Thursday, February 14, 2013

Get Rid of the Word "Semi-Vegetative"

I was "semi-vegetative" at this hospital. This is the computer I did my first e-mail.

I've worked in home-based care, not hospital. When the "semi-vegetative" state was mentioned, I thought that this was only seen in the hospital. A person with this never would have made it home. Now at home, I had to look it up. It kept giving me persistent vegetative state (PVS).  Something wasn't right. I asked around. This state doesn't exist in the text-books. 
Here it is  I thought I moved up, and I hadn't. This is a false category...and a misnomer, too.

There is something that does fit this...

Behavioral criteria for the diagnosis of
Follows simple commands
  • Gives yes or no responses verbally or with gestures
  • Verbalizes intelligibly
  • Demonstrates other purposeful behavior, including nonreflexive movements or affective gestures that occur in direct relationship to relevant environmental stimuli, eg:
    • appropriate smiling or crying in response to specific emotional stimuli
    • vocalization or gesturing in direct response to linguistic content of questions
    • directed reaching for objects that demonstrates a clear relationship between object location and direction of reach
    • modification of touch or grasp to accommodate the size and shapes of objects
    • pursuit eye movements or sustained vision fixation upon a external visual stimulus
*At least one is required for diagnosis
(I didn't do all of these.)

What's the word I took out? It was "MCS." This stands for minimally conscious state. 

MCS is not PVS. MCS is more appropriate if I was able to handle money. Wait a minute! I was in a whole ward of people who were "semi-vegetative." Were all those people misdiagnosed? There's a problem in not being able to move up in PVS. 
Progression would be linear, and go from PVS to MCS...not to "semi-vegetative." It's not a giant leap. Just follow the textbook.

1 comment:

  1. I have been in 3 comas, 6 brain surgeries, hydrocephalic.............TBI, even though one can't respond does not mean a person is not cognitively aware of everything going on around us. Vegetable? NO WAY! I was more aware of everything going on and I wanted to cry out, "I am here"! I want to thank you for noticing.