Mom of 13yo on vent fights for 2nd opinion- hate on display

[mmhmm]

Jan 6, 2014 20:09:37 GMT -5 justme said:

Jan 6, 2014 18:05:47 GMT -5 Opti said:

You need to correct and save your display name.

I have. Twice! When I go to change it it says justme, so I can't figure out what else to do.

Drop Virgil a love note. Maybe he can figure it out.  I tried, but I couldn't change it, either.

[justme]

Jan 6, 2014 18:50:26 GMT -5 lynnerself said:

This from her uncle
"Sealey said his niece looks peaceful, like she’s sleeping, and he believes he saw her smile as she was leaving Children’s Hospital Oakland."

www.latimes.com/local/lanow/la-me-ln-jahi-mcmath-transfer-brain-dead-20140106,0,5200263.story#ixzz2pfJ08jRQ

And this from her lawyer:
Jahi's body had "deteriorated so badly" that her chances for survival seemed bleak, said the family's attorney Christopher Dolan. The family had been demanding that doctors at Children's Hospital surgically insert a feeding tube for the girl, who did not receive nutrition for more than three weeks after she was declared brain dead.

"Right now," Dolan added, "we don't know if she's going to make it."

www.mercurynews.com/breaking-news/ci_24853879/jahi-mcmath-brain-dead-girl-moved-undisclosed-care

What are they giving her hormones for?? (Second source)

[mmhmm]

Jan 6, 2014 20:14:25 GMT -5 nutty said:

but if a heart beat was established through resucitation why the ventilator after that? I love A and P except I didn't finish it.

Because, without the ventilator the heart can pump blood around all day but it won't get oxygenated because the lungs aren't functioning.  The lungs aren't functioning because the patient is unable to breathe to give them something to work with.

[mmhmm]

Jan 6, 2014 20:15:56 GMT -5 justme said:

Jan 6, 2014 18:50:26 GMT -5 lynnerself said:

This from her uncle
"Sealey said his niece looks peaceful, like she’s sleeping, and he believes he saw her smile as she was leaving Children’s Hospital Oakland."

www.latimes.com/local/lanow/la-me-ln-jahi-mcmath-transfer-brain-dead-20140106,0,5200263.story#ixzz2pfJ08jRQ

And this from her lawyer:
Jahi's body had "deteriorated so badly" that her chances for survival seemed bleak, said the family's attorney Christopher Dolan. The family had been demanding that doctors at Children's Hospital surgically insert a feeding tube for the girl, who did not receive nutrition for more than three weeks after she was declared brain dead.

"Right now," Dolan added, "we don't know if she's going to make it."

www.mercurynews.com/breaking-news/ci_24853879/jahi-mcmath-brain-dead-girl-moved-undisclosed-care

What are they giving her hormones for?? (Second source)

Because they're not dealing with reality.  I don't care what they put into a dead body, it isn't going to do anything positive.

[achelois]

You are correct, nutty, if the heart stops, no circulation anywhere. All the ventilator does does is blow air with varying amounts of oxygen added, depending on what the patient needs, into the lungs. That is all it does, on its most basic level.


In with the good air, out with the bad.

In many cases, the patients do begin to breathe on their own when the heart restarts,but not all. In this girl's case, there was too much brain damage and her brain died, so it can never make her breathe on her own again.

If the person were to start breathing again after a cardiac arrest, and doing a good job of it, the tube is removed. The tube is placed so oxygen can be given and so that the tube can be connected to the ventilator, so a person does not have to stand there squeezing a bag to inflate the lungs indefinitely. It is also put there to seal off the airway so that stuff from the person's stomach does not get into the lungs. (If it hasn't already).

[justme]

Jan 6, 2014 20:19:13 GMT -5 mmhmm said:

Jan 6, 2014 20:15:56 GMT -5 justme said:

What are they giving her hormones for?? (Second source)

Because they're not dealing with reality.  I don't care what they put into a dead body, it isn't going to do anything positive.

But do you know what the hormones would be for? I get where nutrients and antibiotics would come from in the delusion they seem to be in, but I don't know what hormones would help?

[mmhmm]

Jan 6, 2014 20:21:56 GMT -5 justme said:

Jan 6, 2014 20:19:13 GMT -5 mmhmm said:

Because they're not dealing with reality.  I don't care what they put into a dead body, it isn't going to do anything positive.

But do you know what the hormones would be for? I get where nutrients and antibiotics would come from in the delusion they seem to be in, but I don't know what hormones would help?

I don't have a clue, justme.  I have no idea what kind of hormones anybody with any medical training at all would give to a dead person.  It doesn't make a lick of sense.  I get the feeling they might be being given to drive up expenses in this useless fight.  The facility that took this little girl's body is going to wanna be paid, don'cha know.

[justme]

nutty - Also, keep in mind that since brain death isn't as easy to detect as cardiac death (you can hear the heart stop beating) there's no immediate way for them to tell if the brain has died. From what I've read they usually do two tests at least 12 hours apart, and are even more thorough in children. So it takes the medical team at least 24 hours to determine that brain death has occurred (after the time they start to suspect it has based on symptoms) so during that time they would have to have the patient on a ventilator. Also, the brain may have died a day after the cardiac arrest occurred so at the time they put her on the ventilator her brain was still alive.

[achelois]

She developed diabetes insipidus from the lack of pituitary activity.



edited to add: I agree that this made no sense to continue to treat a brain dead person, but possibly it was in the court order?

[mmhmm]

Jan 6, 2014 20:26:08 GMT -5 achelois said:

She developed diabetes insipidus from the lack of pituitary activity.

That might be the excuse they give for giving the hormone (if it's vasopressin); however, once you're dead you can't really develop anything.  Dead folks don't get diseases/conditions/syndromes.  If they're giving stuff like vasopressin to a dead body, they're completely unethical, in my view.

[mmhmm]

Jan 6, 2014 20:26:08 GMT -5 achelois said:

She developed diabetes insipidus from the lack of pituitary activity.



edited to add: I agree that this made no sense to continue to treat a brain dead person, but possibly it was in the court order?

I'm pretty sure the court order to continue life support has passed it's due date.  The last court order was simply to release the child to the custody of her mother, as far as I know.

[Deleted]

Ok so if I am understanding right then when  cardiac arrest occurs the lungs cease to function and even if the heart is brought back the lungs don't recover, I am sorry, is this the case.

[justme]

Well, I think any facility that took her was already well into being unethical so I guess they might as well go whole hog into the unethical realm.

[Deleted]

OH I SEE, light bulb goes of. THe ventilator is for the LEVEL of oxygenated blood that needs to get to the lungs until OR if the heart starts acting right.

[mmhmm]

Jan 6, 2014 20:34:39 GMT -5 nutty said:

Ok so if I am understanding right then when  cardiac arrest occurs the lungs cease to function and even if the heart is brought back the lungs don't recover, I am sorry, is this the case.

Yes, nutty.  You got it!  When the heart stops beating, circulation stops.  The lungs have nothing to process, so they stop.  Most of the time, in children however, the cause of cardiac arrest is respiratory arrest (the lungs stop working first and the patient can't breathe).  In this particular case, we have no idea what actually happened.

ETA:  Once the lungs stop they, unlike the heart, don't have their own system to get them going again.  If the patient doesn't breathe, or receive mechanical ventilation, the lungs won't function.

[achelois]

Jan 6, 2014 20:33:36 GMT -5 mmhmm said:

Jan 6, 2014 20:26:08 GMT -5 achelois said:

She developed diabetes insipidus from the lack of pituitary activity.



edited to add: I agree that this made no sense to continue to treat a brain dead person, but possibly it was in the court order?

I'm pretty sure the court order to continue life support has passed it's due date.  The last court order was simply to release the child to the custody of her mother, as far as I know.

I meant it was continued by the court order from the date of death until the body was released to the mother, sorry. If whoever has her now is still doing it, it is a money grab. 

[mmhmm]

Jan 6, 2014 20:38:55 GMT -5 nutty said:

OH I SEE, light bulb goes of. THe ventilator is for the LEVEL of oxygenated blood that needs to get to the lungs until OR if the heart starts acting right.

Yes.  The ventilator will  provide the oxygen necessary to get the body going, if it's possible.

[mmhmm]

Jan 6, 2014 20:41:08 GMT -5 achelois said:

Jan 6, 2014 20:33:36 GMT -5 mmhmm said:

I'm pretty sure the court order to continue life support has passed it's due date.  The last court order was simply to release the child to the custody of her mother, as far as I know.

I meant it was continued by the court order from the date of death until the body was released to the mother, sorry. If whoever has her now is still doing it, it is a money grab. 

That's how I see it, as well.  As far as I'm concerned, this little fiasco should serve to stop whatever facility accepted this child from ever operating again.  Additionally, any doctor(s) involved should have their licenses revoked!

[Deleted]

AHHH, so with a cardiac arrest a person would always need ventilation as you said, oh wait no if the heart starts again the lungs may start again. So ventilation is prophalactic maybe Can a heart beat be detected again but the lungs never res start?

Well that's kinda crazy that we have ways of artificially keeping lungs going bun unlike getting the heart going its CPR, CPR is man made and ventilation is machine...hmm just stuff to ponder. makes you wonder why we were made like this.

[justme]

Jan 6, 2014 20:44:27 GMT -5 nutty said:

AHHH, so with a cardiac arrest a person would always need ventilation as you said, oh wait no if the heart starts again the lungs may start again. So ventilation is prophalactic maybe Can a heart beat be detected again but the lungs never res start?

Well that's kinda crazy that we have ways of artificially keeping lungs going bun unlike getting the heart going its CPR, CPR is man made and ventilation is machine...hmm just stuff to ponder. makes you wonder why we were made like this.

In the case of brain death, yes. The heart can operate without the brain, as long as it's still getting oxygen it can continue to beat and circulate blood. But the lungs, the lungs don't operate on their own without signals from the brain. So if the lungs quit on themselves or the brain stops sending a signal to the lungs the heart could keep beating and the lungs stop functioning.

In this case at some point her brain died, which stopped sending a signal to the lungs so when they take her of a ventilator she stops breathing (apnea). We don't know at what point the lungs stopped functioning on their own and whether it was the lungs that stopped first or the brain stopped telling the lungs to work. I'm not sure if the lungs stopped functioning on their own (brain still alive) whether the ventilator would be enough to keep them working or not.

[mmhmm]

Jan 6, 2014 20:44:27 GMT -5 nutty said:

AHHH, so with a cardiac arrest a person would always need ventilation as you said, oh wait no if the heart starts again the lungs may start again. So ventilation is prophalactic maybe Can a heart beat be detected again but the lungs never res start?

Well that's kinda crazy that we have ways of artificially keeping lungs going bun unlike getting the heart going its CPR, CPR is man made and ventilation is machine...hmm just stuff to ponder. makes you wonder why we were made like this.

After a cardiac arrest, the patient will always be mechanically ventilated.  There are no exceptions.  The patient is ventilated during the course of the resuscitation.  This reduces the workload on the weakened heart, and on the patient him/herself.  After full cardiac arrest, the patient is in a very weakened and vulnerable state.  Good circulation and oxygenation are primary, as is keeping the patient quiet, and taking every bit of pressure off of him/her - including the pressure to breathe.

Yes, a heartbeat can return but the patient may still not breathe.  That's pretty common.

[billisonboard]

Musical Interlude Time

[mmhmm]

Jan 6, 2014 20:49:54 GMT -5 justme said:

Jan 6, 2014 20:44:27 GMT -5 nutty said:

AHHH, so with a cardiac arrest a person would always need ventilation as you said, oh wait no if the heart starts again the lungs may start again. So ventilation is prophalactic maybe Can a heart beat be detected again but the lungs never res start?

Well that's kinda crazy that we have ways of artificially keeping lungs going bun unlike getting the heart going its CPR, CPR is man made and ventilation is machine...hmm just stuff to ponder. makes you wonder why we were made like this.

In the case of brain death, yes. The heart can operate without the brain, as long as it's still getting oxygen it can continue to beat and circulate blood. But the lungs, the lungs don't operate on their own without signals from the brain. So if the lungs quit on themselves or the brain stops sending a signal to the lungs the heart could keep beating and the lungs stop functioning.

In this case at some point her brain died, which stopped sending a signal to the lungs so when they take her of a ventilator she stops breathing (apnea). We don't know at what point the lungs stopped functioning on their own and whether it was the lungs that stopped first or the brain stopped telling the lungs to work. I'm not sure if the lungs stopped functioning on their own (brain still alive) whether the ventilator would be enough to keep them working or not.

The ventilator will continue to keep the lungs working without the involvement of the brain.

[Deleted]

<dancing around my office>

[Deleted]

So if a cardiac arrest happens then the brain may or may not die. Why does a brain die in a cardiac arrest and the brain dying is not something that would be known until the heart is beating again and tests can be performed, is that right. Is is unusual for the brain to die?

[Deleted]

So again the ventilator is a propholatic treatment, like just in case?

[lynnerself]

Jan 6, 2014 20:43:58 GMT -5 mmhmm said:

Jan 6, 2014 20:41:08 GMT -5 achelois said:

I meant it was continued by the court order from the date of death until the body was released to the mother, sorry. If whoever has her now is still doing it, it is a money grab. 

That's how I see it, as well.  As far as I'm concerned, this little fiasco should serve to stop whatever facility accepted this child from ever operating again.  Additionally, any doctor(s) involved should have their licenses revoked!

From Dolan again
"In the end, they found a facility with help from Catholic and right-to-life organizations, including the Terri Schiavo Foundation, he said. "
www.sfgate.com/bayarea/article/Jahi-McMath-is-safe-receiving-nutrients-5118175.php

[justme]

Jan 6, 2014 20:53:36 GMT -5 mmhmm said:

Jan 6, 2014 20:49:54 GMT -5 justme said:

In the case of brain death, yes. The heart can operate without the brain, as long as it's still getting oxygen it can continue to beat and circulate blood. But the lungs, the lungs don't operate on their own without signals from the brain. So if the lungs quit on themselves or the brain stops sending a signal to the lungs the heart could keep beating and the lungs stop functioning.

In this case at some point her brain died, which stopped sending a signal to the lungs so when they take her of a ventilator she stops breathing (apnea). We don't know at what point the lungs stopped functioning on their own and whether it was the lungs that stopped first or the brain stopped telling the lungs to work. I'm not sure if the lungs stopped functioning on their own (brain still alive) whether the ventilator would be enough to keep them working or not.

The ventilator will continue to keep the lungs working without the involvement of the brain.

Yes. I kept going around in circles trying to be clear and may have still not been. I meant to say that the lungs could stop working on their own (brain fine), the brain stops working (and therefore stops the lungs, but physically lungs are still ok), or both brain & lungs stop functioning separate from the other. But I think in all cases the lungs would keep working on a ventilator.

I don't know how damaged lungs would have to be for a ventilator to not work, that was what I was unclear on.

[mmhmm]

Jan 6, 2014 20:55:59 GMT -5 nutty said:

So if a cardiac arrest happens then the brain may or may not die. Why does a brain die in a cardiac arrest and the brain dying is not something that would be known until the heart is beating again and tests can be performed, is that right. Is is unusual for the brain to die?

Yes.  Cardiac arrest doesn't necessarily cause brain death.  Most of the time, a full cardiac arrest can't be resuscitated.  On those occasions where a successful resuscitation is accomplished (usually because they're in the hospital and resuscitation procedures are started immediately), the brain is usually fine.  I don't know I've ever seen a case of brain death in a successfully resuscitated cardiac arrest victim, nutty - at least, not one that was caused by the cardiac arrest.

[mmhmm]

Jan 6, 2014 20:56:34 GMT -5 nutty said:

So again the ventilator is a propholatic treatment, like just in case?

No.  The ventilator is necessary to be sure there is plenty of oxygen in the blood to be carried to the tissues.  It's not prophylactic.  It's absolutely necessary if the patient cannot breathe on his/her own.