Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

If you want to know what to do if your mom has hypoxic brain injury after cardiac arrest, Parkinson’s disease, severe LV dysfunction, is comatose with a functioning brain stem and with tracheostomy, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com, and I have another quick tip for families in intensive care.

Today, I have an email from Sreela who says,

“Hi Patrik,

I’m writing to seek expert advice and insights regarding my mother’s condition. She’s a 56-year-old lady recently diagnosed with severe hypoxic ischemic encephalopathy (HIE), following multiple medical complications including a cardiac arrest.

Here are the key medical details.

• Diagnosis: Severe hypoxic ischemic encephalopathy, Parkinson’s disease, Acute Motor Sensory Axonal Neuropathy (AMSAN), and severe left ventricular dysfunction.
• Current State: Comatose with functioning brainstem.
• Supportive Care: She has been successfully weaned off the ventilator and inotropic support but is needing a tracheostomy to maintain her airway, and she’s maintaining oxygen saturations on room air with stable vital signs.

Here are my questions.  Given her current vegetative state and MRI findings, we would like to understand:

1. The potential for cortical recovery, given that her brainstem is functioning.
2. The latest research or treatments that may aid in neuroregeneration or recovery.
3. Rehabilitation strategies or experimental approaches that might improve her prognosis.

Attached to this email are her recent MRI reports, discharge summary, and relevant medical records for your review.

I wanted to provide an update on my mom’s current condition. She has been shifted to a palliative care center and is receiving oxygen support, but no other medications. We are focusing on keeping her hydrated. At the moment, she occasionally opens and closes her eyes, though not fully. There are some reflex actions when her legs are tickled, and she moves them slightly. However, we are unsure if she is conscious.

She was removed from ventilator support on the 26th of December 2024, and she’s now breathing on her own with the assistance of an oxygen cylinder and a tracheostomy.

We are deeply concerned about my mother’s condition and are willing to explore advanced care or research protocols that might assist in her recovery. Your guidance and expertise in this matter would mean the world to us.

Please let me know if you require further details or additional documentation.

Thank you for your time and consideration.

From, Sreela.”

Well, I’m very sorry to hear about your mom’s situation.

So, I’m not a neurologist. I’m a critical care nurse with extensive experience in critical care nursing, as well as Intensive Care at Home nursing. Here’s what I can see. First off, before you go down to alternative treatments and strategies and rehabilitation strategies, that’s all advisable, and I would advise on that, whatever you can find there.

Here’s my take on the situation, because I’ve spoken to you, obviously, you and I have spoken, and I’ve seen your mom on a video call. Like I explained to you on our video call, the first thing that needs to happen is she needs to get out of bed. So, imagine, with or without a brain injury, someone is tied to a bed or lays in bed for weeks on end. That’s not going to help neurological recovery, that is common sense.

Common sense for your mom’s situation would be the following: To get out of bed, go through a physical rehabilitation program, physiotherapy, physical therapy, breathing exercises, leg exercises, arm exercises, that will stimulate the brain. She needs to get out of bed every day, and maybe that’s not possible straight away, so then she needs to be set up in the bed. She needs to start some physical therapy in the bed. She then needs to be sat on the edge of the bed to see whether she can tolerate that. If she can tolerate that, sit her out of bed every day and prolong the time she’s sitting out of bed, and she can tolerate that. That might get the oxygen down because finally the lungs can expand and are open when someone is sitting out of bed. They’re not expanded and open when someone is lying in bed.

Get her out of palliative care. Palliative care means end of life care, that’s not what you want for your mom, get her out of palliative care. Why is she in palliative care? Is that something you agreed with? Is that something your family wants? Does she have an advanced care plan? Did she say she wants to go to palliative care in case something like this happens?

But I’ll tell you what’s not being used here, and I’ll tell you what is actually the most important part that families in intensive care always forget— use a common sense approach. You want your mom to get better but you’re having her lie in bed 21 hours a day, that is not common sense. I’ve not seen patients improve without mobilization, very, very rarely. So, use a common sense approach, get your mom out of bed, get a physical therapy, then see what happens. It’ll only happen over time; it won’t happen in a heartbeat. Recovery and rehabilitation, it’s like switching on a light with a dimmer, it’s not like switching on a light with a switch. Very simple.

Whilst your email illustrates that you have a great understanding of your mom’s condition, you’re not using common sense, not yet. Get it out of palliative care, because palliative care means end of life care. Let’s not beat around the bush here. So, get her out of there, get her to rehabilitation where they focus on physical therapy, occupational therapy, mobilization, and see what happens. There’s no guarantee she will improve, but there’s a high chance she may improve if you start that process. There’s a super high chance you won’t improve if you keep doing what you’re doing. There’s a very high chance things will improve if you use a common sense approach.

Don’t get bogged down by the negativity of the team that you’re dealing with and by the negativity of the intensive care team that you were dealing with because that got you to palliative care, and that eventually led you to us here, because you realize a different approach is needed.

Another option here is Intensive Care at Home. She’s also a candidate for Intensive Care at Home. I encourage you to check out intensivecareathome.com for more information there. She would be a good candidate for that, and she could have rehabilitation and recovery at home, if that’s possible. But even if it’s not possible, she can have palliative care at home.

Always use common sense. Don’t let the fancy medical talk from doctors and nurses dissuade you from using common sense, and don’t let the negativity that comes from there dissuade you from using common sense. That’s what I have to say about your mom’s situation.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. We have saved many lives with our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com. You can verify that on our podcast section at intensivecarehotline.com where you can watch podcasts that we’ve done with our clients, video podcasts, and also audio podcasts where our clients verify how we have helped them in saving their loved ones’ lives.

I’m also the founder and managing director of intensivecareathome.com  You can find more information at intensivecareathome.com, where we send our critical care nurses into the home for ventilation and tracheostomy clients, adults and children, in the home.

We have helped hundreds and hundreds of members and clients over the years. We can only change the intensive care landscape and the intensive care industry if you come to us and if you let us help you to change your loved one’s life to the better, and therefore, to change the industry, who is, I believe, in a big crisis now. Whilst there’s a lot of good things happening in critical care, there’s also a lot of bad things happening in critical care. We can only change it if we can help you, if you let us help you to improve your loved one’s life and your life instantly.

That’s why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly on your behalf or with you. When I talk to doctors and nurses directly, I ask all the questions that you have not even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time, so that you can get a second opinion in real time. We also do medical record reviews after intensive care, if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click on the membership link or if you go to intensivecaresupport.org  directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I’ve personally written and recorded, helping you to make informed decisions, have peace of mind, control, power, and influence, so that your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share this video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on a show, and you will get notification for the YouTube live if you are a subscriber to my YouTube channel or a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.