Family wants to keep life support for girl brain dead after tonsil surgery #6

[Karmady]

Has anyone posted this?

http://www.tc.umn.edu/~parkx032/CY-LCADA.html

any blog in blue typeface with a pink background with cyber sermons, etc. is suspect, imo. Who is this person and why is the link being posted here?

eta: never mind --from the link

James Park is an independent existential philosopher
with deep interest in medical ethics,
especially the many issues surrounding the end of life.
As said in this essay, he would like to donate his own body as a living cadaver.
Medical Ethics and Death are two of the seven doors
to his website called "An Existential Philosopher's Museum":

I can't get the facepalm smiley from edit mode, so please imagine it.

 

[PoirotryInMotion]

Has anyone posted this?

http://www.tc.umn.edu/~parkx032/CY-LCADA.html

Hmmm. He seems to have a lot of tangenting thoughts about a lot of topics (click on his "Other Cyber-Sermons" at the bottom). Including these:

Romantic Love is a Hoax!
Emotional Programming to 'Fall in Love' . D

Why I Am a Unitarian Universalist . D O

Deprogramming Former Members of Al-Qaeda . D

Sex-Balanced Senate . D N

Ideal Immigrants:
New Criteria for Selecting New Americans . D

O. Outreach. Sermons especially appropriate for a Sunday
on which you intend to advertise for visitors from the general public
—people who have never before attended a UU service.
These talks presuppose no previous knowledge of UU thinking or traditions.
And they address subjects already alive in the minds
of people on the verge of becoming Unitarian Universalists.



ETA: ah, cross-posted with another cynic, I see...

 

[PoirotryInMotion]

any blog in blue typeface with a pink background with cyber sermons, etc. is suspect, imo. Who is this person and why is the link being posted here?

eta: never mind --from the link

James Park is an independent existential philosopher
with deep interest in medical ethics,
especially the many issues surrounding the end of life.
As said in this essay, he would like to donate his own body as a living cadaver.
Medical Ethics and Death are two of the seven doors
to his website called "An Existential Philosopher's Museum":

I can't get the facepalm smiley from edit mode, so please imagine it.

lol! That first made me burst out laughing. I'm sure it's just b/c I need to go to bed. fftobed:

 

[Linda7NJ]

Has anyone posted this?

http://www.tc.umn.edu/~parkx032/CY-LCADA.html

I'm fine with it....don't care what anyone does when I'm gone...if I can still manage to help another....great.....

 

[Karmady]

Question: do you think it was necessary for Dolan and uncle to bash CHO in the media for mom to get to where they are now? Could mom had just fought the court battle without the press and still had the same outcome? I'm not exactly sure how much the media affected the judges' decisions so I am trying to determine if the media was to help mom with giving Jahi more time or if the media was about $$$ and dolan's own agenda. TIA

Idk. Maybe, maybe not. I've been of the opinion that in a TRO situation, they probably would have been given at least time to appeal. And, imo, that's all the court actually did at the end of the day -- other than putting the matter into the hands of someone who can exercise discretion w/o worrying about committing a criminal or unethical act personally (I mean the coroner). And clearly that law is the one that needs addressed.

That said, congratueffinglations to getting where they are now. So "necessary" isn't a word I'd use. I can't say the word I'd use here.

jmo

 

[SeekingJana]

Their online ordering system works great (or at least did the last time I used it 4+ years ago) :innocent:

This was around 8 years ago. No smart phones yet.

 

[MissJ]

My son had a bleeding problem. When he was small we were in the ER constantly with nose bleeds and many times he was admitted because they were unable to stop the bleeding except by applying pressure with a urinary catheter inserted in his nose and inflated. Daily he would be checked to see if it could be deflated and bleeding had stopped. Once stopped multiple areas were cauterized. Topical medications never worked. If his bleeds had been in the area of his tonsils I'm sure nothing could have been done by anyone to save him. He bled through packing. We did the whole thing multiple times with multiple areas cauterized each time . I'm explaining this because some think the nurses just stood around and let Jahi bleed to death. Sometimes it happens that nothing can be done by the nurses except get the physician to the bedside during a bleed. I'm sure they did that. Maybe they(physician's) attempted some bedside repair. We don't know the whole story. My friend's son died in his allergist's office from an anaphylactic reaction. His physician was there trying to save him but it couldn't be done. Sometimes even in a hospital setting people cannot be saved.

 

[Kaliste]

Glad to know it was prob'ly not a delusion on my part.
But still, why no nail polish in OR then, 24 - 30 yrs ago?

And is nail polish acceptable now on OR patients?

Thx in adv for any response. :seeya:

I have one coming up in a few days, no one has mentioned restrictions on nail polish yet but I'll report back

 

[gngr~snap]

IMO since the pulse-ox has been used they have backed off on nail polish removal rules in most outpatient procedures. I was to have no jewelery or nail polish in 2008 for my hysterectomy and an overnight stay was planned.
Who knows! Every facililty is different. What about all the acrylic nails now? — good luck removing those! Lol
Moo
Sent from my SGH-T679 using Tapatalk 2

 

[SeekingJana]

Wow! That is an intense thought-- that maybe she WAS returned to the OR, and the family has not said so. It seems unlikely on the one hand-- it is hard for me to believe the family would "en masse" omit that very critical detail.

Nothing about the OR-- AND nothing about the ENT surgery service. I am actually quite bothered that most of the criticisms of "the hospital" come from the uncle, attorney, and family. Only Dr. Durand, chief of pediatrics, has been named by name as someone they are particularly vexed with. No one else by name. Not a single nurse, doc, or housekeeper. That has always been a red flag for me-- that the "entire" facility has been maligned, but only one person named.

And yet, for all of the supposed vitriol toward "the nurses" who let Jahi bleed to death during "shift change", and "required" the family to clean up Jahi's blood, the NURSES of the PICU have been singled out for praise by the family as compassionate.

So I have a hard time reconciling the image of "evil" PICU nurses, with the "compassionate" PICU nurses. And the docs are not mentioned at all. There WERE doc/s present. They ordered transfusions. And the family has NOT slammed the ENT docs in public-- ONLY Durand and "the hospital".

K_Z, I've always had a strong feeling that she was rushed back to O.R. for ligation/ cauterization of bleeders.
As a nurse who has worked in MANY different intensive care settings, I know the space is really limited as far as surgical instrument packs, cautery units set up and blood transfusions would be all at the same time.

I would expect to see all of the above equipment, plus a CRNA and Anesthesiologist tubing her first, or maybe the Code was first and she would have been tubed there, of course.

But, having had post- op bleeders, we didn't leave them in ICU. OR staff came and together, we ran with our bleeding patient back to OR to the surgeon who had responsibility for the patient's post op course. Sometimes, well, you can imagine that there are still probably blood splatters on some recessed spotlights in some ICU units....

The reason the family may not have mentioned this in their disjointed narratives with " wandering truths" is because once she was out of PICU, she was out of their sight. You really can't talk much about something that went on behind O.R. doors, if you weren't in O.R., right?

I confess that O.R. was always like " another world" to me. I could not stand any part of it even as a student nurse... I avoided Surgical Rotation in Clinicals ha... but I am glad there are people like you who are there.

 

[MsSeal]

My son had a bleeding problem. When he was small we were in the ER constantly with nose bleeds and many times he was admitted because they were unable to stop the bleeding except by applying pressure with a urinary catheter inserted in his nose and inflated. Daily he would be checked to see if it could be deflated and bleeding had stopped. Once stopped multiple areas were cauterized. Topical medications never worked. If his bleeds had been in the area of his tonsils I'm sure nothing could have been done by anyone to save him. He bled through packing. We did the whole thing multiple times with multiple areas cauterized each time . I'm explaining this because some think the nurses just stood around and let Jahi bleed to death. Sometimes it happens that nothing can be done by the nurses except get the physician to the bedside during a bleed. I'm sure they did that. Maybe they(physician's) attempted some bedside repair. We don't know the whole story. My friend's son died in his allergist's office from an anaphylactic reaction. His physician was there trying to save him but it couldn't be done. Sometimes even in a hospital setting people cannot be saved.

There is always that small risk that something catastrophic can happen. A small but real risk especially with this kind of surgery.

Is there a way to find out how many of these surgeries are done each year at CHO and what the complication rates are. What is the surgeon's record?

You could do 99.9% of the surgeries without a hitch and that one time there is massive bleeding resulting in death it will change the statistics and ruin reputations. Then there are all the circumstances that come into play. Without reading the medical record carefully and talking to everyone involved from her arrival to the hospital until she was resucitated and on the vent how would you know exactly what happened?

Medicine is the one area where you cannot make a mistake. You just can't. It has to be like Minute Rice, perfect every time and you have to give a guarantee like Midas Muffler.

Similar to airplanes. Millions of Boeings take off every day and get to their desitation safely but there is always that chance of the major crash and when it happens it is big.

 

[NevadaMom]

K_Z, I've always had a strong feeling that she was rushed back to O.R. for ligation/ cauterization of bleeders.
As a nurse who has worked in MANY different intensive care settings, I know the space is really limited as far as surgical instrument packs, cautery units set up and blood transfusions would be all at the same time.

I would expect to see all of the above equipment, plus a CRNA and Anesthesiologist tubing her first, or maybe the Code was first and she would have been tubed there, of course.

But, having had post- op bleeders, we didn't leave them in ICU. OR staff came and together, we ran with our bleeding patient back to OR to the surgeon who had responsibility for the patient's post op course. Sometimes, well, you can imagine that there are still probably blood splatters on some recessed spotlights in some ICU units....

The reason the family may not have mentioned this in their disjointed narratives with " wandering truths" is because once she was out of PICU, she was out of their sight. You really can't talk much about something that went on behind O.R. doors, if you weren't in O.R., right?

I confess that O.R. was always like " another world" to me. I could not stand any part of it even as a student nurse... I avoided Surgical Rotation in Clinicals ha... but I am glad there are people like you who are there.

It's also been mentioned that the mother fainted as well, so there is that potential lapse in knowledge of what occurred. I think I remember someone making mention that the grandmother was also not present the whole time either, so there may well have been a period of time during her bleed and code that none of the family was there even if there was not a trip back into OR. Not sure on the grandma though.


Kind of OT: It may seem really weird, but this whole situation has been fascinating to me from a medical stand point. I've done a load of googling and research about all the different medical terminology that's been tossed around. I'm not really sure I'm cut out for any brand of medical school (I hate math, oh how I hate math). It's made me once again consider it for a moment or two here and there. :fence:

 

[otto]

Not sure if you mean what it is or where it is. Linking just in case you're curious as to what it is.

Pulse oximetry - Wikipedia, the free encyclopedia

I am definitely not in the medical community, but I'm learning as I read. Thank you for the link

There must be a certain logic and instinct that kicks in telling a mother that her child is dead. Doesn't maternal instinct also inform a mother that her cold, lifeless. unresponsive child is deceased?

We know every Mom should rationally understand that nutrition will not bring her child back from the dead, and we know that there is no religion that supports this treatment of a deceased body, so what is the motivation behind this? Is this an extreme guilt reaction that has manifested itself as a denial type of mental illness? Obviously this is not normal, so something else must be going on.

We know the lawyer's motive. He wants to stuff his pockets from a bigger pot. He's actively involved in petitioning the government to raise the limit on death of a child in a hospital compensation from $250,000 to half a million or better, maybe $30 million (the family first heard this number somewhere ... probably the lawyer).

Even an increase from a quarter of a million to half a million will improve the lawyer's ambulance chasing income. Does he have the religious doctor on payroll? That this lawyer used this family, and preyed upon the mother of the deceased ... as he did to further his own cause ... this should form the basis for being disbarred. This woman will be traumatised for the remainder of her life for not putting her daughter to rest, but instead making a spectacle of her and watching her deteriorate before her eyes. Dr Bryne (medical doctor), the related religious leader, the uncle, the grandmother (licenced vocational nurse), and the lawyer (chasing money) have all participated in what must now be unbearably devastating for the mother. Could she be ready to bury her daughter, and people around her are telling her that if she can just hang on a little longer, they might have a better chance of a larger award?

 

[otto]

It's also been mentioned that the mother fainted as well, so there is that potential lapse in knowledge of what occurred. I think I remember someone making mention that the grandmother was also not present the whole time either, so there may well have been a period of time during her bleed and code that none of the family was there even if there was not a trip back into OR. Not sure on the grandma though.


Kind of OT: It may seem really weird, but this whole situation has been fascinating to me from a medical stand point. I've done a load of googling and research about all the different medical terminology that's been tossed around. I'm not really sure I'm cut out for any brand of medical school (I hate math, oh how I hate math). It's made me once again consider it for a moment or two here and there. :fence:

Math is the best, you just need someone to show you how to look at it right. After that, it all falls into place.

 

[otto]

There is always that small risk that something catastrophic can happen. A small but real risk especially with this kind of surgery.

Is there a way to find out how many of these surgeries are done each year at CHO and what the complication rates are. What is the surgeon's record?

You could do 99.9% of the surgeries without a hitch and that one time there is massive bleeding resulting in death it will change the statistics and ruin reputations. Then there are all the circumstances that come into play. Without reading the medical record carefully and talking to everyone involved from her arrival to the hospital until she was resucitated and on the vent how would you know exactly what happened?

Medicine is the one area where you cannot make a mistake. You just can't. It has to be like Minute Rice, perfect every time and you have to give a guarantee like Midas Muffler.

Similar to airplanes. Millions of Boeings take off every day and get to their desitation safely but there is always that chance of the major crash and when it happens it is big.

I heard on the local news that 1/15,000 children die annually in the US after undergoing tonsillectomy surgery (no other surgeries at the same time). There are 530,000 tonsillectomies performed on children under the age of 15 in the US annually. I researched a link and found Wikipedia. I don't know where the link is offhand, but I've linked it before. I have no reason to think that it would be inaccurate.

The primary cause of death is uncontrolled bleeding.

 

[MissJ]

Is a popsicle a liquid?

"Sucking" anything (ie use of straws, what one might do with a popsicle) would be discouraged after oral surgery, would that apply here as well?

I would think anything that encouraged gulping or sucking would be out of bounds but im no expert...

There is always that small risk that something catastrophic can happen. A small but real risk especially with this kind of surgery.

Is there a way to find out how many of these surgeries are done each year at CHO and what the complication rates are. What is the surgeon's record?

You could do 99.9% of the surgeries without a hitch and that one time there is massive bleeding resulting in death it will change the statistics and ruin reputations. Then there are all the circumstances that come into play. Without reading the medical record carefully and talking to everyone involved from her arrival to the hospital until she was resucitated and on the vent how would you know exactly what happened?

Medicine is the one area where you cannot make a mistake. You just can't. It has to be like Minute Rice, perfect every time and you have to give a guarantee like Midas Muffler.

Similar to airplanes. Millions of Boeings take off every day and get to their desitation safely but there is always that chance of the major crash and when it happens it is big.

I understand. But we don't know who (if) made a mistake...I've always wondered what in the world her family was thinking while they were suctioning a fresh post op? It is never advisable to do that. Nor to have her talk or suck on anything. She was spitting out clots. Did her family dislodge the clots with the suction? If they did all the things they have said they did....they may have been the one to make the mistake. I haven't seen any evidence any medical professional made any mistake. I have heard (from the family's statements) that they did things they shouldn't have. There are risks with any procedure and bad outcomes do happen.. My mother arrested after an elective surgery. She was a relatively young woman. It doesn't mean that someone did anything wrong.:twocents:

 

[otto]

IMO since the pulse-ox has been used they have backed off on nail polish removal rules in most outpatient procedures. I was to have no jewelery or nail polish in 2008 for my hysterectomy and an overnight stay was planned.
Who knows! Every facililty is different. What about all the acrylic nails now? — good luck removing those! Lol
Moo
Sent from my SGH-T679 using Tapatalk 2

I think that the nail polish was applied after she was declared dead and before the family made an application to have ventilation continued.

 

[NevadaMom]

Math is the best, you just need someone to show you how to look at it right. After that, it all falls into place.

My husband is always like "oh it's so easy" and then he goes and does math on Khan Academy for giggles. He really likes calculus, trig, differential equations ... things that make me go cross eyed looking at his paper of work.

Clearly my iron stomach when it comes to gore is not enough (not boogers though... I cannot handle boogers, especially when kids eat them :scared

 

[MissJ]

I heard on the local news that 1/15,000 children die annually in the US after undergoing tonsillectomy surgery (no other surgeries at the same time). There are 530,000 tonsillectomies performed on children under the age of 15 in the US annually. I researched a link and found Wikipedia. I don't know where the link is offhand, but I've linked it before. I have no reason to think that it would be inaccurate.

The primary cause of death is uncontrolled bleeding.

Thanks for your research and info.

 

[Donjeta]

Fetuses have rights? Starting when exactly?
She was 14 weeks along, according to the article and at that time the only thing ascertained was the child had a heartbeat because of the ventilator.


Sent from my iPhone using Tapatalk

Fetuses do seem to have (some) rights in the state of Texas, starting when they legislated that the fetus's right to life takes the precedence over the deceased mother's right to be disconnected from machines. Whether that law is a good thing or not is debatable. But I think the fetus does not have a heartbeat because of the ventilator in exactly the same way that its mother and Jahi have a heartbeat because of the ventilator. I mean, obviously the fetus wouldn't have a heartbeat now if not for the ventilator, but back when it all started they never resuscitated the fetus and never brought it back from the death and never got its heart beating again, it was still alive and has had its heartbeat all along through the mother's cardiac arrest and eventual brain death. At that point of a pregnancy the heartbeat is not uncommonly the only thing that has been ascertained and we generally presume that those other fetuses are alive without requiring other confirmation.

Same to me.

Dressing up a corpse to say "good-bye ....to a corpse"?

IMO it's the same. A funeral is for the living, not the dead. Just as this is for her mother. It's an expensive waste of time for the comfort and peace for the living loved ones.

Death used to mean when the heart stopped beating too.

Since when was it commonly accepted that prayers are useless and miracles are impossible?
Seems many want her religious leader to get that through her head.


Sent from my iPhone using Tapatalk

Funeral rituals are very different all over the world and some types of funerals are definitely not what I would ever consider doing to the remains of my own loved ones but there is one common denominator in all of them which is that the purpose of the ritual is to help the living to let go of the dead and accept what happened. Sometimes, depending on their beliefs regarding the afterlife, it's an attempt to help the soul of the deceased forward to a good place.

This is the opposite of what is happening in Jahi's case, it's a way to avoid letting go of the dead and an attempt to keep the soul still attached to the body.

Death used to mean when the heart stopped beating because it was what invariably happened before we had the capacity to plug people into machines and keep things going after parts of them died. Before the advent of the modern brain scanning and modern emergency medicine nobody was ever even diagnosed brain dead because there were none. Once the brain died, the heart died too. The only way to ascertain that anyone had experienced an irreversible cessation of brain function and had no brain perfusion was to see that yup, he's not breathing, his heart stopped, he's dead.

People are free to believe in prayers and miracles but an expectation of a miracle is not a medical indication to continue treatment of a deceased person. It is a religious thing, so perhaps there are churches who'd like to step up and provide this for the people believing that a miracle will happen, but it is not a job for the hospitals.

This quote from a Catholic theology site sums it up imo.

http://catholicmoraltheology.com/what-are-we-learning-from-the-jahi-mcmath-case/

Of course, God can work a miracle. But prudential medical decisions cannot be made based merely on the hope that God might choose to act miraculously.

God chooses to resurrect brain dead people very infrequently and there is no brain scan or a lab test that would let hospitals know that He is going to raise Jahi McMath from the death with any larger probability than any other brain dead person.

JMO.