Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

Quick Tip for Families in Intensive Care: My Sister had an Aneurysm & TBI (Traumatic Brain Injury) 3 Weeks Ago, She’s Waking Up Too Slowly. Should We Continue Treatment?

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

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

“Hi Patrik,

My sister had a fall on a holiday. She fell down some stairs. We all thought she may be tripped up, only to find out she had an aneurysm which burst, and she had 2 fractures on his brain. The ICU team said she has a very serious head injury.

She was initially hospitalized in Spain, put into an induced coma for three weeks, and then she was flown home to Edinburgh Royal Infirmary. They took her out of the induced coma after a week, but she still needs the ventilator to help her breathe. There’s no response at all from her.  They are saying they’re not happy with her progress. She’s been lying flat since it happened. So, they said they’re going to try sitting her up to see if it helps.

At one point, her kids said, “Mom, if you know where we are, move your finger/stick your tongue out which she did on a couple of occasions. She opened her eyes but nothing really more than that. We all know she’s seriously ill, but we need to know her chances of her recovery as we think they’re giving up on her too soon.

Thank you so much for all your advice and for everything that you do.

We hope we can find some help in your reply.

From Lynn.”

Thank you so much, Lynn, for sharing your sister’s situation. Now, those situations are very, very difficult and I have seen those situations probably hundreds, potentially thousands of times.

I have worked in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over five years and where I have been consulting and advocating for families in intensive care here at intensivecarehotline.com since 2013.

We have saved many lives with our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com. You can also verify the work that we’ve done on our podcast section at intensivecarehotline.com where we’ve done some client interviews, verifying the work that we’ve done.

Now, coming back to Lynn. Lynn, those situations are very, very difficult. On the one hand, you can see your sister is incredibly sick, and she’s been in an induced coma for 3 weeks. She has a significant brain injury, and you just don’t know whether she’ll go and recover to a level that you feel happy with, and that is a massive challenge because on the one hand, you don’t want anyone to give up too soon. On the other hand, you want to maximize her quality of life and the outcome that you get while she’s getting and receiving treatment in intensive care.

So, by giving up too soon, you probably know the outcome already because if intensive care teams or families are giving up too soon and life support is withdrawn, you know the outcome.

A better approach from my decades worth of experience is to make decisions today that you don’t regret in 12 months’ time. What do I mean by that? What I mean by that is, everyday counts. Every day your sister is alive and is making even only small progress, chances are she will recover to a certain degree. Will she recover to the point where she is back to baseline to what it was like before? Nobody knows.

Now, given that your sister is still on a ventilator after over 3 weeks, the question here is, do you want to remove mechanical ventilation and life support, and do you want to let her go? Or do you want to continue life support? Do you want to potentially put in a tracheostomy? You haven’t mentioned whether your sister has a tracheostomy or not, but your sister might need a tracheostomy to give her every chance that she needs to get better.

She can’t stay on the ventilator with a breathing tube in her mouth forever because there’s too much damage that can be caused. Also, once she has a tracheostomy, it’s much easier for your sister to get mobilized and get out of bed.

So, once that has been achieved with mobilization, physical therapy, rehabilitation, again, your sister is much more likely to recover to a certain degree, to a certain point. So, I don’t believe that your sister’s treatment therapy and rehabilitation program has been maximized with what you’ve shared here.

Imagine someone’s confining you to a bed for 3 weeks, you would have been in an induced coma and you’re coming out of that with a head and brain injury, you need some gentle but ongoing stimulation, i.e., getting out of bed, physical therapy, mobilization. If all of that still doesn’t show that she can improve, then you might have to revisit your strategy.

But unless all of those things have been done, I do believe it is way too early for you to make any decisions that might potentially shorten your sister’s life unless you know exactly what she wants. That’s one of the challenges here, you don’t really know what she wants, and you only find out over time.

Now, there’s another thing to keep in mind. There’s probably no rush to end her life or is there? What’s the urgency in potentially killing someone? You can always revisit that. If things don’t go well, you can always keep talking about end of life or start the conversation about end of life if your sister isn’t improving. If she’s not improving again, you can always start talking about palliative care and end of life care. There’s no rush, no urgency, and you can always revisit that.

Also, another thing that you haven’t mentioned, is your sister’s suffering? You haven’t mentioned much about that. Is there suffering involved when patients go through a recovery phase in ICU? Yes, absolutely. Is it worth the suffering? Do people who want to live go through suffering? Probably, but there’s always a price to pay.

So, I hope that helps you answer your questions.

One more last thing, Lynn, talk to a neurologist and see what they say what they think the recovery is going to be like. But also keep in mind that intensive care teams in the U.K., in particular, with the NHS system, they often try to empty beds by unfortunately prematurely withdraw life support.

We have been involved in many, many cases that we also turned around, of course, where the NHS (National Health Service) and the ICU teams want to prematurely withdraw life support and literally kill people. You shouldn’t buy into that narrative. You should put all resources forward for your sister so that she gets best care and treatment, making sure you make informed decisions, you have peace of mind, control, power, and influence, making sure your sister gets best care and treatment.

Now, because we get so many questions from families in intensive care, that’s why we created a membership for families of critically ill patients in intensive care. 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 e-books and 21 videos that I have personally written and recorded sharing all my vast ICU nursing experience with you, once again so that you can make informed decisions, have peace of mind, control, power, influence so that you can influence decision making fast, making sure your loved one gets best care and treatment.

I also 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 can’t afford to get wrong. I also talk to doctors and nurses directly and when I talk to doctors and nurses directly on your behalf, I ask all the questions 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.

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.

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or 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, hit the notification bell, comment below what you want to see next, what questions and insights you have, share the video with your friends and families.

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

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.