Saturday, December 19, 2009

What to do when your loved one is diagnosed as Persistent Vegetative or Minimally Conscious State ?

My this post is only for those who become Persistent Vegetative State or Minimally Conscious State in result of ahead trauma, It can be supposed for Locked in Syndrome but their injury is little different and I am not a heath care personal or a doctor. What I am going to advise that is only a sharing of my personal experiences and study of different cases. I am also sorry for my poor English.
It often takes one month approximately to diagnose one in a condition called Persistent Vegetative State or Minimally Conscious state because of different reasons but doctors feel the position much early but the condition of the patient due to severity of 'brain shock' is a hurdle to diagnose. However most of the doctors arrange a little physiotherapy in all sorts of coma or a coma like situation. Here starts the liability of the family and friends of the patients. First thing to tell is that they should be ready for a very long time struggle and should have to make long terms plans.
First important thing is to tell them that they should not care anyone saying that there is no cure for these patients and second thing to not to care is of any version of saying of anybody about their consciousness. In my view most of them are conscious but they can not communicate due to loss of motor function and weakness due to that severe brain shock.
It is much better to bring them home when they are a little physically settle but that is also a great task to make sure a round the clock care of these patients and to arrange their rehabilitation work and their exercises. It should be kept in view very seriously that they should must be very afraid due to their total disability but they should also very fond of listening and also some viewing to their loved ones and close ones.
After physically improvement the most important work is to arrange their rehab plan. Every muscle of their body from face to foot need attention and it is not possible for physiothrapists only. Their caregiver should have to take part in this long term job and even kids can take part in this task. when I was involved in this struggle for my son Jawad Pasha I knew nothing and could arrange only simple physiotherapy for first one and a half year but I am always thankful to one Dr Carina Eksteen of Pretoria University(South Africa) and others who guided us when they came Pakistan to help 2005 Earth quake victims. My son was unable to hold his neck till then after the special exercises they told it took a year to improve his neck holding. So it is very necessary to start it soon and it is multiple direction job.Guidance from qualified rehab persons is very important and everyone available should be ready to contribute it.
Other very important thing is to take care of their psychological condition. They should be given hope and treated with love. Everyone should be careful while talking before them and keep in mind that they may be understanding all which one is saying. They are in need of attention and they want to join you either they can communicate or not.
A very important advise is about moving them. Medical advise about changing of their side after every two hours is very good but that is almost according to the hospitals position. A little movement of arms,legs and neck is very necessary after every 20-30 minutes even if they are sleeping. Bringing them out of their rooms is also very important and it should be extended as much as possible. I am myself willing to arrange a horse ride for my son but could not arrange yet.
Another success we achieved is to control their Seizures/fits. We simply try to divert their attention to somewhere else at start of these Seizures/Fits and than we try to find the reason of these fits which may be pain,Feeling cold or hot,hunger or thirst,tiredness or some other psychological reason and we are almost successful to control most of the such seizures. The main issue of these patients is general heath care and there are almost no medicines which can be used for their brains and up to now nothing is known successful for their recovery but hope in near future technologies like deep brain stimulation Therapy or stem cells could help these patients.
I am sure that many of them can improve and recover due to personal attention and care and soon there will be no need of thinking for many of them to remove their feeding tube or to stop their feeding.