Monday, July 26, 2010

I.C.U. Psychosis

ICU Psychosis is this fun little thing that is frighteningly common to trauma patients in the ICU. They commonly exhibit a cluster of serious psychiatric symptoms.

ICU psychosis is caused by a combination of things, like environmental problems such as: sleep deprivation, stress, continuous light, medical monitoring, loss of day cycle (think being in an enclosed room all the time) and more. Add to this medical causes like pain, drug side effects, medical trauma, and dehydration.

More or less with the constant monitoring, trauma, drugs, disorienting location and host of other symptoms ICU units are the perfect place for people to go nuts for a short amount of time.

This was mentioned to me one day by Saul, the doctor I mentioned earlier, and happened to me that very night. It was 3 days after the operation. At the time sleep came in 30 minute intervals, hopefully totaling an few hours a day. I still had a morphine system for the pain, oxygen tubes, and an arm full of various IVs, not to mention the monitoring system for my vitals.

After dozing for about a hour (a record at the time) I woke up in the middle of the night disoriented and in excruciating pain. My face and head felt fine but the rest of my body seemed distant. My back felt like 1,000 nails were piercing it, my limbs, other than one hand, weren't moving or reacting at all. With the room covered in drapes I could not recognize any details that had seemed so familiar. I had no idea how I got their,and although I knew I had the operation, I was completely lost on where I was and what was going on.

Looking around I saw all of the medical apparatus coming out of my body, the frame of the bed seemed to be connected to me, and the walls and windows of the room seemed no different than my own limbs. Everything in the room felt as though it were a part of me, as if when I was sleeping a construction crew had drilled, nailed, and cemented my body to the architecture of the room. For 20 minutes I thought that I had morphed and melted into the this undefined space. It was as if the pain I was feeling was the beams of the room going through my body. If I stayed there I thought the architecture would just slowly consume me until I was swallowed by the room.

And the funny thing is I tried to stay calm. To rationally think of what was going on, but each new clue led me to the same conclusion, I was being devoured by the building.

This lasted for maybe 20 minutes, pure fright, and feeling like my brain was being stretched and might snap. I finally saw a push button lying on the bed, slowly it came to me that this was a 'call button' and if I pushed it someone, anyone would come. Luckily it was next to my good arm and after pushing it an ICU nurse showed up minutes later.

Calmly I explained to him how the building had begun digesting me and taking over my body, calmly he explained to me that I was a patient, had had a spinal operation and was in the ICU. His argument, mixed with a little morphine, worked, and while I still like my argument I finally was talked down from the ledge.

Welcome to the ICU.

2 comments:

  1. Holy hell. I am so glad you are writing about this, love having these insights into your daily life, but am so sorry you're going through it.

    What a trip. I love you, friend.

    Jeremy

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  2. Hi, Scott,

    I am linking to this very insightful post of yours in a hopefully viral email that I am putting together about ICU Psychosis and chronotherapy and the positive vs. negative health consequences of embracing vs. ignoring natural time vs.corporate standard time -- as described at truetyme.org. Hope you do not mind, and would you like to see the email I am putting together?

    Regards,

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