ICU Psychosis

Subject: icu psychosis

Message: There is not much information on the web about ICU
Psychosis. A week ago today, my dad underwent a double lung
transplant. He is doing well except for this psychosis. We as a family
feel helpless. We have not been allowed to go into his room, and we
can only watch him from a glass window. Please tell me this gets
better? I know it is probably harder on the family, but we don’t know
what to do. Are there any suggestions you can give?
Thank you,
Jacqueline

Dear Jacqueline,
ICU psychosis was not a topic talked about by the doctors, surgeons, or medical staff before transplant. It is something most patients suffer from after spending a few days in the ICU. I experienced this more during my first transplant (2005) as I spent 21 days in the unit behind glass, 17 of which was in a drug induced coma. The four days I was awake I thought everyday was Christmas. I watched the clock intently all day and night. Time was so slow. I couldn’t focus on the tv, and the last thing I wanted to do was interact with the people outside the glass. It was like a deep depression. I saw people (my old HS phys ed teacher) who weren’t really there. It was a lonely feeling. But, this all passes. At the time I was miserable but once I go to a medical floor, instantly I was better. I was able to sleep and the best part was I could talk and touch my visitors. This was the point where I knew I was going to live. Time passed by so quickly at that point.

Now after my second transplant, ICU psychosis was much different. I was only in the ICU for three days and not on contact precautions, there was no glass separating me for the rest of the world. since there were no windows I was very confused whether it was day or night. I then moved to a med/surg floor where my psychosis got worse. The pain meds mixed with antibiotics and lack of sleep made me hallucinate. I would fall asleep and then start talking and moving (directing traffic, talking to my god son, act like a composer) and then awake quickly with a jerk. I also got cabin fever as I spent 21 days in the hospital post-transplant. I was “climbing the walls.”

In 2001 my paternal grandparents were in a serious car accident. My grandfather was pronounced dead on the scene and my grandmother was transferred to the city hospital in serious condition. After a few days in ICU, we were able to visit her. She was hallucinating, often talking with my “grandfather’s angel.” She would talk about having coffee with them and them with her best china. All though she was in and out of psychosis, we agreed with her because telling her that no one was there would just anger her. We reminded her daily of where she was and what had happened. A soon she was medically sound, we got her out of the room asap. Just to walk around the until/hospital helped clear her mind and bring her back to reality. She spent over 60 days in the hospital. We brought her pictures of her grandkids and events that were taking place while she was inpatient. We kept her updated on the current news, and constantly reminded her of the date.

Things you can do to help: 1. Remind your dad of the date 2. Bring in pictures, cards, etc to remind him of his family and friends 3. Talk about current events and news 4. While he is behind glass, write big signs for him to read and maybe tape them to the door 4. Don’t have too many visitors, especially at one time (personally I felt like a was a zoo attraction) 5. Remind him of his medical goals and how close he is to reaching them, “it’s a big mountain but he is near the top.” 5. Just agree with things he may see or hear (this will soon pass)

All in time this whole transplant journey will seem like just another event in life. Although your father’s life decisions will always take his lung transplant into account, he will be able to live a healthier and happier life. Good luck! Hope this helps.

Sincerely,
Amber