Joan Rivers will probably not survive this and Melissa Rivers (her daughter) will have to make all the decisions until such time that Joan passes away.. 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 their beloved comedienne. She will probably hang in there for a few more days and then she will be put in a private room where she will pass away.
Latest reports say that Joan Rivers is now “resting comfortably” in a medically induced coma. The phrase “on life support” has been heard. So what does that mean? Here are some answers from Hollywood Insider and scientific writer Dave Matt.
These are not 100% certain facts as they pertain to Miss Rivers, and not even her doctors know what will ultimately happen, but I will present a very likely scenario for what is probably happening to Miss Rivers and to what may have happened to her — all the elements that led up to her current status as a patient in New York City’s Mount Sinai hospital.
Early Thursday 28 August 2014 – Miss Rivers was put under sedation for what some initially believed to be an ENDOSCOPY — a 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 resource for digestive disorders.”
Later reports stated that she went there to have her vocal chords examined. 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. It’s not a great idea, but it can be done.
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; chiefly, endoscopy of the stomach and esophagus.
During the procedure, it was reported that Miss Rivers stopped breathing and her heart stopped beating. This unforeseen complication can happen during any procedure where one is anesthetized to any degree — even in a dentist’s chair.
Sources now say that CPR was applied at the clinic but one can assume that more aggressive means of life sustaining support actually 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 endoscopic procedure and whatever life saving measures they did there — at that very moment — and how well they worked minute by minute — will determine the ultimate fate of Joan Rivers.
If the doctor or doctors who performed the procedure at the clinic were skilled in emergency medicine and equipped for emergency resuscitation — if 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 JOan Rivers went without breathing or someone breathing for her via mouth to mouth or by “bagging.” The organ most in question and usually the most affected is the brain.
The ambulance that came to take Miss Rivers to Mount Sinai — even under the fastest circumstances — would have taken at least 8-10 minutes.
Upon arrival, the paramedics would have started or initiated resuscitation — perhaps 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, she is said to be 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 certain possibilities.
She may have suffered brain damage from a lack of oxygen to the brain, and they are watching her neurological signs. This is very likely. A deep coma slows down swelling of the injured brain.
Miss Rivers may have suffered some extensive organ damage from the lack of oxygen to her other organs as well, and the best way to keep her body oxygenated and to keep her other 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. Her body temperature has also been lowered as this seems to aid in reducing further brain damage.
It is now known that Miss Rivers’ life is indeed being maintained by mechanical means. She might also have been comatose to begin with and the drug-induced coma serves only to ensure that she is in a totally suspended and “stable” 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 before, during or after any medical procedure.
Miss Rivers is 81 years old, and while her energy and her talent seems eternally energetic, advanced age is not in her favour at this point. When she is removed from life sustaining equipment — breathing and feeding machines etc — she will either continue to breath on her own for an unknown length of time, or she will expire. The hospital has not said — and will not say — the extent of the of brain damage, but neurologists will watch her brain functions with electronic telemetry. If she shows little to no brain function, then removing her from the machines after whatever length of time has been determined by her family will either result in her death or continued life in a yet-to-be-determined condition.
My best guess is that she is currently being held in a “stable” condition while doctors 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? Yes — in a sense — essentially she is totally on life support. I cannot say if her brain is damaged , but it sounds suspiciously like there must be some degree of suspected brain deficit.
Keep in mind that Joan Rivers 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 and beating, simply pops up instantly and becomes awake. That can happen — mostly in movies — but obviously this is not the case here. The doctors at the endoscopy clinic did not bring her “back to life.”
Currently the doctors ay Mount Sinai are watching her organ functions. Kidneys, lungs, brain etc. Her brain is the main thing thrown into this life or death equation.
The other looming danger here — assuming her brain is okay or somewhat okay — 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. At the present time, that issue has not been addressed because her brain function takes top priority.
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 — a brain that has been injured to some extent.
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.” This is a grim situation.
Her daughter Melissa 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 or opting to hasten death by disconnecting her from all manner of life support. The fact that she will die within the next week to ten days is the most likely scenario.
Melissa Rivers will have to make all the decisions until such time that Joan passes away or she recovers.
Let’s pray that Joan Rivers comes to her rest without any fear or pain.