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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM  , where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our readers and the question last week was Part 2 of a counselling/ consulting session with one of our readers and the question last week was

My Mother is in long-term care with tracheostomy, on the ventilator and in kidney failure? When is enough enough? (PART2)

You can check out the answer to last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer question from one of our readers and the question this week is

My husband suffered a heart attack, has been in an induced coma for over three weeks now and is not waking up! What do I do? Help!

This question from Martha formed part of a consulting/counselling session with me.

 

Martha writes

Hi Patrik,

My 65 year old husband suffered a major heart attack on the 16th of April and was in an induced coma for over a month. He was intubated for three weeks and now has a tracheotomy. The process of taking him off the Fentanyl and Versed(Midazolam) is taking very long.

He gets very agitated and upset almost as if having withdrawal from the drug.

This in turn makes his blood pressure and heart rate go up and they raise the drug again. Is there anything I can do to help him come through?

I try to keep him calm and as the hours pass, I see more of him come out, but then they sedate him again and the process starts all over.

They just started giving him phenobarbital to try to wean him off the versed/ Midazolam and they are transitioning to a Fentynal patch.

It’s like a never ending wheel. I really want him off the meds, but don’t want to hurt him. The Intensive Care team thinks he may have had a stroke, but being there with him all day I don’t believe that to be the case.

My husband has no other premedical conditions.

Is there anything I can do and is this the process for weaning? I feel that the longer he is on it the more dependent he becomes and the more his body starts to weaken and shut down.

I truly appreciate your help and support.  It is very difficult to watch my husband go through this. We have always tried our best not to use any meds unless absolutely necessary,  so that makes it even harder to deal with.

Thank you again,
Martha

 

Hi Martha,

Thank you for your question and for signing up for 1:1 consulting/counselling!

I’m very sorry to hear that you and your husband are in such a difficult situation.

“Waking up” after a prolonged induced coma– one month in an induced coma is a very long time- can be very challenging especially if the medications being used are Fentanyl and Midazolam(Versed).

Fentanyl is a strong pain killer(opiate) and Midazolam(Versed) is a strong sedative and it’s also a Benzodiazepine. Both drugs, Fentanyl and Midazolam(Versed) make critically ill Patients in Intensive Care addicted, especially after long usage.

In a prolonged induced coma, both drugs are drugs of choice and work well to keep a critically ill Patient in Intensive Care sedated and they also come with the side effects that I mentioned.

Therefore both drugs need to be weaned off gradually in order to wean them off slowly, so that your husband is not going through withdrawals from the drugs. The agitation that you are referring to is most likely caused by withdrawing from the Fentanyl and Midazolam(Versed).

If your husband suffered a stroke, then “waking up” and assessing your husband’s neurological condition is getting even more difficult.

In order to find out whether your husband had a stroke, they need to do a referral to a neurologist and do a CT scan of the brain.

Effective ways of managing the withdrawal process, the agitation and also the “waking up” phase are to use other drugs such as Clonidine, Dexmedetomidine (trade name Precedex), Valium(Diazepam), Haloperidol and/or Quetiapine in order to wean your husband off the Fentanyl and the Midazolam/Versed.

I have never heard of Phenobarbital given to get critically ill Patients out of an induced coma, if anything the drug keeps to keep people sedated even more. You need to check with the Intensive Care team why they are giving the Phenobarbital.

Nevertheless, even if other drugs are used, “waking up” after a prolonged induced coma is challenging and the situation you are describing is a very common situation after a prolonged induced coma in Intensive Care.

Related article/video:

• HOW LONG DOES IT TAKE TO WAKE UP AFTER AN INDUCED COMA?

 

• The 5 Mistakes you are unconsciously making if your critically ill loved one is in an induced coma and is not “waking up”!

 

• The 10 answers to the 10 most frequently asked questions when your loved one isn’t “waking up “ after an induced coma!

 

Besides the drug therapy, good nursing care, such as getting regular washes or showers, regular mouthcare, getting out of bed and also getting some natural daylight can often help and improve the situation.

There is such a strong emphasis on drugs(which is important), however getting good nursing care is highly underrated and it’s very important too.

• Get one on one phone/ Skype counselling/ consulting with Patrik

It’s also important that your husband will rest at night with a good night sleep and is awake during the day. Most critically ill Patients in Intensive Care have a disturbed day and night rhythm and that contributes to the agitation.

Things that you can do are to ask for good nursing care and also find out what they are doing in order to manage the withdrawal from the Fentanyl and the Versed/Midazolam.

If you are not happy with the way things are being managed you need to get comfortable in speaking up and ask for what you want.

I can help you managing the Intensive Care team so that you get results faster, make informed decisions and get peace of mind, control, power and influence.

You may also want to find out whether your husband is enrolled in a medical research study, because often critically ill Patients are enrolled in studies that they don’t know about and sometimes this impacts on which drugs they can have or can’t have.

Related articles/videos:

• The 5 reasons why you need to be DIFFICULT and DEMANDING when your loved one is critically ill in Intensive Care

• How MEDICAL RESEARCH DOMINATES your critically ill loved one’s diagnosis and prognosis, as well as the CARE and TREATMENT your loved one IS RECEIVING or NOT RECEIVING!

Don’t be shy and don’t be intimidated by the “perceived power” and the “perceived authority” of the Intensive Care team.

Also, be patient. “Waking up” after a prolonged induced coma is a process and not an event. It’s like switching on a light with a dimmer and not with a switch.

Give your husband the time he needs to work through this challenge in his own time.

It’s often two steps forward and one step back.

I hope that helps.

Please let me know if you have any other questions.

Thank you& Kind Regards

Patrik

How can you become the best advocate for your critically ill loved one, make informed decisions and get PEACE OF MIND, control, power and influence quickly, whilst your loved one is critically ill in Intensive Care?

You get to that all important feeling of PEACE OF MIND, CONTROL, POWER AND INFLUENCE when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!

In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

In your FREE report you’ll also discover

• How to ask the doctors and the nurses the right questions
• Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
• How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
• 5 mind blowing tips& strategies helping you to get on the right path to PEACE OF MIND, control, power and influence in your situation
• You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
• How to stop being intimidated by the Intensive Care team and how you will be seen as equals
• You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
• How you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s episode of “YOUR QUESTIONS ANSWERED”and I’ll see you again in another update next week!

Make sure you also check out our “BLOG” section for more tips and strategies or send me an email to [email protected] with your questions!

Or you can call us! Find phone numbers on our contact tab.

Also check out our Ebook section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling with me via Skype or over the phone and via email by clicking on the email and phone counselling tabs on the top of the website!

This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Related Articles/Videos

• • • • • • • What is an induced coma and why is my critically ill loved one in an induced coma

 

 

• • • • • • • How LONG does it take to WAKE UP after an induced coma?

 

 

• • • • • • • How LONG can someone stay in an INDUCED COMA?

 

 

• • • • • • • How long can you keep a critically ill Patient in Intensive Care in an induced coma

 

 

• • • • • • • How long can a breathing tube or an endotracheal tube can stay in

 

 

• • • • • • • The 10 COMMANDMENTS for PEACE OF MIND, control, power and influence if your loved one is critically ill in Intensive Care

 

 

• • • • • • • Tracheostomy and weaning off the ventilator in Intensive Care, how long can it take?

 

 

• • • • • • • Why do doctors in Intensive Care insert a Tracheostomy after an induced coma?

 

 

• • • • • • • How long should a Patient be on a ventilator before having a Tracheostomy?

 

 

• • • • • • • Why does my loved one need a Tracheostomy in Intensive Care

 

 

• • • • • • • What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up?

 

 

• • • • • • • My 80 year old father is in Intensive Care with Myeloma! The Intensive Care team HAS ASKED ME TO SIGN A “DNR” AND I REFUSED! What are MY OPTIONS?

 

 

• • • • • • • The 3 most dangerous mistakes that you are making but you are unaware of, if your loved one is a critically ill Patient in Intensive Care

 

 

• • • • • • • The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”

 

 

• • • • • • • HOW TO STOP BEING HELD HOSTAGE BY THE INTENSIVE CARE TEAM if your loved one is critically ill in Intensive Care!

 

 

• • • • • • • HOW TO CONTROL YOUR POSITIVE SELF- IMAGE whilst your loved one is critically ill in Intensive Care

 

 

• • • • • • • How long does it take to wake up from a Traumatic brain injury or severe head injury

 

 

• • • • • • • Does my critically ill loved one in an induced coma or with head injuries feel my presence?

 

 

• • • • • • • My 25 year old wife has been in ICU for one month with Tracheostomy and is still in an induced coma

 

 

• • • • • • • My Mum has been diagnosed with STOMACH CANCER and is in ICU ventilated. CAN I TAKE HER HOME on a ventilator?

 

 

• • • • • • • The questions you need to ask the most senior doctor in Intensive Care, if your loved one is critically ill in Intensive Care

 

 

• • • • • • • A 5 step BLUEPRINT for DYING WELL and with DIGNITY in Intensive Care

 

 

• • • • • • • How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed

 

 

• • • • • • • Why you must make up your own mind about your critically ill loved one’s situation in Intensive Care even if you’re not a doctor or a nurse!

 

 

• • • • • • • The ELEPHANT IN THE ROOM or HOW THE INTENSIVE CARE TEAM IS MAKING DECISIONS whilst your loved one is critically ill in Intensive Care!

 

 

• • • • • • • 5 ways you are UNCONSCIOUSLY SABOTAGING yourself whilst your loved one is CRITICALLY ILL in Intensive Care and HOW TO STOP doing it!

 

 

• • • • • • • How to make sure that “what you see is always what you get” whilst your loved one is critically ill in Intensive Care

 

 

• • • • • • • 5 steps to become a better negotiator if your loved one is critically ill in Intensive Care

 

 

• • • • • • • 5 Ways to have control, power and influence while your loved one is critically ill in Intensive Care

 

 

• • • • • • • 6 phrases you should never say when your loved one is critically ill in Intensive Care

 

 

• • • • • • • How to REPROGRAM YOUR MIND if your loved one is critically ill in Intensive Care

 

 

• • • • • • • How to play a “HIGH STAKES GAME” that only the Intensive Care team knows HOW TO WIN!

 

 

• • • • • • • Family overjoyed as top court rules doctors must seek consent before taking a patient off life support

 

 

• • • • • • • How to make sure that your values and beliefs are known whilst your loved one is critically ill in Intensive Care

 

 

• • • • • • • My loved one has HIV, lymphoma on his brain, seizures, septic and is ventilated! The Intensive Care team is trying to TAKE MY HOPE AWAY and they are all NEGATIVE! HELP!

 

 

• • • • • • • MY PARTNER IS IN INTENSIVE CARE AFTER A BLEED ON A BRAIN! WE ARE WORRIED THAT THE INTENSIVE CARE TEAM WANTS TO SWITCH OFF THE VENTILATOR! HELP!

 

 

• • • • • • • CAN YOU GO HOME ON A VENTILATOR?

 

 

• • • • • • HOW TO DEAL WITH A DIFFICULT INTENSIVE CARE TEAM, WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

 

 

• • • • • • DISRUPT before you are being DISRUPTED, whilst your loved one is critically ill in Intensive Care!

 

 

• • • • • • HOW TO STAY STRONG WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!”

 

 

• • • • • • What the doctors and the nurses behaviour in Intensive Care is telling you about the culture in a unit

 

 

• • • • • • How to take control if your loved one has a severe brain injury and is critically ill in Intensive Care

 

 

• • • • • • Family Meetings in Intensive Care or the Elephant in the Room

 

 

• • • • • • How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1)

 

 

• • • • • • How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2)

 

 

• • • • • • The four DEADLY SINS that Families of critically ill Patients in Intensive Care CONSTANTLY MAKE, but they are UNAWARE OF!

 

 

• • • • • • My HUSBAND had a HORRIBLE work accident and went into CARDIAC ARREST! Will he be PERMANENTLY DISABLED

 

 

• • • • • • HOW TO GET AN UNFAIR ADVANTAGE whilst your loved one is critically ill in Intensive Care!

 

 

• • • • • • How to MUTE your NEGATIVE INNER DIALOGUE whilst your loved one is critically ill in Intensive Care!

 

 

• • • • • • Why decision making in Intensive Care GOES WAY BEYOND your critically ill loved one’s DIAGNOSIS AND PROGNOSIS!

 

 

• • • • • • How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS

 

 

• • • • • • WHAT HAPPENS IF MY CRITICALLY ILL LOVED ONE CAN’T BE WEANED OFF THE VENTILATOR?

 

 

• • • • • • The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care!

 

 

• • • • • • How to get PEACE OF MIND, more control, more power and influence if your critically ill loved one is DYING in Intensive Care!

 

 

• • • • • • CAN I TAKE MY LOVED ONE HOME ON A VENTILATOR TO DIE?

 

 

• • • • • • The 5 ways how RESILIENT FAMILIES in Intensive Care STAND BACK UP when life knocks them down!

 

 

• • • • • • Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care

 

 

• • • • • • The 5 QUESTIONS you need to ask, if the Intensive Care team wants you to DONATE your loved one’s ORGANS in an END OF LIFE SITUATION!

 

 

• • • • • • MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART 1)

 

 

• • • • • • How MEDICAL RESEARCH DOMINATES your critically ill loved one’s diagnosis and prognosis, as well as the CARE and TREATMENT your loved one IS RECEIVING or NOT RECEIVING

 

 

• • • • • • 5 things NOBODY HAS EVER TOLD YOU about Intensive Care

 

 

• • • • • • WHAT WOULD YOU DO if you knew that you COULD NOT FAIL, whilst your loved one is critically ill in Intensive Care

 

 

• • • • • • How the Intensive Care team is SKILFULLY PLAYING WITH YOUR EMOTIONS, if your loved one is critically ill in Intensive Care!

 

 

• • • • • • My father is in Intensive Care ventilated with LIVER FAILURE and KIDNEY FAILURE, I DON’T THINK HE WILL SURVIVE! HELP

 

 

• • • • • • HOW TO GIVE YOURSELF PERMISSION TO HAVE PEACE OF MIND, CONTROL, POWER AND INFLUENCE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

 

 

• • • • • • My father has been weaned off the ventilator in Intensive Care and still has the Tracheostomy in. When can the Tracheostomy be removed?

 

 

• • • • • • HOW LONG DO YOU NEED TO BE ON A VENTILATOR AFTER A LUNG TRANSPLANT

 

 

• • • • • • HOW LONG can a critically ill Patient stay on ECMO?

 

 

• • • • • • THE ULTIMATE FASTLANE TO PEACE OF MIND, CONTROL, POWER AND INFLUENCE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!