Family wants to keep life support for girl brain dead after tonsil surgery #3

[Donjeta]

http://www.ncbi.nlm.nih.gov/pubmed/18362457

Here's someone who "survived" 165 days with aggressive treatment.
It's probably much easier never to start than to stop in the middle.

 

[gngr~snap]

What are your thoughts on patient self suction with a yankhauer and family performing same within a very short time post op?

While working in recovery we had our share of t & a's. I can recall suctioning at the corner of the mouth being cautious that the child did not close the lips around the yankhauer.

In my limited experience, I have only used a yankauer with trachs.
I have seen children as young as 3 or 4 suction themselves. Their mother's were busy talking or taking too long, but they were not new trachs. Those poor babies used it with expert precision
It broke my heart.
Moo
ETA: What I don't get is why Jahi was supposed to be using it at all.
If it was out and available, why was she not returned to the OR?
Then there is the story about spitting in a cup and napkins.
It is alleged that she lost 4 pints.
Was that measured in the collection recepticle/container?
Is losing 4 pints even survivable?
IDK. MOO
I have read NUMEROUS postoperative T&A reports. Blood loss during surgery, was reported to be between 5 and 30 ccs- 1 teaspoon to 1 ounce. From 1989- 2003 our pediatric office never lost one patient referred to an Otolayngologist for surgery. Obese, sleep apnea, whatever!
I'm scratching my head here!
Sent from my SGH-T679 using Tapatalk 2

 

[Donjeta]

"She wasn’t able to talk, and she started to write notes to her mother saying I’m swallowing too much mucus, mom — am I OK? Mom — I feel like I’m choking,” Sealey told the Mercury News. “And she began to write these notes because she couldn’t talk because there was so much blood — it wasn’t mucus — it was blood. But my sister, the mother, was too afraid to let her know that it was blood and not mucus.”

Read more: http://www.nydailynews.com/life-sty...nsils-removed-article-1.1549502#ixzz2pKNVOieo

I just find this whole description a little bit odd. If she was bleeding all over the place, spitting blood, suctioning blood, and swallowing mouthfuls of blood, and everybody was concerned because there was so much of it, why wouldn't she have known that it was blood without being told? A normal thirteen year old knows what blood looks like and what it tastes like and I'm thinking that the ones that don't might not have the word 'mucus' in their vocabulary.

 

[Wolf Dreamer]

I have no malice toward this mother. Only compassion. I don't understand how. So many can be so callous and disrespectful toward her
I don't share her beliefs but I wouldn't shake her and tell her "she's dead dead dead" either. I'd hug her.

I'm still upset hospital staff, according to mom, keep referring to this child as "the body"
It's beyond disrespectful.


Sent from my iPhone using Tapatalk 2

"this child" is gone. All that is left *is* the body. For any who believe in souls, the soul has left, and could worse be trapped in limbo - no body but not allowed to fly.

IMO it is unhelpful in the extreme to present Jahi in a way that continues perpetuate the myth that she is alive. I might hug the mother but I would also be telling her - this is just a body and your daughter has gone.

 

[Wolf Dreamer]

"She wasn’t able to talk, and she started to write notes to her mother saying I’m swallowing too much mucus, mom — am I OK? Mom — I feel like I’m choking,” Sealey told the Mercury News. “And she began to write these notes because she couldn’t talk because there was so much blood — it wasn’t mucus — it was blood. But my sister, the mother, was too afraid to let her know that it was blood and not mucus.”

Read more: http://www.nydailynews.com/life-sty...nsils-removed-article-1.1549502#ixzz2pKNVOieo

I just find this whole description a little bit odd. If she was bleeding all over the place, spitting blood, suctioning blood, and swallowing mouthfuls of blood, and everybody was concerned because there was so much of it, why wouldn't she have known that it was blood without being told? A normal thirteen year old knows what blood looks like and what it tastes like and I'm thinking that the ones that don't might not have the word 'mucus' in their vocabulary.

Also, if she could write notes, why was she asking someone to wipe her nose at one point? I know my instinct when I feel something on my face is to wipe it myself. She must've known about the blood (and if there was that much not sure she'd have been writing notes either).

The more I read of the family accounts the less I believe them and the more I fear that they did indeed ignore instructions to let Jahi recover quietly. And that they - or their representatives - are trying to increase the drama of the story to sway opinion.

I very much wish there was a way to legally compel the release of the medical records.

 

[Wolf Dreamer]

When my youngest daughter was a child she kept getting tonsilitis. I asked her peds. dr about removing her tonsils. He said unless she gets it at least 4 times a yr. I wouldn't even consider it because 1 in 1,000 tonsil surgeries a child dies, and that's 1 to many. I never forgot that conversation. She still has her tonsils.

This happened to a friend of mine with her son. He has terrible tonsilitis but the doctor said he wouldn't put him forward for surgery unless it happened 4 or more times in a year because of the risks.

 

[SophieRose]

The federal judge hearing the case today also has a Masters of Divinity, received in 2012 from Pacific School of Religion in Berkeley.

http://www.fjc.gov/servlet/nGetInfo?jid=59&cid=999&ctype=na&instate=na

 

[txsvicki]

This happened to a friend of mine with her son. He has terrible tonsilitis but the doctor said he wouldn't put him forward for surgery unless it happened 4 or more times in a year because of the risks.

the risk of 1 in a thousand is too high for me. It's good that the statistics were posted because I'd have never thought the risks are that high, and plan to tell my daughter. Doctors won't be removing my grandchild's tonsils after my daughter hears this.

 

[rob]

Very well said.

I am beginning to have concerns that perhaps all of the misinformation being presented about brain death in the media is going to lead to grief and second thoughts for mothers who have been in a similar situation but chosen to remove the vent in a timely manner. Are they wondering if they should have waited for longer? I pray not.

I for one can say that I felt confident (and still do) in the decision made by our family.

 

[MEN3C]

the risk of 1 in a thousand is too high for me. It's good that the statistics were posted because I'd have never thought the risks are that high, and plan to tell my daughter. Doctors won't be removing my grandchild's tonsils after my daughter hears this.

If we are talking about mortality, I do not believe the risk is that high. The number I have seen is between 1 in 10000 to 1 in 35000.

Source: http://www.jfponline.com/fileadmin/jfp_archive/pdf/5910/5910JFP_Article5Web.pdf

I would want to see a source for a number as high as 1 in 1000. If you are talking about some complication (instead of mortality), then the numbers would obviously be higher.

 

[jjenny]

http://www.ncbi.nlm.nih.gov/pubmed/18362457

Here's someone who "survived" 165 days with aggressive treatment.
It's probably much easier never to start than to stop in the middle.

And likely would have much longer if ventillator wasn't turned off after that.

 

[jjenny]

I don't know if this has been posted already.

Medical ethicists worry that Jahi's case threatens definition of death.

http://www.ktvu.com/news/news/local/medical-ethicists-worry-jahis-case-threatens-defin/ncbX6/

Exactly. Why don't the judges just follow the law? Apparently the law isn't worth a paper it's written on. The child is legally dead. Yet the hospital has to keep her on ventillator wtih no end in sight.

 

[Elley Mae]

Why is this judge not allowing the hospital to carry out a law that is in place, not this hospitals law but the law of the state of California?

 

[Donjeta]

And likely would have much longer if ventillator wasn't turned off after that.

I *think* her heart failed before the ventilator was turned off.

 

[Softail]

Judge orders talks between Jahi McMath's family, Children's Hospital Oakland

OAKLAND, Calif. -- A federal magistrate will meet Friday with lawyers for a California hospital and a 13-year-old California girl declared brain dead after tonsil surgery.
The judge issued an order Thursday instructing representatives of Children's Hospital Oakland and the family of Jahi McMath to attend the mandatory settlement conference and try to avoid going to trial.
The hospital and Jahi's mother have been locked in a harrowing clash over the girl's care in recent weeks.

The issue also is being considered by the state judge who so far has blocked Children's Hospital from removing Jahi's ventilator. Judge Grillo has scheduled a hearing for Friday morning so he can speak with the opposing sides about how to handle that part of the case.

http://www.cbsnews.com/news/judge-o...hi-mcmaths-family-childrens-hospital-oakland/

Should be interesting today. A meeting with a federal judge, and a hearing with Judge Grillo.

 

[jjenny]

I *think* her heart failed before the ventilator was turned off.

After re-reading it, I think you are right.
:seeya:

 

[jjenny]

Why is this judge not allowing the hospital to carry out a law that is in place, not this hospitals law but the law of the state of California?

I have no idea either. Why is hospital required to be in talks with the family? Seems like the law is clear, but apparently not to the judges.
Also seems the family filed in different courts. What if different judges reach different decisions?

 

[Donjeta]

According to Wikipedia the mortality rate is not quite as high as one child per thousand.

The morbidity rate associated with tonsillectomy is 2% to 4% due to post-operative bleeding; the mortality rate is 1 in 15,000, due to bleeding, airway obstruction, or anesthesia complications.[9]

Tonsillectomy - Wikipedia, the free encyclopedia

The source for that information is reportedly p. 544 in Lee KL. (2008). Essential Otolaryngology: Head and Neck Surgery, Ninth Edition. McGraw-Hill Professional. ISBN 0-07-148270-9.


Uvulopalatopharyngoplasty mortality in adult patients:
http://www.ncbi.nlm.nih.gov/pubmed/15091217
http://oto.sagepub.com/content/149/2_suppl/P140.2.abstract

The serious complication rate was 3.5% (28/808) (95% confidence interval [CI] 2.0% to 4.9%), and the mortality rate was 0.1% (1/808) (95% CI 0.0% to 0.2%).

The incidence of serious nonfatal complications and 30-day mortality after UPPP are 1.5% and 0.2%, respectively in a large cohort of UPPP patients at veteran hospitals.

 

[Softail]

Two crucial hearings today in fight over Jahi McMath

(CNN) -- There will be two crucial court hearings Friday in the ongoing battle over Jahi McMath, a 13-year-old girl on a ventilator who has been declared dead by doctors.

A settlement hearing is expected in federal court and another hearing is scheduled in state court, court officials said.

In federal court, a magistrate will oversee mandatory talks between representatives of Children's Hospital Oakland and the family of Jahi McMath,CNN affiliate KTVU reported.

In state court, also Friday morning, an Alameda County judge, will be talking to both sides about the controversial issue that has become a national news story.

http://www.cnn.com/2014/01/03/health/jahi-mcmath-girl-brain-dead/

I am sooooo confused. A Settlement hearing with the Federal Court? I don't get it. :waitasec:

 

[Elley Mae]

What makes your heart beat?

http://health.howstuffworks.com/human-body/systems/circulatory/what-makes-your-heart-beat.htm