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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today, I have an email from Tyler who says,

“Hi Patrik,

My dad is 72 years of age. He became unconscious and now he’s got a brain injury, and he went into a coma. The pressure in the brain is normal. It doesn’t require any release. He started opening his eyes after 10 days when we apply pressure to him and he’s in pain. On the 11th day, he opened his eyes on his own for longer periods, about 30 minutes at a time. What are his chances of a normal recovery?”

Well, thank you so much for your question.

I have seen these situations many, many times. I have worked in critical care and intensive care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years. I’ve been consulting and advocating since 2013 here at intensivecarehotline.com.

We’ve been consulting and advocating for families in intensive care all around the world. You can look up what our clients say on our testimonial section or on what they say on our interviews and our client interviews on our podcast section. I can confidently say that we have saved many lives with our consulting and advocacy.

So, coming back to today’s question. So, it’s good that after brain injury, they no longer have to measure his ICPs (intracranial pressure) and that the pressures are normal. That is certainly a good thing. Also, him opening eyes after 11 days for longer periods of time, up to 30 minutes is also a very good sign.

Now, here is what families in intensive care often forget. Waking up and recovering in intensive care is like switching on a light with a dimmer. It’s not like switching on with a light.

Now, when patients come out of an induced coma and don’t have a brain injury, they don’t wake up like you switch on a light. Again, they wake up like switching on a light with a dimmer, very slowly. It can also often be two steps forward and one step back. It’ll probably be the same with your dad’s situation.

So, you’re asking what is the chance of normal recovery? I don’t know. Nobody knows. One thing is for sure if you’re not trying, there won’t be any recovery. You need to give it time. You need to give this time.

There are patients out there who have recovered fully and there are patients out there, they have not recovered at all. They have actually passed away. Then there are patients who might recover only to a certain degree.

Now, the other question here, besides asking, what are the chances of a normal recovery? You may also want to ask what does a meaningful recovery mean to you and your family? Meaningful recovery means how important is it for you to have your dad around even if he hasn’t fully recovered.

In order to get to a full recovery, I think it is important that once he’s getting more awake that slowly but surely the physical therapy starts, and physiotherapy starts. Slowly but surely, neurology, rehab starts. Also very, very important and slowly but surely ventilator weaning starts.

You haven’t mentioned that he’s still ventilated, but if your dad was unconscious, I’m 100% certain he would be ventilated. So, does he have a tracheostomy? Can he avoid a tracheostomy? Those are also questions that need to be asked.

Now, you might be in it for the long haul here and your dad might need a long time to recover to a point where you would consider him fully recovered or it might be a while until you would consider it meaningful recovery. So, the good news is he’s opening his eyes, his brain pressure seems to have normalized.

Other things that are important here are does he have any seizures. If so, does he need any anti-seizure medication? Have they done the CT scan of the brain? Have they done the MRI scan of the brain? Have they done the EEG (electroencephalograph) of the brain? If so, what does it say? What’s the prognosis according to CT scan of the brain? MRI scan of the brain? EEG? What does the neurologist say?

So, those are all questions that you need to ask in order to get to your answer, but you will need to be patient here. I haven’t seen any quick fixes of patients waking up after brain injury or after an induced coma. Just not a reality.

Other things you may want to consider is if your dad, for example, has gone into kidney failure or liver failure, which might also delay him waking up. Other things you need to be certain about is that they stop the actual sedatives and opiates. Also, very important that you ask that question.

Do you have access to the medical records? These are all very important factors to consider in a situation like that. You may be wondering why is he not waking up and he might still be on sedatives or opiates also known as pain medication? So, very important that you ask all these questions.

Is there something else that’s holding him back from waking up? Is he getting good nursing care? Are they washing him regularly? Doing good mouth care, eye care, nose care, skin care? Are they turning him regularly? Are the doctors and nurses talking nicely to him? Also, very important for your dad’s recovery.

So, that is my quick tip for today.

I hope that helps you understand what’s happening there and what your next steps are. Also, is he hemodynamically stable? Because if he’s not hemodynamically stable, he may not be ready to wake up.

So, because we get so many questions from families in intensive care, that’s why we created membership for families of critically ill patients in intensive care at intensivecarehotline.com. If you click on the membership link there, you can become a member there or 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.

You also get exclusive access to 21 e-books and 21 videos that I have personally written and recorded, and those e-books and videos will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly, once again, and I ask all the questions to the doctors and nurses that you haven’t 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, once again, making sure you make informed decisions, you have peace of mind, control, power, and influence.

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

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.

Thank you so much for watching.

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

I also do a weekly YouTube live where I answer your questions live on the show. If you want to know or if you want to get notification, just subscribe to my YouTube channel and you get a weekly notification or go to intensivecarehotline.com and subscribe to our email you that are there and then you get up all the updates there.

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.