What hope does modern medicine give Gienek Loska and patients in a coma?

Gienek Loska, the winner of the “X Factor” program, is in a coma for the fifth month. He fell into it after a stroke, which he had during a visit to his mother in Belarus. We hope that he will come out of it, because the Music Foundation, which informed about everything on Facebook, added that Gienek reacts to the presence of his relatives. What is a coma and what does modern medicine offer those who enter it?

1. When does a dream turn into a coma?

A coma is a state of profound unconsciousness lasting more than an hour in which the patient is not aware of himself or the environment. It cannot be interrupted by strong stimuli. A prolonged coma can last about two to five weeks. The sick person, who does not come back to consciousness during this time, goes into a vegetative state in which he regains alertness and opens his eyes, but remains unconscious. One year after the traumatic brain injury, and three or six months after the non-traumatic injury, the vegetative state is considered permanent.

2. What is the state of minimal awareness?

After a coma or vegetative state, a patient may be in a state of minimal consciousness. Then, he inconsistently shows signs of contact with the world, e.g. cries or laughs, follows objects with his eyes, reacts to simple verbal commands. The manifestations of consciousness are sporadic but repetitive. However, conscious communication with the patient remains impossible. Regarding the effects of therapies leading to awakening, such patients have a better prognosis than those in a vegetative state.

3. What is a pharmacological coma?

Pharmacological coma is caused by hypnotics and narcotic analgesics. They are given to severely ill patients in order to be able to undergo intensive treatment, such as mechanical ventilation of the lungs (replacement breathing), and to minimize suffering during severe illness. This procedure is called sedation. The degree of contact with the patient depends on the doses of drugs and their metabolism. Amnesia from the use of this therapy is very common in sedated patients.

4. The first minutes count

In order to minimize the risk of falling into a coma after an injury, it is important to begin chest compressions and artificial respiration in the first minutes of treatment. Normally the brain has an oxygen reserve for about four minutes with cardiac arrest and respiration. There is no chance of professional resuscitation in such a short time, so the help of people who are at the scene of the accident is very important. Doctors emphasize that the first days and months are the most important in attempts to wake up from a coma. Especially then, intensive rehabilitation is needed, including on stimulating sound and touch stimuli. It is important to maintain physiological functions, as well as massages, gymnastics and upright positioning.

5. Coma most often after accidents

In Poland, the number of patients over 18 years of age diagnosed with coma was as follows: in 2013 – 667, in 2014 – 618, and in the first half of 2015 it was 350 cases. Most people fall into a coma after road accidents. Often these are children who are hit by a car.

6. Where do they wake up from a coma?

There are no statistics on how many people manage to wake up from a coma. In Poland, a center for children in a coma, Klinka Budzik, has been operating for three years, in which 26 young patients have already woken up. It was built by actress Ewa Błaszczyk, whose daughter Ola fell into a coma at the age of 6. A similar facility, but for adults, is created in Olsztyn by prof. Wojciech Maksymowicz. – There are even three times more adults in a coma than children. Currently, after several weeks of treatment, they go to care facilities or home, because there is no good offer for them in the health care system, although there are rehabilitation methods that could be offered to them, if there were funds for it – says the doctor. The Care and Treatment Institute specializing in caring for patients in a coma is run by the “Light” Foundation in Toruń.

7. Waking up is a process

Its beginning can be considered the first, conscious and repeated reaction of the patient to a specific stimulus. Sometimes the patient is unresponsive, but the MRI shows that his brain is working. This means that he may have been awake before, but how to contact him has not been discovered. Today the so-called cyber eye for non-verbal contact with the patient. This device picks up the slightest eye movement that we are not able to notice. Patients who would be visually perceived as unreachable in society use the cyber eye to complete the tests with the staff. In the patient, you can even read the intentions of movement, because every brain, even if damaged, produces waves that are analyzed and examined.

8. What does the return look like?

People who have fallen into a coma after brain injuries do not behave in the same way when they wake up as they did before the accident. Many patients do not speak, most use wheelchairs, and few walk on their own. Everyone needs care. They learn to sit down, get up again, recognize tastes, smells, use the toilet. Maciej Zientarski, an automotive journalist who had a car accident in February 2008, admitted that he does not always remember what happened the previous day. However, we also know the case of Jason Padgett, who after awakening from a coma, turned from ignorance to a mathematical genius.

9. Do miracles happen in medicine?

Since the human brain can still surprise scientists, “miracles” in medicine are still possible. There are awakenings of patients in the face of whom medicine has helplessly spread its hands. Doctors did not give Mateusz Matczak, the representative of Poland in swimming, any chance to regain consciousness. And after a few weeks of living in a coma, he woke up. Nine months after the accident, he returned to the swimming pool and took part in the Polish championship. He also returned to the university.

10. Poles use the Japanese method

Poland is the second, next to Japan, country where experimental surgeries were carried out to awaken patients from coma by implanting brain stimulators. After such procedures performed in May and July 2016 at the University Teaching Hospital in Olsztyn, patients begin to regain consciousness. The operation consists in placing electrodes in the cervical section, which stimulate the core and the brain with a current, which is to awaken the patient from a coma. In addition to Ola, the daughter of actress Ewa Błaszczyk, such stimulators were implanted in Olsztyn in six more people. There was an improvement in consciousness in all of them.

11. Stem cells to wake the sick

Medical experiments are underway to use stem cells to treat coma. – I hope that stem cells will become a new group of drugs in the treatment of difficult diseases of the nervous system, such as amyotrophic lateral sclerosis, multiple sclerosis or prolonged coma – says prof. Wojciech Maksymowicz, who conducts the research. It is known from animal experiments that stem cells stimulate natural regenerative processes. When administered to the site of damage, they can force the body to repair damaged parts of the brain.

12. Guardianship is guaranteed by law

The Day of Patients in Śpiączka was established by the Seym in 2012 and is celebrated on April 18. In the resolution adopted, the deputies stressed that people in a coma, unable to strive for respect for their rights, should be cared for and taken care of by the Republic of Poland. The law is there, but patients’ families still struggle with access to professional care.