The period following intensive care

How do I feel following treatment at the ICU?

On an ordinary ward

When you have completed treatment at the intensive care unit (ICU) there typically follows a post-treatment period on an ordinary ward. Since the level of care on such a ward is lower than at an ICU, staffing on such a ward is lower. This means that staff have more patients per person to take care of. After being constantly monitored by staff and connected to equipment at the ICU, it may therefore feel lonely and a bit unsettling not to constantly have staff around oneself. If you are concerned, talk to the staff about it, but the transition to the less intensive level of care is an entirely normal process of recovery, and the staff are there to see to your continued care and rehabilitation.

Less strength and muscle weakness

The length of your stay at an ICU can vary widely depending on the reason for your admission and the course of your illness. If you have had a long stay at the ICU you may experience muscle weakness, fatigue, exhaustion and lethargy long after discharge from the hospital. Not having the same strength as before you became ill may make you feel both disappointed and frustrated. Mild exercise such as a short walk if you can or feel like it can be the first step towards regaining strength and muscle power. Often the physiotherapist on the ward will give you advice on this before you are sent home.

Loss of memory

You may also experience memory loss during your stay at the ICU, which may be the result of medication, stress and the illness or trauma. Some people have only a few memories of their hospitalization, while others experience derealisation, nightmares or hallucinations that can continue to trouble you.

Difficulty concentrating and sleeping problems

Sometimes it can be difficult to concentrate for very long and you may find it difficult to absorb information. You may feel anxious and nervous and have difficulty relaxing. Depression is common and affects many patients. Insomnia is also common, especially during the initial period following a stay in intensive care. You may be plagued by dreams which are different from usual, frequently nightmares which can be very unpleasant and continue for a long time.

Mood swings

Mood swings are common following a stay at an ICU, as can a fear of becoming ill again. This can make you feel stressed. Confusion, insomnia, depression and other psychological disorders usually subside spontaneously after a period of time.

The recovery may take some time

It takes time to recover from a severe injury or illness and it is important not to place excessive demands on oneself. It can be helpful to know that most problems are temporary. Talking with relatives about problems and what happened during the hospital stay can be helpful.

Weight loss and loss of appetite

Immediately following the ICU stay you may experience swelling, e.g. in your hands and feet. This will eventually disappear and you will then lose weight instead because of loss of muscle mass and decreased appetite. Loss of appetite may be the result of changes to your sense of taste and odour which mean that food does not taste as good as before, and this means that you eat less. Nausea is also common. Changes to your sense of smell and taste and the loss of appetite usually disappear after a while, as does the nausea. Nausea can also be remedied by eating frequent, small meals.

Hoarseness

Hoarseness is another common problem that you may experience, and because you may have had an endotracheal tube in your throat or a tracheal tube fitted via a hole in your throat connected to a ventilator that assists you with breathing. Your voice may be weak and husky, and is often due to muscle weakness. You may find it difficult to cough properly, take deep breaths and you may become out of breath when you exert yourself, which may also be due to muscle weakness. Hoarseness usually goes away all by itself. When you start to recuperate and gain weight it usually becomes easier to cough and take deep breaths.

Hair loss and sensitive skin

Hair loss and sensitive skin are examples of other problems that may occur, and are partly the result of weight loss and loss of essential vitamins and minerals, but are also a response to the stress your body is exposed to due to illness or injury. These problems will go away by themselves after a period of time.

SIR recommendations for follow-up the period following intensive care

For those patients who have been treated a longer time in ICU, SIR has some recommendations. However, the structure may vary between different intensive care units, and for some ICUs, complete follow-up is lacking. On several ICU, a follow-up reception has been set up for your patient and family members to be invited after hospitalization. The SIR recommends that if you have been treated for more than 96 hours at ICU, it is good and positive if the ICU staff can visit you at the ordinary ward. This in order to establish a contact between ICU and the ward and contribute to continuity in your care. You will also be given the opportunity to ask questions about your stay at ICU and your health. You and your close relatives can also be offered a visit to the intensive care follow-up reception so as to provide you with the opportunity to gain further insight into what really happened during the day of care, receive support to understand your experiences and, if necessary, receive remittance for further support