Mind & Body

Have you ever walked past the Intensive Care Unit or ICU in a hospital and wondered about what happens behind those closed doors?

In 2008 I secured a contract to fundraise for the Intensive Care Foundation, the representative body for doctors and nurses who work in the field of intensive care medicine. For the first two years of the contract, I simply had a professional interest in the Foundation and an appreciation of its cause.

Unexpectedly, during Easter 2009 I had reason to change my view of intensivism from one of professional interest to that of deep held personal admiration. Unexpectedly, my father, who is in his 60s, was admitted to an ICU having collapsed at his home in Ascot.

Following 24 hours in ICU, the doctors told us that they had done everything they could but that his prospects were not good and he was unlikely to survive the night. They explained that his lungs had collapsed, he was suffering from heart failure, he had been put on dialysis because his kidneys were no longer working and he was up to the maximum dosage of antibiotics. We pushed for facts about his chances, something doctors are unable and, therefore, very unwilling to give but they did tell us that if he managed to survive the infection, his lungs and system would be so damaged that he was unlikely to ever leave hospital.

A scary milestone

Amazingly, he did survive the night, which, at this point, was a mixed blessing, given the prognosis. After about 6 days, the doctors began to reduce his sedation and he started to come round. It was a scary milestone. He did not know where he was, he could not talk because of the ventilator and he could not move due to muscle wastage and the effects of the sedation.

A week on from him first waking up was where the hard work really began. Up to this point, he had been so ill that he was a passenger in his recovery, passively receiving medical treatments just to keep him alive. However, it became clear that this would not continue. Firstly, the clinicians knew that they had to get him off the ventilator and breathing for himself if he was ever going to stand a chance of leaving intensive care and, secondly, as his sedation was reduced, he became more aware of his situation and was, naturally, keen to put his point of view across.

Weeks of weaning from the ventilator ensued as well as physiotherapy to enable him to move. Both were incredibly tough – the weaning was so hard because he thought he could not breathe without the help of the ventilator and the physiotherapy was extremely painful for him, his muscles had wasted so much that the mere act of sitting in a chair was excruciating. Of course, all of this put him in a dreadful mood; he did not want visitors, he did not want the medical staff to help him and he did not want to do any of the things that the staff kept saying were essential for his recovery.

Eventually, after three weeks or so, he seemed to turn a corner and he began to appreciate that the physiotherapy and the weaning were a means to re-gaining some independence. Once this happened, he was quickly discharged from intensive care and released from hospital some time afterwards. Throughout this stage of his recovery, the staff kept telling us that it was up to him – his recovery would be determined by his own mental attitude.

They were right, and this has continued. Twelve months on from his discharge he is living independently and he has fought hard to continue to do the things he loves. He has said several times that he could just sit in a chair all day but then he would have no life. For this reason, he works hard to maintain his health enough to enable him to do the things he enjoys. This has meant continuing with the physiotherapy, resting, eating well and knowing his limitations.

Miraculous recoveries do happen

So what has this experience taught me? It shows that miracle recoveries can occur, when the doctors would not be drawn on giving absolute prognoses there was a good reason. It has also demonstrated the power of the patient to determine their recovery but, as importantly, it has shown me that when things look hopeless the teams in intensive care have been trained to provide interventions that truly can change lives.

Tanya Pepin

NOTE ABOUT THE AUTHOR
Tanya Pepin is a non profit consultant at JPA
www.jpa-group.com

MORE INFO
For more information about the Intensive Care Foundation visit www.ics.ac.uk/foundation_home

Tel: 020 7280 4350 | tanya@jpa-group.com