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Taking care of patient in semi-coma

Resolved Question:

hello doctor, My mother in law was in semi coma condition from last eight years, she open her eyes we feed her with food pipe , but their is no response on her side, please advice what kind of test we can take for knowing her conditions please help, Kanika


Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hello,

 

Thank you for asking your query.

 

I am sorry to hear about your in-laws medical condition and will try to assist you my best.

 

From your description she seems to be more or less in a persistent vegetative state. A vegetatvie state of this long duration will have definitely to do with a damage in the brain. There are many problems which can cause coma. Ranging from metabolic, hormonal problems to neurological problems. But all other than neurological issues will either progress or get better in some duration. If there is neurological problem the comma can persist.

 

So there could be a stroke or a brain infection like encephalitis which led to the coma in the first place. I am afraid by this time a lot irreversible damage might be done and recovery might not be possible.

 

Now coming to your specific query , what kind of tests can be done :

 

1. MRI of the brain

2. Blood tests – Electrolytes, Renal and Liver function tests, Thyroid function tests.

 

These basic tests will give a relatively fair idea on how things are with her now. If needed further tests can be done after analyzing this data.

 

Hope this helps.

Please feel free to ask follow-up questions if any via this email.


Patient replied :

Thank you Doctor for a reply,

As my mother in law was in coma from last 8 years, She is diabetic and in the year 2004 ,Dec her sugar level was increased at 650 which results in non supply of oxygen to the brain ,Had a heart attack and doctors done angioplasty and she was on manual ventilator at her first stage of coma but as time passes ventilator was removed andctors discharged her from hospital,

Now at present she is at home we are feeding her with food pipe opening her eyes may be listening also but its difficult to say that she is recognising or understanding because she is not responding,



Please advice


Expert:  Dr. Sudhir Kumar replied 3 Days.

Hello,

 

Thank for providing with more information.

 

So the during the diabetic coma, she suffered a anoxic brain damage (lack of supply to brain). As I said a neurological problem will always cause this long a coma. 

I understand that this is a difficult situation for the family. I need you to understand some facts. What you need to provide is supportive care. The chance for recovery is very less. So you need to be aware when you spend your time and resources. 

 

The above mentioned tests are not necessary, but you can get it done to know the current situation. 

 

Hope this helps.

Thank you


Patient replied :

Thank you Doctor,

as you have said that chance of recovery is less but as the family member we dont want to lose hope because she has managed well in this condition from last 8 years every thing is normal except her reaction and she was on bed she look around has normal problems like cough and etc as normal person face, i want to tell some more details to you and want to know is their any chance or any treatment related to this in whole world we can take her,

details in more detailed are as follows,

On 15dec2004 morning 7.00am she is feeling pain in her heart when we take her to doctor he says that she got heart attack and give her medicine to put it under the tongue mean while he takes the sample of blood for testing sugar level. After few min she collapse and stop breathing (sugar level was around 650) then doctor give her CPR and put a pipe for ventilator it takes around 5-10 min she dose not breath in this time the ventilator was manual. At 10.30 am she was shifted to a bigger hospital. Over there we come to know that some damage is done in her brain she was unconscious after so many test at 9.00pm she was operated and angioplasty was done and a stent was placed in her body from that day she was on ventilator for two and a half months after three months we take her to home and she start opening her eyes after 1-2 months after coming home.

dear doctor thanks for your prompt reply,please advice 


Expert:  Dr. Sudhir Kumar replied 2 Days.

Hello,

 

Thank you for the followup query. It seems she might have suffered brain damage during the CPR  and early ventilatory period. Unfortunately there is nothing much that can be done as of now. Provide her good supportive care.

 

Hope this helps.

Thank you


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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