Tuesday, February 2, 2010

54 hours

It feels like it has been a week but it has only been 54 hours since Elana started the Coma. So far Dr. Cantu is happy with how the Coma is going. She is running a slight fever but that is normal for Coma patients. They are taking throat, urine & blood cultures to see if there are any problems that may require antibiotics.

Ordinarily, at this stage in the Coma, the patient would be"under" with only ketamine. However, in about 20% of Coma patients, propofol (if that sounds familiar, it is because that was the drug that killed Michael Jackson) is needed to keep the patient completely "under". At some point during the night, Elana actually sat up and tried to remove the tubes from her mouth. Again, this is not uncommon for Coma patients. Regulating the amount of ketamine is both a science and an art. It is impossible to know beforehand how much ketamine will be needed to snow the patient over.

However, the amount of ketamine she is receiving on an hourly basis is staggering compared to how much she received in Tampa during her 3-day infusion treatments last June and October. I can tell you that at 200 mg /hr, which is the highest dosage you can receive at any point during the 3-day infusion treatment, your mind has left the planet and you are severely hallucinating. For those of you who prefer colloquial terminology; you are tripping your face off and have no idea who or what is real. And Elana only was receiving that highest dosage for 1 1/2 hours of the 4 hour infusion. Over the course of a 4 hour infusion in Tampa, Elana would get between 550 -600 mg of ketamine (approx 135 - 150 mg / hr). As Hans and Franz used to say, "Hear me now & believe me later", that is a lot of ketamine.

By comparison, On Sunday, she started with 240 mg /hr on a continuous basis. On Monday it was raised to 320 mg / hr & today it was raised again to 400 mg / hr. Today she will receive in excess of 9000 mg of ketamine. You can only imagine the party going on her head at that level. All kidding aside, she is probably having extreme and terrifying hallucinations. At the same time she is beginning to go through the severe effects of withdrawal from all the opioids (Vicadin, Morphine & Oxycontin) that she was taking in heavy dosages each day. This is a good thing, because it would have been almost impossible, and probably not so safe, for her to remove the addiction in a conscious state. The reality is that when she wakes up she is still going to be going the effects of withdrawal and the hallucinations. According to the doctor and those who I have spoken to who have gone through this, the toughest days will be after she wakes up. At that point I have to be with her 24 hours a day so she has something and someone familiar and calming with her at all times.

Sorry for all the medical talk. Time to call Jesse and find out who is favorite basketball player is. Some days it's Kobe other days it's D-Wade.



  1. I don't think you have to worry about her hallucinating right now. Those will come as she wakes up. There may be some of it but she will be given drugs to make her forget and this is a mercy as far as I am concerned!
    It sounds like you are getting the full meal deal on this one and we wish you all lthe very best. Pleasant dreams Ekana and Lance, hang in there. Our thoughts are with you.
    Fern & Theo

  2. We are all still here and all still praying, and God is good. Elana is being taken care of, I know it. I must believe it. She was ripping out that IV because she thought someone was trying to steal her pocket book on the subway en route to Soho from Dabee's apartment on the Upper East Side.

    It's good that there are no infections right? And sounds like everything is as normal as can be for someone with as such a progressed case that E has, right???

    It's a blessing she can detox while asleep!! That's a whole nightmare in itself. So there is some good in the LONGEST WEEK IN HISTORY!


  3. I think she sat up because she wanted her hair brushed and moisturizer put on her face.

    I am happy to hear all is going well and yes, this is the longest week in history. Elana will be happy to know that Amy and I talk 100 times a day to get through the days.

    Lance, Amy and I would be happy to come to Mexico next week for extra familiar faces.

    Sending you love and strength and missing you more than you know.


  4. Lance,
    If I'm exhausted, I can only imagine how you are feeling. Thanks so much for these updates. I am so grateful for them. Go get a sandwich and take a nap....
    With love,

  5. Lance,
    Thank you for explaining what exactly our poor girl is going through. Each day that she goes through this takes a bit of the worry away. I am not sure how you are holding it together and still finding the time and energy to do this blog for us but THANK YOU!!!

  6. Lance,

    All our prayers pour out to you and Elana, from the homefront at SWC.

    I know that writing this blog must be so emotional on so many levels for you that you possibly can not explain it yourself, but just think that when you look back at this in weeks, months and years from now it will all be in the past and you will have a beautiful future.

    Most people would have probably backed out and given up from the frustration of takeing care of an ill loved one where you have been and are an ablosutely WONDERFUL person, husband father and son and it only comes out in the actions that you have taken and the strength that you have had to keep it together. God Bless and my prayers are with you daily.


  7. Oh Lance! I had no idea this was all going on. I am so sorry to hear that you are both going through this. I am praying for you guys. I will remain optimistic that this new treatment may help. Elana is a fighter and too strong willed to let this push her around. PLease be sure to take some care of yourself during this time. It will help her when she is ready to wake up. At any rate, please know that I am thinking about you guys and sending lots of prayers and love from los angeles. xoxo-Emilia (a sorority sister of Elana's from ASU)

  8. I had no idea Elana was going through this - please send her my love, warm wishes and prayers as she endures this great challenge in her life. Elana is one of the sweetest, funniest and kindest people I have met. Lots of love - Kessie (sorority sister from ASU)

  9. Hi Lance,
    Seth just forwarded me the link. We're thinking of you and Elana and have you both in our hearts and prayers. Love, Heather

  10. Hi Lance...My name is Al Andrade I live in R.I. I wanted to check on how Elana is doing with the long treatment...I too have CRPS (formaly known as RSDS) I have the nerve disease from head to toe do to a crushing injury to my right foot at work in 95...I had it for 5 years now as a matter of fact I talk to Dr.Micheal Gershon...LOL...I betcha know him...He would tell me how Elana is doing because me having the same disease I can say that I know exactly how she feels and its not an easy thing to go through for both you and Elana...My wife Cheryl watches me struggle with daily life every single day...I chose not to do the coma thing cuz its to high of a risk for me...One I have high blood pressure and I'm also a recovering heart attack victom...But I am doing Ketamine Infusions in Boston...I'm doing 250 mg for about 6 hours sometimes longer once a month...But know the treatment isn't as effective as when I first started...I wanted to tell you that myself and Cheryl will pray for you and that Elana will safely make it through her treatment...Our thought are with you both...One day there will be a cure for this aweful disease...But be strong and never give up hope...We both will check in to see how Elana is doing...If you have any thing you want me to tell Dr.Micheal G I'll be more than happy to pass it on...Again keep strong and never give up hope...Al

  11. Hi Lance,

    My name is Cheryl Conti-Andrade, wife of the above blogger. My heart and soul ache for you! I have watched my husband, Al, a 3rd degree black belt, iron worker, carpenter and master of many things just physically become weaker! It hurts!!! I also see Michael Gershon and we share our stories. If it wasn't for him, I don't think my husband or myself would be here. He along with Al's medical doctors are incredible!!!

    The person who is truly incredible is Al, he has not let this pull him down. He now knows his limitations, thanks to counseling and making deals with me. He just keeps going and I don't know how he does it! We have a lot of faith, I found my faith after this disease hit Al. I knew I couldn't do it alone and turned to God! (Actually turned to my rabbit Emmitt first, let Michael tell u that story, it will make u laugh. Michael, I give u permission to tell the story, anything to put a smile on their faces.

    Elena is young and strong and that is very important!! She sounds like a fighter like Al, which is a great thing!

    If you wish to speak to either one of us please call us at 401-885-0199 anytime day or night. We will listen, we are living it.

    In the meantime your whole family is in our prayers and I hope to God this is the answer for her. If I could c a least one person cured; I would be so happy!!!

    Yes Michael, if u r reading this I am crying, so I am having my therapy. lol