Hi and welcome. I replied to your journal already but welcome to ptsd board. I’m not sure how a coma would be but I suspect it would depend on what caused it and how deep it would be. Locked in syndrome would be the worst, aware and awake but unable to move or communicate. Let’s hope we never have to find out for ourselves.

Weldome, michael142709. You're not alone in having a PTSD and autism diagnosis here. You wrote about a person in a coma: "I've always been curious how a coma would go, what you would see or dream about in a coma." I worked full time as the hospital chaplain on a neurosurgical ward, and about 1/3 of our floor's 20 patients were in a coma at any given time.

Most were induced on purpose by our own brain surgeons for the sake of keeping the patient lying completely still in bed for their own safety during their post-op recovery from a brain surgery. Sometimes the brain would swell from being handled like that, and brain swelling too much for the space it has inside the skull Here's a diagram for you.

"After the initial impact occurs, the brain undergoes a delayed trauma – it swells – pushing itself against the skull and reducing the flow of oxygen-rich blood. This is called secondary injury, which is often more damaging than the primary injury."
https://mayfieldclinic.com/pe-tbi.htm#:~:text=After%20the%20initial%20impact%20occurs,damaging%20than%20the%20primary%20injury.

Therefore, in order to give the swelling somewhere to go, the brain surgeons I worked alongside would cut a small square of the skull out, kind of like you would cut a square plug out of a watermelon rind. That would allow the brain to swell out of the skull and therefore not reduce the flow of oxygen-rich blood that can kill a person or cause them brain damage with that secondary in a concussion. The brain literally slurped out of that hole in the patient's skull bone safely. The area was covered with a little gauze tent that was carefully tended to by the nurses on the unit. I literally often saw about 1/3 of the patient's brains, then, on my unit. Sometimes I actually spoke to them while they lay there talking back to me with their brain hanging out of their head, all safely.

When the swelling went down, believe it or not, the small skull square that allowed the opening of the hole in the first place was then put back, and it was fastened with simple crazy glue like you buy at any store. Having the brain out and exposed like that after surgery, though, is risky, so that's why our brain surgeons often induced a coma for the patient so they would lie perfectly still until their brain's swelling went down.

What we learned about a coma was that it's different from sleep. Patients didn't seem to dream. What's more, we learned to tell visitors not to talk in front of the patient in bed in a coma unless they wanted that patient to hear what they were saying. Patients woke up from comas really angry that visitors had stood at the foot of the bed and talked about them as if they weren't even there. That's different from sleep, during which we usually don't just lie there asleep and hear people around us that way. If people make noise while we're sleeping it wakes us up instead.

Thanks for asking about this coma information because usually I don't have anybody to tell these stories to. As you can imagine, most of my job as the full time chaplain on this brain surgery unit didn't have to do with religion, it had more to do with calming patients and loved ones about these extreme procedures. Inducing a coma scares people as they think they might not wake up. Letting their brain swell out sounds like such a weird treatment that it's hard for patients and loved ones not to be frightened.

Indeed, brain surgery is risky since it involves one of the two things on earth still not mapped: the human brain and the bottom of the Pacific Ocean floor. We did have patients die on our unit from time to time, but never from a coma, not once.

As someone with PTSD myself, it was fascinating to serve patients and loved ones and support surgeons on a unit that healed the brain. It's still quite mysterious; you mention seizures, and those would happen along with comas. Most patients got well, though often recovery had its short term period of recovering directly from surgery and its long term period of learning to live with changes in the brain again. That was especially true of our stroke survivors, for instance, who often had damage to their speech center in the brain and therefore had to learn to talk all over again. The brain rewires itself around the damaged area in such cases. Unlike the rest of the body and how it grows new cells to replace old ones, the brain's cells do not regenerate. They do rewire, though, so that's what speech therapy after brain surgery was, repetition of speech like a baby to get new wiring around damage in the brain so speech could flow on rewired nerve patterns in the brain.

This is probably more than you wanted to know, but your curiosity sparked my memory of what fun it was working on that brain unit. To build trust with patients and their loved ones for these extreme procedures, I as chaplain was included much more than on any other unit in the hospital. I helped the surgeon explain the upcoming procedure to the patient and their loved ones pre-0p, then I was actually in the room during the surgery. Often patients are awake during brain surgery as it's safer not to put them to sleep for it. During the surgery the surgeons monitored how safely they were operating by having the patient count to ten or answer their name and the date to be sure operating wasn't damaging memory centers. I was the person in the room who did that talking to the patient while they underwent the surgery.

Then, of course, there was the counseling after the surgery and the testing to see if any memory damage was done by having the patient count or say the date and their name post-0p. There again it helped with all of that in this post-op period if there was a pre-op trust built between the patient and myself.

In addition to changes in speech and memory after brain surgery, we found that prompting the brain to rewire itself to keep going sometimes produced a rearrangement of the patient's personality, too. I live now next door to a patient who had an aneurysm and underwent brain surgery through a hole drilled in her skull. She's a great neighbor, a suburban mother of 3, a Lutheran, but after her surgery she became someone who cursed a lot and was a bit rough as to her manners interacting with other people, especially her husband. Her personality changed after her surgery.

For you to follow up on what you say in your post here that others suggested to you, you can start a journal here on Daily Strength. Then you can share it if you want to by making DS "friends" who will be the only ones able to read it. Others on DS can't read it like they can read posts on the open support group boards. I say that because as Community Leader here now I have over 140 such friends on DS who have granted me access to their journal and you say you don't mind typing. Me, 4 years ago a peer member here suggested I keep a gratitude journal, and I've done that daily off line for 4 years now.

Wow that is very interesting . I never thought there was such detail involved in comas. I never knew any one in a coma and I was just wondering. I read stories of people's behavior changing after brain injuries, but never after a surgery. I had a fever at two I had wondered if that caused me to get Asperger's and autism some say I was born with it, but I don't know . The mind is really complicated. Thank you for the insight it really is interesting. I wish they would of taught that in school. How do you deal with PTSD. I feel like it will always haunt me the rest of my life, and I will never be able to live a normal life. therapy helps a bit but seems like it is such a slow process. Thank you again for listening really is fascinating the human mind

You're welcome. Serving both as an ER hospital chaplain and a hospital chaplain on a neurosurgical unit are ways I have coped with living with PTSD beyond being a victim of it. There's a view that recovery can go in 3 stages from victim to survivor to thriver, Getting well enough to make it from survivor to thriver getting paid to deal with trauma and brain injury helped me with my PTSD, too.

It doesn't mean that it stopped bothering me that I have PTSD, or that I stopped having PTSD symptoms. But it did mean that I could live with the fact that PTSD is chronic but can't be cured without feeling like I was stuck in the same place forever. By using it to have a career it became part of my progress through life.

Welcome Michael, you have different brain like me. I have autism and PTSD but not Aspergers. My case Manager thinks I do but my Therapist said nope, I don't. I am just like Dr. Temple Grandin in away, smart. From what I understand PTSD can happen from what you experience and my therapist had said individual with autism makes us more prone. But Michael, I look at it this way God entrust all of us on this support group with something because He knows that we got what it takes to change this world. Plus everyone I met has something they are struggling with even if they don't talk about it.. Michael I am glad that you are here.