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Bachophile - an opinion? Could Ariel Sharon be conscious?; If so, might he be "locked in"?
Topic Started: Jan 28 2013, 05:09 PM (477 Views)
Amanda
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I know his family has been clinging to hope for ages, but this is supposed to have been based on real medical testing. Do you think there's anything to it, bach? Or is he too far gone, as already determined by MRIs and whatnot?

The "locked in state" is my idea of a living hell. Sharon has been kept alive after a massive stroke seven years ago, during which he has shown no meaningful brain activity. If this has changed, it might mean he is "locked in". BRRR.

If he IS in a so-called "locked in state" - conscious but unable to communicate - some might conclude it would make up for all past wrong-doing for which he is held responsible. Reading up on Judaism about atonement recently, I was fascinated to learn that suffering on earth (even including the pain of death), is regarded as a significant source of atonement.

http://www.nytimes.com/2013/01/28/world/middleeast/ariel-sharon-brain-scan-shows-response-to-stimuli.html?

Edited by Amanda, Jan 29 2013, 09:27 AM.
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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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"Daily Telegraph", London July 27 2005
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Kincaid
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HOLY CARP!!!
I admit I didn't realize he was still alive.
Kincaid - disgusted Republican Partisan since 2006.
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Mikhailoh
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I was not either. And I totally agree - the locked in condition would surely lead me to madness in short order.
Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball
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VPG
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Ariel Sharon Coma: Brain Activity Shown In Tests Of Former Israel Prime Minister

JERUSALEM -- A team of Israeli and U.S. scientists say new tests on comatose former Prime Minister Ariel Sharon show significant brain activity.
Ben-Gurion University on Sunday said Sharon responded to external stimuli at Soroka Hospital in Beersheba.
He was shown pictures of his family and listened to recordings of his son's voice while undergoing a special brain imaging scan. The university said "significant brain activity was observed ... indicating appropriate processing of these stimulations."
However, Sharon remains in a deep coma.
Sharon, 84, led Israel from 2001 until suffering a stroke in 2006. Since then, he has been in a vegetative state, connected to a respirator.

Sharon was a storied military officer who fought in three wars before entering politics. He unilaterally withdrew Israeli troops and settlers from Gaza in 2005.

I'M NOT YELLING.........I'M ITALIAN...........THAT'S HOW WE TALK!


"People say that we're in a time when there are no heroes, they just don't know where to look."
Ronald Reagan, Inaugural, 1971

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Amanda
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VPG Your snippet of news about Sharon caught my attention - realized I hadn't actually linked the story as I thought. I edited it in the thread intro, but for anyone who didn't see the change, here's what I'd meant to link. Much the same as yours, but from the NYTimes.

http://www.nytimes.com/2013/01/28/world/middleeast/ariel-sharon-brain-scan-shows-response-to-stimuli.html?
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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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"Daily Telegraph", London July 27 2005
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Klaus
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HOLY CARP!!!
Is there some way how we can turn this into an abortion thread?
Trifonov Fleisher Klaus Sokolov Zimmerman
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Dewey
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What, it doesn't already have enough potential to turn into a train wreck?
"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685.

"Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous

"Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011

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Mikhailoh
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If you want trouble, find yourself a redhead
It's Schiavo, Hitler, Holocaust and Israeli behavior all wrapped into one neat package. Who needs abortion and religion?
Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball
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Amanda
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Well, take the discussion wherever you choose, but I admit "locked in" and other impairments of consciousness have given me a good bit to think about in terms of Medical Directives - if only, just how to word mine. I'd certainly want to know the medical team had done their utmost to assess my status. This is why I wrote in an earlier thread, I wanted to know what doctors themselves write in their own directives assuming they're the most aware of what might go wrong.

It's hard to imagine just WHAT these people are experiencing. It seems there's quite a range of consciousness levels being rethought.

The worst (just imagining) must be the classic "locked in" where there is neither cognitive impairment nor decrease in physical sensation but the patient remains unable to move a muscle . That is, except perhaps to blink and/or twitch a finger. (So far, that's the only way we know how completely s/he is completely "there". The one exception is the amazing breakthrough listed below, #1).

The worst "LOOKING", though, must be when families see fit to videotape the patient - formerly fit and attractive, now wasted and deformed, for all the world to see as they grunt and grimace. How humiliating to one still in one's normal state.

It IS fascinating to follow even superficially, recent breakthroughs which have caused the medical community to rethink "vegetative states" and other levels of consciousness. Clearly, previous definitions are inadequate, as even long-term comatose patients, have come to, if only to a limited degree. A few instances resulted in major regained consciousness. l Read #2 about the S. African patient. The issues are amazingly complex.

The thought of true "locked in" is hellacious. I must read "the Diving Bell and the Butterfly", dictated by such a patient (eyeblinks). Not knowing about his exact status, I don't know how much he could still feel, his senses. Merely imagining a fly alighting on me ("itch"), is enough to feel I'm going mad. The closest I've come, is being in an MRI tube and getting an itch on my nose - forbidden to move a muscle for fear of spoiling the expensive test.

But that's qualitatively different, because of the element of choice. I CAN move, but am WILLING myself not to.

I note that one of the Ambien revived patients has only managed to utter one complete sentence ("Want a drink"). How can one not assume that he found the strength to express that thought, because he was dying of thirst? Ugh!

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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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"Daily Telegraph", London July 27 2005
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Amanda
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BREAKTHROUGHS in communication/revival:

#1) Neuroscientists (along with A.I. experts), HAVE recently found a way to communicate with completely immobilized patients, by measuring their brain waves. It seems that key is measuring activation in the parts of the brain which would be aroused, by one's actually moving according to the action suggested. (Must be the motor cortex.). Thus actually moving isn't necessary but just THINKING of moving.

The great thing, is it could permit the patient to express such needs as scratching an itch, quenching thirst (and --?) I am grateful on behalf of the species, that they are working on such techniques to reach patients otherwise in unknown degrees of hell.

http://www.dailymail.co.uk/health/article-2232064/Man-vegetative-state-communicates-using-power-thought.html

#2) It's been found fairly recently that a strange chemical (Ambien, used as a sleep medicine), works to rouse many patients in wither vegetative states or minimal consciousness. (Now increasingly, the distinction is blurred because of this research). Some kind of a "paradoxical effect". I.e., it wakes them instead of putting them to sleep. To me this is even more remarkable. N.b. I took Ambien for almost a decade and it is a REALLY weird drug. Other sedative drugs are being experimented with.

http://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-minimally-conscious.html?pagewanted=all&_r=0

I think I will write in my medical will that I wish to be enrolled in clinical trials experimenting to alleviate so-called "disorders of consciousness". Otherwise, it would surely be unaffordable to have the kind of testing and therapies applied, for anyone but an Ariel Sharon. And only the very young would qualify. Reading about instances, some super dedicated parents make their lives revolve around caring for their comatose children.

Such research certainly has the potential to cause a storm of debates about insurance coverage and organ transplants. (But OMG who dares even to imagine what it would be like to be prepped for organ transplants while alert and aware?) Anyone care to suggest how they might want to reword their Medical Directives in light of these breakthroughs? At the very least, I'd want to insure I was "put down" humanely. (How? Ideally through morphine overdose, I guess.)
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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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Dewey
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Amanda, most states have established pretty standard formats for advance directives. These documents have a few places where options can be taken or declined, but they're standardized in order to make sure that a.) they comport with applicable state law; and b.) that their standardized language has been tested and defined via court precedent. To try to start to write advanced directives from scratch could result in a legal nightmare when the documents might be applied, and hospital and family attorneys got hold of them. Not to worry, though, at least here in my state, I can tell you that those "standardized options" include consideration of what you're talking about here, as well as the state's legal standards of precisely when the document can be applied (that, frankly, isn't really up to you).
"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685.

"Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous

"Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011

I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14
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Amanda
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Dewey
Jan 29 2013, 05:00 PM
Amanda, most states have established pretty standard formats for advance directives. These documents have a few places where options can be taken or declined, but they're standardized in order to make sure that a.) they comport with applicable state law; and b.) that their standardized language has been tested and defined via court precedent. To try to start to write advanced directives from scratch could result in a legal nightmare when the documents might be applied, and hospital and family attorneys got hold of them. Not to worry, though, at least here in my state, I can tell you that those "standardized options" include consideration of what you're talking about here, as well as the state's legal standards of precisely when the document can be applied (that, frankly, isn't really up to you).
I guess then the best would be to start the morphine drip right off the bat. That seems to be what they mostly do anyway when a patient isn't young and is in a steady decline (cancer/heart failure).

Especially in my rural locale very far from medical centers. :sad:
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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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bachophile
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AS is not really comatose, never has been. defined more like "minimally responsive". this big fuss about the fMRI was that it documented by imaging what caretakers have known already, that he is not in a deep coma but seems to have some awareness of surrondings but without anyone truly knowing the extent.

"I don't know much about classical music. For years I thought the Goldberg Variations were something Mr. and Mrs. Goldberg did on their wedding night." Woody Allen
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bachophile
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HOLY CARP!!!
Quote:
 
Reading up on Judaism about atonement recently, I was fascinated to learn that suffering on earth (even including the pain of death), is regarded as a significant source of atonement.



i always figured those jesus freaks picked up the idea somewhere...
"I don't know much about classical music. For years I thought the Goldberg Variations were something Mr. and Mrs. Goldberg did on their wedding night." Woody Allen
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Mikhailoh
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If you want trouble, find yourself a redhead
'Jesus freaks'. Now there is a term I haven't heard in a while. :lol2:
Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball
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Amanda
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I thought I'd read he IS/has been in a deep coma. The NY Times article calls it a "vegetative state". That's about as profoundly "out" as it gets (though I HAVE read that term is on the way out - partially because of the negative connotations to the family of referring to such patients as "vegetable" ).

"Minimally responsive" is a whole lot closer to consciousness. In considering "disorders of consciousness" (the new diagnostic category), that one is certainly more possible to rouse. No wonder his family has steadfastly refused to let him be "unplugged." Of course, the hope (you mentioned this a ways back) that he might be awoken and resume a government role, is pretty far-fetched.

But not a few patients HAVE come to from a minimally responsive state - even after quite a number of years. (Read especially about the Ambien arousals - the South African guy being the most remarkable.)

It also sounds like he might, indeed, be considered a possible "locked in" patient. BRRR.
If you, bach, glance here again - please respond to the locked-in part of my original question.



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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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Amanda
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Most famous Ambien awakening - Louis Viljoen - who was, interestingly, also the first.
And after three years in a "vegetative state", 1999. He was not only aroused but has also reached the level where he is now remaining awake, WITHOUT the medication. I had no idea of that.

Naturally, this has given hope to many for whom it's only a pipe dream. But still! Interestingly too, he reports having no recollection from the times "out" - including the periods during which he slipped away between Ambien "awakenings". That makes it sound quite different from "locked in" status. (Not to say, locked in doesn't exist and isn't a nightmare. It's enough to read "The Diving Bell and the Butterfly", to get that clear.)

Quote:
 
The first report of a zolpidem awakening came from South Africa, in 1999. A patient named Louis Viljoen, who, three years before, was declared vegetative after he was hit by a truck, had taken to clawing at his mattress during the night. Thinking he was suffering from insomnia, his family doctor suggested zolpidem to help him sleep. But 20 minutes after his mother ground the tablet up and fed it to him through a straw, Viljoen began to stir. His eyes, which normally wandered the room, vacant and unfocused, flickered with the light of consciousness. And then he began to talk (his first words were “Hello, Mummy”), and move (he could control his limbs and facial muscles). A few hours later he became unresponsive. But the next day, and for many days after that, zolpidem revived him, a few hours at a time.

Here was a case worthy of Hollywood: three years was well past the point at which doctors would expect any sort of spontaneous recovery. Viljoen awoke with the ability to speak in complete sentences. Not only did he recognize his mother, but he also recognized the voices of people who had spoken to him only when he was apparently vegetative. He remembered nothing of the mysterious realm he kept receding back into. When doctors asked him what it was like to slip away, he said he felt no changes at all. But he could recall conversations from the previous day’s awakening, along with bits and pieces of his former life: his favorite rugby team, specific matches he attended, players that he rooted for and against. As time passed, his cognition improved. He could laugh at jokes, and his awakenings stretched from a few hours to entire days. Eventually, he no longer needed zolpidem.

In the years that followed, a steady trickle of similar reports emerged — some from doctors who tried zolpidem after hearing about the Viljoen case, others from those who discovered its benefits accidentally, as Viljoen’s doctor had. The drug did not work for everyone, and even when it did, its effects typically wore off after an hour or two. But for a lucky few, those effects were profound. People who seemed vegetative for years were waking up.
http://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-minimally-conscious.html?pagewanted=all&_r=0


http://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-minimally-conscious.html?pagewanted=all&_r=1&
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We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.
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"Daily Telegraph", London July 27 2005
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bachophile
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HOLY CARP!!!
i have no idea if he is locked in,

although being not so far away from me, a few buildings away, i can go by and check, but the door is probably locked, so i guess he is locked in.
"I don't know much about classical music. For years I thought the Goldberg Variations were something Mr. and Mrs. Goldberg did on their wedding night." Woody Allen
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