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9hotonic
Jan 29, 2016

(after hearing the library has games , i arrive at the front desk, disguised as a non-gamer)

"er.. im here for some.. book's"

FAN OF NICKELBACK posted:

The worst part, and I'm going to go wrestle sleep after this, is when you realize you have always been wrong about what brain damage really is.

See, it's not "oh they are dumber now and I guess I'll wipe their rear end"

it's more like "oh, this bit makes them paranoid, and this over here makes recognizing voices and words not work. Over here they go blind, and this part is basically ms. This last bit just makes them too functionally apathetic to even move."

So basically sometimes they are cute and dumb and other times they are trapped in a confusing and unimaginable hell with no hope of escape. Also maybe if you really give it your all you can get them to a level of function that removes any plug you'd be able to pull anyway, but just that level.

the brain is like a computer, its very finely built to perform many functions. if you destroy it or break it critically, it stops working, but if you very slightly damage or bruise certain parts, it'll (metaphorically) glitch and not work properly but still work. most mental illnesses occur simply because the brain lacks the facilities to do or manage certain things, or they just don't work properly, its kind of hosed up how delicate this poo poo is but we need to do anything.

anyway OP, im sorry for what you have to go through, stay safe friend :sympathy:

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Nathilus
Apr 4, 2002

I alone can see through the media bias.

I'm also stupid on a scale that can only be measured in Reddits.

FAN OF NICKELBACK posted:

just go write wills ok, even if you're in your 20's or whatever

You do it. Seriously. You are currently your kid's only conscious parent. Get a living trust set up asap. It barely matters if you have any actual possessions or money to transfer. The nonmonetary stuff is just as important.

Don't fret too much about the kid's reaction. It doesn't mean she's any more psycho than a regular kid. She just lacks the brain development and experience to know how she should react to this kind of trauma. Besides people grieve differently from one another, even speaking purely of adults.

You're probably sick to death of sympathy by now, so I'll finish by saying it's important to not lose hope. Your wife is still alive. Weird poo poo happens sometimes. Even if there does come a time for you to make the call, you have a daughter you need to remain strong for. The world is still limitless for her and all her best years are ahead of her. You can make that happen with or without your wife.

Oh and since I can't share my condolences, gently caress you instead. You piece of poo poo. I hate you. Your posting sucks.

sout
Apr 24, 2014

I have no idea what to say other than to wish you and yours well, you shouldn't have to be dealing with this.

This ought to be in E/N, where you'd maybe get more genuinely helpful advice, or more likely just a little bit less trolling.

Drunkboxer
Jun 30, 2007

Enfield posted:

also op please talk to someone who isnt loving retarded which is what gbs is, also stupid as poo poo, and smells bad

yeah you should probably talk to someone who understands how lovely grieving is OP

grief can go eat a loving dick as far as im concerned

Shame Boy
Mar 2, 2010

Nathilus posted:

You do it. Seriously. You are currently your kid's only conscious parent. Get a living trust set up asap. It barely matters if you have any actual possessions or money to transfer. The nonmonetary stuff is just as important.

Don't fret too much about the kid's reaction. It doesn't mean she's any more psycho than a regular kid. She just lacks the brain development and experience to know how she should react to this kind of trauma. Besides people grieve differently from one another, even speaking purely of adults.

You're probably sick to death of sympathy by now, so I'll finish by saying it's important to not lose hope. Your wife is still alive. Weird poo poo happens sometimes. Even if there does come a time for you to make the call, you have a daughter you need to remain strong for. The world is still limitless for her and all her best years are ahead of her. You can make that happen with or without your wife.

Oh and since I can't share my condolences, gently caress you instead. You piece of poo poo. I hate you. Your posting sucks.

He said he's already making a living will so yeah

FAN OF NICKELBACK
Apr 9, 2002

sout posted:

I have no idea what to say other than to wish you and yours well, you shouldn't have to be dealing with this.

This ought to be in E/N, where you'd maybe get more genuinely helpful advice, or more likely just a little bit less trolling.

I mean good looking out and all, but I really can't sufficiently underscore how completely useless, uncomfortable and unnatural being inundated with pity and empathy is on the reg, and finding it here would feel twice as foreign.

Also I mean . . . I dunno if really I'd look for or take advice or anything unless some neurologist happened to be reading and was like "hey try this reasonable thing! it might actually miracle something, check out this study!"

Overall, it's not exactly a thing that has a whole ton of available perspectived experience or clear paths back to every day life, y'know.

I think I would actually feel worse if someone in even a slightly less shittier situation actually logged into Something Awful looking for a return on emotional investment.

I mean, drat. That would be wounding to observe.

I guess questions are cool though, it feels good to just lay things out and think things through in ways i might not have, but I still can't go into a lot of identifying sorta info or details for reasons.

EXTREME INSERTION
Jun 4, 2011

by LadyAmbien

Squish posted:

So what was the actual surgery that has lead to catastrophic blood loss? How long was she in the post-op ward before discharge?

There's no such thing as minor surgery

FAN OF NICKELBACK
Apr 9, 2002
oh also here's a thing in case anyone wants to see how bad anoxic eschemia actually is, and what it looks like to beat the odds and come back after 10+ minutes of CPR after your heart sits around without a job to do. consider this a psa that i am kinda upset never appeared on tv when i was a kid.

if anyone feels as though i am overestimating the damage, feel free to play devil's advocate, i ain't gonna be mad at you

[summarized transcript]
code:
technique:
  multiplanar multisequence mr images of the brain were performed without contrast.

findings:  
  [posturing/seizures] affected clarity of some imaging sequences.  sagittal t1 weighted images
  show prominence of splenium of the corpus collosum with relative t1 weighted signal 
  hypointensity.  mild increased flair signal in anteriar aspect of left temporal lobe.  cere.
  sulci and vetricles are normal.

  t2 weighted images show mild edema in splenium.  Similar seen in centrum semiovale 
  bilaterally.

  dw image outline edema in splenium and semiovale.  assoc. low signal on adc maps consistent 
  with diffusion restriction in these regions.  no hemorrhage observed.  inflammatory changes 
  observed in sphenoid sinus and somewhat lesser extent in left maxillary sinus.

  compared with previous mri from 5 days prior, some d.r. in splenium / semiovale consistant
  with hypoxic ischemic encephalopathy.  previous edema in occipital lobes not as obvious 
  
  d.r. in splenium associated with poor prognosis.

FAN OF NICKELBACK fucked around with this message at 16:13 on Feb 22, 2016

nomadologique
Mar 9, 2011

DUNK A DILL PICKLE REALDO
good luck op. i am very sorry for your loss.

nomadologique
Mar 9, 2011

DUNK A DILL PICKLE REALDO

FAN OF NICKELBACK posted:

I mean good looking out and all, but I really can't sufficiently underscore how completely useless, uncomfortable and unnatural being inundated with pity and empathy is on the reg, and finding it here would feel twice as foreign.

I think I would actually feel worse if someone in even a slightly less shittier situation actually logged into Something Awful looking for a return on emotional investment.

you came here to vent, and we came here to read poo poo, and since you posted this in the middle of our shitposting, we get to emotionally process our distant grief, imagining if it were our own, by saying how sorry we are.

dad gay. so what
Feb 18, 2003

by FactsAreUseless
i didnt read any of it. i refuse.

a hole-y ghost
May 10, 2010

I don't get it :confused:

a hole-y ghost
May 10, 2010

Okay I read the interesting parts. Why did they take out her blood with surgery? Doesn't seem that smart to me. Did you get a refund?

ziasquinn
Jan 1, 2006

Fallen Rib

a hole-y ghost posted:

Okay I read the interesting parts. Why did they take out her blood with surgery? Doesn't seem that smart to me. Did you get a refund?

Save on your bills by giving blood while you're split open for a nice discount

a shiny rock
Nov 13, 2009

jump as high as you can and measure it. then tomorrow try to jump even higher. you'll be the new michael jordan in no time

ClamdestineBoyster
Aug 15, 2015
Probation
Can't post for 10 years!
So she got brain damage from listening to nickelback? :shrug:

Moon Atari
Dec 26, 2010

Well drat, that really sucks.

Shame Boy
Mar 2, 2010

dad gay. so what posted:

i didnt read any of it. i refuse.

brain dead gay. so what

VelociBacon
Dec 8, 2009

OP I'm one of the people that deals with all the ICU and ventilator stuff your wife is going through. Super sorry to hear about this but wanted to say I wish all families/spouses were as reasonable as you seem to be. Have you got in touch with social working at the ICU? They can at the least put you in touch with some resources that might make this all a bit easier.

Feel free to PM me if you would like clarification on anything that you're hearing or being told but don't think to ask about at the time ETC.

e: Actually I'm going to edit this and just add a few things

You seem resentful about not being informed that outcomes can be really bad after CPR, and that you feel you were fed misinformation about the actual state of your wife when they told you they were trying to stabilize her rhythym. The intent was not to be misleading - when someone is in cardiac arrest they will usually have cardiac electrical activity still, it's not like the movies where someone's ECG just turns into a flatline (usually). When you were told they were trying to stabilize her rhythym she was probably in and out of many different electrical states (ie: ventricular tachycardia/fibrillation, pulseless electrical activity, etc).

The other thing is that even if you knew outcomes were poor for cardiac arrests, you'd still have wanted them to do CPR due to the chance at a GOOD outcome. To be honest, even if you didn't want it the team would have done it anyways because it's the right decision.



For the rest of you goons, have a conversation with whoever is going to be speaking to the medical team on your behalf if you have some incident happen, and express strongly how you feel about whether you would want to be kept alive if you're unable to move/speak/are likely no longer cognititive.

VelociBacon fucked around with this message at 17:56 on Feb 22, 2016

FishionMailed
Feb 2, 2014

by zen death robot
drat OP that sucks man I'm sorry

FAN OF NICKELBACK
Apr 9, 2002

VelociBacon posted:

OP I'm one of the people that deals with all the ICU and ventilator stuff your wife is going through. Super sorry to hear about this but wanted to say I wish all families/spouses were as reasonable as you seem to be. Have you got in touch with social working at the ICU? They can at the least put you in touch with some resources that might make this all a bit easier.

Feel free to PM me if you would like clarification on anything that you're hearing or being told but don't think to ask about at the time ETC.

e: Actually I'm going to edit this and just add a few things

You seem resentful about not being informed that outcomes can be really bad after CPR, and that you feel you were fed misinformation about the actual state of your wife when they told you they were trying to stabilize her rhythym. The intent was not to be misleading - when someone is in cardiac arrest they will usually have cardiac electrical activity still, it's not like the movies where someone's ECG just turns into a flatline (usually). When you were told they were trying to stabilize her rhythym she was probably in and out of many different electrical states (ie: ventricular tachycardia/fibrillation, pulseless electrical activity, etc).

The other thing is that even if you knew outcomes were poor for cardiac arrests, you'd still have wanted them to do CPR due to the chance at a GOOD outcome. To be honest, even if you didn't want it the team would have done it anyways because it's the right decision.



For the rest of you goons, have a conversation with whoever is going to be speaking to the medical team on your behalf if you have some incident happen, and express strongly how you feel about whether you would want to be kept alive if you're unable to move/speak/are likely no longer cognititive.

I'll only take issue with the fact that it's the "right" decision.

She passed out from blood loss 5-7 minutes away from the hospital, ~6 minutes after her bleeding began. Think about that math for a moment, as well as that she was, confirmed, asystole on arrival.

Regardless of age, it becomes a very trepidatious argument to assert that pushing through 12 minutes of CPR is the "right" thing to do.

(www.ncbi.nlm.nih.gov) posted:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074242/
whereas only 2% to 9% of patients who experience out-of-hospital cardiac arrest survive to discharge [4–6]. Functional outcomes of survivors are variable, but poor-quality survival is common [7], with only 3% to 7% able to return to their previous level of functioning [8]. The prevalence of coma or persistent vegetative state among survivors represents an enormous burden on patients, their families, health care personnel, and resources.

10,000 people have an OOH arrest. 500 do not stay dead. 25 go back to work and have neat water-cooler conversation.

of the remaining 475 . . .

Approximately 40% enter a persistent vegetative state. So thats . . . 190 situations that are emotionally and financially devastating to an entire family for an untold and ongoing number of years.

That leaves us with 285 not-dead people (hooray you did it!)

Mild to moderate deficits are seen in 34% (96) and severe cognitive deficits in 17% (45)

the remaining 144 have some memory issues and go home eventually.

So, and I'm sure there's contradictory studies and forgot to link them all as I went, I'm going to have to say that it's even mathematically hard to pronounce it the right thing to do. There's a greater chance that you're financially straining entire families for indefinite amounts of time, keeping them emotionally hostage to a hospital's visiting hours, than actually saving anyone.

Sure, hypothermia and other techniques can increase the ratio--but there are some clear situations (hypothermia not possible, timeframes not met etc etc) in which it's almost irresponsible to set it firmly as a matter of standard policy. If my math is off, whoops. Still though, it's not going to be that far off.

nomadologique
Mar 9, 2011

DUNK A DILL PICKLE REALDO
it's "the right thing" because our society does not like death or dying, and will refuse it to you or your loved one at most opportunities.

Mozi
Apr 4, 2004

Forms change so fast
Time is moving past
Memory is smoke
Gonna get wider when I die
Nap Ghost
uh that really sucks i'm sorry to hear that it happened

...

yup

Ride The Gravitron
May 2, 2008

by FactsAreUseless
What the gently caress is wrong with your family? Your wife's life is hanging in the balance and their response is "keep your private life private"?!

Kick them all out of you life.

nomadologique
Mar 9, 2011

DUNK A DILL PICKLE REALDO
his FIL has a sweet camaro and he still wants to take it fo ra spin on saturdays

FishionMailed
Feb 2, 2014

by zen death robot

FAN OF NICKELBACK posted:

I'll only take issue with the fact that it's the "right" decision.

She passed out from blood loss 5-7 minutes away from the hospital, ~6 minutes after her bleeding began. Think about that math for a moment, as well as that she was, confirmed, asystole on arrival.

Regardless of age, it becomes a very trepidatious argument to assert that pushing through 12 minutes of CPR is the "right" thing to do.


10,000 people have an OOH arrest. 500 do not stay dead. 25 go back to work and have neat water-cooler conversation.

of the remaining 475 . . .

Approximately 40% enter a persistent vegetative state. So thats . . . 190 situations that are emotionally and financially devastating to an entire family for an untold and ongoing number of years.

That leaves us with 285 not-dead people (hooray you did it!)

Mild to moderate deficits are seen in 34% (96) and severe cognitive deficits in 17% (45)

the remaining 144 have some memory issues and go home eventually.

So, and I'm sure there's contradictory studies and forgot to link them all as I went, I'm going to have to say that it's even mathematically hard to pronounce it the right thing to do. There's a greater chance that you're financially straining entire families for indefinite amounts of time, keeping them emotionally hostage to a hospital's visiting hours, than actually saving anyone.

Sure, hypothermia and other techniques can increase the ratio--but there are some clear situations (hypothermia not possible, timeframes not met etc etc) in which it's almost irresponsible to set it firmly as a matter of standard policy. If my math is off, whoops. Still though, it's not going to be that far off.

I think you mean 1000 not 10,000?

Are you saying that ~20% of ooh cardiac arrests that need CPR end in a vegetative state (your 190 situations) and thus it isn't worth risking CPR to save the other 285 people?

Not quite following what you're saying here... are you saying CPR made your wife's situation worse or are you saying CPR saved her body so to speak but she's still in a vegetative state so what's the point? As in, without CPR she would have died but that's better than vegetative state?

If it's the latter I see what you're saying but imo you're speaking from grief because surely the people who do end up okay would have preferred to go through CPR rather than have the ER go 'well they're probably hosed anyway no point.' I think most people would opt to take that chance that they are saved rather than die and not risk brain damage. I know I would, and I'd also want the hospital to do absolutely everything in their power to try and save someone I loved.

If I'm reading your post right, 285 people entered an ooh cardiac arrest, didn't recover on their own and needed CPR, and made it home okay versus 331 people who ended up with some form of brain damage. But those 331 people would have been dead anyway so what you're saying is you would rather not take the ~ 50/50 chance that CPR would result in saving the person with no brain damage (or even the greater than 50% chance that you'd be saved with mild brain damage)?

I get that you're in a lovely situation but I just don't see your point really. There isn't a conspiracy involved here to raise hospital costs by having people be in vegetative states and obv it's a lovely situation either way but given the risk involved I think most people would take the chance to live and maybe get brain damage rather than die for sure. And it isn't really the hospital's fault that there's no plan in case of bad poo poo :(

FishionMailed fucked around with this message at 19:47 on Feb 22, 2016

Shame Boy
Mar 2, 2010

Volume posted:

What the gently caress is wrong with your family? Your wife's life is hanging in the balance and their response is "keep your private life private"?!

Kick them all out of you life.

Seems like a not terribly unreasonable response to an incredibly deeply personal tragedy. I mean I wouldn't do it myself but I could see why they wouldn't want all their friends and coworkers and facebook buddies suddenly sending them hollow messages about "i'll pray for u" or whatever

FishionMailed
Feb 2, 2014

by zen death robot
Yeah... I get not wanting to blast things like that into the public space but at the same time I feel like OP should be allowed to take to someone about it if he needs/wants to.

Maybe a middle road solution is warranted.

FAN OF NICKELBACK
Apr 9, 2002
They're good people. I'm not somehow under their control even if I seem resentful or irritated.

I'm just respecting their process, and resentful and angry about everything.

She was my best friend, and the partnerships behind and around that just made the world look a little different than it did before or does now.

FishionMailed
Feb 2, 2014

by zen death robot
I mean yeah that's completely understandable. I can't even imagine what I'd do in such a situation :(

VelociBacon
Dec 8, 2009

I've seen lots of young otherwise healthy people have really good outcomes after this much CPR. It's definitely worth doing but I appreciate that it doesn't make this whole thing hurt less.

FAN OF NICKELBACK
Apr 9, 2002
Again, context matters.

If you cannot do hypothermic treatment, the patient has lost a significant enough amount of blood to stop their heart and you know the brain has likely been out of oxygen for minimum of three minutes . . . then maybe you shouldn't go all the way to 12 minutes with your CPR.

In that and similar cases it's almost irresponsible as an implemented standard policy.

You, at that point, are much more likely to be creating an awful situation for everyone involved then truly save even one person in the context of anything resembling who they were before your efforts.

Driver's licenses should basically have two numbers in the lower right corner, the first being the number of minutes without oxygen that you're willing to accept resuscitation efforts (if known), and the second being how many minutes of CPR you're willing to acccept if the first number isn't known or has been maxed.

Michael Bayleaf
Jun 4, 2006

Tortured By Flan
both my numbers would be 69

FishionMailed
Feb 2, 2014

by zen death robot

FAN OF NICKELBACK posted:

Driver's licenses should basically have two numbers in the lower right corner, the first being the number of minutes without oxygen that you're willing to accept resuscitation efforts (if known), and the second being how many minutes of CPR you're willing to acccept if the first number isn't known or has been maxed.

That's not necessarily a bad idea but then you kinda get into the 'can patients really give informed consent given their lack of medical knowledge' can of worms imo.

Scornful Sexbot
Sep 24, 2007


Dinosaur Gum
It won't help much OP but you convinced me to write up a will. I don't have a wife or kids, but I never thought my folks would have to figure out if I'd wanna be a vegetable.

Spoiler alert, I'm gonna have them dump my stupid malfunctioning bod in the trash, so if I have an untimely death you've helped my fam. Thanks OP.

Christina Arugula
Aug 10, 2004
How do you like your lawn? Broiled or charred?
Ramrod XTreme
Chiming in as a neurology resident that has dealt with more than a few cases of anoxic brain injury related to cardiac arrest. You will have to forgive me if I am inelegant as I have just finished a week of nights.

First, I am so sorry for the living hell you must be going through.

I would speak about anoxic brain injury in cardiac arrest, but it seems you already have the basics (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074242/). The science behind the hypothermia protocol isn't that sound and it is difficult to show that it actually has a significant benefit (what ethical person would run a randomized control trial on this?). In my experience all the hypothermia protocol does is make prognostication much much more difficult since there is very little good data about outcomes.

From what you have said about your wife's case, it sounds like she has not woken up after 3+ days as well as had post arrest myoclonus (did she just have myoclonus or status myoclonus?). From a general perspective these are not favorable prognostic signs. However, I don't know your wife's case so I don't know all the nuances and I don't intend on giving medical advice.

I tell all families this, that as her surrogate you have to make decisions in her best interest, no matter how heart rending it is. It does not sound like she is brain-dead (which, frankly, would make the decision making much easier), so her quality of life has to be considered and what she would find an acceptable quality of life. In the end there are no right answers with these sorts of questions.

Again I am very sorry that you are going through this, you have my sympathies.

ziasquinn
Jan 1, 2006

Fallen Rib
These flesh vessels really loving suck

Christina Arugula
Aug 10, 2004
How do you like your lawn? Broiled or charred?
Ramrod XTreme

Your Dead Gay Son posted:

These flesh vessels really loving suck

Do they loving ever.

Drunk Nerds
Jan 25, 2011

Just close your eyes
Fun Shoe
Sever

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FAN OF NICKELBACK
Apr 9, 2002

Magellanicice9 posted:

Chiming in as a neurology resident that has dealt with more than a few cases of anoxic brain injury related to cardiac arrest. You will have to forgive me if I am inelegant as I have just finished a week of nights.

First, I am so sorry for the living hell you must be going through.

I would speak about anoxic brain injury in cardiac arrest, but it seems you already have the basics (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074242/). The science behind the hypothermia protocol isn't that sound and it is difficult to show that it actually has a significant benefit (what ethical person would run a randomized control trial on this?). In my experience all the hypothermia protocol does is make prognostication much much more difficult since there is very little good data about outcomes.

From what you have said about your wife's case, it sounds like she has not woken up after 3+ days as well as had post arrest myoclonus (did she just have myoclonus or status myoclonus?). From a general perspective these are not favorable prognostic signs. However, I don't know your wife's case so I don't know all the nuances and I don't intend on giving medical advice.

I tell all families this, that as her surrogate you have to make decisions in her best interest, no matter how heart rending it is. It does not sound like she is brain-dead (which, frankly, would make the decision making much easier), so her quality of life has to be considered and what she would find an acceptable quality of life. In the end there are no right answers with these sorts of questions.

Again I am very sorry that you are going through this, you have my sympathies.

She never entered a coma, just straight into "wakeful unawareness" once they took the propofol off after seizing ceased in just over 24 hours. her pupils ceased being bilaterally dilated however and, though they don't move meaningfully or much at all really, they do respond to light. She does the basic things like chews on her intubation, yawns/gags/pain reflexes to an extent, and that's just about it really. lotta decorticate posturing.

The first MRI on day three only diagnosed her with Posterior Reversable Encephalopathy Syndrome, though that seems to be subsiding for the most part with no other visible changes noted.

The actual MRI results from the second MRI were posted a bit earlier up as well. Go hog wild.

Her eyes open, she seizes as a default response to basically anything, and the only thing that even seemed like it might have been a good sign was three or four days ago when she slowly lifted her arm up with her hand/wrist limp and moved it slowly away from her body towards family.

Pretty sure that was just "a thing that occured" however in hindsight.

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