The ICU: Going to Hell and Back

“Ariella?  Do you know where you are?”  — Ichilov, I responded.  “Open your eyes, Ariella.  Where in Ichilov?”  I had no voice from being intibated.  So, I squealed in a raspy voice –Recovery…  “ICU.  Right.”

–I’m going to throw…   Vomit.  The nurse quickly raised the bed to a sitting position so I didn’t asphyxiate on my own vomit.  She removed the oxygen from my nose, to allow the vomit to escape through the nasal passage.  And, then she cleaned and changed me.

“Raise your hands and close your eyes, Ariella,” says the doctor.  “Keep them up.”    “Okay, now, hold your hands out, close your eyes and touch your nose with your index finger.”  I miss my nose.  “It’s okay.  Just practice.”  Holy crap.  I have the brain capacity of a drunk person.

Touching my face with his finger on each side, he asks, “does this feel the same?”  Everything feels the same until he touches the right side of my forehead.  “No,” I answered with a worried look on my face.  I couldn’t feel my right eye or the right side of my forehead.  “It’s okay.  It’ll come back.”  Phew.

“Ariella, move your neck to the right,” my surgeon said, as he forced my chin in that direction.  The muscles of my scalp and neck had been sliced.  They were sore and tight.   –“I can’t.  Ow!!”  The muscles hurt.  Pushing the open incision against a hard foam pillow was excruciating.  But, my doctor didn’t care.  “Yes, you can.  Come on.  Keep moving it.  Force yourself.  I need you to work on this all day.  The next time I come here today, I want to see you looking to the right.  Understand?”  –Yes.  “Uch, you’re mean,” I thought.

Vomit.  The vomiting continued all day, interrupted only by pain and sleep.

My head shook uncontrollably, due to a heightened heart rate – a result of the pain.  “Help!  I’m in pain!  Please give me something.”  At first, I received morphine, but they stopped giving me morphine because of my nausea.  So, it was one volterin shot in the bum after another, and one IV injection of acytametiphine after another.  Are you kidding?  I have brain surgery, and you give me Tylenol?!  Come on!

My family was allowed to visit for half an hour every four hours, but I was usually unable to stay awake for their visit.  “Hey babe.  How do you feel?” asked my mom.  With what strength I had, I muttered, “I don’t recommend brain surgery.”  She laughed, “Only you would make a joke after brain surgery.”  And, then she helped me vomit into the basin.  Brain surgery sucked.  This was nothing like Grey’s Anatomy.

“Ariella, you’re not facing toward the right!  I thought we had an agreement.”  Crap.  There’s the surgeon again.  “Give me a break,” I thought.  I’ve been puking my guts out here.  I moved my head to the right a little for him.  Fun.  Self-inflicted pain.  “Good job,” he said.  “Keep it up.”

By the end of the day, my condition had not improved.  I was sleeping too much, and the nausea had not subsided.  More concerning was that I was having pre-ventricular contractions…my heart was making an extra beat.  The doctors were concerned that I may have chemical meningitis…whatever that is.  So, my doctor ordered another head CT and directed that I stay in the ICU another night and day.

I didn’t sleep all that night.  The discomfort of the nausea was miserable, and the face pain returned.  “HELP!”  Great, none of the nurses spoke English.  This was not the time I wanted to improve my Hebrew!  But, in horrible pain and nausea, I was forced to speak Hebrew.  “Koev li ha’panim nora.  Ani choshevet sh’ha’nituach lo avad.  Bevakesha tni li mashehu neged l’kevim.” – my face hurts terribly.  I think the surgery didn’t work.  Please give me something for the pain.  —  Voltarin and Tylenol is all I received.  They did nothing for my pain.

I couldn’t turn in bed on my own due to the apparatus on my legs preventing blood clots and the uncomfortable pillow propping up my head.  I needed help.  “Efshar lihistovev li?  Zeh lo noach li kakha.” – Can you turn me.?  I’m not comfortable like this.  — The nurses turned me, and then turned me again.  I couldn’t get comfortable.  I couldn’t sleep for a second.  The nausea made me restless and in pain, and the face pain continued to worsen.

Electric shocking pains were stabbing me in the face.  The right side of my face was on fire.  I hadn’t taken Tegretol in 2 days, and the TN had returned with a vengeance.  “Bevaka.sha titkashri rofey.  Ani tzrikha Percocet, tegretol, gabapentin, mashehu.  Koev li ha’panim!”  –Please call a doctor.  I need Percocet, tegretol, gabapentin, something.  My face hurts! — Her answer was, “it’s the middle of the night.  There is no doctor.  I can’t give you anything more.”  I was left to suffer.

“Ani holekhet lehaki!!!”  – I’m going to puke!  I knew that phrase well.  I couldn’t hold it in before a nurse arrived.  So, I vomited all over myself.  I apologized to the nurse for having made a mess.  I felt terrible for being so whiny and now needing to be cleaned.  But, for the first time all night, I saw the nurse feel sympathy for me.  My pleas for help had been validated.  My vomiting made her realize that I really was in pain.  She cleaned me up, changed my gown and sheets and gave me more anti-nausea medication.

The entire night continued on like this.   With nothing else to do but vomit and scream in pain, I exercised my neck, forcing my head, little by little, to the right.  It was the only productive thing I could do through it all.

The morning arrived without any interruption in pain or nausea, and the chief resident came for morning rotations.  The nurse explained to him that I didn’t sleep a second all night due to pain in my face and vomiting.

He came over, and I explained that I was having a TN attack.  “The surgery didn’t work,” I cried.   “No, no.  This doesn’t mean the surgery didn’t work.  We went into the nerve center of your brain.  The nerves are very nervous.  It is normal to have trigeminal pain after the surgery.”  That was a relief to know.  He ordered Tegretol, Gabapentin and Amytriptiline (my regular drugs) to prevent future pain and Percocet for the pain now.  But, seconds after taking it, I vomited it up.

The surgeons made their rounds. One surgeon presented my case, as I listened, hoping not to puke all over the doctors.  The attending surgeon explained to the residents that with MVD, the patient’s head and neck are often stuck in the position of the surgery and struggle to come out of it.

He asked me to turn my head to the right, expecting me to barely be able to move.  What he didn’t know is that I had all night to exercise my neck.  So, I moved my head all the way to the right with pride.  “Wow,” the doctor said.  “Very nice.”  Yeah.  Awesome.  I can puke to the left AND to the right.

Then came the neurological exams again.  “Raise your hands.  Touch your finger to your nose.  Can you feel this?  Does this feel the same?”  “How is your face?”  If freaking HURTS!

I just wished my family could be there.  I had no one by my side, and I was suffering.  Finally, I saw my mom.  “Mom, help me.  I’m in pain, and I can’t stop puking…. Get the basin!  I’m going to puke…..  My stomach!”  Bright green projectile vomit.  I was vomiting up bile all over my mom’s shoes, all over the nurse, all over my sheets, all over my gown.  I was disgusting.

As the day went on, the vomiting slowed, but the pain continued.  The nurse forced me out of bed, and into the shower, where she took the showerhead and unsympathetically sprayed my incision.  “Thanks.  Cause I needed more pain,” I thought.

Then, she threw me into a chair.  I had zero sense of balance, so my head fell from side to side like a ragdoll.  She’d lift my head.  It’d fall again.  I was a real life Raggedy Ann.

Then, the nurse suggested that I eat something.  I suggested she was nuts.  Had she noticed my propensity to vomit everywhere?

By the evening, I was able to take a Percocet and keep it down.  Progress.  So, a day late, I was released from the ICU into the Neurosurgery ward, where I had started the day of my surgery.  I had gone to hell and back.  But, was I really back or had I just gone to another level of hell?


4 thoughts on “The ICU: Going to Hell and Back

  1. Ariella, I was a friend of Andre’s many years ago. I wrote to you once before. You have accomplished something very meaningful by writing this and using the internet. For what it’s worth, I can cry some of the tears that he didn’t cry for you. And I can send you a tiny bit of the love that you deserved a long, long time ago. For what it may be worth.

  2. Ariella you are in my prayers. Your will and courage are an inspiration.
    Have a speedy and full recovery. Refuah Shlemah

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