Oxygen therapy breathes new life into woman in a coma

Written By Unknown on Minggu, 20 April 2014 | 22.23

MUMBAI: When Sonabai Morasker boards a bus for Shippur village near Kolhapur on April 25, she will leave without the memory of four days she spent in a state of unconsciousness—or coma— in a city hospital. A widow who manages her tiny farm back home, Morasker had failed to "wake up" after the effects of the anaesthesia wore off following an open heart surgery to replace a leaky mitral valve in February.

An MRI scan showed the culprit—air bubbles, or air embolism, in her brain. With Morasker showing no signs of improvement even after four days, doctors at L H Hiranandani Hospital in Powai placed her in an oxygen chamber. And in what could pass off for the script of a Bollywood blockbuster, within 15 minutes of receiving oxygen therapy, the 42-year-old woman opened her eyes and wanted to know where she was.

When TOI met Morasker in her rented room in Kharghar last week, she had no recollection of the drama that unfolded on February 2. "I remember the operation theatre's bright lights before closing my eyes. The next thing was I opened my eyes in a similar room," she said.

Her son-in-law Prakash Kesarkar said she hadn't realized that four days had passed between the two incidents. "Immediately after she came around, the doctor asked her if she recognized me. She said, 'This is my Prakash'," he recalled.

Hiranandani Hospital doctors are amazed at Morasker's "complete" recovery. "Her neurological examination after a month of discharge showed that she hasn't suffered any brain damage," said Dr Vaishnav Manmath, who specializes in hyperbaric oxygen therapy. It is rare that air bubbles detected in a person's do not cause any damage.

Morasker suffers from rheumatic heart disease, a condition in which the heart gets damaged due to a bacterial infection in childhood. She couldn't walk even a few steps without getting breathless. "The sarpanch gave us a letter and recommended that we come to Hiranandani Hospital for free treatment," said Prakash.

Accordingly, Morasker underwent a valve replacement at the Powai hospital on February 2. The next morning, the ICU nurses informed her family that she hadn't "woken up" after the surgery. "We were shattered as we waited for doctors to go through a series of tests and treatment," Prakash said.

According to doctors, air bubbles can occur due to a number of reasons—from being strapped to a heart-lung machine to fixing of an intravenous line. Cardiologist Dr Ameya Amonkar said, "There is no way of pinning down a reason for air bubbles. As hyperbaric oxygen is the best treatment it, we immediately recommended her for it." According to Dr Manmath, as oxygen was being delivered under pressure, the air bubbles in Morasker's brain got dissolved into the blood plasma.

The medical world, however, is a bit skeptical. "If the woman has no brain damage even after bubbles stopped blood flow to her brain for four days, it means that she is plain lucky," said a doctor from Nair Hospital who didn't want to be identified.

Dr Sangeeta Rawat, who heads the neurological department of KEM Hospital in Parel, said, "It seems like a mystery. How was it that there was no brain damage despite there being no blood supply for so long?" She felt the coma was perhaps induced by "some metabolic reason" such as lack of some electrolytes rather than air bubbles.

However, Sonabai is blissfully unaware of all the medical nuances. She's happy that she can now "walk fast" and "climb stairs without having to stop".

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