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    ICU Psychosis

    My wife believes that her father is suffering from ICU psychosis. He's been in the ICU for over 4 weeks now (C2 complete injury), and his anxiety level and feeling that he's fighting for his life (can't breathe, heart is going to stop, etc) has been increasing. It's especially bad at night and during shift change. Has anyone else experienced this, and what can be done to treat it? I don't know what if anything is being done for it by the hospital staff.

    #2
    could be the meds he's on, plus near complete immobility doesn't help anxiety issues. did he ever have anxiety issues before his injury? did this get increasingly worse since he's been there?
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

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      #3
      At C2, he might very well not be able to breathe on his own; still, dealing with the anxiety will be important.
      Daniel

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        #4
        I had issues with that as well. My husband and daughter (one at a time) spent a few nights with me. That helped, as the lack of sleep compounded it.
        T7-8 since Feb 2005

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          #5
          As far as I know he never had any anxiety issues before, he's very sound mentally and exceptionally intelligent. Yes, the anxiety has been getting progressively worse. Regarding meds, they're giving him vicodin for headaches (he won't take morphine), a blood thinner (don't know the name); that's all I know for sure. I'll need to find out more specifics.

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            #6
            meds and immobility plus thinking about his life and how to deal with the change al could be part.
            Never take life seriously, nobody gets out alive anyway

            Frank's blog:
            http://www.franktalk-scurry.blogspot.com
            My regular blog:
            http://www.ithinkithinktoomuchblog.blogspot.com

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              #7
              When I had ICU Psychosis they prescribed Haldol (Haloperidol). I was C5,C6,C7.

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                #8
                I still don't know what was psychosis and what was real. Every night these ppl came to get me, took me to xray, wanted to remove my c-collar but I wouldn't let them without dr.'s permission, which they never had. This happened 3 or 4 times. Mysteriously, all my x-rays from that hospital have vanished.

                It was a teaching hospital, they said they needed the x-rays for some project. I was cool w/ that, just not w/ removing my c-collar. It was plastic, why would they have needed to remove it? Why didn't they just get Dr. Hsu's permission?

                Did this really happen? It sure is vivid in my mind.

                I do know the black holes on the acoustic ceiling tiles weren't really little villagers that got progressively meaner. I even knew that then, but they were still scary.

                I do know I was in a ward w like 20 other ppl, all gorked but me and 1 guy who was gunshot. I waved at him, he waved back. Then they took him away (to surgery, I think) and he was gorked too, afterwards.

                I really recommend a clock that says am and pm, for ICU patients. It's all so disorienting.

                Sorry your family is going thru this.
                Blog:
                Does This Wheelchair Make My Ass Look Fat?

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                  #9
                  Wow, thanks for all the replies. So from the responses thus far (and from reading one of the similar threads) it seems like this is something that happens to a lot of people, is often more severe than what my FIL is experiencing, and you pretty much just have to work through it until it runs its course (kinda like a bad acid trip). I'll ask about the Haloperidol, although he's not having any crazy hallucinations (yet) so maybe he doesn't need it.

                  Comment


                    #10
                    I had similar experiences during my stay at the shock trauma center. My motor vehicle accident was August 10th, and I have a C5/6 incomplete injury. I slept about a total of 7 hours during my ~2 week stay. I was on all sorts of medication (including ambien). I already had anxiety issues prior to the injury, and as others have mentioned, the paralysis and immobility only heightened my already high level of anxiety. They would not give me anything for the anxiety, but instead were only trying to manipulate sleep meds. It was horrible. I had some extremely vivid and bizarre hallucinations - about the facility, the staff, you name it.

                    This facility also did not allow family to stay over night, which I feel is a big mistake. If I had a family member stay with me, it would have been a different experience - and I might have gotten the needed rest and sleep, as it would have helped to alleviate many of my anxieties. Things were compounded for me at the time because I was intubated, and then had a trach, and so I couldn't even communicate any of this.

                    Maybe they can treat the anxiety, and this will help to alleviate some of his symptoms.
                    "Get busy living, or get busy dying." - Andy

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                      #11
                      I think the good news about ICU psychosis is that it goes away after you get out of ICU! My experience was that the sudden lack of sensory input made my mind go wild. Like Bethany, I still don't know what was real and what had been hallucinated. I'm pretty sure I wasn't on a hospital ship but you couldn't convince me of that at the time.

                      One of the things that I remember is that I was very sensitive to conversation going on around me and my imagination would go wild when anything negative was said. I really appreciated family and staff that could keep things upbeat and simple. It's not a time for a real rational discussion of the pros and cons of his situation. You just need to be really supportive and positive about potential outcomes. Even if those outcomes now don't seem so positive. It's just really hard to come to grips with reality in such a sensory deprived situation. it's like being a child again. you lose your defense mechanisms and much of your sense of identity. The result is a profound sense of vulnerability.
                      Last edited by Wesley; 13 Oct 2008, 6:18 PM.

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                        #12
                        Talk to the head nurse or clinical nurse specialist on the unit. Ask to have a family conference. There are methods that help to decrease ICU psychosis (if this is what is going on). Consultation from a psychiatric clinical nurse specialist and/or psychiatrist may also be very helpful. The need must have a plan that everyone follows consistently (health care team, family, friends, etc.).

                        It is also possible, esp. in an elderly person, that excessive use of sedating/anti-anxiety drugs or electrolyte or hormone imbalances can contribute to this. If there is a room with a window or skylight, get him moved to it and keep the curtains open during the day. If not, then be sure the nurses are darkening his area at night and turning on the lights during the day. They should minimize care at night (too many ICUs do bathing on the night shift, for example). Day/night confusion is a major contributor to ICU psychosis.

                        Here are some good resources:

                        http://www.medicinenet.com/icu_psychosis/article.htm

                        http://include.nurse.com/apps/pbcs.d...=2002204120307

                        http://www.icu-usa.com/tour/medical_...s/delirium.htm

                        (KLD)
                        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                          #13
                          Originally posted by betheny

                          I do know the black holes on the acoustic ceiling tiles weren't really little villagers that got progressively meaner. I even knew that then, but they were still scary.
                          Yes, I am pretty sure that the Halloween Cookies that were trying to push me down the cellar stairs weren't real. There were other scenes as well.

                          For me, the real key was company at night. It took about 3 nights. Just someone there to grab their hand when I woke up in the middle of one of these spells. I am pretty sure they put me on some sort of anti anxiety med at the time, but I would have to look back at the notes my mom made to be sure. Bud lack of sleep jus compounds the effects, and finally getting some sleep helped greatly. The issues didn;t go away completely, but were greatly lessened.

                          (I really don't think family staying overnight was a hospital policy, I think that they just allowed it on a case by case thing, b/c no one stayed with me again. )

                          My daughter says that she knew when I was getting better, when I DIDN:T little tiny men walking on the walls, but saw boxes of gloves instead.
                          Last edited by sjean423; 13 Oct 2008, 8:27 PM.
                          T7-8 since Feb 2005

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                            #14
                            Originally posted by betheny
                            I do know the black holes on the acoustic ceiling tiles weren't really little villagers that got progressively meaner. I even knew that then, but they were still scary.
                            o my god that was way too funny!!!!!!!!!! i laughed so hard!

                            i never had any of that stuff but darvoset made me keep trying to find my car, then when i did, i couldn't find my keys and kept repeating itself.

                            i did have one where i was in the football stadium's squawk box and there was a bread box in there full of gray kittens...
                            Never take life seriously, nobody gets out alive anyway

                            Frank's blog:
                            http://www.franktalk-scurry.blogspot.com
                            My regular blog:
                            http://www.ithinkithinktoomuchblog.blogspot.com

                            Comment


                              #15
                              I had some major anxiety issues during my 22 days in the ICU i only slept about four hours of spread out sleep a night. Its very hard to comprehend that just about every aspect of your life has changed in the blink of an eye... it gets better with time...

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