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

[SwampMama]

But at this point do we even know if it was bedwetting? It seems to me to be incontinence due to obesity. There IS a definite link between those two. Possibly mom figured the surgery would cure the obesity which would cure the "uncontrolled urination" .



When thinking of the Jahi's reported health and medical problems, consider our source of information which is Jahi's mom (since she wont allow the hospital to speak about her medical history). Jahi's mom has been much less than forthcoming with giving us the complete truth. She is more likely to give much more distorted view on such things.

http://www.sharecare.com/health/urinary-incontinence/obesity-contribute-to-urinary-incontinence

"Particularly for women, obesity is linked with incontinence. In people with obesity, the pelvic floor muscles must support excess abdominal fat as well as the pelvic organs, which can lead to stress incontinence (leaking when coughing or jumping). In addition, obesity may place pressure on the bladder and interfere with its blood and nerve supply. Fat tissue itself may contribute to overactive bladder (frequent urination and urges to urinate) by altering the balance of chemical messengers between nerve cells. Weight loss can sometimes improve incontinence without other treatment."

 

[SwampMama]

Is Sleep Apnea A Possible Cause of Bed-Wetting?

http://apneasleepdisorders.com/bed-wetting-and-sleep-apnea/

"Recent studies have shown that bed wetting and sleep apnea are possibly linked. To be more precise, there have been evidence showing that sleep apnea may actually be a cause of bed-wetting. Bed-wetting among children is not such an uncommon problem. Oftentimes, the child will outgrow it on his own but there are also cases where it can only get worse when not dealt with right away."

 

[Donjeta]

Do you know of a study that indicates sleep apnea in adults leads to obesity and bedwetting. I have never heard that before. That seems like the sort of thing that should be on mainstream TV in the US ... obesity means that you will pee the bed. That would sure help with reducing the problem

No one has claimed that obesity means you will pee the bed.

I think that bed wetting is more commonly a symptom of children's sleep apnea than adults' sleep apnea. Jahi was a pediatric patient, so I am not sure what looking up studies about bedwetting adults tells us about her but here is one link anyway:

Sleep research has documented that nocturia and bedwetting are symptoms of obstructive sleep apnea (OSA) in adults and that bedwetting is predictive of OSA in children.

http://www.ncbi.nlm.nih.gov/pubmed/12715403




Regarding the chicken and egg problem (obesity vs. sleep apnea), it is hard to pinpoint causality in conditions that may be part of a vicious cycle. Chicken lays an egg and the egg becomes a chicken and the chicken lays an egg and the egg becomes a chicken and so on. There is quite a bit of research that indicates sleep problems cause metabolic changes such as insulin resistance and changes in ghrelin and leptin levels (associated with hunger) which in turn predispose one to obesity. Obesity predisposes one to sleep apnea. Once you have sleep apnea you may experience daytime tiredness and that may decrease your physical activity levels and if the sleep apnea messes up with your metabolic hormones further you may become more overweight which may make your sleep apnea worse and so on...

I don't think we will be able to tell what was the chicken and the egg in Jahi's case.

http://www.healthcentral.com/obesity/c/45116/38444/obesity-connection/

Obstructive sleep apnea is much more common in obese individuals. It is believed that the airway of the obese individual becomes obstructed by large tonsils, enlarged tongue and increased fat in the neck, all pressing on the airway when the pharyngeal (throat) muscles are relaxed with sleep. A person's neck circumference is a good predictor of sleep apnea. Obese men with a neck circumference of 17 inches or greater, and women with a neck circumference of 16 inches or greater are more likely to have sleep apnea. One study which looked at NFL lineman pointed to a very high incidence of sleep apnea.

The worst part of this is that not only does obesity have an association with sleep apnea, but sleep apnea as well as resultant poor sleep, tends to cause people to eat more. There seems to be a relationship between hunger and satiety hormones and sleep deprivation, though the exact nature of this relationship is unclear. Also, individuals with sleep apnea often have elevated blood pressure, fasting glucose, and high cholesterol, all of which can be made worse with sleep deprivation. So, it's a vicious cycle. Obesity, especially morbid obesity (BMI > 40), can lead to sleep apnea, which, itself, then causes derangements of hormones that control eating habits, leading to more weight gain, worsened blood pressure, glucose intolerance, worsened apnea and the cycle goes on and on.

http://www.healthcentral.com/obesity/c/45116/38444/obesity-connection/

I don't think that the death of this child was a result of sleep apnea.

It has been reported that the death of this child was a result of a catastrophic post-operative bleeding complication that led to a heart attack and eventual brain death.

This was an obese child that needed surgery at the age of 13 to breath properly. She had psychological, physiological, or congenital problem ... it has to be one ... because she had more than one medical problem ... can't breath, pees on the bed and has uncontrolled urination, short attention span problems, obese, wakes up during the night ... a myriad of problems.

A myriad of problems that is not that uncommon in sleep apnea.

We have not seen Jahi's medical records and probably never will so there may have been a number of conditions we have no idea about but if she was scheduled for sleep apnea surgery I must assume that sleep apnea was considered to be a probable cause behind at least some of her problems.

 

[Sonya610]

Sleep apnea strikes me as more of a neurotic, hyperactivity issue, not an obesity issue. People that I know that don't sleep enough tend to be more lean than obese. That is, they're waking up through the night, clearly they can go to the bathroom rather than pee the bed, and they're not sitting around licking the bottom of the peanut butter jar.

Sleep apnea is different than being a light sleeper that gets up or wakes up frequently at night.

With sleep apnea the person stops breathing while sleeping (or barely breathes) and that pulls them out of deep sleep but they often don't wake up completely. Their throat can basically close due to tissue obstruction which is where obesity comes into play. They often stop breathing then start again with a loud snort.

Also "uncontrolled urination" does not sound at all like bed wetting (which is by its very nature uncontrolled as the person is asleep). It sounds like she literally could not control it during the day, or could not hold it and it would just start to flow.

 

[oceanblueeyes]

Obesity can lead to sleep apnea. Bed wetting can be seen in healthy children until the age of 5 or 6. Some children fall into such a deep sleep that they do not wake up to go to the bathroom, but they are not necessarily obese.

Children that do not wake up to go to the bathroom can be very active, healthy children. Sleep apnea is not a cause of obesity, as far as I know. I haven't really seen any correlation between the two.

Does sleep apnea cause bedwetting in adults?
Is weight gain a result of sleep apnea, or is it the other way around?

I thought I read that she became overweight and wasn't always an obese child all of her life.

Did she have another condition that caused her to gain weight and then make her develop sleep apnea?

I do think Jahi is dead and already with the angels but I will not condemn this mother. Since this story began I have read countless stories across the net where other loved ones have had 'to pull the plug' on their loved ones, and most of them, even today, are left with guilt, and second guessing themselves if they did the right thing. I think that is a normal response. I also think Jahi's mom clinging to false hope is also normal.

To me today is a very sad day no matter how this winds up. Doctors recommended she have these surgeries and now she is dead. And a mother will always beat herself up for allowing the surgeries to go forward.

Go in peace Jahi.

 

[oceanblueeyes]

My son had brain surgery when he was 5 years old. He's now 18 years old, so it was a long time ago. I still remember it like it was yesterday because it was really scary. After signing the papers accepting the risk of death, I was preparing myself for the worst, and hoping for the best. I was prepared for all possible outcomes. That's what it means when someone signs a consent form at the hospital prior to surgery. Patients need to arrive early for surgery and read the documents prior to signing them. They should ask questions if they are uncertain of what it means that "death" is a risk.

The intensive care unit that my son was in was a 6-8 bed unit. There were a couple of private rooms where several doctors were present while a 14 year old youth coughed and puked for a couple of days. He probably had cystic fibrosis. It was awful to listen to. The rest of the unit was a central nursing station with about 4-6 beds, but it wasn't busy when we were there ... except for the 14 year old boy puking his lungs out. The sounds in the hospital seem worse than the sights.

Many years ago when my ex-husband was 9 years old he lost his mother after she had a tonsillectomy. They kept her a few hours at the hospital and she returned home. He woke up to find her on the floor bleeding from the nose and mouth and she died in his arms before help could be summoned.

Then our son had a tonsillectomy along with taking his adenoids out too. He was not released in a few hours but was an in-patient closely monitored especially for any signs of hemorrhaging. Once they were satisfied that everything was as it should be they released him and he had no problems whatsoever. That was in the late 70s.

I had to make the decision to take my father off of life support and he lived for three days after then before he passed away. It isn't an easy decision to make unless the patient themselves have signed written orders they do not want to be put on life support.

Now I know Jahi's surgeries were more complex but the doctors are the ones that recommended all these surgeries. I remember one time my father broke his shoulder/arm in two different places and the surgeons refused to do the surgery when it first happened, saying with his health issues it was just too risky. So they waited for three weeks and during that time they built him up as much as they could before the surgery.

It makes me wonder if these doctors did the same with Jahi so things could go as well as possible in order to get the best outcome they could.

imo

 

[Elley Mae]

Listening to the news reports all week-end I can tell you the appeal has yet to be filed with the court.

Courts are not open 24/7. The clerks office will open in the morning. If an appeal is filed it will be in the morning. A request for a stay of the 12/30 order may also be filed.

I live about an hour's drive outside of Oakland. This is a big local story here. The lead story with each local news cast.

Has anyone posted the Fund Raiser planned for today in Oakland was canceled? During the evening news they showed the mother's church praying. Haven't seen the mother or grandmother speak for a day or so. Just the Uncle speaks for the family now. I expect fireworks tomorrow!

Thanks for this local update.

 

[Trino]

One problem I see in terms of whether the whole story was told is that it was initially reported that a perfectly healthy child had a routine tonsillectomy and died. Today, we know that there is an awful lot more to the story.

If the grandmother is a registered nurse, then I would have expected the family to fully come to terms with the reality of the situation sooner than Dec 12 to Dec 29 ... seventeen days and counting.

Is no one listening to the grandmother? Did she have experience in ICU such that she knew how to suction a patient with her granddaughter's condition? I don't really understand what the grandmother was doing in ICU, and I'm a little surprised that more than one family member would be allowed in ICU. When my son was in ICU, it was a very quiet recovery area for a couple of days with at most one family member. Once a patient was active enough to visit with family, he or she was moved to a unit bed. Is the religious or legal advisor having more influence over the mother than the grandmother (the nurse)?

Post Snipped...

See previous posts re: grandmother. She is sticking with the family - interesting for a nurse.

 

[Elley Mae]

Re: Jahi's physical condition before surgery.

http://www.cnn.com/2013/12/17/health/california-girl-brain-dead/

On December 16th, in a telephone interview with CNN, Omari Sealey said that doctors had recommended Jahi have surgery to treat her sleep apnea, weight gain, inability to concentrate, short attention span, and uncontrolled urination.
Sealey doctors told Jahi and her mother that the surgery would give the teen more energy, better focus, weight loss and control over her urination.

Doctors had recommended the tonsillectomy to treat Jahi's sleep apnea, weight gain, inability to concentrate, short attention span and uncontrolled urination, her uncle Omari Sealey told CNN on Monday in a telephone interview.

"They said that she would have more energy, focus more, lose weight, and the urinating would stop," he said.

wendiesan
thanks for the link

snipped from link

The surgery, which occurred December 9, initially appeared to have gone well, said Sandy Chatman, Jahi's grandmother who is herself a nurse and saw the girl in the recovery room.

"She was alert and talking, and she was asking for a Popsicle because she said her throat hurt," Chatman said.

By the Gmother's account all went well until she ate the popsicle then she began to bleed.

 

[Softail]

Family running out of time to move Jahi McMath

"I was informed, you know, via the attorney to not have the fundraiser because we're still trying to solidify a facility for Jahi and we definitely don't want to raise funds, you know, for something that is not iron clad," Pastor Derrick Mann said

http://abclocal.go.com/kgo/story?section=news/local/east_bay&id=9375308

Hmmmm.... Interesting that the attorney advised against "fund raising" for a facility that doesn't exist.

 

[Trino]

Family running out of time to move Jahi McMath

"I was informed, you know, via the attorney to not have the fundraiser because we're still trying to solidify a facility for Jahi and we definitely don't want to raise funds, you know, for something that is not iron clad," Pastor Derrick Mann said

http://abclocal.go.com/kgo/story?section=news/local/east_bay&id=9375308

Hmmmm.... Interesting that the attorney advised against "fund raising" for a facility that doesn't exist.

Maybe he's been reading WS?

 

[Elley Mae]

Right! I read uncontrolled urination. I do not know what they meant by that.
Was it in general? Was it only at night?
It is not clear IMO
http://www.cnn.com/2013/12/17/health/california-girl-brain-dead/
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It would seem to have to be different. I know a female(12-13) at the time, that wet the bed. She was not over weight. I was told that she was given a pill ? to take at night that kept her from wetting while sleeping. It worked if she took it, as far as I know the wetting stopped. I guess it was something she grew out of. idk jmo

 

[Sonya610]

The hospital all but said in their letter that they would consider doing the stomach tube and trach surgeries IF a place to send the body was found.

Why isn't the family just asking to take her HOME??? If they really believed she will wake up wouldn't any of us choose to take her HOME rather than let all support be turned off today? It makes no sense to me at all!

I have to wonder if there is going to be a "scene" or some such thing at the hospital if they turn the machines off at 5:00 today. I could see things getting ugly.

 

[Donjeta]

It would seem to have to be different. I know a female(12-13) at the time, that wet the bed. She was not over weight. I was told that she was given a pill ? to take at night that kept her from wetting while sleeping. It worked if she took it, as far as I know the wetting stopped. I guess it was something she grew out of. idk jmo

Likely she got desmopressin which mimics the effects of antidiuretic hormone. It is intended to decrease urine production at night.

 

[Jacie Estes]

I have no experience with tonsillectomies but my husband and I have had several out patient procedures over the years. I am pretty sure that at all of them, we were given food to eat in the recovery room; we were usually hungry because we hadn't eaten since the night before. But I also recall the nurse telling me that they wanted to make sure that I could eat something before I was discharged. Imwasmconstantly monitor for various signs and symptoms; I remember them being very insistent that I pee, because they wanted to make sure my kidneys were not affected by the anesthesia.

I would guess that they would want something similar for a tonsillectomy, but solid food would not be an option.


I remember the nurses being very attentive and am surprised to read that the nurses at this hospital were not attentive to Jahi. I had one nurse specifically assigned to me but the recovery area was very active and there was lots of staff around, who I assume would help out with another patient in a crisis.

Colonoscopies have become even scarier for me now.

I have had 2 procedures with anesthesia since June, one in a surgical center and one in a hospital, and will have another, hopefully, next week. Both times I was given cinnamon raisin toast and a Pepsi. The second time I was intubated and my throat is still sensitive from that. As scary/unpleasant as colonoscopies are, they are so important.

I could see Jahi being given a popsicle, the cold would help reduce swelling. Sad all the way around; there are no winners here.

 

[CarolinaMoon]

I searched and searched this thread for the article, but my patience ran out and I'm just posting this from memory.

IIRC, early on, Jahi's mother stated about the original surgery that she was sorry she got a second opinion. I assume that meant that the first doctor recommended against surgery and she went to a second doctor who felt that the surgery could be successful.

If so, it's likely the more conservative doctor recommended CPap therapy at night and aggressive diet and exercise to bring Jahi's problems under control. That would have taken a long time and a great deal of persuasion on Mom's part.

Perhaps Jahi and/or her mother didn't want to go that route. Whatever the reason, they went to a second doctor to find a quicker solution to the problem in terms of immediate improvement in the apnea which would lead to more energy for Jahi and more of a willingness to exercise and diet.

If so, it is so easy to understand the mother's overwhelming guilt that she shouldn't have agreed to surgery over the more conservative treatment. Did she convince her daughter to undergo the surgery or did Jahi herself want to go that route.

 

[caradana]

Would the coroner's office even let them bring home a dead body, if they wanted to? In their view, is that a public health hazard -> dead body in a house, particularly with children?

 

[Softail]

Would the coroner's office even let them bring home a dead body, if they wanted to? In their view, is that a public health hazard -> dead body in a house, particularly with children?

Yikes! I would hope there is a policy in place to not allow this to happen!

 

[Jacie Estes]

It seems all there is to do now is just wait to see if she is moved or if she is removed from the vent. Prayers offered for Jahi and for her family.

This has not been an easy thread to read. IMHO

 

[Charlie09]

Realistically, if Jahi is dead (and by all accounts, I do believe she is), it's not really at a benefit to have a decomposing body in the hospital of children that have very weak/susceptible immune systems.

No offense, but what in that is so hard for some to understand?

No offense, but it's not like she's a dying body just decaying either.