13 Year old gir declared brain dead has now officially died

[Pea-n-Me]

This is an old article (12/18) but interesting, it talks about the Family suctioning the blood on their own in the ICU. I know Jahi's grandmother is a nurse, but really? Can suctioning cause more bleeding if not properly performed? Pea???

http://www.nbcbayarea.com/news/local/Oakland-8th-Grader-Brain-Dead-After-236015681.html

Apologies, if this was already discussed upthread. I didn't see it.

If someone is choking on blood, there is really no choice but to suction it out of the airway. I can't say for sure, but from what I've read her surgical area, i.e. the part that could have been bleeding, was fairly large, since it wasn't just tonsils that were removed, but adenoids and excess tissue along the airways deep inside as well. (The hospital has referred to it as "complex" surgery.) I mean, sure, you can do some tissue damage if you suction roughly, but in a situation where someone is profusely bleeding and perhaps the patient and family members are flailing (or in this case, a family member was suctioning??), you do the best you can. I doubt the suctioning would be the biggest problem, though; it would be the surgical area itself. As others have said, an emergent return to the OR would be warranted asap. It is hard to say what happened there, according to the family's perspective. Profuse bleeding would be an emergency anywhere. In all likelihood, a Code, or at least a Rapid Response, would be called to get help onboard right away. As I said before, medical records, especially electronic ones, should tell the story. It is so unclear from these articles. It seems she was taken to the ICU instead of the OR. And at what point was the cardiac arrest - did she cardiac arrest first and then bleed, or did she bleed and then cardiac arrest? There is no way to know - at least from the many articles that I've sorted through about the case.

At any rate, heartbreaking however it happened. I'm sure she must have been frightened. And her family (and staff involved) will relive those moments forever.

 

[Mouse House Mama]

While I completely respect your personal choice, I think you hit the nail on the head when you said you've never considered the money aspect and you will just "figure it out". That's a big problem actually because whether you are privately insured, on medicare, medicaid, union insurance or whatever, SOMEONE is ponying up the money through higher premiums or taxes to cover something that goes beyond a normal standard of care, (because you would be technically deceased if you met the legal definition for "brain dead"). Are you really comfortable with someone else subsidizing your own personal choice of "hoping for a miracle"? What if your choice is putting undue hardship on someone else financially? Because that is what would happen if we all decided to hope to be that one miracle. Can you imagine what would happen to healthcare costs?

I'm not trying to be unkind, but I feel very strongly about this subject. I support anyone's right to choose whether they want to choose life support, however, I do think that they should be willing to have either the long term insurance in place or the available cash resources to cover it.

The money comes from me and everyone else who pays insurance and/or taxes unless "you" have a financial plan to pay all the bills without our assistance.

While I do agree with you both that I would not want to burden anyone. Taxpayers, family etc. BUT- what about all the people who are currently "taxing" the healthcare system because of their poor life choices? What about the alcoholic who ruined their liver and kidneys? Should we not pay for dialysis? Or what about weight loss surgery and the follow up surgeries? Should we pay for those people's choices? In both scenarios those people will both die without treatment. Now before anyone starts flaming I just picked those 2 dx of the top of my head. There are tons of others. Those "illnesses" cost money also. Who gets to decide who is worth "saving?" Now I get the whole brain dead argument but in either scenario the person will die. Of course being brain dead isn't a hugely hopeful dx but either way the outcome will be the same. I don't know what the answer is but how do we decide who gets to live and who doesn't?

 

[DisneyJamieCA]

While I do agree with you both that I would not want to burden anyone. Taxpayers, family etc. BUT- what about all the people who are currently "taxing" the healthcare system because of their poor life choices? What about the alcoholic who ruined their liver and kidneys? Should we not pay for dialysis? Or what about weight loss surgery and the follow up surgeries? Should we pay for those people's choices? In both scenarios those people will both die without treatment. Now before anyone starts flaming I just picked those 2 dx of the top of my head. There are tons of others. Those "illnesses" cost money also. Who gets to decide who is worth "saving?" Now I get the whole brain dead argument but in either scenario the person will die. Of course being brain dead isn't a hugely hopeful dx but either way the outcome will be the same. I don't know what the answer is but how do we decide who gets to live and who doesn't?

You are comparing apples to oranges. In your examples there is something that can be done to help save their lives. In this case, they did everything they could and there is nothing left to do. They are paying to keep a dead body warm. Yes, that is harsh, but it is the truth. If there was some life saving surgery for her of course the doctors would do it. But there isn't.

Somebody else asked why it would matter to us if this goes on - as far as her body, I don't know so I've stayed out of that part, but from a purely logical standpoint it is wasting (again a harsh word in this case, but true) a bed, resources, court time, money; not to mention the emotional and physical toll on the hospital staff.

If there was anything that could be done for this little girl or any shred of hope of recovery, I think everybody here would understand the family exhausting every last possibility and cheering them on. However that isn't the case. She is not going to get better.

 

[RockAndRollBallerina]

In my opinion it is because most families don't go to the media, couple that with the type of surgery that the girl had and her age and it is a Media free for all and the family and their attorney keep feeding the the Media.

This, normal people don't run to the media just because something hasn't gone their way, or when something tragic happens to a family member. They handle the problem, or issue like adults instead of going to get national attention for it.
I can only imagine the pain and suffering this family is going through, but running to the press was not a path they should have taken in this case. Unfortunately, they did, and now have significantly more weight on their shoulders than just their daughter who no technically is no longer living. I can't see why any family would want to be dealing with the press during a time like this.

 

[DisneyFan32WI]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

This quote from the mother is absolutely ridiculous:
"To watch my daughter just sit there and not have food ... I'm just so happy that she is kind of a thick girl so she still looks good," Nailah Winkfield told ABC’s "Good Morning America." "I tell her every day, 'Jahi, you losin' weight girl, but you still look good.' I just think it's inhumane to not feed my child, to not refer to her by her name, and stop us in our tracks."

Read more: http://www.nydailynews.com/news/nat...spital-mother-article-1.1563261#ixzz2pAx0fGBe

 

[DisneyJamieCA]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

Without knowing what the family was told re: complications, risk, how it would help (did she need it because she wasn't breathing at night for example) I can't answer.

 

[Pea-n-Me]

I started to write my last two responses a couple of hours ago, but was interrupted. Sorry if they seemed a bit out of place given the more recent posts.

But in regard to those, all I'll say is, it's no picnic being on a vent (people often pull them out themselves and refuse to have them put back in, it's so unpleasant). And of course, living with a trach and/or a feeding tube, confined to a bed with little brain function is at best, very difficult as well. (Imagine not being able to turn if you're uncomfortable, or being unable to scratch an itch, or being cared for round the clock by various people and personalities, your most private of functions and needs being tended to by others, etc.) Most people would not want that. I have a Living Will in place and have left word with the people I've appointed as my Health Care Proxies, one of whom is a nurse with a level of understanding of complex medical issues similar to my own, that I am willing to put in a good fight, primarily so my children won't lose their mother, but if it comes down to languishing with little purpose on life support indefinitely, no way. I trust that those decisions will be made in good faith and honored if and when the time ever comes. I review it with the nurse periodically.

I actually meant to post earlier that I wondered what Jahi herself would want here, if she understood the facts in a realistic way. I don't think it's too early to discuss with our children in a general way what their wishes would be should anything like that happen. That way there is some level of comfort should decisions have to be made.

When I had to make the decision to take my family member off of life support, I was fortunate in that just days before, after she'd had an accident, she'd made her wishes known to me. The thing that helped me the most during my pastoral support was the hospital chaplain telling me that she had given me a great gift of telling me what her desires were. It was so true, and really what got me through it. But even with all of my medical experience, it was still eye opening at how difficult it was to be the one to make care decisions for another person.

 

[LiveYourLife]

I am probably going to get torched for saying this, but it's just my opinion and random thoughts. I think there are two different situations going on with Jahi's family:

1) As many have shared, I think Jahi's mother is being driven by feelings of denial and guilt (who can blame her, it is her child) to keep Jahi on death support and is praying for a resurrection (miracle) but medically that just is not going to happen. She cannot see through her feelings of denial and guilt to let Jahi go. This is where someone professional needs to step in and help her cope through these very dark days. She has been quoted recently expessing concerns that her daughter is not being fed, is starving, glad she is a "thick girl", and tells her daughter that she is losing weight, but still "looks good". Jahi's mother needs help.

2) I think the Uncle is fueling this media circus, along with the help of the opportunistic lawyer, and is being driven by $$$$$$$. Yes, I do think the Uncle is devastated to have lost his Niece, but at this point - he appears (based on FB posts, Twitter posts, IG posts, etc....) to have moved past the devastation. The longer Jahi is kept on death support, the longer the charade goes on. Which is just sad to not let Jahi rest in peace, and to be using her like this.

Separate from the Family, I also feel that this New Beginnings is using Jahi's story to gain financial backing and awareness of their facility. Based on the comment upthread about any negative posts on their site will be deleted and people would be banned for posting negative comments. That just screams being opportunistic to me.

Just my opinion, and a sad tragedy no matter how you look at it.

 

[DLgal]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

This quote from the mother is absolutely ridiculous:
"To watch my daughter just sit there and not have food ... I'm just so happy that she is kind of a thick girl so she still looks good," Nailah Winkfield told ABC’s "Good Morning America." "I tell her every day, 'Jahi, you losin' weight girl, but you still look good.' I just think it's inhumane to not feed my child, to not refer to her by her name, and stop us in our tracks."

Read more: http://www.nydailynews.com/news/national/brain-dead-jahi-mcmath-starving-california-hospital-mother-article-1.1563261#ixzz2pAx0fGBe

Okay, seriously? This woman is so far off the deep end it's ridiculous.

 

[lsyorke]

In my opinion it is because most families don't go to the media, couple that with the type of surgery that the girl had and her age and it is a Media free for all and the family and their attorney keep feeding the the Media.

Exactly. While the brain death designation is very hard for families, I don't know of one, in my practice, where they didn't remove life support within days.Now, removing life support in a non-brain death situation is much more complicated and usually results in considerable time and resources. This has turned into a circus, which is only prolonging this families pain.

 

[JanaDee]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

This quote from the mother is absolutely ridiculous:
"To watch my daughter just sit there and not have food ... I'm just so happy that she is kind of a thick girl so she still looks good," Nailah Winkfield told ABCs "Good Morning America." "I tell her every day, 'Jahi, you losin' weight girl, but you still look good.' I just think it's inhumane to not feed my child, to not refer to her by her name, and stop us in our tracks."

Read more: http://www.nydailynews.com/news/nat...spital-mother-article-1.1563261#ixzz2pAx0fGBe

I chose the same exact surgery for myself, and chose a tonsillectomy for sleep apnea for my 3 year old child.

I would make the same decision again.

 

[mnrose]

This is NOT life support. They are simply forcing the body, through mechanical measures, to continue doing specific tasks. There is no "life" left. The brain is dead. Gone. Not working any longer. There is nothing to have come back. The only reason there is anything that looks like "life" is because of the machines and fluids forcing the lungs to expand and the heart to beat. That is all.

As for your specific post, I really hope you have the financial means to do this independently. I believe that, once you are declared dead (by multiple doctors including independent ones like this case even), all finances must be provided by the family and must be paid before care is continued. Now, I am not talking traumatic brain injury or vegetative state. I am talking clinically brain dead. No life left to support. The hospital should not be "forced" to continue to support someone on their dime who is no longer alive. That is silly. That is not what hospitals are for. They are for the ill and injured who need medical help to stay alive.

I really think at this point that someone needs to step in and stop the insanity. Yes, the family is grieving and refusing to understand what has happened. I get that. Denial is part of the grieving process. The problem is, they are not in the right mind frame to make these decisions since they refuse to see and understand everything. In other words, they are not of sound mind and body.

I am sorry, but I find the fact this is still going on disgusting. There is no reason this child is being kept in this way still. The child is gone. Nothing will change that at this point. As harsh as it sounds, it is a body that is taking up resources that do nothing for it, cost a lot of money, and could better be used on someone who is still alive.

I 100% agree with everything you've said. This is the most hideous waste of resources I have ever seen. Not only the hospital, but the courts and lawyers. The money being spent is absurd.

I am sorry....very sorry....for this family, but this is NOT helping the situation. These are REAL (and I'm certain, TAXPAYER) dollars that could be spent in much better ways. This is not "free" care. The hospital is expending real dollars that could spent to actual provide medical care to living children.

At the micro level, I'm sure every person here would say "this isn't a problem....it's ONE case"...at the macro level, this sort of nonsense (pull out all stops to keep me alive) that helps contribute to our skyrocketing medical costs. We can't keep doing this. We just can't. In general, 80% of all the money spent on your medical care in your lifetime is spent in the last mnths of your life. This doesn't make a lot of sense! News flash: 100% of us are going to DIE....and we need to come to terms with that and get over out bad selves and not spend endless money to stave off something which will come anyway. Yes, if there is a reasonable chance of a good outcome and adding significant years to a person's life, sure, spend away. If there is not, let's all be rational and have some shred of dignity about our final days

 

[Pea-n-Me]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

I am one of those people that doesn't take surgery lightly. I wouldn't do it unless it was necessary. But if my child had a condition like sleep apnea and her quality of life was negatively affected, and surgery would correct at least some of that, then I suppose I would consent to it.

Further, my husband has had a similar surgery and it was necessary for his quality of life. One of the things I remember most is the surgeon talking to me post operatively was how close she was to his brain in some of the operative areas.

Last week my DD had an elective surgery (not taken lightly, but again, a quality of life issue) and let me tell you, news of this case kept me awake at night wondering about all those bad things that can go wrong. I wasn't relaxed until a) the surgeon came out to tell me all went well and b) I took her home.

My DS is having surgery in a few days, too. Not sleeping well thinking of it. (Hence posting at 3am.)

 

[DisneyFan32WI]

I only asked the question because I am also a worry wart over surgery (really high anxiety). I remember a doctor wanted to put tubes in my daughter's ears and I ran, not walked, away from that clinic! She eventually outgrew the ear infection thing, so I was happy with my decision. I thought I read that this wasn't just a routine surgery. I'll have to find where I saw that. If it wasn't a routine procedure, I don't think I would risk it.

 

[15isto2]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

This quote from the mother is absolutely ridiculous:
"To watch my daughter just sit there and not have food ... I'm just so happy that she is kind of a thick girl so she still looks good," Nailah Winkfield told ABC’s "Good Morning America." "I tell her every day, 'Jahi, you losin' weight girl, but you still look good.' I just think it's inhumane to not feed my child, to not refer to her by her name, and stop us in our tracks."

Read more: http://www.nydailynews.com/news/nat...spital-mother-article-1.1563261#ixzz2pAx0fGBe

Nope, I would have tried weight loss first which does not seem to be the case here, untill she died anyway

 

[mhfrau]

While I do agree with you both that I would not want to burden anyone. Taxpayers, family etc. BUT- what about all the people who are currently "taxing" the healthcare system because of their poor life choices? What about the alcoholic who ruined their liver and kidneys? Should we not pay for dialysis? Or what about weight loss surgery and the follow up surgeries? Should we pay for those people's choices? In both scenarios those people will both die without treatment. Now before anyone starts flaming I just picked those 2 dx of the top of my head. There are tons of others. Those "illnesses" cost money also. Who gets to decide who is worth "saving?" Now I get the whole brain dead argument but in either scenario the person will die. Of course being brain dead isn't a hugely hopeful dx but either way the outcome will be the same. I don't know what the answer is but how do we decide who gets to live and who doesn't?

The argument on "lifestyle choices" is a separate issue. Also, extremely healthy, fit people get diagnosed with cancer every day, so insurance covering any of those things is doing exactly what insurance is designed to do. My own mother inlaw has reached her lifetime limit of 2 million dollars treating her breast cancer since 1985. She is completely addicted to medical care and once tried to get her doctor to run a PSA because she had it in her mind that she needed it. Since she doesn't have a prostate, , they wouldn't do it, but I think she is a prime example of going overboard!

People pay into a pool and assume risk for other's health. That is the only way health insurance can work... everyone is contributing and some people utilize more, and some less. Somebody somewhere has to make a decision on cost versus reward, and that is what you are essentially agreeing to if you participate in insurance.

As far as who gets to decide who is "worth saving", well, I don't think it's as sinister as you are making it seem. Everyone has the option to decide if extraordinary measures are what they want, and if that is what is best for their family. Notice I said extraordinary. Something like weight loss surgery is not something that is performed to keep a person alive at that particular moment of time. BUT, if you have voiced ahead of time that you feel strongly about being kept on life support and want it in all circumstances, even if you think your only hope is a "miracle", then it seems irresponsible, (sorry, but it does), to then say that you've never thought of the costs involved and how your family is going to fulfill their financial obligations to provide that for you.

But in Jahi's case, she is not alive. And you know what? I truly believe that if she would get her Lazarus miracle like her mother is so desperately hoping for, then it wouldn't matter one little bit if her vent was shut down. If God is going to resurrect that child, he will do it no matter what.

 

[JanaDee]

Nope, I would have tried weight loss first which does not seem to be the case here, untill she died anyway

If you have large tonsils and/or adenoids, losing weight will not help the problem.

 

[gottaluvPluto]

Would you guys have chosen surgery for your child in this case? It was for sleep apnea, correct?

This quote from the mother is absolutely ridiculous:
"To watch my daughter just sit there and not have food ... I'm just so happy that she is kind of a thick girl so she still looks good," Nailah Winkfield told ABC’s "Good Morning America." "I tell her every day, 'Jahi, you losin' weight girl, but you still look good.' I just think it's inhumane to not feed my child, to not refer to her by her name, and stop us in our tracks."

Read more: http://www.nydailynews.com/news/nat...spital-mother-article-1.1563261#ixzz2pAx0fGBe

I would not do the surgery if my child was obese. I would help my child get healthy first.

 

[gottaluvPluto]

If you have large tonsils and/or adenoids, losing weight will not help the problem.

A friend of mine had a child with the above and he was obese. The mother helped him lose weight before the surgery. The family ate healthy and worked out 3 times a week. The boy lost weight and then had the surgery.

 

[sonnyjane]

I only asked the question because I am also a worry wart over surgery (really high anxiety). I remember a doctor wanted to put tubes in my daughter's ears and I ran, not walked, away from that clinic! She eventually outgrew the ear infection thing, so I was happy with my decision. I thought I read that this wasn't just a routine surgery. I'll have to find where I saw that. If it wasn't a routine procedure, I don't think I would risk it.

When I had to go in for my cancer surgery, I was very much aware that there could be complications. They said I would be under for at least 4 hours (it ended up being closer to 6). I'd only ever been under once before for wisdom teeth and didn't react well so I was nervous. When they came in to explain the process of putting me under, they said they would be back in a few minutes but would let me spend some time alone with my husband first. I was really kind of emotional! I started crying and telling him how much I loved him... Thinking that if this is the last time I ever see him I want to soak it in, etc. My husband shrugged it off to be reassuring and said he would see me soon, but it was very real in my mind. I can also completely understand how this family could have signed everything with the same level of consideration that most people sign consent forms when they go sky-diving, etc. sure it's a risk but you just assume it's no big deal so you skim over everything and sign, even though DEATH is a consequence.