to ask about recovery from medically induced coma.

[catsnickedallmypens]

Posting for traffic here.

A member of my family was recently admitted to hospital with pneumonia. His condition was so serious that he was put into a medically induced coma. His sedation has now been reduced and he is awake. We are told he's going to be in hospital for a long while and will need intensive physio and medical help to recover.

My question is have any of you had friends or relatives who have gone through this and if so what was the recovery process and timeline like?

Equally are their any medical staff on here who have worked in the field and can give me any information or advice?

Also, how can we help him with his recovery?

Thanks

My elderly father was in a similar situation a few years ago. Iirc he was in hospital for about 3.5 weeks. He was in his early 80s but pre-pneumonia used to walk about half a mile each day to get a newspaper every morning and was very independent.

When he came out of hospital, he had a 6 week support plan with carers going in to help him get out of bed etc. He had meals on wheels for the 6 weeks and used a Zimmer frame to slowly make his way around ( actually 2 Zimmerman frames, one upstairs and one downstairs). He could just about make his way up and down the stairs with the carers help. We were also very happy to give him additional support from the family. At the time we looked at local nursing homes to see if any could accommodate him for a period of convalescence but none could help.

By the end of the 6 weeks he no longer needed carers, meals on wheels or the Zimmer frames but wasn't strong enough to get his own shopping. It took about 6 months to be about 80% recovered and he probably made a 90% recovery in total.

But bearing in mind how ill he was and his age, I think he made an astonishingly good recovery.

Ahh Cats you my thoughts are with you. Xx
My DH went through this exact senario last March after a serious bout of flu he contracted pnuemonia and was an induced coma for 17 days. The first 7 days in isolation.
Due mainly, I think to his age (53)and fitness he made a remarkable recovery and just last week received a full discharge letter from his consultant.
Whilst in hospital we received the same advice regarding recovery.
However once he was home although very weak after the first six weeks he started ti make a fantastic recovery.
If someone had told me this whilst he was still in hospital I would have never believed them.So please have hope.

One thing I would say is I knew straight away once he woke out of the coma , although still very ill and extremely weak he was back in spirit he had not changed one bit. Still my lovely DH.

Thank you peri and granof that's reassuring. My relative is only 34 and has other health issues. He seems to still be him in terms of character and personality (only brought out of the coma yesterday).but he's very weak. He can't move his arms or legs at the moment or speak very well. Is this normal?

I work on icu . Studies show that for every 1 day on icu , it takes up to 10 days to get well. This is due to the stress and strain that gets put on the patients body. In some cases the patient has a slow recovery in other cases I have been pleasantly surprised. Your relative will be sore and stiff and very weak. Possibly a sore throats and mouth if they had been intubated ( breathing tube) we encourage our patients to get out of bed soon as possible even if it's only for 30 mins . Be patient. Also remember that they have lost time , may have strange memories or dreams but will some times also recall something you may of said to them when they were sedated. It's very surreal. Find out if the icu does an after care clinic. Some trusts do where you have a chance to speak to nurses about your time on icu. I wish your family well, and your relative a safe and speedy recovery.

Thank you Drinkswine (love your name btw, true class!) that's very helpful. Yes he was intubated. What's the situation re him talking? Is it the intubation and subsequent soreness in his mouth and throat that stops him from speaking properly are there other issues due to the sedation?

Also, is there anything we can do to help his recovery and make him feel less helpless/vulnerable?

The sore mouth and throat can be from different factors. The et tube, the tapes holding it in place, infection, dry throat, irritation, oral thrush due to antibiotics etc.
To help your relative be patient with them. Don't over do it with visitors , let them rest . Bring them photos , favourite music. Encourage them to get out of bed, do exercises given to them but at the same time try to understand that they are experiencing something like a twilight zone.

Bring him sweets and juice as it really hurts having the tubes taken out of your throat/ nose. My mum/ visitors brought me mashed up fruit and soft food - rice and mince etc as hospital food is quite hard to get down.

Thank you so much, we're flailing around in the dark here and desperately trying to help him. Your advice is very much appreciated.

Probably not what you want to hear but I had terrible memories of hallucinations/psychosis and other physical issues which may be upsetting for people to hear about. I was in a medically induced coma for three weeks.
Happy to tell you more if you want to pM me.
I had septic shock/multiple organ failure.

Hi, I was in a medically induced coma for 14 days due to pneumonia 7 years ago. When I woke up I was extremely disorientated and scared due to the effects described by ciele - I was also very weak. I couldn't speak above a whisper and had lost a great deal of strength in my limbs; walking/standing was impossible, as was dressing, feeding myself etc I had intensive physiotherapy and was able to regain these skills relatively quickly. For months afterwards I found the strength in my limbs failed if I became too tired though. The worst aspect was the shock and disorientation I experienced as I came to terms with what had happened - there was no support available at my hospital. I read and re-read my ICU diary to try to make sense of it. Your family member may well need practical and emotional support for some time.

I also had terrible constipation and felt like I had lost a month of my life so maybe keep a few newspapers so he can get back up to date with life?

It's the missing days. When I go to my patients , I always speak to them wether they are sedated or not. I tell the the date, the time , tell them what the weather is doing. A lot of the drugs we give can cause confusion, what we call cam positive. I believe more after care should be available not just for the patients, many of whom would of died without our help , but also for the relatives. They too have been on an emotional journey. There isn't much help for staff either if that's any consultation . We see the worst in people, in circumstances , horrific circumstances and have to try and carry on to the next. I have had many a soul destroying shift which would break any ice queen.

Thank you, all of you who have posted. I appreciate all of your wisdom. And the gloomy stuff is important because I want and need honest opinion.
drinks I want to say how much I appreciate you. Apart from my nephew's stuff my mum is elderly and goes to about as many clinics as are available.

Despite being on it's knees for years the NHS is amazing and providing a first class service.

I'm an anaesthetist and we look after the ICU patients out of hours. In hours they are either looked after by anaesthetists or intensivists.

Depending on how long he was intubated for he may well have swollen vocal cords. The plastic tube between them irritates them. The vocal cords moving is what creates the tone of the voice, if they're swollen it will be a croaky whisper. It should come right but can take a few days.

When I was an icu registrar one of our morning jobs was to throw balls to the longer term patients - soft foam ball which we basically played "catch" with from the end of the bed. It helps with upper body strength, just throwing forwards and backwards a few times. Physios will also help with exercises for upper and lower body muscles. ICU myopathy (where the muscles are weak) is very well recognised, it's the result of being in bed not moving for a prolonged period.

Hallucinations and nightmares or icu psychosis come from many aspects - there is the disruption to the day/night cycle (no icu is ever truly dark), there are side effects of the sedatives (particularly opioids), there is the disjointedness of having people approach from behind or the side unexpectedly for things like airway suctioning, mouth care. One of the things I always do is approach my patients from the front so they can see me coming! I also explain what I'm going to do before I do it.

In terms of practical things - softened food for a few days while the sore mouth heals; books, puzzles or other things which you can put down every few minutes when fatigued; whiteboard and marker for writing requests / messages when unable to talk; things for hands to fiddle with for increasing grip and arm strength. Also chocolates and biscuits for the nurses 😉 Ask if you can play catch with them for short periods 😄

It takes a good 6 months to recover from serious bouts of illness, longer depending on the severity and other concurrent medical issues. Once home, people get fatigued very quickly, have issues with memory and concentration, have impaired muscle strength / general weakness, can have tummy upsets or constipation, nothing horrendous but all contributing to a slower recovery.

Hope your relative is on the mend now!

I was in ITU for 3 week just over 4 years ago. I didn't talk for several days, and my voice was croaky for weeks and weeks - after all this time, and lots of singing, I still don't have the strength of singing voice I had pre ITU!
I also could barely move and because of my injuries it was a further 4 weeks after I woke up until I was out of bed at all. My first physio exercises were just moving my fingers!

What helped - my own music, on some sort of mp3 player. Cordial, to make the water more interesting. Fluffy socks. As I got better, books but sounds like it might be a little while for your relative.
I wish them and you speedy healing and recovery.

My father spent 3 weeks in ITU previously following surgical complications. He was in an induced coma 3 times and had 2 cardiac arrests. It took months for him to recover but he is now back to his usual hobbies and almost baseline level of fitness. I remember him being very weak and intermittently confused in ITU.
I hope the outcome is good for your relative.

My DF was in at 55 in much the same circumstances, pneumonia, induced coma and lung operation. He's ex military and the type who finds it impossible to sit still. He came out of the coma a little confused and very weak and not able to speak (we made laminated cards for him, to cover basic questions). After a week he was determined to exercise little and often. There were no beds available in high dependency unit, so he eventually convinced the staff to let him out on day release home. After 3 days of day release he was recovering at home. He was very thin and tired easily and easily confused, but 3 months on he was back to normal. We have friends who worked in a nearby ward who privately told us afterwards that the staff were amazed the outcome and had expected one very different (we had several soft conversations with staff when they were preparing us for the possibility of every outcome.)

To support, we had friends and family coming to the ICU waiting room to drop off food and make sure we took it in turns to walk outside and get fresh air. We made him laminated cards (the would like Ice one was used a lot), bought in sports podcasts for him to catch up on cricket and things like Radio 4 news quiz and audio books. He hated the hospital food so would bring in food for him. We also made a printed explainer for him, including things like the date and where he was (he woke up thinking he was overseas). He hated seeming weak, so we looked up private hire of pools nearby so he could gently do swimming recovery in private (not as expensive as you might think).

I work in icu. Waking up patients can be a slow progress. They do not always follow a smooth recovery trajectory. sometimes partients need resedating a few times as they are not quite ready to manage breathing for themselves yet. The staff will keep trying as keeping patients indefinitely sedated increases the risk of catching further infections. (Not to scare you, just so you have realistic expectations). He will need intensive physio. He he young but will still have lost a significant amount of muscle tone whilst sedated. It is a long recovery process but I've seen patients walk back in to say 6months after we discharged them looking fantastic! Wouldn't have even recognised them. I would also add that due to how sick he has been and the drugs given to sedate him, he may be very confused for a while after waking up. Patients loose their natural circadian ryrhmn, night and day are very similar in icu (same bed, one nurse at the end of the bed, machines beeping, half hearing conversations and not knowing if they are about you/about someone else...)
It's a tough time for all involved. Hope he has a smooth recovery. Thoughts are with you and your family.

for all you lovely ICU staff and brave former patients

Hi OP, I'm sorry you're going through such a stressful time

My brother was put into a coma after he'd contracted Leigonnaire's disease. It was 20 years ago now, and it's difficult to remember the time-scales involved because it's a nightmarish blur.

He went in with pneumonia, almost immediately knocked out and ventilated. I remember a young junior doctor standing in a corridor arguing with a consultant. The junior doctor was adamant it was Leigonnaire's and her intervention saved his ife.

The doctors kept telling us to say goodbye. The nursing staff in intensive care told us they'd 'got people back' who were this bad before and not to give up hope.

Later the doctors said they had no choice but to turn the life support off, as the carbon monoxide blood poisoning was kiling him.

When the life support was turned off he didn't die. He just kept going. The next day he sat up in bed, projectile vomited and asked for a sandwich! It was almost miraculous. The nurse sent me off with directions to the hospital kitchen because they don't have food on the intensive care ward (I got lost).

After waking up he suffered frightening hallucinations and shouted about monkeys coming out of the walls - I think it was a side effect of coming off all the medications, he'd been pumped full of every antibiotic and antiviral going, which made him puff up and go slightly orange (so there was a hint of Elvis about him).

His kidneys didn't swing back into action straight away, he had limited vision in one eye and problems with balance. Within a few days he was back at home - the care on the intensive care ward was amazing but he ended up on a neglected renal ward surrounded by dying elderly men. When he phoned my parents hysterical that he'd been put there to die and they wouldn't even give him a pillow, my parents fetched him - signed him out and carried him to the car because staff couldn't find a wheelchair.

He was very weak, but he needed to be at home, he'd been through a terrifying experience. GP came to see him every day - mostly out of guilt we think, because he'd misdiagnosed Leigonnaire's as a panic attack and if we'd taken his advice my brother would be dead.

He was off work for 6 weeks I think. The kidney and vision problems rectified themselves quickly. It was lucky that he was young (mid-20s) , fairly fit and had never smoked - or things would have been different. I don't remember him needing any physio, he did need lots of rest and support doing simple things around the house because he was so weak.

The only ongoing issue was with balance, he was okay on the flat but got dizzy on slopes or stairs. He used a fancy walking cane for years, and quite enjoyed the attention I think! The whole experience has left him with hypochondriac type tendencies, but it's a small price to pay and understandable.

Hang on in there OP, just take it one day at a time and you'll get through. Don't forget to eat and sleep.

Forgot to say , my brother could barely speak at all at first, just croak. Someone gave us a sheet of words he could point to, to communicate, but he was off his face from the drugs and preoccupied with the wall-monkeys.

Give it a week OP, fingers crossed things will look very different in a week.

Thank you very much, all of you. I greatly appreciate you taking time to respond. It's good to hear that his presentation at the moment is normal for the situation and gives me some insight into how he may be experiencing things right now.

And thank you for your kind thoughts and wishes.