Brain Dead Child Discharged to Home With Parents

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    Brain-dead son can move feet, dad says
    By Jason Bergreen
    The Salt Lake Tribune



    Six-year-old cancer patient Jesse Koochin's condition is "dire" at best, his father acknowledged Sunday, but the boy doctors pronounced brain-dead last week now can move his feet.
    "That was a new thing that occurred just last night," Steve Koochin told reporters at a Sunday afternoon news conference at Olympus Hills Park near Holladay. "I was elated."
    Holding up two photos taken of Jesse smiling when he was an infant, Koochin appeared optimistic about his son's chances of surviving.
    "That's my son right there," he said, pointing to the pictures. "That's his spirit."
    Gayle Koochin, Jesse's mother, reported the same movement by her son when she rubbed his foot Saturday. She also said his cheeks were pink and he was warm to the touch.
    "We have to have faith in Jesse," she said. "There are many who don't. It's up to him."
    A judge granted a restraining order last week barring doctors at Primary Children's Medical Center in Salt Lake City from removing Jesse from life support and allowing his parents to take him home to their Salt Lake apartment. He remains hooked up to a ventilator to help him breathe, his father said, and his diet consists of vitamins and organic juices. Full-time nurses are caring for Jesse at night and part-time during the day.
    On Sunday, Jesse's blood pressure was 90 over 57 and his pulse was 108 beats per minute, his father said.
    "You can put your finger on his temple and feel every heartbeat," he said.
    Jesse's medulloblastoma brain cancer was diagnosed April 19, four days after his 6th birthday. Doctors found a tangerine-size tumor. Jesse underwent radiation and


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    holistic therapy in Florida and Georgia as well as alternative treatments in Mexico. He was hospitalized in Utah on Sept. 15 when he had trouble breathing on his own.
    Doctors determined through separate examinations by two physicians last week that Jesse was brain-dead - a conclusion his parents reject.
    "He is not his brain," Steve Koochin said Sunday. "There is nobody that is just his brain."
    When asked if he planned legal action against the hospital, Koochin only said, "Our focus is on Jesse."
    He said the community's response to the boy's struggle has been overwhelming and that the family appreciated the support. Over the weekend, an LDS Church member visited the Koochin home and blessed Jesse. He said strangers have approached Gayle in public to hug her.
    The Koochins, uncertain about their next move, hope to know more about their son's fate by the end of the week.
    "Either he's going to start improving on a day-to-day basis or he's going to start deteriorating on a day-to-day basis," Koochin said.
    jbergreen@sltrib.com
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  4. 25 Comments so far...

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    Well, I would think that if their son has a chance of recovery they would want him in the hospital where he can have close monitoring and such. And, even with brain death, some spinal reflexes can be present right? Maybe that's what they're seeing with his feet.
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    From what I understand about brain death; once you're brain dead, you're dead. There is no circulation in the brain. I'm not sure why his feet move when stimulated. It may be possible that a dead person could still have automatic reflexes; but not sure about that. I mean, unless this boy really isn't brain dead. I Know you can keep a dead body functioning to an extent by keeping it on life support. I can't imagine how it has lasted so long though. Normally, the blood pressure would have started to crash, electrolytes out of balance and needing lots of replacements, etc... But this boy is still "alive" if you can call it that. Amazing. Unless....he really isn't brain dead...
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    I feel badly for the family, because it's clear they are in some serious denial, but who wouldn't be?

    On the other hand, kudos to those parents for taking their child home. Whatever happens, spontaneous remission (so unlikely) or slipping into the beyond, his parents have control of him, not the staff of a hospital.

    Without medical support, he will no doubt make his last journey (of this life, anyway) a little quicker.

    But they'll do it together, and without medical intrusion.

    I say, kudos, and God's Speed.
  8. 0
    There's at least one case in the literature of a brain dead child who has 'survived' at home for fourteen years and counting. He didn't have cancer, but it's interesting...
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    I thought that someone can be declared brain dead and yet still have at least part of their brain stem functioning? That would explain involuntary movements and reflexes. But I may very well be wrong!
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    Quote from Gompers
    I thought that someone can be declared brain dead and yet still have at least part of their brain stem functioning? That would explain involuntary movements and reflexes. But I may very well be wrong!
    According to the drs who diagnosed the little boy as brain dead they stated that his body was already beginning to decompose. 3 doctors diagnosed him brain dead, but who knows??? Where there is the slightest spark of life there is hope.
  11. 0
    Quote from CeCiRN
    According to the drs who diagnosed the little boy as brain dead they stated that his body was already beginning to decompose. 3 doctors diagnosed him brain dead, but who knows??? Where there is the slightest spark of life there is hope.
    Okay, decomposition means plain old vanilla "dead," not "brain dead."

    I think Lazarus and, depending on your interpretation, J. C. himself were the only two to pull of that miracle.

    I also doubt that it is legal for the parents to keep their decomposing child's body, no matter what their believe in miracles. There are rules about the management of decomposing humans, and it related to public health.

    Perhaps there is some confusion as to the meaning of "decompensation" versus "decomposition."
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    Quote from chris_at_lucas_RN
    Okay, decomposition means plain old vanilla "dead," not "brain dead."

    I think Lazarus and, depending on your interpretation, J. C. himself were the only two to pull of that miracle.

    I also doubt that it is legal for the parents to keep their decomposing child's body, no matter what their believe in miracles. There are rules about the management of decomposing humans, and it related to public health.

    Perhaps there is some confusion as to the meaning of "decompensation" versus "decomposition."
    I know that decomposition means dead. I just went by the article in the newspaper. The little boy is on a vent so naturally his heart is still beating. They are giving updates on the little boy in the news so if you want more information try www.slctribune.com. But the drs said that his body was starting to decompose, unless I'm mistaken and I very well may be.
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    Quote from chris_at_lucas_RN
    Okay, decomposition means plain old vanilla "dead," not "brain dead."

    I think Lazarus and, depending on your interpretation, J. C. himself were the only two to pull of that miracle.

    I also doubt that it is legal for the parents to keep their decomposing child's body, no matter what their believe in miracles. There are rules about the management of decomposing humans, and it related to public health.

    Perhaps there is some confusion as to the meaning of "decompensation" versus "decomposition."
    Sounds like he's dead to me. Soon his brain will start to liquefy as atrophy sets in and the brain matter itself is replaced by CSF. They'll see liquid oozing out his ears as this occurs. His heart will stop soon; immediately, I suspect, if they disconnect the ventilator. The only thing keeping his cheeks pink is the ventilator perfusing his (decomposing) organs.

    Didn't we already have this discussion under neuro nursing? Lack of cortical function, regardless of brainstem function, can be used in some facilities to declare a patient brain dead, and brain dead means DEAD. Period. I suspect his feet "movement" is decorticate or decerebrate posturing.

    This is really sad. I, too, think these poor parents are in some serious denial. However, I am unclear as to why the nurses working in the home or hospice aren't helping them face facts and accept what seems to have occurred--death--rather then givng them false hopes. Well, miracles have been known to occur, but not with decomposing bodies--as chris said, not since biblical times, with Lazarus and Jesus Christ Himself!
    Last edit by stevierae on Oct 20, '04
    KelRN215 likes this.


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