Bobbi Kristina Brown has been getting attention in the news because she is in a coma. On January 31, 2015, the world became aware Bobbi Kristina Brown, daughter of singer Bobby Brown and the late R &B dvia, Whitney Houston, was rushed to the hospital because she was found in the bathtub face down. On Tuesday, February 3, 2015 she was moved to another hospital and placed in a medical induce coma or medical coma (Botelho & Newsome, 2015). There are many questions about Bobbi’s quality of life upon awaking from her coma. At the same time, people are wondering about the families’ mental health status since they have decided to keep Bobbi Kristina Brown on life support. The purpose of this article is to educate the public on an anoxic brain injury, its prognosis, and how it’s effects the family mental and emotionally.
Brain injuries can be classified into two categories, traumatic and acquired. A traumatic brain injury (TBI) is when the brain is struck by an external force (e.g., vehicle accident or fall). An acquired brain injury (ABI) is a non-traumatic brain injury (e.g., stroke or near drowning). According to the Brain Injury Association of America, (2012), BIAA, there are eleven types of brain injuries: Diffuse Axonal Injury (TBI), Concussion (TBI), Contusion (TBI), Coup-contre coup injury (TBI), Second Impact Syndrome (TBI), Open and Closed Head Injuries, Penetrating Injury (TBI), Shaken Baby Syndrome (TBI), Locked in Syndrome (TBI), Anoxic brain injury (ABI), and Hypoxic brain injury (ABI). Bobbi Kristian Brown has sustained an anoxic brain injury. An anoxic brain injury is when the brain is injured due to a lack of oxygen and there are three subtypes: Anoxic Anoxia, Anemic Anoxia, and Toxic Anoxia. An anoxic anoxia is when the brain is injured due to receiving no oxygen. An Anemic Anoxia is when there is little oxygen in the blood and Toxic Anoxia is when toxics or substances is blocking the oxygen in the blood from being used (BIAA, 2012). On January 31, 2015 she was rushed to the hospital and was placed in a medical induced coma.
“Medically-induced coma (also referred to as medical coma) is a drug-induced state of profound brain inactivation and unconsciousness used to treat refractory intracranial hypertension and status epilepticus, i.e., epilepsy that is refractory to standard medical therapies [1–3]” (Shanechi, Chemali, Liberman, Solt, & Brown, 2013, p. 1). The purpose is to reduce the swelling inside brain. The swelling, intracranial hypertension is what damages brain cells. The medically-induced coma is monitored by electroencephalogram, EEG, and titrating utilizing an anesthetic at a particular rate that will provide continuous suppression of brain inactivity (Shanechi e al., 2013). An attempt was made to bring Bobbi Kristina out of her coma, however she began to have seizures and they returned her to a medically induced state. Her prognosis is very guarded if not poor.
Dr. Sasan Yadegar a neurosurgical doctor with Dignity Health Northridge Hospital and Trauma Center, who is not treating Bobbi Kristina however familiar with her condition, shared his thoughts regarding her prognosis. A condition that Bobbi Kristina is experiencing would be medically induced from three to six months. The first step of recovery is looking for Bobbi Kristina to breathe on her own, then to open her eyes, and then follow some type of command. The following of commands is correlated to her degree of cognitive functioning such as having the ability to following through with one, two, or three step commands. Individuals who experience an anoxic brain injury versus a traumatic brain injury have more cognitive impairments. According to Fitzgerald, Aditya, Prior, McNeill, & Pentland (2010) they conducted a study of patients’ diagnosis with TBI and anoxic brain injury (AnBI) in inpatient rehab with same deficits. The results were AnBI patients progressed more slowly. Another study by Cullen & Weizs (2011, January) found that between AnBI and TBI patients, AnBI patient were worse on all Functional Independence Measure (FIM), and cognitive gains. Bobbi Kristina if she recovers will not have the same degree of cognitive functioning that she had prior to her anoxic brain injury. The severity will create many degrees of distress within the family.
Impact of Coma on Family
Since the onset of Bobbi Kristina’s incident which left her unresponsive, her family has chosen to keep her on life support. One never knows the psychological and/or emotional distress family members are going through regarding having a love one in vegetative or little brain consciousness state. In addition to Bobbi Kristina’s health status, there are questions related to suspicion of foul play by her significant other. Therefore family members may be experiencing anger, anxiety, grief, depression, and numbness.
There is nothing wrong with a person experiencing these type of emotions and according to Kitzinger & Kitzinger (2014) “We suggest that counseling, while undoubtedly helpful to some relatives on some occasions, is not the only – or necessarily the most appropriate – response to family distress” (p. 629). At times we have an immediate inclination that a person is demonstrating maladaptive patterns of psychological, emotional, or behavioral distress. When in reality, it is a natural and appropriate response to an emotional charge situation or incident. Offering counseling services may send the wrong message that a person is not supposed to feel any type of negative emotions, which is not true. If a person is experiencing impairment in their day to day functions for an extend period of time and in other areas such as school, occupational, and social, then counseling services need to be offer.
Bobbi Kristina was found face down in a tub on January 31, 2015 and placed in an induce coma. She was taken out of the coma, however experience seizures which led to a return to a medically induced coma state where she currently remains. Bobbi Kristina has sustained an anoxic brain injury that resulted from lack of oxygen. Prognosis for anoxic brain injury are poor especially compared to traumatic brain injuries. Family members’ response to distress is a part of normal functioning. At any time during their distress they can utilizing professional counseling services to assist with going through process of their emotions if their emotional state is causing impairments in other areas of functioning. Life has ups and downs and by quick to not allow family members to experience negative emotions, is taking away one’s humanness and one’s natural way of dealing with stress.
Brain Injury Association of American (2012, October 12). About brain injury. Retrieved from http://www.biausa.org/about-brain-injury.htm
Botelho, G. & Newsome, J., (2015, February 3). Bobbi Kristina Brown moved to new hospital amid fight for life. Retrieve http://www.cnn.com/2015/02/03/entertainment/whitney-houston-daughter-bobbi-kristina-hospitalized/index.html
Cullen, N.K & Weiz, K. (2011, January). Cognitive correlates with functional outcomes after anoxic brain injury: A case-controlled comparison with traumatic brain injury. Brain Injury, 25(1), 35 - 43.
Kitzinger, C & Kitzinger, J. (2014). Grief, anger and despair in relatives of severely brain injured patients: responding without pathologising. Clinical Rehabilitation, 28(7), 627–631.
Fitzgerald, A., Aditya, H., Prior, A., McNeill, E., & Pentland, B. (2010). Anoxic brain injury: Clinical patterns and functional outcomes. A study of 93 cases. Brain Injury, 24(11), 1311 – 1323.
Shanechi, M. M., Chemali, J.J., Liberman, M., Solt, K., & Brown, E.N. (2013). A brain-machine interface for control of medically-induced Coma. Plo Computational
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