STILNOX

Tannie Frieda en Oom Kobus du Plessis, wie saam met my gewerk het op Harrismith, het my een aand gebel Desember 2010 en laat weet van die uitsending op KykNET, Robinson Regstreeks waar Freek met Dr Wally Nel gepraat het oor die geval van Louis Viljoen:

 Sienie Viljoen sat by her son’s ­bedside every night for three years, holding his lifeless hand and scanning his vacant eyes for any sign that he was somewhere in his broken body.  Louis was hit by a car in the East Rand town of Springs as he crossed the street. His doctors said he would never regain consciousness.

But he did.

And now the story of how his mother woke him up by chance 13 years ago has led to a new treatment for patients with severe brain injuries that is giving hope to others across the world.

Every evening, Sienie Viljoen visited her comatose son and fed him, praying for a miracle. An unlikely miracle, because medical science accepts that patients who have been in a permanent vegetative state for years after a brain injury, just do not wake up.

But one night in 1999, Louis was restless and his mother phoned her general practitioner, Dr Wally Nel, to ask if she could give Louis one of her sleeping tablets. She had some Stilnox with her, and Nel said she could crush half a tablet and give it to him.

After about 15 minutes, colour returned to Louis’ cheeks. His eyes focused and for the first time in four years she heard his voice: “Hallo Mammie.”

Many others have since followed Louis.

Late last year, 26-year-old Chris Cox of the US, whom doctors said had suffered irreversible brain damage, woke up after being given the same sleeping pill as Louis, which is known in that country as Ambien.

Last December, 23-year-old Australian Sam Goddard, who had suffered eight consecutive strokes, came out of his coma and spoke again.

But back in 1999, Louis fell back into his coma after an hour and a half of blissful wakefulness. The next day his mother tried the pill again and again Louis woke up.

She phoned Nel who did not believe her, but he went to visit them. He was astounded and immediately contacted a number of neurologists.

“They would not believe me, but I was persistent,” he said.

And eventually even the skeptical neurologists witnessed the pill’s effect. There was no medical explanation.

A while later, Professor Ralf Claus, the head of nuclear medicine at Medunsa, heard about the case.

He had just received a new medical scanning machine that could detect brain cell function. He and Nel then scanned Louis’ brain, before and after he took Stilnox. The results were astounding.

The scans revealed that large areas of Louis’ brain were totally inactive before taking the pill. When the medication took effect, many “dead” brain cells functioned again, until the medication wore off.

There was no precedent and no explanation. During the last 12 years of intensive study, Nel and Claus have concluded that it has something to do with neurotransmitters in the brain.

In healthy people, Stilnox calms the brain and induces sleep, but it has the opposite effect on those with brain injuries.

“In the past we believed that after a brain injury, in the damaged areas, cells were dead for good. Our research has shown that this is not the case. Many brain cells die, of course, but many don’t die and seem to go to sleep. They can be reawakened,” says Claus.

Claus and Nel have since helped hundreds of patients across the world. Claus has moved to the UK, but Nel is still a GP in Springs. They have published a number of scientific papers.

They have also discovered that Stilnox not only helps patients in comas, but those with different kinds of brain injuries, including strokes and cerebral palsy.

“It does not matter how old the brain injury is, the dormant cells can still wake up even after many years,” says Claus.

Further research on Stilnox’s effectiveness is ongoing worldwide.

Louis, however, remains bedridden in the nursing home, but half a tablet twice a day keeps him awake full-time and he continues to improve slowly.

Instead of just holding his hand, his mother now laughs at his jokes and he hugs her when she leaves. “My son was dead. I have my son back,” she says.

Ek het Dr Nel opgesoek op die internet en sy nommer bekom en hom geskakel. Hy het versoek dat ek aan hom 'n e-pos stuur sodat hy meer kan weet oor Henru se situasie, wat ek toe gedoen het en toe 'n afspraak by hom bekom in Januarie 2011.

By die spreekkamer het hy Henru ondersoek en versoek dat ek hom eers na die Steve Biko Hospitaal moes neem vir 'n scan en dan sou ons weer terug gaan om die medikasie te laat neem.

Einde Januarie 2011 is ons na sy spreekkamer en Dr Nel het eers 'n halwe tablet vir Henru gegee en na ongeveer 10 minute kon mens 'n reaksie in sy oë waarneem. Dit was of die oë meer lewendig geword het. Verder het sy arms bietjie meer ontspan, maar daar was geen ander merkbare verandering nie.

Ons is toe huis toe en het so voortgegaan met die toediening van die Stilnox - 'n hawe tablet elke aand en elke oggend.

 

4 Februarie 2011 het ek die volgende mail aan Dr Wally gestuur:

Geagte Dokter Nel

Hiermee net 'n kort inligtings nota met betrekking tot Henru.

Ek het hom vandag geneem na die Arbeidsterapeut om sy handspalkies aan te pas. Sy was baie verbaas om te sien hoe sy hande verbeter het en hoe maklik dit is om die spalkies aan te sit. Die linkerhand is egter nog bietjie meer spasties as die regterhand. Ek het egter steeds niks vir haar gesê oor die Stilnox nie.

Iets wat die meeste opvallend is, is die feit dat sy epileptiese aanvalle dramaties afgeneem het. Waar hy gemiddeld 10 aanvalle per dag gehad het (petit mal) wat 'n paar sekondes tot twee minute duur en saans ongeveer 5 (grand mal) wat tot 40 minute duur, het hy sedert Dinsdag na die eerste toediening van Stilnox slegs ongeveer 22:30 een grand mal aanval gehad wat net 3 minute geduur het, Woensdagoggend 06:20 een wat 7 minute geduur het en Donderdagaand een wat 3 minute geduur het. Daar is beslis 'n baie groot verandering wat dit aanbetref.

Met die sig is daar steeds by tye waar hy bewegings volg en blyk dit ook daar 'n effense aktiwiteit aan die gang is.

 

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27 Mei 2011 het ek die volgende gestuur:

Geagte Dr Nel

Met Henru gaan dit steeds baie goed. Hy is geopereer die 24ste April 2011 aan beide heupe wat ontwrig het en het maar bietjie moeilik gekry vir die afgelope 4 weke. Van Maandag af het hy bietjie begin verbeter.

Omdat hy nie in gips geplaas is na die operasie nie, het die dokter aanbeveel dat ek die Stilnox verhoog sodat hy beter kan slaap en derhalwe het ons die dosis verhoog na 1 tablet soggens en 1 saans. Sedert die operasie het hy toe geen epileptiese aanvalle ervaar nie waar dit gewoonlik ten minste 5 per dag was. Ek moet ook meld dat die Epanutin nou al van 7,5ml saans verminder is na 6,5ml saans. Van Maandag die 22ste het ons die Stilnox weer begin verminder na ‘n half soggens en ‘n half saans en toe het die epilepsie weer begin. Nie so erg nie maar dit is weer daar. Dinsdag en Woensdag was daar weer niks en Donderdag en Vrydag was dit weer erger – drie per aand vanaf ongeveer 20:30.

Oor die algemeen sal ek dus sê dat daar tot op datum geen noemenswaardige verandering in sy liggaamlike toestand was na die toediening van die Stilnox nie, maar met betrekking tot die epilepsie is daar ‘n beduidende verskil te bespeur.

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Hierna het die epilepsie steeds meer gekontroleer en bietjie onder beheer geraak. Alhoewel hy nog gekry het, was dit nie so intens nie.

Ons het met die Stilnox voortgegaan tot November 2012 en dit toe gestaak omdat daar geen verdere verandering plaasgevind het nie en ook weens die kostes daaraan verbonde.