June 2, 2016 / Patrik Hutzel - Critical Care Nurse Consultant / No Comments

My 29 year old husband is in Intensive Care with a brain injury and fractured legs! He’s been in an induced coma for four weeks and he has been septic! Will he be OK?

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

My uncle is on BIPAP after two weeks on the ventilator and the doctors think that putting the breathing tube back in is futile! What does it mean?

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 29 year old husband is in Intensive Care with a brain injury and fractured legs! He’s been in an induced coma for four weeks and he has been septic! Will he be OK?

This question from Olta formed part of an email consulting/counselling session with me.

Olta writes

Hello Patrik,

I’m the wife of an army officer, he is 29 years old.

40 days ago he had an accident with a head injury, the doctors operated on him and the operation went very well and the doctors put him in an induced coma…the CT scan of the brain showed that he doesn’t have any brain injury but he had a severe leg infection and they kept him in an induced coma for one month.

My husband has never been ill in his life before and he can’t talk yet cause they haven’t closed the tracheostomy yet…two days before he had plastic surgery in his leg…he was in a septic condition during all this time…

Then they woke him up and he responded very well. He seems to listen and when I come closer to him he kisses me on the lips.

He doesn’t need mechanical ventilation anymore. He has never been taking drugs or alcohol and he was physically very strong. How long do you think it will take him to come back to normality?

The doctors woke him up a week ago then they operated on his leg two days ago with general Anesthesia. They closed it up and now he doesn’t have sepsis or infection anymore on his leg.

I hope that makes sense and I’m sorry if I’m not too clear…so he had an accident in which he injured his head and crashed the right leg…the doctors operated him urgently for the head injury and left his tibial fracture and wound untouched…than they put him in an induced coma for 6 days and after that they woke him up.

But by that time he was still on mechanical ventilation…after that they left him awake for three days, then he had his leg operated for the tibial fracture…they woke him up again after the operation but the wound in his leg got infected and had sepsis too…so they put him back to sleep and they did the tracheostomy.

His situation became worse and worse…they medicated the infection with IV Antibiotics for two weeks and now he is ok…but they decided to operate his leg at the plastic surgery department…all his organs are functioning very well and now he is awake again as I write to you. Today besides recognizing me he seemed to confirm what I said by shaking his head…I hope I have been clear…thanks

Olta

Hi Olta,

thank you for your email and for your enquiry. And thank you for signing up to my email counselling/ consulting service.

I am very sorry to hear what you and your husband are currently going through.

Being in an induced coma for one month is a very long time, however if your husband is now awake and is recognizing you, it’s very encouraging.

Check out my counselling/ consulting options via phone/skype or email

1:1 Phone/Skype counselling/ consulting with Patrik

1:1 email counselling/ consulting with Patrik

If your husband was septic because of his leg infection it’s probably the reason why they kept him in the induced coma. Even though four weeks is a long time for an induced coma, if he was septic and they didn’t want to take the risk of operating on his leg it was most likely the right thing to do.

It’s nothing unusual that fractures are not getting operated on straight away in a Critical Care environment if Patients are unstable and have other injuries or fractures that make it too risky. Leaving critically ill Patients in an induced coma during those periods when it’s too risky to intervene and do procedures makes sense and it often gives Patients time to heal and rest.

Especially with Sepsis, it’s good that they didn’t take the risk and taking your husband to theatre for operating on the leg!

On top of that, given that he had a head/brain injury, it was probably wise to leave him in an induced coma for a bit longer so his head and brain had time to rest and heal as well.
After such a long critical illness with sepsis, your husband will need time.

It’s very encouraging that he recognizes you and that he can confirm what you are saying.

Being in an induced coma for so long with sepsis can take its toll and it will most likely take your husband some time to fully recover.

However it’s a good sign that after the plastic surgery he’s had that he didn’t to go back on the ventilator.

It’s also a good sign that he’s not septic anymore. Therefore it was wise to not operate on the tibial fracture, get the IV Antibiotics going first, treat the infection/ sepsis and then operate on it.

Recovering after a longstanding critical illness can take time. You need to be patient and it’s often two steps forward and one step back.

The most important thing that I can see is that your husband doesn’t have any brain injuries, therefore he should be able to fully recover.

This might take time, but your husband’s first goal is to get out of Intensive Care first and it sounds to me like he’s not too far away from doing that.

Also, keep in mind your husband will have lots of medications from the induced coma and from the general anesthesia in his body that will most likely slow him down as well.

Again, one step at the time, day by day and often hour by hour.

It’s important for you that you keep your sanity and that you stay positive.

Here is a link to an article/video that will help you to stay positive:

How to stay positive if your loved one is critically ill in Intensive Care

Here is also a link to an article/video that will help you to understand what’s happening as well as it relates to wake up after an induced coma

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

I hope that clarifies, any other questions please let me know.

Kind Regards

Patrik

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