From Coma to Emerging Consciousness

Sam’s Medical Status:  I had a friend email me today about Sam.  She was a little confused because I sometimes talk about him being “asleep” and “awake”.  Another order of confusion is in the Glasgow Coma Scale which says that 3 to 8 on the scale is a coma and 9 to 15 is not (Sam is now an 11).  From what I’ve read about comas and/or recovering from a coma, one doesn’t usually just “wake up” from a coma like you see in the movies or on TV.  Recovery from a coma is a slow process as we’ve seen with Sam. 

It just so happened that on Monday evening Erin called me and said the doctors at the VA hospital told her they don’t consider Sam to be in a “Coma” anymore but in a “state of emerging consciousness”.  I’m not sure if this is a clinical term or not but they did tell her this was a significant landmark in his recovery.  So, from this point, I won’t speak of Sam being in a Coma.  It will make more sense when I talk about him being “awake” and “asleep”.

Once a patient gets above an 8 on the Glasgow Coma Scale, the numbers become less and less useful.  There is another scale that is used to track the progress of patients who have previously been in a coma—it’s called the Rancho Los Amigos Scale or Rancho Scale for short.  I saw an explanation of this scale at one of the nurses stations at the VA hospital, so for now, I’m assuming they will be using the Rancho Scale to track Sam’s progress.  I’ll research the Rancho Scale a little further give you Sam’s current status. 

Tuesday afternoon I spoke to Erin and she gave me an update on the latest little miracles—My parents went to Palo Alto to drop off some cloths for my wife and also all of Sam and Erin’s Harry Potter books.  Erin said she was reading the first book to Sam yesterday morning and would stop every now and then to ask him, “if you want me to keep reading, blink your eyes”—and he blinked away.  She asked him this question a few different times as she was reading, and every time he would blink a couple of times to make her continue.   

Erin said Sam is also starting to move his arms a little.  As my parents left this morning, he waved at them and even lifted up his forearm a little bit.  Previously he was only able to move his fingers and wrist a little bit.  Erin said, this morning Sam was really becoming more and more animated with his facial expressions, so you could really tell if he was in pain or happy.  

Visitors to the VA Hospital to see Sam:  A few of you have emailed that you are getting excited about coming to see Sam and want more information on when you can visit.  I’m still in the process of gathering information, so please give me a little more time.  I would say by next week, I can start coordinating visits from folks.  Here are a few tips on visiting Sam (I’m sure Erin will give me more later):

• It’s very important that Sam not receive too much stimulation at one time.
• Visitors need to remain calm and not make any loud noises.
• No one under the age of 16 is allowed in the room.
• Gowns and gloves are still required at this time (mask are no longer needed).
• Most visits will probably be scheduled with 2 to 3 people at a time.
• The best time to visit Sam is (roughly) between the hours of 10:00 AM and noon in the morning.  Other time frames can be worked out if needed.

It will be good for Sam to receive visitors and Erin is exciting about people coming to see them.  But, as I said, it needs to be done in a way that will not create too much stimulation for Sam.  Keep in mind that even though he is now considered out of the coma, he still has a tracheotomy tube, he has two large wounds on his right calf and thigh that are normally exposed so they get fresh air (the wounds really look good by the way, but are still a little scary when you first see them), and most importantly, Sam isn’t at a point where he can recognize most people—so he’s not going to react when you come into the room.  That can be a little disconcerting and scary, so please be ready.  He does pretty good at recognizing Erin’s voice and even tracks her with his eyes when he’s really awake and fresh, but normally he stays pretty still. 

 
Click on “Palo Alto VA Hospital” at the on top of this blog menu to get directions to the VA hospital.