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

Intensive Care (ICU) | Last Active: Sep 16 7:52pm | Replies (609)

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@muriel66

Almost two years after suffering severe septic shock and nine months after suffering septic shock, both because of the way my body responds to surgery, I again am reading about PICS. I continue to face struggles that affect my days. I finally am writing on this page. I wasn't able to write in the diary that was given to me while in and after I left Mayo intensive care (and went to a room on a different floor). My de-conditioning, my decreased cognitive ability, my immense fatigue, my emotional upset, and my schedule of very helpful medical care... such as dialysis, physical therapy, services entering the room... left me not wanting to do one more thing (not to mention that my physical de-conditioning meant that for a period of time, my hands could not write). I did pray almost continually, listened to all who provided me care, tried to eat, etc.. But my greatest expenditure of energy likely was to eliminate body-waste successfully and regularly; once the bladder catheter and anal "garter snake" (my expression) were removed. Ha, ha!

Almost two years after my 2016 hospitalization, I again am diagnosed with moderate major depression. And, I have sluggish cognitive ability. Because I again am at a point of accepting my emotional-mental state, and my fatigue, I hopefully will post regularly on this site. It helps me when I express myself in writing. Today started as one of my more difficult days. I awoke five hours ago and still feel like I am mostly asleep. Possibly this is because of a change in medication for the depression. However, the change occurred before last week when I gained more energy and even experienced happiness. (Note: I always am thankful... thankful for excellent, insightful, kind, inspirational, steadfast care from the entire Mayo personnel; from my husband, sons, friends, neighbors... and always thankful God's peaceful presence and amazing wisdom!)

Though my depression was less of a fog last week, today the heavy weight returned to my mind and body. I see a local psychologist and last week he cautioned me that this could happen. Writing about the way I feel is helpful, so I will give writing at this site another shot. Also helpful is reading and re-reading the Mayo online information about PICS. I did that earlier today and was reminded that the way I am today (physically, mentally, and emotionally) aligns with PICS. I also am reminded that I will continue to recover as fully as is possible...thankfully! Today is sunny and now it is a little bit warmer in northwestern Minnesota, so I am going outside. I hope that whoever reads this, has as healthy a day as possible. M.H.

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Replies to "Almost two years after suffering severe septic shock and nine months after suffering septic shock, both..."

@muriel66 I am so grateful that you are able to share your experiences here with us. It is incredibly helpful for others to know that they are not alone in facing these challenges. I completely agree that writing can be so therapeutic. It forces us to really examine ourselves and when we can share it publicly and know there is an opportunity to help others, the collateral effect is powerful.

Does anyone else have experiences with writing - whether in a real time diary format during your acute illness, or in a reflective way later on?

@andreab, I would like to write more but am still so foggy from my last episode (septic and adrenal shock, pneumonia, delirium, etc.). My brain doesn’t seem to want to clear and it seems to get worse with each episode, which worries me. Still, I have some memories of the ICU both good ones and troubling ones. I remember procedural pain but also remember my husband holding my hand and singing softly to me. The latter seems to call me back from the delirium. He’s a great person and a devoted husband throughout this protracted illness. I’m very fortunate in many ways. I’ve never met anyone who has had similar experiences so this forum is wonderful for me. I hope I can also be helpful to others despite my cognitive foggiest.

@rckj my apologies for the delay in my response. I have read through all of your posts in this conversation, and I am so thankful to you for sharing your story with all of us. Experiencing critical illness one time is often life changing and traumatic, but to have gone through this multiple times must seem surreal. I imagine one never gets "used to" being critically ill. You also have such a unique situation in that you are yourself a psychologist with expertise in precisely what you are dealing with. I hear you mention concern for your patients and how to manage and juggle the work/life/healing balance. Please know that it is very common for people who have experienced critical illness, to have a delay in returning to work. This is something that is not talked about that much, so often times people think they have to just "toughen up" and get back to work. But the reality is just exactly what you are describing. Even if your physical self has healed, the cognitive difficulties/"fogginess" and emotional wounds can just as easily prevent you from returning to life as it was. The fogginess that you describe is also reflected in what @muriel66 has shared with us as well. You can see you are not alone in this!

@andreab thank you for following my posts and your kind and understanding response. It does seem very surreal and I agree that you never get “used to” it. I truly don’t know how many times I’ve been through this. My husband estimates over 20 times. I have severe adrenal insufficiency and am also susceptible to infections, hence pneumonia, sepsis, adrenal shock, delirium, etc., without warning symptoms, is the pattern. I feel so worried for my husband having to see this repeatedly and being frightened for my life (as am I). He is strong and supportive but I worry about the impact on him and other family and friends. The good news is I traveled from my home on the east coast to Mayo in Minnesota in the summer and now have action plans which are helping, both with daily functioning and in reducing the number of episodes. It has given me so much more hope and has made a difference. I keep thinking about the surreal nature of all this and realized something both good and sad. The closest hospital knows me very well. ER, ICU staff, MD’s, etc and I all know each other. They know exactly what to do for me in crisis. A huge comfort and relief but it is also sad that we should know each other so well under these circumstances. The standing joke is “ couldn’t you just come back to visit?”. But I am fortunate that their skill and kindness has gotten me through so much and I trust them even during scary procedures. I sometimes feel haunted with the memories of some procedures. I don’t want to spell it out further because I’m afraid it would trigger someone else on this forum. My memories are foggy but persistent. I’m trying to work on coming to terms with this. With regards to work, you and others here have given me some perspective especially that I can’t just tough it out. I have to care for myself first then judge if I’m truly ready to care for others as a psychologist. The needs of my patients pull on my heart but they are being well cared for by colleagues. Being in the trauma field is a unique position but perhaps I must tend to my own trauma first, given the circumstances. I thank you and all of the people on this forum for your amazing kindness and support. I hope I can also be of help to others as needed. Not being familiar with sharing in this way, I had held back my name. I see now that that was an unnecessary fear. Thanks to all, Rhoda