My Partner is in Intensive Care after MVA with a head injury and he’s not waking up after 3 weeks! (PART 1)

Published: Fri, 08/05/16

Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of “YOUR QUESTIONS ANSWERED" and in last week’s episode I answered another question from our readers and the question last week was

My Mom had two heart attacks within 6 months and is now in Intensive Care! She’s in an induced coma, what’s next for her?

You can check out the answer to last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer another question from one of our readers and the question this week is

My Partner is in Intensive Care after MVA with a head injury and he’s not waking up after 3 weeks! (PART 1)

This question from Jessica formed part of a 1:1 phone counselling/consulting session with me!

Jessica describes her partner’s situation as follows

Dear Patrik,

since my partner was admitted to Intensive Care three weeks ago your website and your email newsletters have kept me going.

He was in a serious RTA(Road traffic accident) and he had to have multiple surgeries and also had a bleed on the brain and therefore he had to be kept in a medically induced coma for over 2 weeks.

Myself, my family and friends have been optimistic all along. A few days ago sedation was stopped and he was given a tracheostomy, he still hasn’t woken up, but we all remained very optimistic that it is still early days.

He hasn't needed any brain surgery and the brain/ intracranial pressure monitor was removed a week ago, I don't think his brain pressures were very raised.

Even though you warn about formal meetings and the agendas of Intensive Care teams, I was not prepared when the ICU consultant called a meeting with myself and my partner’s family and said it is very concerning that my partner has not woken up yet.

He said this could mean brain stem death, or severe impairment to areas of the brain affecting functions, because of a very severe head injury and we would need to think about what we need to do and what decisions to make in those circumstances!

I didn’t expect such a gloomy outlook for my partner so soon!! I remained calm and questioned his prognosis but at the end of the meeting I was very upset and taken aback at the negativity.

He has opened his eyes once and doing actions such as coughing, moving his mouth and leg on occasion. However, myself and my partner’s family are devastated at the Intensive Care Unit doctor’s prognosis when an MRI brain scan hasn’t even been performed yet!

We are now dreading the results. I am preparing myself for the next meeting and trying to be strong and ask questions. Other than see his neurologist, who is the specialist in this area, is there anything else we can do? We feel it is only early days.

Thanks

Jessica

Hi Jessica,

I’m very sorry to hear what you and your partner are currently dealing with. It sounds like a very challenging and scary situation!

Thanks again for using my 1:1 phone/ Skype counselling and consulting service!

As you have pointed out correctly it is very early days, even though three weeks in Intensive Care might feel like a lifetime for you and your family.

Three weeks in Intensive Care after an RTA with a severe head and brain injury is not very long from my experience!

Therefore in severe head and brain injuries, generally speaking most rules in ICU are thrown out of the window when it comes to severe head and brain injuries!

Severe head and brain injuries usually can take time to heal and it can take a long time to “wake up”!

Severe head and brain injuries also tend to be one of the main reasons why an induced coma can take longer than usual.

The simple reason for a prolonged induced coma is that the head and brain injury not only needs time to heal, it’s also a case of managing and monitoring the brain pressure(=intracranial pressure).

The brain pressure/ intracranial pressure needs to monitored and managed closely, with a brain bleed there is a risk of an increased brain/ intracranial pressure that could potentially cause irreversible brain damage.

Related article/video:

What is the prognosis after my critically ill loved one’s brain has not had sufficient oxygen supply(hypoxic brain injury)?

Therefore with a head and brain injury, including a brain bleed, a prolonged induced coma makes sense to

Monitor and manage the brain/intracranial pressure and reduce the risk or exclude potential irreversible brain damage

Give the brain time to rest and heal

With the prolonged induced coma, it also makes sense to perform a tracheostomy, to use less sedation and then give your partner a better chance to wake up easier, as with a normal breathing tube he would need a lot more sedation for the induced coma and therefore “waking up” might even take longer.

Tracheostomies are much easier to handle and make “waking up” after and induced coma easier and it usually also facilitates an easier weaning process off the ventilator.

Another thing that stands out to me is that no MRI has been done after more than three weeks in ICU for a severe head and brain injury.

This appears to be very unusual and is certainly not the norm. I’m almost bound to say that it’s negligent for somebody with a severe head and brain injury not to have an MRI of the brain.

You should be questioning that and especially since the Intensive Care team is negative and paints a “doom and gloom” picture, you should not hesitate to ask for facts rather than their negativity!

It doesn’t surprise me at all that the Intensive Care team is negative, there are probably many reasons for it and I will address it later.

It’s a good sign that they only monitored the brain/intracranial pressures for about a week, that’s a sign that the brain/intracranial pressures must have been normal by the time they removed the intracranial pressure monitor.

But most importantly, let me once again point out to you that when it comes to head and brain injuries in Intensive Care all rules get thrown out of the window!

By that I mean that you have to keep in mind that the brain has a life on its own and the brain can’t be controlled.

All other major organs such as the heart, the lungs, the kidneys and the liver can be supported and controlled at least temporarily in ICU. Not so with the brain, the brain can’t be controlled.

Therefore you need to be patient and you need to be prepared that “waking up” after your partner’s head and brain injury might take much longer than you expected.

How much time? I don’t know, however I have seen some head and brain injury Patents for up to 6 months in ICU and they have recovered and then gone to rehabilitation.

“Waking up” after a severe head or brain injury might also take longer because usually critically ill Patients with a severe head or brain injury are even more deeply sedated than other Patients. Usually more sedatives and pain killers(Opiates) are necessary to protect the brain and manage the brain/intracranial pressures and therefore as a consequence of more sedatives and pain killers being used, “waking up” can be delayed.

Positioning of the Intensive Care team vs your positioning!

But know this: No matter the positioning of the Intensive Care team and no matter their “doom and gloom” and their negativity, time is the ultimate healer when it comes to head and brain injuries.

The fact of the matter is that the Intensive Care team probably has a small interest in keeping your partner in ICU for 6 months as they will be counting the money ($$$) or the Pounds(£££), they will be counting the number of days he will be occupying an expensive and scarce ICU bed and so forth.

They will also estimate the emotional investment it takes to recover somebody for a long time to come in Intensive Care!

Your job is to fight for what you want and for what you believe in and not let the Intensive Care team dictate what you should and shouldn't do.

Don’t let any negativity by the Intensive Care team wear you down or hold you back to stand up for what you believe in!

What do you believe in?

Good indicators tend to be how your partner has dealt with adversity and challenges in the past. Do you think he can and will improve? What is your gut feeling telling you?

It’s definitely a good sign that your partner has got a tracheostomy now and it will buy your partner time to “wake up” in his own time!

It’s nothing uncommon that “waking up” after a head brain injury takes a lot longer than expected. If anything, expectations to “wake up” within a certain time period after an induced coma and a head and brain injury are most likely not to be met.

Therefore it’s nothing unusual and nothing unexpected that the Intensive Care team is painting a negative and “doom and gloom” picture.

At the end of the day a prolonged induced coma and a head and brain injury are a recipe for not knowing what to expect.

As I said before, the brain has a life on its own and can’t be controlled.

From my perspective, it’s almost a reflex from the Intensive Care team to be negative and to paint a “doom and gloom” picture, because at the end of the day they don’t know what to expect either… because critically ill Patients with a head and brain injury tend to be so different when it comes to “waking up” and the time frames around it.

It’s not only the time frames that vary, it’s also that the outcomes vary. Some people might “wake up” and are going to be fine, others “wake up” and are confused, apathetic, lethargic, aggressive etc… and others don’t “wake up” at all.

Therefore it’s a standard response from the Intensive Care team to be negative to not only protect their professional reputation, but also to be in a position that enables them to get what they want in case your partner isn’t really “waking up”.

Therefore, I can already see that the next steps might be for the Intensive Care team to suggest a “withdrawal of treatment” or a “limitation of life support” as being “in the best interest” of your critically ill partner.

It’s therefore that I warn about meetings with the Intensive Care team and their agendas, because I have seen it over and over again.

Are you prepared?

If you are unprepared for this you might get “sold” on their agenda by the Intensive Care team.

Intensive Care teams can be very shrewd and adept at “selling” families of critically ill Patients in Intensive Care what they think might be “in the best interest” of a Patient, however 9 times out of 10, what’s happening “behind the scenes” in Intensive Care is almost always impacting on how the Intensive Care team positions your partner’s care, treatment, their prognosis and their diagnosis!

Remember, Intensive Care teams “manage” families of critically ill Patients in Intensive Care 7 days a week, 24 hours a day and they know what to say, how to say it, when to say it and what not to say…

They’ve seen it all and they know how to use their “perceived power” and their “perceived authority” to get what they want.

It’s a good sign that they’ve performed a tracheostomy and it’s a good sign that he’s doing some coughing, blinking his eyes etc…

Your job is to be prepared, to be strong and to do “whatever it takes” to do the right thing for you and your partner.

But you should not act like 99% of families of critically ill Patients in Intensive Care who don’t make informed decisions, who don’t question, who don’t do their own research and therefore have no PEACE OF MIND, no control, no power and no influence!

You are on your way to make informed decisions, get peace of mind, get power, get control and get influence!

Related article/video:

THE 5 REASONS WHY YOU NEED TO BE DIFFICULT AND DEMANDING WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

It takes a lot of courage to start “managing” the Intensive Care team, because most families in Intensive Care feel intimidated by the “perceived power” and the “perceived authority” of the Intensive Care team, but in my 1:1 counselling and consulting as well as in my Ebooks, Videos and Audio recordings you’ll find proven strategies that will work for getting the best care and treatment for your partner!

Those resources will also help you fight any negativity from the Intensive Care team, because you are now armed with powerful insider information that you can use to your advantage!

Here are other resources again that will help you in your situation: (click on the links)