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How to survive a stint in the ICU psychologically unscathed
Intrusive disturbing flash backs, ……….is something people associate with war zones and hijackings. Many a movie has been made, documenting the suffering.
The hapless victim, experiences a HORRIFIC event and then, get’s stuck there. Replaying the experience, over and over again. The memory pops into their mind, day and night.
The rerun happens without prompting.
The medical name for the condition is PTSD (post traumatic stress disorder).
It’s HARD to “fix”.
Time and hours of therapy, can bury the hurt, but even years later, it can resurface. Eish !
PTSD in the critically ill
Did you know, you don’t have to be “living” dangerously, to get it ?
A stint in an ICU, can bring on the condition.
It doesn’t happen to everyone, but it does happen……………and the after effects, can diminish the quality of life of a person, at a time, they are battling to put their lives, back together, after a surgery. And you guessed it, the closer the person comes to leaving the ICU, in a body bag, the more likely they are to have a psychological scar.
A traumatic environment
It’s a growing problem, as thanks to medical advances, more and more people experience and survive, an ICU encounter.
Now it could be viewed as the PRICE OF DOING, business.
But a few ICU teams are looking for ways to minimize the problem.
Lessening the “trauma”
A couple of things have been tried.
- Adding a psychologists, to the ICU team, has been shown to help.
- So has, the practice of keeping an ICU diary.
Nurses, family and friends, documenting the life and times of the person, while they are in the ICU. The thinking behind the diary, is that having access to the details, which are often “missing” or “twisted”, can help fill in the gaps. And thus help the person make sense of their memories.
But, although both these strategies work, the probability that they will be widely implemented, any time soon, is quite low….
ICU nurses are too busy and adding a psychologist to the team, costs money.
A cheaper “fix”
This prompted a team from Iran, to look for an easy to implement and inexpensive solution. Realizing that one of the “traumas” of an ICU experience is
The flashing lights and constant beeping of the machines.
Coupled with no time cues – the lights are ON, day and night.
The team wondered if ear plugs and eye masks, might help…..
Going inside an ICU
They tried out their strategy on folks, spending time in the open-heart cardiac surgery intensive care unit of Shahid Rajaee Hospital, in Iran.
Now all of these people KNEW they were having surgery.
And none of them had a history of psychological problems.
There psychological state was assessed just before the surgery and then, two months later, using a standard questionnaire, that measures these things.
The instrument they used was the Impact of Event Scale-Revised (IES-R), which asks people 22 questions related to the presence/absence of intrusive memories, hyperarousal and avoidance.
Before the “trauma”
Although, I am guessing, they were all pretty nervous. Open heart surgery is NOT A WALK in the park.
The scores indicate…………..
NOTE : The score is out of 88. A high score, would be a sign of trouble.
No one was especially freaked out, at the start of the study.
“Masking” the environment
Some folks were issued with an eye mask and ear plugs, and told to use them when they were sleeping, both at night and during the day.
The rest, checked in for their surgery, in the usual way.
At the two month mark, there was a difference in their scores….
The people who had “hidden away” during their stay in the ICU, had a score 11.72 ± 6.48, while those that had experienced ICU in the usual way, clocked in with scores of 29.50 ± 5.90.
This was a significant difference.
Clearly being shielded from the ICU environment, protected their psyche.
Surviving a stint in the ICU
Now getting your hands on an eye mask and ear plugs is NOT hard. Both hospitals and airlines, often distribute branded versions of them. They’re routinely used on trans-Atlantic flights …….. but they’re NOT a standard part of life in an ICU.
This research suggests, they should be.
If you or a loved one, are going to spend time, in an ICU, ear plugs and an eye mask, should be part of your hospital kit.
Deploying it, will help create BETTER BODY CHEMISTRY in the long run.
After surgery, your gut can take a while to wake up delaying your discharge from the hospital. To solve postoperative ileus you need to chew on it.
Chatting on your cell phone while visiting a sick friend in hospital might result in you leaving the hospital with a few nasty bacteria stuck on the keypad.
You’re scheduled for heart surgery – you’re trying to schedule the op to accommodate family and work commitments. Stop… you need to factor in the moon too.