8mm
Posted on 08/01/2007 11:00:27 AM PDT by ElkGroveDan
NEW YORK - A brain-damaged man who could communicate only with slight eye or thumb movements for six years can speak again, after stimulating electrodes were placed in his brain, researchers report.
The 38-year-old also regained the ability to chew and swallow, which allows him to be spoon-fed, rather than relying on nourishment through a tube in his belly.
The man's brain was injured during an assault, he spent six years with only occasional signs of consciousness and no useful movement of his limbs. In an experiment, researchers implanted electrodes in his brain for a procedure called deep brain stimulation, which is routinely done for Parkinson's disease and some other illnesses.
They turned the electrodes on and off over six months to test their effect, and reported the results in Thursday's issue of the journal Nature. The man, who was not identified at the family's request, now has them on throughout the day.
Experts called the report exciting but cautioned that the approach must be tested in more people before its value can be known. The researchers have already begun a study of additional patients.
Before the electrodes were implanted the man was in what doctors call a "minimally conscious state." That means he showed only occasional awareness of himself and the environment. In a coma or vegetative state, by contrast, patients show no outward signs of awareness.
There are no firm statistics on how many Americans are in a minimally conscious state, but one estimate suggests 112,000 to 280,000. Doctors may try medications to improve their condition but no drugs have been firmly established as helpful.
The man described in the Nature study speaks in a breathy but audible voice, said Dr. Joseph Giacino, a co-lead author. He does not initiate conversations but can reply to others, typically with one to three words, said Giacino, of the JFK Johnson Rehabilitation Institute in Edison, N.J.
Several weeks ago he recited the first half of the Pledge of Allegiance without assistance, Giacino said.
The man also recovered some movement. He can demonstrate motions such as brushing his teeth, said study lead author Dr. Nicholas Schiff of Weill Cornell Medical College in New York. He can't actually carry out that task because the tendons in his arms contracted after years of immobility.
"He is still totally dependent and severely disabled," Schiff said.
But the treatment has helped him, the man's mother said in a statement. "Now, my son can eat, express himself and let us know if he is in pain. He enjoys a qualify of life we never thought possible," she said.
Dr. James Bernat, a professor of neurology at Darmouth Medical School who didn't participate in the new work, called the Nature report exciting and important. Further study is needed to shed light on how many patients would respond and how to identify the minimally conscious patients with the best chance of being helped, he said.
He noted that a similar treatment did not help Terri Schiavo, the Florida woman in a vegetative state whose care triggered national controversy before her death in 2005. That's the typical outcome for electrical brain stimulation in vegetative states, he said.
Dr. Ross Zafonte of the University of Pittsburgh, who also was familiar with the study results, agreed that "we need to know more" and said the approach is "very interesting and holds great promise."
___
Read my tagline.
Of course, you’re not saying that you have never, uninvitedly, imposed your paralogisms about Schiavo on non-Schiavo threads about spontaneous brain-injury recoveries — that would never happen. Right? Right? Of course not...
_________
Nope. Guilty as charged. But through all of the research you did to go back to my May ‘05 comments, were you surprised that you could find not a single post in which I supported the starving of Terri?
That's my point. He'll still try, even though he's in Florida!
He's down there now, convinced the world revolves around him and that he is the arbiter of life and death.
As far as Greer is concerned, the day he became a lousy county court judge is the day he became God.
Starving for a fair diagnosis, by Reverend Robert Johansen [National Review, March 16, 2005]
~~~~~
Neurologists who are familiar with diagnosing and treating PVS and other brain injuries have told me that PVS is a notoriously difficult diagnosis to make. It requires a great deal of time spent with the patient over several days or weeks. The reason for this, as Dr. Bell explained, is that brain-injured patients have severely disrupted sleep/wake cycles. Dr. Mack Jones, a neurologist in Ft. Walton Beach, Fla., added that patients with severe brain injury will have greatly varying levels of alertness: “Two independent examiners may get an entirely different impression depending on when and how long he/she has spent performing the examination. For example, one examiner may unknowingly attempt to evaluate the patient during a stage of sleep. Another examiner, by chance, may find a more responsive patient simply because [the patient is] now more aroused.” Dr. Morin concurred, saying that in his experience “the attention of brain-injured patients is very erratic,” and that because of this he has “seen inadequate assessments even by experienced neurologists.” Because of these difficulties, the American Academy of Neurology has made it clear that it can take months for a physician to establish with confidence the diagnosis of PVS. A 1996 British Medical Journal study, conducted at England’s Royal Hospital for Neurodisability, concluded that there was a 43-percent error rate in the diagnosis of PVS. Inadequate time spent by specialists evaluating patients was listed as a contributing factor for the high incidence of errors. [Emphasis added.]
Dr. Cranford examined Terri on one occasion, for approximately 45 minutes. Another doctor for Michael Schiavo, Dr. Peter Bambikidis of the Cleveland Clinic Foundation in Ohio, examined Terri for about half an hour. When Dr. Bell learned of the cursory nature of these exams, he said: “You can’t do this. To make a diagnosis of PVS based on one examination is fallacious.” In Cranford’s examination, described by one witness as “brutal,” he discounted evidence under his own eyes of Terri’s responsiveness. At one point, Dr. Cranford struck Terri very hard on the forehead between her eyes. Terri recoiled and moaned, seemingly in pain. In his court testimony, Cranford dismissed the reaction and moan as a “reflex.”
[Note, please, that Dr. Cranford did admit that Terri responded to a painful stimulus. PVS patients by definition cannot feel pain. Terri's medical history is replete with references to her feeling pain, calling attention to her pain, and being treated for pain.]
"I asked Dr. Bell if he thought a moan uttered after a painful blow could be a reflex. "It's highly unlikely," he replied. He qualified his answer by noting that he had not actually seen the video of the exam, but he believes that the description of Terri's reaction is not consistent with a reflex. "A moan is not a reflex," Bell said. "A wince or grimace is not a reflex." "
By the very definition of Persistent Vegetative State, the patient must exhibit no “evidence of awareness of self or environment” or “ability to interact with others.” As one neurologist put it, if a patient shows “any response to the outside world, the patient isn’t in a PVS.” All it takes, according to Dr. Jones, is “only one examiner to discover the presence of higher brain function and the naysayers’ opinions are, by the very definition of PVS, null and void.”
Sure it was. That's why ma and pa failed to find a single doc in the entire world to challenge that diagnosis in court. All they generated was background noise from folks after that fundamental failure to produce.
Ron Cranford has Died, by Wesley J. Smith
~~~~~
Ron Cranford has Died
Ronald Cranford, the neurologist and bioethicist who made something of a career testifying on behalf of dehydrating the cognitively disabled, has died. He had kidney cancer, and I assume that this was the cause of his death.
I disagreed vehemently with Dr. Cranford. I saw him testify in the Robert Wendland case and his cool recounting of the process of dehydration chilled me to my bones, as did his ready admission that he had removed sustenance from people who were clearly conscious. I actually think that testimony was the primary reason the court refused to allow Wendland's tube sustenance to be stopped. And his examination of Terri Schiavo seemed conducted in such a hurried way that she would be unlikely to respond.
We met only once at a debate about Terri Schiavo in Florida. We were pleasant and civil to each other. Nothing more.
What is the proper response to the death of someone who has been an implacable adversary? I think it is the response we should have to the death of every human being. We should set those old disputes aside and hope that in the Great Beyond, he finds forgiveness and peace.
posted by Wesley J. Smith at 8:33 AM
~~~~~
(BykrBayb, you should have been pinged to my previous post [#105]. My apologies.)
That is miles from the fact. Both Drs. Hammesfahr and Maxfield did challenge it in court, and another forty doctors, many of them board-certified neurologists, offered affidavits that Terri should have better testing. Reverend Johansen, in his article, -- which, please read! -- stated that he found many more doctors who were aghast at Terri's treatment and would be willing to come forward also.
In the malpractice trials, Michael Schiavo's own lawyers argued in court that Terri was not PVS.
The parents should have found credible docs from the 40 claimed to have provided affidavits. Hammersfahr was and is not credible. Maxfield is the same, since he claimed Terri was very alert and aware. That was after 6 years of no response. Maxfield seems to have been Hammersfahr's team member in the hyperbaric oxygen scam. Hammersfahr and Maxfield were a team making empty claims and promising results with no evidence.
Thanks for all of your great posts on Terri as well as others, they are Excellent, Accurate and to the Point!
As we all know “You can lead a Donkey to water, but you can make it drink.” Thankyou again, I have learned much.
The doctors didn't "claim" to file affidavits. They filed affidavits. Read what they had to say. The affidavits are readily available online and they are tremendously educational to non-medics. Some offered sound medical reasons that Terri could not be PVS. They all asked for up-to-date testing and they all put their medical credentials on the line to speak for Terri.
Did any doctor on your side come forward with an affidavit swearing that Terri was PVS?
He is a board-certified neurologist. It's the three doctors who did cursory examinations who are not credible. Declaring a patient to be PVS in a single short examination is "fallacious," according to Drs. Morin and Bell (see paragraph one, post #105). Dr. Cranford spent all of 42 minutes, and even then he had to admit in court that Terri reacted to pain and other stimuli. (We all heard him say so in the videotaped exam, too.)
Dr. Hammesfahr worked fifteen times as long with Terri, doing extensive testing, and he did it pro bono where Dr. Cranford was paid for his same-every-time death "opinion."
>> Maxfield is the same, since he claimed Terri was very alert and aware.
You are reasoning backwards.
You claimed they filed affidavits. Whatever was in them regarding Terri’s PVS was useless. If they were any good, the parents should have chosen them instead of the other 2.
He's not credible. The same applies to a bunchof other board certified whatevers I know.
"Declaring a patient to be PVS in a single short examination is "fallacious,""
They have years of background med records. It's not all that hard to do when the patient simply remains unresponsive.
There is always more! :-) This is the Dred Scott case of the new century. If you want to do more homework, I'd recommend the previous war thread. Read this: FL lawyer says Giuliani, Romney, McCain wrong on Schiavo case. This is the ONLY thread where I've gotten a real answer to my repeated question, how did Terri go from asleep in bed to a crumpled, broken heap on the hallway floor -- right after her angry husband came home?
The answer was: there are some cardiac arrests that are never explained. (As if this were a viable theory in the middle of a domestic fight.) Now, that is a ridiculous and bizarre answer but at least it's a theory. So, we did the numbers and it worked out that the odds were 1 in 2,500,000 of this happening to Terri. That leaves odds of 2,500,000 to one that she DIDN'T just collapse innocently. There was only one other person present, he doesn't have an alibi, and he immediately lied to the police investigators. Michael Schiavo.
The death camp threw a doctor and a lawyer at that thread How sad that these gentlemen revealed themselves to be trolls and were kicked out of Free Republic. Imagine, a doctor troll and a lawyer troll. What next.
Hahahaha!
>> They have years of background med records.
Who has? Those "board certified whatevers"? This is too funny :-)
Terri's med records include countless incidents of her suffering pain, communicating her pain to nurses [cognitive function] and being treated for pain. They also record her speaking -- saying "stop!" -- in response to pain [cognitive function]. The med records do not support your case at all.
>> It's not all that hard to do when the patient simply remains unresponsive
The patient didn't.
And by golly, they did! When I make a claim, by golly it's true!!
>> Whatever was in them regarding Terri’s PVS was useless. If they were any good, the parents should have chosen them instead of the other 2.
That is quite simply the silliest inference I have ever heard on a Terri thread.
Thank for you diligence, T'wit. The trolls I can argue with, the ignorant confound me.
Well if you think Hammersfahr is a fine ole doc, you're free to visit and take your family to him anytime. I think he's a quack.
"Terri's med records include countless incidents of her suffering pain, communicating her pain to nurses [cognitive function] and being treated for pain. They also record her speaking -- saying "stop!""
Those aren't the contents of med records. After reviewing all the facts, these various comments are simply anecdotal. Terri did not perform for the docs, the parents produced no credible med evidence the judge could believe and that's the bottom line.
Obviously.
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.