How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6536
Experience:  14 years as clinician in the field of Family Practice
Type Your Health Question Here...
Anthony Bray, MD is online now
A new question is answered every 9 seconds

Ive written about this before. My brother, 41, HIV+, overdosed

Resolved Question:

I've written about this before. My brother, 41, HIV+, overdosed on 6500 mg of Seroquel on May 17th. Subsequently experienced what looked like pneumonia, but broncoscopy turned up negative. Lung biopsy was performed, but so far nothing has shown up and no results have come in (biopsy performed 24 hours ago). The doctors think the biopsy, which they sent to every department for testing of every possible cause, will turn up negative and that the fact of the matter is that the Seroquel caused significant lung damage. His lungs have gotten worse on x-ray every day. They are now doing a special procedure to provide oxygen in his blood to his organs. I don't know the name, but it involves placing one end of a line in the neck and another in the groin. They said that with this machine he is on 100% oxygen and that the output of oxygen from the right side of his heart to his left is falling, when it should be rising. They said there is nothing they can really do except wait for the lungs to start to get better on their own. Is there any realistic prospect of survival?
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello,

Customer:

Hi

Anthony Bray MD :

It does sound pretty dire... it sounds that he is suffering from ARDS ( Adult Respiratory Distress Syndrome) I would guess from your description....

Customer:

yes, the doctor said that is exactly what he is suffering from

Customer:

ARDS

Anthony Bray MD :

He is ICU and ventilator as well as the bypass procedure??

Customer:

Yes, he is in the cardiac ICU and ventilator at 50% and the bypass procedure

Customer:

50% oxygen on ventilator, 100% oxygen on bypass procedure

Anthony Bray MD :

The circumstance sounds that he may have about 30% chance of survival but even that may be high estimate with his seeming deterioration...

Customer:

yes, his lungs keep getting worse. the doctors have kept saying that "it will be a long haul" and keep hoping that somehow his lungs and body will fight back

Anthony Bray MD :

ARDS itself is very serious with a high mortality rate.. it itself is not a hopeless diagnosis and some do survive this...

Anthony Bray MD :

Right, the key would be for him to stabilize and turn the corner...

Customer:

how might that happen? (stabilizing and turning the corner)...would he just start to get better one day

Customer:

soon

Anthony Bray MD :

It is possible I have to admit to you that he may progressively get worse and pass...His lungs will heal eventaully if he can hold on and stabilze from the insult though....

Customer:

yes at this point i'm skeptical of him getting better because every single day since they discovered the problem with the lungs things have only gotten worse

Customer:

there hasn't been one day or any significant time period during which things were stable

Anthony Bray MD :

From a prognosis standpoint it sounds that he really needs to begin to turn around within next 3 days or he might never recover.. recovery from ARDS is slow at best....

Anthony Bray MD :

I see>> yes those are bad signs I am afraid...

Customer:

are there any drugs they can give him to help the lungs stabilize and recover? (he has had this issue for the past 8-9 days)

Anthony Bray MD :

It sounds that they have him maxed out on treatment... there are treatment strategies for this condition but no panacea....

Customer:

yes he is on a lot of medication. what would you say his chances are? still 30% ?

Anthony Bray MD :

That would be my approximate guess but it may be lower I am afraid from your description... I have to qualify this by acknowleding that I don't have his complete picture so I am limited in any estimate of prognosis... much information to be gained in the details...

Customer:

ok, fair enough. what about a lung transplant? I offered to give one of my healthy lungs

Anthony Bray MD :

The picture of the progressive decline is alarming and one that I have seen with ARDS...

Anthony Bray MD :

I don't know if he would currently be a good candidate for surgery... the cardiothoracic surgery team may be consulted perhaps in this regard but it is often a trap in this condition that these patients are so very unstable even this approach may not be feasible....

Anthony Bray MD :

It is a fair question but I do not think that you would be advised to try and donate...(I don't think that is an option for lung transplant surgery )

Customer:

ok. so how does all this play out? what happens next that gets him to the end?

Anthony Bray MD :

Well he may suffer respiratory failure despite all efforts...he hopefully may stablize and slowly recover but he might progressively get worse to the point that he can't be successfully ventilated...

Anthony Bray MD :

Despite what people think the ventilator and even the bypass procedure would have their limitations....

Customer:

with the 100% oxygen from the bypass procedure and the 50% oxygen from the ventilator his oxygenation rate is around 97-100. So as far as the time frame this would take about, what, a week or so?

Anthony Bray MD :

Well that of course may vary quite a bit... 97 to 100% are good sat numbers so he would seem stable from that standpoint at this time... it is the prospect of progressive worsening that could take place... if worsening then he may have only a few days.. if he stabilizes then it may be a slow and difficult recovery... may be another two weeks or more on ventilator even in a good scenario...

Customer:

that's what was confusing, they said the oxygen output from the left side of the heart was decreasing, but to me his 97-110 percent oxygenation seemed really good

Anthony Bray MD :

His young age would be a factor in his favor...

Customer:

well, we'll just hope for the best. Thank you for answering all my questions

Anthony Bray MD :

You are very welcome! I'm sorry that your brother is in such a precarious place right now. I hope that it gets better for him. You are in situation of hope for the best but at same time brace for the worst.. Good luck to you and him>>

Customer:

Many thanks

Anthony Bray MD :

Let me know if you have further questions and I will be happy to get back with you!

Customer:

ok i will for sure

Anthony Bray MD :

You are very welcome!

Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6536
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 3 other Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery
 
 
 

Related Health Questions