Friday, 6 July 2012

What it feels like to be intubated

I had my operation on the 13th May and it all went well. It took me hours to come around from the anaesthetic but apart from that it was ok. One thing that was a little distressing was being conscious when they took the breathing tube out. It was a LMA (laryngeal mask airway) rather than an ET tube (endotrachial tube). ET tubes enter the windpipe whereas LMAs don't. Even so it wasn't a nice experience and out of the four operations I've had this was the first time I remembered them taking the tube out. I was only meant to be in hospital overnight but due to a minor complication I had to stay in a little longer. The problem was retention which is known post anaesthesia but uncommon in females apparently. Let's put it this way I will have a greater respect for any of my patients that have or require a catheter. Apart from the embarrassment of having it inserted you have to think about every movement because believe me you do not want to tug on one of those! How people pull them out with the balloon inflated is beyond me. Two days after my operation was when it really kicked off. I only know what I've been told of the Friday and what happened after I regained consciousness. At 07:30 I was found with a GCS of 3. For anyone unfamiliar that is completely unresponsive to anything. Normal functioning people have a GCS of 15. The doctors did sternal rubs which are incredibly painful and for days after I had a bruised chest. Nothing. The patient opposite said it was quite scary seeing me in this situation. The doctors didn't know what was going on and were escalating it up the ranks. Eventually I was taken to HDU (high dependency unit) where the decision was made to intubate me (put me on a ventilator). I was transferred via ambulance to A&E resus at another hospital, had a CT scan of my head to make sure there was no bleed and taken to intensive care. It freaks me out that all this happened and I have absolutely no recollection of any of this. My first memory was hearing voices and the feeling that something was in my mouth. One of the first thing I remember hearing was 'Are we going to have to cut her pyjamas off?'. I can't really remember seeing anything until I was extubated (tube taken out) and on oxygen. I vaguely remember my friends being there but not much else. I obviously started to get agitated as the staff kept telling me I was ok and that I was in ICU. As I became more aware I felt a need to breathe but I couldn't. At regular intervals my chest filled with a pressure which felt so awful. I realised I was intubated and on a ventilator. The pressure I was feeling in my chest was my lungs filling with oxygen. The more awake I became the more agitated I got and I remember bringing my left arm up towards my face but was repeatedly knocked back down by the nurses. Even though the ventilator was breathing for me I felt like I was suffocating because my natural breathing reflex was again present but there was a tube blocking my airway preventing me from taking my own breaths. If I thought that was hideous it was nothing compared to what came next, suctioning. The nurse passed the suction catheter down the ET tube and as soon as it touched my windpipe it triggered a coughing/gagging reflex. Of course I couldn't cough and the feeling was horrendous. In between the awful feeling of the suctioning there would be the pressure of oxygen being forced into my lungs. Being so out of control was almost unbearable and created a sense of panic. Not only had I woken up in a completely different ward in a completely different hospital, I had woken up intubated. Despite the reassurances of the staff telling me it was alright it really didn't feel like it. When the moment came for them to extubate it felt like such a relief. It was terrible feeling the ET tube being pulled from my windpipe, it felt like it would never stop. Then more suctioning but this time with a Yankeur and a great deal of coughing. To take breaths myself and be back in control was, well, I can't describe it. I just can't describe how it felt to have my lungs fill but to not be breathing. I couldn't work out what the intense pressure was to begin with. It was almost like the sensation you get when you wretch before vomiting. An involuntary reflex, which it was essentially, but it wasn't my stomach contracting. A short sharp burst of pressure rather than a natural slow inhalation. Of course I couldn't speak after the trauma of being intubated. It took days for my voice to return to normal. I am incredibly grateful for everything that was done to help me but it truly was one of the most distressing experiences of my life. I woke up with an arterial line and four large bore cannulas attached to various things. I still have the marks from where they were inserted three weeks on. They must have dug around a lot to find the artery in my wrist because it took nearly two weeks for the pain to subside. Fortunately it was only a short stay in ICU and I was transferred back to the hospital I came from to the relief of the patient opposite me. She was just glad to see I was ok. I'm used to emergency situations (dealing with them as opposed to being the cause of them) so I couldn't really appreciate how terrifying it must be for other patients witnessing something like that. I total I was in hospital for 10 days and I must say the majority of the time I was treated very well. I had my stroppy moments but I think it was frustration. It was difficult trying to remain a patient and not to put my nurses hat on and occasionally I would turn nurse but I think it's unavoidable when you are in this situation. One thing I am sure of is that this will make me a better nurse. I have experienced things that nurses don't normally experience. I've felt things that nurse don't normally experience. Nobody knows the reason for my what was essentially a coma. I have my theory but it will remain just one of those things.

1 comment:

  1. Thank you for posting this. Although unpleasant, I recently had made the decision to have my father intubated. Some part of me regrets this because his outlook is not good. Knowing what he is going through is oddly comforting and terrible at the same time. I would rather know!

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