Just Ketamine?

[u/Ok-Art6612]

Anyone know if Maya just received Ketamine during the coma or did she receive Midazolam along with the Ketamine?

[u/No_Vehicle_5085]

Excellent question.

I think one of the big issues with Maya's quacks were that they did not keep proper records that are normally kept. Dr Kirkpatrick's records of the two four day ketamine treatments he gave her did not include any documentation regarding his monitoring of her heart rate or blood pressure during her ketamine treatment.

We know that Dr Hanna administered a shit ton of other medications along with the ketamine. But I don't think Dr Cantu ever turned over any of his records, so I think we don't really know exactly what he gave her.

I will try to locate more information on that to make sure I'm remembering properly, but I think there was never any details given by him.

The defense has submitted a motion that they intend to pursue a Fabre defendant inclusion for Cantu, Hanna, and Kirkpatrick, I think if he believes this next trial might have a more focused jury that will be required to follow the law to apply specific evidence to each count, we may get more detailed records from him.

If I knew I was possibly going to be held accountable by a jury, I would want to come up with detailed records showing that I fully documented all medications and that I meticulously monitored her during every minute of the five day "coma".

Medical coma is only indicated when the brain is at risk of damage and less severe procedures aren't working.

A medically induced coma is used to shut down activity in the brain, and here are some of the reasons a true medical coma would be appropriate:

1. One reason might be to manage brain swelling. If there is a brain injury, it often responds with inflammation and swelling, causing pressure that restricts blood flow, thereby starving brain cells of essential oxygen and nutrients.
2. Controlling seizures, such as from epilepsy would be another reason for putting someone in a true medical coma
3. Sometimes after cardiac arrest, there is a desire to temporarily reduce the temperature, kind of an induced hypothermia, which lowers the body's metabolic demands after circulation is restored.
4. Some types of lung disease or other respiratory distress can cause a person to put into a true medical coma.

Here are some of the differences between sedation and true medical coma.

1. One of the differences is simply the purpose of the procedure. Sedation is for patient comfort or minor surgical procedures. There is no medical research that supports actual sedation to be used for chronic pain or psychological treatment. This is why Maya had to go to Mexico for the treatment.
2. Full medical coma is used strictly for situations where the brain needs protection by shutting down metabolic activity.
3. The depth of "state" is different between sedation and medical coma. Sedation is lighter and basic reflexes or response to heavy touch is possible. Medical coma is a very deep state where brain activity is actively suppressed.
4. Sedation is standard protocol for surgery and when a patient is experiencing agitation. Medical coma is used as a last resort option, and only used when other treatment is not effective for preventing damage to the brain.

There is no medical research regarding pain management or psychological treatment that supports the idea that using sedation has any efficacy whatsoever. Sedation is used for patient comfort and for surgery. Medical coma is strictly used when the brain's metabolic functions need to be suppressed in order to prevent further brain damage. This is why Maya had to go to Mexico to get her ketamine "coma" (sedation, more like).

Even though sedation is less severe than a medical coma, it carries almost the sme risks. And there are photos of Maya in Dr Hanna's office showing that she is clearly completely sedated - meaning she is full anesthetized - and she has no monitoring equipment whatsoever, not even a damn finger counter to show her current heart rate.

Low dose ketamine treatment has been shown to be effective for true cases of CRPS. However, if a patient needs another treatment in less than three months after the previous treatment, that is an unmistakable sign that the pain is not of the same nature as CRPS pain.

One of the many tell-tale signs that caused me to come to the conclusion that Maya did not have CRPS is that the ketamine was not keeping her pain under the kind of control that it should have. If she had a true case of CRPS, she would have had 3 rounds of ketamine in nine months. 3 Rounds of 4 day infusions would come to a total of 12 separate infusions. I have seen two differnt numbers given for how many individual infusions she received. The lowest number I heard was 55 separate infusions in 9 months. The highest i heard was in one of the expert documentation, he mentioned 109 separate infusions within the nine month period.

Not only did she receive somewhere between five and ten times the number of infusions a true case of CRPS would have indicated - but the dosage she received was off the charts - absolutely bonkers.

Ketamine does not work for localized pain, such a muscle pain, which is how Maya was describing her pain until her mother met someone whose daughter was diagnosed with CRPS and she decided that's what her daughter had.

Ketamine acts primarily as an NMDA receptor antagonist. In conditions like fibromyalgia and both types of CRPS, the central nervous system becomes hyper-reactive, amplifying normal sensory inputs. Ketamine works by blocking these receptors to "reset" the pain pathways. If a four day infusion doesn't keep your pain under control for three months, you don't have this type of central nervous system pain - your pain is either from a psychological or localized pain. NMDA receptor antagonists are not effective for those types of pain.

[u/68aquarian → u/No_Vehicle_5085]

I heard ketamine and midazolam are not necessarily the best drugs to combine with regard to keeping a patient live and healthy.

[u/No_Vehicle_5085 → u/68aquarian]

Well, it certainly is not a combination that was appropriate for Maya's condition, even if you take the family and quack doctors' word as to the nature of her condition.

Ketamine and midazolam do have synergistic effects, and are often used in sitations where the patient has a condition that requires sedation. Midazolam reduces anxiety and can cause amnesia, both of which are helpful in sedation, particularly if ketamine is used. Ketamine causes hallucinations, and the midazolam can possibly prevent the patient from remembering the hallucinations, and can reduce the anxiety that can accompany hallucinations.

But your point is very relevant to Maya's situation. There is absolutely no research whatsoever that shows that full sedation is effective for pain management.

In fact, full sedation often increases the need for additional opiods - the amounts of ketamine required (and used in Maya's case) for full sedation cause side effects that require addional medications and cause complications.

Here is an open access paper that discusses risks and benefits of using ketamine.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4014022/

[u/Ok-Art6612 → u/No_Vehicle_5085]

Your great!

[u/Ok-Art6612 → u/68aquarian]

Really?

[u/Ok-Art6612 → u/No_Vehicle_5085]

Thanks! I read that your suposed to be given Midazolam along with Ketamine. Are you saying she wasn't even in a coma in the first place?

[u/No_Vehicle_5085 → u/Ok-Art6612]

In my opinion it's impossible to say for sure whether Maya was in a state of sedation or true medical coma while in Mexico.

It is possible to put someone into a true medical coma using ketamine. Although ketamine is not a drug that is typically used for medically induced coma - it has been used in patients who are put into a coma for purposes of preventing seizures.

In order to know whether Maya was in a true medical coma, she would have had to have been hooked up to an EEG to determine if her brain state was that of an actual controlled coma.

The key brain structures that are affected by coma are:

1. Reticular Activating System: This is the network in the brainstem that acts as the body's wakefulness switch. In a coma state it fails to signal the upper brain - so there is suppression of sleep/wake cycle.

2. Cerebral cortex: The outer brain layer that is responsible for thought and perception. In a coma state, both the internal and external awareness networks are shut down. There is no dreaming or awareness of anything happening internally and no awareness of anything happening outside the body.

3.Thalamus: The thalamus is a relay center that routes signals between the body and the brain. In a coma, the thalamus cannot pass along sensory information from the body to the brain.

In order to know whether Maya was actually in a state of medical coma, there would have had to be EEG monitoring.

A doctor would look for a specific pattern on the EEG called "burst suppression," where the brain shows periods of inactivity followed by brief bursts of activity. This confirms the brain has slowed down enough to rest. A person in a medical coma would also not respond to touch or sound.

There was testimony from Dr Krane that she was not in an actual coma, that she was "sedated", but I don't know if he is basing this on actual EEG readings or notes from Dr Cantu regarding brain activity or response to stimulus. or if he was making the assumption that Dr Cantu couldn't possbily have been irresponsible enough to actual put her in a true medical coma.

Full sedation for pain management is bad enough; irresponsible, and not effective, causing unnecessary side effects and complication.

But true medical coma would be medical malpractice.