Woman wakes up after being in a coma for a year and a half – 04/25/2023 – Equilibrium

In November 2021, Isabel Cardoso underwent elective surgery – an aesthetic procedure on the breast after the removal of a tumor, which later proved to be benign, but which took a small part of her breast, something that bothered her.

Post-op, Isabel suffered from a lack of oxygen, something her husband, Luciano Bueno, says he’s not sure how it happened.

The lack of oxygen in the brain, also known as cerebral hypoxia, can cause serious and irreversible damage to cells within minutes, as the brain is a highly sensitive organ and depends on a constant supply of oxygen and nutrients to function.

The loss of oxygen flow can cause neurological problems such as loss of memory and motor coordination, difficulty concentrating, convulsions and coma – exactly what happened to Isabel.

“In the following days, she had several seizures and had to be put into an induced coma so that the drugs could control the seizures. But when those drugs were withdrawn, which is the time to see how the patient reacts, nothing happened. She was totally sleeping, sometimes she opened her eyes, but it was what doctors call a non-contacting eye opening – we didn’t even know if she could see”, says her husband.

At the time, Isabel was 45 and Luciano, 43. They had been married for almost 15 years and were waiting in the adoption queue for the opportunity to have a son or daughter.

“We had a planned life, dreams of doing many things together. The first moment was a shock, but my expectation was that she would wake up from the induced coma and that we would go home together, resuming life little by little. When she didn’t come back, it was that I really thought, ‘My God, what now?'”

Luciano says that the doctors gradually explained Isabel’s difficult prognosis – the more time that passed, the lesser the chances of her returning to her former self.

The chances of recovery for a person who has been in a coma for more than a year are relatively low. According to a study published in the scientific journal Neurology in 2019, the recovery rate after a year of coma was around 4%.

Neurologist Amauri Araújo Godinho, who did not follow Isabel’s case, explains that the low expectation is precisely due to the severity of the brain injuries caused by the lack of oxygen in the brain.

“There are very sensitive brain areas, especially autonomic functions, when damaged, permanent sequelae. A condition in which the patient opens his eyes in a non-contacting way, is a state of vegetative state, normally we do not see improvement in these patients. I would never say to a family create an expectation that that patient”, points out the doctor, who works at Hospital Santa Lúcia, in Brasília.

In children, according to the neurologist, although it is not yet guaranteed, recovery is slightly more common due to neuroplasticity – the ability of a child’s brain to change its structure and function in response to stimuli and experiences during the process. of brain development.

“In these cases, other areas of the brain can take over the function of those that were damaged.”

The team also informed Luciano that he would have to take his wife home, adapting the home to serve as “home care”, with the assistance that Isabel needed.

“It was more of a blow, because I thought she would stay there in the hospital until she got better. I couldn’t understand, at first, the benefits she could have at home, but after a lot of research, I understood that the hospital is inhospitable for someone in the position Isa, with fragile health.”

By working in his own company, in which he shares the partnership with his brother, Luciano was able to take time off to take care of his wife.

Even though Isabel was being well assisted, a bedridden patient, in general, has more fragile health. This made her need recurrent hospitalizations.

“Flu, for us, is not the same thing for a patient in her condition. Isa was hospitalized to treat respiratory conditions, thrombosis… It always took 15 or 20 days to solve each specific problem”, recalls Luciano.

‘I was told the condition was irreversible’

The team also informed Luciano that he would have to take his wife home, adapting the home to serve as “home care”, with the assistance that Isabel needed.

“It was more of a blow, because I thought she would stay there in the hospital until she got better. I couldn’t understand, at first, the benefits she could have at home, but after a lot of research, I understood that the hospital is inhospitable for someone in the position Isa, with fragile health.”

By working in his own company, in which he shares the partnership with his brother, Luciano was able to take time off to take care of his wife.

Even though Isabel was being well assisted, a bedridden patient, in general, has more fragile health. This made her need recurrent hospitalizations.

“Flu, for us, is not the same thing for a patient in her condition. Isa was hospitalized to treat respiratory conditions, thrombosis… It always took 15 or 20 days to solve each specific problem”, recalls Luciano.

“The doctor told me that the condition was definitive, that it is irreversible, right? He said that the chances of Isa actually waking up were 2%. I embraced that number and always joked that ‘while there’s bamboo, there’s an arrow’.”

Luciano says that he began “actively looking for that 2%”.

“I did extensive research on patients who had woken up from coma states. I looked through the scientific literature, but no case was similar to my wife’s.”

The ‘miracle of UTI 4’

In March of this year, Isabel had to be hospitalized to treat tracheobronchitis. During the period in the hospital, she began to have seizures and had to be taken to the ICU again.

Back in the recovery room, one of the nurses, who used to make frequent visits to Isabel’s room, wished her the usual “good morning”.

“When we saw her, Isa was moving her mouth. As she has a tracheostomy [a presença de um tubo na região da garganta], for the sound to come out you have to plug that little hole. We did so, and she was able to respond, even with great difficulty, say her name, and nod that she knew she was in the hospital. It was too exciting. I remembered at the time that the doctor gave us only a 2% chance, but my wife woke up”, says her husband.

More people from the team of doctors and nurses who had participated in Isabel’s treatment over the last year and a half were called into the room.

Gustavo Tarre, ICU coordinator at Hospital Marcelino Champagnat, in Curitiba, where Isabel stayed, says that the patient’s “awakening” was a surprise for everyone.

“I’ve never seen a case like hers. Some patients show progressive improvement after an induced coma, but hers was really surprising, because one day she was one way and the next day she woke up completely different.”

The doctor explains that it is not known what caused Isabel to interact again. According to him, no drug or therapy other than what she had already used in other hospitalizations was administered.

At the hospital, the case, rare even in the medical literature, came to be called the “miracle of ICU 4”, in reference to the number of the treatment unit where Isabel stayed most of the time.

Elizabeth’s recovery

The improbable evolution rekindled Luciano’s hope in his wife’s recovery, even if the path is difficult.

The husband says that she has small actions that indicate that at least part of her memory remains intact, despite the neurological damage. She remembers her name, is moved to see family members, but seems to have no memories of the couple’s dog, adopted shortly before the episode that led to her coma.

“Despite the surprising gain, it still cannot be said that it has recovered because it still has many sequels. Because it still has a lot of sequels. He still has a lot to do,” says Tarre.

The treatment, done at home, consists of speech therapy and physiotherapy sessions, as well as follow-up with a psychiatrist.

While Isabel continues to seek recovery, Luciano says he keeps her as comfortable as possible, including with herself. “I schedule sessions with a podiatrist, which is something she has always needed, as well as professionals to do her hair, I moisturize her skin… I think maintaining her self-esteem is important for her.”

“It’s one step at a time, one day at a time. But now I know that she’s there, that she listens to me and, even with limitations, manages to interact. It’s something that fills me with hope”, he adds.

This text was published here