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

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 from Jessica again,

My Partner is in Intensive Care after MVA with a head injury and he’s not waking up after 3 weeks! (PART 2)

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

Here’s Jessica’s update from what has happened since our last episode

Dear Patrik,

thank you so much for your help and insights!

My partner had an MRI scan yesterday and it wasn't as bad as they had expected.   In fact I think they were quite surprised.

I was called to a meeting to discuss the results and thought I am going to be strong in this and not get emotional or make any quick decisions.   They say he "should" awake.   They said he does have a small bleed on the brain stem, not as bad as they expected, but there is severe damage to the basal ganglia.

This can lead to problems with movement down the left side and personality changes, saying "he will never be the same person again" and that he may need long term care.  But just as you said, they admitted brain injuries are such an open book and no two people are the same.

One of the doctors agreed the brain can kind of heal itself.   At least now they are talking about the things that you have mentioned before and making a plan for neurorehab when he awakes.

All his friends, from the start have said that he is a fighter!!  And I know he is, and he is the most resilient person I have ever known.  He has got through the Gulf War in the 1990s and also problems when serving in Northern Ireland with the IRA.

Physically he has got through things like broken legs, ankle I know that can't really be compared to this.  He is a strong character, he's never really been afraid of anything.   Obviously the doctors don't know any of this; they don't know his personality.

When I have thought negatively about it, it is his friends, your website and your counsel that keep me going as he is the last person that would give up! He has got a lot to live and get better for, he loves his career, his friends and family and has a young child he adores and would do anything to see, have fun with and care for again.

So thank you for all your help.   Myself, his family and friends are staying optimistic and we simply won't give up for him.  We are hoping he awakes soon and take things from there but at least now the doctors are planning some neurorehab, which they haven't mentioned until now.  I am relieved but scared at the same time, I know I have to keep positive.

Jessica

Hi Jessica,

that’s fantastic feedback!

I’m so glad that they finally give you a more positive picture and and more positive outlook!

As I have said previously, brain and head injuries are an open book indeed and they come in all sorts of shapes and sizes!

Giving up is not an option and you wouldn’t do yourself, your partner or his family a favour if you were to throw in the towel!

Nevertheless, you may have to brace yourself for a relatively long time to wait until your partner may “wake up” and also get off the ventilator and tracheostomy.

Related article/video:

• HOW LONG DOES IT TAKE TO WAKE UP FROM A TRAUMATIC BRAIN INJURY OR SEVERE HEAD INJURY?

As I have mentioned before, “waking up” after an induced coma and “waking up” after a severe head and brain injury may take days, sometimes weeks and sometimes even months.

It’s so hard to predict.

The bottom line is that your partner will take as much time as he needs to “wake up” after the induced coma and the head injury!

The good news is like we mentioned before in our last counselling session that your partner didn’t have any surgery on his brain and he didn’t need the intracranial pressure monitoring for more than a week.

Those are all good signs.

And once again, it’s nothing new that Intensive Care teams can be very bleak and blunt in their negative outlooks, in order to protect their professional reputation and stay in control of the communication and the results.

Unless you are sensitive to the dynamics and the communication style, you and your partner’s family would feel completely taken aback and intimidated by the “perceived power” and the “perceived authority” of the Intensive Care team!

Recommended:

• THE 10 THINGS YOU DIDN’T KNOW ABOUT SEVERE HEAD OR BRAIN INJURIES (INCLUDING TRAUMATIC BRAIN INJURY AND STROKE) IN INTENSIVE CARE THAT YOU MUST KNOW, ESPECIALLY IF YOUR CRITICALLY ILL LOVED ONE ISN’T WAKING UP!

Therefore it is extremely important that you put things in perspective here, as three weeks in Intensive Care after the induced coma, the head and brain injury as well as the multiple surgeries your partner underwent is not a very long time frame at all.

It’s still very early days in the bigger scheme of things!

There is a very good chance that your partner will “wake up” and come out of the induced coma soon and then they can focus on weaning him off the ventilator and the tracheostomy.

Therefore it was a good decision that your partner had a tracheostomy as this is doing two things for him

• It reduces the amount of sedatives and opiates(pain killers) he needs and therefore he can “wake up” quicker

• It buys him time to “wake up” in his own time as the tracheostomy can be easier tolerated than a breathing tube(endotracheal tube)

Now you can relax a little bit given that the Intensive Care team has changed their point of view from a negative and “doom and bloom” picture to a more positive outlook and wanting to get your partner into rehabilitation.

Now you can focus on supporting your partner in “waking up” in his own time and be there for him!

Related article/video

• Does my critically ill loved one in an induced coma or with head injuries feel my presence?

There is a very good chance that by the time your partner is “waking up” that he might be confused, agitated, delirious or even aggressive.

Be prepared for that and also get ready to see a change in his personality at least in the short term.

There is a very good chance that by the time your partner is coming out of the coma that with the tracheostomy in place he will be unable to communicate properly, especially if he is still confused.

This can be very frustrating for all parties involved, you, your partner and also the doctors and the nurses.

It is often very difficult to manage a critically ill Patient who is unable to communicate because of the tracheostomy and confusion.

Related article/video

• TRACHEOSTOMY AND WEANING OFF THE VENTILATOR IN INTENSIVE CARE, HOW LONG CAN IT TAKE?

Therefore, while we are all wishing your partner will “wake up” ASAP, there is a chance that the next steps after he has “woken up” will be challenging too!

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Therefore stay strong and positive!

Your friend

Patrik