a single case report on the effect of VAT on a Near Drowning

Roald VAT report lungs

ROALD’S SESSIONS ON MULTIVIB. – DATE STARTED : 25 JUNE 2007

25/06/2007 4pm -First session for 22 minutes on Red – Roald became very relaxed in both arms and legs during treatment – slept through the night, normally wakes upwhen turned – remarked by Caregiver (Daphne)

26/06/2007 11am-Second session for 22 minutes on Orange – exercised his arms and legs and shoulders – muscles became more relaxed after about 10 minutes – when session ended on Orange, we put Red on for 10 minutes without any exercising.

26/06/2007 5pm- Third session on yellow for lungs -just relaxed nothing specific noticeable

27/06/2007 11am – 4th session on Orange for 23 minutes and then on Red for 10 minutes, doing exercises 1st 23 minutes but not during last 10 minutes. Caregiver (Jacobeth) notices spontanious movements of the hands/fingers that she did not see before. 5pm 5th session on yellow for lungs –

28/06/2007 Red for 23 minutes and then on Orange for 10 minutes and evening on Yellow for 23 minutes – a lot of coughing and better breathing

29/06/2007 Orange for 23 minutes and then on Red for 10 minutes and evening on Yellow for 23 minutes – better sleeping and breathing

30/06/2007 Red for 23 minutes and then on Orange for 10 minutes and evening on Yellow for 23 minutes – a lot of coughing and better breathing. Started introducing Green as well and found great results with attentiveness/awareness

01/07/2007 Orange for 23 minutes and then on Red for 10 minutes and evening on Yellow for 23 minutes – better sleeping and breathing

02/07/2007 Green for 23 minutes and then on Orange for 10 minutes and evening on Yellow for 23 minutes – went to woundcare nurse and she saw a definite change in. Roald wanted the information about the mattress – he all of a sudden is very alert and looks around and reacts to the slightest noises

03/07/2007 Red for 23 minutes and then on Orange for 10 minutes and evening on Yellow for 23 minutes – a lot more aware of his surroundings and reacts appropriately

04/07/2007 Orange for 23 minutes and then on Green for 10 minutes and evening on Yellow for 23 minutes – better sleeping and breathing

05/07/2007 Green for 23 minutes and then on Orange for 10 minutes and evening on Yellow for 23 minutes and also introduced Blue in evenings for additional 10 min following the Yellow session. Following the Blue session I noticed today 6/7/07) in the car he did not pull the jaw back once whilst travelling to the nurse – jaw really seemed more relaxed

06/07/2007 Red for 23 minutes and Orange for 10 minutes and evening Yellow for 23 minutes and then 10 minutes more on Blue for the Jaw. Today in the car he also showed clear signs of understanding what happened when a man tried to sell flags to us and he moved it around in front of the windscreen, Roald pulled his head away and kept flickering his eyes. His saturation is also improving and heartbeat better!! Monitored him last night.

By Roald John Rudman – recording above of first sessions with VAT started 25 June 2007 until 6 July 2007.

Date today: 15 September 2008

Present Age: 13 Y 7 M old

Age of accident: 2 Y 8 M old (date of accident: 6 October 1997)

Descriptions of circumstances around accident: Roald had a near-drowning on 6 October 1998 whilst in the care of his caregiver and siblings. He was pulled from the pool by a family friend and CPR started immediately after the airways was cleared by the friend who’s brother happened to be a medical doctor and he learned the technique from him at an early age when he practiced on him during his studies. I was phoned at the office and phoned the emergency services immediately to speed to our house and I left to rush home as well. Unfortunately two members of the SA police arrived before us and the one policeman stopped the CPR and declared Roald dead. He therefore lied covered with a duvet for approximately 20 minutes before the emergency services arrived and started with CPR and medical treatment again, they did get a pulse within minutes and he was rushed to the hospital but unfortunately Roald suffered severe anoxic brain damage by then. Roald spent 44 days in Intensive Care and then came home where we are caring for him to this day. He also contracted the Pseudomonas Aeruginosa whilst in Intensive Care and this Bacterium D infection attacked his lungs. He was later diagnosed by a Pediatric Neurologist as Bi-Hemiplegic with epileptic tendencies. Our son lost about 70% of the volume of his brain as shown by an MR scan done about three months post near-drowning. He had slow but steady improvements throughout the last 12 years that we attribute to various therapies done with him. (see list attached)

Which functions were damaged:

Roald lost the ability to speak, eat (he gets tube-feeding), walk, swallowing & normal bowel functions and his eye sight was affected. His hearing was good following the accident and his cough reflex…

Post Hospitalization status: Roald’s eyes were still closed when we brought him home

After 44 days and he was semi-comatose in those early days, he then progressed to a vegetative state followed by a minimal conscious state to a little boy we believe today is totally aware of his surroundings and understands what is going on around him. He however is trapped in his own body by severe motor disabilities caused by the brain injury and years of spasticity.

Care at home: At first we looked after him ourselves with some outside help from nursing agencies but the quality of care often led us down and we would step in ourselves to take care of him. We looked after him at night for the first 8 years but had help during the day when we worked. The last four years we have 24H care 7 days per week and we use people that we trained ourselves to take care of him. We also work from home to enable us to be close to him.

Sleep patterns: Normal accept when he is ill – he will then also sleep during the day or be awake a lot more at night caused by breathing problems and fever mostly.

Status before VAT: We acquired a VAT mattress in June of 2007 and started with sessions as soon as we received the equipment. Before VAT sessions Roald had a lot of pain following a hip dislocation and a pressure sore as a result of this. He also had regular lung infections made worse by the Pseudomonas that he acquired in hospital following his Near-drowning in 1997 in the intensive care unit of the hospital!

We acquired the VAT for two reasons to try and relieve the pain and to help with the lung functions and better breathing!

Immediate VAT reactions (first week): See as noted above…

How often does he get VAT on a regular basis: He gets 3 VAT sessions of about 26 minutes – 30 minutes per day/7 days per week with the only exception when we are not home and that happens very seldom (only once this year for 3 days).

Which CD’s used and which CD’s preferred by Roald: We regularly use: Yellow, Orange, Red and Blue – he loves Red and seems relaxed also when we play regular classic music or relaxation CD’s. We also do sessions on the special Heart CD and it really calms him down. We also just started with the new 74 minute CD as received for the period that he will be in traction following a hip operation in October 2008.

Which functions have slowly improved: Roald had a tendency of a much higher than normal heart rate of approximately 124 or higher even when he has a fever, we have to monitor his heart rate and saturation on a daily basis with a saturation monitor, his heart rate and saturation improved a lot since we have been using VAT – heart rate down to 85 – 90 and saturation up from higher 87 – 90 to between 94 – 98. We are able to notice that he has a lot less pain especially during and shortly after sessions. He sleeps much better at night and that is also an indication of less pain of the dislocated hip caused by a wrong procedure by an Orthopedic surgeon, this was confirmed by three other specialist doctors afterwards! We have had a healthier than ever year behind us with no hospitalizations, before we could have as many as three per year.

– 3 –

Roald’s wound healed in a much shorter period than expected by medical wound specialists and we avoided plastic surgery as was suggested by several doctors. Roald smiles a lot more and watches TV intently whereas before we did not know if he could really see well or even looked at the screen.

His spasticity also improved and we often find a totally relaxed young man that tolerates his exercises better than before because of less spastic muscles. His face also changed as a result of combined VAT sessions (on Blue) and electric stimulation of the face with a special device at home but also two sessions of Vitalstim twice per week at a Rehabilitation centre. His mouth is closed and does not hang open anymore and we also see less drooling and more swallows!!

Reduction of lung problems, depth of breath, clearing of lungs, inflammations or colds: All of the mentioned improved dramatically since we started using VAT, as also

seen in comments above. We recorded his saturation and heart beat for three weeks, recording readings on a daily basis for 7 days a week and the above conclusion was made from these statistics. We are able to maintain him with natural supplements and we only needed antibiotics once this past winter, whereas before we had to give antibiotics about 4 – 5 times per annum.

General functions now (during and after winter): Overall health improved by at least 80% and a year of overall much better immunity behind us than ever before during the

first eleven years post accident. The last sputum test also did not show the Pseudomonas Aeruginosa and we were told that it will always show up in tests! We recently saw a lung specialist who was quite amazed by Roald’s health and the fact that his lungs are healthy accept for a little spot of calcification and a scar of previous aspiration whilst performing a Video- Floroscopy at a hospital some years ago when Roald aspirated on Barium as a result of wrong positioning by medical staff.

As far as emotional improvements: Roald smiles a lot more, his caregivers speaks about regular awareness of his environment and him complaining if he is uncomfortable or if he hurts in any way (he uses his voice to moan) or will pull is face in agony if they hurt him during exercise sessions. He lifts his head every time that I come into the room and speak to him (acknowledges my presence). He plays games with me when he has to go to sleep, pretends his asleep and if I slowly lift my hand away from him if holding him or his hand, he opens his eyes and looks at me and lifts his head up keeping me there until he is asleep. He also moans if I tell him that I am going out and waits for me to greet him when I come back. He plays on his newly acquired WII with his caregivers (they hold his hand) and he loves to win, smiles from ear to ear if he is praised! – His awareness of surroundings overall improved by at least 50% compared to before starting to use VAT in 2007. He says Yes or No with his eyes by blinking once or twice – his dad asked him recently if we could take him to a local fisio as to the Rehab centre that is much further away, he immediately indicated NO, when asked if he liked the young therapists he blinked once immediately to show YES!

Total duration of report period: Started using VAT 25 June 2007 until Currently

Thus: 1 year 3 months to date.

“As his mom I truly believe that the better lung function and breathing enables him to do more than before & ensures a better quality of life for him!” Elna Rudman (mother of Roald John Rudman)

Submittedby Olav Skille