Hi anyone. Help please with the Glasgow Coma thing

[WHIZZY100]

My nephew had a bad car crash on Friday and has been unresponsive ever since. Just returned from hospital where they have told his parents (my sister) that he has a score of 3 and I want to know it people actually come out of a coma with an initial score of 3. I really would appreciate knowing the actual facts so that I can help my sister and family come to terms with something that we know absolutely nothing about. Many thanks.

[Kirk5w7]

Evidently, I had no response to anything, I was not given a number on the Glasgow scale, I was not expected to recover at all, but here I am, I was in hospital a total of three months the last 5 weeks in a rehab unit, doctors came to shake my hand before I went off to the rehab unit. My husband said he would classify me as a 2, there was no response from me at all, I had viral encephalitis and was 3 weeks in a coma with expected organ failure, which didn't happen, luckily.

I am 61 years of age now and am 2 years into my recovery, no one can tell how any individual will recover, I'm just glad my family never gave up on me, they read to me played me music and chatted and included me in all their conversations, my husband would not let them put DNR on my notes and it wasn't necessary.

So keep on believing and give all the support you can, I had to learn to walk again and I have balance and memory problems and I am unable to work but my personality is unchanged and I do not have epilepsy or suffer from headaches.

But every one is different, the brain is a wonderful organ able to do so much, but practice practice practice like babies and young children do, repetition helps the brain make new pathways when old ones are destroyed.

Hopefully, your nephew will eventually come round, but it's a long road, don't lose sight of that, it will test everyone involved but don't forget the love and hugs along the way.

I wish you all well, love Janet xxxxx

[cat3]

What your sister and brother-in-law need to hear more than anything is that there is hope. The recovery of an individual often defies what the GCS has indicated and most doctors are reluctant to offer a prognosis owing to the brain's complexity, and its ability to repair after different types of trauma. I'd advise you to forget scales and statistics because ultimately it's a waiting game which can't be rushed................even though the waiting is so painful.

It is a slow, slow process and the best way you can support your sister is with quiet positivity and practical help with meals and everyday stuff she cannot face right now. If you can offer reassurances to keep her as calm as possible she will, as others do, drift into a degree of acceptance and learn to take one day at a time.

I wish you strength, and I will be hoping and wishing for some positive signs towards your nephew's recovery.

Very best wishes to you all. Cat x

[markv3553]

Hi Whizzy,

Going back to New Year's Eve in 2011 I was a victim of a violent assault which resulted in me falling backwards and smashing my skull - when I was taken to hospital I arrived (so I'm told and my discharge notes say) with a GCS of 3. After a few days this improved to 8 and because I became agitated (which is apparently normal given the nature of a severe head trauma) three weeks later I was up and about and some 5 weeks later returned home from the hospital.

Recovery has been a slow process after spending a year off work and going to numerous rehabilitation things I have now returned to work, like I said a slow process but a GCS of 3 is certainly recoverable and be positive about his recovery.

With best wishes, thoughts and prayers with you.

Mark

[Hidden]

Forget the Glasgow Coma Scale; the medical trade have scales and charts for everything, including the Bristol Stool Chart; everything contributes to statistics to give intelligence led treatment.

My advice to you is not look this up on the net because the score, despite what is written next to it, means nothing if you do not understand the functionaries that contributed to the overall score. [That's from my missus, a senior nurse for 37 years].

If you want to know - ask the direct question; you will likely be fobbed off because despite all the advances in the world to maintain life by removing haematoma and all the rest of it the brain takes a long time to recover and damage from RTAs is usually severe. They cannot accurately predict the outcome.

Following my TBI in 1967 and subsequent craniotomy to remove the clots my dear old Mum was told that a recovery was not on the books and if, due to some miracle, I did survive she should be aware of the vegetative state I would be in.

Not the case. At 63 I'm virtually fully functional, a full recover as far as I can go, took 20/25 years. However, I went to work a week after being kicked out of hospital 2.5 months after the op and continued right to date [with a few sackings and suchlike in between]. I managed professional qualifications whilst in recovery and now work in a University.

I am not boasting; merely outlining what *is* possible.

The problems that remain with me: slight short term memory loss, spatial awareness, intolerance to noise and petit mal.

[pgl1]

Thoughts and prayers go with you. My sister was in a coma this time last year. It is a long road to recovery as others have stated. The GCS score was something we were a bit worried about but in the grand scale of things it sounds as though your Nephew is a fighter. It will be a long hard road but you can only wait to see the outcome, support each other as a family and take each day as it comes. It may be a cliche, but there will be ups and downs and nobody, not even the professionals can predict the outcome as the brain is so complex.

I hope your Nephew is ok. PLease keep the forum posted xx

[research]

Hi,

I can strongly empathise with what you and your family must be going through. I had a bad car accident in 2000 and my parents were also told that I had a Glasgow Coma Scale score of 3 also. I was in a coma for 3 weeks but then slowly recovered, going back to university after 9 months and now I have just completed a Masters. It was a lot of hard work, and I needed the constant support and understanding of family and friends, especially as I have no feeling and limited movement in my right arm. It may be hard for you all - I was quite horrible to my family as I didn't want to be dependent on them but I had to be - so please don't take it too personally if he's moody and frustrated.If he does come out of this with a lasting impairment, then please don't see him as 'faulty' or 'damaged goods'; accept him for who he is. I really hope this has helped and I wish you all the best of luck.

Kind regards, Julia

[davesdad]

Hello Wizzy,

I am so glad that you have found this community so soon after the accident - I wish it had been here to 2006!

As others have said the answer to your direct question is yes, people can make excellent recoveries from GCS 3. Like research (the person who posted above) our son was in a coma at GCS 3 following his accident and was held in that coma for 3 weeks by the medics as the first part of his long recovery process. The accident was in 2006 when he was 16. Though his education was obviously disrupted, he is now completely self sufficient and this year he enrolled at a leading university to read history.

That said every case is different, Cat 3 gave a really good answer but do have your sister ask the doctors any question that she wants too. The medics will do their very best to answer them however Cat is right and if they say that they don't know they are not being evasive it is because they really do not know. Your nephew will most likely be held in a coma for a while as that is the best way to treat him. It won't be until his medication is reduced that the medics will begin to really find out what the effects of the injury are.

I have not noticed anyone post at such an early stage before and so I wanted to give a couple of bits of advice based on our experiences in the first days and weeks. Though it is hard, do try to get everyone to assume that your nephew can hear what is said to him and around him even though he can't respond. Our son has told us that he has vague memories of his Mum talking to him about past holidays even though we know this happened when he was deeply unconscious. The next bit of advice sounds strange but it was given to us by the staff in the ICU at Sheffield Children's Hospital. They suggested that, if we wanted, it could be useful later if we took photos of our son while he was still in the coma and all wired up to the machines. They were right to suggest we to do this as it later had two benefits, firstly our son has a record and a better understanding of the "missing" weeks in his life. Also during the recovery they helped us recall just how far we had come from those first day's when, like your sister, we had no idea what the outcome might be.

Please keep using this board as the need arrises, your nephew may well make a very good recovery but there will be twists and turns along the way and there are people here who have first hand experiences of them all!

God bless you, your sister and the whole family.

[WHIZZY100 in reply to davesdad]

I cant tell you how grateful I am for your reply. It has been a great help to me and I am now going to the hospital and I am going to tell my sister all about this board and the wonderful people who have been so helpful in my search. I honestly thought when I left the hospital yesterday that his life was gone and awful things were to come but now I know that although it will be a long road to recovery it is possible. My sister is generally a very positive person (having already been through one child on life support a few years ago) and i have no doubt this will be what she needs today. Many many thanks to everyone who has replied.

[cat3 in reply to davesdad]

Hi davesdad. Just wanted to say I couldn't agree more with comments about talking to the patient.

I still remember echoes of visitors and nurses talking to me and the comfort it gave me.

And the photos too. We've all said what an enormous help it would have been when, after my discharge, I was asking endless questions about my surroundings and treatment in ICU, to have been able to point to a sort of photo-diary.........so I could actually see myself in that situation instead of feeling 'invisible'.

Very good advice to anyone with a loved one in that awful situation. x

[thepiercy]

Can only echo what others have said. GCS can be used as a predictor of outcome but as with many of these measures it is about averages. Do you know anyone with 2.4 children? What actually happens to an individual can vary enormously and is affected by the kind of injury, where it is, how old you are, .. and innumerable other factors .My GCS was unclear but recorded as 3-5 (apparently i thrashed about a bit) but i made a very quick and frankly amazing recovery. It's early days, stay strong and keep talking to him

[carole195 in reply to thepiercy]

Hi Whizzy my partner suffered a TBI on Boxing Day and I have kept a diary of what has happened to him throughout his recovery along with all that has happened to me too. This gives me something to look back on when the progress you may see yourself is minimal. Every tiny movement along the way is important and is catalogued along with some photographs to remind me of how far we have come. I talk to him by the hour, read my book to him (even if he does miss the start and end of the story) and play music and football commentary to him.

From my very short experience the first weeks will be healing weeks for your nephew and as time goes on rehab is factored in.

This will be the hardest thing you and your family have to do, but try to stay strong (don't wobble like I have) and don't expect too much too soon.

The team of Drs and nurses are fantastic and will do their utmost. Your family will be in my thoughts stay positive

Carole x