Bobbi Kristina Brown found unresponsive in bathtub. #3

MSNBC reporting. Links to come.

She's breathing, according to CNN. [video=cnn;entertainment/2015/01/31/bobby-kristina-brown-found-unresponsive.cnn]http://www.cnn.com/2015/01/31/entertainment/whitney-houston-daughter-unresponsive/index.html[/video]

My opinion, and I know it isn't popular, is that she is, unfortunately, permanently and irreversibly neurologically damaged to at least a PVS state, if not brain dead. I don't think she will ever recover to any significant degree, even to getting off a ventilator. Sadly, there is really very little realistic hope of any kind of recovery here, IMO.

All the commentators are being "soooooo careful" to not say anything realistic about what's going on. Sometimes I wonder if Sanjay Gupta is really even a doc-- because he does not talk like any medical specialist I have ever met. He sugar coats EVERYTHING, IMO. Maybe because of liability issues for CNN or something, or maybe just minimizing what he knows to be true, out of respect. He downplays everything serious he comments on, not just in this situation, IMO.

BK is in a devastating, dire situation. I'm sorry to be that blunt, but anyone with a serious amount of health care and ICU experience will agree. Drowning, arrest at the scene, 3 weeks of coma-- there is just nothing at all about this situation that should prompt false hope in people who are not her closest loved ones. They are devastated, and in denial, and that is completely understandable. I have great compassion for any family in that situation. But those of us much further removed from the emotion, and the exquisitely painful circumstances of her situation, can be more objective about what's going on.

I agree with Katydid's ICU friend above-- they have "brought her out of" whatever medically depressed state she has been in-- probably several times.

The specialists know exactly what her situation is right now.

It's a hard, hard truth, but sometimes people are more broken than we are able to fix.

Even someone withOUT health care and ICU experience agrees with your take, K_Z...and that would be me.

Based on what I could glean from the timetable of events from the beginning, I have felt persistently sad and sorry that the outcome for BK was and still is grim.

Thank you again for your info and insight, so valuable and necessary for my understanding to endorse why I felt as I did from the gate.

~jmo~

"When they told me my mother was dead after her open heart surgery, I asked if they could put her back on the heart/lung machine. (no) I would have done anything, anything to have her still with me, even as a nearly lifeless pet. I was not ready to let go but the decision was out of my hands. I understand if Bobby feels that he can't lose his daughter. It's quite possible that he simply loves her. "

First of all, gracenote, my condolences for your loss. And thank you for your honestly in writing this.


I don't know how long it has been since your mother passed, but could you please comment about how you feel now about keeping a loved one on machines as "an almost lifeless pet"? I wonder what you would have to say to the Brown family if you had the opportunity to talk with them.

IMO each of us has the right to live and the right to die with dignity. Keeping someone hooked up to various machines with a body that has ceased to function is really not very respectful of that loved one, IMO.

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I agree about Dr. Gupta. When he first started I really respected him and watched for his reports. But nowadays, he has been "media-ized".

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Another peeve of mine: The National Enquirer bashing that goes on. Yet everyone reads their articles, don't they? In this case they have presented an exclusive interview with someone who brought forth relevant information about this case. They are well known for vetting their sources pretty thoroughly, including administering lie detector tests at times. (I don't know that they did that for this story, but they have done it for other stories and have included the information within the story that the person passed the lie detector test.)

NE has been accurate with many, many of their stories over the years. Do I believe every single thing they say is gospel truth? No, not always. But I don't think it is because they want to print lies, I think it is due to faulty source information.

K_Z said:

My opinion, and I know it isn't popular, is that she is, unfortunately, permanently and irreversibly neurologically damaged to at least a PVS state, if not brain dead. I don't think she will ever recover to any significant degree, even to getting off a ventilator. Sadly, there is really very little realistic hope of any kind of recovery here, IMO.

All the commentators are being "soooooo careful" to not say anything realistic about what's going on. Sometimes I wonder if Sanjay Gupta is really even a doc-- because he does not talk like any medical specialist I have ever met. He sugar coats EVERYTHING, IMO. Maybe because of liability issues for CNN or something, or maybe just minimizing what he knows to be true, out of respect. He downplays everything serious he comments on, not just in this situation, IMO.

BK is in a devastating, dire situation. I'm sorry to be that blunt, but anyone with a serious amount of health care and ICU experience will agree. Drowning, arrest at the scene, 3 weeks of coma-- there is just nothing at all about this situation that should prompt false hope in people who are not her closest loved ones. They are devastated, and in denial, and that is completely understandable. I have great compassion for any family in that situation. But those of us much further removed from the emotion, and the exquisitely painful circumstances of her situation, can be more objective about what's going on.

I agree with Katydid's ICU friend above-- they have "brought her out of" whatever medically depressed state she has been in-- probably several times.

The specialists know exactly what her situation is right now.

It's a hard, hard truth, but sometimes people are more broken than we are able to fix.

Click to expand...

bbm, It's popular in my neck of the woods, I value honest knowledgeable answers in these situations, Thanks for your contributions here.

Please continue here for Bobbi Kristina

Dr. Sanjay Gupta is a practicing neurosurgeon and associate chief of neurosurgery at Grady Memorial Hospital and an assistant professor at Emory University Hospital in Atlanta. He is a columnist for Time magazine, a contributor to CBS News, and a chief medical correspondent at CNN.

Before joining CNN in 2001, Dr. Gupta was a neurosurgeon at the University of Tennessee’s Semmes-Murphey clinic, and before that at the University of Michigan Medical Center. He became a partner in the Great Lakes Brain and Spine Institute in 2000. In 1997, he was chosen as a White House Fellow, serving as special advisor to First Lady Hillary Rodham Clinton...

http://www.everydayhealth.com/authors/sanjay-gupta/

University of Michigan Medical School (1993) *

Residency - University of Michigan Hospital (2000) *

Fellowship - University of Tennessee Bowld Hosptial (2001) *

http://www.vitals.com/doctors/Dr_Sanjay_K_Gupta_2/credentials

U

TTF14 said:

She's breathing, according to CNN. [video=cnn;entertainment/2015/01/31/bobby-kristina-brown-found-unresponsive.cnn]http://www.cnn.com/2015/01/31/entertainment/whitney-houston-daughter-unresponsive/index.html[/video]

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Is this a new post? I'm a little confused as most of the replies here were carried over.

That post was from 1/31 when she was found. Just hop down to where it picks up today...

I just want to pop in and state that I actually am quite familiar with Sanjay Gupta's background. My criticism of his celebrity doc commentary was meant to point out that he comments as though he is a just a layperson with only a "bit more" knowledge, not as a highly experienced and trained specialist. He is obviously much more highly educated and experienced than I am in the area of neurology/ neurosurgery, and I don't pretend to know more than he does. And that's exactly my point. I believe that it's his serious responsibility not to be a celebrity talking head "making nice" to every possible viewpoint, and give dumbed down soft opinions on matters of fact-- but, instead a responsibiity to provide actual, solid, science based facts that non-medically educated people can use to make realistic interpretations.

Here is just ONE reference (recent; 2012) related to the outcomes of adult drownings with cardiac arrest at the scene:

A previous study reported a survival rate of only 1.7% in 1,669 adult drowning patients who were in a cardiac arrest when the emergency medical services (EMS) arrived. Of these, only 0.7% survived with a favourable neurological outcome at 1-month after the near-drowning incident [2]. Despite the advances in critical and emergency care medicine, several attempts to resuscitation have proven unsuccessful in improving the outcomes of drowning and near-drowning victims [3],[4].

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http://www.sjtrem.com/content/22/1/77

BBM. Full text article at link, not just abstract.

Even though I want to know everything, I really give the family (both sides) credit for keeping the paps away.
I was so afraid terrible pictures of BK would be leaked for money. She would not be a sleeping beauty. BB has controlled the media. BB knows how to avoid the press and also use the press to his best. Also the hospital has been very guarded with everything.

Sanjay Gupta and news sources are probably scared of being sued.

And a few more references with statistics for drownings with cardiac arrest at the scene (BBM). The acronyms "OHCA" = out of hospital cardiac arrest, and "ROSC" = return of spontaneous circulation, which means an effective heartbeat.

Results

EMS attended 336 drowning-related OHCA during the study period. Cases frequently occurred in summer (45%) and the majority of patients were male (70%) and adult (77%). EMS resuscitation was attempted on 154 (46%) patients. Of these patients, 41 (27%) survived to hospital arrival and 12 (8%) survived to hospital discharge (5 adults [6%] and 7 [12%] children). Few patients were found in a shockable rhythm (6%), with the majority presenting in asystole (79%) or pulse-less electrical activity (13%). An initial shockable rhythm was found to positively predict survival (AOR 48.70, 95% CI: 3.80–624.86) while increased EMS response time (AOR 0.73, 95% CI: 0.54–0.98) and salt water drowning (AOR 0.69, 95% CI: 0.01–0.84) were found to negatively predict survival.

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http://www.resuscitationjournal.com/article/S0300-9572(13)00051-8/abstract?cc=y

RESULTS:

During the study period, 66,716 OHCAs were documented, and resuscitation was attempted for 62,048 patients (1300 children [2%] and 60,748 adults [98%]). Among these OHCAs, 1737 (3% of OHCAs) were due to drowning (36 younger children [2%], 32 older children [2%], and 1669 adults [96%]). The odds of one-month survival were significantly higher for younger children (28% [10/36]; adjusted odds ratio [AOR], 20.20 [95% confidence interval {CI} 7.45-54.78]) and older children (9% [3/32]; AOR, 4.47 [95% CI 1.04-19.27]) when compared with adults (2% [28/1669]). However, younger children (6% [2/36]; AOR, 5.23 [95% CI 0.52-51.73]) and older children (3% [1/32]; AOR, 2.53 [95% CI 0.19-34.07]) did not have a higher odds of neurologically favorable outcome than adults (1% [11/1669]).

CONCLUSION:

In this large OHCA registry, children had better one-month survival rates after OHCA due to drowning compared with adults. Most survivors in all groups had unfavorable neurological outcomes.

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http://www.ncbi.nlm.nih.gov/pubmed/23831805

A very comprehensive discussion of drowning and pre-hospital and ICU care:

http://www.nejm.org/doi/full/10.1056/NEJMra1013317

Recent recommendations related to advanced cardiac life support resuscitation longer than 30 min, for child drowning victims:

Conclusions Drowned children in whom return of spontaneous circulation is not achieved within 30 minutes of advanced life support have an extremely poor outcome. Good neurological outcome is more likely when spontaneous circulation returns within 30 minutes of advanced life support, especially when the drowning incident occurs in winter. These findings question the therapeutic value of resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia.

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http://www.bmj.com/content/350/bmj.h418

http://www.medicalnewstoday.com/articles/289168.php

K_Z said:

My opinion, and I know it isn't popular, is that she is, unfortunately, permanently and irreversibly neurologically damaged to at least a PVS state, if not brain dead. I don't think she will ever recover to any significant degree, even to getting off a ventilator. Sadly, there is really very little realistic hope of any kind of recovery here, IMO.

All the commentators are being "soooooo careful" to not say anything realistic about what's going on. Sometimes I wonder if Sanjay Gupta is really even a doc-- because he does not talk like any medical specialist I have ever met. He sugar coats EVERYTHING, IMO. Maybe because of liability issues for CNN or something, or maybe just minimizing what he knows to be true, out of respect. He downplays everything serious he comments on, not just in this situation, IMO.

BK is in a devastating, dire situation. I'm sorry to be that blunt, but anyone with a serious amount of health care and ICU experience will agree. Drowning, arrest at the scene, 3 weeks of coma-- there is just nothing at all about this situation that should prompt false hope in people who are not her closest loved ones. They are devastated, and in denial, and that is completely understandable. I have great compassion for any family in that situation. But those of us much further removed from the emotion, and the exquisitely painful circumstances of her situation, can be more objective about what's going on.

I agree with Katydid's ICU friend above-- they have "brought her out of" whatever medically depressed state she has been in-- probably several times.

The specialists know exactly what her situation is right now.

It's a hard, hard truth, but sometimes people are more broken than we are able to fix.

Click to expand...

Sanjay Gupta is a very real physician. Not all physicians think the same way. It is not an indoctrination, or is it?

K_Z said:

I just want to pop in and state that I actually am quite familiar with Sanjay Gupta's background. My criticism of his celebrity doc commentary was meant to point out that he comments as though he is a just a layperson with only a "bit more" knowledge, not as a highly experienced and trained specialist. He is obviously much more highly educated and experienced than I am in the area of neurology/ neurosurgery, and I don't pretend to know more than he does. And that's exactly my point. I believe that it's his serious responsibility not to be a celebrity talking head "making nice" to every possible viewpoint, and give dumbed down soft opinions on matters of fact-- but, instead a responsibiity to provide actual, solid, science based facts that non-medically educated people can use to make realistic interpretations.

Here is just ONE reference (recent; 2012) related to the outcomes of adult drownings with cardiac arrest at the scene:



http://www.sjtrem.com/content/22/1/77

BBM. Full text article at link, not just abstract.

Click to expand...

That is how good doctors communicate with lay people. In a language that they understand. The average person is confused by medical jargon.

BTW, KZ, I agree with you that Bk probably didnt have an infection. I was speculating that based on several news reports that her trach was an emergency procedure.

In all likelihood, I agree it was a planned procedure where she also got a g tube in preparation of her leaving the ICU for another destination.

I'm going to apologize for even mentioning a celebrity doctor by name, let alone daring to criticize their commentary.

It isn't helpful to the conversation here to continue to discuss Sanjay Gupta, so let's get back to the on topic discussion of BKB.

Thanks.

Hiandmighty said:

BTW, KZ, I agree with you that Bk probably didnt have an infection. I was speculating that based on several news reports that her trach was an emergency procedure.

In all likelihood, I agree it was a planned procedure where she also got a g tube in preparation of her leaving the ICU for another destination.

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I hope I didn't imply that she doesn't have an infection-- it's highly likely she does have several sources of infection, as well as more than possible that she has ARDS. (Adult respiratory distress syndrome.) Either way, the trach was indicated, and there's no indication it was any kind of emergency procedure.

http://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome

http://www.ncbi.nlm.nih.gov/pubmed/907076

K_Z said:

I hope I didn't imply that she doesn't have an infection-- it's highly likely she does have several sources of infection, as well as more than possible that she has ARDS. (Adult respiratory distress syndrome.) Either way, the trach was indicated, and there's no indication it was any kind of emergency procedure.

http://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome

http://www.ncbi.nlm.nih.gov/pubmed/907076

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I agree. It's simply a matter of well established protocol to trade out an ET tube for a trach in a patient who doesn't show signs of being able to be weaned from mechanical ventilation.