Thanks so much for your prayers for Ian. Since I first wrote Ian has air lifted to South Africa to get better medical care. This is an update from Ian's aunt on how he is doing. His family will not have Internet access. If there is some thing major that happens they will try to let every one know. So please continue to pray for Ian as he recovers. THANKS!
Ian is still stable. Ken said that to look at him you would never think things were going well, his whole body and his eyes are yellow, and he has a bunch of tubes in him and they have him heavily sedated and still on a respirator. He said that there are about 8 huge syringe-like things hanging from the walls that are feeding different things into his body. On top of that, he said they come in regularly and do manual pushes of different things into his IV. There is a big drafting-type table in the room with a huge chart on it that they keep recording things on and studying constantly to determine what to do next. He said that there is a clear system to what they are doing and they all are very effecient and expert at it. They have given Ken nothing but hope. He said they are very matter of fact about telling him that this is the normal process and everything is proceeding just as they want it to and expect it to. They tell him that Ian's body is being cleaned up and even tho the values still look bad, they are supposed to look exactly as they do, and they will change and improve. The physician's name is Dr. Barten (not sure of the spelling and don't know the first name). He is an expert in pediatric brain damage. He is on the pediatric ICU full-time (he doesn't leave to go to other units) and he tells Ken that Ian will open his eyes in a day or two, be talking a day or two after that, and will walk out of the hospital in a week or two. I guess he sees or anticipates Ken's skepticism, so he keeps telling him stories about this kid and that kid who were worse than Ian and they recovered fully. Ken said he is very confident and matter of fact about it. he also said that this dr is very passionate about his work and he is all over Ian. He feels that Ian is in amazingly capable hands. The nurses are very good too, and they are also very kind to Ken when they have to keep asking him to move out of their way :) They gave him a spot at the corner of the bed where he can have his hand on Ian's foot and be out their way, but he still gravitates up towards Ian's head eventually. The process is still unfolding though, so the concern is that something could go wrong, change for the worst, or go off course for some reason, but so far that it is not happening and things are progressing in the right direction. He asked this doc how many cases of cerebral malaria he sees and he said 2 or 3 a year. This concerned Ken at first but Dr Barten mentioned that he is consulting with a malaria specialist about Ian's treatment. The doctor on the medi-vac team arranged for Ian to be brought to this hospital specifically so that this particular dr would be managing his treatment. He said there is no one better for Ian's situation. right now, all the fluids and Ian's immune system are focused on cleaning up all the dead cells and debris in Ian's body. I can say from what i know that his brain won't (and shouldn't) come up until his body is stable. The dr said that the same clean up that is actively happening in his body is also happening in his brain. Ken was a little disturbed that Ian's eyes were partially open but his eyes were not moving. I'm sure that looks scary. I told him that the brain shuts down in stages and comes up in stages, and that right now all the oxygen in his brain is going to the lower level functions and not the higher level functions. His brain will focus on the lower brain vital functions first (breathing, kidneys, etc.), and then the vital sensory-motor connections next (reacting reflexively to sensory stimuli like light and pain), but, his brain will not waste one ounce of energy on higher level things like comprehension (on the input end) or with intention (on the output end). His eyes are not moving because his brain does not care right now about understanding the visual world or about looking around to see what's going on in the world. When the brain gets the all clear, is told that the body is stable and that there is now energy to spare, then some of those oxygen resources will start getting channeled out to the higher level brain functions again, and Ian will wake up. It will be slow and stiff at first, the sensory-motor connections to the higher levels may take some time to get up and running, but his brain will adapt and grow new connections where it needs to when the time is right. It just won't deal with that until the brain is ready to engage with the world again. So it is not a bad sign that he is still in a coma. Like the dr told him, his body is doing exactly what it should be doing right now, brain included.
