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Hartstein: This is gonna take time

NEWS STORY
31/12/2013

Former FIA Medical Delegate, Gary Hartstein, is feeling positive following today's press conference but admits that things were clearly very bad on Monday.

On his blog, the New Yorker, who was mysteriously dropped as FIA Medical Delegate in 2012, continues to give a fascinating, no-nonsense take on what he believes is happening in Grenoble.

Having been the right-hand man of Professor Sid Watkins, and subsequently succeeded him on his retirement, his is one of the very few opinions we can take seriously at this time.

"Michael is in very good hands," he writes. "It doesn't matter a hoot that this or that famous neurosurgeon and/or neurointensivist would or wouldn't do this or that element of Michael's treatment, the point is that these guys are smart, they're talking to each other and to the family, and they seem technically up to the job. Oh and by the way, the decision to evacuate the second, intracerebral, hematoma seems to me, a non neurointensivist, to make sense. But more on this later.

"It sounds retrospectively that Michael's ICP (intracranial pressure) was worrisomely and persistently high yesterday," he continues, "despite the right sided bone flap not having been closed. This was a standard and totally normal decision Sunday in the OR (operating room). The ICP problem was so worrisome that they considered a dip to be a “respite” allowing them to scoot to the scan. Now remember, I'm piecing this together from the words used, so everything I say is therefore subject to interpretation. But we've all had patients like this and agonised over going to the scan, coz until just before (the respite they're talking about) every time we touched them their ICP shot up. So the decision was made to gain some room, and drain what sounds like superficial left-sided hematoma. These are usually left alone, and it had previously (and reasonably) been decided not to touch this one. But given the ICP problem, and that overall the brain was less “angry”, it was decided to evacuate it, especially as this meant leaving the left sided bone flap off.

"This leads me to insist on just how sick Michael was yesterday. These guys were sweating bullets, doing everything known to man to help, and they deserve a lot of credit. But this was seriously life threatening minute to minute yesterday.

"Lastly, I think we can A) reset all the countdown clocks we started yesterday (time to reduce sedation, time to wean from vent, etc). And B) insist on just how severely Michael is injured. Be patient. This is gonna take a long time."

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1. Posted by Kismet, 07/01/2014 2:52

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