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Quick Tip for Families in Intensive Care: My Mother Survived Pneumonia & Cardiac Arrest in ICU! 6 Weeks ICU and She’s Not Waking Up! Help!

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

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

“Hi Patrik,

My mother was admitted to the ICU last year on November 29th with pneumonia. She got sedated and needed a ventilator working with 100% of oxygen. As she was not responding to medications quickly enough, they started proning her to improve her lungs and it worked until they got her down to 50% or 60% of oxygen levels, also known as FiO2 (fraction of inspired oxygen) on the ventilator. Not really sure how much, but it was considerably less than 100%.

Then because of the proning procedure, she had a cardiac arrest on December the 1st. The doctor on site says it lasted less than 4 minutes and she was assisted at all times.”

Now, for any of you that don’t know what proning is, proning basically is turning the patient in ICU on their tummy head down for pneumonia or ARDS (Acute Respiratory Distress Syndrome) not only to drain excess fluids of the lungs, but also to get the lungs to expand, which is much easier when someone is proned because the back of the lungs is in the air and can expand.

Now, carry on with Patricia’s email,

“They got her off all sedations completely on December the 25th after weaning it off for a little longer than a week. She would open her eyes and move them but would not focus. She would sometimes move her legs and feet as well.

A few weeks later, she was cured from her illness and was able to breathe on her own but still using the tracheostomy and with little neurological improvements. She was released from ICU on January the 16th. Since then, we saw her biggest neurological improvements.

She will now focus on people talking or moving around the room and on the TV, she will blink when asked to, and is also moving her arms and legs quite frequently. Still, we are very confused about her neurological prognosis. Most doctors are either negative or as vague as possible.

We still hope there is some sedative running on her body as she sleeps most of the day. During her time in ICU, she took medications for everything they never knew what got to her.

On your website, I’ve read that cardiac arrest, kidney failure, ARDS, septic shock, and using two different types of sedatives at the same time, could delay waking up. She had all of this, what do you think? Could it be a delayed waking from sedation? Or at this point, there is no possibility other than anoxic brain injury, even though it lasted less than four minutes?

Please give us your opinion. We don’t really know what to do or think we feel lost, and the doctors won’t really help. Thank you in advance and sorry for the long email.

Patricia.”                                

Well, thank you so much Patricia for sharing this. This is really a success story for your mom because I’m sure that the ICU team would have given you the doom and gloom in the beginning.

There would be other families reading or watching this who think, “Well, my mom didn’t make it, or my family member didn’t make it and they were negative right from the start.” I think your mom has done extremely well to survive this episode and get out of ICU life. Now, obviously, she’s struggling with recovery and she’s struggling with waking up.

So, let’s just break this down step-by-step. Your mom was in an induced coma for over a month according to the timelines in your email. That’s a very long time.

You didn’t say when she had the tracheostomy. Did they stop the sedation when she had the tracheostomy? You didn’t elaborate on that, but either way, she was in an induced coma for at least a month according to your email.

So, some of it depends during that time, what sedation she had. Did she have propofol? Did she have Midazolam? Did she have Precedex? Did she have a combination of all of that? Was she on fentanyl? Was she on morphine? Was she on Dilaudid? Was she on OxyContin or a combination of any of the above? So, a lot of it depends on that.

Some of it depends on was your mother in kidney failure, liver failure. If she was in kidney or liver failure, takes a lot longer for sedatives and opiates to get out of the system because the kidneys don’t excrete them and the liver doesn’t metabolize them, then they often end up in the body tissue. Some of it also depends on whether people are potentially overweight because if they’re overweight, some of it will be stored, for lack of a better term, in the body fat.

But next, has she had a CT scan or an MRI scan of the brain after the cardiac arrest? Has she had an EEG of the brain? Is she having seizures? If she’s having seizures, for example, she’s on anti-seizure medication, it’s much more likely that she actually might have anoxic or hypoxic brain injury. But it sounds to me like she’s sort of opening eyes, she’s obeying commands, she’s doing some of the right things she’s doing.

Now, here is another thing that you got to keep in mind. So, when someone has been in an induced coma for so long and has been in ICU for so long, give them time. You haven’t shared whether your mom is getting mobilized. You haven’t shared whether she’s getting out of bed every day. You haven’t shared whether they’re doing physical therapy. You haven’t shared any of that. Has she gone on to a rehabilitation facility? You haven’t shared any of that.

So, what are the stimulants she’s getting? What medications is she still on? For example, if she’s getting out of bed every day in a chair, that will certainly help her to regain her function. When someone is in an induced coma for over a month, they’re getting deconditioned extremely quickly. They are losing their muscle tone very quickly. They’re getting deconditioned so quickly that they often have to start learning to walk again, learning to move again, learning to eat and drink again. So, where is she at with that? Is she just confused but is she doing all other bodily functions?

The other thing that I would highly recommend to you, and I don’t think you’ve done that I got your email correctly, you need to get access to the medical records as simple as that. You need to get a need to get access to the medical records as quickly as possible to see what they’ve done, what they haven’t done.

You should also get a second opinion; we are halfway there. I’m already giving you a second opinion, but I could even give you a better second opinion if you gave us access to the medical records, if that makes sense.

So, it’s probably a combination of things in terms of, is there a delay in waking up just because she’s very sick? Or is there a delay in waking up because she’s still getting rid of sedatives and opiates? It’s probably a combination of that.

A lot of it comes down to mobilization, physical therapy, speech therapy, learning to eat and drink again, learning to mobilize again, learning to move her arms, move her legs. She has taken massive steps here, which is really great.

Once again, this should be encouragement for anyone who’s in a similar situation knowing full well that there is recovery on the other end.

The other thing is here, Patricia, she needs to go on to a good rehabilitation place, where they can focus on physical rehabilitation.

So, I hope that answers your questions and gives you some insights and gives other families insights that are watching this video. So, this is a really good email. Thank you so much.

Now, if you want your questions answered, we have created a membership for families of critically ill patients in intensive care if you go to intensivecarehotline.com and you click on the membership link. In the membership, you have access to me and my team, 24 hours a day, in a membership area and via email and we answer all questions, intensive care related. You can also get access by going to intensivecaresupport.org directly.

Also, in the membership, you also have access to 21 ebooks and 21 videos that are specifically made just for our members. They will focus on all of your questions in ICU, but you only get access to them if you become a member.

I have worked in intensive care for over 20 years, nearly 25 years in three different countries. I have also worked as a nurse manager in intensive care for over 5 years. I have been consulting and advocating for families in intensive care all over the world since 2013 here at intensivecarehotline.com.

I can confidently say that we’ve saved lives. You can just have a look at our testimonial section, and you can also have a look at our podcast section where we have done interviews with some of our clients to verify what I’m saying.

I’m also offering one-on-one consulting advocacy with you and your families. I also talk to doctors and nurses directly. I talk to you on Skype, Zoom, WhatsApp, phone, whichever medium works best for you. I also participate in family meetings with intensive care teams with you so that you can make informed decisions, have peace of mind control, power, and influence.

Furthermore, 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. We also offer medical record reviews after intensive care as well.

Now, and all of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

If you like my video, subscribe to my YouTube channel for regular updates for families 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.

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.