In March 2010 I came down with a nasty stomach bug whilst on holiday in France. By the time I got home a few days later I felt weak and feverish; my chest was aching. I spent 2 days in bed at home thinking I had a bad dose of man-flu. But my respiratory rate then started to climb and my wife took me to the John Radcliffe hospital in Oxford.
I was diagnosed with community acquired pneumonia in both lungs and put on antibiotics. I remember a consultant saying to me "you've got pneumonia, its a bit rubbish, and you're going to be here for a few days, and then you're going to need to take it easy for a few weeks". I remember thinking "I hope you're right, because I feel truly awful". Unfortunately he was wrong. It was about then that I first realised I was having to fight more and more with each passing hour to get oxygen into my lungs. Slow suffocation from the inside is very frightening.
That night I deteriorated on the ward and was moved to ICU first thing the next morning. I remember, as do many who have posted on the ICUSteps website, the passing ceiling lights as you're wheeled down the hospital corridors. I don't remember much after that, except trying to breath.
I fought for breath on a tight fitting mask for 4 days but then my CO2 levels started to rise, I was weakening and so I was sedated, intubated and put on a ventilator. I remained ventilated and sedated in an induced coma for 23 days whilst I and the Oxford ICU team fought my pneumonia. After 18 days I had chest surgery to drain effusions from around both my lungs and my heart. The infection and effusions at last abated and on day 24 I was extubated.
But I couldn't cope off the ventilator so I was intubated and sedated again and the following day I had a tracheostomy. I then spent a week being weaned off the ventilator.
From the moment I was extubated on day 24, I was completely delirious, and although its over 3 years since I left hospital, the nightmares are as clear as ever. They revolved around me fighting for breath, fighting to stay with my family, believing many of my friends and family had died due to a global pandemic, travelling to far flung corners of the world to try to get treatment and on several occasions believing that I had run out of options and so having to come to terms with death. I never stopped fighting, but sometimes it felt like check mate. And then I wouldn't die, and the dream would continue.
My wife kept a diary, and I can now reconcile the actual events in the ICU unit and therefore the stimuli around me, with my dreams. The stimuli included all the ventilator alarms, the other devices keeping you and the other patients around you alive, the conversations around the bed, the phones ringing, and all the blinking monitors and flashing lights.
I post-rationalise now (though there is no science behind this) that my nightmares were the result of my pickled brain trying to make sense of the ICU environment and stimuli and the circumstances I found myself in.
But the nightmares were so real that it needed to be explained to me over and over again in the week after I had come round that my friends and family were alive, that I was in Oxford not South Africa, and that millions of people around the world hadn't died. My wife gave me a radio to listen to, and it was probably the normality of listening to the BBC that convinced me that I had just been really ill. Nothing more, nothing less.
I quickly went from feeling very unlucky to have been critically ill, to very lucky to be alive. But I totally underestimated in my own mind quite how disabled I was. I couldn't walk, couldn't sit up, couldn't speak (until I was allowed a speaking valve in my tracheostomy). Trying to make sense of the world when you can't speak or write is hard - I had so many questions which I couldn't ask. I couldn't move my shoulders - they were totally frozen - and every time I was rolled in bed by the nurses my left leg delivered sharp shooting pains, due to some ossification in a muscle in my left hip, which I have since learnt happens to some people when the body undergoes extreme trauma. I remember sitting in a special chair next to my bed (which the nurses had lifted me into) and I couldn't handle it for more than an hour as the weight of my knees was too much for my wasted calf muscles to bear. I cried to be put back to bed. I was 34 but I felt 94.
None of us think we'll end up in a wheelchair or on a Zimmer frame learning to walk again - until it happens. And even then its very surreal. I couldn't get up off a floor for about 3 months after I came out of hospital. My core muscles were so destroyed that 4 months after coming home I slipped a disc in my lower back which ultimately required micro-discectomy surgery to fix a year later.
I have been very fortunate to have had a lot of help and support through my illness and recovery, and even with that, it was a really long slog. I now have a total appreciation for what people in permanent pain have to endure. I have since made a full recovery, but for some scars and a loss of some flexibility. I have been very lucky.
I now value my health and physical independence so much. I count myself so lucky to be able to swim and run (rather slowly!), to pick up my kids, to live life independently. For many people who survive ICU, I imagine things are a lot tougher. And I know that when the chips are down, all that matters are those you love and being with them.
To those of you reading this who are fresh out of ICU, or whose loved ones are going through it right now, I wish you all the best. Be determined and with luck and patience, you'll get through it. Ask for help and support from those who have been through it too - don't try to deal with it on your own.
Finally, I am full of gratitude every day to all the medical staff at the John Radcliffe and Churchill hospitals in Oxford who saved my life and cared for me so wonderfully. Thank you.