Intensive care unit Q

[ineedanswerstothisPLS]

Hi. I name changed because I don’t want this associated with my usual name. I’m embarrassed even though I don’t know why. I know there is no shame in mental illness but I’m humiliated with my obsessiveness over this.

I was in intensive care with pneumonia and sepsis. I was put on a ventilator. I was taken to theatre to be intubated and my husband said I was gone around an hour.

My hospital doesn’t offer any follow up. I don’t have any medical consultants I can ask.

I was diagnosed with PTSD and trialled on anti depressants and tried CBT. Nothing has really worked. I find it important to know as many facts as possible to help me cope. A huge anxiety for me is because I don’t know what happened to me when I was in the medically induced coma. Obviously husband told me as much as he was there for.

I don’t understand why I was taken to theatre and why it took so long. If anyone could give any sort of explanation or have any knowledge, I’d be really appreciative. Please and thank you.

Hi OP, sorry you’re feeling this way. IME, some patients are in recovery longer than expected as we are waiting for porters/and sometimes a nurse to be free to take them back to the ward.

Please call the ICU and ask if they have a follow up service. Hope you feel better soon

Ineedanswers I'm so glad you're feeling better, please please get a copy of your medical and nursing notes, you sound a lot like me and having time to read through everything will allow you to formulate questions before you have any kind of follow up.
It will be the nurses in ICU who will have the information you need, they are the ones who do the caring, doctors might see you several times a day but you have 1to1 nursing 24 hours a day. Like I said cake is your friend, go and visit ICU, if for no other reason than to say thank you.
It is becoming more widely acknowledged that it's vital for patients in ICU to be able to fill in the gaps and make sense of what happened to them, some have started to keep a diary next to the bed for visitors to write in along with the basics of the care provided.
Whenever I go into HDU/ICU I get family to keep a diary for me, I live in dread of the next induced coma but knowing that I can put a time line together afterwards is precious.

Hi Op, I can’t help with your theatre questions but I’m really glad your feeling better with the lovely responses you’ve had. Your mental health recovery is just as important as your physical recovery, I hope you find someone through pals who can settle your mind for you and help you get back to feeling like you xx

Maybe it was a difficult intubation and they needed some additional equipment e.g. bronchoscope to do the intubation?
I'd be very surprised if you couldn't get some more information via PALS.
However, I would second the comment from PP about the amount of time spent waiting around etc in theatre. An hour goes by so quickly. The actual intubation probably only took a matter of minutes.

I'm so sorry this has happened to you I have a family member currently in ITU and the hospital are making a journal for them about everything that is happening whilst they are in a coma, to hopefully and eventually give to them, detailing all procedures, who visited, aspects of their care etc, for when they leave the unit. My family are also making a journal. All staff I have spoken to involved in their care understand how important this is for their patients, to help to fill in the blanks to help with PTSD.

As others have said- apply to have the notes released. You were only away an hour. So let's say 5 minutes (minimum) pushing time to theatre. Transfer onto theatre trolley (10 minutes) ensuring equipment is where it should be, and discussing plan 1 (optimal) 2 (back up) 3 (emergency) at least 10minutes. Prep with drugs for intubation 5 minutes (minimum) Intubation successful oral and tube secure, with X-ray to confirm position 15 minutes (minimal) transfer to ICU trolley and back to dept 5 minutes. So there is 50 minutes minimum with a straight forward intubation. If they'd done it in the ICU- would have been at least a 45minute proceedure so actually a pretty quick one.

You might find this useful. Younger survivors of sepsis often develop MH issues, PTSD is t uncommon
www.sepsis.org/life-after-sepsis/faq/ptsd/

Hi OP, I am a consultant in Intensive Care Medicine with a special interest in follow up of patients. From what you say, you will most likely have been taken to theatre to be intubated due to the high likelihood of you being a difficult intubation due to your recent surgery. There is usually more specialised equipment available to deal with the situation in theatre rather than ITU.

PTSD is fairly common in ex ICU patients and it is good that you have had access to CBT. For patients with severe PTSD the next step might be referral to a clinical psychology service. It is a shame that your unit has no follow up service, we routinely see patients 2 Months post discharge and many patients are helped by just going through their notes and explaining what has happened. I would suggest you consider ringing your ITU and asking to meet with one of the consultants ( there will usually be at least 5/6 of them).

Lastly there is a great online support group called ICU steps and lots of areas have their own local meeting groups where ex patients can meet up for mutual support. Patients seem to find these groups very useful.

Best of luck in your recovery OP, most patients I see have significant,y recovered at 6-12 Months even those with quite severe symptoms.

Hi OP, I am a consultant in Intensive Care Medicine with a special interest in follow up of patients. From what you say, you will most likely have been taken to theatre to be intubated due to the high likelihood of you being a difficult intubation due to your recent surgery. There is usually more specialised equipment available to deal with the situation in theatre rather than ITU.

PTSD is fairly common in ex ICU patients and it is good that you have had access to CBT. For patients with severe PTSD the next step might be referral to a clinical psychology service. It is a shame that your unit has no follow up service, we routinely see patients 2 Months post discharge and many patients are helped by just going through their notes and explaining what has happened. I would suggest you consider ringing your ITU and asking to meet with one of the consultants ( there will usually be at least 5/6 of them).

Lastly there is a great online support group called ICU steps and lots of areas have their own local meeting groups where ex patients can meet up for mutual support. Patients seem to find these groups very useful.

Best of luck in your recovery OP, most patients I see have significant,y recovered at 6-12 Months even those with quite severe symptoms.

and wish I’d asked a long time ago

You might not have been ready a long time ago, you've started asking now because you're ready to deal with it.

ICU is an amazing, life-saving place with some of the best staff in the NHS...it's also one of the most terrifying. I remember regaining consciousness, having no recollection of what had happened and thinking I'd been abducted either by aliens or a mad scientist for experiments - scared doesn't begin to cover it and the meds making me combative made (and make) things worse.

Talking it out helps, detailed information helps (me at least) and time helps. I've had multiple ICU stays and I still have side effects afterwards, but I am now able to process and move on much more easily. I feel most sorry for whoever is with me when I start to wake up!

I am sure the ITU will be able to help you.
I recently contacted one after the recent serious illness and death of a patient. His widow needed information to help her to process what had happened. I contacted the hospital bereavement office but I am sure you could contact through PALS or your named consultants secretary if you have it. The consultant ic ICU went through the patients notes with me and offered to do the same for the widow.
He was very willing to offer info and to be contacted again.
I would strongly suggest that you similarly try to discuss your case with someone who was closely involved and who has access to your notes. I am sure it will help you to put those minutes aside and to continue your recovery. Best of luck.