New Lease on Life

I remember this friendly older woman I met once on the regular medical floor. She had various respiratory ailments like COPD that unfortunately progressed into respiratory failure. She coded like three times during her stay with us, including twice in the ICU, which is never good. If you have multiple full arrests in the ICU, they're probably already throwing everything at you that they can: mechanical ventilation, cardiac meds, etc. And multiple codes usually starve your brain of oxygen despite all the effort. Eventually she had to have a tracheostomy and feeding tube (trached and pegged, as we say) and was sent to a long-term acute care hospital. I didn't know what her awareness level was, but I thought she was pretty much gone. I was really surprised she survived to discharge.

There's a system in place to try to rehabilitate people like her; facilities for people who need lots of rehabilitation—not just physical therapy but mental/cognitive rebuilding, respiratory therapy, occupational therapy to return to daily life. But because I work in ICU, where these kinds of patients are sent out as soon as they're stable enough to go, I don't know much about this kind of rehab. I expected that she would spend the remainder of her days in a nursing home bed, possibly never recovering consciousness.

She came back to the hospital like a year later for a relatively minor case of pneumonia, and I couldn't believe my eyes. She was back to her normal self, sitting in the chair reading a magazine! She never got to close her tracheostomy, so she had to put a valve on in order to speak. But speak she could, and she seemed to have no cognitive deficit, no brain impairment. I was staggered. I mean, you could say she's not back to "normal"...she's been in and out of hospitals for a year, which irritates her, and she's got a trach, but heck. I'd take that if I were in her shoes.

I guess I'm pretty gullible. Critical care nurses and physicians can be pretty cynical about people who've suffered severe medical catastrophes that have the potential to destroy your brain. I don't mean cynical about their care (they're usually extremely good at their care), but about the long-term rehabilitation efforts I mentioned above. And when they talk like that, I believe them. But I guess rehab really can work.


EDIT: I left this open on my computer in draft mode! Apparently one of my sons found it and managed to publish it, but not before giving it the title "Q1**1*1q*!*!*!**!*!1111". :-) Sorry if you saw that!