My aunt was in a coma from 12/30/08 to 1/5/08. She recognizes our uncle, she recognizes me, and she recognizes her kids. But she didn’t recognize her boss nor any of her friends. On ocassion, she doesn’t recognize us. She knows her first name, but not her last name. When the doctor asked where she’s at, she replied “home”, not in the hospital. The doctors don’t have much on an explanation. I think she has only spoken three full sentences. “I have to pee” “How are you doing?” “Can I see my mother?”.
Is regaining full mental capacity after a coma a very slow process, or is something else going wrong?
The most important question is why she went into a coma in the first place. Going into a coma for that length of time is very severe and people don’t tend to just snap of it. Did she get hit by a train (like one of my best friends) or did she have a stroke or something else? Some people can recover almost completely but it generally takes some amount of time and some never do. Even the doctors probably just have to guess the long-term prognosis this early on. She may even be on serious drugs that influence what you are seeing now.
I am not a doctor but I did go to grad school in behavioral neuroscience. I guess that could be caused by a large number of conditions or diseases. If the doctors don’t know what caused it, all they can do is guess based on the progress she is making. It is possible that she may make a full recovery or that she may lose some critical functions permanently. Only time will tell this early on but most people don’t just wake up from a week-long coma and go about their business unimpaired right away. It sounds like she is better off than many patients in the same circumstances.
One of my relatives spent several weeks in a coma after a car accident. Her recovery was a slow process, it wasn’t like in the movies where the person wakes up and is fine. She was unconscious or mostly unconscious for about two weeks. When she first began to regain some level of consciousness she spent a lot of time screaming. She gradually regained the ability to speak along with fuller consciousness over another two weeks. She was then able to make intelligible but often irrelevant, incorrect, or nonsensical statements. She could name family members in photos but not in person. She couldn’t correctly describe her living situation or immediate family. She claimed the flowers in her room were from her (non-existant) “Aunt Mae”, and believed she was in a college dormitory rather than a hospital. This sort of thing went on for another week or so.
Interestingly, from HER perspective she did just suddenly wake up mostly fine at the end of this time. After coming out of the coma she initially had anterograde amnesia (was not forming new memories), which is why she was unable to understand where she was or remember who had sent the flowers. Since she wasn’t forming new memories she doesn’t remember the first few weeks after she, from our perspective, woke up from the coma.
She continued to have some retrograde amnesia (inability to recall old memories) for several months afterward and had other issues relating to the head injury, but was back in school and functioning pretty normally six months later.
Yeah, my cousin-in-law, a speech pathologist who works with coma patients, recently told me that it’s a two steps forward, one step back kind of process. If you think of a coma as intense sleep, imagine that waking-up period where the morning DJ invades your dreams stretched out over weeks. The snap-out-of-it concept is right up there with goateed evil twins.
Just another anecdote. My uncle, while not in a coma, was basically kept doped up to incomprehensibility for the better part of a year as the result of complications from surgery. His family finally decided that they could take better care of him at home—without the all the mind-numbing medication. As the drugs started wearing off, he was often confused about things (although I don’t think he ever didn’t recognize anyone), and one of the hardest things he had wrapping his mind around was the fact that a year of his life had passed of which he had no recollection. After several weeks, he was fine, though, and still is to this day. Well, other than losing half his insides.
Consider that the brain has millions (figuratively; actually a lot more) of connections. In simple terms, a “coma” occurs when the parts of the brain governing awareness is not working properly. It’s not a single neuron or a single switch; it’s a collection of millions of little switches. A spectrum.
When there is a diffuse injury, such as brain edema, many of those connections stop functioning. Each individual connection may or may not regain its function and the ability for that particular connection to remain functional may wax and wane.
Consciousness (and brain function) is not at all like turning a switch on and off. It’s much more like a collection of all the lights in a large city. Some events may disrupt the power to the whole city, and if the power is restored all at once and the city infrastructure has not been damage, full function is regained all at once. Other times the nature of the damage (a flood, say, drowning the entire city) is so diffuse that restoration of function–if it happens at all–occurs in fits and starts, sputtering here and there.