Opioids, Isolation and Tears- Life in ICU

The 6 days I spent in ICU after the transplant operation were unsurprisingly the toughest. I batted away my body's cries of "What the hell has just happened?" with regular dispatches from the fentanyl opioid trigger in my right hand. Even at my most awake I was still drowsy and my speech was weak and slurred. Gradually I become aware of all the new "wires" going in and out of me- 3 cannulas in my arm, a drain on each side of my stomach, a catheter, oxygen into the nose (not really very intrusive) and at least 2 lines going into my neck. I don't remember it happening but the breathing tube I had in during the surgery was removed quickly once I was awake. A post-op PCR test returned a positive result (probably still related to when I had covid a month before the operation) and meant that, after my first day or so in ICU, the team decided Bex couldn't visit me anymore. 

So much happened during this time- some of which I was aware of and some I only began to piece together or learn about weeks later talking to Bex. In an ideal world, the stay in ICU is 2-3 days but mine lasted 6. Others have much longer and face bigger challenges than me but there were some initial challenges as my body rebooted. Initially my kidneys were super slow to kick into action but after a few days of real concern things improved, with me narrowly avoiding the need for dialysis. I needed a couple of units of blood transfusions as my haemogobin level dropped and there were questions about whether there might be a bleed somewhere internally. A period of "will he/won't he ever wee or poo again" was brought to an end via a two pronged laxative attack.

On some wards, where they wanted to alert passing medical folks to my Covid risk, they put a sign on the door handle explaining I had had covid. In ICU a maintenance team arrived and screwed a huge piece of perspex across the door to my room. To be clear, this sheet was as high or higher and a good amount wider than the door itself and was clearly intended for (and very successful at) stopping any use of said door (a separate smaller door allowed nurses and co in and out). This perpsex sheet did provide a nice Laurel and Hardy moment as my nurse and a porter, having successfully detached me from all monitors and drug administration machines, tried to wheel my bed out to go for a CT scan and were thwarted by the impassable door. Maintenace came and removed, and then later reattached, the sheet allowing me to go for the scan. Ah, jokes...

I guess the fact that one of my highlights of ICU was people failing to get a bed through a door, is a good indicator of how little fun it was. At times I lost track of whether it was morning or evening as I slept so much but without any regularity. For seemingly long periods I was left alone in my room while my nurse was taking breaks- this is clearly not unreasonable but it made for a good deal of loneliness. My bed faced in to the corridor of the ward and there was a window behind me. I remember thinking that there must indeed be a window behind me, but I don't remember seeing it the whole time I was in ICU. Like the unseen window, I knew there was a bright and better future out there for me but I couldn't see it yet and right now everything felt dark and difficult.

I felt so rough but was absolutely determined to do everything asked of me. Yes, I can sit in the chair. Yes, I can walk across the room. Yes, I can eat a yoghurt. Bex and the kids and getting back to them was 100% my motivation and I was going to give everything I had to get back to them. I had no idea where in the hospital it was now, but I knew that somewhere my hospital bag still had in it the letters I'd written Bex and the kids in case the worst happened. Obviously the worst hadn't happened and I was desperate to get home to them. In 2019, because I was so ill, my sister-in-law's husband had taken part in the dads race at my kids' school sports day. As a result of covid, this year was the first school sports day since then and a good friend went to support our kids and ran in the dads' race while I lay in bed in ICU. I wanted to be dad again*.

For all that I faced in ICU, Bex had it harder. Aside from the emotions she was going through, there was trying to get clear information from the nurses while my care and plans were handled by 3 different teams and then passing this information on to family desperate to know what is going on. There was arranging to come and visit me and sorting the childcare needed to allow this to happen. There was dealing with calls from a semi-coherent husband wondering what everything meant. There was helping our kids handle the emotion of their dad having had a major operation and them being unable to see him. There was the end of school year including various events for our eldest who was finishing primary school. There was dealing with the builders as they came to the end of the 6 month project on our house. And then there was all the normal everyday things you have to do to keep the house running and the children fed. She may not have the big L on her tummy from the surgeon's scalpel but she has scars too from this exhausting journey. Bex is phenomenal and has shown her immense strength as she has carried so much for so many months/years.

ICU was physically and emotionally hard. My body was so weak and beaten and I had to really push myself to start taking the first steps towards recovery. The sadness and loneliness I felt was still eclipsed by the joy I had to be alive and the immense gratitude I had for my donor. One of the ICU nurses said to Bex that it was so good to be looking after liver transplant patients again. During covid, liver transplants were suspended and this nurse said that they lost so many patients who couldn't get their life saving operation during this time. I will never forget how privileged I am and what a great gift of life this is that I have been given. And I will never forget those who didn't make it this far. And I will never forget my donor and their family whose generosity in the midst of their grief gave me a future.

"Rejoice with those who rejoice; mourn with those who mourn" The Bible, Romans chapter 12 verse 15

* For the record both my sister-in-law's husband and my friend tripped and fell in the dads' races and I fully intend to show them how it's actually done in 2023!