While the hospital staff has been helpful, I was getting frustrated by the lack of precision in what I was hearing. So when I talked to the neurologist today I mentioned that I was at an academic institution and had access to medical journal article databases. Could she recommend any terms that I might search for in them?
Yes, and she gave me four: cardiac arrest neurological prognostication.
I also found out that another term for my father’s condition is hypoxic (lack of oxygen)-ischemic (resulting from a blood-clot heart-attack) coma (deep sleep). So I searched articles, and I searched the web. I found this, and many other things, saying the same thing
During cardiac arrest or states of profound hypotension, cerebral blood flow falls to minimal levels and global cerebral hypoxic-ischemic injury begins within minutes. If reperfusion is not instituted within minutes, a high rate of major morbidity and mortality ensues. In fact, there is probably no clinical condition in medicine today which engenders a more overwhelming sense of clinical nihilism than hypoxic-ischemic coma. The role of the clinician in managing these patients has, until very recently, been restricted to prognostication, and little else.
My reading followed some dispiriting talks with staff regarding my dad’s lack of progress, and what that may mean. Probably means.
So I am down.
We are still seeing some pretty involved reflexes. If his foot is tickled he will move his foot out of the way and rebalance himself. He grimaces on hearing a nurse who sounds like a particularly ill-liked business associated. He cries, sheds tears, when my brother or I talk to him.
But an EEG reveals that most of the reflexes we see are driven by the spinal column, and not the brain.
The tears disturb me.
I told him a story today. I have always reacted negatively to cold water: after I get out of cool water I become stiff, painful, and generally disagreeable. One time, years ago, my father took me and my brother to Chicago and we went swimming in Lake Michigan. After an ornery day and night we went to a hotel restaurant to eat breakfast. I loved (and still love) toast and pancakes, so I completely pulled myself together to order my delicious deal in a refined and dignified (for a kid) manner.
“So you were faking,” he said to me, obviously tired by 16 hours with this little hellion. I took offense, and an argument later ensued.
I told all this to my dad today, and then said “If you get better now, I promise not to say you are faking.”
“I love you so much.”
I miss my dad.