Bobbi Kristina Brown found unresponsive in bathtub. #4

Discussion in 'Celebrity and Entertainment News' started by i.b.nora, Jan 31, 2015.

  1. BetteDavisEyes

    BetteDavisEyes All the boys think she's a spy...

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  2. StephanieH

    StephanieH Active Member

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    She has severe, irreversible brain damage. If she were my child, I would take her off life support and let her go.
     
  3. jggordo

    jggordo Well-Known Member

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  4. K_Z

    K_Z Verified Anesthetist

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    The headline says there is "conflict" over BK's condition. There may be conflict in how the family communicates with the media, and the accuracy of what they communicate publicly. But I don't think there is any conflict at all among BK's medical staff, and their assessment of her current condition and future potential. And another hard fact is coming soon-- BK will have to be moved again.

    As I posted a while back, this is an acute care rehab hospital. It is not a long term care facility. BK simply can't stay there very long. From all we have heard, there is little to no actual "rehab" that could occur with an unresponsive patient who is vent dependent. Rehab hospitals are aggressively focused on rehab-- swallow studies, regaining eating, ventilator weaning, mobility issues, self care, occupational therapy-- learning to talk and communicate again, etc.

    So, I'm sorry to be rather direct, but there is nothing that this kind of facility can do for BK beyond custodial care-- turning, passive range of motion, skin care, pulmonary care, basic hygiene, tube feeds. This is not rehabilitative care-- it's maintenance care/ custodial care. Apparently they got her off the sedation drips, which will make placement MUCH easier, and that is a positive sign (albeit very small).

    There are facilities that excel at custodial care for PVS patients, and other patients with devastating neurological conditions-- but moving to that kind of facility is going to be an overt admission that the "acute" phase of BK's situation is over, and the focus has moved to long term custodial care. BB doesn't seem to be at that place yet, and appears to still be in denial, but regardless, she will have to be moved soon. I think there is zero chance BB will ever take BK off the vent-- she will linger as long as she can in her current condition, as physical deterioration continues. She is young, so that could be many years. That seems to be the choice BB has made, whether anyone else agrees with it, or not. I don't agree with it, but his decision doesn't surprise me. And there is plenty of $$ to do whatever he wants, so that's good.

    It's my opinion that DeKalb staff (multidisciplinary team) are having the difficult "formal" conversations with family explaining that there is not much they can do there for her in terms of rehab, and they need to be making plans for another move to some kind of long term care situation at a private home, or long term care facility. I think we will hear that she has been moved again fairly soon-- days to a few weeks from now.
     
  5. popsicle

    popsicle faith hope love

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    Bobbi Kristina

    Houstons: Bobbi Kristina Breathing On Her Own

    Browns Were Right


    The Houston family is now changing their tune, saying Bobbi Kristina is OFF life support, but they continue to maintain there's no real hope for recovery.
    The Houston family now tells TMZ, Bobbi Kristina is breathing without the assistance of a ventilator. They say, "According to the doctors she's breathing on her own but the trach has to stay."
    But the family still maintains Bobbi Kristina has "global and irreversible brain damage and remains unresponsive."
    It appears the Houston and Brown families have different ideas about how to handle the prospect of long term care ... something that is now a real possibility.


    http://www.tmz.com/2015/04/20/bobby-brown-bobbi-kristina-life-support-improvement-hospital-pat-houston-photos/
     
  6. Rocco

    Rocco Well-Known Member

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    Did they change the wording in the article? (Sometimes when they update, they do that) Now, the link says:

    "As we reported, the Houston family says it's not true ... they say she's still on life support and her condition has not changed at all."
     
  7. popsicle

    popsicle faith hope love

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  8. CoolJ

    CoolJ Well-Known Member

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    K_Z , if she was addicted to opiates when she was first admitted, how would they deal with that? Would they continue to administer her pain meds or to wean her off?
     
  9. BetteDavisEyes

    BetteDavisEyes All the boys think she's a spy...

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    Bobbi Kristina Brown's brain damage 'irreversible,' grandmother says

    By Todd Leopold, CNN

    Updated 9:46 AM ET, Tue April 21, 2015

    (CNN)—Bobbi Kristina Brown, the daughter of Bobby Brown and Whitney Houston, has "global and irreversible brain damage," according to her grandmother.

    Though the 22-year-old is no longer in a medically induced coma, she remains unresponsive, Cissy Houston said in a statement Monday after visiting her granddaughter.

    "Meeting with the doctors and understanding that she can live in this condition for a lifetime truly saddens me," Houston said. "We can only trust in God for a miracle at this time."

    Houston's statement matched that from a source with knowledge of Brown's condition, who told CNN on Monday that she remained in the same neurological state she has been in for nearly three months...

    http://www.cnn.com/2015/04/20/entertainment/feat-bobbi-kristina-bobby-brown/index.html
     
  10. BetteDavisEyes

    BetteDavisEyes All the boys think she's a spy...

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    Legal question: If Bobby Brown transfers Bobbi Kristina to a long-term care facility where she could reside for many years, what happens to the criminal investigation?
     
  11. Quester

    Quester New Member

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    Eyes open but still no one home?

    Is BB keeping her alive waiting for next estate payout? At age ?25?

    Is this a passive aggressive strategy of sticking it to the Hs and depleting the estate? AKA if he can't have the/some money, nobody can?
     
  12. BetteDavisEyes

    BetteDavisEyes All the boys think she's a spy...

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    It's my understanding that Pat Houston is the Executor of Bobbi Kristina's Estate. If BK "survives" until her 25th birthday, I think there will be legal action before the next distribution of the Trust is paid to Bobbi Kristina who would be incapable of managing her own assets. I think the wisdom of continued custodial care for someone in a persistent vegetative state could be brought into question at that time, if not before. I doubt that the Houstons want to rock the boat this soon following BK's tragic near-drowning, but in a few years if the young woman has shown no signs of improvement, I think Pat Houston will seek legal advice on how best to proceed. :moo:

    Perhaps one of Websleuth's legal experts will weigh in on this.
     
  13. katydid23

    katydid23 Verified Juanette

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  14. jggordo

    jggordo Well-Known Member

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    This incident is one of the last connections to Whitney Houston, IMO. Both ex-husband and daughter are hanging on to a celebrity that has passed. BKB wanted to be her Mom and BB hung on as long as he could. To me it is shameful that the family uses every opportunity to hang on to fame and to invigorate or re-invorgate celebrity status.

    JMO
     
  15. Greater Than

    Greater Than <b><span style="color:#000099;">WS Senior Moderato

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    According to the TMZ article posted above, BB is not "keeping her alive." She's breathing on her own.

    K_Z, how do they know she's breathing on her own? Would they have withdrawn the vent to see her response? And why does the trach have to stay if she's not vent dependant?
     
  16. rachaellouise

    rachaellouise Active Member

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    A few observations: I watched the reality show with BK and her family and it was obvious she was not close to her grandmother and rarely saw her (in fact it seems she avoided her!) so I wouldn't put much weight on whatever she says.

    Also slightly suspicious of the fact thr Houstons seem eager to 'let her be with God' which means they will inherit the money ASAP, whereas the Browns seem to want to keep BK going no matter what which would mean using up the estate money for medical costs.

    I just don't trust the Houstons after seeing that TV show, they knew this girl was on drugs and they just let it carry on and kept filming because it made good TV. JMO


    Sent from my iPad using Tapatalk
     
  17. trigger

    trigger Well-Known Member

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    My beautiful 33yo Nephew collapsed in the bathroom on Jan 31st also. He was not breathing. Ambulance responded and they revived him, got a slight pulse and rushed him to hospital. His eyes were slightly open, filmy and his eyes were moving. Two hours later his eyes were wide open and clear and he was looking straight up and his eyes did not move anymore. The nurse put drops in his eyes and closed them and put a cloth over each eye and were taped. He was on a breathing machine. His Dr came in and said he was brain dead and if he lived he would be in a nursing home on a machine in a vegetated state for the rest of his life. The Dr knew this just by looking at his eyes. He knew right away. The dr was going to move him upstairs for testing but his body started shutting down and he passed away shortly after. We just got a call just an hour ago from the Coroner saying it was a heroine overdose. No needles were found in the bathroom but my sister saw a small glassine bag in the toilet.
     
  18. bexlex

    bexlex New Member

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    I'm so sorry Trigger...... big hugs to you!
     
  19. K_Z

    K_Z Verified Anesthetist

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    To answer your last question first, anyone who is unresponsive, unable to swallow, cough, and has no gag reflex, cannot protect their airway. (These reflexes are HIGHER responses in the brain, than brainstem initiation of breaths.) If someone cannot protect their airway, they are at severe risk for aspiration of gastric contents (especially sugar rich tube feed solution), as well as inability to protect their airway from their own secretions. Aspiration kills people-- even alert vent-dependent patients, or patients more healthy than BK. Either by a form of chemical-burn pneumonia, or by bacterial growth from sugar-rich tube feed in the lungs, or infection from secretions. Aspiration is bad, very bad. It leads to permanent lung damage if the person survives the aspiration event. (And aspiration can be a chronic process in the critically ill, leaking bad gunk into the lungs continuously.)

    The question then becomes "why" can't they protect their airway, and how permanent is the "why"-- is it the result of medication, surgery and recovery, trauma and recovery, brain damage, etc.

    In someone with neurological damage so severe that their level of consciousness and protective reflexes are permanently altered, the trach is absolutely necessary to protect their airway for the rest of their life.

    Pulmonary acute care physiology is considerably more complex than that, but I think that covers the basics.

    Now, backing up to, "is she breathing?" We don't know, because the facility will not tell (due to patient privacy), and the family is not coherent in their messages to the public. I will re-iterate that no one who has been on a ventilator for 3 months, just "starts" breathing effectively again suddenly, with adequate effort and volume, and pressures. Intercostal muscles, diaphragm, and other muscles of breathing are severely weakened by the process of mechanical ventilation (even after just a few days or weeks), and are scaveneged (thinned and weakened by starvation and catabolic processes).

    The brainstem has tissue responsible for the process of initiating, and maintaining respiratory effort. It IS possible for someone to permanently have no higher cerebral brain functions (consciousness, thinking, etc) AND still have some primitive brain stem functions intact.

    For someone who has no higher cerebral function, but has some level of brainstem function intact, pulmonary function is tenuous. Often the person may initiate a negative pressure inspiration (try to take a breath-- which the ventilator will recognize) from time to time, or even regularly, but the muscles are too weak to draw in enough air. In that situation, the vent can be set to synchronize a push of air when triggered by the inspiratory efforts of the patient, while also delivering mandatory breaths if the patient doesn't initiate a breath. There are also settings that provide pressure support in between breaths-- holding fragile airways open with positive pressure (similar to CPAP or BiPap, if you are familiar with those machines for home use). There are also settings to provide extra "push" of air/ O2 at the end of breaths (mechanical or organic) to hold open airways. ("Positive end expiratory pressure.") And ventilators are set to deliver a certain volume of air, with a certain blend of oxygen and air, under a certain amount of pressure, with a certain amount of humidity, etc. Ventilation of the critically ill is a very precise area of expertise, with the need to constantly adjust the various settings of blend of gasses and vent settings.

    So, the reason I explain all this is that my feeling is that there is a difference of perspective between CH and BB as to what constitutes "life support"-- which is a layperson term, not a medical term. BK almost certainly has the "hoses" from the ventilator attached 24/7 to her trach (if only for humidity)--- but what the ventilator is DOING from moment to moment, hour to hour, is subject to the report of the family member.

    If, for example, BK is assisting the vent in any way, it's possible some family members may interpret that as "off life support." If the vent and tubing is attached to her trach, other family members may interpret that as "still on life support." Add to the confusion of the family that apparently BK's seizure-suppression meds have been partially or totally withdrawn. Some may see that as "off life support".

    What seems certain is that she is largely unresponsive, has a devastating anoxic neurological injury that is permanent, and has been critically ill for 3 months. There is little to no hope for improvement in that scenario-- as I posted the adult near-drowning outcome statistics many threads ago. Almost no one in similar circumstances has an outcome even this good-- this is the best that can be expected, after an unwitnessed near drowning, of unknown duration or cause, with prolonged cardiac arrest. It really doesn't get any better than what she currently has, statistically. Sadly.
     
  20. bettybaby00

    bettybaby00 Active Member

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    Man this brings way too many memories of my mom.

    You certainly explained it better than any doctor or nurse we dealt with at the time. To be fair, however, as a relative of someone in that kind of state--vent dependent--it's a great deal to absorb as you're going through it.

    I think your interpretation of the families public statements are spot on. Sadly this poor girl has a dismal prognosis, and I hope the family can come to grips with their situation.
     

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