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> "what's the effect of psychotrauma resulting from illness and hospitalization on cognitive function" Ventilators are extremely physically traumatic - those p

> "what's the effect of psychotrauma resulting from illness and hospitalization on cognitive function" Ventilators are extremely physically traumatic - those patients are considered to be the sickest in any hospital.

isoprophlex 6y ago
It must be hell to have a bunch of suited figures tell you "we're putting you to sleep, hope to see you on the other side"... and then wake up intubated.
- noneeeed 6y ago
  I believe ITU patients often suffer from psychosis while in treatment and PTSD afterwards. Intensive medical intervention really can be incredibly traumatic for many, over and above the trauma of the illness or injury that put you in ITU.
  - treeman79 6y ago
    For me the treatments went bad, it was being ignored and dismissed at every stage. I had a full on embolism in my lung. Multiple doctors and ER missed it. Kept insisting it was anxiety. Only when skin turned completely white did they reluctantly run an x-ray. Oops. Then I had a reaction to blood thinners. Nurses called me a liar, that no one has a bad reaction. Oh turns out it’s fairly common. Had to let it get to a stroke before they would Change medication. Repeat at every stage.
- zikzak 6y ago
  I have a screwed up neck. WHen I had surgery for a different part of my body I had to be awake while they "put the tube in". You are on an operating table with an anesthetic in your throat, your arms are restrained, then these masked (which would seem more normal now, I guess) and gowned figures start forcing tube down your throat while you try to "swallow it" and breath through your nose... there's a point where you can't breath. As soon as it is in place and you feel like you are going to suffocate they hit you with the general anesthetic and it's light out. You wake up (no time has passed for you) and your throat is sore. I had nightmares about it for months after (initially, whenever I closed my eyes). The drugs they give you in the hospital help somewhat but once home, look out. I can't imagine what it would be like to wake up in an ICU with that tube still in. I know eventually I will need another operation and I sometimes realize this will all happen again. I am trying to learn to live with this and realizing without the operations I will die, etc. Also, that so many people are dealing with so many worse things.
  - spuz 6y ago
    It is traumatic for sure. The best coping method I can think of is to remember that these are professionals providing the best possible care for you using practices that have been refined over decades. Everything they do is in an effort to eventually make you feel better. I had a gastroscopy which involves putting a tube down your gullet and it was pretty unpleasant but not too bad all things considered. However I can only imagine having a tube down your windpipe would feel incredibly distressing.
  - hobbescotch 6y ago
    I can really relate to this. I have had to have a cornea transplant and many other eye surgeries over the past year where I had to be awake during them. I know in a few years I will likely be going through the same thing and I’m having trouble coping with that. It is really not fun having an operation on your eye while being awake and seeing the whole thing happen through that eye!
- redis_mlc 6y ago
  > and then wake up intubated This is a misconception about ventilators. No, they don't wake you up until days/weeks later, until after the tube is removed. The reason is that patients fight the tube, so must be in a coma.
kace91 6y ago
In which way are they physically traumatic? (Not doubting you, just curious and completely ignorant on how they're used)
- Smaug123 6y ago
  The most intensive form of ventilation is so extremely unpleasant that patients are usually kept sedated for the whole thing. An external pump shoves air into the lungs via a tube through the mouth and down the windpipe; there's a very small window of pressures where you can do this without physically damaging the lung. The tube itself is immensely uncomfortable and I imagine its mere presence would be traumatic enough even if your life were not at risk (for example, you can't speak because it sits against the vocal cords). The muscles that normally cause you to breathe are completely inactivated chemically during ventilation, and this can cause them to atrophy. There's a pretty good set of diagrams at https://eu.usatoday.com/in-depth/news/2020/04/10/coronavirus-ventilator-how-works-why-covid-19-patients-need/2942996001/ https://eu.usatoday.com/in-depth/news/2020/04/10/coronavirus... .
  - easytiger 6y ago
    Furthermore most people, certainly before covid, who are so ill wouldn't even be considered for ICU respirator use because the recovery time from the trauma to keep them alive might exceed their likely life expectancy anyway. There is a worry that during covid more people are being referred for respiraton when previously they wouldn't be. That was the issue, at least in the UK with the field hospitals as well. They couldn't handle patients with multidisciplinary issues and so were utterly pointless under generally applied ICU practices. https://www.telegraph.co.uk/global-health/science-and-disease/intensive-care-doctors-question-overly-aggressive-use-ventilators/ https://www.telegraph.co.uk/global-health/science-and-diseas...
    - srtjstjsj 6y ago
      In perhaps the most frustrating linguistic confusion of the pandemic (competing with "lockdown"): A respirator is a mask. A ventilator is a pump. Ventilators are far more dangerous than respirators.
deleted 6y ago
[deleted]

isoprophlex 6y ago

It must be hell to have a bunch of suited figures tell you "we're putting you to sleep, hope to see you on the other side"... and then wake up intubated.

noneeeed 6y ago
I believe ITU patients often suffer from psychosis while in treatment and PTSD afterwards. Intensive medical intervention really can be incredibly traumatic for many, over and above the trauma of the illness or injury that put you in ITU.
- treeman79 6y ago
  For me the treatments went bad, it was being ignored and dismissed at every stage. I had a full on embolism in my lung. Multiple doctors and ER missed it. Kept insisting it was anxiety. Only when skin turned completely white did they reluctantly run an x-ray. Oops. Then I had a reaction to blood thinners. Nurses called me a liar, that no one has a bad reaction. Oh turns out it’s fairly common. Had to let it get to a stroke before they would Change medication. Repeat at every stage.
zikzak 6y ago
I have a screwed up neck. WHen I had surgery for a different part of my body I had to be awake while they "put the tube in". You are on an operating table with an anesthetic in your throat, your arms are restrained, then these masked (which would seem more normal now, I guess) and gowned figures start forcing tube down your throat while you try to "swallow it" and breath through your nose... there's a point where you can't breath. As soon as it is in place and you feel like you are going to suffocate they hit you with the general anesthetic and it's light out. You wake up (no time has passed for you) and your throat is sore. I had nightmares about it for months after (initially, whenever I closed my eyes). The drugs they give you in the hospital help somewhat but once home, look out. I can't imagine what it would be like to wake up in an ICU with that tube still in. I know eventually I will need another operation and I sometimes realize this will all happen again. I am trying to learn to live with this and realizing without the operations I will die, etc. Also, that so many people are dealing with so many worse things.
- spuz 6y ago
  It is traumatic for sure. The best coping method I can think of is to remember that these are professionals providing the best possible care for you using practices that have been refined over decades. Everything they do is in an effort to eventually make you feel better. I had a gastroscopy which involves putting a tube down your gullet and it was pretty unpleasant but not too bad all things considered. However I can only imagine having a tube down your windpipe would feel incredibly distressing.
- hobbescotch 6y ago
  I can really relate to this. I have had to have a cornea transplant and many other eye surgeries over the past year where I had to be awake during them. I know in a few years I will likely be going through the same thing and I’m having trouble coping with that. It is really not fun having an operation on your eye while being awake and seeing the whole thing happen through that eye!
redis_mlc 6y ago
> and then wake up intubated This is a misconception about ventilators. No, they don't wake you up until days/weeks later, until after the tube is removed. The reason is that patients fight the tube, so must be in a coma.

kace91 6y ago

In which way are they physically traumatic? (Not doubting you, just curious and completely ignorant on how they're used)

Smaug123 6y ago
The most intensive form of ventilation is so extremely unpleasant that patients are usually kept sedated for the whole thing. An external pump shoves air into the lungs via a tube through the mouth and down the windpipe; there's a very small window of pressures where you can do this without physically damaging the lung. The tube itself is immensely uncomfortable and I imagine its mere presence would be traumatic enough even if your life were not at risk (for example, you can't speak because it sits against the vocal cords). The muscles that normally cause you to breathe are completely inactivated chemically during ventilation, and this can cause them to atrophy. There's a pretty good set of diagrams at https://eu.usatoday.com/in-depth/news/2020/04/10/coronavirus-ventilator-how-works-why-covid-19-patients-need/2942996001/ https://eu.usatoday.com/in-depth/news/2020/04/10/coronavirus... .
- easytiger 6y ago
  Furthermore most people, certainly before covid, who are so ill wouldn't even be considered for ICU respirator use because the recovery time from the trauma to keep them alive might exceed their likely life expectancy anyway. There is a worry that during covid more people are being referred for respiraton when previously they wouldn't be. That was the issue, at least in the UK with the field hospitals as well. They couldn't handle patients with multidisciplinary issues and so were utterly pointless under generally applied ICU practices. https://www.telegraph.co.uk/global-health/science-and-disease/intensive-care-doctors-question-overly-aggressive-use-ventilators/ https://www.telegraph.co.uk/global-health/science-and-diseas...
  - srtjstjsj 6y ago
    In perhaps the most frustrating linguistic confusion of the pandemic (competing with "lockdown"): A respirator is a mask. A ventilator is a pump. Ventilators are far more dangerous than respirators.

deleted 6y ago

[deleted]