I’ll be the first to admit that I’ve not really followed the case. Today I’ve seen multiple references to possible physical abuse by her husband, which generally cite a bone scan done when she was first admitted to the hospital.
I tried to find more information, but all my web searches turn up seriously biased sites that rehash one of three things as evidence of abuse:
she had broken bones when she was admitted to the hospital
she had previously broken bones that were in different stages of healing
she had a “compression fracture” that indicates abuse
I found what purports to be the radiology report and lists what had been broken at some point in her history, but doesn’t seem to say what, if any, bones were actually broken at the time of her hospitalization.
Upon reading that report, I determined I must have been abused because I too have repeated broken ankles, a broken foot, damage to my knees, several broken ribs, two broken elbows, and a broken nose. Except that I was never abused, I’m just a colossal clutz who never should have taken up rollerskating in the '70s, attending Metallica shows in the '80s, or hiking in the '90s. (For the new millenium I’ve taken up staying at home, doing my math homework, and drinking tea. So far I’ve only received two major burns and no broken bones. And I’m getting As in math for the first time.)
Also, the report said that the breakages could have been due to a couple of different types of degenerative diseases.
So I guess these are my questions:
What is the difference between a compression fracture and a, uh, fracture fracture?
Does anybody know if those previous injuries can all be accounted for just by living?
Has there been any report of degenerative bone disease in Schiavo?
Could malnutrition brought on by her bulimia be responsible for bone degeneration to the point that she would have suffered these kinds of fractures due to the stresses of every day life?
A compression fracture usually refers to a fracture of the vertebrae (the spine bones) where one of them gets squashed. This is a very common fracture in people with osteporosis.
The more typical fracture (that I think you’re referring to when you say “fracture, fracture”) affects the longer bones in the body. In those cases, the bones break.
It’s also worth recalling that Terri Schiavo had a cardiac arrest at the start of this saga. That mean’s she almost certainly underwent CPR (cardiopulmonary rescusitation). Fractures are quite common complications of CPR.
BTW, simply lying around for 15 years, especially in a ‘vegetative state’, can also rot your bones to the point of spontaneous fractures or fractures as a result of minimal trauma.
Mrs Geek and I were having a somewhat heated discussion about this earlier today (just so you know who is on which side, I believe they should keep the tube out and Mrs Geek thinks it should go back in). Also important to this discussion is the fact that Mrs Geek used to be a nuclear med tech before she became a full time mommy.
The copy of the bone scan we found on the internet had the word “trauma” highlighted in red several times and another area highlighted in yellow. According to Mrs Geek though the report didn’t mean what they were making it out to mean on the internet. For example, Mrs Geek said that just about everyone she ever did a scan on had trauma to their ankles and feet, and that compression fractures were very common. Basically, Terry, like you, is a normal person who has had some injuries during her life.
The long and short of it is that the report doesn’t indicate abuse.
I used to ride horses competitively, and fall out of trees on a regular basis…between trees and jumping, I have broken about a third of my bones at least once, and with the skiing accident that did my back in, I added a few more nasty rebreaks and a few new breaks.
I probably look like someone really worked me over…though an abusive exfiance did break an arm, a collar bone and nail my head hard enough into a wall that the downstairs neighbors called the cops on him…I got way more injuries from my own stuff than I ever did living with a very physical abuser.
Oh, and fall up stairs sigh put me down for klutz of the month club…
Irrelevant to the discussion, which is about fractures found upon her in 1991. A bone scan done on March 5, 1991, and not released until 2002, found compression fractures, a broken back, pelvis, ankle, bone bruises and ossifications.
Oddly enough, Michael Schiavo, who was trained in CPR, did not administer CPR to his wife.
You gave CPR as a likely cause of the thorax injuries. If it is established that her husband did not perform CPR on her, and that the heart resuscitation measures performed on her in the ER did not involve gross trauma to the thorax, then it is relevant.
Given the very high likelihood of chest trauma from CPR (see my cite above), it makes no difference who performs it - trauma is likely. So, short of various radiologic studies in the days after the CPR, how could you prove there was no “gross trauma”?
(BTW, the fact that her husband didn’t give the CPR might make chest trauma more likely. Some might say that the “best” CPR, being appropriately vigorous, is more likely to break bones. Michael may have been trained, but he was no expert.)
Regardless, look here. It is the court transcript with the radiologist who reported on the bone scan. Please start by noting that the date - March 1991 - fully one year after the cardiac arrest. IMHO, that is more than enough time for immobilzation-associated bone disease to develop. Second, it clarifies the fact that the signs of trauma on the scan were all acute, i.e. no more than 18 months old and probably less given Terri’s youth (and hence her likely ability to heal quickly). In other words, everything was totally consistent with trauma from the CPR and her initial collapse (especially on a background of anorexia/bulimia bone disease).
By checking her medical records for descriptions of what methods of heart resuscitation were used, and whether chest compression was involved, or whether the CPR was limited to defibrillation and medication.
That document does not state what kind of CPR was administered. CPR can mean many different techniques, depending on whether equipment and medicine are at hand. Chest compression? Defibrillation? Injection?
“CPR” generally refers to the rescue breathing and the chest compressions.
They would not defibrillate her or give her injections without doing chest compressions; these are all part of ACLS (Advanced Cardiac Life Support), which is very structured.
If the document says she got CPR (and this is one on the Schindlers’ web site, mind you), she got chest compressions.
Actually, it can’t. CPR only refers to chest compressions and ventilations (either mouth-to-mouth, mouth-to-mask, or bag-valve-mask). Defibrillation and Advanced Cardiac Life Support meds are called just that. They are not considered part of CPR.
Also, I would say there is absolutely no chance that she was taken to the hospital in an ALS ambulance but did not get CPR. Defibrillation and meds dont’ work without it. In addition, I can’t recall a case where CPR by me or another provider did not result in broken bones. That’s just how it works.
Bulemia and other eating disorders are notorious for calcium loss and all sorts of physical complications even years after the disorder was resolved. My own teeth lost all of their enamel permanently after an eating disorder in my early teens. Terry was actively bulemic, so weak bones are no suprise.
Second, lots of broken bones are of concern in pediatric patients, and less so in adults. Reports I’ve read suggested she was a hiker and led an active lifestyle. This combined with the above leads one to have a higher incidence of broken bones.
Third, if broken bones= abuse, I would be a poster child, as I have broken all my fingers repeatedly (softball and gymnastics), my ankle (boyfriend carrying me piggyback while drunk slipped on ice), my wrist, my knee (trying to break down a set during high school plays), a toe (fat kid at prechool where I taught accidentally jumped on it), etc etc. Perhaps I should live in some sort of padded suit…
Terry is a vegetable. See her cat scans. Those ventricles ain’t gonna shrink back down any time soon. And all those bright spots are brain damage. Very very little actual brain left. Enough for breathing fairly rythemically, but maintaining body temperature stability might even be a stretch. It’s very sad, but “Terry” died years ago. Now’s it’s time to let her body go too.
I didn’t read the date and injury reports and don’t have an informed opinion of TS’s injuries, but do know that muscle and bone loss can begin as early as the third day of complete bedrest. This is a large issue in medicine for bed bound patients. Bones require proper nutrition and weight bearing exercise to maintain themselves.
I also wanted to recomfirm the idea that bones are broken during CPR. My son, born at 23 weeks and with incompletely formed bones (characteristic of that gestation) still suffered broken ribs from CPR.
Perhaps a hijack, but: Among the allegations against Michael Schiavo, I often see several references to his size, as if they should add extra suspicion that he’s an abusive husband. He something like 6-5, 250 pounds, although considering my sources, that could well be exaggerated. No matter, as it bothers me a great deal that because he’s a large man (I’m 6-6, 230), he’s automatically assumed by some to be violent. I’m about as harmless as a puppy (aside from being a general klutz), but because I’m big, I guess I’m just another candidate to abuse. I have to think there is no correlation between size and abusiveness, and that a smaller man would be just as able to inflict damage on someone if they had the inkling.
Is it true that Michael Schiavo took nursing training in order to know how to better care for his wife?
I have read that there is court testimony that prior to the insurance settlement, Terri’s parents had said that Terri was “madly in love” with Michael and that they were a happy couple.
Of course, I cannot cite for any of this. I’ve channel surfed on the story so much since last Sunday that the week is becoming an oblong blur.
Michael became a registured nurse and a respiratory therapist after his wife’s heart attack so as to be able to take better care of her. I am not aware of any evidence that he was trained in CPR before his wife’s heart attack.