My heart bleeds as I receive these messages from my aunt. This is not going to happen. I believe in miracles and damn it I declare an intervention, the unexplained, a medical miracle that cannot be explained.
We received a message through a friend that knows brain functions as he is a surgeon and these were his words.
Take to heart: combative behavior is a high level form of function. Contrast that with wondering if there will be signs of any "presence" in there at all, yelling into an ear and asking him to blink or show two fingers. Trust me... combative behavior needs to be looked at in that perspective. For a lot of people with traumatic brain injury, it's more than they can muster.
In order to be combative, you have to think and feel, want (and not want), initiate movement and then have the hookups for nerve and muscle to execute on that drive. Combative is good.
In my experience, combative behavior is often seen in people with brain contusions that are manifested as "salt and pepper" hemorrhages in the frontal lobes as seen on CT scan. Injury in this region of brain can make people volatile, regressive, and sometimes moody or even violent. It's sometimes referred to as "frontal dis-inhibition". It can disable the self-reflective governing function that we (at least most of us) exert when we DON'T act on every impulsive thought we have. Sometimes there are complete recoveries, sometimes there are lingering effects of this but it's pretty hard to measure. Recovery from these kinds of changes can play out over many months and he may or may not remember a lot of what's going on now, when he gets through it. If not, good! Who wants to remember months of languishing in the healthcare system?
Before Surgery: He is going into surgery today. I talked to the anesthesiologist and the orthopedic doctors. Dave's son is on his way from Illinois. With Dave's children and everyone's love and input, we feel OK with our very difficult decision. Our fear and reasoning for the anesthesia mixed with the new need for surgery and his mental condition was real. The anesthesiologist definitely confirmed this. But we don't have a choice and it is a matter of choosing which risk is the one that is the least damaging. They have to keep him in a state of sedation because of his mental condition. There is a risk for not coming out of sedation. So many scales to balance and the rest is in Gds hands. That's where we left it. We will be forever grateful to each and every one of our friends, family and people who don't even know us.
After Surgery: Scared now but have to take this hour by hour. Trauma surgeon just delivered a message that makes me apprehensive about a full mental recovery. The broken body is dependent on the trauma team getting him off the breathing ventilator to breath on his own. Highly likely pneumonia has started with the amount of days he can't walk. The mentation is dependent on the ability of the broken body the get moving to eliminate and rid itself of toxins so his brain has the opportunity to heal. The brain ability to heal is oxygen so he has to be able to use his lungs. All this has to work for his recovery. At first, I couldn't help but feel the surgeon delivered this message with hospital liability in mind. Then after viewing how upset it got me, he said "to ease your mind please know that we have done these types of treatments many times. There is nothing that we can't treat here."
He may have thought that made me feel better but he never said we can treat him and he will come out of it with a sound mind. Omg. What has happened? I have to take this hour by hour. I can't go further.
So the news is subjective. He made it through surgery and his leg looks
fine. Not sure if a good looking leg is good news when the brain is in
trouble. There's no good answer yet in my eyes. Hour by hour will tell.
They are working to get him off the ventilator primary so he can breath
on his own. That is the first step to a sound mind opportunity. I will
be here for couple hours yet to observe the ups and downs for my poor