Posted on 10/10/2006 4:04:27 PM PDT by wagglebee
GRESHAM, Oregon October 10, 2006 (LifeSiteNews.com) – A young boy, who had previously been diagnosed as being in a “permanent vegetative state,” has awakened from a 22 month-long coma and is breathing on his own.
Devon Rivers collapsed in a seizure during a phys-ed class in 2004 and his condition was never explained, though some doctors suggested it was caused by an unknown viral infection. Doctors agreed, however, that he had little hope of recovery.
His mother, Carla Rivers, visited him regularly and, in addition to physical therapy by his paediatric nursing home to keep his limbs supple, she talked to him in the belief that coma patients can retain their hearing and some understanding.
"For two years the doctors said there was no hope," said Carla Rivers. "Everything that happens in Devon's life is a gain. There's no losses."
Despite the doctors’ gloomy prognosis, eleven year-old Devon is now being prepared for occupational therapy to help him re-learn motor skills and is able to play with his siblings. Doctors cannot explain the reason either for his unexpected awakening or for his steady recovery.
In August of this year his mother, Carla Rivers, noticed that he began turning his head to follow movement; instead of a blank stare, he was reacting to his environment. Days later Devon was breathing without a respirator.
Carla Rivers said, “Devon may make a full recovery or what we see today may be what we get…God's plan is greater than ours. There's nothing we can do to force it any sooner or hold it back,” she said.
Coma patients and others with severe cognitive disabilities have been labelled “hopeless” only to recover frequently enough that some doctors and ethicists are questioning the accuracy of the diagnosis of “persistent vegetative state” (PVS).
The diagnosis is ambiguous in that symptoms of patients can vary greatly and still be called “vegetative.” A 1996 study published in the British Medical Journal showed that 43% of patients diagnosed with PVS do not qualify for the diagnosis.
In 2003, Kate Adamson, a former coma patient who had been diagnosed PVS, appeared on the television talk show the O'Reilly Factor. She said that, like Terri Schiavo, the hospital had removed her feeding tube that was only reinserted after eight days when her lawyer-husband threatened to sue the hospital.
Read related LifeSiteNews.com coverage:
Diagnosis of Persistent Vegetative State Questioned as Former Patient Speaks Out
http://www.lifesite.net/ldn/2003/nov/03111207.html
No it was not.
"ignoring the input of all her caregivers and doctors who spent more time with her. "
She had 2 docs testify they could do something for her and as I remember, one was simply hawking hyperbaric oxygen treatment, which will do zip. No other docs ocntradicted the diagnosis of PVS. The caregivers were incompitent with regard to knowing what was going on with Terri. As I said above, Gov Bush's team verified the diagnosis and her condition.
What imaging? Do you have a source or recall enough for me to search for your reference? All accounts I've seen, which are extensive, deny that Terri ever had an MRI or a PET. Numerous board-certified neurologists signed affidavits petitioning the court to obtain imaging that had not been done.
Thanks, bjs1779!
Beg pardon? I've never seen report of any testing by Gov. Bush's "team," whatever that is. It sounds highly improbable because Michael, the guardian, did not allow anyone to test Terri, save by explicit court order. Perhaps you could reference the court order or give me a lead? Otherwise, I find this very difficult to believe.
That's not saying much -- no other doctors were permitted to examine her. However, MANY neurologists and medical professionals doubted the diagnosis on the basis of the information available. (The court ignored them all.) The one who was actually permitted to visit Terri (without an exam) changed his mind about the PVS diagnosis upon seeing her, and filed the following affidavit.
Dr. William Polk Cheshire, Jr. (board certified neurologist) is a director of a Mayo Clinic laboratory and works for the Florida Statewide Adult Protective Services Team. [If this is the Bush team you are referring to, this doctor's statement is contrary to what you allege.]
"I have personal knowledge of the facts stated in this declaration and, if called as a witness, I could and would testify competently thereto under oath. I would like to disclose that I came into this case with the belief that it can be ethically permissible to discontinue artificially provided nutrition and hydration for patients in a persistent vegetative state. Having now reviewed the relevant facts, having met and observed Ms. Schiavo in person, and having reflected deeply on the moral and ethical issues, I would like to explain why I change my mind in regard to this particular case.
...
"Based on my review of extensive medical records documenting Terri's care over the years, on my personal observation of Terri (for 1 and 1/2 hours), on my observations of Terri's responses in the many hours of videotapes taken in 2002, she demonstrates a number of behaviors I believe cast a reasonable doubt on the prior diagnosis of PVS.
"1. Her behavior is frequently context-specific. Although she does not seem to track or follow visual objects consistently or for long periods of time, she does fixate her gaze on colorful objects or human faces for some 15 seconds at a time and occasionally follows with her eyes at least briefly as these objects move from side to side. When I first walked into her room, she immediately turned her head toward me and looked directly at my face. There was a lot of curiosity or expectation in her expression, and she maintained eye contact for about half a minute. Later, when she again looked at me, she brought her lips together as if to pronounce the letter "O,"
"2. There have been reports of Terri rarely using actual words specific to her situational context. The July 25, 2003 affidavit of the speech pathologist Sarah Green Mole, MS, on page 6, reads, "The records of Mediplex reflect the fact that she has said 'stop' in apparent response to a medical procedure being done to her."
"3. In the taped examination by Dr. Hammesfahr from 2002, when asked to close her eyes she began to blink repeatedly. Although it was unclear whether she squeezed her grip when asked, she did appear to raise her right leg four times in succession each time she was asked to do so. Rehabilitation notes from 1991 indicated that she tracked inconsistently, and although she did not develop a yes/no communication system, did follow some commands inconsistently and demonstrated good eye contact to family members.
"There is a remarkable moment in the videotape of the September 3, 2002 examination by Dr. Hammesfahr that seemed to go unnoticed at the time. At 2:44 p.m., Dr. Hammesfahr had just turned Terri onto her right side to examine her back with a painful sharp stimulus (a sharp piece of wood), to which Terri had responded with signs of discomfort. Well after he ceased applying the stimulus and had returned Terri to a comfortable position, he says to her parents, "So, we're going to have to roll her over...." Immediately Terri cries. She vocalizes a crying sound, "Ugh, ha, ha, ha," presses her eyebrows together, and sadly grimaces.
"It is important to note that, at that moment, no one is touching Terri or causing actual pain. Rather, she appears to comprehend the meaning of Dr. Hammesfahr's comment and she signals her ANTICIPATION of pain. This response suggests some degree of language processing and interpretation at the level of the cerebral cortex. It also suggests that she may be aware of pain beyond what could be explained by simple reflex withdrawal. "Persistent vegetative state" patients do not have the capacity to experience pain or suffering.
"Pain and suffering are attributes of consciousness requiring cerebral cortical functioning, and patients who are permanently and completely unconscious cannot experience these symptoms. And yet, in my review of Terri's medical records, pain issues keep surfacing. The nurses at Woodside Hospice told us that she often has pain with menstrual cramps. Menstrual flow is associated with agitation, repeated or sustained moaning, facial grimacing, limb posturing, and facial flushing, all of which subside once she is given ibuprofen.
"Some of the records document moaning, crying, and other painful behavior in the setting of urinary tract infections... To enter the room of Terri Schiavo is nothing like entering the room of a patient who is comatose or brain-dead or in some neurological sense no longer there. Terri [Schindler] Schiavo demonstrates behaviors in a variety of cognitive domains that call into question the previous neurologic diagnosis of persistent vegetative state. [emphasis added]
"Specifically, she has demonstrated behaviors that are context-specific, sustained, and indicative of a cerebral cortical processing that, upon careful neurologic consideration, would not be expected in a persistent vegetative state.
"Based on this evidence, I believe that, within a reasonable degree of medical certainty, there is a greater likelihood that Terri is in a minimally conscious state, than a persistent vegetative state. When serious doubts exist as to whether a cognitively impaired person is or is not consciously aware, even if these doubts cannot be conclusively resolved, it is better to err on the side of protecting vulnerable life."
Respectfully submitted
William Polk Cheshire, Jr., M.D., M.A., F.A.A.N.
Michael was not the guardian. Gov Bush appointed some other guy, a prof from FL and MIchael was taken out of the pic at that time. In general, med reports are not released for public viewing. The findings however were, and they confimed the irreversible PVS previously diagnosed.
I doubt Dr. Cheshire's was part of the Bush team. He made his comments after seeing what the parents put out, which was deceiving at best. Cheshire basically said what I thought and said at the time. I was deceived and that was straightened out by further findings were released from Bush's appointed guardian ad litum.
The other guy was Jay Wolfson. He was guardian ad litem. That's a different job and did not replace Michael Schiavo's guardianship. By law, Wolfson was supposed to represent Terri, but his report merely echoed the prior Greer court findings in virtually every detail. That, of course, did nothing for Terri.
No careful observer was surprised when Wolfson showed up soon after as a speaker at a U Penn "bioethics" banquet celebrating the legal victory that cost Terri Schiavo her life. Nearly all the top players in Terri's death were at the party. Michael Schiavo himself was the keynote speaker. Judge George Greer was a speaker. The late Dr. Ronald Cranford, who called himself "Dr. Humane Death" and who cast the deciding vote to kill Terri, was a speaker.
They made it plain that they were all on the same team all along.
That sounds correct T'wit. From a source I found.
-----------------------------------------------
(Jay)Wolfson is from the Florida Health Information Center at the University of South Florida. Although he was appointed by a judge as Schiavo's guardian ad litem under the new law, Michael Schiavo remains her legal guardian.
To write his report, Wolfson reviewed all of the court records and previous testimony in the case. He also visited with Schiavo at the hospice where she is staying in Pinellas Park. Wolfson was not allowed to do any further investigation into the case.
Dr. Cheshire was appoointed by DFS to 'observe' Terri, in her 5th day of dehyration BTW. If you read post #146, the rest of your point is just jibber.
I was deceived
That is apparent.
Sure he was. Check it out. He was representing the Florida Department of Children and Families. That's why he was even permitted to observe Terri. (Very few people were ever allowed to visit.)
Here is the essence of his reasons for finding Terri to be most likely in a minimally conscious state. (He could not state his view more certainly than that because, remember, he was not permitted to do testing, only observing.) (This is from a WND story based on Dr. Cheshire's affidavit.)
[Dr. Cheshire] cited seven reasons to doubt the prior diagnosis of PVS in Terri Schiavo:
# He found her facial expression brightens and she smiles in response to the voice of familiar people such as her parents or her nurse. Her agitation subsides and her facial demeanor softens when quiet music is played. "When jubilant piano music is played, her face brightens, she lifts her eyebrows, smiles, and even laughs." Cheshire said several times he witnessed Schiavo laugh when someone in the room made a humorous comment.
# She fixates her gaze on colorful objects and human faces for up to 15 seconds at a time and occasionally follows with her eyes as objects move from side to side. "When I first walked into the room, she immediately turned her head toward me and looked directly at my face. There was a look of curiosity or expectation in her expression, and she maintained eye contact for about half a minute." Cheshire said she also appeared to attempt to speak to him.
# Although he did not hear her utter distinct words, the doctor said "she demonstrates emotional expressivity by her use of single syllable vocalizations and cooing sounds. In reviewing previous affidavits, he noted that as late as 2003, the patient was heard to tell nurses to "stop" during certain procedures.
# He noted that in a previous examination by a neurologist, the patient appeared to try to follow certain commands – such as closing her eyes. She also raised her right leg four times when asked to do so in 2002 under examination.
# In that same 2002 examination by a neurologist, captured on videotape, Schiavo was turned on her side and probed with a sharp piece of wood. She reacted with sounds of discomfort. After that procedure, the neurologist commented to her parents that they would have to roll her over on her other side. Schiavo vocalized a crying sound in response. "It is important to note that, at that moment, no one is touching Terri or causing actual pain," he writes. Rather, he says, she appears to comprehending what was said and anticipating pain.
# According to the definition of PVS, he writes, patients do not have the capacity to experience pain and suffering. Yet, he concludes, after reviewing her medical records, pain issues frequently arise. "The nurses at Woodside Hospice told us that she often has pain with menstrual cramps." The pain and agitation subside when she is given ibuprofen. "If Terri is consciously aware of pain, and therefore is capable of suffering, then her diagnosis of PVS may be tragically mistaken," he concludes.
# "To enter the room of Terri Schiavo is nothing like entering the room of a patient who is comatose or brain-dead or in some neurological sense no longer there," he writes. "Although Terri did not demonstrate during our 90-minute visit compelling evidence of verbalization, conscious awareness, or volitional behavior, yet the visitor has the distinct sense of the presence of a living human being who seems at some level to be aware of some things around her."
"As I looked at Terri, and she gazed directly back at me, I asked myself whether, if I were her attending physician, I could in good conscience withdraw her feeding and hydration," he wrote. "No, I could not. I could not withdraw life support if I were asked. I could not withhold life-sustaining nutrition and hydration from this beautiful lady whose face brightens in the presence of others."
. . .
For the record, there are many other affidavits from neurologists, therapists and other medical professionals that cast doubt on the PVS diagnosis. Some, based on hands-on experience, held out hope for some degree of rehabilitation for Terri. All of the affidavits called for real, up-to-date imaging and testing, but Michael would not permit it.
Terri was determined to be absolutely blind at autosy. Cheshire's comments are almost all due to watching the parents videos. Id I examine someone, I can tell if they are blind. If this guy, the doc, couldn't do that, then he's a quack.
"For the record, there are many other affidavits from neurologists, therapists and other medical professionals that cast doubt on the PVS diagnosis."
For the record, none of them were competent to make such a determination. For the record there were none out of only 2, or 3 docs, that were correct in what they said.
The docs that reported to Greer were correct. Obviously anyone else looking into it would agree with them. Terri was blind and could not swallow as the autopsy proved. The less than 2mins of coincidental evidence showed on hte parents tapes was just that, coincidental. It could not be reproduced, nor was it confirmed, or verified by the doc present for the hour long exam. In fact he contradicted what the parents claimed and what he said, in the end, turned out to be correct.
Some of our visitors, who had flaunted their great ability to interpret the scans -- even though they had no medical training whatever -- got an embarrassing (and very funny) lesson. See Polybius's comments at #94 and thereafter. But the fun starts early -- go back to #1 and read the whole thing, especially the condescending sneers that soon turn to sheepish, red-faced muttering.
Yeah, whatever. I don't believe Cheshire, and he was proved to be wrong by the autopsy results.
Which ones, the two who spent less than an hour each for single-visit exams? That's miles short of the standard needed to diagnose PVS. Those were the two who said Terri was PVS. (Dr. Cheshire spent as much time as both of them put together.)
Two worked pro bono, i.e., were not being paid to parrot the view a lawyer hired them to say. One spent about five hours in multiple visits, the other about ten hours. IOW, they spent ten times as much time with their examinations as the first two. They were the ones who took pains to do real examinations, up to professional diagnostic standards, and they both found Terri to be alert.
Wow, I hadn't seen that article before, which you linked to. Wasn't it amazing how all the death bots swarmed onto the thread, only to be exposed as frauds by a real doctor! LOL.
Cheers.
The autopsy results said they could not determine if she was PVS. It said PVS had to be a clinical diagnosis on a live patient to determine PVS. You should read it sometime.
All that said, Cheshire was in a position to do just that.
She was not blind before being dehydrated to death. Dr. Hammesfahr observed her to be acutely near-sighted and measured her ability to see -- for practical purposes, she could see only five or ten inches. That matters a lot because tracking is a big part of diagnosis. Before Hammesfahr reported her limited vision, Terri was being asked to track things too far away for her to see -- and they flunked her for it when the problem was with her eyesight, not her tracking.
Dr. Cranford also found that she could see, and told her so in his videotaped exam. He complimented her on following his instructions and told her -- I think this is the exact quotation -- "You CAN see a little, can't you!" Bizarre thing to say if she were either blind or PVS.
So, both sides found that she was sighted, if only a little.
Dr. Thogmartin's finding (= cortical blindness) was hypothetical and post-mortem, not an observed fact.
Certainly Terri could swallow. The autopsy did not "prove" she couldn't. (Go back and read it.) What it did say was that she could not SAFELY be fed by mouth because of the RISK of aspirating.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.