Wednesday 6 December 2006

'LOCKED IN' State

Today, I was re-referred a patient in the male medical ward. Previously, like a few days ago, he was sent to ICU - he started choking, unresponsive and his state was just deteriorating and hence was warrented to be moved for emergency procedures in ICU. While he was there, he was referred to me... I obviously rejected the referral as he was unresponsive and advised the doctors to re-refer when he is much better.

Today, mid-morning, the male medical ward called me up. He has been re-referred for a swallowing assessment. I asked the nurse who called if the patient is alert or drowsy... He was unable to answered and shifted the call to someone else. I suspect its a doctor, but he has never identified himself.

Anyways, I re-assured the man that I would visit the patient before the end of the day. I almost forgotten,but i went anyways, whilst all others went home.

Before assessing the patient, I took his medical file and started reading. BOY OH BOY.... I read 'LOCKED IN'... "BLINKING"... "YES AND NO"... COMMUNICATING.... my heart raced... Do you know what this means?

This was a normal man... had a stroke which resulted in him having physical impairments but able to communicate.... then he had an episode in the wards... sent off to ICU... got better and transfered back to the normal medical ward... and now... he is unable to say anything but able to understand... he is communicating to us using his eyes to say 'YES' and "NO'.... hence... he is a man... LOCKED inside himsef... I was excited...

Sadly, he was in a poor state... so I have to give him a few more days to recover before he is safe for a swallowing assessment and reliable communication skills assessments .. Shall i keep you all updated with his?

LOCKED IN people... do you understand this?? Sigh... I think this may be my first case in Brunei... LOCKED IN... how exciting!!!

10 comments:

Anonymous said...

Yea, there was once a very religious Cleric (unsure where his origin was). He got locked in and used a type of Card with Alphabets on it to communicate. Like the first line was A-H etc. I found it rather interesting that making a full sentence didn't take that much time. You know "1,2,3,4" , "Y" , "1" , "A,B,C,D,E" , "1,2,3" , "Q,R,S" ..
Finally spells out YES just by rolling your eyeballs up to confirm a letter (YES was an example, I think YES was 2 blinks or something)

FR said...

i knw what it is. i learnt about it. that is so interesting =) do update us about him.

Padian said...

:) Yes.. it is very exciting :) Since this is my first, and communication is limited... I am researching Augmentative Alternative communication tools...

Long2's suggestion in using the alphabet chart and line (basic communication) will be used as soon as i find out if the patient can read... and has good vision, and or head control.

But... this is something new, exciting... blood is rushing... I am smiling... and as I am typing away this comment, baby is helping me find sites and/or articles about this syndrom.

As you will find out, if you search and read, there won't be much info... so perhaps I will email my lecturers again for help and advice. I am sure they would be very happy to hear from me again...

Anonymous said...

I don't recall who the cleric is, but I do distinctly remember watching it from one episode of "Jejak Rasul".. Maybe you could ask around if anyone have seen this particular episode. I am sure there are loads. I watched it!! LoLsie (^^)

dr.rin said...

Thanks to Meel and Wikipedia, I understand a bit more about this "locked-in syndrome". It definitely is an interesting case, though I wonder what the patient is feeling now. Must be frustrating to be so aware and not able to do anything about it except for facial movements. Thank god you noticed, Meel!

RSHA said...

Yes Meela do update, and who is little.lin?

Nah, dont you tink its a good ting dat ure being transfered to KB. something new :) blessing in disguise bah tu.

Anonymous said...

little.lin is my friend!! Good Job Team!!! (^^)

Padian said...

Little lin is your friend huh nazim ;) OKAY :P

Anyways... yup.. It is interesting.. tapi kesian jua. BUT, i don't think the family quite grasp this idea yet... so will have to wait and see... I have not seen him today.. I am giving him a few days to 'recover'

dr.rin said...

haha, Nazim H, I am honoured to be called your friend, but I think Meela might get jealous! ;P Anyway, did u get the link to the photos from DK? Meela, come visit us in Germany!!!

AlaiMidget said...

wow~ interesting! not for him and the family of cors. i read an article about this many many years ago and the patient recovered (dunno if fully) ...keep us updated ka meela!

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