Emma

Brief Outline:

Emma spent 12 days in ICU in late December 2020 after contracting Covid. Her recovery included coming to terms with the possibility of getting Covid again. Interviewed for the study in April 2021.

Background:

Emma (41) works as a ward clerk in an A&E department. She and her husband have two children (15 and 16). White British.

More about me...

Onset

Emma works as a ward clerk in an A&E department. Having worked with Covid 19 patients for months without catching it, her husband fell ill with Covid shortly before Christmas 2020. The family of four – Emma and her husband, and their two children aged 15 and 16 – got tested. All but her husband’s tests came back negative. She was initially only concerned with his health, and not think much of it when she herself developed a cough and shortness of breath. She waved goodbye to her children and husband when leaving to house to get herself checked out at work.

A&E and the ward

As Emma walked through A&E, she started to struggle to breathe more and more. She was led to a Covid area, where her colleagues measured her oxygen levels. As these were low, Emma was admitted to hospital and taken to a ward. The ICU outreach team came by to have a look at how she was doing. Emma received information on plasma exchange. Because her husband and parents were not present to help her decide what would be best to do, she photographed the pages of the information leaflet and shared these with them. Emma even asked nurses around her what she should do, and eventually agreed to the trial.

The next morning, she was moved to a room on her own and put on CPAP (Continuous Positive Airway Pressure) – which she described as “awful”. She was taken for a scan, and then up to ICU. Emma has a hazy memory of this time but remembers doctors telling here that they were going to ventilate her. She FaceTimed her family – a memory that made her emotional, as, she explained, “you do say your goodbyes”.

In ICU

From her time in ICU, Emma remembered her night terrors. At the time of the interview these were still largely indistinguishable from reality. She could hear people talking, but could not speak, so she tapped the side of the bed to make nurses come to her bedside.

At this point her husband was communicating with ICU staff: they called him daily, and he would pass on information to Emma’s parents (who, in turn, would inform her sister) and friends. He would collect their questions and ask those when he next spoke to the clinical team. Her husband, who at this time was still dealing with his own Covid infection and had nobody close to support him, would keep notes of these conversations. Emma would use these later to piece some of what happened together, alongside the notes from nurses that came as part of the discharge summary. The ICU team also received a lot of calls from Emma’s colleagues, whose calls they eventually had to curtail, because they received so many.

Emma remembers being weaned off the ventilator after nine days. This was painful, confusing, and a relief. She felt that the staff were happy, and that she was expected to also to be happy, but instead she just felt horrible; “nothing felt right”. Her voice was not hers, her throat was sore, and she felt weak: her “whole body had changed”.

For a while she did not feel like contacting her family even though it was offered. She had dreamt that they had come to say goodbye and had passed away. It was a friendly nurse who a few days later suggested calling them. This nurse “slotted the iPad into a sick bowl”, and Emma agreed. It turned out that FaceTiming her family was the “best feeling in the world”. At the same time, she noticed that her family was both happy and somewhat shocked to see her as she was, realising the reality of it all. After this call, and when she was able to interact better with her phone, she stayed in touch with her family frequently, as well as with her parents – with whom she felt it was easier to let herself go, rather than in front of the children, for whom she wanted to stay strong.

There were other patients on the ICU ward whom Emma could not see but could hear. It was particularly distressing to hear one patient refuse the ventilator; he passed away shortly after. Other patients were about the same age as her and did not make it. It made her feel like she, too, would not be able to make it out of hospital. Emma found that she was unable to stand up, which was “hard-hitting”. Emma recalled a distressing incident when a nurse left her to try to stand up on her own, but she was not yet able to and fell. Other staff were more helpful: they brought a frame to hold onto and stayed with Emma whilst she tried to stand up and walk.

Emma was visited by Speech and language therapists (SLT) and another professional who helped her regain the ability to swallow. She been receiving food via a nasal tube. She still felt a lot of confusion and a sense of alienation about her body: would she remember how to swallow? Would her sense of taste return to how it was? Would her appetite return?

Discharge to the ward

But she continued to get better and she was discharged to the ward after being weaned off the ventilator, was another unpleasant experience.

Whilst ICU had felt to Emma as a place in which she was scared to be scared, the ward was a place where she “could breathe” and at least could be scared and could cry. A sense of dependency and embarrassment characterises this time on the ward for Emma. Immediately after she was brought to the ward, the staff left to do the handover. Emma would have preferred them to do this at her bedside, so that she could get a sense of who the new nurses would be, and so that she would have been able to draw their attention when she needed help – now, there was nobody there to call when she soiled herself, and she had to wait for a long time for somebody to come and help her. A most helpful nurse helped Emma to get to the shower, washed her, combed out her hair, and changed her sheets – all of which that made Emma feel human again, and she slept without night terrors for the first time. The shower allowed her to “feel normal again”. She just wanted to get home and understand “which boxes she needed to tick” to be discharged.

The physios came to do exercises. Emma did these despite finding them painful and demanding. With the clinical staff doing so much for her –Emma felt that they really wanted her to get better – she also tried to do things for them, such as already sitting in the chair when they came, which helped her push herself further. Having this staff support her in this way has been the most helpful thing in helping her recover.

Discharge from hospital

Emma was discharged in early January 2021, earlier than she would have perhaps otherwise have been if it had not been for the influx of other Covid patients. Emma really wanted to go home yet going home was also scary: from having somebody there who took your measurements every hour, she went to “nothing”. At home she was unable to climb stairs, and the nightmares continued –she dreamt of somebody coming into the house and bringing Covid in. Her husband was going back to work after having been at home whilst Emma was in hospital. The children were able to help out after that. At the same time, Emma did not want to worry them too much.

Making and measuring progress

Emma “would have killed for an oximeter” but decided against getting one as she feels she would have it attached to her finger all the time, and it would not help her recovery. She was glad that she didn’t buy one: rather than being directed by the numbers, Emma willed herself to do just a little bit more every day. Go outside, walk the length of one house, then another. Every day, Emma walked that little bit further, regaining her strength slowly but surely. She also got a cycling machine.

Informal support

In hospital, Emma had received more messages then she could read, let alone answer. After discharge from hospital, medically trained friends could help answer questions that Emma had not thought to, or dared to, ask beforehand. Emma felt that other friends perhaps expected her to look sicker when they finally saw her after discharge. They had organised a range of things to celebrate her coming home, but she would have been more able to appreciate this had it come later: in the beginning she was just still too tired, too unwell, too scared of catching Covid again.

Professional support

Emma has received support from the hospital: The staff arranged for Emma to speak to one of their counsellors on the phone. Emma did not find telephone contact very helpful as she cannot see them, and it felt rather awkward. Face to face counselling would have help her more she felt, but at the time of the interview this was not an option. She has also received a follow-up with the ICU consultant and nurse, and the physio, and got an X-ray three months after discharge (one week before the interview). Emma she would have loved to have this sooner and more frequently. The staff initiated a whole range of things for the symptoms she is still struggling with, including hearing loss in one ear, phlegm, confusion, brain fog and hair loss.

Emma remained anxious: her worst fear was getting Covid again. This limited her ability to go out. To make matters worse, when she first went out when the ‘rule of 6’ was introduced, one of her friends who was present later tested positive – which came exactly the time when she was starting to go out again, setting her back to being very careful, and not wanting lockdown to end.

Emma is grateful for what staff have done for her. Her message to health care professionals: keep in mind that “patients are just scared”. Her message to other patients is “give yourself time”, as that is what recovery will take. At the time of the interview, Emma was looking to go back to work in a month. Although the idea scared her, she also felt that going back sooner rather than later would help her more than not doing so. She added: “I really enjoy my life and I can’t let something stop that.”

Emma had not expected to become so ill that she needed to be mechanically ventilated.

Emma had not expected to become so ill that she needed to be mechanically ventilated.

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I work as a receptionist and a ward clerk in A&E, so for ten months, I’d been with Covid patients. I’d worked so much overtime, because there was quite a lot of absences and things like that, and I’d not been poorly, I’d not got Covid. I hadn’t had my injections by then, I hadn’t had any antibodies from it, because we had our antibody tests, so if I’m honest with you, I thought, I’m alright from this, because if I was going to get it, I’d have had it by now. I’d been in that much…but it just goes to show you about our PPE does its job, otherwise I would have been poorly before that. Yeah, so the only reason that I phoned up was because I didn’t feel good, I felt…my chest felt a bit tight, I felt poorly, I felt I needed something like an inhaler, or I needed something just to give myself a bit of a boost with my breathing.

Not for one second, not for one second, did I think I was as poorly as I was going to be, at all, and I walked in, I was out of breath, but I walked in. And I can remember being looked at, and the look, it’s only the eyes, because you can only see the eyes, the look that I got was, you’re not well, and then I sort of thought, well, I know I’m not well, but I’m not that unwell. Yeah, and then I could just tell by the people that were outside the little unit they put you in, it was like a room, they’re Covid rooms that they’ve all built, and I could tell that I’m poorly here, and it did scare me, but I still wasn’t that bothered, because I wasn’t that poorly. I still didn’t feel that poorly, and to go on a ventilator or to be like that. You’ve got to be really poorly, and I didn’t feel really poorly, not once did I think I was poorly enough for that to happen, not once, not even when they came in on Christmas Day morning and told me, not once did I think that. I still didn’t feel that poorly, yeah.

Emma has little sense of timescales around the time she was transferred to intensive care.

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Emma has little sense of timescales around the time she was transferred to intensive care.

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I was on a ward all by myself, I get quite confused around all this time because I don’t know how long I was actually there for. But I know it was at some point the next morning, I was then moved to a room on my own, where they kept coming in to check me. They then told me I was being taken up to intensive care, because I wasn’t particularly breathing well on my own at all, and I was going to be put on a…is it a CPAP machine, I think? Where you have the tubes on it? Yeah, I was scared, obviously.

They then took me up…I then had a scan; they then took me for the scan. I then was taken up to intensive care, I was kept on intensive care…I don’t know whether I went in there in the morning and stayed to the following morning, or whether it was the afternoon that I went there and was there ‘til the following morning. Time, I’ve got no idea on timescales at all. I had the CPAP machine on, which is awful, because it’s quite close to your face, but you know it’s doing the right thing.

Emma witnessed the death of a patient who decided against mechanical ventilation.

Emma witnessed the death of a patient who decided against mechanical ventilation.

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Do you remember any of the patients around you?

Yeah. You couldn’t see them, but you could hear them, so you could hear the things that they were saying, and then you could hear when one passed away. Literally everything, you could hear the nurses with them, and then you could just…you could hear people, even though…so where you are or where I was, there was a patient over that way, and they weren’t…I couldn’t see them. There was nothing wrong with how they were set up, it wasn’t like that, it wasn’t like, oh, it was so over-crowded, everyone was jammed, it wasn’t like that at all. You’re in a hospital, you’re in a like…it’s not even like a ward, it’s not like when you go, you see things and there’s bed, bed, bed like that. It wasn’t like that at all, but I could hear this person, and they were…they didn’t want to be taken to be ventilated, they didn’t, they really didn’t want to be taken.

And in my head, I’m thinking, I don’t blame you, I don’t blame you, I’ve just been through that, I don’t blame you. But then I wanted to turn round to them and go, but it could save you. You’ve got to, you don’t…and ten minutes later, that person was dead. They didn’t make it, and they weren’t old, they weren’t old at all, they were in their forties. Yeah, but they just…and I could hear them, but they wouldn’t go, they just wouldn’t go and be ventilated. They had everything set up, and they were taking them down, and as they went to take them down, they were refusing to go. They literally were, well, I’m not going, and they became a bit…not aggressive as in hitting or throwing things, they became aggressive in their voice, in their tone.

And I just…I was getting so angry with them because I’m like, why aren’t they just taking that patient? Why aren’t they just taking that patient and I don’t know whether…knocking them out, I don’t mean knocking them out, I mean, like sedating or something. They could have saved them, and they didn’t. They just…this person died, and then another lady, she died as well, and she was only young. And that’s when I thought, I’m not going to get out of here. Yeah. So, you do remember them, and you know who’s around you, but you don’t see who’s around you, you don’t…you don’t know who they are, you don’t know anything like that at all, but you know that there is people around you who are really poorly. Yeah.

Emma recalled how doctors tried to wean her off the ventilator and asked her if she wanted to call her family.

Emma recalled how doctors tried to wean her off the ventilator and asked her if she wanted to call her family.

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And then I’ve got certain on and off memories from that, just at different times, and then I woke up another time and they were telling me…they were asking me if I’d had enough. And I was going…I was doing that, I’d really had enough, and they were saying, we’re going to try and take you off the ventilator. Again, nothing was clear, nothing made 100 per cent sense, but it did make sense, if that…again if that makes sense. Nothing was 100 per cent crystal, I didn’t…certain bits of it, if I say it all now, it’s sort of like, how did you know that? I don’t know, I just did, but they took…they wheeled me from one room to another, because I was awake, not as in sitting up awake, but I was awake in the fact that my brain was awake, and they wheeled me from a bed into another room. And I can remember the feeling of it being wheeled into another room, and then they said, we’re going to start taking you off the ventilator, which I can just remember, I was so frustrated. I just wanted to…something didn’t feel right, but I’m not sure what didn’t feel right, and I just wanted them to take me off whatever it was.

And they said, we’re going to start taking you off the ventilator, but you need to open your eyes, and I can remember opening one eye, because I couldn’t open both eyes. And they said, you have to open both eyes, and I just got this strength, and opened up both my eyes and then shut them again. And they said, brilliant, you’ve opened them, and then I don’t understand it fully, but then they started to take me off the ventilator, which just felt like my body was being crushed inwards. And I just kept trying to get the tube out of my mouth, or something out, because it…I just felt like I wasn’t breathing at all. And it just…it went slower and slower and slower, and I felt like my front was touching my back.

It felt like my body was collapsing in, and then when they took…I’m assuming the last point came out, when they took the last thing out of me. I can just remember them saying, welcome back, Emma, and a line of people in front of me, and they were clapping, and I went, thank beep for that, but not in a normal voice. My voice wasn’t normal at all, and it scared me a bit, and then they just laughed. And then I went out, I can remember sort of like coming in and out, a sleepy sort of like…I wouldn’t say unconscious, but coming in and out, and I couldn’t open both my eyes, because one eye, I could open, and I’d have a picture. The next eye I’d open, if I opened them together, I’d have two lots, so it’s as if I’d have one lot of just say for instance somebody standing there, but they’d also be there as well.

So, it was like two lots of vision, they didn’t join, and my mouth was just drooling all the time, and then it was sore, and my throat was very…could only talk like that, it was really painful. They tried…I remember coming round and I had a tube up my nose and I…I don’t know why, but I whipped it out, and I later found it was an NG tube that went into your stomach, and I just pulled and pulled this tube. I don’t know what I thought I was going to achieve, and I don’t know how I thought it was going to help, but for whatever reason, I wanted this tube gone. And then I don’t remember anything again from that point, and then I woke up in another part of ITU, and I can…they said to me, do I want to contact my family.

Emma missed human contact. When a nurse touched her, although she was wearing PPE, “it felt human”.

Emma missed human contact. When a nurse touched her, although she was wearing PPE, “it felt human”.

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Then a lady on the other side, she said to me, you alright, and we just started chatting. Not chatting chatting, but she was like, you alright, my love, they won’t be long, they’ll be coming in. And I still couldn’t speak properly, but was like, thank you. She just smiled at me, and she was just really nice, whereas when you’re on ITU, I was literally looking at a door, and like I said to you, I had people around me, but I couldn’t see anyone, I didn’t know who was around me. On this ward, I had four other people around me, one of them absolutely crackers, and the others just a couple, older, and then the lady in front of me, but yeah, just…it was human contact. I hadn’t had any of that apart from nurses that you can just see their eyes, which is horrible, really horrible, because you can’t even see the expressions. You couldn’t…you wouldn’t know who anyone was, you couldn’t…you can’t see a face and all I wanted was somebody to touch me in a…not in a sexual way, please…that’s made that sound really wrong, I don’t mean it…I just wanted someone to…I’d have killed for a cuddle, anyone, I just… I would have killed for a cuddle.

But just someone to put their hand on you and just sort of go, are you alright, darling, like that nurse did. I think it might even have been that night, actually, she just came in, and I cried, and she just held my hand. Oh, it was amazing, because you can’t…you know, they’re too busy putting on all their PPE and just having their visors on with your masks on and your gloves on and your…and even though she had her gloves on, it just felt human. It felt really nice, and that’s something with Covid that you don’t…because normally people touch you, everyone’s so scared of touching, and you’re labelled Covid, so people literally stay away from you a lot more. And you don’t realise how much you need human contact, yeah, yeah.

When Emma could not use her phone, the nurse helped her make the calls until she could do so herself.

When Emma could not use her phone, the nurse helped her make the calls until she could do so herself.

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So, it took me ages to get into the phone, and then it wouldn’t work because there was no service. There was a reason why it wouldn’t work, so they brought out this iPad, and they brought out the iPad and put it in front of me. He got a sick bowl, turned it over, slotted a hole in it and put the iPad in it, and I remember thinking, you’ve done this a few times before, because why would you have done that with a sick bowl if you hadn’t have done it? And he slotted it in the sick bowl, and he then got into the iPad and went for the app or the phone or whatever it was, and I couldn’t remember my husband’s mobile number. I had no memory of his mobile number at all, and I’ve always known his number. It’s only his number and my mum’s number that I actually know, everyone else’s, I wouldn’t have a clue. The kids, anyone, it’s just because they’ve had theirs the longest. But I tried putting this number in so many times and coming up with different numbers. Eventually we did it and he…the nurse actually then put the number in and dialled it, and it went through and my husband just…because I think we’d tried it on the phone, so he knew that somebody was trying him.

And then he answered it and it was just him, and it was good. And then the kids came and it was really good, but it was really sad at the same time, because I couldn’t talk properly, I couldn’t see properly, and I could see by their faces that I wasn’t how they remembered me. I could see everything was…yeah, I could see that they were looking at me and it was like, we are so pleased that you are here, but I could see the kids… you know your kids or you know your parents or you know your husbands, wives, whatever, and you know that in their eyes, you can see that they’re looking at you, and they’re like, what’s wrong? And I could see the kids like, what’s wrong with Mum? She doesn’t sound like me, and I had this suction tube that I had to keep suctioning out my mouth, and they hadn’t seen me for so long, and the last time I saw them, I walked out the house and said, just popping down to the hospital, be back shortly, didn’t even give them a kiss, didn’t give them anything.

And they were looking at me, and my eyes, obviously only one could open, my tongue, my mouth was pure white and thick, really, really thick, so how I was talking, they could see my tongue, and my voice wasn’t normal. I thought I was quite normal, but I was slurry, and my face was all still just…obviously trying to…I’d been stuck like that, hadn’t I, and it’s trying to get everything back. So nothing was normal, whatever that is, but normal, and I could see them looking, as if to say, she’s not good, is she? She might be there, but what’s happened to Mum? And [husband] was…my husband was so happy, and I could see he was so happy, but I could see in his eyes, I could see him looking as if to say, oh god, you know, she’s awake, but what’s the reality of this?

And then I phoned my parents straight after, and I’ve never seen my dad cry, but I did then, and I think they promised me everything in the world that I could ever have or…you know, anything, and just the talking to them, just…it felt amazing. I felt like a little girl again, like I wanted my mum and dad. I broke down more with my parents than I did with my husband and my kids, because I didn’t want them to see me break down. If it was [husband] on his own, but I didn’t want my kids to see my break down, and yeah, I broke down more with my parents, and then [husband] phoned me back, and everyone was just trying to phone me, and then, I just…that was it. I wasn’t on the phone to them for long at all, I couldn’t, I really couldn’t, I was knackered, I was so tired, that really took it out of me in every way, emotional, everything. Yeah. It was the best feeling in the world, yeah.

Gosh. Did you talk to them afterwards about what that was like for them?

I don’t know, I think I must have, like because I spoke to them after that point, I spoke to them so much. I spoke to them…they’d say, chat to me whenever you want, and I’d FaceTime, I’d try and text. It’s really quite funny, actually, because I had…on my phone I had over 500 text messages of people, friends, everything. I had I don’t know how many WhatsApp, Facebook, all of that lot, I had so many different things, and I’ve got such a lovely circle of friends, and I sent…I done a message a couple of days later, because I was being bombarded constantly. And as the time went on, I could pick my phone up and I was getting better at doing different things, you know. And the more I used it, the more…and because there’s no-one else, so you are on your own there, so your phone becomes quite a big…they’re a big thing to us anyway, aren’t they, but it becomes a really big thing, because I could chat to the kids, I could chat to [husband], my parents, my sister, my auntie, my friends.

Emma is particularly grateful to the nurse who encouraged her to call her family.

Emma is particularly grateful to the nurse who encouraged her to call her family.

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Do you remember any staff in particular from the ICU?

Yeah, I do, I do, one which shouldn’t work there at all. She terrified me, really terrified me. She was…and it’s horrible to say, she was a horrible lady, and that’s one of the reasons that I didn’t think I was going to make it out, because of how she treated me, and that’s… yeah, she was awful, really awful. And then I can’t remember the nurse’s name in the evening, who gave me the iPad and told me to phone my family, do you know what, he was a lifesaver, absolutely changed everything for me. And I tried to find out who he was, just to say to him…he didn’t do anything above and beyond what any normal human being would have done. It was just the one thing of…and he didn’t even talk to me really nicely as in like, oh…or like that, he was just like, phone your family. Phone your family, look, I’ll go and get something and phone your family, really matter of fact, really bang, bang, just like, you know, well, what’s the problem love, phone your family, sort of thing.

And he did, he brought it out and then he just kept coming over to me and…I mean, I think they only looked after two patients. He was looking after me and this man that had been on the ventilator for ages, and he said to me, oh, your…he said, it’s a good job he’s asleep, he said, because you’re going to take up a lot of my time. And he was really funny and nice, but…and he just…he was brilliant, but like I say, he didn’t do anything, and he probably would not have any memory of me, because what he did was just so normal, but it was really nice.

Emma had too many messages to respond to, so she posted a general message on social media for all to read. She had the messages made into a book.

Emma had too many messages to respond to, so she posted a general message on social media for all to read. She had the messages made into a book.

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On my phone I had over 500 text messages off people, friends, everything. I had I don’t know how many WhatsApps, Facebook, all of that lot, I had so many different things, and I’ve got such a lovely circle of friends, and I sent…I done a message a couple of days later, because I was being bombarded constantly. And as the time went on, I could pick my phone up and I was getting better at doing different things, you know. And the more I used it, the more…and because there’s no-one else, so you are on your own there, so your phone becomes quite a big…they’re a big thing to us anyway, aren’t they, but it becomes a really big thing. Because I could chat to the kids, I could chat to [husband], my parents, my sister, my auntie, my friends.

And I was just…it’s like a snowball effect, everyone was just messaging and asking how I was, and I didn’t get to reply to all the messages, and so I put…it felt like an attention seeking, but it wasn’t. I’d had so many messages on Facebook, like hundreds, it was ridiculous, that in the end I thought, right, I’m just going to put something on this so people know I’m awake, I’m here, I’m fine, and I put this message on Facebook that made perfect sense, perfect sense to me. And I read it time and time again before I posted it, it was just like a quick sort of thing, a little paragraph, you know, boom, done, and then that way it would have kept people at bay for a bit. You know, my husband was being bombarded and so were my parents and sister, and this message, when I read back now, absolutely makes me die. It wasn’t even in English, it wasn’t even words. I have no idea when I read it, I know roughly what it said, but I do not know how I could have thought it made any sense at all. And it was just…I love it, I’ve had all the messages and that that I had when I was in hospital, my parents messaged me every day and my husband did and the kids, and just certain friends messaged me every day when I was asleep, and I’ve had it all made into a book.

Emma remembered particular staff members, and how they made a difference to her, mostly in a positive sense.

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Emma remembered particular staff members, and how they made a difference to her, mostly in a positive sense.

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And another lady who was from theatres, she came down to help because they were so busy, and she just…I couldn’t…I just…obviously I hadn’t been to the toilet for 11 days, I think it was. They obviously give you stuff and you don’t think about things like that until you think, I actually don’t know when the last time I’ve been to the toilet is, but I feel like I need to.

And she was like, oh, do you need to go? And it’s so embarrassing, because all these things you could do, but all of a sudden you can’t do anything, so the littlest thing like getting up and going for a number two to the toilet, to having to sort of say, I think I might need to go to the toilet. But you can’t stand up, you can’t get to it, you can’t wipe yourself, you can’t do anything. It’s humiliating, but they don’t care, but it’s you that cares, so you have to get over that pretty quickly in your head, that they don’t care, you’re the one with the problem here, love. And she just laughed about it. I can’t remember what she said, but I can just remember thinking, I’m so pleased it’s you that’s here. It could have been anyone, and maybe the next person was like that as well, but…and I didn’t need to go to the toilet and I hadn’t been to the toilet or anything, but…and she just said, do you want me to freshen you up? And I was like, yeah.

And she did, and I didn’t feel embarrassed by it, I didn’t feel like a piece of meat, not that a piece of meat, but do you know what I mean. I didn’t feel…and I’m big, so I wasn’t bothered about, oh gosh, you’re looking at my stomach and my saggy boobs are going from one side to the other, I didn’t feel like anything like that at all. She just made me feel like, I’m here to help you and I’ll give you a hand, whatever you want. And then when I went onto the ward, every one of those nurses, there was two in particular, the one that showered me, and the one that sat there with me at night when I’d had a nightmare again, and I couldn’t sleep, and she just came in and she just held my hand, and I just cried and cried.

Yeah, so you know, there is, there was lots, and even a lot of the physios that came round, they were like, you’re doing really good today, Emma. Oh my god, you’ve done this and you’ve done that and not patronising, not patronising, oh, you clever girl, sort of thing, it was just a…you’re doing really well. Alright, let’s see about doing this. And then if I’d go, oh, do you think I’ll be able to get to there today or to do this and they’d be like, no, we’re not even going to try that, that’s just not happening. So yeah, there was, there was so many different nurses, doctors, yeah, you know, a lot of them, I only had one bad experience, but a lot of them were brilliant, really, really good. Yeah.

Emma recalled building her strength back up day by day with the help of the physiotherapists.

Emma recalled building her strength back up day by day with the help of the physiotherapists.

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Every day was like, I went, can I have a frame, I need to try and walk, so they’d come in and they’d say, right, today we’re going to do this. They gave me a couple of days, but you know, today we’re going to do this, we’re going to do that, and I’d be like, right, okay, so we’d sit at the end of the bed, the physio would show me the exercises. Even though it hurt, it really hurt, it was so hard, every…there wasn’t one part of my body that didn’t hurt, and I couldn’t breathe properly. I felt like someone had tied something round my chest, and I had a pain going down the middle of my chest, which apparently was from the ventilator where it goes…the tubes are so…where they go in, it was just uncomfortable and painful. So, everything on me was hurting, but every exercise they gave me, I was doing everything, everything they would say to me about, if you go down to the end of the bed and just…they gave me a frame, just try and stand up. They showed me how to stand up, sit down, stand up, sit down, I’d try and do that, and then each day I’d build it up to stand up, sit down, to sit on the chair, there was a chair there.

And sitting on that chair, I even took a picture, I look hideous. .It's the most awful photo in the world, but I’ve never been so proud that I managed to move from a bed to a chair. I sat on the chair and sent a picture to my husband, and then it went from, you know, getting up from the bed to the chair, to walking to the end of the bed. So, then once I’d walked to the end of the bed, I wanted to get to the other side of the bed. And then it would be the toilet wasn’t far from my bed, so then it was, I want to get to the toilet. And then I’d always have to have someone with me, and once I got into the toilet, it was the getting back from the toilet. Then it was going to the window and then just each day or throughout the days, you just build up and up, and then having less oxygen on.

If it hadn’t have been from having all the physios there and the nurses with that bit more time, because they seemed to have more time than what they did…what I’d assume they would do normally, to get you up and about and get you moving. I don’t think I’d have probably been anywhere near as far along as I was, because they all…they wanted you to get better, not because they wanted your bed. Not because they wanted you out so that they could get home and go see someone, they wanted you to get better. They were all quite passionate, and you could tell if the ones that weren’t, they were just like there to shove your medicine in or…but you know, and that’s fine, isn’t it? If that’s what you choose to take from a job, that’s…but they all wanted you to get…so you could see that they’d come in, and they’d be like, hi Emma, how is it today? Right, what have you done today?

And it was just like that, it was just nice, and they were all friendly, yeah, and I think they actually…they make it, they make it for you, they make you want to…in a very childish way, they make you want to please them. Because of how they’re coming in, you…like one of the days they were going to me, see how many times you can get up and down, up and down. And I knew these two physios, I knew they were coming back. I think they were physio, I can’t…you have physios and you have something else, and they looked very much in their uniforms the same. I can’t think, but I’m sure these were physios, and they’d be like…I knew they were coming back the following day, so I made sure that I was up and sitting in the chair when they came round. Just because I knew what they…and they were like, she’s up and she’s in the chair. And I was like, oh yeah, yeah, I’m in the chair. But yeah, you just wanted to be able to do stuff to please them as well, because they gave you so much, you wanted to be able to show them that you could do it, yeah.

Emma’s husband passed updates from the clinical staff on to other family members, and asked questions on their behalf.

Emma’s husband passed updates from the clinical staff on to other family members, and asked questions on their behalf.

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Let’s go back a little bit over the contact that your family had with staff, are you aware of how they were kept informed of how you…

So, my husband was the one that got any updates, and then my husband would phone my mum and dad and my sister, and then my mum and dad would phone my auntie, and my sister would then phone whoever, and my husband would then phone my friends, or would phone one of my friends who then, as you do, sets up a WhatsApp group, and it filters through the WhatsApp groups. So [husband] would phone once a day and speak to whoever, or they would phone him, but it was only once a day, an update.

Yeah, and my colleagues that I work with, they were limited to phoning once a day as well, because they would phone up, apparently, and it made a lot of the staff in ITU laugh, they would phone up continuously, that they had to speak to the matron and matron had to let them know that they would give an update on me once a day when the nurse in charge did an update.

So I think they were bombarded, but yeah, the consultant who looked after me would phone [name husband] and give him an update daily on progress, and [name husband] would have a list of questions which I found when I…not long ago, actually, and he’d have a list of questions of things that he’d want to ask, or my parents, my sister or somebody would want to ask, and he would go through and ask the questions, get the answers and then pass the answers back, yeah. But that must have been hard for them, because normally you see someone, don’t you, you know. For me, it was fine, I was asleep, I was having an extended lay in, but it’s hard for them, because they can’t see you, and they can’t even touch you, and I think that’s got to be the hardest part for your family, and people don’t think about them, about how it affects them a lot of the time.

It’s probably harder for them than it is for the person going through it at the time.

Emma felt both happy and lost about being discharged early.

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Emma felt both happy and lost about being discharged early.

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From what I can gather, in an ideal world, I probably wouldn’t have been discharged as early as I was, but I was happy to go. I was improving daily, I was managing to be off the oxygen, and they needed the beds, so I’m a realist, I’m not…you know, I wasn’t put in danger from going, I wasn’t…there was nothing bad or anything like that, but I do think if I’d have been in hospital for a bit longer, maybe I might not have felt as…I don’t want to say abandoned, because I don’t think I was abandoned, but lost. I was a bit lost and a bit…I felt really vulnerable being out in the big bad world without a medical professional sitting on my shoulder, checking my obs and checking me every so often.

But if I’d have had something like that sooner instead of three months down the line, would have been lovely, but I do understand there’s only so much the NHS can do, I get that, yeah.

Emma advised that people give themselves time to recover, and try to be realistic in setting goals.

Emma advised that people give themselves time to recover, and try to be realistic in setting goals.

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Is there anything like a message you’d like to give to other people who’ve been to…you’d like to tell other people about intensive care and Covid?

There’s so many things you could say, isn’t there, I don’t know, I just…I think it’s horrible, but I think, you know, with all the support and everyone around you, you can…and you’ve got to be positive. You can get through anything, can’t you, and you know, like I said to you earlier, my puzzle was completely scattered, but everything was there, and it’s all piecing it back together, and my puzzle’s got a long way to go, but it’s nearly there, and that’s only three months, and you know, a few days ago I had a few bits of my puzzle gone again, but they’re slowly going back, and I think it’s just going to take time, and that’s what you’ve got to give yourself, is time, and we don’t give ourselves enough time, do we? That’s the problem. We just don’t, and we need to, and it does take time. But yeah.

How do you do it, give yourself time?

I don’t know, I don’t honestly know. It just…you’ve got to not be hard, you see. I gave myself different goals and achievements and I always would speak to my husband or kids and anyone, and they’d look at them and go like is that achievable, and then I’d usually re-evaluate them and have a look and go, no, maybe not actually, but that’s what I wanted to do. I wanted to do that but wanting and being able are two very different things, so I’d give myself that goal of walking that three or four houses down, where my original goal would have been, we’ve got a post box, I’m getting to the post box. That wouldn’t have been achievable, but it’s what I wanted, and there’s a big difference, isn’t there? What you want and what you can achieve, and if you set your goals too high, you’re going to fail, so you’ve got to be realistic. Yeah.

It’s not easy.

No.

The Speech and Language Therapists (SLTs) helped Emma to get used to eating and drinking again after mechanical ventilation.

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The Speech and Language Therapists (SLTs) helped Emma to get used to eating and drinking again after mechanical ventilation.

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And then I went to the ward, and it’s just from there everything picked up. I couldn’t…I spent a couple of days of not being able to move, physio came in, the SALT team [SLT], is it, the swallow people, SALT [SLT], I want to call them SALT [SLT], where you swallow, you can’t eat, you don’t want to eat, food has got no importance at all. I couldn’t swallow, I was terrified of drinking, eating, anything, because your throat didn’t feel like your own, so to swallow anything, I thought, I’m not going to be able to swallow, it’s not going to swallow, it’s going to go down a different hole, or does my body even remember how to swallow, even having a sip of a drink felt alien, it felt weird. And nothing tasted the same, so I was only drinking water, but it didn’t taste like water.