Very good news to share this evening! I met with the Behavioral Neurology team, Psychology team, PT, OT and Speech today. Corey has been upgraded from a vegetative coma status to minimally conscious. The team says she’s no longer considered to be in a coma!
BMR is working with Corey in their coma/emergence program. As Corey responds to sensory stimulation she is graded. It is based on a 22pt. Coma Recovery scale. Her responses are based on reflexive and arousal responsiveness building to cognitive responses. Although she is not showing consistent responses, she’s hinting towards what they refer to as emerging awareness responses. For example, her reach towards Amelia’s photographs, her response to certain voices and she has shown emotion with tears to specific circumstances. She is currently a 3-4 for her base grade.
As I explained, the teams work with her on a rotating schedule so the same people are not observing her at the same time of day each day. This is important because her behaviors change throughout the day allowing the team members to catch the responses as they happen naturally.
The following is PT/OT’s report. Corey has her eyes open 75% of the time in each session. She has fixated orientation to the right and downward towards the right when presented with visual stimulus. NEW observation; She has begun to move her eyes to midline (focusing forward) intermittently. Her eye tracking (following a stimulus from left to right) is minimal to the left and consistent to the right.
NEW observation; she had a riting response. When she is on the bolster and they roll her from left to right, they are looking for her protective instinct to “catch” herself from the motion of rolling to one side. Her eyes did respond to the awareness of tipping and she looked towards the direction of the tipping! Lord only knows what she thought and wanted to say as she was rolling! She continues to respond to tactical stimulation by withdrawing to pain stimulus on the upper and lower extremities. She has awareness to “quiet change” If you move to one side or the other quietly, she will try to track you as if she doesn’t want to miss anything! That’s Corey!!
Speech/OT has witnessed frequent spontaneous swallowing. She is managing her saliva. She gives a munching motion when cold stimulus is placed on her mouth and swallows consistently after the stimulus is removed. This is big! Most brain trauma patients have no secretion (saliva) control and need to be taught how to swallow again. This all leads to learning how to eat independently. They will continue focusing on her oral strengthening. NEW observation; she responded to auditory stimulation. She had a startle response on her right side! She continues to tolerate the trach being capped. Another positive step towards removing it!
The emergence process can be very slow, but in their opinion, Corey is moving very quickly. She’s showing them responses that are very encouraging for the first month of a brain trauma patient. Keep in mind they are impressed but cautious. We are still on a long path of recovery but she is showing she’s progressing in the right direction!
They don’t know our girl…they haven’t seen anything yet!!!