Returned from the other world. The little patient of the neurosurgery department, Eldos Rakhimzhan, who came to his senses after six months of coma, is confidently recovering. And although doctors are afraid to make any predictions, they agreed to talk about the child’s condition.
A long corridor, a door that leads to two double rooms... I open the door to one of them and see a boy covered with a light sheet.
“Hello!” I extend my hand to him and feel a firm handshake from a child’s hand. He smiles and looks with happy eyes at me, the doctor, and his mother. Just think - quite recently he was in a coma and the doctors did not make any predictions as to whether Eldos Rakhimzhan would be able to come to his senses at all.
Let us remind you that three-year-old Yeldos was hit by a young driver in August. In the first hours after the accident, the child experienced clinical death, craniotomy surgery and fell into a coma. For 6 long months he did not come to his senses.
“The child was admitted to our hospital in extremely serious condition in August 2011. On admission he was in a coma. Hemodynamics are unstable. The child was operated on, a craniotomy was performed, and the child was placed on artificial ventilation. The boy was in a comatose state for a long time. In October, after his condition stabilized, he was transferred to the ward of the neurosurgery department. But at the time he was transferred to the department, he was in a coma and came to his senses just recently. Last month there is a trend towards improvement. His condition is assessed as mildly stunned. He began to recognize his mother and began to follow basic commands. He takes food on his own, but previously he was fed through a tube,” says Timur Begmanov, head of the department of pediatric neurosurgery at the regional children’s hospital.
Eldos’s mother, who just a few months ago accused doctors of inaction, today cannot find words of gratitude to the doctors who returned her child from the other world.
“I am eternally grateful to all the specialists of this clinic. And first of all to the chief doctor - Anuarbek Abdibekovich Maimakov, the head of the department Timur Begmanov and all the doctors. They gave my child a second birthday,” says Bibigul Mambetalieva.
Doctors prefer not to remember offensive words. Mom is easy to understand, they say.
“We are all parents, and when a child lies in such a state, no matter how much is done to him, it will always seem to us that everything is not enough: little attention, little help. It's clear. The main thing is that the child has now come to his senses. This is already a huge victory,” smiles the deputy chief physician of the regional children’s hospital, Bolat Nuskabaev.
Now Eldos faces a long period of rehabilitation. But today it is possible to notice how much his condition has changed, the massage therapist believes.
“In just a month, his condition has improved significantly. He didn't just start moving his arms and legs. The day is not far off when he will be able to speak freely, I have no doubt about it,” the doctor smiles.
Moreover, just a couple of days ago he uttered his first word after six months - mom.
When I left, Eldos waved to me. And before leaving his room, I conveyed my deepest regards and wishes to him. get well soon to the boy from all Kazakhstanis, Russians, all visitors to our site. Get well soon, baby!
P.S.: the photo of the child was provided by Eldos’s mother. The chief doctor of the clinic prohibited photography and video recording of the patient.
The young father was looking after his newborn son, after which the child was taken to the hospital in a coma with head bruises. The health of the two-month-old child, taken with head bruises to the Children's University Clinical Hospital, no longer causes concern among doctors. The same cannot be said about the parents of the injured baby... On the night of September 7, a two-month-old newborn boy with severe bruises to his head and back was brought to a children's hospital from a Riga apartment. The grandmother called an ambulance. The little patient was admitted to the intensive care unit. For a whole week, doctors fought for the life of a child who was in a coma. “The baby came to his senses, began to breathe on his own, react to those around him, but for now he is being fed through a tube,” hospital spokeswoman Romena Namniece told about the improvements. The child has internal hematomas, but externally he is no different from other newborns. “Now the baby is in a regular department, where he will not only be treated throughout the week, but will also undergo a full examination,” says Romena Namniece. While the child was in the intensive care unit, the mother visited her son twice. Whether she will continue to come to the child is unknown. Perhaps this will depend on the decision taken immediately after the tragedy by the Orphaned Court to deprive the woman of custody rights over her two-month-old son. This is not the first time she finds herself in such a situation: in January, the Orphan's Court took away her rights to her eldest child, who was not yet one year old. According to documents, the two-month-old boy does not have a father. But there is a biological father - a 20-year-old man whom the police arrested on suspicion of causing grievous bodily harm to a child. “The child’s father is under arrest,” said State Police press secretary Aigars Berzins. The police are working with him to find out the circumstances of the evening when the child was injured. So far, the picture of the sad events has not been restored. The child's mother testifies that she was the one who dropped the baby. And the father of the newborn says that, at the mother’s request, he was looking after his son and dropped the baby when he was holding him in his arms and at the same time cooking porridge. The police have reason to believe that the child’s injuries were inflicted elsewhere, and then the baby was brought to the apartment, where an ambulance was called. Director of the Center for Medical Disasters Martins Šits says that such severe injuries leave consequences for life. “The child’s development will now actually begin from scratch,” says Dr. Shits. - What was developed and invested in the baby was all lost. It is also possible that in the future the boy’s development may be inhibited and only active work with the child, constant communication, visiting various sports studios can help the child develop on a par with his peers. The doctor said that similar cases where parents injured their children had happened before, but now society has finally begun to pay more attention to this problem.Angela PANKOVA
The spouses believe that the doctors made a mistake twice: when they did not agree to give the woman a caesarean section and when they did not transfer the baby from the maternity hospital to the regional intensive care unit for three days.
For Victor and Olga, the birth of their first child was a long-awaited event. For seven years the couple dreamed of having a child. The pregnancy was easy and painless. Future mom I registered on time and passed all the tests. The baby developed normally. However, the birth was very difficult. The newborn has been in intensive care for two weeks now.
“The ultrasound showed that the baby is healthy, but the umbilical cord is wrapped around his neck.”
The short young woman barely opened the doors of the intensive care unit. “Hello, I’m Olya,” the interlocutor tried to sit down next to me. However, wincing in pain, she stood up almost immediately:
The doctors say that I will now be able to sit only in a month,” says Olga. - But it is not important. I don't even think about it. I’m only worried about one thing: for my son to get out and become healthy. In the meantime, he lies with a tube in his tummy. It’s only been two days since I started breathing on my own. No doctor can predict what will happen to him next.
- How was your pregnancy? Were there any complications?
There were no problems, I was never even in the hospital. I saw a very good doctor - Valentina Ivanovna Kurasova, went to her regularly, took the required tests. The last time was July 11th. The doctor sent me to the hospital because, according to her, my due date had come. In addition, I had a large fetus. That same day I went to the maternity hospital. The doctor on duty examined me, listened to the baby’s heartbeat, and I was sent to the ward.
* “During the contractions, I felt that something was wrong,” says Olga, “and asked the doctor to give me a caesarean section because I wouldn’t be able to give birth. But the doctor replied: “I myself know what to do...” Photo by the author
At lunchtime I was scheduled for an ultrasound. It showed that the child was healthy, but the umbilical cord was wrapped around his neck. I started to worry, I even started talking about a caesarean section, but the doctors calmed me down. On the evening of July 13th, I started having contractions. The doctor on duty said: “Just wait until the morning, then we’ll transfer you to the delivery room.” On July 14 at six o'clock in the morning I was transferred to the maternity ward. They measured my blood pressure again, did an examination and left me alone. After 20 minutes, my husband’s sister came to see me, and we were with her all day, until the evening.
I remember this day very poorly. It was so hard and painful for me that at some point I thought I couldn’t stand it any longer. At one o'clock in the afternoon my water broke, labor activity I was weak, and they started giving me injections and IVs. In the evening, when my husband arrived, my green water broke. From that moment on, every 10-15 minutes a doctor came into the delivery room to deliver the baby. I felt that something was wrong; I almost lost consciousness from the pain. And she asked the doctor: “Give me a caesarean section, I won’t be able to give birth on my own.” I remember a colleague of my attending physician came into my room, looked at me, asked when my water broke, and said to the doctor: “What are you waiting for? Give it to the table." But our doctor replied: “I myself know what to do.” I gave birth only at nine in the evening. And until now I have never heard my son cry...
The child was blue-violet in color, without signs of life. I saw him come out: the baby was wrapped with the umbilical cord around his neck twice and another time around his body - a young father Viktor Yatsenko, who was present at the birth, can barely cope with his excitement. - The child was born, and he was immediately connected to some kind of machine, supposedly to suck out fluid from the lungs. The device was in the delivery room, and I saw it malfunction and turn off several times. The doctors, cursing, tried to set him up. Then the pediatrician came and took the child to the intensive care unit. I also went there to find out what happened. But they answered me: “Don’t worry, everything will be fine tomorrow,” explaining that the baby had swallowed amniotic fluid.
However, the next day there was no improvement. The doctors didn't explain anything to us. The baby's legs and arms were shaking, and he was prescribed only glucose to support his general condition. I believe that three days were lost. It was during these days that the child needed to be saved! Why wasn’t he immediately transported to the regional intensive care unit? After all, they have more modern equipment; they specialize in rescuing critically ill children from all over the region.
"Our doctor acted as instructed"
A week later, we were advised to seek advice from a professor from St. Petersburg, Anna Skoromets, who was in Sumy in those days,” continues Viktor Yatsenko. - She is the head of the department of child neurology at the university, Doctor of Medical Sciences. I personally brought her to the intensive care unit. After examining the baby, the doctor wrote a conclusion: “Posthypoxic severe encephalopathy. Coma. Status epilepticus. Edema is swelling of the brain." She advised us all to undergo an in-depth examination to rule out viral encephalitis. I took the tests to Kharkov and two days later I received negative results for the presence of a viral infection.
I am sure that the doctor who delivered the child is to blame for what happened to my child. On July 24, I wrote a complaint addressed to the head of the regional health department, Pavlyuk. But so far I have not received an answer. On July 27, I wrote a statement to the prosecutor's office. There is no answer either. I really want an objective examination to be carried out in our situation and the doctor to be punished.
Already on the second day, we baptized our son right in the intensive care unit. Doctors tell us: “Pray!” - and do not make any predictions. And the priest said that now the boy already has a protector. After that, the son began to slowly cling to life. Now he is already disconnected from the ventilator, but is still breathing with difficulty.
Tiny Vadim is in the neonatal intensive care ward of the Sumy Regional Children's Hospital.
The child was brought to us in very serious condition,” says Head of Neonatal Intensive Care Unit Lyudmila Yusyuk. “Our resuscitation team transported him from the maternity hospital. The diagnosis of asphyxia has many causes, but it is too early to say what caused it. At the moment, all the functions of the little patient are gradually restored, he is already breathing on his own, and is gradually returning to normal. physiological norms. Let us hope for the best.
Law enforcement officials have also refrained from commenting for now, clarifying that the check has just begun.
A special commission was created, which included specialists from the regional health department, - commented to FACTS employee of the city prosecutor's office Victoria Litovko. “When specialists understand the situation (and by law this will take a month), we will be able to voice the final version of what happened.
The case with little Vadim, unfortunately, is far from isolated. The city prosecutor's office assured the FACTS correspondent that they receive a lot of such complaints against doctors. It’s just that not all parents are ready to talk about their troubles to journalists. Unfortunately, the relatives of the victims have to prove medical error very difficult. Doctors often don't talk about the real reason what happened. Or, for example, as in this case, they hide behind compliance job descriptions and orders. I was able to verify this by visiting the office chief physician of Sumy maternity hospital No. 1 Dmitry Kravtsov.
I can’t give any comments yet,” said Dmitry Alexandrovich. - A commission has been created, which includes competent specialists from the health department. When she finishes checking, then we can talk about the reason. For now, I can say that our doctor acted in accordance with the instructions, indications for caesarean section did not have. What actually happened to the child and why he has such a complex pathology can be discussed after all the tests have been carried out. While the check is underway, the doctor continues to perform his professional duties. I personally have no complaints about him.
Coma is a deep sleep in which a person’s consciousness is completely impaired, there is no motor reaction or sensitivity, and reflexes disappear. The comatose state in children and adults has quite large differences. First of all, coma in young patients can occur as a result infectious diseases, surgical interventions, diseases of the nervous system and mental health.
Classification of coma
There are two types of coma:
- Somatogenic - this means that coma arose as a result of diseases of internal organs, infectious lesions of the body, toxic poisoning;
- Brain or cerebral - a comatose state that occurs when the central nervous system is disrupted.
In medical terminology, you can hear such definitions of coma as:
- Primary, that is, one that originates from a serious lesion of the brain (its parts, tissues and membranes);
- Secondary coma is one that is associated with disorders of the thyroid gland, food poisoning, and also a whole list of possible damage to the internal organs of a person.
Coma, both in children and adults, can begin after suffering an inflammatory process of the brain, liver failure, swelling of internal organs and the brain in particular.
Causes
When a coma occurs in children, brain edema occurs, that is, its membranes swell, become damaged, and the patient falls into a coma. For example, if the body experiences oxygen starvation, then first of all, vital organs - the heart and brain - suffer from this.
For reference!
Brain tissue consumes oxygen approximately 20 times more than the heart and other internal organs person.
The brain begins to experience acute oxygen starvation if a person does not have enough air (respiratory failure begins).
Another cause of coma is a sharp decrease in sugar levels. If a child’s sugar drops below 2.2 mmol/l, then this condition is followed by convulsions, fainting and coma.
Coma begins with hyponatremia, hypokalemia and with an increase in the concentration of magnesium in the blood. These conditions are followed by loss of consciousness, cardiac activity is disrupted, and coma develops.
Brain damage
A blow to the head, a bruise, compression of brain tissue by a benign or malignant tumor, accumulation of fluid in the brain - this leads to disruption of the functional activity of the central nervous system.
Important!
It is necessary to understand that any brain damage is accompanied by cerebral edema, which leads to oxygen starvation and increases the risk of coma.
Coma can be caused by poisoning from toxins, poisons, and even certain medications.
If we talk about the causes of coma in young children (up to one year), then this is an infectious lesion of the brain, inflammatory processes in the form of meningitis,. According to statistics, who have children preschool age cause various types of poisoning. IN school age children are characterized by greater activity and this leads to traumatic brain injuries and head injuries.
Infectious diseases
When the child’s body is infected, consciousness is impaired, there is no reaction from the central nervous system, and convulsions appear. Damage to the body by infection begins with the manifestation of neurotoxicosis and a state of shock. Treatment in this case will involve special anti-shock therapy, anticonvulsant therapy (in the obvious presence of convulsions), respiratory support in case of respiratory arrest and circulatory impairment.
How does a coma manifest?
The first symptom of a coma is loss of consciousness, that is, the child does not respond to words, touches, he completely lacks reflexes and any body reactions. IN early age When a child is in a comatose state, the so-called reserve tissues of the brain are activated. In this case, the prognosis for recovery from coma and treatment is more favorable than in the case of coma at a later age.
The scientist Mikhelson distinguished several types of coma:
- Somnolence - the child falls into a deep unconscious sleep, but can still be awakened for a while. Then he immediately begins to fall asleep. Domnolence occurs during drug poisoning with barbiturates. If poisoning occurs in a child under 5 years of age, then after emerging from a comatose state, he, as a rule, completely loses the mental and physiological skills previously acquired.
- - this is a unique state of the body in which a person can move, but at the same time he completely lacks consciousness and a sense of reality. A person (both small and adult) is in a completely inadequate state. This condition can occur due to poisoning with medications and poisonous mushrooms, in particular fly agaric.
- Stupor – the patient completely lacks consciousness, orientation in space, and has no motor reflexes.
All these states are precoma. When a coma sets in, a person cannot move, talk, his muscles do not work, his brain is damaged, and there are no reflexes.
How do you come out of a coma?
There is an option for recovering from a coma, in which the functioning of the central nervous system is completely restored, and also when the patient is left with significant brain damage.
Recovery from a coma almost always occurs gradually. The speed of recovery from a coma depends on how much and which parts of the brain are damaged. The first stage of recovery from a coma is vegetative standing - a person breathes independently, his blood circulation is normalized, digestion works at a level to maintain basic vital functions. Following this type of recovery from a coma, the restoration of speech, nervous system, and reflexes begins. You should not expect a patient coming out of a coma to have a healthy reaction to what is happening and to have all the mental and physical skills that were there before. All life processes must be started gradually.
A person in a coma experiences depression of the nervous system. This is very dangerous, because this process progresses and failure of vital organs is possible, for example, respiratory activity may stop. While in a coma, a person stops responding to external stimuli and the world, he may have no reflexes.
Stages of coma
Classifying coma according to the degree of its depth, we can distinguish the following types of this condition:
In this article we will take a closer look at the condition of a person in a penultimate degree coma.
Coma 3rd degree. Chances of survival
This is a very dangerous condition for human life, in which the body cannot practically function independently. Therefore, it is impossible to predict how long it will last. It all depends on the body itself, on the degree of brain damage, and on the age of the person. Coming out of a coma is quite difficult; as a rule, only about 4% of people are able to overcome this barrier. Moreover, even if the person has regained consciousness, most likely he will remain disabled.
If you are in a third-degree coma and return to consciousness, the recovery process will be very long, especially after such serious complications. As a rule, people learn to speak, sit, read, and walk again. Rehabilitation period may take quite a bit long time: from several months to several years.
According to studies, if in the first 24 hours after the onset of a coma a person does not feel external irritants and pain, and the pupils do not react to light in any way, then such a patient will die. However, if at least one reaction is present, then the prognosis is more favorable for recovery. It is worth noting that the health of all organs and the age of the patient who has developed a 3rd degree coma play a huge role.
Chances of survival after an accident
About thirty thousand people a year die as a result of road accidents and three hundred thousand become their victims. Many of them become disabled as a result. One of the most common consequences of a road accident is traumatic brain injury, which often causes a person to fall into a coma.
If, after an accident, a person’s life requires hardware support, and the patient himself has no reflexes and does not respond to pain and other stimuli, a 3rd degree coma is diagnosed. The chances of survival after an accident that leads to this condition are negligible. The prognosis for such patients is disappointing, but there is still a chance of returning to life. It all depends on the degree of brain injury as a result of the accident.
If a stage 3 coma is diagnosed, the chances of survival depend on the following factors:
- Degree of brain injury.
- Long-term consequences of TBI.
- Fracture
- Fracture of the cranial vault.
- Fracture of the temporal bones.
- Concussion.
- Trauma to blood vessels.
- Brain swelling.
Probability of survival after a stroke
A stroke is a disruption of the blood supply to the brain. It happens for two reasons. The first is blockage of blood vessels in the brain, the second is bleeding in the brain.
One of the consequences of cerebrovascular accident is coma (apoplectiform coma). In case of hemorrhage, a 3rd degree coma may occur. The chances of surviving a stroke are directly related to age and the extent of the damage. Signs of this condition:
The duration of the coma depends on a number of factors:
- Coma stage. In the first or second stage, the chances of recovery are very high. With the third or fourth, the outcome is usually unfavorable.
- Condition of the body.
- Patient's age.
- Equipping with necessary equipment.
- Patient care.
Signs of third degree coma during stroke
This condition has its own distinctive features:
- Lack of response to pain.
- The pupils do not respond to light stimuli.
- Lack of swallowing reflex.
- Lack of muscle tone.
- Reduced body temperature.
- Inability to breathe independently.
- Bowel movements occur uncontrollably.
- Presence of seizures.
As a rule, the prognosis for recovery from a third-degree coma is unfavorable due to the absence of vital signs.
Probability of survival after neonatal coma
A child may fall into a coma in the event of a deep disorder of the central nervous system, which is accompanied by loss of consciousness. The reasons for the development of coma in a child are the following: pathological conditions: renal and liver failure, meningoencephalitis, tumor and brain injury, diabetes, water-electrolyte imbalance, cerebral hemorrhage, hypoxia during childbirth and hypovolemia.
Newborns fall into a comatose state much more easily. It is very scary when a third degree coma is diagnosed. A child has a higher chance of survival than older people. This is explained by the characteristics of the child’s body.
In the case when a 3rd degree coma occurs, the newborn has a chance of survival, but, unfortunately, it is very small. If the baby manages to get out of a serious condition, severe complications or disability are possible. At the same time, we must not forget about the percentage of children, albeit small, who managed to cope with this without any consequences.
Consequences of coma
The longer the unconscious state lasts, the more difficult it will be to get out of it and recover. A 3rd degree coma can occur differently for everyone. The consequences, as a rule, depend on the degree of brain damage, the length of time spent in an unconscious state, the reasons that led to the coma, the health of the organs and age. The younger the body, the higher the chances of a favorable outcome. However, doctors rarely make a prognosis for recovery, since such patients are very sick.
Despite the fact that newborns recover from a coma more easily, the consequences can be very sad. Doctors immediately warn relatives how dangerous a 3rd degree coma is. Of course, there are chances of survival, but at the same time a person may remain a “plant” and never learn to swallow, blink, sit and walk.
For an adult, a prolonged stay in a coma is fraught with the development of amnesia, the inability to move and speak, eat and defecate independently. Rehabilitation after a deep coma can take from a week to several years. In this case, recovery may never occur, and the person will remain in a vegetative state for the rest of his life, when he can only sleep and breathe on his own, without reacting in any way to what is happening.
Statistics show that the chance of a full recovery is extremely small, but such events do happen. Most often it is possible, or in case of recovery from a coma - a severe form of disability.
Complications
The main complication after a coma is a violation of the regulatory functions of the central nervous system. Subsequently, vomiting often occurs, which can enter the respiratory tract, and stagnation of urine, which can lead to rupture. Bladder. Complications also affect the brain. Coma often leads to breathing problems, pulmonary edema and cardiac arrest. Often these complications lead to biological death.
The feasibility of maintaining body functions
Modern medicine makes it possible to artificially maintain the vital functions of the body for quite a long time, but the question often arises about the feasibility of these measures. This dilemma arises for relatives when they are informed that the brain cells have died, that is, in fact, the person himself. Often a decision is made to remove artificial life support.
