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View Full Version : Thoughts and prayers for Courtney King-Dye



riderboy
Mar. 4, 2010, 05:10 PM
Cross post from the dressage forum. She apparently fell from a young horse, struck her head sans helmet and is hospitalized with a brain injury of unknown severity at this point. Keep her in you thoughts and prayers and wear your damn helmet.

Auburn
Mar. 4, 2010, 05:35 PM
Prayers being sent from KY.

Wear your helmet, every time, every ride! :yes:

denny
Mar. 4, 2010, 06:14 PM
I watched her ride at the Klaus Balkenhol clinic at U-Mass a couple of years ago. The best. What a tragic shame.

Wear your damn helmet.

SevenDogs
Mar. 4, 2010, 06:28 PM
Best wishes to Courtney for a full and speedy recovery!

Let's all wear our damn helmets.

annikak
Mar. 4, 2010, 06:43 PM
So sad....life can change so quickly:cry:

One can only wonder if she had been wearing a helmet.... Even in that light, jingles to Courtney, her husband, her parents/family and friends.

Bless the minds and hands that are on her case.

RunForIt
Mar. 4, 2010, 06:46 PM
This young woman has done so much, worked so hard, performed so brilliantly...all my prayers and hopes go out to her and her family.

1516
Mar. 4, 2010, 06:53 PM
again, wear your damn helmet.

Ajierene
Mar. 4, 2010, 06:57 PM
Hopefully Courtney's incident will help shed light on why a helmet is so important.

When people mention the statistic possibilities of falling off while flatting, I reply that it may be a one in a million chance, but I do not want to be that one.

I am hoping Courtney comes out of this just fine.

CookiePony
Mar. 4, 2010, 07:13 PM
Oh, how awful. Jingling for her.

barnmaven
Mar. 4, 2010, 08:57 PM
Jingles from NC. What a rough few days.

Lori T
Mar. 4, 2010, 09:39 PM
Holy cow, I come on here and first read about Dobbins, and now this...I kept thinking, this all can't be right. Someone must be playing a joke. Praying for a good and speedy outcome.

AnotherRound
Mar. 4, 2010, 10:20 PM
From what I've heard, she'll recover and be ok. I don't know everything going on with her, so this is really an assumption, but from what I've heard about her situation, she will be fine.

Small bleeds won't kill her, but the swelling in the brain which having those bleeds causes, and which swelling they found, can kill her if not immediately addressed. Apparently she's in an excellent hospital and they immediately reduced the swelling. I am certain they PUT her in a coma. That is what the routine treatment for swelling because of a contusion (bruise) or bleed ( hemorage) or concussion (bruise from banging the brain agasinst the skull) is, so, she's not in a coma because she's injured. Its a neuroprotective procedure using medication or anesthesia which reduces her metabolic rate and her brain activity to give her brain a chance to heal and recover. And the brain does a dady job of recovering, given the chance, such as it is currently being given to Courtney, if she is put into a coma with meds.

We have seen this many times in similar threads: A coma, from which people have a varied recovery, once the anesthesia treatment is finished (varied amounts of time in such a coma, depending on the degree of trauma).

The probelm with these kinds of contusions to the brain, or concussions, is that the bleed burns the surface (or tissue in general, if inside the brain) of the brain and later that burn becomes scar tissue and/or calcified. Its like havin a small hermorragic stroke. When we age, we might have many manhy of these things, and they reduce our brain function and create problems in mentation and we get an early dementia, just like the prize fighters. Usually, they happen so at the end of life that they don't get years and years to form scar tissue and calcification. But if they happen early in life, we have years of functioning which we reley on for middle and late age while fighting these calcifications.

So she might recover, immediately, but eventually these lesions, or bruises, will inform her early dementia (possbly).

Its why we don't want our 10 year old sons playing baseball and getting a concussion. Or, why a 30 year old prize fighter is buying time from his later life to have these terrible bruses; his dementia will come about much earlier than those without concussions who get bleeds and demential later, like n the 80's and 90's.

These are the processes which bring about early death and dementia. And I won't even address football.

Eventing? If only the press got ahold of eventing in concurrance with their new awareness of the dangers of concussions in football. That would be interesting.

This is the process behind which we pontificate about helmets. When one or our own was injured without a helmet, we can't help but think how much of their future might have been protected by a helmet - how much less of a lesion, smaller a contusion, how much more protected migh their brain have been, this one extra time, with a helmet.

Hopefully her contusions are so small that they are negligible, the swelling reduced quickly and that damage mitigated; her recovery swift and complete, and her contusions and calcifications no more than anything any of us uninjured will come up with in our old age.

I look forward, and anticipate, her continued competition.

Anyone, the most careful, can be caught unawares, fall unwittingly under a horse's hooves, fall off the deck of the family room, down the stairs, under the fear of a mare stung by a bee. Slide on ice, slide on water, mud, on the road with our new porche. There is no guarantee in life.

The best life lived is the one lived boldly and with a laugh rising in our belly.

I wish Courtney the best, and I know her recovery will be swift.

blackwly
Mar. 4, 2010, 11:12 PM
I am certain they PUT her in a coma. That is what the routine treatment for swelling because of a contusion (bruise) or bleed ( hemorage) or concussion (bruise from banging the brain agasinst the skull) is, so, she's not in a coma because she's injured. Its a neuroprotective procedure using medication or anesthesia which reduces her metabolic rate and her brain activity to give her brain a chance to heal and recover. And the brain does a dady job of recovering, given the chance, such as it is currently being given to Courtney, if she is put into a coma with meds....


So she might recover, immediately, but eventually these lesions, or bruises, will inform her early dementia (possbly).



There are a lot of errors in this explanation. I do not know anything about Courtney's injury. However, an induced coma is by no means a "routine treatment" for head injury. We often call it a pentobarb coma (because pentobarbital is the agent used to reduce intracranial pressure and induces the "coma") but this is an absolute last ditch effort to save someone who is otherwise going to die. On the neurosurgical service where I work, we see about 125 significant head injuries per month (ie with evidence of hemorrhage on head CT and altered mental status) and average about 1 pentobarb coma per month, maybe. Pentobarb is frought with complications and many people die or wind up in a persistent vegetative state despite it's use. I have never seen anyone wake up "immediately" when the drug is stopped. I have seen a few cases of people who were eventually able to live full lives, with some residual deficits, after extensive rehab.

Now, I have no idea if Courtney is being treated with this sort of aggressive measure or not. It is possible that she is just on other sedating medications (not technically an induced coma) to keep her intracranial pressure down and allow her to tolerate the ventilator. Just wanted to clear up the confusion.

I would also say that early dementia is not the issue right now and we honestly don't know enough about the pathogenesis of this process to make a lot of predictions about which head injured patients will wind up with these sorts of problems. It appears that those at risk are those who have repeated head trauma, especially if they do not fully recover between injuries. There is not much evidence to suggest that a single severe head injury will lead to delayed dementia.

blackwly
Mar. 4, 2010, 11:16 PM
Oh, and wear your helmet. But also wear it on your motorcycle, your ATV, your motorscooter, and your bike. Wear your seatbelt and don't drive drunk.

If everyone did that the head trauma numbers at my hospital would probably go down by about 70%, I would guestimate.

Noctis
Mar. 5, 2010, 07:01 AM
Sending huge prayers and jingles for Courtney.

frugalannie
Mar. 5, 2010, 08:00 AM
I. too, saw Courtney at the Balkenhol clinic at UMass and was impressed by her. Sending jingles her way and hope, because I know someone who survived and thrived after a major TBI.

My friend was schooling XC in the spring and had a fall. Immediate and excellent medical care, including what was probably a pentobarb coma, resulted in her being able to attend a world class graduate school that autumn and do brilliantly. She may well be the poster child for positive outcomes in the face of TBI.

Thank you for the explanation, Blackwly. I knew that my friend had been medicated into a coma, but I didn't know any more about it.

graytbmare
Mar. 5, 2010, 08:26 AM
Thoughts and prayers from NY for an amazing rider!

annikak
Mar. 5, 2010, 10:06 AM
Blackwly, Thank you for that explanation of what occurs in such cases. I think that confusion exists, as when we put (not me;)- the docs who I work with who are amazing) people into their (mercifully) snowed state, their families often think it's a medically induced coma. Not really (as can be seen during their sedation vacations....)

When people go in innercool, we do "paralyze" them, but only to make their recovery easier- because I can think of nothing worse than being on a vent.... It is at these times the expression "better living thru chemistry" truly makes sense to me.

I continue my hope, and jingles.

bambam
Mar. 5, 2010, 04:18 PM
Jingles for Courtney!
The current update on Chronicle indicates she is in a coma and it is not medically induced.

3phase
Mar. 5, 2010, 05:14 PM
Can't believe the 5 bad falls that have happened over the past weekish (and probably more than we know about.)
Wearing your helmet is definitely a necessary thing but even with a helmet I have had more than a few concussions (one sending me to hospital after blacking out for a few mins.) But with that said, wearing your helmet can prevent worse. Riding is a dangerous sport and we all realize this.

Hoping the best for everyone that has fallen especially Courtney, Jan Bynny, Rebecca Howard, Karen O'Connor and Rebecca Lee.

4Martini
Mar. 5, 2010, 05:19 PM
Jingles from Colorado! I have been amazed by the articles I have read about her and when I have seen her ride. What an amazing lady!