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Joan Rivers: Doctors Say There Is Hope

Wednesday, 03 Sep 2014 04:10 PM

By Charlotte Libov

Although she’s been unconscious for more than a week, there is still hope that Joan Rivers could recover, doctors say. However, as time goes by, her chances are likely to get slimmer.
“I would be very guarded with my prognosis at this point in time,” Marc Leavey, M.D., a board-certified internist at Mercy Medical Center in Baltimore, told Newsmax Health. 
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Rivers, 81, went into cardiac arrest last Thursday morning during a surgical procedure on her throat at an outpatient clinic. She was rushed to Mount Sinai Hospital in New York, where doctors put her in a medically induced coma to give her brain a chance to recover.
Since then, she has been on life support while doctors evaluate the extent of brain damage she may have suffered during the time her brain was without oxygen.
On Wednesday, the comedy legend was moved out of intensive care unit, but she remains in serious condition and on life support, according to reports.
If she does regain consciousness, her level of impairment will depend on how long her brain was without oxygen, said Dr. Leavey.  “When it’s upwards of several minutes, there can be permanent and significant brain damage,” he said.
“We also don’t know her underlying medical condition. She appeared healthy before suffering cardiac arrest, but we don’t know her blood pressure, cholesterol, or other factors in her medical condition before this occurred.”
Chauncey Crandall, M.D., one of the nation’s top cardiologists, says that duration of oxygen deprivation is likely the critical factor in whether Rivers can recover. “If a person goes without oxygen for a significant amount of time, the heart can recover, but the brain does not,” he said.
There have been cases where people who have sustained brain injury due to lack of oxygen have fully recovered, but these are rare, said Dr. Crandall, director of preventive medicine at the Palm Beach Cardiovascular Clinic.
During his more than 30 years as a doctor, Dr. Crandall has seen two such cases. One involved a 53-year-old man who was pronounced dead, but came back to life after being shocked with a defibrillator. The other involved a 55-year-old man whose case is somewhat similar to that of Joan Rivers.
The man went into cardiac arrest during an exercise session and was brought to the hospital where Dr. Crandall practices. Like Rivers, he was put into a medically induced coma. He spent three weeks on life support, during which time his wife refused to discontinue life support even though there was no discernible brain activity. She and Dr. Crandall prayed for the man. Finally, he suddenly moved and eventually recovered.
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Dr. Crandall considers these two cases “miracles,” and he says they are extraordinarily rare.
But, he says, “There is always hope, and miracles do happen.”

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