still no change...is this normal?

[tdstewart]

After 9 days, my 63 yr old mother is still non responsive. She has has major brain swelling, causing a mid line shift. Each day, the CT scan shows no decrease of the swelling. The DR. had her ventilator turned off to see if she could breath on her own, and she couldn't. They are planning on giving her a trech. tomorrow. She has severe emphasema, causing the doctors much concern. The Doctor told us that they are more worried about her breathing than the swelling on her brain. How long does it usually take for the swelling to come down, and when it does, should her responses come back? We are also worried that this could be the beginning of the end because of the breathing difficulties. Any help would be appreciated. Thanks

[caregiver222]

They suggests a trach too quickly, mostly because it enables the hospital to get the patient off a ward where special nursing car is required. It ios standard procedure to "pressure" a patient's family into authorizing a trach, with the lie that "it can be reversed." Yes, but this is not usually the case. They did this with my mother, and I bought it, despite having decades of hospital experience. Yup. Color me stupid. Of ALL people I should have known better. Of course verbal communication and rehab goes to zero baseline with a trach. Sometimes a trach is necessary, and they don't always lie, but it is in a hospitals best interest to minimize patient care costs, and a trach does that.  As for improvement I have a little 101 year old sweety-pie patient who will be 102 in March. She was completely unresponsive a year and a half ago, essentially vegetative, and a half ago and could not talk, respond to commands in any way, nor swallow. The best rehab people gave up on her. Last night she laughed at my finger puppet, and asked me "Have you told your girlfriend I exist?" Incredibly she has been moving upwards in sentience every single day. So you never know. One of the problems with a trach is suctioning. You should learn how to do this yourself. Also beware of nebulized oxygen, which can often deposit too much water in the lungs.

[hopefullnurse]

--there is no normal for brain bleeds/strokes.  each stroke is unique/as is the person.  i can tell you that i have seen both sides of the spectrum with these, and cannot predict the outcome.  best advice--never give up hope, always talk to the person as if they will recover.   best of luck to you.