Relative in ICU with heat stroke and is not going to make it

[SmokeyMountainRain]

Posting for traffic. Has anybody been through this? Close relative, relatively young 50s), was found incoherent last Wednesday. Rushed to hospital straight to ICU as she'd fallen into a coma. They've kept her asleep, tried to wake her twice and she cannot breath on her own whatsoever. They've ran repeated scans which show due to the heat stroke damage the part of her brain that tells her to breath is severely damaged. They've pretty much said she's incompatible with life now and we will have to turn the machines off this week unless by some miracle she wakes up. Her core temp was 41 degrees for 4 days, she's now at 40. Not responded to any medication, antibiotics etc.

She wasn't even doing anything strenuous. Just in her flat watching telly. Has anyone been through this? Does anyone have any advice? I don't even know what to think and feel it just seems so so cruel. No brain bleeds or blockages on the scan. Substantial brain swelling and damage.

posting for traffic as can't see any similar threads

Any advice or miracle stories please send them my way. Thank you x

OP has said she is a smoker who has COPD. I am so sorry that this has happened but this isnt just a natural side effect of heat. Its is indicative of her lung issues and thats what has caused this. I think it's actually very unfair to say this is just due to hot weather, it clearly isnt.

I have worked on a respiratory ward and we lost a lot of patients when it was hot- all due to preexisting lung conditions

So sorry to hear this, it's certainly been brutal weather recently, and very difficult to deal with for the unwell, both young and elderly.

COPD can absolutely affect someone's ability to cope with heat. Hot weather, particularly when it's humid, makes breathing more difficult and increases the workload on the heart and lungs. It also increases the risk of dehydration, which can make airway mucus thicker and worsen breathlessness. That's why people with COPD are often advised to stay cool, keep well hydrated and avoid being out during the hottest part of the day.

I am so sorry this has happened but this is due to her COPD and not the fact its merely hot

Unfortunately with bruising and subsequent swelling in the brain, the encasing skull being not able to swell alongside the brain to encompass it is what causes the irreversible brain damage that isnt compatible with life.

Have you got someone with you to support you?

It's so so sad and really striking how easy it is fall seriously ill from the heat when on your own. If a person is being stoic and doesn't know or recognise the signs of heat exhaustion, it can so easily turn into heat stroke - especially if confusion strikes early.

Whatever anyone may personally think about heatwaves in this country, please check in daily with those you know live alone and don't assume you know all there is to know about their vulnerability to the heat.

This. I read that comment, and thought it was just not true, and would be upsetting for some.

I spent 10 days on life support, in ICU after contracting bacterial meningitis and septicemia. Meningitis is classed as an acquired brain injury. I was given a 30% chance of survival.

When a patient is in ICU, there's two paths, the first is another ward (usually High Dependency) or the morgue. As harsh as that sounds, it's reality.

The brain is amazing and it can recover (to some extent) but 1% chance of surviving is more or less non-existent. It's all very well surviving, but at what cost could that be? Being alive but severely brain damaged, that round the clock care is required.

I'm not sure what you're trying to prove here. If a person has an underlying condition that makes them vulnerable to the heat, its entirely legitimate to say the heat has made them unwell.

This is so sad, OP. It must have been such a shock for you all. I'm really sorry.❤

It's certainly made me realise how dangerous very hot weather can be, so thank you for sharing. I need to downsize now I'm retired, and this has made me realise that not only do I need to take into account how much it will cost to keep my next place warm, but I also need to consider how to keep it cool. Thank you for sharing.

I'm lucky enough to live at the top of a hill, where there's almost always a breeze. When I had to go into town last week, I was astonished by how much hotter it was.

What l terrible position to be in, l honestly do feel for you. You are quite within your rights to ask for a second opinion, so do not let them tell you anything different, Martha's Law, as others have mentioned
After trying on several occasions to wake her, and she is unable to breathe without a ventilator, if l was in your shoes, l would let her go. I know it is easy for me to say, but had to do the same with my mum. She would have had no life at all, lying in a hospital bed being kept alive by artifical means. In a way she has already gone, but l know you are thinking, but she is still here. It's so difficult to make that decision, but the doctors always want what is best for the patient. I hope you will be able to find the answer you are looking for. I send you best wishes through this gruelling time.

I’m not saying that l agree with that train of thought, just what other people’s logic was

That is absolutely tragic. I’m so sorry OP.

When a patient is in ICU, there's two paths, the first is another ward (usually High Dependency) or the morgue. As harsh as that sounds, it's reality

Well of course it's reality. Where else would they go if it wasn't another ward or die? Honestly the utter shite some posters come out with is ridiculous. I've been in ICU and so has my dad and we're still here! ICU means you have a higher level of care than in a ward because you are more ill than someone on a normal ward not that you will always die.

My son spent a whopping 7 weeks in intensive care. It got about as bad as it could get without the worst actually happening including ecmo, dialysis and oscillator. He was intubated for 4 weeks.

He wasn't expected to survive. They said he was the sickest child in the country, never mind the hospital but he did against all of the many odds that were against him including a 17 minute cardiac arrest.

Best wishes to you, OP. I hope you can get a miracle for your loved one. xx

That sounds really rough. Hope you're both ok now.

I am not trying to prove anything. I'm merely responding to the original claim that extreme heat causes death or brain injury in otherwise healthy 50-year-olds. While it can happen, it is an extremely rare occurrence, and it's not helpful to create unnecessary panic. From the information provided, it appears the individual mentioned had pre-existing health conditions, which are an important part of the context. Thats all.

People getting worried about relatives suddenly dropping into comas in their 50s isnt productive either is it?

I'm so sorry that your relative has had such a catastrophic brain injury from heat stroke. We live in a highly insulated new build and we were in the red zone. Our house temperature was 32.5C. We drew the curtains, kept the windows closed and it was unbearable. DH is 82. I'm younger. We really struggled, but DH got lots of face flannels and soaked them, then froze them. We had them on our heads all day. The relief and the difference in how we felt was enormous. It's a cheap and effective way of keeping the brain cool and I highly recommend it.

I can't emphasise enough that you should make them give you as much time as they possibly can. I'm NOT advocating for keeping someone alive on a machine forever but this is very, very, very early days and the brain is complex. My auntie was given no chance of survival after a brain injury (falling off a horse) and relatives told they needed to turn off the machines. Doctors categorically said she'd never walk, talk, breathe, sit up, know us etc (I was in the room when this was said). The family fought for several days but eventually had to accept it. They turned off the machines and she breathed on her own. Now she lives an independent life with just a little support but she walks, talks, sings, texts, chats on the phone, knits, goes shopping and has a full and lovely life. Don't let them give up on your relative too soon.

OP I’m so very sorry, this must be so hard. My DH was on a ventilator for a week after collapsing under similar circumstances, and I can only relate my own experience and what the doctors responsible for his care advised at the time.

Gently, your relative has developed bilateral pneumonia as a result of simply being on the ventilator and that’s not good. Just being on the ventilator itself is a risk because it bypasses the body’s natural defences and can introduce dangerous bacteria into the lungs.

I’m assuming they’ve done a gram stain to determine treatment, so they’ll be 100% sure that the antibiotics are appropriate. Part of the problem now is that she’s been on the ventilator for six days. That’s a long time and the longer she is on it the less likely it is that she will be successfully weaned off it even if she were to regain consciousness - because she was in a weakened state to start with, and the lung infection will have severely complicated things.

My DH was taken off the ventilator after a week. It was suggested to me that his quality of life would be nil in the very unlikely event that he regained consciousness and that it would be in his best interests to let him pass peacefully. They made it clear that it was my decision up to a point, but just as clear that in the end they would take over and make a best interests decision if I felt unable to consent.

As previous posters have suggested, you could try Martha’s law, but to me it sounds as though that would only prolong things and it may be that the best option for her is to let her pass peacefully, as hard as that is for those who love her.

From my own experience, the decision was a simple one. We had had ‘the conversation’ and promised each other that we wouldn’t let allow languishing on life support with no hope, so I knew I was doing what he would have wanted.

We weren’t allowed to be present when they took him off life support but we went straight back in when they had finished the procedure. It’s nothing like you see on medical dramas - passing isn’t immediate, dramatic, or scary. DH took about four hours, during which time all of the monitors were turned around and the curtains drawn around his bed - he was being monitored from the nurses station. The ITU nurses were on hand and very supportive. He wasn’t distressed, he just looked as though he was sleeping, breathing gradually slowed until it stopped and then a nurse came in to confirm that he had passed.

The one thing I wasn’t prepared for was being asked about organ donation. It comes very soon after passing, for obvious reasons. Again, we’d had the conversation so the decision was an easy one, and I have the comfort of knowing that he helped several people with the donations made.

They say that you don’t truly know your strengths until you need them, and I’m praying that you find the strength you need to support you through what must be a very difficult time.💐

He's doing well now, thanks. It was 2 years ago. I had no idea how dangerous sepsis could be at the time, barely knew what it was!

Was going to post the same thing. There is a huge amount of misunderstanding about it.

Martha's Law is more about concern that a patient is declining and relatives basically asking if they need more care. OP's relative is already receiving the highest possible level of care at hospital.

With respect, OP’s relative now has bilateral pneumonia as a result of just being on the ventilator. That severely complicates things - she’s been on the ventilator six days and unfortunately the longer she is on it, the less chance there is of successfully weaning her off. It’s also very concerning that the infection isn’t responding to treatment - sepsis is a very real risk - so I think OP has to be guided by medical opinion. It’s a myth that family have the last word on removal of life support - if no consent is forthcoming the doctors can and do make best interest decisions.

I'm so sorry, that's just awful.

I hope and pray she wakes up. 🙏

The thread title is misleading. The lady in ICU is there because she has COPD (due to smoking) which means unlike others in her age bracket it makes her susceptible to heat stroke. Smoking cigarettes is the root cause of this medical emergency, which is a tragedy for all concerned.