Post-Intensive Care Syndrome (PICS) - Let's talk

Have you heard of Post-Intensive Care Syndrome? Sometimes it's called post ICU syndrome or PICS. PICS is defined as new or worse health problems after critical illness. These problems can affect your mind, body, thoughts, and/or feelings.

On Connect we would like to bring together people who have been affected by critical illness, and hopefully lighten the burden you bear. Patients and family members welcome.

Grab a cup of tea, or beverage of your choice, and let's chat. Why not start by introducing yourself?

Interested in more discussions like this? Go to the Intensive Care (ICU) Support Group.

@vlbondon

A lot of us empathize with what you've been through; you are not alone. Don't know your age but the older we are the longer recovery takes. Keep adding a bit to the physical part of your rehab if you can. Days when you just can't, don't worry, It took me six months to actually be normal, and I still am not where I'd like to be. I am 78 and young in every way before my sepsis hit last October, no symptoms, delirium finally moved my partner to get me up and go to ER, didn't leave for 10 days, IV Rx there and home another 6 days. Near death, yes. Good care, yes. Good support system, small but good. Patience is what you need, and caring for yourself first priority. You've overdone it in the near past, and I did too, so now it will take much longer to get things done. That is ok. We are not indispensable. Ask for help from those you have, even Nextdoor.com members pitch in for you if you need help. Church etc may be there for you, they do a lot when folks are ill and need work around the house, or just a visit. Talk about your experience when you can, with those you trust.

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Thank you, @vlbondon - I very much appreciate your empathy and kind words. Especially the point that we are not indispensable.

Fortunately I'm only 39. While I'm overweight, I live a very active lifestyle (walking the dog, dancing, pilates, etc). I think that and my tenacity have been a saving grace.

Thank you again < 3

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@megh02170

Hi everyone,
Happy to meet everyone, sorry we are here together. I was discharged on July 2nd, 2024 after 8 days in the ICU, 9 days total at the hospital. I experienced some kind of mystery respiratory incident - I got too sick for it to be just pneumonia but got better too fast for it to be ARDS.

I'm home now, trying to figure out what "recovered" means. I'm doing physical therapy, and regular therapy. I'd like to do a group for survivors but haven't found one beyond this page (which I deeply appreciate!). My respiratory rate is improving, my muscles are getting stronger. I do still have confusion, brain fog... my brain feels like its 60-70% of what it was. Sleep is improving. Thank God I'm on summer break for work and can focus on myself.

I'm still trying to navigate almost dying - how did I let myself get so sick? (In part I threw myself into work because my husband left me in November. He "couldn't do it" anymore, wasn't willing to work on the relationship.) Am I happy with the life I would have left behind? (I'm not) How do I create a life I'm proud of, thats bigger than just work?

I'm also trying to learn how to let people in, to let them care for me the way I care for them. I work in a helping field, and give so freely to others without expectation. I'm using the website signupgenius.com to let people offer their help. Its amazing how people have rallied to help me, I'm struggling to accept their love.

I feel really lucky in so many ways - to have had access to phenomenal medical care, to have made it out, to be recovering well, to have the support of others, to have found this group, to have a future. This is not how I expected the summer to go. I know they God doesn't give you more than you can handle, but I wish He was less confident in my abilities to persist.

If anyone has suggestions on supports for my mother as well, that would be really appreciated. She has had two adult children in the ICU this year, which is a lot.

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Hey @megh02170, at the risk of overwhelming you, I have a number of places to link you to on this website.

I know you said your recovery ruled out ARDS, but I thought you might still appreciate the stories shared in this discussion:
- ARDS Support: my story and looking to help other survivors https://connect.mayoclinic.org/discussion/ards-support-my-story-and-looking-to-help-other-survivors/

PICS-F (post-intensive care-family) is a real thing. Family members are affected by ICU stays as well. @andreab explains in this blog and discussion:
- Breaking it Down: Post Intensive Care Syndrome and The Family https://connect.mayoclinic.org/blog/pics/newsfeed-post/breaking-it-down-post-intensive-care-syndrome-and-the-family/

- The ICU experience from a loved one's perspective https://connect.mayoclinic.org/discussion/the-icu-experience-from-a-loved-ones-perspective/

I agree with the helpful tips that @vlbondon offered. If talking it out isn't for you, you might find journaling helpful:
- ICU diaries - how do they help? https://connect.mayoclinic.org/blog/pics/newsfeed-post/around-one-third-icu-survivors-get-ptsd-but-diaries-offer-hope-for-recovery/

I know @rosemarya really appreciated her husband's help with filling in the gaps when she was ready to piece things back together. Perhaps, working on an ICU diary together with your mom could be beneficial to both of you?

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@colleenyoung

Hey @megh02170, at the risk of overwhelming you, I have a number of places to link you to on this website.

I know you said your recovery ruled out ARDS, but I thought you might still appreciate the stories shared in this discussion:
- ARDS Support: my story and looking to help other survivors https://connect.mayoclinic.org/discussion/ards-support-my-story-and-looking-to-help-other-survivors/

PICS-F (post-intensive care-family) is a real thing. Family members are affected by ICU stays as well. @andreab explains in this blog and discussion:
- Breaking it Down: Post Intensive Care Syndrome and The Family https://connect.mayoclinic.org/blog/pics/newsfeed-post/breaking-it-down-post-intensive-care-syndrome-and-the-family/

- The ICU experience from a loved one's perspective https://connect.mayoclinic.org/discussion/the-icu-experience-from-a-loved-ones-perspective/

I agree with the helpful tips that @vlbondon offered. If talking it out isn't for you, you might find journaling helpful:
- ICU diaries - how do they help? https://connect.mayoclinic.org/blog/pics/newsfeed-post/around-one-third-icu-survivors-get-ptsd-but-diaries-offer-hope-for-recovery/

I know @rosemarya really appreciated her husband's help with filling in the gaps when she was ready to piece things back together. Perhaps, working on an ICU diary together with your mom could be beneficial to both of you?

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I had an article on ICU diaries published towards the end of last year, using extracts from my own diary and describing how it helped my psychological recovery, if anyone is interested in reading it: https://link.springer.com/article/10.1007/s00134-023-07233-2

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@lamphey

I had an article on ICU diaries published towards the end of last year, using extracts from my own diary and describing how it helped my psychological recovery, if anyone is interested in reading it: https://link.springer.com/article/10.1007/s00134-023-07233-2

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Great article, @lamphey. How did writing a diary of your ICU experience help you? Why would you recommend writing one's experience to others?

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@colleenyoung

Great article, @lamphey. How did writing a diary of your ICU experience help you? Why would you recommend writing one's experience to others?

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Apologies if I have misunderstood your question but I didn't write the diary. I wrote an article based on the diary that was created and maintained by my partner at the time.

An ICU Diary or patient journal can be a valuable therapeutic aid in the patient's psychological recovery. Many former patients, no matter what the source of their admission, are left with no memory of their time in ICU or they have a fragmented and delusional recall of events, where they are unable to determine what is real and what is imagined. This missing time or having memories of a life you didn't live is disturbing and can put you on a pathway to PTSD diagnosis.

There are three different elements to my ICU Diary, the day-to-day journaling, photographs taken during my coma while both on and off ECMO and my written notes from when I was unable to communicate verbally due to the trach. Each one provides a different perspective of my ICU experience.

The bulk of the diary is the day-to-day journaling, which covers the first fifty days of my hospitalisation and has allowed me to create a timeline of events so I can anchor my experience in reality
The twelve photographs add a layer of reality that augments the written words and emphasises the severity of my illness.
I find my written notes the most fascinating to look back on because I am not relying on someone else's interpretation of events. These notes were written in real-time, by my hand and putting on paper my thoughts in that particular moment.

My ICU Diary is one of my most treasured possessions and nearly fifteen years later, it continues to serve as a grounding mechanism when PTSD and depression tighten their grip and I find myself struggling to move forward.

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My wife kept some notes, and wrote out a rough timeline of events after I was released (two years ago I spent a month in the ICU with ARDS and pneumonia, intubated, then trach, etc). That helped, but I can also attest to the importance of a diary, whether kept by family or even a treatment list kept by the ICU staff. What I had only filled in a few gaps, but it helped. Talking through the experience with my wife helped as well. We have no ICU support group that I can find locally, so I've relied on an online group in the UK, and now finally came across this site.

For those earlier in recovery, it takes time. Be patient. Don't expect to return to normal in a couple of months, and to some lesser extent maybe not in a couple of years. It isn't just the physical, but emotional and mental scare that take time to heal, and changes that take time to adjust to.

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It's been 16 months and I thought I was much improved, that is until I started reading about other people's experiences. I died and was resuscitated, I was also intubated. I had Covid. I do not remember anything that happened although I have been told that I was awake and alert when I was intubated. Writing notes. My son and niece were called and I was also trying to.commnicate with them. I remember nothing. I must have fallen asleep because on the 2 day I woke up and I remember being very confused not knowing why I had been intubated and moved to ICU.
I have had a couple of very anxious days now. I had hoped I had finally gotten over the trauma of ICU.

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@dtfsk

My wife kept some notes, and wrote out a rough timeline of events after I was released (two years ago I spent a month in the ICU with ARDS and pneumonia, intubated, then trach, etc). That helped, but I can also attest to the importance of a diary, whether kept by family or even a treatment list kept by the ICU staff. What I had only filled in a few gaps, but it helped. Talking through the experience with my wife helped as well. We have no ICU support group that I can find locally, so I've relied on an online group in the UK, and now finally came across this site.

For those earlier in recovery, it takes time. Be patient. Don't expect to return to normal in a couple of months, and to some lesser extent maybe not in a couple of years. It isn't just the physical, but emotional and mental scare that take time to heal, and changes that take time to adjust to.

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Such helpful advice about keeping a diary, @dtfsk. And you're so right that post-ICU is more than just physical. It takes time to heal.

How are you doing now? What challenges remain and what is getting better?

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@colleenyoung

Such helpful advice about keeping a diary, @dtfsk. And you're so right that post-ICU is more than just physical. It takes time to heal.

How are you doing now? What challenges remain and what is getting better?

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I am doing better now, thank you for asking. Main challenges are some relatively minor residual eyesight issues due to a damaged optical nerve from sedation; sleep is erratic; and stress is more difficult to manage at times.

But as time goes on, the more I find ways to adapt, and that in turn seems to lessen the impact of changes, and even leads to improvements. One example is short term memory problems that seem common with PICS, such as forgetting a word during conversation, or immediately forgetting something we just planned to do a few seconds earlier. Lately I've made more of an effort to retrain my memory skills by memorizing dates, directions, names, etc without relying on written notes. That is helping, I also picked up a new hobby that I really enjoy, and that has helped with focus and regaining a positive rather than fearful outlook.

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