Mended Hearts Open Forum

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  • 1.  ICU Psychosis

    Posted 04-06-2021 07:14
    To All Mended Heart Members,

    After my 3rd open heart surgery in eleven months, I suffered a sever case of ICU psychosis. Anyone who has suffered from this during their recovery knows to what I am talking about. 

    ICU psychosis is a disorder in which patients in an intensive care unit (ICU) or a similar setting experience a cluster of serious psychiatric symptoms. Another term that may be used interchangeably for ICU psychosis is ICU syndrome. ICU psychosis is also a form of delirium, or acute brain failure. My experience was the most frightening experience of my life. I thought the ICU staff was trying to kill me. I lost my sense of where I was.  I took a full swing at a nurse, I was restrained with bed straps. In my minds eye I was on the ceiling looking down at everyone trying and waiting the right time to escape. I was out of my mind. I attempted to pull all the tubes out of my body. Got up in the middle of the bed with the restraints and tried to bust out. It was my "One Flew Over the Cuckoo Nest" ICU experience.  I personally was not my usual self. I was out of my mind. I was having bad day!

    If you have incurred ICU Psychosis I would like to hear from you. 

    Regards,


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    Michael Hinderlie
    Port Charlotte FL
    (941) 421-0482
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  • 2.  RE: ICU Psychosis

    Posted 04-07-2021 09:07
    Hi Michael,

    I had ICU psychosis, although my experience was different than yours. I spent 20 days in ICU after my CABGx5 surgery was complicated by ventilator induced bacterial pneumonia and antibiotic induced cdiff.  I was sedated in a medically induced coma for the first 13 of those days, as the doctors and nurses periodically tried to wean me off the ventilator.

    My ICU psychosis was filled with delusions and hallucinations, just like yours, but they were not at all frightening, although they were sometimes extremely frustrating.  As an example, and among other things, I at first was convinced that I was at a hospital in the Bahamas, and that my surgeon was my old commanding officer when we served on board our ship in the Navy (I never served in the Navy).  I also was confronted with an illegitimate daughter who I had fathered in Korea during the Korean War (I was a baby at the time of the Korean War and have never even visited Korea).  I then believed that the surgeon (who also served as hospital administrator) and an abusive nurse were keeping me captive in a bed from which I couldn't escape, and I was trying to get my daughter (my real daughter) to get her motorcycle gang (not real) to rescue me.  I later believed that I had a second surgery (not real) and I was recovering in the Seaman's Institute in lower Manhattan (I was really in Jersey City Medical Center the whole time), I was involved with a (fictional) dockworkers uprising in lower Manhattan, my daughter and her friends were teleporting through the hospital whiteboard system to see me, and to attend a Russian festival that was going on outside my room, the hospital needed me to attend a meeting in Washington DC to resolve some political difficulties it was experiencing, and one of my male nurses was Jesus Christ.  Get the picture?  I was stark, raving mad.  But I was not violent and never had to be restrained (although the night before I was discharged to the rehab hospital, I did damage a metal cart trying to pull myself up to a sitting position from my bed (At least I think this was real and not one more hallucination).

    My hallucinations ended the day I left the ICU and entered the rehab hospital.  I did have to confer a number of times with my wife about whether a number of events actually did happen because so much of what I experienced seemed absolutely real at the time and not at all dreamlike.  As an example, I was having a conversation with the attending cardiologist at the rehab hospital one day about my medical history and asked him if the records reflected my second surgery at JCMC.  When he told me that he had no record of a second surgery, I needed to ask my wife if I had such a surgery and was amazed when she told me no.  I had no idea that it wasn't real.  And to this day, 38 months later, I do believe that the male nurse who I thought was Jesus, actually is a Christlike incarnation of the spirit of Jesus, to whom I owe everything for his kindness to me-and I'm a Jewish secular Zen Buddhist!

    If you would like to talk person to person, my number is 201-256-7231.

    All the best,

    Ira

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    Ira Reid
    Hoboken NJ
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  • 3.  RE: ICU Psychosis

    Posted 04-07-2021 21:11
    Michael I had CABGx5, and had very similar emotions, but not to the same extent. You're not alone with this.

    My first day out of surgery I thought they were trying to kill me, and I would have bouts of paranoia and times when I was snappy, mean and "not myself," and had that "Cuckoo's Nest" feeling. It sounds like you had an extreme version of what happened to me. I totally get what you went through.

    Funny story about hallucinations. I had my surgery in Los Angeles in late October of 2019. My second day in the ICU after surgery, I woke up at 3am and turned to look out my window and saw a huge plume of orange smoke rising above the city. Was I hallucinating? Did I not make it through the surgery and was in the bad place? I tried to go back to sleep, but woke up again, looked out my window, and there was now a bright wall of flames covering the horizon that was getting more intense by the minute. Uh-oh. Of course, it turned out that I had a perfect view of the start of the Getty wildfire during that horrible fire season in LA.

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    Sal
    Los AngelesCA
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  • 4.  RE: ICU Psychosis

    Posted 04-08-2021 09:25
    Y’all’s stories reminded me of my ten days in medically induced coma post open heart surgery ( complicated by cardiogenic shock). I called all that “coma dreams” but the doctors told me they were morphine induced., and to not dwell on them. This is not so easily done. These dreams, Hallucinations, are very real to me still after 8 years. Some were very scary nightmares; but also There was a pink decorated Chinese restaurant scene, where my son announced to me that his wife was pregnant. ; MotherTeresa, my grandmothers, my mothers, were volunteering at the neonatal unit on the top floor of the hospital ( its a heart hospital no maturity unit at all). (Cribs were designer decorated), . Fortunately my “good experiences” were more powerful than the nightmare ones.
    We could all get together and make a movie.
    Hopefully time will cause the scary stuff to fade... remember your brain needs to heal from all that trauma too. Try not to dwell on the scary stuff and Enjoy each new day now.
    If you are having anxiety, racing thoughts, depression from all this, please talk to your doctors: maybe medicines and therapy will help.

    Marilyn B. Rosenhouse
    Mobile: (214)850-0655




  • 5.  RE: ICU Psychosis

    Posted 04-09-2021 04:49
    I've done some reading of the medical literature about ICU psychosis, and it tends to occur more frequently among older adults than younger adults.  I don't recall if the articles explained why this is the case, but I can speculate that it may have something to do with our aging aging brains, perhaps the blood vessels in or feeding the brain.  It also is more likely if you have consumed alcohol within the week prior to surgery.

    Although my hallucinations were more in the nature of adventures than the horrific experiences of some others, I think it might be a prudent idea to inform your surgeon and medical team in advance that you have experienced these in the past if you ever again need major surgery for any reason, and that is what I intend to do.  My doctors and nurses had no idea that I was experiencing an altered state of consciousness for two weeks while sedated and for most of an additional week once awakened.  In fact, my wife tells me that when I first awoke, I started talking about physics to a nurse, a conversation (actually more of a lecture) about which I have zero memory.  My wife explained this to the nurse as being normal for me to engage in such monologues about arcane subjects and an indication that I was feeling better.

    By the way, if you google ICU hallucinations or psychosis, you will find websites where people discuss their experiences, much as we discuss our heart experiences here.  From my limited reading of these sites, the fear based experiences seem more common, and I wonder whether the emotional reaction to the experiences, and even the nature of the experiences themselves, bear a relationship to the underlying way of being in the world experienced by each of us, e.g. a more anxious or fearful person might experience more nightmarish hallucinations.  If so, perhaps meditation would be a useful preparation for major surgery in nonemergency cases.

    Best,

    Ira

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    Ira Reid
    Hoboken NJ
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  • 6.  RE: ICU Psychosis

    Posted 04-12-2021 13:36

    Michael,
    I would like to share my post surgery experiences recovering from an ascending aortic aneurysm repair in 2007.  The night after surgery, I also experienced some form of dream, nightmare or hallucination.  The experience was so vivid and powerful, I was able to recall very specific details when awake and write down the memories. 
    The three experiences were later explained to me by a nurse practitioner as a form of psychosis brought about by the psychoactive meds given to all open heart surgery patients, to help them mind forget the worst of the experience. All of the dreams took place during the summer, after midnight and in the dark. My surgery was during a heat wave in July, i was sedated over night for twelve hours after surgery and we had lived two years Jersey City when we were first married. Here is a brief summary of my post surgery technicolor hallucinations or dream states: 

    1st Dream Sequence - Place:  A rundown, warehouse area of downtown, Jersey City; Date:  August evening - recent past;  Time: Past midnight

    2nd Dream Sequence - Place:  US Army Patton Barracks (Grenadier Kaserne), Heidelberg, Germany Date:   1965 to 1970 Time:   3:00 AM

    3rd Dream Sequence - Place:  Soho District - Lower Manhattan, NYC; Date:  Summer, 2007;  Time:  Late evening

    This may provide you some understanding of the effects of the psychoactive drugs which you were probably given during or after surgery.  Send an email to  fvfabry@gmail.com, if you would like more details.
    All the Best,
    Vic Fabry 



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    Victor Fabry, CEO
    Greylock Advisors, LLC
    Short Hills, New Jersey
    fvfabry@gmail.com
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  • 7.  RE: ICU Psychosis

    Posted 04-16-2021 13:46

    Was anyone who suffered from this aware of how to prepare or prevent this in a new hospitalization. In 2016 I had a gastric surgery which was supposed to be very routine. After being discharged and home for a few days I went by ambulance back in. Over the course of the next month I had two blood clots that required interventional radiology treatment. In preparing for the second treatment I experienced a full psychotic incident. No one was ever able to explain why it happened but reading your stories it was so similar. I was fully convinced I was having a heart attack. I was visiting with my children and telling them good bye. After my treatment I was telling my doctor all about the heart attack asking about the damage. My mother had to take him outside to explain I was nuts. They made me have a ct scan and a psychiatrist was called. It is as vivid today as it was then.  

    'I am scheduled to have open heart surgery in May to fix my mitral valve. I am so anxious about experiencing this again. I am worried about being alone in the hospital due to COVID and surgery if this happens again. Any advice on how to deal with what I call surgery ptsd? 
     



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    Cameron Peek
    Deltaville VA
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  • 8.  RE: ICU Psychosis

    Posted 04-17-2021 04:47
    Hi Cameron,

    Welcome to the group.  During my readings , I learned that ICU Psychosis is a greater risk for people in their 50's and older, and if you have consumed alcohol in the week prior to surgery.  The first factor is beyond your control but the second one is well within your control if you're having a scheduled surgery.

    I have decided for myself, and have recommended this to everyone, that it would be wise to abstain from all alcohol whatsoever during the week prior to surgery and inform for doctors and the nursing staff, in advance, that you have a history of ICU Psychosis.  Apparently, many medical teams will have no idea whatsoever that you are experiencing ICU Psychosis if, like me, you are not violent or overtly acting crazy.  I experienced mine during and after 13 days sedated on a ventilator and for a week afterwards.  I wasn't physically acting out (I could barely move) and nobody had a clue what I was experiencing.  I understand that, with advance notice, the medical team can include medication in your IV to inhibit these symptoms.

    I also suggest reading more about ICU Psychosis in the internet.  There are a number if scholarly studies about it, and it it is now a relatively well known phenomenon listed in the DSM-5 (Diagnostic and Statistical Manual published by the American Psychiatric Association).  

    Best of luck and keep us posted.

    Ira

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    Ira Reid
    Hoboken NJ
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  • 9.  RE: ICU Psychosis

    Posted 04-17-2021 07:03
    One more thing that I forgot to mention in my last post, Cameron.  Your delusional/hallucinated heart attack was very similar to my delusion that I had a second heart surgery after my bypass surgery, in which all of my blood was replaced.  It was so real an experience to me that, when I was at the rehab hospital one month after my open heart surgery, one of the attending rehab cardiologists casually mentioned that he'd read my file and noted that I had "been through the ringer," to which I responded by asking him if he read about my second heart surgery.  He looked puzzled and told me there was nothing in the record about a second surgery.  At that point, I called my wife to ask her about it and she told me that I never had a second surgery.  I then spent the next two weeks exploring with my wife what was real and what was hallucinated about my heart hospitalization.  I also began my internet research into ICU Psychosis.

    These hallucinations/delusions still seem as real to me today, more than three years later, as any other normal, waking experience.  I just recognize them as having been hallucinated.  I am including many of them in a book I am writing about my heart attack and its lessons from a philosophical/psychological perspective.

    Ira

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    Ira Reid
    Hoboken NJ
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