Sago Mine survivor Randal McCloy Jr. was breathing on his own, moving all of his extremities and scheduled for “aggressive physical therapy” Monday, although he was still in a coma, doctors at West Virginia University Hospitals said.There was no change in his neurological condition Monday, and doctors said it was “too early to make a prognosis” about his possible recovery.“His brain stem appears to be completely normal,” said Dr. Julian Bailes, a neurosurgeon. He said doctors will be able to better assess McCloy’s neurological function after they clear up a fever McCloy had early Monday morning and as all sedatives, which were ceased at noon Sunday, clear out of his system.The fever is “an almost expected complication” in intensive care patients, said Dr. Larry Roberts, director of the Jon Michael Moore Trauma Center at WVU Hospitals.
Although the brain stem seems normal, it is the “cerebral cortex — your thinking and your level of consciousness and so forth” that “carbon monoxide typically affects,” Bailes said.McCloy, 26, has been hospitalized since Wednesday, when he was rescued after being trapped for 42 hours in the Sago Mine near Tallmansville. Twelve of his fellow miners died in the mine, which filled with carbon monoxide after an explosion Jan. 2.“He is likely one of the longest survivors of this sort of exposure — not only carbon monoxide, but other circumstances in the mine for about 42 hours,” Bailes said.McCloy’s relatives have been at the hospital with him, playing his favorite music and talking to him often, said Roberts.“Personally, I believe that patients in a coma do perceive what’s going on around them,” Roberts said. “Having family, friends interact with the patient, tell him what’s going on ... all these stimuli I believe do help.”Along with carbon monoxide poisoning and oxygen deprivation, McCloy experienced kidney failure, liver problems and a slight decrease in heart function, Roberts said.“His liver appears to have recovered most of its function,” he said, and “most of the other organ systems continue to head in the right direction.” McCloy has several teams of specialists attending him, Roberts said.The physical therapy Monday involved moving all of McCloy’s extremities to promote good blood flow to all muscle groups, Roberts said.Although he was breathing on his own Monday, McCloy was still connected to a ventilator. The ventilator’s role was to provide some air pressure that people normally get from simply standing up and moving around, but which an immobile patient such as McCloy lacks.“He’s doing all the work on his own,” Roberts said. Doctors have been able to continually lower the ventilator’s settings, evidence that McCloy is breathing more and more independently.To remove the ventilator, doctors would have to remove McCloy’s breathing tube, and Roberts said “we usually wait for a patient to be out of a coma” before that happens.
“Clearly there is evidence that we’re heading in that direction in many ways,” he said.Bailes said McCloy is in a “moderate coma,” as evidenced by his reaction to localized pain stimuli — “he comes up to grab your hand” to try to stop the stimuli. McCloy has done that since Wednesday, he said.“That’s a very important distinction,” Bailes said. “As you go deeper into a coma, a [patient’s] brain doesn’t even care that they’re being stimulated. They’re not trying to avoid that noxious stimuli. So that’s a very important stage.”McCloy was still in critical, but stable, condition. “I have to emphasize,” Bailes said, “that he has a long way to go.”The doctors’ Monday briefing was available to the public at www.health.wvu.edu.To contact staff writer Tara Tuckwiller, use e-mail or call 348-5189.