ICU Illness Part 4

Someone wrote: “I had to accept myself in all my gory glory. Sometimes rage, sadness, and a myriad of other strong emotions will be part of your experience, too.” And so it was with me. Here is one of my journal entries:

Tired. Too tired to read. Often too tired to even eat. Numb with fatigue of body and emotional shock.
Feel
Express
Accept
Move on
Get up
Do it again
Keep the dining room table cleaned off because he likes that so much!
Find a way to cope with the shock

“You can’t be any other place than where you actually are!”

This verse from Ephesians 6:10 helped hold me upright. “Be strong in the Lord and the power of His might.”
Holman translation: Finally, be strengthened by the Lord and by His vast strength. And the NIV:  Finally, be strong in the Lord and in His mighty power. A portion of this verse is also on one of the hospital walls.

The doctor told me Bob was in critical condition, streptococcal pneumonia, kidney injury and failure, sepsis, Type A flu. I went back and forth between home and the hospital as the weather dictated. Our adult kids did not want me to stay there every night as that was so tiring. They knew. They had taken turns doing just that! One doctor told us weeks later that the first week at Mercy Anderson he was the sickest man in the building.

People Bob had worked with and friends from church took turns taking shifts sitting with him when one of us could not be there. Our friend Robb was with Bob Tuesday afternoon when the doctors decided to let him wake up. Emily made it there moments later from her office downtown. She called saying he was asking for me. I rushed to get out of the shower and arrive.

He could barely whisper after having the tube in his throat for almost five days. Then we learned the horror of ICU psychosis. It was explained to me that even with the heavy sedation given, the ICU patients do not truly sleep. His symptoms included paranoia that the food and water were drugged or poisoned, agitation, anxiety, seeing things that were not there, disorientation. He was absolutely exhausted.

He did not recognize me as his wife. That first night in his agitation I told him he really needed to sleep. He replied, “My wife is in the bathroom.” I calmly stated, “Honey, I am your wife.” He said, “No, my other wife.” The children joked we should record or write down everything he said to use against him later. An attempt at comic relief.

The night nurse was able to tape a sheet over the light board on the wall as Bob kept staring at the medical notes there and asking me why they were moving. They were perfectly still. One aide was able to show me how to minimize the text the next day. It was a long night, every night.

Later Bob thought people had neglected him and his needs in the night. The nights I stayed he was very restless and often upset even though I was by his side. He had worked at Mercy Clermont for almost 40 years. Here he was at Mercy Anderson. He was certain he had to go back to Clermont to get the care he needed. He was determined to get out of his bed even if he had to crawl to the front door. He thought his friend Jim would bring the truck and take him back if only he could get to the front door. He was agitated and upset with me for not taking him. One night he tried to climb out of bed, ivs and all. I was able to reach the buzzer to call the nurse. He helped me get Bob back to bed. He had to be restrained with soft restraints. It was so sad. It was hard to believe my strong, intelligent, reasonable, loving husband was this person in the bed. Five days of delirium were exhausting and discouraging. Yes, we had him back with us, but his condition was still guarded and in so many ways unimaginable.

He was certain his mother was dead because he remembered receiving a larger than usual check at Christmas. (She was very much alive and awaiting word on his condition in California.) He believed he made roast beef sandwiches on sourdough bread at Queen Elizabeth’s funeral in London. (She, too, was very much alive.)

One on-line definition states that organic factors that can contribute to the delirium include infection and drugs. My husband certainly had plenty of both. Not only was he suffering from streptococcal pneumonia, kidney failure, kidney injury, and flu, but eventually he was also tested and MRSA pneumonia was added to his list of ailments.

 

My very, very ill husband.

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He bargained with me that he would drink his water if I would give him his cell phone. I gave in. He drank one sip and that was it. He told me the next morning he was able to make Fidelity investment account and bank transfers with the hospital remote. Even now, many months later, he is finding contacts he must have deleted from his cell phone while in the hospital. He called me five times one evening at home on both the cell phone and his hospital phone, giggling at his profound ability. He asked for paper and pen. The inveterate list-maker wanted to create psychotic lists. Ever so slowly his brain began to clear.

My counselor told me that this sort of psychosis is truly a form a suffering as the patient cannot determine reality from the delirium. My sister-in-law was able to coach our adult children and myself as to how we should talk to him to help calm him. Saying things such as “May I take care of that for you?” when he had outlandish fears such as thinking someone was robbing our social security account as he did not believe the recent deposits were in the right amount.

And oh, his financial fears. He had been a wonderful provider for our entire marriage! Here he was in ICU worried because he thought that every single procedure had to be paid for in cash before he would be treated. When he was unconscious and swelling from the kidney failure, our daughter and the nurse were able to remove his wedding ring. I had tearfully put his ring on a chain about my neck when he was insentient. I often slipped it on my finger as I tried to sleep, hoping for the resurrection of his health and our marriage. Once awake, he spotted the ring on my necklace and gave me detailed psychotic instructions that I was to go to his gold guy and sell it to help pay for all these procedures.

The ICU doctor tried to assure him that Medicare and our supplemental insurance would cover all the bills because his was a catastrophic illness. When the doctor left the room, my terribly confused husband confided in me that he did not believe a word the doctor said. I went to the financial office and they assured me that indeed the doctor was correct. It was a hard sell from then on! I would not let him worry about the payment without reminding him it was all going to be okay from a financial standpoint.