8 Days in ICU : Part 2

I'll mostly skip over the day I spent in Lower Hutt hospital's ICU. Mainly because it was all pretty much a blur as I struggled to breath following the large amount of IV fluids that were poured into me on admission.
I do remember that I wasn't feeling too bad when they loaded me into the ambulance for the 25 minute drive into Wellington accompanied by two paramedics who specialised in the transfer of high risk patients.

I will however go back to one memory I had of the Hutt ICU. It was on that first day when I could hardly breath. They tried a breathing device on me called a C-PAP (Continuous positive airway pressure). It was a tightly fitting mask that strapped to my face (so it couldn't be torn off by a panicking patient) that responded to my breathing signals. If I gently breathed in it would provide a flow of oxygen & air at a greater rate, taking all the hard work away from me. Well that was the theory!! I would gently breath in and wham!!! my lungs filled to bursting point. I panicked and pushed out and the darn thing sucked all the air out of my lungs in a second.

It was terrifying! I'd been warned that it was uncomfortable and that it would take about thirty minutes to adjust but this was all out of proportion to the air supply I felt I needed. I think I said something like "take it off!, take it off" in a panicked state and the nurses duly obliged.

It was at about this stage in the proceedings as we entered the first night that the hallucinations started.
More about them later...

So once transferred and settled into the Wellington ICU on Monday things didn't seem too bad.
But the doctors were still waiting for the cultures to grow and indicate what sort of bug was in my lungs and blood. That took three days and although they were pumping me full of IV antibiotics, they wern't as it turned out the correct ones. So I was still getting sicker and sicker. I went from being able to talk and move in my bed to being totally helpless in just a couple of days.

I had to be lifted in bed by at least two nurses even if it were just a few inches. I had no strength at all.
I was breathing with the help of a "Hi-Flow" device that gave a constant flow of oxygen and air directly into my nose, it helped but I still felt like I was breathing CO2, there was just this terrible feeling of drowning.

I told Sarah that I felt that I could survive this, all I needed to do was keep breathing right?
Well apparently it doesn't work that way! My breathing was just a continuous series of rapid puffs.
 I figured that I could do that for 24 hours and by then the drugs would start to work and things would get easier.
However after staring at the ceiling for over a day concentrating on just that one thing, breathing. I was worse! I was now almost too weak to breath and what air I did get in felt like it had no oxygen in it at all.

I was seriously considering being put under and ventilated, I was just so very tired. This was by far the hardest thing I'd ever done. I imagined it was akin to climbing Everest without oxygen.

The nurses asked to put me back on the C-PAP machine and I initially declined, however they said this was a better machine than the one I'd fought against previously. I whispered that if they could set it as low as it would go and slowly increase the flow I would hold up my hand when I felt it was set right. This worked a treat and gave me the air I needed to go on. It gently breathed for me and I could finally sleep. Prior to that I had been to afraid to sleep just in case I didn't wake up. Not a likely scenario in ICU but then when your whole life hangs on a little plastic hose...

It was on the Wednesday night that things got really scary. I'd managed to drop off to sleep and was woken by the sounds of the emergency alarm and a crash team that had assembled in my room.
A doctor said to me "Mr Scanlan we have a bit of a problem, your heart is racing out of control and although you are at no immediate risk, if we don't slow it down you may suffer heart damage"
I looked up at the monitors that I'd asked to have strategically placed so that I could see them. Heart rate 220bpm and climbing!

Another female doctor said that she was going to administer a drug to my IV line that would slow my heart. "It would be uncomfortable for about ten seconds" She injected the drug and I was instantly gripped in what I can only describe as abject terror. Nothing I had experienced in my life had prepared me for those ten seconds. It felt like I died and in just a few seconds the lights would go out.
Ten seconds later and I felt somewhat normal again if not completely stunned.

We looked at the monitor.. 150bpm..160..170..200..220.  Oh bugger!!!
She said she would have to use the drug again (I forget it's name) and Pow! I'm stricken once again with total fear. Apparently it interferes with the electrical signals from the brain and even though you know what's about to happen nothing you do will stop the feeling of terror that pervades you.
I stare back up at the monitor... 120.... and steady. I don't remember much after that. I imagine I would have slumped back to sleep completely exhausted. No explanation was given for the cause and it did not thank goodness occur again.

Now those hallucinations...I'd been running a high fever on a number of occasions and that coupled with lack of sleep was causing me to have both aural and visual hallucinations. Some of them were quite spectacular, a wild west steam train that ploughed it's way out of the ground on a picturesque green prairie and rumbled past me in full HD was one such vision.

For entertainment all I needed to do was close me eyes, there was not the usual blackness but rather an alternate world of shapes, images and people. Voices filled my head, none made any sense and I certainly wasn't bothered by any of it as I knew they were harmless. Knowing their cause helped.

Sometimes I'd look out into the main ward from my room and watch the huge foot long insects crawling over the walls and ceiling. Ants were every where, tiny red fire ants that covered everything. It was kind of interesting, never knowing what would appear next. These hallucinations lasted right up to about day five. By which time the drugs had started to work and I was on the mend.

Eating was all but impossible, I'd declined a feeding tube. Sarah spoon fed me what little sustenance I did get. You all know my thoughts on hospital food. Besides I couldn't breath and eat at the same time and I know which one took precedence! The result was that I lost eight kilo's in that first week.
Muscle mass completely disappeared. On about day five I managed with the help of Sarah to pick up my mobile phone and send a message out to friends to say I was OK. The phone felt like a brick! I could hardly hold it. It was another four days before I tried again.

Toilet requirements were easy I had a catheter for urine and I have no idea how I got through eight days without a bowel motion, but I must have as I have no recollection of any such endeavors.
The following week up on the cancer ward would more than make up for that!

So by day eight I was deemed well enough to be moved to a conventional ward, in this case 5 North, the haematology and cancer ward. From there it was another five weeks before I found myself back home and on the very slow road to recovery.

In my next post I'll cover life on the wards...

So what went wrong? : 8 days in ICU, Part-1

I know it's been six weeks since I wrote a proper post. That's how sick I've been. Just too weak and lethargic to open my laptop and type. Well it's now time for a catch-up. I'm still weak and have several health problems yet to be resolved, but here goes....

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Thursday May 10th I was in great shape, I was able to exercise and get about with very little fatigue. I had a bit of a wheeze that I was assuming would go as I got fitter. I was about to start on my plan to take erythromycin as a means to help me ween off prednisone completely.

Friday I woke feeling quite unwell and running a fever, but that's not something that's out of the ordinary for me.

By Saturday I was quite unwell and decided to spend the day in bed. I put the fever down to side effects of the Adcetris as the same thing had happened at that point in the last cycle. I decided that I'd make a visit to ED on Sunday to get a blood test and check for neutropenia.

Sunday morning 8am and I was physically unable to get out of bed. I was running a fever in the high 39's and delirious. Sarah dressed me as I was too weak. I then managed to stagger with her help the short distance to her car. I reclined the seat back and endured the short trip to hospital. I staggered into the Emergency Dept while Sarah parked the car.

Once at the desk the nurse handed me a form. I looked at it blankly and slumped into a seat. I think they realised at that point that I was in a fairly bad way.
Sarah started to fill out the form but before she could complete it a couple of male ED doctors scooped me up on a gurney and rushed me into the theatre.

My blood pressure was 50 and dropping, organ failure and death were a serious possibility. The doctors immediately placed five cannulas in various parts of my body along with a catheter in my bladder. Some were for monitoring, others to get fluids in fast.

Three & a half litres of fluid was then pushed into my body to raise my blood pressure. A side effect of pushing so much fluid into your body so quickly (they were literally squeezing the bags) is that my lungs filled with fluid and within minutes I felt like I was drowning. My lungs felt like concrete and it just didn't feel like I was getting any usable air.

One of the Doctors suggested to Sarah and I that we gather family members around as there was a very high chance that I may not make it. This he said would be a challenge for a healthy person but with my complications survival was even more unlikely.
He asked how I felt about being put in an induced coma and placed on a ventilator.
I replied that I would like them to do whatever it took (to save my life).
This was somehow interpreted as a "no" from me and he wrote in my notes a whole paragraph stating that I'd basically placed a "DNR" request!. (Do Not Resuscitate).

I was then taken upstairs to ICU (Intensive Care Unit) at Hutt Hospital.
Another Doctor then queried my apparent desire for no medical intervention and the error was luckily corrected. I'm still considering laying a compliant about this incident as it could have had fatal consequences.

Once again this doctor expressed the view that there was a serious risk that I would not make it and that family should be informed. Personally I felt that I would make it but it would be a battle. He explained that if I was going to be placed in an induced coma then family should be there to say goodbye to as once asleep it would be too late, I'd just not wake from the coma if I failed to respond to treatment. He said that if they needed to ventilate they would give us enough time to contact family and for them to get to my bedside.

The results of the blood and sputum cultures showed I had a serious infection in my lungs from the common bug "pseudomonas" as a result of being neutropenic from the chemo. I was indeed very, very sick. I've often been told that I never seem to realise just how sick I am, I always think that the guy in the next bed is way worse than me. This time I was that guy! Too weak to even move in bed, my only focus was to breath.

The following day I was transferred to Wellington hospital's ICU unit at the request of my haematology doctor. Wellington hospital is virtually brand new and their Intensive care unit is second to none. I likened it to being in a NASA lab.
I was placed in a large open room with a large glass sliding door in the front facing onto the rest of the open ward. This was an isolation room, designed to protect me from infection.

Just been transferred to Wellington ICU. The worst was yet to come.

Large monitors and all kinds of  medical devices were around and above me on both sides. On the other side of the large glass door a nurse stood at a desk watching me 24/7. At least I felt safe. That was as long as I had the strength to breath....

Continued next post.