New to ICU Psychosis / pneumonia / children visiting?

[mixi29]

My partner was admitted to the ICU on sat eve after an operation to repair his duodenum which had been perforated by an endoscopic procedure. He originally went into hosp for just a keyhole gall bladder removal and things have just spiralled. I left this evening as his temp was rising and they were querying infection. I was also told that he had ICU Psychosis (his behaviour has been very uncharacteristic) I was just wondering what experience other people had of either of these conditions and what treatments had been used successfully. I really need to hear some positive accounts right now as I'm finding it hard to stay positive. Also, I have two youngish children (10 and 12) and was wondering what experience people had of visiting with kids in the ICU and how to make it as stress free as possible. Thank you.

[muncii]

Hi Mixi this sounds a very difficult time for you, and also that it has all happened over a very short period, which can be a terrible shock. I'm sure the ICU staff are doing everything possible to treat and stabilise your partner. As you may have gathered from the posts on this site, ICU psychosis in patients seems very 'normal' given the circumstances. Ex-ICU patients including myself, reflect back on our 'other-world'experiences with a mixture of emotions including bafflement, anxiety, and a certain amount of wry humour. It sounds as though your partner's ICU staff have got some understanding of this, which is a good thing.

Perhaps it would help to explain to your children that your partner is not his 'normal self' at the moment as a result of his medical condition and treatment? I'd guess they are old enough to understand a fairly straight forward explanation, if they are puzzled and worried about his mental state. But I don't have any experience of how to help children deal with visiting a loved one in ICU, perhaps other people have got some suggestions. I know ICU is a scary and surreal environment, so I'd guess it's important for you, as mother and partner, to stay calm, positive, and re-assuring - even though you may feel very far from that. Take each day as it comes, and you will see little improvements growing all the time.

[Amslovessparkle in reply to muncii]

Hello, I am so sorry you are going through this terrible time, I was in ITU for nearly 4 months, I came out in March. I have 3 boys and we used pictures to show them of me before they came in and explained the wires and machines were there to help. The nurse's are amazing for support let them know when they come in, I also had a DVD player so they could watch there favourite DVD or a radio, CD player.

It's was amazing how well they coped my boys even had to open Christmas prezys in ITU children seem to be made of tough stuff. I really hope your husband gets betting and wish you all the luck in the world.

Amanda

[Hidden]

Dear Mixi, I am an intensive care nurse. What you are going through right now is very stressful. From your post am I right in thinking that your partner is not on a breathing machine? Especially as you mention the change in his behaviour? ICU psychosis often known as delirium is common and not always for people who have spent many months in ICU although this can be the case too. There are many factors which cause this, infection, noise, lack of normal sleep, reaction to pain relief such as morphine plus other medication. Please try not to worry, talk about what is happening at home, friends, family and life in general. Ask the staff to talk to your children, tell them what is happening and why. Children are very inquisitive and need answers, thy are also very resilient and as long as you are truthful they will be fine. In our ITU we allow children, we explain everything to them and what is does, from a personal point I think it is really important to know where Daddy has gone. Do you have family/friends to support you this is very helpful. It will take time for things to settle down and this has been very unfortunate. Try and rest and take time out for yourself. If you check out the ICUsteps web site there is some useful information for you and your partner plus a supplement on delirium which others have found useful.

Take care

[mixi29]

Thank you all so much for all your helpful comments. Today has been a better day in terms of his body (clear chest x ray, reduced infection markers, slightly better oxygen levels) but definitely not in terms of his mind.

I left him this evening with boxing gloves on that were tied to the side of the bed so that he didn't rip any more of his wires out. As you can imagine this was terribly distressing to witness (let alone how he must have actually felt.) It's like he has totally disappeared inside himself somewhere. The nurse didn't help matters by telling me that usually she would be able to keep a close watch on him but it would be tricky tonight as they were short staffed! He was due to have some kind of sedative at around 9 so hopefully that may have helped as long as it didn't affect his breathing too much.

How long is this delirium/psychosis likely to last? And does it fade gradually or is there a drug that can be taken to help. I've heard of geriatric dementia patients who have been prescribed anti psychotic drugs - is this an option? So scary because tonight he really reminded me of his Mother who had dementia. Is there a chance all of this stress could have caused early onset or something. So much to worry about.

[patchworker]

I'm so sorry you're having such a tough time. My family have told me how hard it was for them.

My ICU psychosis started immediately I woke to find myself on a ventilator in ICU. I was sure I was being tortured, and that the nurses were going to kill me. From that point of view, it's quite reasonable to fight back! I had a nurse sitting beside me all the time, and every time I tried to pull the tube from my throat she said " Put your hands down Jane" in such a stern voice that I obeyed. I was terrified of her. My psychosis improved as my health improved, I was taken off the ventilator after eleven days, and although I was still in ICU my thinking was clearer, but I still had frequent nightmares. When the staff were able to cut down on the drugs I was given, I could think clearly enough to realize everyone was trying to help me.

What your husband has is dementia, but not the same as his mother's. It is temporary, it will fade, but he'll always remember it. When he's finally well, he may need to talk to someone from ICU to help him understand what really happened. He'll find it difficult to tell reality from dreams.

[patchworker]

Sorry, I didn't mean dementia, I meant delirium . Sorry.

[mixi29]

Thank you patchworker. It is helpful to read from your first hand experience how my partner is probably feeling.

I think what you say about it becoming better as your physical health improved is also going to be the case for him. I noticed a slight change for the better when I went in today, he was much calmer (not tied to bed thankfully), though definitely still very confused and talking to himself. This ties in with the other improvements he seems to be making too; they are hopefully going to remove his central line this eve which should make it easier for him to sleep. He looks absolutely exhausted poor thing but as you obviously know, conditions in ICU are definitely not conducive to anyone getting much rest!

I am feeling more positive now that each day (and each sleep he manages to get) will lead to small improvements in his mental state.

Thank you so much for taking the time to respond.

[Shamurdoch in reply to mixi29]

Hi there I feel like I'm reading my own story here! My husband is the same he is 44 and had an accident 3 weeks ago, he has been on and off the ventilator 3 times but was diagnosed with delirium 2 weeks ago, yesterday he was like your husband but was sedated before they had to put gloves on him, today he was much calmer but still very confused however he did know me which was a comfort for the short few seconds that he opened his eyes. I see from your last post this was 20 days ago and I just wondered if you could tell me how long this lasted with your husband. I do hope he is better now as I have struggled and my daughters are much older at 17 and 14 yrs so I can only imagine how difficult it has been for you with younger children.