Saturday, January 21, 2006

Update on Ariel Sharon

Well, it looks like Ariel's doctors are determined to turn him into a vegetable. He's been unconscious for more than 2 weeks now, and they're considering now to get him off the ventilator. Reports have it he "may have opened" his eyes once, and his breathing has "improved".

He is an old man with a fatal illness, and should be allowed a graceful death, not lie in the hospital in a vegetative state waiting for that pneumonia or embolism that will eventually kill him, probably within a few weeks.

That's the problem with treating famous and important people. When they seem to receive extra special treatment, what they are in fact receiving is treatment that's not based on medical decision-making, i.e. inappropriate treatment.

Friday, January 06, 2006

Ariel Sharon's Brain

I think George Bush should consider some better use for his time than praying for Sharon's recovery.

The reports indicate that Sharon had two brain infarctions, the latter of which was "massive" and hemorrhagic (i.e. bleeding). The doctors operated for 7 hours, "to try and stop the bleeding". This does not make much sense, and I wonder who's doing the operating because 7 hours is an awfully long time to operate. They need to hire a faster neurosurgeon. The longer the operation takes, the more problems you run into. Say someone has a spontaneous bleed in the brain. It should take the 5th year resident about 1.5-2 hours to remove. If there's a hemorrhagic stroke, surgery is not usually a viable option, unless there is massive swelling, in which case you could do decompressive surgery, which basically means removing a huge chunk of bone from the side of the stroke to give the brain more space. Even that's usually reserved for relatively young patients with good chances of recovery.

If you do operate a hemorrhagic infarction, what you end up doing is removing a lot of brain tissue, and battling with endless little bleeds, and chances are the brain is going to look just the same or worse after the operation. It looks like this is exactly what happened, and Sharon was "rushed" back to the OR again friday morning. Another 4 hours of operating ensued. OK, 11 hours of operating I'd accept if they had done bypass surgery, i.e. trying to recover the blood flow by a demanding procedure in which a skin artery is connected to the an artery that supplies the brain tissue.

The reports do not state which side of the brain the stroke has affected. They didn't mention what his level of consciousness was at the time of admission, either. If he was it's the left side, he'll probably never speak again. In any case he'll never walk again. If he was unconscious at the time of admission, he'll never be coming off the ventilator again.

Based on the information available, I'd wager this guy is as good as dead.

Looks like the local neurosurgeons have been doing a lot of futile work on a 77-year old obese man just because he's the PM. I I guess the politicians need something to occupy the public's mind while they're trying to figure out what the hell they're going to do next...

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