Have you ever been in an induced coma?

[Squiff70]

Five years ago I was put into a medically induced coma on a critical care unit and put on life support. I was ventilated like this for nearly 5 weeks.

Whilst being in the coma, I had the most horrendous 'nightmares' imaginable. Months later, whilst still still recovering, I wrote a blog about some of them and some of them are so distressing I haven't been able to revisit that blog since. I remember some of those nightmares and they still haunt me to this day.

When we're conscious and have nightmares, they only go so far before we wake up. Terrified, confused, distressed and disorientated, but awake. In a coma, you can't do that. You're forced to endure the full severity of those awful dreams and can't wake up when they get too scary. I had so many, I can remember at least 12 different nightmares I had during that coma in great detail.

I had normal dreams as well as terrifying ones. Except they weren't normal as they still affect me now even though they weren't scary. For example, one dream was about my cousin being a vet. She was caring for animals in this dream. In reality, my cousin works in retail. Five years on, I still REALLY struggle to acknowledge the fact that she isn't a vet. I have to remind myself regularly that this was just a dream but any time I think about her, or see her, or speak to her, I am on the verge of asking about her veterinary career and have to stop myself before the words tumble out of my mouth because she'd think I had lost the plot.

During this coma I had so many dreams and nightmares that they still affect me now. I have 'flashbacks' of the nightmares - often when I'm tired and I see snapshots of those dreams I had back then.

Have any of you been in a medically induced coma and have you experienced anything similar? I'm really curious to know what others have experienced. I don't know what grade/depth of coma I was in though unfortunately.

Yes, I have experienced the same. I was only in the coma for a week but I struggled so hard to determine what was real and what wasn’t afterwards. It really affected me badly. I was convinced the nurses were trying to kill me.

I am 8 years on now and still the occasional thing gives me flashbacks, but it is mostly ok.

There was a great illustrated short film on BBC website by a young guy who had also experienced this. I’ll see if I can find it.

It sounds really awful, I am so sorry. I’m medical myself and have admitted a lot of people to critical care over the years. I must admit I read your OP with fascination as I had no idea that this could happen. What I do know is that a significant proportion of people who are ventilated for a prolonged period of time develop PTSD (up to 30% in some studies after covid I think). It may be worth looking into addressing whether you have that as it can be treated.
From a personal perspective I’ve been ventilated before but only for a couple of hours or so and didn’t experience anything, probably because it wasn’t for very long. It usually affects younger females for some reason.
I hope you can get some support for it

Here is the link www.bbc.co.uk/ideas/videos/i-woke-up-in-icu-and-didnt-know-what-was-real/p0b71653

I haven't but a family member was for two weeks (Covid).

There is a charity that supports people who have been in icu as it can be traumatising as the pp said.

Here's the link:

icusteps.org

I'm sorry you're still negatively affected by your time in icu and I hope that you can find some help and support.

From a professional not a personal experience.
This is a well known and well documented phenomenon. ITU is a strange environment - noisy, little day/night differentiation, little chance to sleep. Coupled with very strong medications with side effects and the physical process of being unwell, a lot of patients experience this sort of thing.
If you contact the hospital (via PALS) some hospitals off post ITU counselling

EMDR can really help with reprocessing memories like this. Lots of research of people experiencing trauma in ICU settings.
Sounds difficult and worth trying to get help with.

There is a novel by Jodi Picoult about this exact phenomenon, 'Wish you were here'.

Not me but a relative had horrendous burns and was put into a coma for weeks and when he woke up he had experienced something similar. He said he also had out of body experiences where he was watching what the nurses were doing and recalled things they had said whilst they were caring for him. They confirmed afterwards that he was correct!

I completely understand. I don't think most people realise that waking up from a coma is a gradual process. You don't go from asleep to awake. Sedation is weaned before it is stopped so that the person can slowly come round. During that period, there are periods of being awake and asleep but with varying degrees of each. I think this is where much of the delirium comes in because it's probably not clear to most patients when they are awake and when they are asleep - they fade in and out of both, with the two merging together. This is a process and it isn't always quick.

During my ICU stay, I had to have a tracheostomy. I had a dream that I was in a very large shopping centre which was filling with water. I was floating around underwater unable to breathe and a diver came and cut my throat to allow me to breathe. I was certain at that point that I'd been given a trachea even though I was still in the coma, so my body sort of knew what was happening even though I was unconscious.

Certain things just don't make sense to me now though. I have a memory of being in ICU and I still don't know if it was real or not. At one point I told a nurse I needed the toilet. She told me ICU patients weren't able to use the toilet so there wasn't one. What I don't understand is how I told the nurse I needed the toilet when I had a trachea.

What makes even less sense is that after I'd been there some considerable time, my parents visited. They were looking after my two rabbits at my house. I told them one of them had been taken by a little girl who told me he was her rabbit, and so she took him. I begged my parents to go and look for him and get him back. They told me both rabbits were safe and well at home and had been hopping round the garden that same day. My mum tried to assure me that neither of the rabbits had been taken. I remember the dream so vividly where he was taken by this little girl. I couldn't be convinced it wasn't true. Again, I must have had the trachea at this point but how did I have this conversation when I couldn't talk? None of it makes any sense and the more I try to work out a timeline of events, the more confused I get and I give up!

So sorry guys, I will reply to all of you when I get chance. I have a newborn baby and a toddler and can't devote the time or attention this needs in one go. I really appreciate and understand the replies and will come back ASAP.

I'm so sorry op that sound unimaginable.

Rather naively I thought when you were in a coma it was like being under general anaesthetic which for me was just a memory of gong under then waking up, nothing in between.

Not me, but my mum. 6 or 7 weeks on life support, with a tracheotomy.

She never spoke of vivid nightmares like you have experienced, and has since passed away so I can’t ask, but she didn’t mention that this recurring dream that she had when I was young, suddenly came back again. In this dream we were walking through a forest near my grandparents house, I was running ahead then all of a sudden went down the wrong path, she would chase me but couldn’t catch up. Usually she would wake up pretty quickly but in the coma she just kept running and not getting any closer to me.

She also had ‘nightmares’ about Tina Turner! Due to infection control (it was a rare form of pneumonia) she was in a private room so we had been able to bring in a small stereo and some cd’s to be played. I had brought some music I knew she liked and my dad had gone and bought some more, including Tina Turners greatest hits. My mum hated Tina Turner but one of the nurses was a fan so the CD was on whenever this particular nurse was on duty. The only music she could remember hearing was Tina Turner, when she came around she made us throw the CD away!

She seemed to recover well from the experience but my Dad definitely suffered PTSD as a result of her illness, not that it was really talked about then (early 2000s). He tried his best but he was so quick to snap at the tiniest little thing. While she was in hospital our relationship took a nosedive, to the point where I moved in with a friend and her family, and never really recovered before he died a few years later.

The wide use of the term ‘medically induced coma’ is really really inaccurate because that isn’t usually what’s happening. Patients who require intubating for whatever reason will initially be anaesthetised to facilitate the process of intubation, but then the anaesthetic is titrated down to provide sedation rather than anaesthesia, with the aim of having patients comfortable but not over-sedated. The reason we all talk to the patients when we’re doing procedures/turning/washing them etc is that we know they’re not in ‘a coma’ much of the time and can quite often hear us. Deep unconsciousness is often not what we’re aiming for because it causes significant side effects that can have serious effects on outcome. There are some scenarios in which deep anaesthesia is needed, particularly in the initial stages of a critical illness, but it’s unusual to keep someone deeply sedated for very long periods.

Critical care delirium as part of the disease process combined with sedative drugs is very common on ICU and can be difficult to spot (particularly in patients who have sedation running) and quite difficult to manage. It is well recognised though and a lot of units have access to psychological support for patients who are troubled by memories of their experiences.

OP, if the idea that you were able to talk with a trachy in is bothering you significantly it may be worth asking for a follow-up appointment with a consultant from your unit. It is often possible to talk with a trachy in once making progress weaning from the ventilator so it’s quite possible you were able to chat with a trachy in. The nurse was also right - there are often very limited bathroom facilities on ICUs because the patients can’t often get to them even if they really want to! HTH.

As an icu Dr really sorry to hear your experiences, unfortunately it's relatively common. If you have a prolonged stay most icus will keep an icu diary of each day and what happened to you eg what you go for scans, family visits, many take photos etc, they don't always give them immediately over as can sometimes trigger worse feelings. They tend to contact patients a month later to offer them

Please please get in touch with the icu where you were, all units have attached clinical psychologist for this reason, they'll be able to sort debriefs, obtain your notes explain gaps, arrange counselling etc etc

Best wishes x

I had dreams when I was under general anaesthetic for a operation.
That really surprised me.

I will ask our friend induced coma for nine weeks. I also thought you were completely out of it

Sounds deeply upsetting. Maybe ask PALS an appointment to go through your notes. You could probably do with counselling aswell.

There's a dedicated icu joint followup clinic with consultants, nurses and psych which will be much more beneficial in this circumstance as will understand the minutiae better, contact icu via switchboard, ask to speak to the nurse in charge and they'll sort it x

hi
yes I have been in an induced coma. This happened to me. I had no idea it happened to other people. I had horrific hallucinations (this is how I have always thought of them). I thought the staff were killing people and washing them away and I would be next. I remember begging people to get me out of there but no one would believe me. It was seven years ago now but I still get flash backs occasionally. I was offered to go back to icu 6 months after, but I didn’t feel at all ready then.
I still haven’t been able to tell anyone what I felt because it sounds ridiculous. This is the first time I have spoken about it.
I feel for you op. It seems we are not the only ones

To those of you who work in ITU can I just thank your for the amazing care you give your patients, it is deeply, deeply appreciated

Not an induced coma but I was on a central feeding line and very high levels of drugs and so I was out of it for long periods. Catheterised etc. I almost died.

I recall floating down a passage to a light at the end. I remember lots of conversation going on around me but I couldn't speak.

My son was in an induced coma for 4 weeks as a baby.
Thankfully he was too little to remember, but if I had known about this it would have been even more heartbreaking.

Greybeardy that is really interesting, because there were times when those conversations around me filtered into my hallucinations. There were some really odd things I remember, such as being tested on my intelligence which doesn’t make sense, but my eldest DS was revising for GCSEs then so it probably came from a conversation around me about that.

I did get my patient diary and photos which I found really helpful, and I also attended ICU steps which was even more helpful. Some patients aren’t ready for it too early though.

Thank you for your reply, and I'm sorry to you and everyone else who has commented on this thread if if looked like I'd abandoned the thread so soon after starting it! I've been extremely busy and it wasn't intentional.

It's interesting that so many professionals like yourself aren't aware what can happen to a patient in a coma from a psychological perspective. I guess the only way to 'know', if you haven't experienced it yourself, is to read people's experiences for anecdotal evidence. It seems lots of people experience this but frustratingly, searching online almost all refer to ICU delirium and it's not the same as experiencing horrendous dreams and nightmares under sedation.

Sorry, hit post by accident.

I do have diagnosed PTSD, however it was diagnosed stemming from a specific life event which took place some years before this ICU admission. I don't doubt for a second that I have PTSD stemming from my expeoroces in ICU also. It has never been a doubt in my mind.

I've had EMDR in the past, not relating to this admission, and unfortunately didn't find it helped. That said, I'm going to make a few enquiries - partly with ICU directly to ask whether they offer any kind of counselling or service whereby they try to fill in some of the gaps or answer questions from former patients, but also the link provided earlier in the thread. Thank you so much for that!