Jahi McMath back in the news - Part 2

[Rachel333]

More thoughts, since I've been reading about this for the past few hours and I guess I can't edit my previous post any longer. I've been making the distinction between Jahi being dead and her body being kept alive, but now I think even saying "her body" is alive isn't a good way to put it, since obviously parts of her body are not. It's likely "she" doesn't even have a brain anymore. Maybe a better way to put it would be that some of her organs are being kept alive? If those organs had died you couldn't even force circulation the way that it's happening with Jahi.

This is actually all really interesting, and everything I've read says that death is not easily definable and is more of a process than an event. For example, did you know that skeletal cells can survive for up to a week after death? They aren't as dependent on oxygen circulation as heart cells. Sperm cells stay alive for a few days after death, too.

[BrownieMomma]

This business with Jahi makes my blood run cold. I think there is something behind it, someone or something that is looking to somehow start benefiting from keeping bodies/organs functional after brain death - and I get no good feeling about that.

I am sure I would cling to every last whiff of hope if it was my child. I also think I might be so lost in grief that I'd lose my rational mind and be easy prey for someone who wanted to keep my child's body functional for whatever reason.

The lawsuit was inevitable. I don't agree with filing it, or announcing something is going to be filed, probably the attorney is looking for some kind of settlement.

[gustava]

I would be surprised if there was a creepy/sci fi save-the-organs group behind this. I think, as someone above said, the family is trying to force a financial settlement. And I'm betting that is because whoever has been funding her stay in New Jersey is cutting off the money.

[Rachel333]

So New Jersey is letting them claim the religious exemption even though Jahi died on another state?

I agree that there's no big conspiracy, just a messed up situation all around.

[DGayle]

By the way, don't ever donate your remains to science. I've heard stories about medical school....

ETA: the Body Worlds exhibit was the creepiest thing i've ever experienced. Thankfully it was the one with all the specimens behind glass. I couldn't handle the open one. Anyway... nothing creepier than seeing a tattoo that was part of the person they sliced and preserved to show organ layout... it's a weird thing, somehow they turn the body into a plastic like substance. There were no facial features in the exhibit i went to, i couldn't handle that either. My friend who was interested in being a nurse asked me to go with her. It's true they don't smell. And one whole section of the exhibit was on lung disease, with a big bin of cigarette packs people got rid of while touring the exhibit.

My directives are donate any organs that can be, and then ship me off to a medical school. Doctoral and nursing students need to work on cadavers to learn. Better do that learning on dead bodies than alive bodies.

I loved Body Worlds and went 2 times. My kids were fascinated by it. If I don't go to a medical school to be sliced up by students who need to learn, then send me to Body Worlds. It's a better use of our bodies than tossing us in an incinerator or a bod in the ground.

[DGayle]

Maybe a better way to put it would be that some of her organs are being kept alive? If those organs had died you couldn't even force circulation the way that it's happening with Jahi.

Her organs aren't alive, and yes, you CAN force circulation by keeping the circulation continuous, it's keeping the veins and arteries from collapsing. It's all artificial. It's literally preservation of a corpse.

[DGayle]

I would be surprised if there was a creepy/sci fi save-the-organs group behind this. I think, as someone above said, the family is trying to force a financial settlement. And I'm betting that is because whoever has been funding her stay in New Jersey is cutting off the money.

It's common practice for hospitals to settle, even when not in the wrong, since it's cheaper than litigating. I don't doubt at all that the fucked-up McMath adults are hoping for a big settlement, and that they'll turn the machines off as soon as a check clears. I hope the hospital fights this.

[Rachel333]

Her organs aren't alive, and yes, you CAN force circulation by keeping the circulation continuous, it's keeping the veins and arteries from collapsing. It's all artificial. It's literally preservation of a corpse.

If they were dead and circulation had stopped they would very quickly degrade to the point that you couldn't restart it. That's all I was trying to say there. Of course you can force circulation by artificially keeping it continuous because that's what's happening in this case. As far as I've been able to figure out there have to be cells still living and functioning for all other metabolic processes to take place, but I'd be genuinely interested in any sources saying that her organs and cells are all dead. It doesn't mean that her body isn't a corpse, though; even in regular deaths not all cells die at once.

I suppose it's useless debating semantics anyway. I've seen quite a few sources where doctors talk about keeping bodies "alive" for organ donation, but that doesn't mean the person is alive in any meaningful sense.

What's really unusual is that they've kept Jahi's body going this long. Everything I could find not relating to Jahi said that when they keep bodies artificially going like this it only lasts a few days even on "life" support. I'm curious what is different about Jahi's body, if anything. Maybe it's not remarkable but there haven't been bodies that have lasted this long just because there haven't been many cases where they try to sustain them this long.

[sparkles]

There were reports that family members were going against doctor's orders post-surgery, giving Jahi things she wasn't supposed to have, letting her talk, etc. I'd be very interested in hearing evidence of this since Mr. Sparkles had this same surgery (UPPP) and we were given VERY explicit instructions–verbal and written–as to what to expect and what we should and shouldn't do. It's an extremely painful recovery so I can see why the family would have wanted to alleviate Jahi's suffering, but there seems to be some suggestion that whatever they did helped bring about the events that led to her death. If there's a settlement, I don't think any of this would come to light.

[DGayle]

Medical science has absolutely advanced to the point that bodies can be preserved. Nothing metabolic is happening when all functions of the corpse are happening by machines. Some bodies decompose after days, while others can last much longer. If the definition for life is there are cells still alive. then Henrietta Lacks, who died back in 1951, is still alive, since some of her cells are still alive and reproducing in labs.

[DGayle]

There were reports that family members were going against doctor's orders post-surgery, giving Jahi things she wasn't supposed to have, letting her talk, etc. I'd be very interested in hearing evidence of this since Mr. Sparkles had this same surgery (UPPP) and we were given VERY explicit instructions–verbal and written–as to what to expect and what we should and shouldn't do. It's an extremely painful recovery so I can see why the family would have wanted to alleviate Jahi's suffering, but there seems to be some suggestion that whatever they did helped bring about the events that led to her death. If there's a settlement, I don't think any of this would come to light.

Based on everything I've read about it, the family shunned the idea of having her lose weight to help alleviate the apnea she was dealing with. If the'd prefer to have her undergo a risky surgery instead of losing some weight, I can see them feeding her a hamburger because she woke up hungry.

Earlier on, they said she woke up and was happy and bubbly, and now they're saying she went into recovery already bleeding profusely. Their own public statements show they're liars.

[Rachel333]

Medical science has absolutely advanced to the point that bodies can be preserved. Nothing metabolic is happening when all functions of the corpse are happening by machines. Some bodies decompose after days, while others can last much longer. If the definition for life is there are cells still alive. then Henrietta Lacks, who died back in 1951, is still alive, since some of her cells are still alive and reproducing in labs.

I actually used that very example a few posts ago! Because no, living cells does not mean the person is alive and that's what I've been saying all along, that this no more means Jahi is alive than it does that Henrietta Lacks is alive.

I don't understand how Jahi's body could lose weight (because reportedly she has lost weight, and that is fairly evident from the pictures we've seen) if there aren't living cells that are breaking down fat and using it for energy, or how her body could be using the oxygen it's getting from her lungs and circulatory system if there aren't living cells working there, or how she could digest the nutrition she's getting through her feeding tube. If everything were completely dead you could easily inflate and deflate the lungs over and over again--that's nothing more than the result of a pressure gradient--but you couldn't get the body to actually use the oxygen that is coming in. How has she started menstruating only recently? How is her body using the artificial hormones being pumped into it?

You say medical science can do this, but how? How does this all work on a cellular level if her body is completely dead? I really want to know because I can't understand how that would work. I can handle complicated explanations!

From an earlier thread about Jahi (a lot of google results are just from freejinger), you wrote

Her brain STEM may have activity, but this doesn't mean her brain itself isn't dead. After Teri Schaivo was finally allowed to go, the autopsy showed her brain matter had atrophied to practically nothing.

You CAN have brain stem activity, and if you want to be technical, even be alive without a brain. In the 40's , a chicken survived a decapitation for TWO YEARS. http://en.wikipedia.org/wiki/Mike_the_Headless_Chicken Amazing how the body can continue, though you can argue there is no life to save.

So yes, Jahi has brain STEM function, but she is dead.

See, I would agree completely with this. Do you no longer think she has any brain stem function at all?

I'm not just trying to argue and I'm certainly willing to be wrong. I just want to know what's going on. In that old thread most people are saying she would have to have some biological activity still going on for her body to stay in that state for so long.

[Toothfairy]

I read that too. Jahi was complaining that she was hungry and her grandmother or family gave her something she wasn't suppose to eat. Her grandmother tried to suction her out then that's when things got bad. Even other patients in the room was talking bad about the family. It's on a blog somewhere. I agree that they surgery wasn't necessary. Diet and exercise probably would've slowed her sleep apnea problem. I'm surprised the surgeon did it.

[bluebird]

For the medical professionals here,outside of a vent and IV/B/P/ECG monitors what machinery do you think Jahi is dependent upon to sustain life? Is her heart alone providing circulation to her body? I cannot imagine that she would be on a VAD for example. I too am having difficulty comprehending brain death vs body death and would like to understand why her body would not be decomposing if the body is considered dead. I also do not mind a complex explanation. Thanks..ETA: I use the words " sustain life" to mean her heart is still beating, basically her current condition.

[Mitz_]

I actually used that very example a few posts ago! Because no, living cells does not mean the person is alive and that's what I've been saying all along, that this no more means Jahi is alive than it does that Henrietta Lacks is alive.

I don't understand how Jahi's body could lose weight (because reportedly she has lost weight, and that is fairly evident from the pictures we've seen) if there aren't living cells that are breaking down fat and using it for energy, or how her body could be using the oxygen it's getting from her lungs and circulatory system if there aren't living cells working there, or how she could digest the nutrition she's getting through her feeding tube. If everything were completely dead you could easily inflate and deflate the lungs over and over again--that's nothing more than the result of a pressure gradient--but you couldn't get the body to actually use the oxygen that is coming in. How has she started menstruating only recently? How is her body using the artificial hormones being pumped into it?

You say medical science can do this, but how? How does this all work on a cellular level if her body is completely dead? I really want to know because I can't understand how that would work. I can handle complicated explanations!

From an earlier thread about Jahi (a lot of google results are just from freejinger), you wrote

See, I would agree completely with this. Do you no longer think she has any brain stem function at all?

I'm not just trying to argue and I'm certainly willing to be wrong. I just want to know what's going on. In that old thread most people are saying she would have to have some biological activity still going on for her body to stay in that state for so long.

Rachel, I also see things in the same light you do, so I understand what you are trying to. Say. Jahi's body is obviously not completely dead and and its obvious that her body is still a mass of living cells and that is how her body is using the oxygen that is being pumped into her. No one knows why her body has kept going this long but it isn't the first time this has happened. No one knows why Henrietta Lack's cells continue to live either, but they do.

There just aren't answers to everything. Jahi is dead, but her body of living cells is perhaps not alive but for the reasons you stated above, it isn't dead either, or perhaps it could be defined as being dead because it has no function independent of the vent.

If you want a LOT more information go to the Facebook page "JAHI Mcmath and the audacity of logic." Go down the page a little and you will find instructions on how to join a private group that is a split off of that page. Make sure you send the administrator a note as they ask, they are being very careful about who they let in.

It's a good group.

[DGayle]

Rachel, I read over that post. Just looked back, and there are a couple posts I missed. Oops.

When I was talking brain stem, it was based on a chicken that survived a beheading. I should have been clearer on that. Our anatomy is different. http://modernfarmer.com/2014/08/heres-c ... hout-head/

Her family says she had a period. That's literally not possibly without the brain functioning, yet there's no brain activity at all. All we have about that period is her family saying so. They also say that she's responding to things despite no brain function.

[DGayle]

I read that too. Jahi was complaining that she was hungry and her grandmother or family gave her something she wasn't suppose to eat. Her grandmother tried to suction her out then that's when things got bad. Even other patients in the room was talking bad about the family. It's on a blog somewhere. I agree that they surgery wasn't necessary. Diet and exercise probably would've slowed her sleep apnea problem. I'm surprised the surgeon did it.

If the family refuses to have their child lose any weight (and there are obese people who are very hostile to being told to lose any weight), what's a doctor to do? Apnea can be deadly. Surgery can be too, but it was probably thought that surgery was the lower risk than letting an obese girl continue on with apnea, especially if she wasn't going to have to lose any weight.

That's kind of an elephant in the room. We're supposed to be supportive of all body sizes, but I think it goes too far when we're supposed to ignore risks and applaud for surgery.

[littlemommy]

Mitz, I'm in that FB group as well!

[sparkles]

Based on everything I've read about it, the family shunned the idea of having her lose weight to help alleviate the apnea she was dealing with. If the'd prefer to have her undergo a risky surgery instead of losing some weight, I can see them feeding her a hamburger because she woke up hungry.

Earlier on, they said she woke up and was happy and bubbly, and now they're saying she went into recovery already bleeding profusely. Their own public statements show they're liars.

I can't imagine ever describing anyone coming out of this surgery as happy and bubbly. Mr. Sparkles was groggy and miserable and in extreme discomfort, even though he was tanked up on pain meds. Just this past Sunday, in fact, completely out of the blue, he started talking about how painful the recovery was. Even though the family's changed their tune now, describing her like that immediately post-surgery has to be blatant lie, as if to say "look what how vibrant and full of life she was and how the lack of care killed her!"

UPPP is also considered last-ditch surgery when other treatments have failed and it's not a cure-all. Mr. Sparkles (who's not obese) still needs his CPAP and the settings are cranked up. He does say it's been a big help though.

[Rachel333]

If the family refuses to have their child lose any weight (and there are obese people who are very hostile to being told to lose any weight), what's a doctor to do? Apnea can be deadly. Surgery can be too, but it was probably thought that surgery was the lower risk than letting an obese girl continue on with apnea, especially if she wasn't going to have to lose any weight.

That's kind of an elephant in the room. We're supposed to be supportive of all body sizes, but I think it goes too far when we're supposed to ignore risks and applaud for surgery.

I agree. I've seen a lot of people complain that it's discrimination that they are asked to lose weight before surgery, not realizing that it is for their safety! Obese people absolutely deserve medical treatment, but there are real risks to obesity and surgery is much more dangerous for the obese.

[BriMamai]

For the medical professionals here,outside of a vent and IV/B/P/ECG monitors what machinery do you think Jahi is dependent upon to sustain life? Is her heart alone providing circulation to her body? I cannot imagine that she would be on a VAD for example. I too am having difficulty comprehending brain death vs body death and would like to understand why her body would not be decomposing if the body is considered dead. I also do not mind a complex explanation. Thanks..ETA: I use the words " sustain life" to mean her heart is still beating, basically her current condition.

Maybe it will help to think of her body's functions like someone who has suffered a high spinal cord injury. Obviously, in the case of a cord injury, the brain is still functional, but it is disconnected from the rest of the body and nervous system. (Think Christopher Reeve) The heart continues to beat, the kidneys make urine, the intestines still absorb nutrients and move waste out of the body. These are all reflexive or intrinsic to the organ and require no input from the brain. The major requirement is that the tissues get the oxygen and nutrients they need. If this happens, they will continue to function. There are some higher functions, like regulation of the heart rate and blood pressure that are controlled by the central nervous system, but the body will maintain the basic function as long as the organs get their minimal requirements. So, with a feeding tube and a ventilator, you can sustain the basic functions of the body without any input from the brain. I don't think she needs any IV fluids, machines to assist her heart (like an LVAD) or other "technology." She would need aggressive care to keep from developing pneumonia, skin breakdown and urinary infections, but that is just good nursing care. When someone has an intact brain, but a high cord injury, these things are undertaken to keep the body functioning to support the brain.

In Jahi's case, the same interventions are undertaken to keep her body functioning. She looks alive because her organs still work. Her brain has clearly shrunken as evidenced by the MRI shown several months ago, and I suspect that over time this will continue to progress. Because of the damage to her brain, I suspect that they have to add in medications to support her endocrine (hormone) function as this is regulated by her pituitary and that was likely severely damaged or destroyed. This has been postulated as one way she may have begun having her periods. You can give a post menopausal woman hormone supplements to get her to have periods, it would work the same way.

[bionicmlle]

Maybe it will help to think of her body's functions like someone who has suffered a high spinal cord injury. Obviously, in the case of a cord injury, the brain is still functional, but it is disconnected from the rest of the body and nervous system. (Think Christopher Reeve) The heart continues to beat, the kidneys make urine, the intestines still absorb nutrients and move waste out of the body. These are all reflexive or intrinsic to the organ and require no input from the brain. The major requirement is that the tissues get the oxygen and nutrients they need. If this happens, they will continue to function. There are some higher functions, like regulation of the heart rate and blood pressure that are controlled by the central nervous system, but the body will maintain the basic function as long as the organs get their minimal requirements. So, with a feeding tube and a ventilator, you can sustain the basic functions of the body without any input from the brain. I don't think she needs any IV fluids, machines to assist her heart (like an LVAD) or other "technology." She would need aggressive care to keep from developing pneumonia, skin breakdown and urinary infections, but that is just good nursing care. When someone has an intact brain, but a high cord injury, these things are undertaken to keep the body functioning to support the brain.

In Jahi's case, the same interventions are undertaken to keep her body functioning. She looks alive because her organs still work. Her brain has clearly shrunken as evidenced by the MRI shown several months ago, and I suspect that over time this will continue to progress. Because of the damage to her brain, I suspect that they have to add in medications to support her endocrine (hormone) function as this is regulated by her pituitary and that was likely severely damaged or destroyed. This has been postulated as one way she may have begun having her periods. You can give a post menopausal woman hormone supplements to get her to have periods, it would work the same way.

This is a great explanation. Our bodies don't need much more than our "reptilian" brain parts to keep our body functioning. In brain death, higher brain functioning that support memory, personality, thought, speech, etc., are dead - the parts that make one innately human, unique or what you might refer to as a "soul." Your brainstem, which support basic low-order bodily functions, can function without "input" from your brain hemispheres and in fact there are certain reflex circuits that run ONLY through the brain stem which is why it seems like people who are braindead may move in response to certain pain or touch - the "movement" doesn't require any input from the brain hemispheres (which are dead) because the nerve circuit routes only through the brainstem (which is still functioning).

When a neurologist does a brain death exam, it is so important to inform a family what they would be looking for in a "normal" person and what they may see in a brain injury or brain death -- so they know that sometimes movement may happen, a person's eyes may move but it doesn't mean they are "fine" or "recovering." From the outset, it seemed that this case started off with really poor communication....

[ghost]

Is this the same thing that is going on with Whitney Houston's daughter?

[bluebird]

Thank you for your response, I appreciate it. Could her condition be reasonably compared to that of a anacephalic baby? I know this is the absence of a brain or most of it but I see a comparison for whatever reason. Essentially, Jahi is brain dead however her brain stem is functional enough to keep her heart beating/circulation/blood pressure. So...it comes down to brain death versus cardiac death and since she has not had cardiac death she is not considered dead (legally/physically) by her family, advocates, etc.? * I am thinking out loud more than I am making a obvious statement* With regards to her brain stem, the functionality of such is not significant when declaring a person brain dead (2 different organs?) or dead at all? Going back to anacephalic babies whose parents want to donate the child's organs this cannot occur until the baby has cardiac death..that is when the baby would be considered legally dead. ETA...I Do not know what the hell I am trying to say or ask outside of trying to wrap my brain around statements that since her brain is dead so is her body. Not arguing at all..I hope to come to this thread one day and find that ALL of Jahi has been allowed to go to heaven.

[Bethella]

Is this the same thing that is going on with Whitney Houston's daughter?

No. Based on what has been released, it appears that Bobbi Kristina has a brain injury/damage due to not getting oxygen. She is in a medically induced coma and still has some brain function (to what level we don't really know but supposedly she had seizures when they tried to wake her up nor do we know her chances of a meaningful recovery). She is not brain dead.