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

[momrids6]

The family was asking for BP medications so I don't think she is being given those. Or maybe she is given some but not all that her body might need.

she is being given vasopressin- which helps maintain BP, but it does not work forever...

 

[gngr~snap]

A bleeding time is considered an innacurate and obsolete test that is no longer offered in most hospitals.

GOOD! I had that done with that razor blade aparatus and a coffee filter! They collected a "dot" every 15 seconds. I failed the first one. They repeated it and I passed the second time. 15 min. later.
???

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[gngr~snap]

she is being given vasopressin- which helps maintain BP, but it does not work forever...

What about diabetes insipidus?
Doesn't that occur sometimes as well?
I may be mixing up desmopressin!
:doh:

" In the early stages this can cause a condition called*neurogenic diabetes insipidus, which is characterised by increased thirst and excessive production of dilute urine. This is due to a reduction in secretion of a hormone called vasopressin (anti-diuretic hormone) and can be treated by administering desmopressin (manufactured anti-diuretic hormone) and replacing lost fluids. Cerebral anoxia may also produce brain swelling and this can add to the damage"
https://www.headway.org.uk/effects-of-anoxic-brain-injury.aspx
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[Harmony 2]

Can someone pls provide link?

Thx in adv.

FYI- The links to all the court documents have been added to the opening post of the thread.

I have alerted a mod about the broken quotes. This has been happening for a couple of days now. I noticed that a comment was attributed to me that I had not made. I hope the problem is addressed promptly.

Broken quotes are a very tedious time consuming task requiring going back through the pages to confirm the original poster. It takes the moderator away from alerts and reading the thread. All the broken quotes on this thread have been repaired.

Please alert as soon as one is posted!!!

 

[momrids6]

What about diabetes insipidus?
Doesn't that occur sometimes as well?
I may be mixing up desmopressin!
:doh:

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yes- it is supposed to help with that, according to the endless literature on the net- but one of the WS Med Members need to explain why would D5W (sugar water) be a good idea with the above.

ETA: I do know D5W is frequently given post op- which may explain why it is being maintained

 

[meanmaryjean]

Diabetes indipidus is NOT 'sugar diabetes'. Two completely separate diseases, easily confused by laypersons. (Actually , diabetes medically refers to increased urination) So diabetes insipidus is when the damaged pituitary can no longer control the levels of sodium and water in the body. The hallmark sign is uncontrolled urine output. It is an eventuality in many cases of this type of cerebral edema brain death.
Intravenous vasopressin in the treatment of choice in the ICU environment. Easily titrated.

 

[meanmaryjean]

So- dextrose solution is not contra-indicated in this condition. It just speaks to the lack of blood flow to the brain and all the organs contained in the cranium.

 

[momrids6]

Diabetes indipidus is NOT 'sugar diabetes'. Two completely separate diseases, easily confused by laypersons. (Actually , diabetes medically refers to increased urination) So diabetes insipidus is when the damaged pituitary can no longer control the levels of sodium and water in the body. The hallmark sign is uncontrolled urine output. It is an eventuality in many cases of this type of cerebral edema brain death.
Intravenous vasopressin in the treatment of choice in the ICU environment. Easily titrated.

bbm; Yep- that would be me...

 

[WisconsinMom]

After lurking for quite some time, I decided to join the forum. This has really affected me. I am a single mother of two, and I worked in the hospital for years. I am now a school nurse. Parents should not have to bury their children. I feel for this family, but I find this whole circus disgusting. I don't know what I'd do in this situation, and I hope that this is something I'm never faced with. I would like to think I would be able to let go and let my child rest in peace. I was very sympathetic with this family in the beginning, and as each day passes, I am truly disgusted with the way they are handling this. Brain death is irreversible. Jahi is gone, and she is not coming back. I feel like they are not allowing themselves to go through the grieving process, by channeling so much anger into CHO. I feel like it's not even about Jahi anymore. It's truly sad. She should be allowed to rest in peace. I'm hoping the courts put an end to this really soon.

 

[MsSeal]

Did anyone catch CNN tonight Anderson Cooper?

Two lawyers going at it. All about the rights of the family to keep her on life support.

I think I am personalizing this because even if the family wins everything they want and are heroes for fighting to save her life I can only picture this sweet girl in a questionable long term care facility fighting infections, terrible bedsores, laying in her stool, multiple health problems from being on a vent long term with no viable brain tissue, no chance of ever seeing her smile again, eyes that will never open, the list goes on. Is that how her mother wants to her be?

I am not saying Jahi life does not have value but from where I sit how it can be a called a life. It is just existing. When I say I am personalizing it would be more heart wrenching for me to see my daughter in that state than to let her go peacefully knowing how vibrant she was (and I do have a daughter). But if I look at twitter and read comments under articles and blogs, many many disagree with me. Then I think what part of me is not getting it.

If she were to wake up I would say I was completely wrong but it appears that she will be vent dependant forever and never regain any brain function at all. I am trying to rationalize why people fight for brain dead people to continue artificial breathing to keep the body functioning. But those are their beliefs and they seem to have a very strong voice and are growing.

I can only believe that the medical personnel who were involved that day have wept. I know people are saying they were heartless but I don't believe that for one minute. No one would have wanted this outcome.

 

[MEN3C]

Diabetes indipidus is NOT 'sugar diabetes'. Two completely separate diseases, easily confused by laypersons. (Actually , diabetes medically refers to increased urination) So diabetes insipidus is when the damaged pituitary can no longer control the levels of sodium and water in the body. The hallmark sign is uncontrolled urine output. It is an eventuality in many cases of this type of cerebral edema brain death.
Intravenous vasopressin in the treatment of choice in the ICU environment. Easily titrated.

Yes. There are many different types of diabetes insipidus as well. If the diabetes insipidus is 'neurogenic', it means the pituitary is not producing enough ADH (vasopressin), and you can just give vasopressin. The diabetes insipidus can also be nephrogenic (e.g kidney issue) in which case vasopressin is being secreted but the kidney does not respond as it should. So in this case, vasopressin would be ineffective. You want to correct the hypernatremia (too much sodium) in this case. You can use several methods like .45% saline and such to do that, or use 5% dextrose but then you do have to worry about hyperglycemia.

There are other types as well but those aren't relevant here. And of course there is diabetes melliticus (type I & II), which is what most lay people think of as diabetes.

 

[thistle]

Welcome to the forum, & I think I understand what you are feeling. I would not want to put myself in Jahi's mother's place, I think it must be the worst place imaginable, but for the sake of their daughter, they should try to cope with it, & celebrate her life. I don't think that she would want all this attention, it feels intrusive, I wish that she could rest in peace.

 

[scmom]

I snipped this from the British Journal of Anaesthesia because it gives some details about physiological changes after brain death.
However, brain death is often associated with marked physiological instability, which, if not managed, can lead to deterioration in organ function before retrieval.
http://bja.oxfordjournals.org/content/108/suppl_1/i96.full
http://bja.oxfordjournals.org/content/108/suppl_1/i96/T1.expansion.html

 

[MEN3C]

In case anyone is interested in the management of DI in the setting of TBI: http://www.mc.vanderbilt.edu/surgery/trauma/Protocols/2007/2007DIABETESINSIPIDUSDxandMgtPMG.pdf

 

[SophieRose]

Dr. David Durand was appointed Chief of Pediatrics early last year. Bet he thought he would never have anything like this in his long career.

http://www.bizjournals.com/sanfrancisco/blog/2013/02/childrens-hospital-oakland-names-dr.html

Children’s Oakland, a 190-bed pediatric hospital that employs 2,700, is in the midst of affiliation talks with UCSF Medical Center that recently received a green light from the Regents of the University of California and from Children’s Oakland’s board of directors.

The hospital has an annual budget of about $350 million, and a research budget of about $50 million, but has had trouble finding funding for a much-needed seismic rebuild and upgrade.

 

[krimekat]

Welcome WisconsinMom!!!

I agree with your statement.

 

[ljwf22]

After lurking for quite some time, I decided to join the forum. This has really affected me. I am a single mother of two, and I worked in the hospital for years. I am now a school nurse. Parents should not have to bury their children. I feel for this family, but I find this whole circus disgusting. I don't know what I'd do in this situation, and I hope that this is something I'm never faced with. I would like to think I would be able to let go and let my child rest in peace. I was very sympathetic with this family in the beginning, and as each day passes, I am truly disgusted with the way they are handling this. Brain death is irreversible. Jahi is gone, and she is not coming back. I feel like they are not allowing themselves to go through the grieving process, by channeling so much anger into CHO. I feel like it's not even about Jahi anymore. It's truly sad. She should be allowed to rest in peace. I'm hoping the courts put an end to this really soon.

:welcome:

 

[Steft50]

Did anyone catch CNN tonight Anderson Cooper?

Two lawyers going at it. All about the rights of the family to keep her on life support.

I think I am personalizing this because even if the family wins everything they want and are heroes for fighting to save her life I can only picture this sweet girl in a questionable long term care facility fighting infections, terrible bedsores, laying in her stool, multiple health problems from being on a vent long term with no viable brain tissue, no chance of ever seeing her smile again, eyes that will never open, the list goes on. Is that how her mother wants to her be?

I am not saying Jahi life does not have value but from where I sit how it can be a called a life. It is just existing. When I say I am personalizing it would be more heart wrenching for me to see my daughter in that state than to let her go peacefully knowing how vibrant she was (and I do have a daughter). But if I look at twitter and read comments under articles and blogs, many many disagree with me. Then I think what part of me is not getting it.

If she were to wake up I would say I was completely wrong but it appears that she will be vent dependant forever and never regain any brain function at all. I am trying to rationalize why people fight for brain dead people to continue artificial breathing to keep the body functioning. But those are their beliefs and they seem to have a very strong voice and are growing.

I can only believe that the medical personnel who were involved that day have wept. I know people are saying they were heartless but I don't believe that for one minute. No one would have wanted this outcome.

:clap:

I applaud you for the best said comments on real feelings today!!

 

[popsicle]

Brain Death Cases

http://thaddeuspope.com/braindeathcases.html

He has collected similar cases here.

 

[Steft50]

:wagon:

After lurking for quite some time, I decided to join the forum. This has really affected me. I am a single mother of two, and I worked in the hospital for years. I am now a school nurse. Parents should not have to bury their children. I feel for this family, but I find this whole circus disgusting. I don't know what I'd do in this situation, and I hope that this is something I'm never faced with. I would like to think I would be able to let go and let my child rest in peace. I was very sympathetic with this family in the beginning, and as each day passes, I am truly disgusted with the way they are handling this. Brain death is irreversible. Jahi is gone, and she is not coming back. I feel like they are not allowing themselves to go through the grieving process, by channeling so much anger into CHO. I feel like it's not even about Jahi anymore. It's truly sad. She should be allowed to rest in peace. I'm hoping the courts put an end to this really soon.

:welcome:


I don't think you are alone in how you feel