The following time after a stay at The Intensive Care Ward

During your stay at The Intensive Care Ward, your circardian rhythm might have been different than usual. Many have trouble falling asleep and resting because of the interference from their surroundings, such as light, anxiety, nightmares or pain (see also "psychological reactions"). Your sleep can also be affected when you come home. You can experience trouble falling asleep or waking up several times during the night.

If you have trouble sleeping, a drink of cold milk before bedtime might help. You can try reading or listening to relaxing music. Some people also benefit from relaxation exercises or back massages. Avoid tea, coffee and alcohol in great amounts since these drinks can affect your sleep.

Your sleep will most likely become better as you become more physically active during daytime. If your sleeping problems are continuous, you can contact your general practitioner.

After your stay at The Intensive Care Ward you will probably feel more tired and weaker than normal. The muscles in your body have lost their strength during hospitalisation. The longer you are hospitalised the more time you need to recover. You will slowly be able to do more but it can take months of training to regain your muscular strength.

You have most likely received food through a stomach tube (a plastic tube which goes through your nose into your stomach) during your stay at The Intensive Care Ward. If you have been put on a respirator during your stay, your throat might be sore afterwards. Maybe your swallow function is affected. This is called incorrect swallowing. During hospitalisation an ergotherapist will provide you with exercises that will strengthen your swallow function and guide you in relation to changing your diets consistency for a time periode.

Treatment with several different types of medications can entail that food will taste differently than before your hospitalisation. Food might taste like metal or extra salty or sweet. This is normal and will ease off.

General muscular weakness can also entail loss of appetite. If you have reduced appetite it might help to eat several small meals during the day to get enough nutrition.

If you have white coating on your tongue and pains when swallowing, it might be a fungal infection caused by the treatment with antibiotics. Contact your general practitioner for treatment.

It is important that you eat and drink to regain your strength. Fatty foods provide most energy. That is why it is important that the food you eat contains a lot of fat, when your appetite is reduced. Fat is mainly found in butter, mayonnaise, cream, full-cream milk, fat cheeses, fat meats, fat fish and desserts.

Protein is the body's "building material". When you are sick the proteins in your muscles and tissue are broken down to a greater extent than normally. Protein from food is used to avoid that too much protein will be broken down in your body. Protein is found in meat, fish, poultry, eggs, cheese and dairy products. You can buy specially made drinks with extra protein and vitamins at the pharmacy. Your general practitioner can make out a prescription for supplementary nutrition.

Make sure to avoid dehydration by drinking plenty of liquids during the day.

In relation to your illness you may have been on a respirator to help you breathe. The respirator helps the lungs through a plastic tube, which is put down your windpipe or through a small hole on the front of your throat. The plastic tube is connected to the respirator and helps getting air into your lungs. Both methods can entail pain in your throat and hoarseness after it is removed.

The respirator-treatment and maybe also your illness may entail that you become short of breath easily. A physiotherapist will provide exercises that will strengthen your lung function while you are hospitalsed. To sit in a chair and do the exercises will improve your lung function.

You can continue your exercises at home with a "PEP-whistle", which will strengthen your lung function.

If you still experience issues with your windpipe when you get home, you can contact your general practitioner.

The respirator treatment can make your voice hoarse. You can also be very dry in your mouth and your saliva production might be reduced. It can be uncomfortable and it may be difficult to speak and swallow. It helps to drink plenty of liquids.

Pains in your body can be caused by wound pains after a surgical operation. It might also be general pains because of prolonged bed rest or nerve pains after an infection in your body. It is important that you tell your general practitioner about the pains you are experiencing so you can be given the right treatment.

In relation to your hospitalisation, you may have had a tube through your urethra up in your bladder (a catheter). When the catheter is removed you might have trouble controlling your bladder function. The bladder function will often return to normal by itself. The urine may have changed in colour because of the medication you have been taking during hospitalisation. This will also return to normal.

Issues with urination can also be caused by inflammation of the bladder. If you have blood in your urine, feel burning or stinging pains when you urinate or you have difficulty urinating, you can contact your general practitioner.

Your gastrointestinal system can be affected by for example medication and bed rest. These factors can have an impact on your digestion in the form of diarrhoea or constipation. Contact your general practitioner if you have symptoms that worry you, for example if you cannot regain your normal weight or your bowel movements are not normalised in time.

Illness and treatment can cause your skin to become dry and itchy. It can help to apply a rich cream. There may be scars caused by various tubes. The scars will become less visible in time. You may experience hair loss but your hair will grow back again. Though, it might have a different texture than usual.

Your hearing, sight, sense of smell, sense of touch and sense of taste might be affected. Your hearing can be affected by different types of medication. Your sight and your ability to focus can be affected by your mental condition. Things that touch your skin may feel different than usual and you may feel prickling sensation in parts of your body.

A reduced desire for sex after hospitalisation can be caused by physical factors, for example general tiredness, pain or air hunger. Psychological factors like anxiety about illness or the consequences thereof and changed looks can affect your desire for sex. It might be helpful to talk about the reasons.

As a woman you may experience that your menstrual period is absent for a time period because of weight loss or your illness.

After long-term hospitalisation with critical illness it is normal to experience psychological reactions. The reactions are connected to your illness, your stay at The Intensive Care Ward, changed body image, and the medical treatment you have received.

You might experience mood swings. Maybe you become easily irritated or sad, maybe you are worried about how long the rehabilitation therapy will take, or the thought of getting sick again.

You can also experience psychological reactions in the form of

• anxiety
• hallucinations
• delusional behaviour
• nightmares
• memory loss
• concentration problems
• depression

It is important that you talk to your relatives and/or a healthcare personnel if you experience psychological reactions, which impact your everyday life and rehabilitation therapy.

It may feel stressful to recover after hospitalisation. Stress through a prolonged time period is inconvenient, so it is important that you talk to your general practitioner about how you can get help.

You will most likely experience different emotions and thoughts about leaving the hospital, which is completely normal. You will not have the same support as you did in the hospital and it can be a difficult time for you and your relatives. You have to start rehabilitation therapy and may experience that it can be a difficult process. The activities that you used to be able to do before your illness might take extra time and energy now. For some people it can take up to 1,5 years to recover from a critical illness and prolonged hospitalisation at The Intensive Care Ward. It is a radical change to go home, so give yourself time and space to return to your normal everyday life. Do not hesitate to ask for help and talk to your relatives about how you are feeling and why you react the way you do.

Even though you are discharged from the hospital and are going through rehabilitation therapy, it does not necessarily mean that you are ready to resume your normal everyday life with work, free time interests and social contact. If you worked before your illness it may be necessary to reduce your workload for a time period. Talk to your boss and your co-workers about your current situation and arrange with them how you can start working again. You can also talk to a social worker in your municipality.

When you have been discharged from the hospital your general practitioner will continue your treatment. Your general practitioner can explain your progress of illness and, if needed, refer you to a psychologist, dietician, ergotherapist or physiotherapist.

You are welcome to contact The Intensive Care Ward if you have questions in relation to your treatment and nursing during your hospitalisation. You are always welcome to visit The Intensive Care Ward.

Link to an information leaflet from ICU (du kan få printet dette bilag i afdelingen).