Facts About Vegetative and Minimally Conscious States After Severe Brain Injury

Mark Sherer, Ph.D., Monica Vaccaro, M.S., John Whyte, MD, Ph.D., Joseph T. Giacino, Ph.D., and the Consciousness Consortium, Model Systems Knowledge Translation Center
Facts About the Vegetative and Minimally Conscious States After Severe Brain Injury

Severe brain injury causes a change in consciousness. Consciousness refers to awareness of the self and the environment. Brain injury can cause a wide range of disturbances of consciousness. Some injuries are mild and may cause relatively minor changes in consciousness such as brief confusion or disorientation.

The most severe injuries cause profound disturbance of consciousness. Twenty to 40% of persons with injuries this severe do not survive. Some persons who survive have a period of time of complete unconsciousness with no awareness of themselves or the world around them. The diagnosis given these people depends on whether their eyes are always closed or whether they have periods when their eyes are open. The state of complete unconsciousness with no eye opening is called coma. The state of complete unconsciousness with some eye opening and periods of wakefulness and sleep is called the vegetative state. As people recover from severe brain injury, they usually pass through various phases of recovery. Recovery can stop at any one of these phases.

Characteristics of coma

  • No eye-opening
  • Unable to follow instructions
  • No speech or other forms of communication
  • No purposeful movement

Characteristics of the vegetative state

  • Return of a sleep-wake cycle with periods of eye opening and eye closing
  • May moan or make other sounds especially when tight muscles are stretched
  • May cry or smile or make other facial expressions without apparent cause
  • May briefly move eyes toward persons or objects
  • May react to a loud sound with a startle
  • Unable to follow instructions
  • No speech or other forms of communication
  • No purposeful movement

Persons in coma or vegetative state require extensive care that may include:

  • Feeding using a feeding tube
  • Turning in bed to prevent pressure sores
  • Special bedding to help prevent pressure sores
  • Assistance with bowel and bladder relief using catheter and/or diapers
  • Management of breathing such as suctioning of secretions; this may include care for a tracheostomy tube
  • Management of muscle tone (excessive tightness of muscles)
  • Special equipment that may include a wheelchair or special bedding to help with proper posture and decrease muscle tightness
  • Management of infections such as pneumonia or urinary tract infections
  • Management of other medical issues such as fever, seizures, etc.

What happens after coma and vegetative state?

When people start to regain consciousness, they may:

  • follow simple instructions from others such as, “Open your eyes,” “Squeeze my hand,” “Say your name,” etc.;
  • communicate by speaking words or by indicating yes or no by head nods or gestures; and/or
  • use a common object in a normal way such as brushing hair with a brush, using a straw to drink, holding a phone to the ear, etc.

Persons with brain injury transition through the period of unconsciousness and subsequent stages of recovery at a slower or faster rate, largely depending on the severity of injury. Those with less severe injuries may transition through these stages more rapidly and some of the stages described here may be poorly recognized or not occur at all. Those with very severe injuries may stall at one or another stage and not be able to make the transition to a higher level of recovery.

For persons with more prolonged periods of unconsciousness, emergence from unconsciousness is a gradual process. Coma rarely lasts more than 4 weeks. Some patients move from coma to the vegetative state but others may move from coma to a period of partial consciousness. It would be very rare for a person to move directly from coma, or vegetative state, to a state of full consciousness.

Persons who have shorter periods of unconsciousness likely had less severe brain injuries initially. Consequently, they are likely to go on to make better recoveries than persons who had longer periods of unconsciousness.

Traumatic brain injury refers to damage to the brain caused by external force such as a car crash or a fall. About 50% of persons who are in a vegetative state one month after traumatic brain injury eventually recover consciousness. They are likely to have a slow course of recovery and usually have some ongoing cognitive and physical impairments and disabilities. People in a vegetative state due to stroke, loss of oxygen to the brain (anoxia) or some types of severe medical illness may not recover as well as those with traumatic brain injury. Those few persons who remain in a prolonged vegetative state may survive for an extended period of time but they often experience medical complications such as pneumonia, respiratory failure, infections, etc. which may reduce life expectancy.

People who have a slow recovery of consciousness continue to have a reduced level of self-awareness or awareness of the world around them. They have inconsistent and limited ability to respond and communicate. This condition of limited awareness is called the minimally conscious state.


Characteristics of the minimally conscious state

  • Sometimes follows simple instructions
  • May communicate yes or no by talking or gesturing
  • May speak some understandable words or phrases
  • May respond to people, things, or other events by:
    • crying, smiling, or laughing;
    • making sounds or gesturing;
    • reaching for objects;
    • trying to hold or use an object or
    • keeping the eyes focused on people or things for a sustained period of time whether they are moving or staying still.

People in a minimally conscious state do these things inconsistently. For example, one time the person might be able to follow a simple instruction and another time they might not be able to follow any instructions at all. This makes it difficult to distinguish the vegetative state from the minimally conscious state.

While in a minimally conscious state, people need extensive care similar to that needed by people in a vegetative state.


Emergence from the minimally conscious state

Once a person can communicate, follow instruc tions, or use an object such as a comb or pencil consistently, they are no longer in a minimally conscious state. Some people remain minimally conscious indefinitely, but many improve. The longer a person remains in a minimally conscious state, the more permanent impairments he or she is likely to have. This is because vegetative and minimally conscious states are caused by severe damage to multiple brain areas. Following emergence from the minimally conscious state, people almost always experience confusion. Sometimes people move directly from coma to this confusional state.


Comparison of Coma, Vegetative State, and Minimally Conscious State

 

Coma

Vegetative State

Minimally Conscious State

Eye Opening

No

Yes

Yes

Sleep/Wake Cycles

No

Yes

Yes

Visual Tracking

No

No

Often

Object Recognition

No

No

Inconsistent

Command Following

No

No

Inconsistent

Communication

No

No

Inconsistent

Contingent Emotion

No

No

Inconsistent


Characteristics of the confusional state

  • Disorientation (inability to keep track of the correct date and place)
  • Severe impairment in attention, memory and other mental abilities
  • Fluctuation in level of responsiveness
  • Restlessness
  • Nighttime sleep disturbance
  • 6. Excessive drowsiness and sleeping during the day
  • Delusions or hallucinations

As with the vegetative and minimally conscious states, the rate and extent of recovery from the confused state vary from person to person. However, almost all people who reach the confused state go on to make further progress. The main factors that determine the eventual degree of recovery are the initial severity of the brain injury and some types of additional medical problems. The shorter the time the person is in the confused state, the better the eventual recovery will be. Mild medical complications such as sleep disturbance or urinary tract infection may prolong the confused state but do not necessarily influence the final outcome.

Once the confusional state resolves, people are usually much better able to pay attention, orient themselves to place and time, and retain memories for day to day experiences. Nevertheless, they are very likely to have some significant cognitive problems such as impaired memory or slowed thinking. These cognitive problems are likely to continue to improve as time passes. Some people make limited progress, while others make a good deal of progress.


Patterns of recovery after very severe brain injury

Some individuals rapidly emerge from coma and briefly remain in the minimally conscious state before recovering a higher level of consciousness with mild impairments. Others may have a longer period in the minimally conscious state after emerging from the vegetative state and then usually have a greater degree of long-term impairment. Occasionally, persons remain in the vegetative or minimally conscious state for an extended period of time and, in rare cases, these conditions may be permanent.

What treatments are used with people in the vegetative or minimally conscious state?

Currently, there is no treatment that has been proven to speed up or improve recovery from the vegetative or minimally conscious state. However, there is general agreement that the primary focus of medical care is to prevent or treat any factors that might hinder recovery (such as hydrocephalus, a build up of fluid on the brain, or use of sedating drugs for other conditions), and to preserve bodily health (such as treating infections or stiffness of joints). Medical facilities and clinicians vary in the extent to which they try various treatments such as medications or sensory stimulation to promote recovery of consciousness. Because the amount of recovery from disorders of consciousness varies so greatly, it is difficult to judge the value of these and other treatments outside of research studies. You can inquire about your physician or program’s philosophy about using these types of treatments.

Transitions to different levels of care

At various points in the process of recovery, persons in the minimally conscious or vegetative state may receive care in a wide range of settings. Initially, the person with severely impaired consciousness is most likely to be treated in an acute care hospital where the focus is primarily on saving his/her life and stabilizing him/her medically. Once that is achieved, the next focus is on recovery of function to whatever level is possible. Sometimes this happens in an acute rehabilitation hospital, which provides a high intensity program of rehabilitation services, including physical therapy, occupational therapy, speech and language therapy, recreational therapy, neuropsychological services and medical services.

Some patients do not transition from the acute care hospital to an acute rehabilitation program. These people may go directly to a skilled nursing facility, a sub-acute rehabilitation program, a nursing home, or even home with family. Persons discharged from an acute rehabilitation program usually go to one of these places as well. Skilled nursing facilities, sub-acute rehabilitation programs, and nursing homes vary widely in the quantity and quality of medical management, nursing care, and rehabilitation therapy services they provide.

Many factors influence decisions about where a person with severe impairment of consciousness or other severe impairments may go after discharge from the acute care hospital or discharge from the acute rehabilitation program. Some of these factors are the person’s medical condition, health insurance coverage and other benefits, the person’s ability to tolerate rehabilitation therapies, the doctor’s philosophy about where people should go to continue to recover after severe injuries, the family’s ability to care for the person at home, the family’s wishes, and practical matters such as that the distance the family has to travel to visit the person at the facility.

The names used to describe levels of care and the settings in which they are provided, vary across the country. It is helpful to work with a social worker or case manager in the facility where your loved one is currently receiving services to plan whatever transitions are necessary. Do not be afraid to ask questions to make sure that you obtain the information you need to help you make the best possible decision.

Things to look for when considering a setting to care for your loved one:

At various points in the process of recovery, persons in the minimally conscious or vegetative state may receive care in a wide range of settings. These include in-patient rehabilitation facilities, skilled nursing facilities, and long-term acute care facilities. The following are some considerations for selecting a place for care:

  • Your family member’s current treatment team has had good experiences with the program when they have referred others there.
  • The staff at the facility makes you feel comfortable, is accessible to talk with about your concerns, and answers your questions.
  • The program and medical staff have experience working with the same kinds of problems that your family member has.
  • The facility is informed about the specifics of the care your loved one needs and is able to meet these care needs. You can have a role in ensuring that a detailed nursing plan of care is developed.
  • The program includes case management to assist in planning for the next level of service, whether it is transition to a rehabilitation program, a facility for long-term care, or home.
  • The program provides education and training for future caregivers.
  • The program uses specific procedures to measure progress.

If support services can be arranged, some persons in the minimally conscious or vegetative state can be cared for at home.


Thoughts from families who have been there

Family members who have a loved one in a minimally conscious or vegetative state have identified a number of important issues:

  • Communicating with healthcare providers
    Be sure to ask questions, share your observations, and express your opinions.
  • Managing medical equipment and supplies
    It is important to be knowledgeable about your loved one’s equipment and supplies, and know how to communicate with the companies who provide these items.
  • Providing care
    Family members often provide some of the care for their loved ones. The amount of care you provide will depend on your role in providing care (this can range from providing most of the care yourself to simply directing the care provided by others), the people such as sitters, attendants, nurses, and family members who are available to help you with providing care, the setting (this could be your home or a skilled nursing facility), and the guidance you receive from health care providers. It is desirable to obtain as much training as possible to provide whatever elements of care you chose to provide and are able to manage. These might include bathing, grooming, bowel and bladder management, mobility, range of motion, and other medical issues that your loved one may have.
  • Learning about financial resources
    You may initially feel overwhelmed when you start to learn about various financial resources that may be appropriate for your loved one. However, with patience, persistence, and some help from others, you will be able to figure out which programs apply and find your way through the application processes.

    Programs you will want to learn about include:

    • Healthcare programs such as Medicare and Medicaid.
    • Income replacement or financial assistance programs such as SSDI (Social Security Disability Insurance), SSI (Supplemental Security Income), or possibly disability insurance policies that you loved one may have had through work.
    • Services to help with community living such as state agencies that assist people in these areas.

    It might not be possible to find someone who knows everything about how to access these various services and programs. The key is to keep asking questions and following up to make sure that you and your loved one get all the benefits that are available. People who may be helpful to you are social workers, therapists, case managers, the local social security office, your state brain injury association chapter, family members or friends who are disabled or who have family who are disabled, or the human resources (personnel) department at your loved one’s employer.

  • Guardianship
    Since your loved one is not able to fully make decisions for himself or herself, it may be helpful for you, or someone else, to be appointed guardian. This may make it easier to handle medical decision making or management of your loved one’s financial matters. If you think that your loved one may need to have a guardian appointed, you will need to contact an attorney to get assistance. Guardianship can be reversed when it is no longer needed.

How to interact with your loved one who is unconsciousness or at a low level of responsiveness

The most natural way of interacting is to talk to your loved one, even though he or she may not respond or understand. Simple things like telling him or her about recent events in your life, what is going on in your family or neighborhood, or the latest news might make you feel a sense of connection. Talking with your loved one about what you are doing as you provide care can increase your comfort with the process of care giving. For example, telling your loved one that you are going to move his or her arms and legs to help prevent joint tightness might make you feel more comfortable with this task. Only do this “range of motion” type activity if you have been instructed to do so by the doctor, nurse, or therapist.

Physical touch is another way of having a sense of connection. Some family members have said that the act of giving a massage or applying lotion to the hands or face helps them to feel close to their loved one. It is also important to avoid the risk of overstimulation as this may result in rapid breathing, tightening of the muscles, grinding of the teeth, restlessness and fatigue.


Taking care of yourself and other family members

Family members of a person in a vegetative or minimally conscious state often feel a sense of loss or grief for the relationship they had prior to the injury. There can be a number of ways to cope with these feelings. A person in a minimally conscious or vegetative state may make very slow progress or go for periods of time with no apparent progress. Sometimes keeping a journal of the changes you have observed may be comforting. This may give you a chance to look back and see ways in which he or she is more able to respond than he or she was at an earlier point in time.

Having a loved one who is in a vegetative or minimally conscious state can be physically and emotionally draining. Managing this alone can be too much to ask of one person. It is important to rely on support from others, looking to existing supports and developing new ones. You might find help from supports you have relied on in the past, such as family, friends, and religious groups.

Other resources to consider include support groups, support agencies, and the Internet. A good way to learn more about these possible supports is to make a contact with the Brain Injury Association of America’s National Brain Injury Information Center (www.biausa.org, 1-800-444-6443) and obtain contact information for the closest state brain injury association (BIAA) chapter. Health care providers such as doctors, therapists, social workers and others can be good sources of information about supports available to you.

Even the most committed caregiver needs to have some private time. If your loved one is at home, this can range from having a friend or family member give you a 2 hour break to go do something for yourself to having full time caregivers for a week or having your loved one spend a brief time in a nursing care facility or hospital. If your loved one is still in the hospital or living in a nursing care facility, having a rotating visitation schedule can give you some breaks while giving other friends and family a chance to spend time with him or her.

When your loved one was first injured you were likely to be in crisis mode, focusing on the problems and putting the rest of life on hold. As time goes by, you will need to shift from crisis management mode, and begin to take care of the concerns of everyday life such as paying bills, maintaining relationships with other family members, and taking care of your own physical and mental health. While it is natural to focus on your injured loved one, other members of your family will have needs too. For some people, formal counseling with a therapist or member of the clergy can be an important part of making adjustments to life changes that have occurred as a result of your loved one’s injury.

While caring for a person in a vegetative or minimally conscious state is an enormous challenge, use of appropriate resources, as described above, can be a big help. Each person will respond differently to this challenge, but almost everyone can cope and move forward. Many family members have a deep sense of personal satisfaction in making life as comfortable and pleasant as possible for a loved one who has sustained a severe injury.


VS-MCS brochure authorship and acknowledgement:

Written by: Mark Sherer, Ph.D., Monica Vaccaro, M.S., John Whyte, MD, Ph.D., Joseph T. Giacino, Ph.D., and the Consciousness Consortium. Members of the Consciousness Consortium include:

  • JFK Johnson Rehabilitation Institute, NJ (Lead Center)–Joseph T. Giacino, Ph.D., P.I.
  • Moss Rehabilitation Research Institute, PA (Co-Lead Center)–John Whyte, MD, Ph.D., P.I. and Sooja Cho, MD, Site P.I.
  • Methodist Rehabilitation Center, MS–Stuart A. Yablon, MD, P.I.
  • Braintree Rehabilitation Hospital, MA–Douglas Katz, MD, P.I.
  • Sunnyview Hospital & Rehabilitation Center, NY–Paul Novak, MS, OTR, P.I.
  • Bryn Mawr Rehab Hospital, PA–David Long, MD, P.I.
  • Texas NeuroRehab Center, TX–Nancy Childs, MD, P.I.
  • Fachkrankenhaus Neresheim, Germany–Bernd Eifert, MD, Ph.D., P.I.

Acknowledgements: Funding for writing and publication of this brochure was provided by National Institute on Disability and Rehabilitation Research grant #H133A031713 (A Multicenter Prospective Randomized Controlled Trial of the Effectiveness of Amantadine Hydrochloride in Promoting Recovery of Function Following Severe Traumatic Brain Injury).

The Brain Injury Association of America (BIAA; www.biausa.org) provided feedback from the consumer perspective for the content of this brochure and is assisting with dissemination of these materials.

Several family members of persons with TBI generously gave their time and valuable insights to assist with the writing of this brochure.

Posted on BrainLine March 25, 2010. Reviewed March 28, 2019.
About the Authors

The Model Systems Knowledge Translation Center is operated by American Institutes for Research (AIR) and is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) under grant number 90DP0082. Four additional organizations support AIR in executing the work of the MSKTC, including George Mason University's Center for Chronic Illness and Disability, WETA's BrainLine, University of Alabama, INOVA, and American Association of People with Disabilities.

Sherer M, Vaccaro M, Whyte J, Giacino JT, & the Consciousness Consortium. Facts about the Vegetative and Minimally Conscious States after Severe Brain Injury 2007. Houston: The Consciousness Consortium. Copyright © 2018 by University of Washington/MSKTC. 

Please check the MSKTC site for any recent updates on this article.

Comments (331)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

My ex of 12 years was struck by a drunk driver while walking to his vehicle last Sunday morning at 4 AM. Doctors pronounced him brain dead, even though he breathed against the machine for a little while, and also showed a reflex when he gagged on the feeding tube. After only two days on life-support, his mother decided to take him off. I have so many questions and thoughts running through my brain. I know it’s not my right to decide how someone grieves or the decisions they make in this difficult time, but personally as a mother of two beautiful boys, I could never let go that fast. And people make recoveries all the time despite the outcomes predicted. Today’s isn’t long enough for anybody to make a recovery. I just wish that I could have given him more time on life-support to see if anything has changed. I will never know now and my boys are left without a father.

My heart goes out to everyone dealing with a similar situation as myself. My mom passed of GBM at 51. (18 yrs ago and it never gets easier)
Never expected to go through something so heartbreaking again. I was wrong. My 38 yr old husband was just diagnosed with leucoencepolopathy in Jan. Reg ICU for 2.5 weeks and has been in an LTAC icu ever since. The worst part is- this disease is so rare- there is no plan or way to know how he’ll be from day to day. Last week he was smiling - this week it seems he doesn’t even know who I am… there is so minimal info on this disease and the odds aren’t in his favor. Anyone else ever heard of this before? Or know someone who has?
Thx

My 63 year old father was found unconcious in his apartment on Monday afternoon. He could have been that way for anywhere between 1 minute to 19 hours. He was rushed to the hospital where it was seen he had an acute subdural hematoma. An emergency craniotomy was performed and the surgery went very well. His vitals have been perfect, he is on a vent since they put him on one when he arrived due to shallow breathing, he is off sedation, but he is not opening his eyes. His EEG showed no seizures but slowed brain activity on the right side which the doctor said is consistent with this type of injury and surgery. He responds to painful stimulation and his body twitches a lot which I am guessing is involuntary. I have never experienced anything like this before and I am just so scared he is not going to open his eyes. Doctors remain positive, but everything right now is unknown. Has anyone experienced a similar situation with a loved one?

Similar my father is in minimal consiousness oprns his eyes blinks roamimg of eyes moves his feet toes bug gas some brain injury he fell in the hospital his heart stopped they took to long to cpr now hes on ventilater had moved to breathing mask for 15 hours but some doctor had to go see test the oxygen probably got knows exactly what and he stopped breatbing tjey did cpr but now set back to vwnt thx to doctor hed in mi imal consiousness doctors say not good but i believe my father can snap out of it god willing

I found your comment while looking for a case similar to my 62 year old dad's. Your father's state seems to match my dad's almost exactly. As of Dec 18th 2023, my father is unconscious, not able to open his eyes after what was his 4th stroke over the span of 5 years. My email is nrshuvo -at- gmail.com if you'd like to get in touch. If you're comfortable sharing I'd want to know how your dad may be today after having gone through the same ordeal as my dad. Thank you so much for your time! I hope things are better for your dad today

My 81 yo mom had a Uti that went septic. It caused her organs to shut down. She suffered a major heart attack. Paramedics came but she had already passed. They did cpr & broke her ribs-it didnt bring her back, so they did cardioshock treatment & that worked. She was rushed to the ER & placed in ICU for 3 mos. When she arrived her hands & feet were black. The rest of her was white, head tilted back, mouth wide open-ghastly-She had died! She was put on a fentanyl induced coma for 3 wks, then ventilator, trachiostomy, feeding tube dialysis & IV drip. She has a GI Bleed but they cant find the source. We didn't give up & visited everyday! Mom opened her eyes after 3 wks...then came squeezing my hand, blinking 1 for Yes, 2 for No...the smiles came eventually & then drops of water & ice chips! Staff started feeding softs & got her up with the hoyer lift. When she was strong enough they xferred her to an LTAC facility about 6 hrs from home. Family couldn't visit now. Fastforward. Mom is now in a veg state at the Hospital 6 hours away, she has suffered 6 Uti's in the past 7 mos (3 went septic) she's in renal failure, getting dialysis, has pneumonia, on the vent , trache, feeding tube, iv drip, gets no water or ice chips, and family visits are very rare! Drs say she is not improving, will not recover & the humane thing to do is cut her vent & let hospice do their thing. They say with every Uti will come more complications, pain & weakend immune system. Which btw is a vicious cycle. Also, how much quality of life does she have living this mere existence. Her only visitors on a daily basis are nurses coming in to turn or poke her, give dialysis or blood transfusions & tests that reveal little to nothing. No easy answers here as I saw my mom come back from the dead.

On june 6, we got a called saying that my mom got into an accident. She was on the way to the casino went her friends. They drove different car and on the way they was on the phone n there was a 40 mins traffic. Semi trunks was parked on emergency lanes so it was packed everywhere. Then suddenly my mom told her friend she felt sleepy n moments later she pulled over on the side n hit a semi truck. The car leaked carbonara monoxide we don’t know how or when

Her friend called my mom bf and my mom bf called me n I tracked her phone n rushed there but it took me 40 mins even when I drove as fast as I could due to heavy traffic.

Luckily when I got there, the car n police was still there and I asked where was my mom n they told me the ambulance already took her to the hospital when I arrive to the hospital the doctor told me she has carbon monoxide poisoning.

Carbon monoxide as u know is gas from the car that when it leaks it takes over the oxygen in your brain n body. The dr said Just 5 mins is enough to kill u or your brain

Even after they reduce the carbon monoxide they cannot reverse the damage done to the brain.

This can cause a person to be in a vegetative state, or unconscious or death.

Right now my mom not awake yet.

Only thing I have in my head is all the arguments with her about stupid things. How can I ask for second chances, when so many was given to me but I disregarded it. I just want her to wake up and hear her complain me and tell me what she think is best for me again.

Right now we just waiting for miracle and fight with her day by day.

My grandpa 78 years old (who I live with & he raised me) had cardiac arrest from a bladder infection. I took him to the emergency room when he told me he couldn’t urinate & he was short of breath. They released him with antibiotics for a bladder infection, 30 hours later his blood pressure dropped to 78/48 then he went into cardiac arrest. The ambulance got to our home quickly & they brought him back with only CPR. The very 1st day they were saying that he wasn’t going to make it. Then when they said they think his kidneys are failing.. They said he wasn’t brain dead but they think he might be in a persistent vegetative state. Then he started to get better, his kidneys got better and he began to open his eyes & move a tiny bit after a week however he was jerking really bad. The nurse cornered me and tried to convince me for almost an hour to pull the plug, despite him looking directly at me! I didn’t want to be rude to the nurse so I let her continue her long horrid rant, as I cried looking into his eyes while trying to ignore her and hope that she just shuts up already. Her rant was the most messed up conversation I’ve ever experienced. I had my grandpas hospital room all decorated with Jesus pictures & crosses, so this nurse started her rant with “I’m also a lady of faith, and I believe your grandpa died a week ago when he had the cardiac arrest and I believe he’s already in heaven, don’t you? His eyes being open is just a reaction & he’s not really there, he’s already in heaven and you need to come to terms with this.” Then after trying to get me to actually respond to her while I’m balling my eyes out, she persists to continue her rant with this “You see these machines are man made and he is being kept artificially alive, if we pull that plug he can’t breathe on his own. God stopped his heart last week, we are keeping his body here with man made machines and I don’t think God would like this do you?” And she continued to try to get me to answer her!!! I keep covering my face and hoping she would just leave and she just continued and worse, she planned a day to pull the plug! I just thought in my head, no no no God wants these machines because I know many people have survived & went on to have children (which is a blessing from God). I also thought why is this lady a nurse if she ACTUALLY believes this bs. The next day I was woke up at 7am I got a call from the hospital (I sat up in bed so fast in total fear) The other nurse (a nice one) calls to tell me “she believes me” he’s actually opening his eyes & tracking her around the room! They NEVER mentioned pulling any plug again! It’s now been a month and a half since his cardiac arrest. He is stable, breathing on his own with a tracheostomy T-collar and on Tuesday they want to put in a J tube feeding tube (I’m skeptical about needed a J tube) and they say that as he wakes up more and more the nasal feeding tube is uncomfortable & that he may rip it out. He opens his eyes, moves his head, moves his hands, squeezes my hand but he’s like in and out of it, sometimes he responds when asked to do something & other times he doesn’t, he also jerks still. It’s been very hard, I visit at least once a day and sing him his favorite songs, I bring his favorite smells, I talk to him, tell him about my day, reminisce memories, encourage him to ask God to continue to heal him, and guide him through what is to expect each day. Sometimes I dance sometimes my fiancé brings up the guitar to play him. All I know is that I have to trust Gods plan & not give up. It’s been a month & a half and he’s still here, I do believe in miracles. I know it’s going to be a long tough recovery if he continues to make it. But I have faith. Also what REALLY helps me is watching Near Death Experience stories especially this TV Show called “I Survived Beyond and Back” (currently on Hulu). It lead me down a rabbit hole of many many more documentaries on Near Death Experiences and they all help me because almost every single experience is similar! Most everyone experienced a heavenly loving warming light. Almost everyone who came back can’t wait to die again! It’s brought me peace knowing that God does indeed exist & love us, no matter what faith you hold. I prayed with my grandpa nightly before this happened, so I know he has welcomed God into his heart & I will continue to pray for God to heal him.

My husband is on life support they are checking his brain to see if he is brain dead is there hope or not thank you Peggy potts

My uncle went into cardiac arrest 3 days ago he’s been in a coma for 3 days now they telling us to pull the plug what should we do?

My dad went into Cardiac arrest Tuesday October 18, 2022. My fiancee gave him cpr and on the fourth try he start breathing. Hes on ventilator, but they take off ventilator for 6 hours and then get put back on there. We ask was does that make his lungs strong, they said not necessarily. He has open and sometimes he lift his hands, and when they changed tubes or him back on machine, he kick his leg. But I think it might be involuntary. I'm very happy that he can breathe on his own, kidneys are good, no seizures, vital signs are good. But we need that contact and command from him.

my husband went thur a cardiac arest july 7 2023 bout a month ago he is 72 years the Doctors did not think my husband would pull thur like he is they said his kdneys failed they bounced back they said he wouldnt have no more reflects and he do he finally got off the ventilator about 2weeks ago i had to intervin because the hospital staff was so stuck on my husabnd had to respond to medical staff which was not goin to happen he would only respond to me i finally talked to the ICU DR, and convinced the DR to give my husband a chance to breathe on his own and he did the first time the DR were really stumped as my husbands recovery due to the fact of my husbands age everything the DR s said that would happen or nit happen was the complete oppisite all postives out comes I learned something so very valuable thur all this not everyone is the same or recovers the same the DRS dont have the final outcomes and they are so very negative they have all the answers when it comes to the negative outcomes but when you ask about the positive outcomes the answer always is they do not know remember always GOD has the final say GOD is the one that pulled and still pulling my husband thur and a very positive outcome

In the last week of June, my 85 year old Mom, a heart patient, started complaining about severe shoulder and neck pains, but no one took her seriously because she was arthritic and always in some sort of pain. On the morning of June 28, she collapsed and went into unconsciousness. This happened in a third world country, so it took maybe about two hours to get her to a local hospital, still in an unconscious state. She was given oxygen and blood test, were taken. Blood pressure was elevated, so she was treated intravenously. CT scan showed no brain damage, but she was said to be in a coma. A feeding tube was inserted into her stomach through her nose, where she was given liquid nutrients. She remained in that state for a little over four weeks, but she was breathing on her own. We kept and oximeter nearby to check her blood oxygen saturation level often. Doctor advised us to take her home and keep her clean and comfortable. After about four days at home, on July 31st, August, sadly she passed away.

Urgent. My husband had cardiac arrest 7 days ago is on a ventilator and unresponsive. He has had seizure. Injury of brain is at the high vertex involving the parietal occipital lobes, cortical increased flair and abnormal increased dwi signal with restricted diffusion within the bilateral occipital lobes…..diffuse hypoxic ischemic injury. …help I think they will recommend shutting off ventilator….june 6, 2020. Is there any hope.

My sister is 25 she had an asthma attack we don’t exactly how long she was out no more than 30 mins her heart stopped they brought her back she she was rushed to hospital were her heart stopped two more times. She in an induced coma they did a catscan and no damage. How likely she can wake up?

Seven days ago my fifty year old husband suffered a stroke the ambulance took him to our small hospital where he stayed in the er till next morning then transferred 70 miles to Olympia five days after stroke he was blinking to answer questions and getting some small movements to left side that nite he had several tias & a seizure on sixth morning on the afternoon of eight day they said he would not recover so intubation tube removed and now on comfort care i cannot go up to visit because first hospital tested him for Covid positive although he’s not had any symptoms. So I’m now waiting for him to be minutes from dying or twenty days quarantine to go to his bed side . There has been no change in his vitals since life support was terminated he is being fed intravenously and kept sedated. I feel completely at a loss as to how denial of all visitation rights not even my voice on a zoom call to reassure him is going to prevent the spread of Covid ?? And getting one visit thru a glass window with a speaker to speak to him prior to the last good bie where you get to go in the room for one hour or less and hold him kiss him and tell him you love him and then you cannot return to hospital you must go home and quarantine cause eleven days ago he rapid tested positive and they never retested him again after seven days

My 45 year old daughter had a stroke on 5th January 2022 with massive brain bleed the operation went well but she's still not opened her eyes she only moved once on command hospital are doing MRI this week then discuss what to do ventilator is helping her breath 30 per cent the other 70 is herself they said about machine being turned off im scared not sure what to do .

Hello, my sister had a rupture aneurysm on January 24, 2022. After surgery, she is pretty much in the same condition as your daughter. I wanted to know what happened to your daughter? Is she awake? any deficits? Please let me know.

On 12/08/21 My 26 year old son got a anoxic brain injury because he had cardiac arrest and they don't know how long his brain was without oxygen.... Today he opened his eyes and blinks .. I talk to him to reassure him he's ok and where he is at. I know everyone is different but how long before other people woke up .. and to what extent?

Eg

My partner had a week in hospital where he was placed in an induced coma due to sepsis arising from liver disease. He appeared to be in a wakeful state when he was brought out of the coma, around 24 hours afterwards. His facial expression had changed from a peaceful sleep to slightly agitated, and he made minimal movements as if a bit restless. His eyes were strangely half-open all day, showing the whites, rather than becoming completely open. And that evening he started being sick over his shoulder, as if cognisant of the fact he must not be sick on his himself or choke. I was told this was a good sign, showing his brain stem was functional. The nurses had to clean him up repeatedly because he was sick (bringing up protein they had fed him through a tube into his stomach, and they syringed the liquid out and then removed the tube, stopping him from being sick again. His eyes were then closed, but the nurses told me he moved his head to one side repeatedly when they cleaned him up, as if they were concerned something had happened to him to cause that. My question is - when his eyes were half open, and he did not communicate, what does that mean about consciousness? There is no mention of ‘half-open’ on the Glasgow Coma Scale. Secondly, if he was able to judge to be sick over his shoulder, does that mean he was minimally conscious or still in a vegetative state? He hd to make a considerable turn of his body to achieve this. Lastly, slightly off topic - i have read that vomiting is sometimes a symptom of brain haemorrhage (which he died from, the nurses being rightly concerned about his head movement after cleaning). Might it have been that he was haemorrhaging much earlier in the day - hence his frown - and then being sick as a consequence? Or was it more likely it happened that evening, immediately prompting him to vomit? I am trying to understand how someone in a vegatitive state would likely react in a delayed or an immediate way, because I still have no answers into how the brain bleed occurred.

My cousin had a stroke five months ago when he was being taken to the hospital he was talking but when in hospital he went into coma. Now after five months he’s off oxygen his eyes are open for a brief time. I talk to him when i visit him sometimes i ask him to move his eyes and he does. I have no faith in the doctor or the nurses we can’t afford a good place. I just wonder if anyone has similar experience. I have confidence he will get thru this but I don’t have the patience because there’s no time. Is my cousin can wake up in a month five months that’s what gets me anxious.

This was very helpful. Thanks for the thoughtful and informative writing. Much appreciated.

Can anyone perhaps share their story or loved ones story with me if similar please.
Loved one 5 months post stroke thrombectomy and still has not opened his eyes, whilst he is responding to simple commands and gestures, speech is unrecognisable. Long term prognosis I do not know.

My spouse had a stroke little over two yes ago, she was in ICU for about a month. She was in a coma and now minimally conscious. She was fairly young at the time, 37, what are we looking at now? I'm hoping some change but nothing seems to change. Seems to be very little solid info on this.

I am in a similar situation with my husband, only thing is it’s been close to 2 months not 2 years. My family is devastated we have two adult daughters and a granddaughter both are under 30 he said for the brainstem stroke and the doctors have not said anything that I really want to hear at this point he is in an unconscious state I’m losing my mind today January 17 is his 60th birthday he’s been like this since December 7.

Hello to everyone. I am Alex from Athens, Greece. On September 5th my 84 year old father fell from the stairs in a resort and was severely injured. The MRi showed a very severe brain injury with multiple bleeds and a big strain at the right part of the brain. He fell in a coma immediately after the fall (GCS 3). They kept him 2,5 months in the ICU and his prognosis was very poor mostly because of his age. When he came around from suppression he entered a vegetative state with eye opening only and no other reaction. After 3 months in the hospital we moved him to a rehabilitation center and four two months he still had no reactions but the eye-opening and a reaction to pain. Then in the end of January he started moving his right hand and he has an overall better mobility at legs. But this mobility is reflexive since he hasn t yet regained consciousness... Today we are closing seven months from his accident... Has anyone had a similar case? Did your person regained consciousness? Thank you

Hi Alex, My partner fell into a cardiac arrest 5 years ago and was resuscitated with adrenaline. He came back to life but he came back in a vegetative state. He has been unconscious for 5 years now being kept alive by tube by his parents. We had small things happen at the start but he has never progressed and now I am pushing to end his life. In my opinion and my journey, It is worth letting them go and pass over. The discord in the families and the burden it becomes on your life is something I am sure they would not have wished for. It a terribly complicated situation - but it has been 5 years and no change.

Hello to everyone. I am Alex from Athens, Greece. On September 5th my 84 year old father fell from the stairs in a resort and was severely injured. The MRi showed a very severe brain injury with multiple bleeds and a big strain at the right part of the brain. He fell in a coma immediately after the fall (GCS 3). They kept him 2,5 months in the ICU and his prognosis was very poor mostly because of his age. When he came around from suppression he entered a vegetative state with eye opening only and no other reaction. After 3 months in the hospital we moved him to a rehabilitation center and four two months he still had no reactions but the eye-opening and a reaction to pain. Then in the end of January he started moving his right hand and he has an overall better mobility at legs. But this mobility is reflexive since he hasn t yet regained consciousness... Today we are closing seven months from his accident... Has anyone had a similar case? Did your person regained consciousness? Thank you

My mother fell hit her head on fireplace stone. Massive brain bleed & they had to open her head to try & drain & stop the bleeding & swelling. She also suffered several strokes. Don't give my mother 76. It took her a year to start to read again. Not always but does she said it comes & goes. She was not able on her own to move her left side not 1 1/2 years since she's woken up she's moving her arm as of this past week! Doctors said it wouldn't happen after 6 months but it is now. She's slowly starting to move her toes. Her mind seems clearer as she goes .& she's remembering things more & more thought sometimes she starts to back slide asking something when you correct her she then remembers and corrects you. So don't give up. My hope u shell walk again.

My mom is currently in a vegetative state due to going into cardiac arrest and lack of oxygen. Doctors are telling us she has severe brain damage and is in a vegetative state. Lately when we see her we talk to her and hold and rub her hands and legs sometimes she opens her eyes and moves a little bit today my aunt said she lifted up and opened her eyes as if she was trying to get up I just want to know does that mean she's conscious in any way? The doctors said its from seizures but I'd like a second opinion.

I experienced the same with my partner who is now 5 years on in a persistent vegetative state. They can moan, wiggle a bit, cry, dribble, and make sounds maybe move there eyes but no one is home. As hard as it can be and what a test of hope and faith these states are! They are better off passing over. The heavy burden it becomes on your heart
and loved ones is not worth it.

Hi, the drs have said my mom is currently in a vegetive state after going into cardiac arrest as well. Her husband believes she’s at least minimally conscious. With Covid restrictions I’m not able to be there, where you able to get any clarity or are the drs right? TIA. -DS

My mom yust passed away July 14 this year 2020 on mger strouck I yust wunder I was talking to my mom on the phone told her I loved her and so on I wunder if she can hear me it yust gives me peace if I know thank you

My father had a brain tumor in the 70's..After surgery to try and remove it, a few days later he went into a coma..About 20 minutes before he passed away, i asked him if he could hear me, to squeeze my hand, which he did.

My niece is in somewhat of a coma after being overdosed before getting surgery to remove fluid from Brain well she reacts when we change her diaper or tickle her feet or even if I accidentally touch her with my hands cold she jumps or reacts but has no movement of eyes it will be a year on Friday June 5th what stage would she be considered under I have been reading up on so much but I’m not sure what she maybe.

Two and a half years ago, my dear friend (since 6th grade) and college roommate Nicky was a 2.5 on the Glasgow Scale following a heart attack and/or aspiration pneumonia in his sleep. He was in a coma for multiple weeks, then a nursing home for several months while we waited to see how his brain would respond. He still has some hearing trouble in his left ear, but that is the only noticable difference, at least to us. I couldn't be more grateful to tell you he is about 95% the same person he was before the ABI.

We didn't find much hope online for people with his prognosis...It happened in July 2017, and by August we were realistically expecting an indefinite vegetative state pinning all of our longshot hopes on stem cell advancements/legislation. The overwhelming love and support he received from his friends and family transcended the bleakness of modern medicine and the biophysical world, then Nickys brain did the rest...with plenty of help from a bunch of great (and a few god awful) medical professionals. Godpeed, and much love!

Wow that is amazing and I'm so glad your friend is on the road to recovery!

Sadly, my brother, who is 53, suffered an Atrial Fibrillation of the heart, which in turn caused a series of massive strokes, causing damage to 60-70% to his brain. He suffered the strokes around the 17th of Aug 2020 and was not found until a week later. He was in ICU for a week and has now been moved into a normal ward.

His prognosis is catastrophic and the Doctors don't give him any hope of recovering.

His now in a vegetative state and reading your story about your friend, gives me some hope for a miracle and that is all we can pray and hope for now... Thank you for sharing your friend's story, god bless!

Dear Eric,
Thank you so much for sharing your story. Currently my family is facing a similar situation on brain damage with vegetative state. Your comments on stem cell advancement raise my interest. Would you be able to share with me some links where i could get more information about this?
Thank you in advance

Hello Eric Posthumus,

Thanks for sharing the story. I'm so sorry for you and friend to get through all this.

i like your story

Five years ago I was induced coma for eight days. Those eight days I was dreaming. I believe god kept me talking and fighting for my life. They thought for sure. I would have brain damaged. I didn’t woke up thinking they were trying to kill me. Before that in my dream I was looking for my daughter julie. I seen beautiful trees just a lot of people that cared. I believed it was god doing that I’m here today. Took a year for recovery still can’t walk well. But I never walk good for the past 10 years. So people please don’t give up on your love ones. They here you and the doctors and so much more. So Thankyou god and my family and dear friends that never gave up on me.

I hope this isnt a rude question but can i just ask if you were dreaming in the vegative state or just during the coma? if you can remember that is, just looking for some comfort that my brother in law isnt suffering while he thrashes around/drools ect. it looks like agony, i hope his brain is protecting itself with something nice. it seems to be a very different situation though, he will most likely not fully recover. i pray every day that he even gets a little back, or passes away. nobody deserves to be stuck in-between.

My friend is beginning stages of waking from an induced coma. He was on his motorcycle and went to pass several cars, when one of them decided to turn left. He was traveling estimated 120mph when he hit the car that was turning. He flew through the air around 40 ft. He hit the ground before flying another 20 ft into a wall of railroad cross ties. That impact tossed him straight up into the air about 10 ft and then he landed on the gravel. This was April 8th, this year, 2021. And it was 2 days ago April 18th that he responded to the nurses commands and they removed his ventilator. He has opened his eyes a couple of times but not anything recent. He suffers a small brain injury, 5 broken ribs, a broken hip, broken ankle and finger. He also had a collapsed lung and a condition that causes the skin to separate and peel off from the muscle due to trauma. All odds have been against him. His motorcycle is unrecognizable. The motor was ripped from the frame. He should not be alive. But this is what I know without question. He has had the support and prayers from his friends and family throughout this process. The shear will and determination from all of us who love and care for him. Not giving up. Not believing there's a chance he won't pull through. This is the reason my friend is still here. You have to want it, feel them healed, and know it in your heart. I know my friend has a very long road ahead of him. But I know God isn't finished with him yet. I hope he will be here to share his story with you one day. Don't ever give up hope in what God can do. And when he doesn't provide you with what you desire. Know that he has a greater plan for us all. And have faith. May he bless each and everyone of you hear and your loved one. May they heal or end their suffering to be with him. And may your hearts be healed and blessed for those who's lives have been taken for his purpose. Amen.

My 19 year old diabetic niece was admitted to the hospital for severe pain. The next morning, the nurse found her in seizures and shortly after she went into a coma for a few weeks. It's been 1 year and 3 months since she's been in a vegetative state. She's been reacting to pain (won't let anyone straighten her fingers or hands), and cries when they're trying to find a vein for blood tests. She raises her neck off of the pillow for a few minutes, moves her legs and hands, smiles, stares at the screen when her favorite Kpop group is on. Unfortunately, she does not respond to any commands. She's had intense physical therapy in the first 4 months, but they gave up on her. She is now in a nursing home. She has a feeding tube and trach. We're still hoping that somehow she pulls through.

BLESS YOUR HEART. FKRVTAKING CARE BASICALLY . ALL DOC.. PROGNOSIS. ENDS LIKE THAT I DONT KNOW WHY?? DOCTORS HARDLY SHOW ANY COMPASSION THESE DAYS..AT TIMES YOU ARE BETTER DOCTOR THAN THEM

My son is 37 in same shape responds to pain hears us and blinks his eyes when we ask him if he knows us he's posturing a lot and they took away his therapy I'm not giving up either so hang in there

Hi
My sister is exactly the same

Two and a half years ago, my dear friend (since 6th grade) and college roommate Nicky Quayles was a 2.5 on the Glasgow Scale following a heart attack and/or aspiration pneumonia in his sleep. He was in a coma for multiple weeks, then a nursing home for several months while we waited to see how his brain would respond. He still has some hearing trouble in his left ear, but that is the only noticable difference, at least to us. I couldn't be more grateful to tell you he is about 95% the same person he was before the ABI.

We didn't find much hope online for people with his prognosis...It happened in July 2017, and by August we were realistically expecting an indefinite vegetative state pinning all of our longshot hopes on stem cell advancements/legislation. The overwhelming love and support he received from his friends and family transcended the bleakness of modern medicine and the biophysical world, then Nickys brain did the rest...with plenty of help from a bunch of great (and a few god awful) medical professionals. Godpeed, and much love!

My mother suffered a stroke almost 2 yrs ago and was responsive when brought into the ER so much so that we left the hospital for a little bit to go home. Just as we reached home, we received a call from the hospital that she was om distress due to the accumulation of blood in her head. Since her health was too precarious to perform surgery they gave her medication which reduced the clots. When we got to the hospital and she was put in ICU and intubated. My mother was still aware at this point and able to follow commands. She was intubated for 7 days and they said that they were going remove it because she couldnt be with it for too long. When they tried to take it out it caused her distress so they said that at this point that a trach was needed. They explained that it didnt need to be a permanent thing but that it would help her breath and that if she did well further down the line they would be able to do away with the trach. Well this was the beginning of out nightmare. We let them perform the tracheostomy (sp?) and all went well so much so that when she came out of sedation she was fighting with the nurses but as time went on I noticed that she was sleeping alot. I mentioned this to the doctors and they said it was the effect of the anesthesia. I still felt uncomfortable so I mentioned it to the nurse who also thought that it was strange. My gut feelings were right, she suffered a stroke after surgery which the doctors were not able to catch. They said that she was in a coma and that we had to make life changing decisions. They basically were saying that she was vegetable and that there was nothing to be gained from continuing her care. Although we dont always get along as a whole my siblings and I all came to the agreement that we would not accept the doctors diagnosis. We tried to change her to a better hospital but her situation was so precarious no hospital was willing to take her. We were forced to give her a feeding tube and transfer her to a (SNF). She is currently at a really good facility that has amazing staff. While she still has a trach and is unable to care for herself, she is able to watch tv, move one of her legs when I'm massaging it and look at people. They have tried to wean her off the vent but she gets to a certain point where she goes into distress and is unable to tolerate it so they end up putting her back on 100% assistance. We have explained to the doctors that we have to find a happy medium where she is able to tolerate breathing on her own in increments. Some of these doctors are all or nothing, its either black or white for them no in between. The doctors also say that she is unresponsive when they visit her, meanwhile they come in for like 5 mins and make a prognosis. When guests have visited my mom she squeezes their hand or cries. I want to know if I'm being unrealistic. I know that she will never be the same but I refuse to deprive my mother of care because they have given up on her. I still have faith and belief in miracles. Has someone been in a similar situation with words of advice.

Hopefully by this time all is very well with your mother's recovery. My aunt had suffered from an aneurysm then a similar fashion as your mother. After the surgery, she was coherent and talkative then the strokes occurred and now she sleeps. Her eyes open and close and also had a trichotomy for her to breath due to the fluid build up. We are scared as to her situation, she suffered 5 strokes and still at times open her eyes. Due to the covid scenario, we can't even visit to speak with her. It's heartbreaking because we can't see her. Your story was uplifting to her how your family found the care that was needed. Is there any advice you can give from your personal experience?

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