The Whole Story: Part Eleven - A Day in the ICU

It's 6:00 AM in the ICU. I haven't slept more than dozing in and out because the nurse is required to check my vitals and measure the output of my EVD every hour in addition to popping in and out to give meds. I can hear the voices from the hallway as the resident teams begin to make their rounds. My neuro team should be here shortly. I wonder who will be taking point today? Will they have anything new to say?

7:00 AM. My neuro team visited without any new information, but they were very sweet and encouraging. My husband helped me to order some breakfast on my phone. That seems to be the easiest way to do it with the least miscommunication. We've finally gotten it in my chart to have me on the gluten free menu! That makes things easier. It's time for the nursing shift change. This happens in the 7:00 hour AM and PM. My nurse from the last shift will bring in the new nurse, introduce them, teach them about how my EVD pole works, and then leave me in their care.

8:00 AM and my neighbor's sons are here for a visit. She is so much more calm and lucid while they are here. I feel like I can rest and not worry about what's going to happen next door. I wasn't able to get much of my breakfast down. The nausea from my IV antibiotics permeates every waking moment. I feel better now than I did in the middle of the night, but I never let them move the green bags out of my reach. We keep trying different meds, surely one of them will work?

9:00 AM. My neighbor's sons haven't been gone for 20 minutes and she's already set off alarms on her side of the room. This new shift of nurses hasn't gotten used to her yet so they all come running quickly. They get her settled and remind her that she needs to press her call button if she wants to get up. Things stay quiet for less than 15 minutes before her alarms go off again. It's been like this all day and all night for days. I feel bad for her, but I've no idea what more I can do than pray.

10 AM. A team of two specialized nurses has arrived to install my PICC line. They've had more and more trouble drawing blood and getting IV's to work on me, so they decided to go this route. I'm very excited not to have anymore pokes! Somehow, the two of them turn my little curtained cubicle into a sterile field. I get a cap to cover my hair, a mask for my face, and a special drape to cover the rest of my body. Everyone else in the room is also wearing caps and masks and special clothing. They put a device on my chest called a Sherlock that acts very much like my Alexa does at home, but this one shows them my veins and helps them to know how to guide the line to my heart. They start out with a very promising looking vein in my right arm, but unfortunately it hits a wall in my shoulder and we have to switch to the other side. This means a complete reset and redo of the sterile field. Once they have it set back up though, things progress quite quickly and they have the line going from my arm to within a couple of centimeters of my heart. They add two ports to the end and I'm good to go! I'm pretty wiped out, so I take a little nap in between vital checks.

Noon. We ordered lunch on the phone about 30 minutes ago and it has arrived. I wonder how they will have cut up the apple this time? I never knew there were so many ways to cut up an apple until I stayed in the hospital. It's not that they're being decorative, I think the staff truly does not have a clue how to cut an apple. Most of the time the core is still fully intact. Sometimes the pieces are huge, sometimes they are tiny, usually it's a combination of the two. Today I have some peanut butter to dip my apple in. I've also got a sandwich on some gluten free bread with chips on the side, but I'll probably save the chips for later to have with some of my medicine. My pain is much improved from the first night, but we have to stay on top of the pain meds or it gets out of control. It's tricky sorting out expectations here. The nurses bring some of my medicine on a schedule and some of it when I ask, but I have to know what to ask for and when to ask. It's a lot to try to keep track of when your brain feels squished and bruised.

1:00 PM. It’s Mother’s Day, and my oldest son, his girlfriend, and my daughter have come to visit. The ICU has a limit of two visitors at a time, so my husband goes out to visit with my daughter while my son and his girlfriend come in to see me. It's nice to hear about things that are happening outside of my little world and to see their sweet faces. After a bit, they trade off with my daughter and I get to hear about all of her adventures. I must be starting to nod off because she says it's time to go. I miss them all and I don't want it to end, but I can't keep my eyes open any longer. I doze off and take a nap.

The afternoon is punctuated by my neighbor's alarms and the nurse checking my vitals. My neighbor manages to pull out her IV at one point which causes quite the stir. I'm exhausted and nauseous and in pain, so I doze in and out.

3:00 PM. They like me to get up and move around as much as possible, but it is such an ordeal with all of the equipment! It's time for me to do a few laps so we start by disconnecting my feeds from the monitors. They are all wired to the same port which tucks neatly into a pocket of my gown. Next, off comes the blood pressure cuff for a nice little break. The nurse turns off the gravity drain for the EVD and then we start to move me out of the bed, trying to arrange the EVD tubes and IV tubes around me as I go. My husband lines up the walker in front of me and places the gait belt around my torso. Next come the lovely hospital socks with their rubber soles to keep me from slipping. I hate wearing them in bed, so I always have to put them on whenever I get out. He takes hold of both poles for the EVD and my IVs, and we’re off! It's pretty slow going, and he has to be careful to match my pace so that no tension is added to any of the tubing. We shuffle slowly out the door of my room and begin a slow circuit around the ICU. It is set up like a bicycle wheel with the monitoring stations and supply areas in the center and all of the patient rooms like spokes coming out from it. I try to make it around at least two or three times each walk. They would like me to do this three times a day, but it's such a hassle that I don't always make that. If it weren't for my husband being here I wouldn't get out nearly as much as I do. I don't know how the other patients manage. When I've done all I can, I collapse back into my bed and allow my husband and the nurse to hook me back up to all the monitors and turn my EVD back on.

5:00 PM. I can't believe it's time to eat again already! We order dinner and it comes in less than an hour. During my last hospital stay I fell in love with the pot roast. It was slathered in a rich, succulent gravy and served with roasted potatoes. Now that I'm on the gluten free menu, it turns out that the gravy is not available to me and the pot roast just isn't the same without it. I order the meat and vegetable special of the night, and my husband has the spinach salad. 

6:30 PM. My surgeon comes by this evening to check on me. He usually comes by in the morning, but depending on how his day goes it can be at a different time. Tonight he orders a special pain medicine for me. I was supposed to get it last night, but there was some confusion and the on call doctor didn't understand. We are hoping to start hearing back from some of the cultures taken during the surgery soon. I've been on broad spectrum antibiotics, but they would like to begin specializing it soon.

7:00 PM. Nursing shift change again. Tonight I only have one nurse, last night I had two. They seem to have a fair amount of turnover and are taking on a number of traveling nurses. Last night I had one regular nurse and one being familiarized with the floor. There is a whiteboard in my room where they keep track of the name of my nurse and what meds I am taking and what time I should take them. She updates all of this and continues on her rounds.

9:00 PM. I'm settling in for the night. Things are quieter, darker. I have fewer visitors. The nurses still come a couple of times an hour. Sometimes I just need to take some Tylenol, sometimes I need my blood pressure taken, sometimes I have to do a full neuro exam. I wonder when I'll be able to sleep again.

Here's the thing: Life in the ICU is otherworldly. You can't plan for it; you can't know what to expect. It's just going to be what it's going to be. Most ICU stays are very short, 48 hours or less. Ours was definitely the exception, but not a record by any means. Another patient was on the ICU floor even longer than us with even more complications. The one certainty we had in this situation was God's love and care for us. When everything else seemed unsure, we could be sure that He was with us and had our ultimate good in mind.

The Whole Story:

Part One - The Call That Changes Your Life
Part Two - When "Wait and See" Wouldn't Sound so Bad
Part Three - Reflecting on My (Almost) Presurgery Week
Part Four - Living in the unknown
Part Five - Taking Opportunities as They're Given
Part Six - The Big Event
Part Seven - How Many of you are There?
Part Eight - Beginning the Journey of Recovery
Part Nine - The Unimaginable
Part Ten - I guess that's better?
Part Eleven - A Day in the ICU
Part Twelve - Long Haul ICU
Part Thirteen - Hair Today, Gone Tomorrow
Part Fourteen - A Soft Discharge
Part Fifteen - The End of the Chapter