Resuming daily life after being in intensive care

Lots of people worry about coming home from hospital or returning to work after a critical illness. It’s normal to wonder whether you’ll be able to cope.

Talk about it with your family and think about how you can adapt things at home to help you. Recovery takes time and you won’t be able to do everything you used to straight away. Ask friends and family for help if you need it until you’re strong enough to do things yourself.

If you used to work, you may not be well enough to return full-time straight away. When you’re feeling better, it’s a good idea to arrange to go back and see your colleagues and talk to your boss. Depending on your job, you may be able to do a few hours a day at first.

If you have young children you may feel under even greater pressure to get back to normal. Do the important things first – other jobs can wait. Take a nap at the same time as the children and don’t be afraid to ask your friends and family for help.

While you were in intensive care you will have received your food as a liquid. You may have been fed through a nasogastric tube (inserted into your nose and down into your stomach), or by a drip straight into your vein. Your body will have used its stored fat and muscle for energy to help fight your illness.

When you are well enough to have solid food again, you may have difficulty eating because:

• you don’t feel hungry
• your mouth is too sore to eat
• food tastes different
• it hurts to swallow.

Start off with small portions and eat more often throughout the day. Instead of full meals, have small meals and two or three snacks each day. You can buy specially prepared milk drinks and desserts, like the ones you were given in hospital, that contain lots of vitamins and minerals.

Take your time when eating and relax afterwards to avoid indigestion. If some foods taste very salty or sweet, it is likely that your taste buds are taking time to get back to normal. This is common and will improve, but don’t add extra salt or sugar to your food in the meantime.

If you enjoy drinking alcohol, check with your doctor that it is safe to drink it with the medication you are taking and that it will not have a bad effect on your condition. Even if it is safe, don’t drink too much.

Sometimes, taking strong antibiotics and steroids can lead to infections. Oral candida (thrush in your mouth) which can give you a thick white substance on the roof of your mouth and tongue, making it painful to swallow. If you think you might have thrush, your GP will be able to treat it easily.

If you need more support or have symptoms that you’re worried about, you should see your GP.

Be sure to drink enough during your recovery as dehydration can:

• dry out your skin
• make you produce less urine, which can have a bad effect on your kidneys
• make you feel very weak and tired.

To avoid dehydration drink regularly during the day. You can have hot drinks as well as water and squash.

You need regular sleep to keep your body healthy. It can take time to get back into a normal sleep routine. You may find it harder to fall asleep, or you may often wake during the night. Try a milky bedtime drink but avoid tea and coffee as the caffeine can keep you awake.

Reading or listening to the radio before you go to sleep may also help. Your GP can give you advice if you have trouble sleeping, but things should return to normal as you become stronger and more active.

After you’ve been critically ill, you and the people around you may seem to change. Your family may make a fuss and might not understand why you seem different, or why you aren’t keen on the hobbies and interests you used to enjoy.

Your family and friends were afraid you might die, so they may want to do everything for you when you get home. If this annoys you, talk to them calmly about how you feel. Don’t bottle things up and get angry.

You may not remember your time in hospital clearly, and this can be confusing and frightening. It may help to talk to your family about what they remember about your stay in hospital, how they felt when you were ill and the things that happened while you were there. If your relative kept a diary while you were in the intensive care unit (ICU), it can be helpful to look at this with them.

It‘s normal to be worried about when it’s safe to start having sex again. Your partner is likely to be worried about this too. You may be concerned about the following:

• if your scars are healed enough
• if medical devices such as a colostomy bag, catheter or pacemaker, will get in the way
• if you will experience any discomfort or pain
• if you have the necessary strength
• that your partner may not want to have sex
• that you may be unable to continue or orgasm.

Most people find it difficult to talk about sex but try to relax and keep a sense of humour. Cuddles are really important. Take things slowly and see what happens.

If you’re worried about your strength, compare the energy needed for sex with the energy you need for your exercises. If you’re coping well with your exercises, you may be able to cope with sex.

Sometimes, medical problems such as impotence (being unable to get and keep an erection) can affect your sex life. If you’re worried, talk to your GP.

When you’ve been seriously ill, you may feel differently about things and you may not want to do things you used to enjoy. For example, you may not feel like seeing lots of people at once, so start by seeing one or two friends at a time for short periods.

You may find it difficult to concentrate or hard to follow a TV program, but your concentration will improve. During your recovery you may be forgetful, but your memory will usually improve as you get better.

Your recovery may take a long time and, as you get better and begin to do more, you may find that things get on top of you. During this time you may lack confidence, worry about your recovery, or even feel depressed. Talking about this to your family or a close friend can help.