Gallagher in a Coma or Just Sedated After Heart Attack?

Sledgehammer-wielding, watermelon-smashing comedian Gallagher (real name: Leo Anthony Gallagher, Jr.) suffered a heart attack yesterday just minutes before he was to perform in Texas yesterday.

The 65-year-old had to have two stents placed in his coronary arteries and according to his manager, Christine Scherrer, he was placed in a “medically induced coma” for the next 24 hours.  This is to allow the entertainer to rest.

This is Gallagher’s second heart attack, his first being in 2011, when he collapsed onstage in Minnesota. Two weeks later Gallagher joked about his brush with death:

You can like God all you want to but I’m pissed at him … I had a heart attack while I was doing sledge-o-matic, which is gonna look great in the paper. But now I could die doing something stupid and my story won’t be as cool.

What is a medically induced coma?

A medically induced coma is when a patient receives a controlled dose of an anesthetic to cause a temporary coma or a deep state of unconsciousness. The objective is to give enough medication to significantly slow brain wave activity. Drugs used include pentobarbital, thiopental, or the drug of Michael Jackson fame, propofol.

This type of coma is typically used to protect the brain from swelling (which is not typically seen after a heart attack). The brain swelling may be caused by injury (such as was the case for Gabby Giffords) or after brain surgery. Being in a coma reduces the blood flow through the brain as well as metabolic rate of brain tissue.

When in a medically induced coma, a patient’s vital signs must be constantly monitored by an anesthesiologist or other physician. Patients are usually intubated and ventilated (this means that a tube is placed in the windpipe and a machine breathes for you). This is done only in a critical care setting.

What is deep sedation?

Deep sedation puts a patient in a semi-conscious state. It is commonly used in medical, surgical and neurological intensive care units and is used when patients undergo major operations.

The types of drugs that are used include anesthetics, benzodiazepines (which are often given to outpatients for anxiety) and opioids (pain medications).

Sedation helps a number of problems experienced by intensive care unit patients:

  • Patients on ventilators: Intubation can be quite irritating and uncomfortable for patients, and sedation is used to make the breathing tube more pleasant.
  • Pain relief: Besides surgical incisions, IV’s, gastric tubes(a tube place through the nose or mouth into the stomach) and urinary catheters can all cause discomfort for patients.
  • Anxiety: Being in an intensive care unit is a scary place to be! Being critically ill and dependent on others for care can cause anxiety. Then add in all the alarms, beeping monitors, and bright fluoroscent lights!

Is Gallagher Really in a Coma?

Plenty of times, the press oversimplifies or is just plain wrong when it comes to reporting on diseases and medical procedures. On the surface, it doesn’t make any sense to us that a heart attack victim would be treated for brain swelling. We suspect that Gallagher is just sedated but only his cardiologist and intensive care doctors would know for sure.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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