ralper

This isn't a political thread and please lets keep it that way. I just read an article about the medical treatment that Ariel Sharon is receiving and I don't quite understand the whole thing. I know very little about medicine and I'm hoping some of you might answer my questions.

What is the purpose of inducing a coma? Why is this done? How is it done?

How is a person removed from a coma? When is this done? Are there any permanent effects of a coma?

What did the doctors do to Sharon while he was in the coma? What did they hope to accomplish?

Thanks in advance. This is a complete mystery to me.

Legal Bill

As Rob has indicated, this is not a political thread. If you want to comment on the politics, please see the politcs sub-forum where there is already a Sharon thread in play.

Rob, I am equally curious as to the science behind this. I hope someone like Steve can give us an education.

dean

My SWAG is that the purpose is to reduce brain activity in order to lessen the risk of brain swelling and blood vessel leakage after surgery. It's probably done with the use of the I.V. administration of a CNS depressant. (Or a large rubber mallet. )

mikegarrison

Inducing a coma is done via drugs. Removing someone from an induced coma is done by removing those drugs.

I believe that the purpose of inducing a coma is to try and lower the amount of blood flow to the brain. It is an attempt to at least stop more damage from occuring until the original problem can be fixed.

Lainey

Rick's father passed away from that kind of stroke.

They offered surgery, (to help drain the blood and relieve pressure), but told us they could not actually stop the bleeding, it had to run it's course. A respirator would have been required, and from the size of the bleed, they knew even if he survived surgery, brain damage would be extensive.

Knowing his father's wishes, Rick declined treatment.

I think they have taken heroic measures to save Sharon's life. If he lives, I wonder about the quality of life he will have after such a massive stroke.

mikegarrison

Always an issue. On the other hand, no one is immune to change. Life is a process. You don't have the same "quality of life" afterwards, but "worse" or "better" implies that there is some objective standard, something that is not quite true. Some people deal with such challenges more readily than others.

This is a very complicated situation, and I don't know how I would deal with it myself. I have seen a local S2Ki member go through something like this, and it impressed me very much how strong he had to be to deal with the aftermath of his father's stroke.

Lainey

Some people have amazed me over the years as they deal with illness, disability, etc. Not everyone has that ability.

We knew Rick's father's wishes in the event of an incapacitating stroke/illness. This stroke would have most likely left him blind, deaf, wheel chair bound and the list went on. It was quite grim. Though it was a difficult decision, Rick followed his father's wishes regarding heroic measures and medical treatment. He decided to let nature (or God, if you are a believer) take its course and declined treatment. I hope someone has the same courage to honor my wishes, if needed someday.

PokS2k

After bypass surg. my stepfather was placed in a drug induced coma for almost a month. Prior to this procedure, he was not doing well, getting agitated and interfered with the tubing from the vent.

He came out of it fine, spent another week or so in the hospital and was fine. This was about 3 years ago.

RC - Ryder

PokS2: you're right on target. It calms down movement and agitation common to awakening, it allows the patient to tolerate the ventilator, and it enables doctors to monitor vital signs (including EEG) under stabilized circumstances.

dangarza

Ralper: The above responses are on target.
Inducing coma (usually with barbiturates or general anesthethics, intravenously) is with the objective of reducing brain metabolic activity, (thus oxygen and other nutrient consumption) to an absolute minimum. WHY?
Surrounding the area of infarcted, or injured brain, there usually is an area called "penumbra" of brain tissue that is injured, but viable. After a brain insult of any kind (infectious, traumatic, vascular) as Dean correctly pointed out, there is going to be swelling caused by the dead cells as well as by cells being unable to control their water equilibrium, also leakage from the damaged blood vessels, and other mechanisms too complicated to elaborate here, but this swelling causes increased pressure inside the head, (the head is a closed compartment) and such an increase in intracranial pressure makes it harder to perfuse the brain. In extreme cases of increased pressure, the pressure inside the head is actually higher than the blood pressure so blood cannot enter the head, the entire brain goes!
Swelling is inevitable, but by decreasing the metabolic demands, you might be able to salvage some injured but viable brain tissue during the "crunch" period (usually 2-3 days) when brain swelling is at its maximum.
There is decreased perfusion, but also decreased demand for oxygen and nutrients, makes sense?
Other tricks include dehydrating the individual with diuretics (to decrease the swelling) and sometimes putting a drain in the head to remove Cerebrospinal fluid (thus decreasing pressure) and also to actually monitor the pressure inside the head.
Induced coma is often used after severe traumatic head injuries or intractable convulsions.