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2 days ago · Breaking it Down: Post Intensive Care Syndrome Wrap Up in Post Intensive Care Syndrome (PICS)

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This month marks one year since we started breaking down the many aspects that encompass Post Intensive Care Syndrome. As a brief recap here are the highlights that we have shared during this series. Click on the links within this recap to visit each blog for a more in depth look.

What is PICS

People with PICS often experience the following:

  • Body: Tiredness, weakness, pain
  • Mind: Forgetfulness, confusion, decreased concentration
  • Emotions: Depression, anxiety, sleep disturbances, flashbacks, and nightmares

Risk Factors

The following is a list and explanation of some of the associated conditions and/or critical care interventions that are currently recognized as risk factors for the development of PICS.

  • Delirium. Of all the risk factors that have been examined at this time, the development of delirium during an ICU stay has been most closely associated with the development of PICS.
  • Length of time on bedrest. This risk factor is directly related to muscle loss and the development of physical weakness.
  • Sepsis. Sepsis is a very serious infection in the body that causes many people to become critically ill. Often times sepsis can cause different organ systems in the body to fail, which in itself is yet another risk factor for PICS.

Signs and Symptoms

People with PICS often experience a wide array of symptoms. The following symptoms are examples of what some people may experience:

  • Body: Weakness, trouble with balance, pain, difficulty completing previously routine tasks such as driving and housework
  • Mind: Difficulty with thinking or memory, trouble concentrating, confusion, word finding difficulty, mental “fog”, and trouble with daily activities and work routines resulting in reduced or loss of work
  • Emotions: Depression, anxiety, sleep disturbances, flashbacks, nightmares, irritability, anger, and agitation

Prevention

Many of the interventions that the critical care team may implement, are directed at preventing the development of delirium while in the ICU. These interventions may include:

  • Evaluating pain. The healthcare team may make medications changes as needed to adjust to pain needs of the patient.
  • Wake up and breathe. For patients requiring help breathing by the use of a breathing machine, the critical care team will routinely assess if the patient is ready to breathe on his or her own.
  • Choosing medications wisely. The critical care team will discuss the medications that the patient is receiving for both pain and sedation needs, and ensure that the right medications at the right doses for the right amount of time are prescribed.
  • Normalizing the sleep wake cycle. Keeping the lights on, curtains and doors open during the day, while turning lights off and minimizing noise and interruptions during the night are helpful steps.
  • Early mobility. Maintaining physical strength is crucial to optimizing and accelerating recovery from critical illness.
  • Family involvement. Critical care teams recognize the power that loved ones have in the healing process of critically ill patients.

Recovery

  • Body Physical activity is one the most important keys to recovery for the critically ill/injured patient. It is increasingly common now for patients to begin working with therapy while still hospitalized – even starting in the intensive care unit!
  • Mind Working with an occupational therapist is highly suggested for anyone who believes they or a loved one may be experiencing PICS. An occupational therapist is a healthcare provider who helps individuals relearn life skills, such as activities of daily living or complete tasks that are meaningful to them while maintaining independence.
  • Emotions – You are not alone in your struggle following critical illness. There is an expanding global network of Peer Support groups focused on ICU recovery sponsored by the Society of Critical Care Medicine. A list of the current groups can be found by following this link: Peer Support Group Directory

The Family

Increased demands placed on family members and loved ones caring for the critically ill can quickly become overwhelming. There are steps that loved ones and family members can take to minimize the negative effects that an ICU environment can have:

  • Take breaks. Whether it is a scheduled coffee break or a walk for fresh air, time to yourself is very important.
  • Sleep. Consider sleeping in a room outside of the hospital or at least the hospital room if possible.
  • Eat. Focus on eating smaller, more nutrient dense meals and snacks during the day. Avoid high sugar, nutrient poor foods. And remember to drink water and stay hydrated.
  • Find support. Joining a support group, sharing your thoughts, worries, and emotions with others can be tremendously helpful.

 

Come back often as we continue to explore recovery from critical illness/injury.

In the meantime, join our conversation online. Have you or a loved one experienced critical illness/injury? You’re not alone. Share your story and connect with others who have been on the same journey:  Intensive Care (ICU)

 

 

 

2 days ago · Post-Intensive Care Syndrome (PICS) - Let's talk in Intensive Care (ICU)

To echo @rosemarya Welcome to the group @melissa3243. All you have to do to be included is start a conversation just as you have done! Also just make sure to click "Follow" on this Group so you get the latest updates. If you would like to share your story please feel free to do so. There have been many people who have joined this conversation and we can frequently connect you with others who may share similar experiences. It helps to know that whatever you are going through, you're not alone!

6 days ago · What did you find most surprising once you were out of the ICU? in Intensive Care (ICU)

@heartbreaker I am sorry you had such a difficult time during your recovery. To physically survive what you went through only to then be left with the intense emotional difficulties seems entirely unfair. However, you are certainly not alone in this. Feeling this way, having flashbacks and nightmares, is very commonly shared among people who have survived critical illness/injury. Post ICU syndrome and the experiences that people have following critical illness/injury are really just now getting the attention from the critical care world that they really deserve. I do want to assure you that there are collaboratives and teams around the world who are coming together to help raise awareness of this issue and who are working to help people not only survive the ICU but to survive and heal in a complete way which allows them to regain as much of their pre-ICU life as possible. Thank you for adding your story to this very important conversation.

6 days ago · What did you find most surprising once you were out of the ICU? in Intensive Care (ICU)

@amandacgrow I am so glad you found this forum and shared your story with us. What an incredible experience you went through. I am so happy for you and your family that you are all well and back running as a normal family does! But that word normal can seem strange, because if you are experiencing your recovery from this event like many others have, things may not seem quite "normal". You mention getting back to your "patterns of life" with kids and work, etc. Many people have talked about difficulties when getting back to those patterns – especially noticing it work. Some people tire more easily, can't concentrate as well, or physically cannot do what they once used to do. And this is actually very normal for many people who have experienced critical illness or injury. The feeling of sadness and grief is also something that I have heard many other share.
I'd like to pull @muriel66 into this conversation as she has shared very kind and wise words with others over the months on this forum, specifically dealing with emotions following critical illness. Thank you for joining this important conversation.

Wed, Jan 2 1:06am · Happy New Year! in Post Intensive Care Syndrome (PICS)

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We just wanted to take a moment to wish a very Happy New Year to you and your loved ones! If critical illness has affected you, we wish you health and healing in this New Year.

We will pick up and round out our Breaking It Down series in the upcoming weeks so stay tuned for that – cheers!

Nov 14, 2018 · What did you find most surprising once you were out of the ICU? in Intensive Care (ICU)

@rmftucker I am glad that you found this thread! I think you will find the conversations very helpful in light of what you have recently been through. While reading your post, I wonder do you feel like some follow up contact with the ICU team would have been (or would be) any help to you in any way?

Nov 13, 2018 · November Support Group in Post Intensive Care Syndrome (PICS)

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We will be at a different location for our November 19th support group! This month we are lucky to be hosted by the Gift of Life staff at the Edward and Jayne Pompeian Home. See below for the details.

Date: November 19th, 2018

Time: 6:30-7:30pm

Where: Edward and Jayne Pompeian Home, 705 2nd St. SW Rochester MN in the Living Room*

What: Please join us as we gather our Post-ICU support group in a different location this month. We will share stories, support, and connect with one another. Light refreshments will be provided.

For inquiries or to RSVP, please email: walker.andrea@mayo.edu

*Doors to the house are locked, staff will be there to greet you and direct you to the Living Room.

 

 

Nov 7, 2018 · Post-Intensive Care Syndrome (PICS) - Let's talk in Intensive Care (ICU)

@glinda Thank you so much for taking this time and walking us through the various ways of grounding yourself. This is incredibly helpful. Do you feel like any one exercise is better than another? Or might it depend on the situation one finds themselves in?