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CHAT WITH PAT
Answers to your personal questions from someone who
cares........ 
DEAR PAT: My wife
is currently in a coma resulting from a cardiac/respiratory arrest. She was not
breathing for a minimum of 7 minutes, but the time could have been much longer.
The doctors are telling me that she is only receiving the most basic of
responses from the brain. She experienced seizures during the first 24 hours of
her coma. She has been in this coma for 8 days now. Her critical care doctor is
asking me to consider signing a "Do Not Resuscitate" form. I do not want to give
up until I have exhausted all possible options. I want her back, but also want
to adhere to her previously stated wish that she not be made to live in a
"vegetative" state. Where or how can I receive information that will help me
make this most crucial of decisions?
PAT’S ANSWER: This is one of the most agonizing decisions a person
can make. A DNR form essentially means that CPR will not be performed if
your wife’s heart stops. It does not mean that medical treatment will not
continue and it does not mean that they will stop feeding her or assisting
her to breathe. In other words, a DNR form does not constitute "giving up."
Many terminally ill patients are asked early on in their illness to consider
having a DNR form. I encourage you to meet with her physicians to discuss
her prognosis. Consider getting second or third opinions from other experts.
Talk with your family, your wife’s family, and clergy. If you and your wife
ever discussed these issues, be sure to consider her wishes and values.
Also, be sure that YOU talk to someone. Having a critically ill spouse is a
terrible thing, and many people try to bear too much on their own.
For more information on coma, try the Coma Recovery Association’s
website. Their address is:
http://www.comarecovery.org
The following website has a nice list of links to resources about DNR
forms – including information about legality, ethics etc.:
http://www.npg.com/npg/legal/do.not.resuscitate.dnr.htm
DEAR PAT:I have a cousin that just had an accident
that resulted in a brain injury. They discovered in doing x-rays that he has
calcium deposits, which the doctor said it was not caused by current trauma-is
this to be concerned with? What causes calcium deposits in the brain? Can it be
reversed? I have been searching for answers on the web for 2 days and have not
found anything. Can you help or lead me in the right direction for answers?
Thanks.
PAT'S RESPONSE:Pat has a cousin who’s kind of hardheaded. I wonder
if… No, actually calcification of the brain can occur from several problems.
Most calcium that enters the body is deposited in bones and teeth.
Sometimes, calcification can occur through aging. Calcification of the
pineal gland for example, sometimes necessitates surgical removal. In other
cases, calcification can occur because of brain cancer, vascular problems in
the brain, some forms of infection (such as tuberculosis or toxoplasmosis),
or a number of other metabolic disorders or problems with the kidneys. As
for reversing the disorder, there are some techniques used for removing
excess calcium deposits from tissues and joints – some involving diet,
others involving medication. Your cousin’s physician should be consulted
about treatment issues.
DEAR
PAT:My Cousin was 28 years old when she was thrown from a car in an accident
and suffered a brain stem injury. She was not expected to live. Yet, she made an
almost complete recovery. We were rather happy about here recovery, when she
began to fall down a lot. My aunt went with her to the hospital to do some
tests, and they discovered numerous brain tumors. They were cancerous, and she
has been undergoing chemotherapy for a while now. My whole family has been
wondering whether or not the tumors were caused by the accident that happened
almost 18 months prior.
PAT'S RESPONSE:Unless your cousin’s accident involved colliding with
a truck carrying radioactive waste these are likely two independent events.
Pat knows of absolutely no evidence that injury to the brain can later cause
cancer in the brain - anymore than breaking a bone will cause cancer in the
bone. Of course, anything is possible. However, as in most cases with
cancer, there will likely be no way to trace it to a single "cause". Many
things increase one’s chances of getting cancer and there are more likely
suspects than brain injury. Genetic vulnerability and exposure to cancer
causing agents in the environment are two big ones. Keep in mind that at
this point, finding out what "caused" the cancer won’t help your cousin.
What is important is giving her love and support so she can fight the cancer
and hopefully win the battle.
DEAR
PAT:Dear Pat: My son has a severe brain injury (he fell 35 ft). He postured
a lot in the hospital and now he is in a rehab hospital. They had him on Haldol
and also had him on Botox. It stopped the posturing, but now he is no longer on
the Haldol and he is starting to posture again. Why would he posture? I am
trying to get the Doctors to do something quick before it gets so they can't
control it. My son is in a coma yet, he has been in one for 2 1/2 months and
they think he is improving, but not while he is posturing. Also he fixes his
eyes to the right at a certain time of the day some days. He tracks well and
responds to sound. Can you give me any encouragement?
PAT'S RESPONSE:Abnormal posturing is usually a sign of serious
Central Nervous System damage. Certainly, a 35-foot fall will cause serious
damage. Normally when a muscle contracts, the muscles on the other side of
the joint provide resistance to contraction. Abnormal posturing occurs when
damage to the CNS prevents the muscles on the other side from acting in
opposition. In the case of a prolonged coma, posturing can continue for a
long period of time. Obviously, I can’t say anything specific about your
son’s case – you should consult with his physician for a prognosis. In
general, most people eventually "emerge" from comas. However, it is also
true that your son sustained a very severe injury and has been in a coma for
an extended period of time. You need to remain optimistic. You also need to
be realistic – even if your son emerges from the coma, there will likely be
a long rehabilitation process and many long-term changes.
Be sure to talk with your son’s physicians and try to understand the
nature and extent of his injuries and get a realistic prognosis. Keep in
mind, you also need to take care of yourself and your family. Consider
talking to a counselor or clergy. We all need help to get through the bad
times.
Pat
thought the readers might enjoy this letter from a TBI survivor and an "Ask Pat"
fan!
(P.S. Pat just loves fan mail!)
DEAR PAT:I understand that you know everything I need to know and what
you don't know isn't worth knowing! My compliments to you for good advice
couched in delightful banter. I am a survivor of a very severe TBI who has been
blessed with considerable recovery. Persistence and integrity coupled with
education and a sense of humor get me through. I also owe a tremendous debt to
family, friends, and mentors (it took a while to find the right ones). Be an
educated consumer; there are good doctors and there are not so good doctors,
shop around for a genuine one - credentials are important, but not a substitute
for compassion. Support groups can be an immense source of information and help;
be sure it is well facilitated, focused, and viable. The BIA (Pat’s note: BIA =
Brain Injury Association) is great! You/I/we are different, just like everybody
else - TBI sequelae make you more unique, not diminished. In many cases, TBI
doesn't affect IQ to the same degree as it does EQ (emotional intelligence);
find alternative ways/coping skills to make up the difference (I'm still working
hard on that one 35 years later). Be a skeptical optimist in exploring new
information, therapies, and rehabilitation techniques - 1,000 years ago,
everyone KNEW the earth was the center of the universe; 500 years ago, everyone
KNEW the earth was flat; 100 years ago, the medical profession KNEW malaria was
caused by vapors; imagine what they'll know tomorrow.
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