When a patient is in a coma, there is no proven treatment to help him regain consciousness. That is why doctors have considered these patients such a daunting medical challenge. And a recent study that shows brain activity in many such patients makes it all the more frustrating. But the wars in Iraq and Afghanistan may be offering some answers.
The U.S. Department of Veterans Affairs has four special “emerging consciousness” programs across the country. In them, comatose or vegetative patients with brain damage caused by accidents, wounds or illness are returning to consciousness in much higher numbers than anywhere else. Their successes have offered hope in a field that has offered very little up until now.
Thanks to increased funding because of the high numbers of soldiers suffering from traumatic brain injuries in the Iraq and Afghanistan wars, the VA has been able to hire more medical personnel to focus on the problem. The increased funding also allows patients a longer time to emerge from a coma — up to 90 days in the VA, as opposed to no more than 30 days outside.
Therapies include all kinds of stimulation for the patient: friends and family help exercise the patient’s muscles, massaging their joints and stretching their limbs. Doctors use drugs, TV shows and different aromas. They strap the patient in a wheelchair and take him out in the sun, or put him on an upright tilt table so that he is in a standing position. They order, question and coax the patient — anything to try and get his brain functioning again.
While it is still unclear what specifically is helping to bring these patients back to consciousness, the numbers are impressive. The VA’s success rate is almost 70 percent. In 11 studies in private hospitals, the best recovery rate for patients who are comatose was 54 percent. And in five of the 11 studies, the rate was less than 10 percent.
Time is needed to understand this success, but the VA’s efforts are offering a ray of hope in this very dark area of the study of the brain.