Thread by @WesElyMD

1/🧵What do ICU survivors tell me about PICS…(post intensive care syndrome)⁉️

Former ICU patient: “I’m angry. I’m furious because the doctors who injured me aren’t willing to help me recover.”

Is this fair?

I think so.

Why?

Read on…(perm to share)

2/ I just got off the phone w a patient who has had PICS for 12 years since nearly dying in the ICU. His story is included in #EDDB…he granted permission to share some thoughts today that I think are eye opening…in terms of how poorly we’re doing w Chronic Disease management

3/ people who never had PTSD before critical illness, leave with inexplicable experiences of road rage, rejecting their spouse, acting in ways that are so foreign to them that they don’t recognize themselves.

They also have tremendous problems with lack of self worth because…

4/ Society doesn’t have appropriate support for PICS pts to deal with their mental health, cognitive dysfunction, and physical disabilities.

PICS patients feel like they’re left behind by growing public health efforts to help other chronic illnesses like #LongCOVID.

5/ This patient told me that the absence of funding lines to help him get a psychologist makes him feel worthless.

He got cognitive testing and his IQ was rated at 110 which they viewed as normal.

Problem is his previous IQ was 135. We have many patients who dropped 2 to 3 SDs.

6/ Why I believe it is fair for him to be mad at doctors is that we definitely cause iatrogenic harm to patients like Sarah Beth (pic w perm) in the ICU by overuse of sedation & mobilization, absence of family, and general lack of adherence to proven #A2Fbundle safety steps.

7/fin
The answers for pts w PICS are many including:
📍me turning off sedation daily & mobilizing patients as (their lives depend on it)
📍setting up post ICU clinics
📍using cognitive & physical rehab when appropriate.
📍validating their suffering
📍personalized care