Coma

Thekherham

The Alien Writer
Super Member
Registered
Joined
Feb 12, 2005
Messages
552
Reaction score
12
Location
5657 Brežendra Rd., Treskebhar, Te’hănys, Alharhan
Tell me about comas (yes, I mean comas, not commas). What is the difference between someone waking up from a coma after, let's say, a couple of days and someone waking up after years in a coma? I started a story about a man waking up after ten years in a coma but then I got stuck. Do things like hair and fingernails/toenails keep growing? What about nourishment? Would he be constantly on IV (?)? Would he recognize his family when he wakes up, i.e. little kids would be teens when he awakens?

Thank you for the help.
 

King Neptune

Banned
Joined
Oct 24, 2012
Messages
4,253
Reaction score
372
Location
The Oceans
I can't give you all the details, but it is very unlikely that someone will wake up after years in a coma, because most people would die while still in the coma. It is news when someone wakes after years in a coma, because it is extremely rare. You probably should search for what you can find online; most of your questions will be answered.
 

cornflake

practical experience, FTW
Super Member
Registered
Joined
Jul 11, 2012
Messages
16,171
Reaction score
3,734
Tell me about comas (yes, I mean comas, not commas). What is the difference between someone waking up from a coma after, let's say, a couple of days and someone waking up after years in a coma? I started a story about a man waking up after ten years in a coma but then I got stuck. Do things like hair and fingernails/toenails keep growing? What about nourishment? Would he be constantly on IV (?)? Would he recognize his family when he wakes up, i.e. little kids would be teens when he awakens?

Thank you for the help.

There are different types of comas, different levels of comas (it's a scale), different reasons for coma states, etc. There are also different states of wakefulness. Most people don't just 'wake up' from comas (depending on what type of coma we're talking about, but excluding purposefully-induced ones [and even then sometimes]); it's a gradual process that can stop at varying points. There are very, very rare cases of people just 'waking up' and talking and being cognitively unaffected, etc., after long periods of being comatose. Sometimes those people are in that state very briefly. Depends on all the above, and sometimes it's just inexplicable.

As above, it's rare to recover from a persistent coma (or vegetative state) to begin with, though people do. Recovery depends on all of the above, plus the person themselves. Someone in a coma is on a feeding tube, not an IV, usually, though could be both, depending on the issue and where the person is.

I have to ask why or how you'd think hair and fingernails and stuff would stop growing? They would not, but I just have to know how you got there.
 

Tsu Dho Nimh

Super Member
Registered
Joined
Sep 2, 2006
Messages
1,534
Reaction score
248
Location
West Enchilada, NM
Do things like hair and fingernails/toenails keep growing? Yes. They require grooming and bathing just like everyone else.

What about nourishment? Probably a feeding tube

Would he be constantly on IV (?)? No ... that doesn't provide the nutrients that you can get into a feeding tube, and keeping the various electrolytes in balance is hard.

Would he recognize his family when he wakes up, i.e. little kids would be teens when he awakens? Dunno

*************
Look up the Terry Schiavo case for what is involved in the long-term care of a minimally responsive patient.
 

Twick

Super Member
Registered
Joined
Oct 16, 2014
Messages
3,291
Reaction score
715
Location
Canada
You might want to read "The Dead Zone," by Stephen King. He goes over a lot of the physical things that happen to a person's body when they've been comatose a while.
 

Maryn

Sees All
Staff member
Super Moderator
Moderator
Kind Benefactor
Super Member
Registered
Joined
Feb 12, 2005
Messages
55,320
Reaction score
25,292
Location
Snow Cave
One of the guys in our kids' social circle in high school was 22--but he'd been in a coma for five years and acted like he was still a teenager, and not a very mature one at that. It was a little disconcerting to see Jesse, who looked older than 22, with his arm around his girlfriend, who looked younger than her 17. I had to keep reminding myself that his brain was still a kid's.

As far as my kids knew, he didn't have any lasting consequences from his coma. He didn't seem especially bright to me, unlike most of the kids in that social group, but he apparently did all right in school, drove a car safely, and was very religious, as was his girlfriend.

I don't know the cause or depth of his coma, but maybe this can help a little.

Maryn, who wishes she could remember his last name to see what he's doing with his life
 

MDSchafer

Banned
Joined
May 21, 2007
Messages
1,871
Reaction score
320
Location
Atlanta, GA
Website
firstfolio.blogspot.com
Tell me about comas (yes, I mean comas, not commas). What is the difference between someone waking up from a coma after, let's say, a couple of days and someone waking up after years in a coma? I started a story about a man waking up after ten years in a coma but then I got stuck. Do things like hair and fingernails/toenails keep growing? What about nourishment? Would he be constantly on IV (?)? Would he recognize his family when he wakes up, i.e. little kids would be teens when he awakens?

Thank you for the help.

So, I used to do this for a living. I tried to break down your answers into a few categories.

Memory: This entirely depends on the mechanics of the energy, ie what kind of brain injury did he suffer? Honestly, anything short of total amnesia is believable. What happens most of the time is that people do not remember the accident that caused the injury, but otherwise their minds are intact. Mostly, for people who get close to a 100 percent recovery broke in two directions. (No one gets a 100 percent recovery, but 95 percent is pretty damn good.) Some people, the minority, remembered everything up to a specific point, usually a few hours before the accident. The majority of people didn't have a firm time of what was the last thing they remembered before the accident, which is to be expected. Retrograde amnesia is super common, and a lot of times it will take anywhere between an hour to twenty four hours before the event.

Nourishment: We use Percutaneous Edoscopic Gastrostomy Tubes, almost universally known as PEG tubes in medical parlance, to feed our long-term coma patients. They're tubes that doctors place in the stomach There's dozens, a hundred maybe, of different tube feeding formulas that we use for people who can't eat for various reasons. The formulas are basically liquid nutrition that provides the calories a body needs. In a hospital they'd have an IV, but we removed them before sending them to a Skilled Nursing Facility.

Activities of Daily Living: Yes, hair, fingernails still grow while you're in a coma. Men will still have erections. Your body continues to function, it's just that no one is running the ship. The patient care techs and the nurses take care of all of the ADLs. They bath the patient, clean them up after they void or move their bowels, feed them, cut their hair and trim their finger nails. Good facilities will shower their patients once a day in addition to cleaning up after BMs and urination.


Waking up: So, I'm going to try and keep this short, but you don't just "Wake Up" from a coma. I used to work at world-leading brain injury rehab and we never had a patient just wake up have full control of their body. That is nothing short of a miracle, but it's super common in fiction. Any significant brain injury requires weeks of intensive therapy and then life-long efforts to overcome.

If you've ever partially woken up from a deep sleep or an intense dream those ten seconds of confusion and lack of mental facilities is the closest analog I can think of for waking up for a coma, only instead of lasting a few seconds it can last for weeks, or more. There's also associated motor neuron damage not to mention muscle and bone atrophy. For the most part brain injury rehab is two steps forward, one step back, and a half a step sideways. It's never like it is in fiction. The only thing I've seen in fiction that got it right was House of Cards, which honestly shocked the crap out of me when I saw that.

While I was doing brain rehab I had a few miracle boys, and I say that because they were all young boys. Guys who came back from full out comas and got as close as possible to a 100 percent recovery. They all had long fights back to health, and I think all would say that four-five years out they still have repercussions from their coma.

If you're interested in doing this realistically I'd strongly recommend that you look up the Rancho el Migo Coma scale. There are a lot of resources tied around that. In my experience everyone who was in a coma went through the levels described in that scale, although at different speeds.

Family: Yes, people remember their family, even before they can really process anything else. They might not be able to respond but they will recognize their family. If a lot of time passes, it can be frustrating. If you remember your little brother as a 10-year-old and suddenly he's 20 with a goatee and Viking hair, it might not be instant, and would probably take some time to process. The parents though, yeah, always. I honestly think there's some sort of bond between a loving parent and their child that transcends what we understand by science.
 

Alsikepike

Super Member
Registered
Joined
Apr 12, 2017
Messages
100
Reaction score
4
Location
Central Minnesota
There'd be a lot of things to consider. There might be some cognitive deterioration after ten years of inactivity. The brain has a kind of, "Use it or lose it" mentality. The man might have trouble speaking, reading, writing, etc. There are a lot of factors to comas that we don't know or entirely understand. It varies from person to person, and the cause of the coma also has a lot to do with recovery. Traumatic brain injuries often have a lot of memory loss and permanent brain-damage involved. You can generally write the story any way you want to, as there's no way to accurately predict how a person will recover from a coma.
 
Last edited:

Los Pollos Hermanos

Craving the next chocolate hit...
Super Member
Registered
Joined
Jan 1, 2014
Messages
480
Reaction score
36
Location
England
A fascinating thread! Pretty please can I be a little bit cheeky and ask a quick question?
It may be of use to anyone viewing this thread now, or in the future.

I have a minor character who ends up in a coma for four months after a fall from a fairly substantial height. His lower body took most of the impact, but he had a thwack of the head onto a pavement/sidewalk for good measure. He gradually regains consciousness over a couple of weeks and, when eventually questioned by the police, has a few *very* vague memories from a few minutes before the incident that caused the fall.

Is the "few minutes before" realistic (as in can occasionally happen), or a complete Big Fat Nope?!

Thanks for any replies and sorry for this little hijack!

:flag:
 
Last edited: