My mum had a cardiac arrest 11 days ago and still... - ICUsteps

ICUsteps

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My mum had a cardiac arrest 11 days ago and still hasn't woken up... any advice would be much appreciated.

Loverofwords profile image
10 Replies

Hi.

My mum suffered a heart attack early morning on the 23rd may and had a cardiac arrest almost instantly. My dad heard her collapse and managed to get to her and start cpr within a minute time frame and the paramedics arrived within six minutes. On arrival they continued cpr before using the defibrillator, and when her heart started again they took her to the nearest hospital. My mum was then transferred to a heart specialist hospital and had a stent fitted around 12 hours after the initial arrest.

Since then my mum has remained in ICU. After around 2 days they began to lower the sedation but my mum didn't seem to like this very much so they had to increase it again. This happened for 2 days and then they took her for a brain scan. The scan showed my mum has some partial damage to the conscious side of the brain.

They have since managed to take her off all sedation and she has been off this for 3 days now. However my mum started shaking and for 24hrs the drs and nurses said this was my mum trying to wake up, but now they have said my mum is having seizures.

My mum is now on seizure medication and she has been having a few mild ones each day, but she needs to have another brain scan tomorrow to check for the seizures and any further damage to the brain.

Has anyone experienced seizures like this after cardiac arrest. Me and my family are worried if this is stopping my mum from waking up.

My mum has also been yawning alot and biting down on the ventilator tube, but we don't know if these are involuntary movements or not.

I would be very grateful for any advice, experiences in regards to any of the above. It's a scary time for all of us, and I have been constantly reading all your previous posts.

Many thanks

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10 Replies
Sepsur profile image
Sepsur

I hope things improve with your Mum

Loverofwords profile image
Loverofwords in reply to Sepsur

Thank you

M-RES profile image
M-RES

My own experience was similar to yours. My wife had an out of hospital cardiac arrest and I was on hand to give her CPR within a couple of minutes, but even that short time without oxygen to the brain can leave some damage, so I'm glad to hear your dad could give CPR quickly, it's so important. The ambulance arrived inside 10 minutes and after about half an hour of the parameds working with her (multiple adrenalin shots and defib shocks), they managed to get a stable enough pulse to rush her into hospital. She, like your mum, suffered ongoing seizures afterwards and was put on anti-epileptic meds (sodium valproate and levetiracetam if memory serves). I think the seizures were partly caused by cerebral oedema and some tissue swelling putting pressure on her brain, but after she was given diuretics and lost some of the fluid she had been retaining the seizures lessened. It was 10 or 11 days before she showed any signs of higher brain function (literally the evening of the day that the CCU team had told us to expect the worst) - involuntary limb movements or eye flickering - and another 3 weeks until she began to show signs of consciousness and started to emerge from the coma, so please don't give up! It can be a very slow process and though there are some general patterns that many people tend to follow when overcoming a cardiac arrest/coma, they are not written in stone.

One thing my wife showed while in a coma was 'wake/sleep' type patterns at regular times of the day - around 3 or 4 O' clock in the afternoon her heart rate would become more erratic, and temp would increase as though there was more brain activity and she was trying to wake, and then after a few hours it would subside as though her brain was going back to sleep. The neurologists diagnosed problems with her reticular activation centre, which were preventing her from regaining full consciousness, but as time went by she managed to overcome it - the brain has an amazing capacity to reroute around issues if it can at all find a way.

The nurses will document your mum's numbers on a regular (hourly?) basis, but it's not a constant observation, so any info you can give them will help to build a better overall picture of how she is progressing. They will probably write up anything you see in their notes. You may think you see movement or reaction, but repetition is the key - is it a one off or genuine signs of improvement? The more you see and record (give them times it occurred) the clearer the picture.

I really hope your mum pulls through. Keep talking to her and encouraging her, she may be able to hear you.

Loverofwords profile image
Loverofwords in reply to M-RES

Thank you so much for your reply.

How is your wife now, if you don't mind me asking?

So far we're on day 14 and my mum has slowly started to open her eyes, again we don't know if these are involuntary or not yet.

My mum has also been put on anti-seizure medication and so far these seem to have subsided thankfully.

My mum had another brain scan which showed minimal activity but she did have a spike when they clapped next to her ear after a few attempts. I believe they said she has a hypoxic brain injury/damage.

We're trying our best to take each day as it comes and I will definitely take your advice on board :)

Sepsur profile image
Sepsur in reply to Loverofwords

This article may shed some light on what is happening with your Mum

icusteps.org/assets/files/b...

M-RES profile image
M-RES in reply to Loverofwords

Hypoxia begins to cause damage the moment your oxygen supply stops. The quicker CPR is started, the less severe the damage, so your dad did the absolute best thing possible in minimising the negative effects.

My wife is OK now - nothing like she was before the arrest, but in good health and we've all learned to live with the disabilities she was left with.

The hypoxia partially damaged her parietal, occipital and frontal lobes, so it affected her short term memory, ability to comprehend complex sets of instructions, spatial awareness, balance to some extent, cognition and most of all vision.

After all her rehab, occupational therapy and physio as an inpatient we paid for her to have hyperbaric oxygen therapy after her discharge which didn't have miraculous results (as some people in the past have reported), but nonetheless did make a noticeable difference at the time.

But she's still here and it could have been much worse. It was hard to let go of the 'before' version of her, because nothing will ever be the same again, but I had to just take a deep breath and push on for her sake. We just have to adapt to whatever comes our way. People think it takes strength to deal with this, but I disagree - it just takes stubbornness.

Hang in there. Glad to hear there may be little signs. The brain has to kind of reboot and things start to 'come back on' in a certain 'expected' sequence from what I remember. It's been 4 years so I'm a little fuzzy now about it, but I seem to recall gross movements (not fine controlled ones), particularly contraction of limbs being a good sign - so, pulling an arm/hand up towards the armpit, or bending a knee a little. It's impossible really to know the extent of hypoxic injuries this early on.

I spent a lot of time at nights reading up on cardiology and neurology, medications, coma scales and types of comas - a crash course in everything that was going on - so that I could talk pragmatically to the ICU team in their own terminology and they could talk back to me honestly about what was happening and what the best and worst case scenarios were. For me it helped me to deal with it all. It made me feel empowered and able to contribute if even in a really tiny way.

I really do hope your mum pulls through.

Loverofwords profile image
Loverofwords in reply to M-RES

Thank you so much for sharing your experience.

My mum was transferred to our local hospital into ICU on Monday and she came off the ventilator that night and my mum has been holding steady since. As her heart attack and cardiac arrest caused some damage to left side of her heart they weren't sure if her heart could cope but so far she's holding strong.

My mum has started to open her eyes for longer periods of time, but we still don't know if this is involuntary or not.

The new doctors have been very doom and gloom, telling my dad this is how my mum will be forever which was hard to hear, especially as it's only three weeks since her arrest.

My mum was sent for another CT scan last night so we will await the results but we're all rooting for her.

Loverofwords profile image
Loverofwords in reply to Loverofwords

My mum was also moved from ICU to another ward last night too as she no longer needs to ventilator or icu care.

Is this the usual done thing? I'm hoping they won't just leave her

Sepsur profile image
Sepsur in reply to Loverofwords

There is a section in this article that explains the usual procedure for dropping down from ICU.

icusteps.org/assets/files/I...

Page 12

It is a bit of a shock the change from ICU to regular ward but it is a necessary step down for getting your Mum home.

I hope she keeps improving.

M-RES profile image
M-RES in reply to Loverofwords

In my wife's instance she was moved to a cardiac ward, but luckily the nursing team had some prior experience of patients coming from ICU, so were aware of her limitations. She spent a month in there before moving to another (slightly) more local hospital while waiting for a place in our nearest rehab unit.

The docs will probably tell you the worst case scenario based on the information they have at that moment in time, because it's better that you're prepared for it, but it's not necessarily always totally accurate and they will amend their prognosis as time goes on if she shows more signs of improvement.

It's good that she's been extubated as long term it can cause additional health risks. If she's continuing to hold her own with minimal or no support then it's a good start. Whatever happens, don't just become a passenger in the system. Don't overdo things, but make sure you ask questions and try to push for things if they're mentioned - stay involved in steering her healthcare.

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