some chores.

I pray for peace for this family, and also for the Drs and RNs who were with this child as she died. They have had trauma too...and as routine as a tonsillectomy is, there are risks involved in any surgery, and even when things are done exactly right, death can happen.

My prayers for all...for peace, for good communication, and for them to all know He holds them in His Hands, and will never let them fall.

Best
Herding Cats

 

[Linda7NJ]

I've personally worked with-in therapy- stroke patients who demonstrated signs of brain recovery 5 years after the onset of their severe strokes- so never say never! Terri Schiavo's husband took her off life support prematurely, she still had a fighting chance.

A chance at what?

I have a living will, thankfully.


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