Melissa Rivers (her daughter) will have to make all the decisions until such time that Joan passes away or she recovers. This isn’t Melissa’s first tragedy, but she’s up to the task. [Damien LeGallienne]
This is a possible scenario for the truth about Joan Rivers’ current condition as the world waits to hear about the fate of a beloved entertainer. Latest reports say that Joan Rivers is now “resting comfortably” while in a medically induced coma. So what does that mean?
These are not pure facts as they pertain to Miss Rivers, but this is a very likely scenario for what is actually happening to Miss Rivers and to what happened to her that led up to her current status at Mount Sinai hospital in New York City.
Early yesterday, Miss Rivers was put under sedation for what some believed to be an ENDOSCOPY — procedure wherein a tube is placed into the throat to have a look at the stomach and esophagus. This was assumed because the private outpatient center where she went for this procedure describes itself as a place to serve as a community resource for digestive disorders.
Later reports stated that she went there to have her vocal chords examined, and that kind of work could have been done in a private surgery suite such as this one where Joan Rivers was taken ill with cardiac arrest.
In either case, the place where Joan went is a qualified medical office where many wealthy New Yorkers go for private care when they get minor procedures, which is what this was reported to have been.
During the procedure, it was reported that Miss Rivers stopped breathing and her heart stopped beating – which can happen during any procedure where one is anesthetized to any degree. Sources now say that CPR was applied at the clinic but one can assume that more aggressive means of life sustaining support began after paramedics arrived on the scene.
Okay, so here is what may have happened afterwards, and in my opinion is probably what is going on now.
Miss Rivers “failed” during the surgery and whatever life saving measures they did there — and that moment — and how well they worked, will determine the ultimate fate of Joan Rivers.
If the doctor or doctors who performed the procedure at the clinic were skilled and equipped for emergency resuscitation and they had some, any or little success reviving her, she still may have gone for a considerable length of time without adequate oxygen for her body to maintain function. The degree of oxygen deprivation depends on the amount of time she went without breathing or someone breathing for her via mouth to mouth or by “bagging.”
The ambulance that came to take her to Mount Sinai — even under the fastest circumstances — would have taken 8-10 minutes. Upon arrival, the paramedics would have started or initiated resuscitation – like shocking her heart with a defibrillator and breathing for her with a bag or mechanical ventilator while or after they rushed her to the hospital wherein more advanced equipment would be available and her condition could be more thoroughly accessed.
Currently, and this is conjecture, she is probably intubated/ventilated — on a breathing machine — and she has been placed in a medically induced coma.
There are many reasons for putting someone in a medically induced coma, but in this case these are some possibilities.
She may have suffered brain damage from a lack of oxygen to the brain, and they are watching her neurological signs. Miss Rivers may have suffered some organ damage from the lack of oxygen to her organs and the best way to keep her body oxygenated and to keep the organs from failing is to keep her deeply unconscious and on a breathing machine or a (ventilator) with an oxygen content that is much higher than ordinary air. She might not be intubated at all — but odds are that she is. She might also be somewhat comatose to begin with and the drug-induced coma serves only to ensure that she is in a totally relaxed state.
Another possibility is that Joan suffered some kind of medical crisis at the private surgery center. She may have had a cardiac event and/or stroke or one of the many things that can go wrong with a patient under sedation.
Miss Rivers is 81 years old, and while her energy and her talent seems eternally energetic, advanced age is not in her favour.
My best guess is that she is currently being held in a “stable” condition while they address the issues of how much end organ and/or brain damage, if any, may have occurred during the time when she was either not breathing or her heart was not beating or both.
Is Joan Rivers on life support? I cannot say, but it sounds suspiciously like — at the very least — a form of life support because Joan was taken to Mount Sinai hospital whilst still unconscious. This is not to suggest that someone who has a heartbeat restored and is now breathing, simply pops up instantly and becomes awake. That can happen — mostly in movies — but obviously this is not the case here.
Currently the doctors will be watching her organ functions. Kidneys, lungs, brain etc. The looming danger here is always the fear of ARDS — Acute Respiratory Distress Syndrome. This is what can happen to lungs after oxygen deprivation or trauma to the body or any of its organs. It is often fatal, but so far ARDS is only something that CAN happen but might not have happened this quickly — or perhaps not at all.
In the end, the odds would suggest that Miss Rivers was without oxygen for some length of time and this is what they are dealing with now.
Hopefully she will recover, but the amount of time that has passed suggests that she is only theoretically “stable” having been medically placed in a “stable” state of “wait and see.” Her family, most likely, is by her side making difficult decisions as the doctors do whatever it is they must do in this situation and keep the family informed on her overall prognosis — which is probably very poor at the current time.
The end results will be, partial recovery, full recovery, lingering coma and life support, or death.
Melissa Rivers (her daughter) will have to make all the decisions until such time that Joan passes away or she recovers. This isn’t Melissa’s first tragedy, but she’s up to the task. Joan might end up in a long term care facility or, as is the case with people who can afford it, she might get round the clock care in her home.
Let’s pray that Joan Rivers, being who she is and how strong she has always shown herself to be, surprises us all and makes a full recovery. If that doesn’t happen, she will have left the world with a legacy that will live on for ages.