Thursday, November 18

The Odds to Beat

I haven't talked to Kate yet today but we've exchanged texts back and forth regarding the meeting at the hospital yesterday. She indicated that what I had predicted the doctors/administrators would talk about today was indeed correct. I'll call it the 'odds game' for lack of a better term though, in Matt's case, I'd rather call it "the Odds to Beat" because I know Matt would want to beat these odds as well. He's already beat the coma odds. Why stop there?

There is nothing 'light-hearted' in these odds, however. I don't mean to be glib. From the recently posted pictures (all of which tore at my heart just a little bit further) and from brief discussions on the extent of Matt's brain injury (see post on diffuse axonal injury - DAI), I am assuming that Matt's DAI is moderate to severe. In cases of severe DAI, the chance of recovering from/coming out of a coma are less than 10%. The numbers are less clear for moderate DAI but are somewhere in the 20 percentile range. For those who do come out of their coma, most are moderately to severely impaired. The severity of impairment relates directly back to the severity of the axonal damage (DAI) which relates directly to the force of the impact (how hard the brain hit the skull as it was forced to decelerate from a higher speed). Since Matt was on a bike (not in a car) he was traveling at a moderate speed (not a high speed like 60+ mph) and, therefore, the force of his deceleration would not be as great as the forces at work during a car crash. I hope that makes sense. It is still serious but there may be less damage to axons (moderate damage vs severe).

In any case, the doctors would weigh all of this information along with his MRIs and progress to date. Knowing that his chances of full recovery are slim and that the likelihood of him being moderately to severely impaired is around 80-90% (based on previous clinical cases), they would make the decision to transfer him to a facility that deals with the moderately/severely impaired in order to open up a bed for someone whose probability of recovery is, perhaps, 50/50. None of it seems fair nor does it seem to take into account the patient's best interest or the proper time necessary for recovery. However, to doctors/administrators, clinical case evidence is what they have to go on; and with administrators/insurance companies pushing for a free bed (for whatever reason but I suspect they do not view Matt as a primary candidate for their comprehensive resources) this is their only alternative. I'm not defending there decisions. Bouncing critical care patients around is nasty busy for both patients and families.

This is, however, just my interpretation. As I said, Kate and I bounce text messages back and forth like lightning some times. I'm sure much gets muddled in the translation.

Right now, we all have time - time to re-evaluate and reflect upon the situation that has brought us all together. There is no longer the urgency of 'life and death' but now the more painstaking process of 'watch and wait'. I often wonder which I loath more. I also often wonder what Matt would do faced with the news of, and with seeing, me in the same state. I know he would be profoundly moved; utter a classic "damn"; offer his help/support; perhaps reach for a cigarette. I know he would find much injustice in the accident and in the state of my semi-conscious life.

Regardless of how this progresses and how long it takes, I know his biggest concern would be for Kate and for Jack. He would not want them to worry nor to be hurt further by this incident. He would want to protect them, to help them, to care for them. I feel that is now my primary responsibility / our primary responsibility in this situation. If we do one thing for him, it should be to support and love his family the way he would want to. I intend to do just that. for him.



Anonymous said...

Thank you so much, Stef, for this comprehensive post and for this last part in particular...

Anonymous said...

Thank so you so much, Stef, for this comprehensive post and for this last part in particular...

Alli. said...

I totally agree, Stef and Alison. It has been important all along for us to be there for Kate, Jack, Bo, Rich, and Susi, and the rest of the family. If Matt could ask for help himself right now, he would ask for that first, I'm certain.

To Matt and family, we love you. We are here for you. You and Matt are in our thoughts and our prayers.