PICS (Post-Intensive Care Syndrome)

by - June 16, 2017

Post-intensive care syndrome is essentially a term to describe the lasting effects after an ICU stay. It can include: cognitive, mental, and physical health issues. For me, I had first learned about PICS when I spoke at a medical retreat. One of the doctors had done a short presentation on PICS. I remember sitting with my mother and almost crying because when I learned about this condition I finally felt like what I had been (and still am) feeling had an answer. I felt like my symptoms had been validated in that very moment. I never felt like I fit the diagnosing criteria for PTSD. I hadn't experienced nightmares or terrifying flash backs. I just didn't feel like I was "bad" enough for PTSD. So when I learned about PICS it was a relief. I had an answer for why I had so many physical issues, memory issues, cognitive issues, and anxiety and depression.

I'd like to go more into PICS for all three aspects and how I was effected by each. Physically, many patients who have ICU stays over one week, develop severe infections like sepsis, and/or require a ventilator develop ICU acquired weakness. I experienced all three of the criteria. I did have to relearn how to walk due to how long I was in a hospital bed comatose. My muscles had began to atrophy and I was extremely weak. As I've talked about in a previous post I had a very difficult time with exhaustion and daily activities like dressing myself, showering, etc. This overwhelming exhaustion had lasted for well over a year. I'm still frequently exhausted, but not to the same degree as before.

Cognitive or brain dysfunction is referring to issues like critical thinking, problem solving, memory retention, and paying attention. I would say this is the part of PICS that has effected me the most and the longest. This is a daily struggle for me that often no one understands. Usually when I try to explain this and how it feels I often get "oh yeah I'm terrible at remembering things too" or, "I have ADD, I'm the same way." It's not the same. Because although I had ADD well before my illness, I wasn't like this. I forget things daily, often minutes after being told something. I can't remember plans or other people's plans if I need too. My thoughts are so scattered. I barely have the ability to think critically anymore. If I try, I get frustrated. I'm easily distracted and I feel sluggish. It's effected every part of me. Especially my job duties. I constantly worry about people's perception of me now. I would like to explain this to everyone I meet so I can have their patience and understanding. But, at the same time I don't want to say anything because I don't want to explain my whole story to every single soul I meet. PICS patient memories have been compared to Alzheimer's and dementia patients.

Mental issues refer to PTSD symptoms, anxiety and depression. I really have never talked about my depression with my illness. I've really stayed away from going in depth about it because I'm so focused on using my experience for talking about the good outcomes. But it's just as important to share the struggles of depression because so many ICU survivors experience it and the whole point of this blog was to share insight and help support other survivors. I don't feel like my depression really hit me until after I returned to work and lasted for several months. I didn't take the proper amount of time mentally and physically to heal before returning to work and as I've discussed before things were not the same when I returned to work. I was severely depressed and frequently found myself at night wishing that I could go back and not live and not fight as hard as I had. The sadness and stress was so overwhelming and consuming and I had no one that could relate to me that was within my family or social circle. I felt very alone. I remember being at work one day in January at the pharmacy, we worked across from a diner that always had heavy traffic with tractor trailers. I remember looking out the window as it snowed. I thought about walking outside, across the parking lot, and across the street with traffic ready to be hit by a semi and not think twice. Or overdosing on insulin because I knew it would be painless. I never talk about these things because they're so shocking, disturbing, and painfully real. But this is what it was like. And i remember being in my apartment with my boyfriend collapsing and breaking down in his arms and crying on the floor because I was so unhappy and I couldn't get the feeling to go away and I didn't know how to fix it. The best healer for me was time. I'm happy to say that now I am genuinely happy and moving forward. As for anxiety, the only anxiety I experience is related to getting sick currently. A minor cough scares me. I'm scared that any degree of what I experienced would happen to me again. I've had one panic attack since getting sick. I threw up at work, freaked myself out, was tachycardic and drove myself to the ED where I collapsed in the lobby. I'm extremely paranoid now of any minor cold or illness that might develop and there's nothing I can do about that. That's just part of living with
what I've gone through and it isn't uncommon.

I really hope this gives some insight into PICS and how it effects patients. The information I used can all be found here. It goes more in depth statistically and clinically.

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