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

[wendiesan]

I didn't think her fingers looked thin, at all, in the picture- and I can't even see her wrists. Her fingers look quite large- to me, but her nail beds look pink and healthy (clear polish?)- how is that possible? Her skin looks healthy too- not ashen or gray. I would think by now- they would be. So, if she is on no medication, and doing everything on her own- does that mean going to the bathroom. I am as confused as I ever was. No PICC line, no IV etc. I didn't think that was possible. Can someone who knows more help me out. Could she look healthy indefinitely if her heart continues to beat and her blood circulates?

I have a theory about the first of your questions.

If you check out the full image (http://media.nbcbayarea.com/images/jahinails.jpg)
rather than the cropped photo now attached to the articles, you will see that there is a striking difference between the apparent size of the wrist and the fingers shown in that photo. I think it may have something to do with the perspective brought about by positioning of the camera in relation to the hand shown in the picture, and the kind and quality of the lens being used, the angle of the wrist when the hand was posed for the shot, etc.

I want to agree with previous posts that there is no way of identifying the person whose hand was photographed from that particular shot. For the sake of argument, I'll assume that it is Jahi's hand.

When I first saw the shot, I thought that the fingers looked swollen. I don't know if that is a condition which is typical of bedridden patients who are in comas, vegetative state, persistent vegetative state, or minimally responsive state, let alone those diagnosed as having suffered brain death. Since Jahi's circulation is being aided by physical therapy only three or four times a week (according to NW's interview), and swollen fingers are consistent with poor circulation, perhaps it's possible that such edema is part of her condition. My guess would be that it would be difficult to keep Jahi's hands above her heart for half hour periods. It would seem pretty logical to assume that her hands would be below the level of her heart most of the time.

I think that lack of exercise, poor nutrition,hormonal imbalance, excessive salt in one's diet, poor blood pressure, heart and liver disease and many other factors, lead to such swelling in the hands and feet of ambulatory people. Therefore, I don't think it's much of a stretch to believe that Jahi's body would be similarly affected. IIRC, back on previous threads it was mentioned that compression stockings might be used in Jahi's care to minimize this effect. Am I sort of in the ball park on this med experts?

Another guess. Since posters who are in the medical professions have said that her nails could grow and abrasions could heal if Jahi's circulation continued to be maintained, then the nails would continue to be pink. It's also possible that the "clear" polish might be "sheer" with just a hint of colour that would enhance the natural colour of her nails and make them look healthier.

 

[wendiesan]

Who is caring for Jahi's siblings? I hope that NW's other children aren't being neglected while she tends to her incapacitated daughter. They need and deserve care, nurturing, and emotional support from their mother during this difficult time. lease:

NW has said in an interview I read that she misses her other children, and that her family is looking after them. I'll try to find that link for you when I get back. I so agree with you BDE, but travel expense, living expenses, schooling for the surviving siblings, etc. may be playing a large part in the separation if Jahi is in a facility outside of California.


ETA: More info at 1074.

 

[MissJ]

So it seems that Mrs Winkfield has confirmed that Jahi is not in California. At least, that's how I interpreted her phrasing. "Back in California...."

Ventilator on room air. That's not exactly "how" a health professional would characterize the settings. Technically, that would be characterized as 21% O2. Room air could imply the vent circuit is open. Or perhaps using an oxygen concentrator. Which also means she may, or may not be in any kind of actual health care facility. She could be in a home care environment. Would make care easier if you didn't have to have oxygen delivery. Anyhooo......fwiw.

Great points you made! It would appear, to me, JMO, that from the things Mom says, Jahi is NOT in a licensed medical facility and insurance would NOT pay. Why? If what Ms. Winkfield says is true, Jahi is getting custodial care....not medical care. No medical procedures are being done. No insurance,medicaid or medicare would pay for this level of care. :moo:

 

[Donjeta]

There can't be too many insurance companies that would pay for any kind of care for a person with a death certificate.

 

[MyBelle]

"NW: (1:30) She moves all the time. She moves a lot. She can--they have to put pillows around her bed because she's even moved and bust her lip because she's startin' to lift at the waist. She moves her upper [extremities] and always her legs and her feet. So, I'm really happy about that."

If she is doing all this, especially lifting at the waist, all they need is some videos, and I feel sure the ruling on death could be overturned. I can imagine small twiches and movements, but moving enough to cause her lip to bleed? Would the body be capable of having seizures? That what all this sounds like to me, but I am in no way medical, just a person who has lived 52 yrs and has never seen anything like this. I just wish the interviewer had asked the Schivo brother did he see any difference in brain damaged and brain dead.

If she's living in another state, I doubt they care that there is a death certificate. afaik, it was never filed in California. Her mother seems very happy with the care provided and that's all that really matters, imo.

 

[Linda7NJ]

BBM



No, it's not. Jahi had a negative cerebral blood flow result in December, done in accordance with the time related requirements (if done too early, brain swelling can give a false result). There was no flow. When there is no blood flow to the brain, the brain tissue dies. Once it dies, it begins to shrivel, soften, and liquify. It no longer receives blood flow.



Unless you have proof that the negative CBF study was not done correctly or the results were incorrect or purposely falsified, then you cannot argue that the heart is circulating blood in her brain.



http://www.donorrecovery.org/learn/understanding-brain-death/

I would think the fact that her brain hasn't rotted to the point her eyeballs rotted and had fallen out of her head, followed by oozing liquified brains proves it. IMO

We've all see a skull.


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[Tulessa]

Donjeta, thank You! although, I I realize, I realize Your your is in the best interest, is info is in the best interest for this baby, i just wanted to thank you, for the interest for this very sweet child, THANK YOU! :blowkiss:

I screwed that up! :floorlaugh:

I went to the doctor yesterday & had knee injections. They gave me .5 Valium. Native Americans don't tolerate meds well.

 

[gitana1]

It's just very sad. Very horrible. I doubt she is having seizures. If there is no blood flow to the brain, there is no brain activity which is what causes seizures. They are probably seeing horrid reflex movement from Jahi's body. Lazarus signs:

People who are brain dead make certain motions that make it look like they are aware of their surroundings. The most horrifying motion of all is the Lazarus sign — it can convince people that their loved one has literally come back from the dead.
The Lazarus sign is an example of a spinal reflex arc. Living people often experience spinal reflex arcs. http://io9.com/the-lazarus-sign-can-convince-you-that-brain-dead-peopl-1500081143

More at link. Apparently, brain dead people can actually look like they are struggling to sit up when disconnected from a respirator. I have a feeling Jahi's body is going through its last moments.

I feel so sorry for this family. It's heartbreaking.

 

[nrdsb4]

Tests can be wrong. Mothers and fathers are allowed to believe in miracles.

http://www.today.com/id/23775873/ns...-dead-man-takes-miraculous-turn/#.UzXDm1eebEg

But 36 hours after the accident, doctors performed a PET scan of his brain and informed his parents, along with other family members who had gathered to keep vigil at the hospital, that there was no blood flowing to Zack’s brain; he was brain-dead.

Doctors showed the scan to Zack’s parents, and, Doug Dunlap told Morales, “There was no activity at all. No blood flow at all.”

First of all, the test you are describing was a PET scan, which from what I understand, for these purposes, a)was done too early to be taken as evidence of brain death (36 hours after a head trauma is too early to be doing a PET scan to assess for brain death) and b)is inferior to a cerebral angiogram for determining absence of blood flow in the brain.

Jahi McMath's exams and data were examined and re-examined multiple times. None of the multiple doctors noted that current medical standards with regard to to the timing, method, or accuracy of all of the exams performed on Jahi were suspect.

You have no evidence that Jahi's angiogram was done incorrectly; certainly you have no evidence to declare categorically that Jahi's brain is actually receiving blood and oxygen simply because she is on a ventilator. But you stated this as if it were a fact.

Jahi's family's interpretations of her condition, based on their own strong desires rather than any medical knowledge or training, can certainly be understood, and compassion for that should be forthcoming, imo. However, we cannot state as fact that Jahi's CBF study is in error simply because "tests can be wrong." Until we have a reason we can document for stating that 6 of her doctors have incorrectly interpreted the data, we cannot state that it is so.

Until I see a link which states that Jahi's CBF study did not follow established medical protocol, I will take it at face value and would certainly not state as fact that it IS wrong simply because "tests can be wrong." The most anyone not medically trained or with specific knowledge of how these tests were carried out on Jahi can do is simply wonder if the tests are actually conclusive.

JMHO and if any certified medical professionals find any errors in my post, PLEASE correct them. We can all learn from the wiser and more knowledgeable among us.

 

[MyBelle]

I would think the fact that her brain hasn't rotted to the point her eyeballs rotted and had fallen out of her head, followed by oozing liquified brains proves it. IMO

We've all see a skull.


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ITA, and even if it has, her mother has every right to sit there, hold her hand and pray for a miracle, imo.

 

[nrdsb4]

I would think the fact that her brain hasn't rotted to the point her eyeballs rotted and had fallen out of her head, followed by oozing liquified brains proves it. IMO

We've all see a skull.


Sent from my iPhone using Tapatalk

That doesn't make any sense from a medical perspective.

 

[nrdsb4]

ITA, and even if it has, her mother has every right to sit there, hold her hand and pray for a miracle, imo.

Of course she does. But that has nothing to do with YOUR declaration that Jahi's brain is receiving blood and oxygen by virtue of being hooked up to a ventilator.

 

[nrdsb4]

It's just very sad. Very horrible. I doubt she is having seizures. If there is no blood flow to the brain, there is no brain activity which is what causes seizures. They are probably seeing horrid reflex movement from Jahi's body. Lazarus signs:

More at link. Apparently, brain dead people can actually look like they are struggling to sit up when disconnected from a respirator. I have a feeling Jahi's body is going through its last moments.

I feel so sorry for this family. It's heartbreaking.

When I was in nursing school, I was working in a nationally renown trauma ICU during the graveyard shift. A patient in the ICU had died within several minutes of my arrival. One of the trauma residents waved me over and told me to listen to the deceased patient's heart as "you can still hear some weird stuff after they are dead." I put my stethescope at the location of an apical pulse and leaned close into him. At that moment, the resident pushed on the corpse's diaphram (I think, I wasn't paying attention to him), and it literally groaned and appeared to try to sit up.

Let me tell you, I'm shocked I didn't need to go change my clothes after that. Immediately after this happened, other interns and residents appeared from the hallway, all laughing at the pale, shaking, and cursing nursing student.

Gallows humor is in abundance in the trauma ICU during the wee hours of the morning.

 

[wendiesan]

NW has said in an interview I read that she misses her other children, and that her family is looking after them. I'll try to find that link for you when I get back. I so agree with you BDE, but travel expense, living expenses, schooling for the surviving siblings, etc. may be playing a large part in the separation if Jahi is in a facility outside of California.

Hi BDE. Here's the quote I referred to:

'Winkfield said she has a place to stay outside of the care facility, but that she is mostly at the center, where she called the staff "angels." She acknowledged it's been very challenging to leave her other three children -- two daughters, ages 19 and 5, and an 11-year-old son -- at home without her.

"I definitely miss my other children," she said. "But my family is super supportive, so even though I'm gone, my children definitely understand why I'm gone, and they're definitely in agreement with me staying here to take care of their sister." '

This is at the end of the article, after you scroll past the photo of the St. Patrick's Day nails.

http://www.nbcbayarea.com/news/loca...er-Says-of-Brain-Dead-Daughter-252700851.html

 

[gitana1]

I would think the fact that her brain hasn't rotted to the point her eyeballs rotted and had fallen out of her head, followed by oozing liquified brains proves it. IMO

We've all see a skull.


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I think there may be membranes and bone that hold the brain in and it may not be as liquid as one would think. I found this (WARNING. GROSS):

I have observed countless autopsies, including quite a few done after exhumation. I remember being surprised at how often an otherwise well preserved appearing body would have brain liquefaction. The brain literally flows out as a viscous soup when the calvarium is pried loose from the top of the head. http://www.cryonet.org/cgi-bin/dsp.cgi?msg=17031

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

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

 

[Donjeta]

I would think the fact that her brain hasn't rotted to the point her eyeballs rotted and had fallen out of her head, followed by oozing liquified brains proves it. IMO

We've all see a skull.


Sent from my iPhone using Tapatalk

A scary picture but it doesn't seem to be necessary for a diagnosis of no brain circulation as it is by no means a rule or even that common. There are holes in the skull where the eyes are but the brain is contained by the meninges which normally contain the CSF. If there is damage to the dura there may be liquid leaking through (sometimes this happens even in a living individual) and in one of the earlier threads we read about a graphic case of a brain dead child who had stuff leaking through his anterior fontanel and necrotic skin but even so his eyeballs didn't fall out.

 

[nrdsb4]

A scary picture but it doesn't seem to be necessary for a diagnosis of no brain circulation as it is by no means a rule or even that common. There are holes in the skull where the eyes are but the brain is contained by the meninges which normally contain the CSF. If there is damage to the dura there may be liquid leaking through (sometimes this happens even in a living individual) and in one of the earlier threads we read about a graphic case of a brain dead child who had stuff leaking through his anterior fontanel and necrotic skin but even so his eyeballs didn't fall out.

Yeah, there is no criteria which states that eyeballs falling out of the head is the determinant for brain death diagnosis. :snooty:

 

[heartfortruth]

It's just very sad. Very horrible. I doubt she is having seizures. If there is no blood flow to the brain, there is no brain activity which is what causes seizures. They are probably seeing horrid reflex movement from Jahi's body. Lazarus signs:

More at link. Apparently, brain dead people can actually look like they are struggling to sit up when disconnected from a respirator. I have a feeling Jahi's body is going through its last moments.

I feel so sorry for this family. It's heartbreaking.

Thank you for this post.. I was at my mother's bedside when she died and after the hospice nurse checked for heart beat with stethoscope and we exchanged looks and nods she turned around to , I guess, write the TOD on the chart , my mother's face contorted into this awful grimace (only way I can describe it) and it looked like she was , not just angry, but MAD! It looked someone defying death! That would have been "so her"! The nurse couldn't explain it as she watched with me until Mother was still again. I have been left with that picture of her in my mind these past years and maybe you have explained what might have happened.

 

[nrdsb4]

^^^I'm sorry you had to see that.

Condolences on your loss.

 

[tiredblondy]

It's just very sad. Very horrible. I doubt she is having seizures. If there is no blood flow to the brain, there is no brain activity which is what causes seizures. They are probably seeing horrid reflex movement from Jahi's body. Lazarus signs:

More at link. Apparently, brain dead people can actually look like they are struggling to sit up when disconnected from a respirator. I have a feeling Jahi's body is going through its last moments.

I feel so sorry for this family. It's heartbreaking.

I've seen this and yes it is horrid. That's exactly as I would describe it. Thanks Git. I'd forgotten about this. Also as with someone I loved there are twitches that can fool you too. It was explained to me as the muscles are starving for oxygen because the blood circulation is not like it is for a vital healthy living person.I know that I hope she can't feel it because in a person experiencing this before death it is extremely painful and was so hard for me to watch That's one of those things no one tells you about. Thank the Lord for morphine!