Back on Sept 20th of 2010, I was admitted to the hospital for a severe asthma exacerbation(so what else is new). About 8 hours into the exacerbation, my breathing took a turn for the worse and a decision was made to intubate me and put me on a ventilator. No big deal, Ive been intubated many times. They knock you out, stick a breathing down your throat, put you on a ventilator and usually by the time you wake up you’re breathing a little better. That’s what’s supposed to happen, but that’s NOT what happened this time.
For some reason when they knocked me out, I didn’t fall asleep. That’s right, I was awake during the entire intubation and subsequent placement on the ventilator. I felt and heard everything !
How is that possible you say?
Normally when they intubate a bad asthmatic, they use a combination of drugs, one to sedate you so that you fall into a deep sleep and another one that temporarily paralyzes all the muscles in your body to make it easier for them to insert the breathing tube and ventilate your lungs. Well for some reason, the “sedation” part of this intubation drug cocktail didn’t get into my bloodstream, so I never fell asleep. I was paralyzed, but fully AWAKE…..and no one knew it, except me. I was trapped in my body and couldn’t move a muscle to alert anyone.
Words cannot describe what it’s like to be completely paralyzed while having a plastic tube shoved down your wind pipe during the middle of a severe asthma attack… and not be able to react to it! To say it was a living hell, doesn’t do it justice. It was like being buried alive with a thousand pounds of dirt on top of you. I have a huge tolerance for respiratory discomfort, but the feeling of suffocation I felt at that moment was indescribable. You feel like you’re drowning, but can’t move a muscle to save your life. The sense of helplessness and terror you experience is overwhelming, and made a thousand times worse, because you know there are people just inches away from people who could help, but who don’t know there’s even a problem.
I tried non-stop with all my might to move my fingers and toes in an attempt to catch someones attention, but to no avail. I could hear and feel everything that was happening to me. I could even see the shadows of people moving around me through my closed eyelids. What seemed like an eternity turned out to be only 22 minutes, but it was the most terrifying and agonizing 22 minutes of my life. There were moments that I pleaded with god to please let me die, so that I could escape the torture. I just wanted my brain to shut off.
And if the horrible feeling of suffocation wasn’t bad enough, there were also the episodes of excruciating pain to deal with. You see it’s standard practice in most ICUs that when a person is intubated and placed on a ventilator, that they also get a Foley catheter ( urinary catheter) inserted into their bladder. Again, normally not a big deal, but for some reason the guy who was trying to put the catheter in me kept encountering resistance or a blockage of some kind. I could hear him talking to another nurse telling her that he was having a hard time getting the catheter in. So to overcome the obstruction he starts FORCING it in! He keeps pushing it harder and harder until it finally passes through whatever obstruction was there. It felt like someone was shoving an an icepick up my urethra.
Simultaneously , I could feel the all too familiar probing of an arterial line needle inside my wrist, as they were apparently trying to insert a second arterial line. They must have inadvertently hit my radial nerve, because all of a sudden it felt like a jolt of electricity split my chest wide open. The pain was so intense I thought I was going to have a heart attack.
A few moments later I could hear panic in the voices of the people around people. The alarms on the cardiac monitor were going off and I could feel people brushing against me. and saying things like.. “Something’s wrong!”….”He’s Crashing!”…..” I don’t think he’s Sedated enough!”. Hearing those words I thought to myself, wow..maybe they finally figured that Im awake in here. For a few brief moments I thought this nightmare was coming to an end. I could even sense that I was regaining a little bit of muscle use, because I was able to wiggle my baby toe. I could then hear one of the doctors say…”He needs more sedation!” I thought to myself, they’re finally gonna put me out of my misery. I’ll be going to sleep shortly. ( I found out later that my systolic blood pressure was close to 300)
So then I can feel them injecting some medication into my foot IV, but as they’re pushing the drug into the IV port , I start to feel a burning sensation around the vein. Sure enough, the vein had blown and the medication that was supposed to be going into my vein was going into the surrounding tissue. I’m thinking …Oh my god, they think the medication is going into my bloodstream, but it’s not. They think they are sedating me , but they’re not. I was in so much despair at that point that I was actually crying and screaming with laughter inside my head. Is this some kind of a cruel joke? How could God let anyone be tortured like this. Will this horrible nightmare ever end? I kept thinking that if I actually did die, no one will ever know the hell I went through in the minutes before.
Then mercifully and almost miraculous , I started to feel the paralytic drug loose its effect and I was actually able to wiggle my toes and fingers a little, which caught a nurses attention. I could here the shock in her voice…”He’s awake!” said. A few seconds later I lost consciousness.
My next memory is of waking up periodically , still intubated and still on the ventilator and trying to alert someone of what had happened earlier. I had been asleep for about 12 hours since the event. The paralytic drug had long sense worn off and I was able to move all of my extremities again, but I still had the breathing tube in, so I couldn’t speak. They knew I was anxious about something because I kept setting off the ventilator alarms and motioning with my hands. Eventually one of the Nurses gave me a pen and paper to communicate with. Well, either they couldn’t read my writing or they thought I was just agitated from being on the ventilator, but for whatever reason I couldn’t get them to understand what I was trying to say. Frustrated, anxious and fearing that they would paralyze me again, I started to pull on my breathing tube, threatening to pull it all the way out. They decided that it would be safer just to extubate me. An hour later, they did just that.
Needless to say I was pretty stressed out. I was still very short of breath from the asthma and the memory of being tortured and buried alive was making my breathing worse. I had my cell phone with me an I was frantically calling and texting everyone I could think of. I just wanted someone to listen to me. I pleaded with everyone who entered my room, to please hear me out….I WAS AWAKE!! I kept saying it over and over again.
One of the Nurses who was actually on duty the night I was intubated told me, she thought something was wrong, because my vital signs were going crazy. She also told me that they had a difficult time getting IVs into me and the Foley catheter. I said, I know..I know… I WAS THERE!! She along with others , including a supervising nurse, admitted to me that “mistakes” had been made. ( Documents that I later received, proved these people correct).
Anyway, later that day still angry and not satisfied that none of the doctors would talk to me about what had happened, I began threatening to yank out all of my IV’s, walk out of the hospital against medical advise and sue them for malpractice. Finally ,one of the doctors who was present during my intubation agreed to talk to me about it. Rather than offer any apologies or sympathies for the hell Id been through, she basically blamed the whole situation on the fact that they couldn’t give me the drug they wanted to (propofol,) because they had read in my chart that I was allergic to it. She explained that they had to use less effective sedation drugs like Presidex and Versed and that I probably just dreamt the whole thing. Of course her statements made me even more furious. I’m not stupid, I told her. I was awake and was even able to recite statements that I heard her say while I was supposedly asleep. Still she insisted it was just a bad dream.
Two days later I was transferred out of the ICU in to the step down unit. Angry, stressed out of my mind, and still reliving the nightmare, they sent a couple psychologists in to evaluate me. They determined that I was suffering from PTDS as a result of the incident and recommended that I seek continued counseling after leaving the hospital. Finally on the morning of my discharge, the hospital administrator and the head of Anesthesiology finally came to my room and offered their apologies. They’re exact words were ” We’re sorry this happened to you”. “This sort of thing is extremely rare, but it does happen”..We’re so sorry”.
It was now the weekend and I was finally home and away from that hell hole, but all the emotional stress of the last few days had caused my asthma to re-flare to the point where I need to be re-hospitalized. Afraid to go back to the same hospital for fear of being intubated again, I went to a different hospital and told them that if I got really bad or if I stopped breathing, that I did not want to be intubated or receive any form of CPR. Fortunately, they got my breathing back under control fairly quickly and after just one day in the ICU and 2 days in the medical ward, I was well enough to go home…again. Before leaving the hospital, I told the doctors what had happened to me at the other hospital. They were very sympathetic, but were also worried that my decision to make myself a DNR ( do not resuscitate) was made based on what had happened to me at the other hospital. They let me know that as tragic and unfortunate as it was, it was just a fluke, a mistake, and not worth making myself a DNR over. I knew they were right and knew I had to seek counseling.
The next couple of weeks were very difficult for me, both mentally and physically. Not only was I suffering from a very severe depression, but my body was still recovering from the asthma itself. I was reliving the nightmare at least 20 times a day, which of course was making my asthma recovery even more difficult. I was starting to withdrawal from people and the activities that I normally like to do. It was like I was in a constant state of road rage. The slightest thing seemed to piss me off.
Finally I got up the courage to seek outside counseling and contacted the psychologist that the inpatient shrinks had recommended. The first few sessions with her were difficult because her office was located only 50 yards from the ICU where the incident occurred. Talking about the incident was even harder, because that meant I had to re-live it again. As the weeks and months went by however, it became easier to talk about it and my PTSD symptoms got easier to live with. She had given me tools to help diffuse the “bomb”, if you will, that would go off on my brain anytime a memory of the event was triggered.
Shortly after I began seeing the shrink, I filed a complaint with hospital itself and also with the State. As expected the hospital’s Patient Relations department investigation findings, showed no wrong doing on the hospitals part. Nevertheless, and knowing that I was severely and psychologically harmed by this event, I contacted a medical malpractice attorney who agreed to take my case.
It took almost 6 months of therapy and a bunch of other distractions in my life ( like my methadone withdrawals adventure and training for the Boston marathon), but finally I was at a point where felt like I wasn’t loosing my mind anymore. The thought of ever having to be intubated again for my asthma no longer seem like a death sentence.
I guess I should thank my lucky stars that I was wasn’t having abdominal surgery or something , as I’m sure the outcome would have been much worse. But what I went though still haunts me and despite all the therapy Ive been through, not a single day goes by that I don’t re-live at least small parts of the event. The difference now is that I know when my brain is messing with me and Im better able quash the bad memories before they suck me all the way in.
You have to remember..I’m an RT. Ive worked in and around ICUs for decades. I know what goes on in them. I know that mistakes are sometimes made and sometimes even covered up. All these people had to do was man up. All they had to do was acknowledge that they screwed up, or that a mistake was made and then apologize. Instead, they blamed it on me because of a supposed allergy to Propofol, OR that I just thought that I was awake. I was just as awake then, as I am now. Anesthesia doesn’t always work the way it’s supposed to.
In closing Id just like to say to those reading this who have asthma themselves; hopefully you’ll never be in a situation where your asthma gets so bad that you need to be intubated in the first place. But if you do, don’t let my story freak you out. Though there are always risks involved with any type anesthesia or intubation, the odds of going through what I went through are extremely rare and the benefits will almost always outweigh the risks. Intubation can often mean the difference between life and death for a severe asthmatic. Most people who are at the point of needing an emergent intubation are usually too out of it to realize what’s going on anyway.
Post script…..To show how far Ive come in just 9 months. On May 25th of this year, during yet another severe asthma exacerbation, I faced my fears and went back to the very same hospital for treatment. I ended up in the same ICU and had to be intubated AGAIN. I made it clear to all the doctors taking care of me that I was scared to death because of what had happened to me the last time. This time, everything went smoothly, they put me into a deep sleep and didn’t feel a thing. I didn’t even have a sore throat afterwards, which I usually do.