'I was seeing things scurrying across the floor': Suburban COVID-19 survivors' stories
Drew Murrie couldn't recognize his family in the pictures nurses put up in his hospital room.
The Vernon Hills father had no idea those people were his wife and their three sons. But that wasn't the most unsettling episode of his coronavirus ordeal.
"I was seeing things scurrying across the floor that weren't there, and butterflies and beds appearing and disappearing," Murrie, 59, said. "A hand came over my face one night."
Murrie had frightening, vivid hallucinations in the intensive care unit, a condition known as "ICU delirium." The sickest patients who have fought the virus on ventilators experience the disorienting state, loosening their grip on reality.
"They end up with some absolutely wild stories of things they sincerely believe happened to them in the hospital that are not true," said Eric Larson, a neuropsychologist at Marianjoy Rehabilitation Hospital in Wheaton. "And you then have to help them sort out what really happened and what did not."
Murrie and other COVID-19 patients who have developed cognitive issues warn that surviving is only half the battle. After they left the ICU, they still faced a long path to physical and emotional recovery.
It is too early in the course of medical research to know if the virus itself is contributing to delirium in hospitalized patients. But some risk factors include the use of sedative medications, mechanical ventilation and sleep deprivation.
"They just have a memory of something really awful happening and something that was really painful and upsetting," Larson said. "And then what they end up doing is filling in the blanks of why it is they felt so scared and upset at the time, and once they start filling in the blanks, all sorts of really frightening and usually inaccurate details can start to creep in."
Sami Uctum, a Glen Ellyn COVID-19 survivor on a ventilator for 11 days, can recall upsetting hallucinations.
"Every time I heard the slamming of a door or cabinet, one of my health care providers was shot and killed right in front of me," Uctum, 55, said. "I want to say I saw that for days."
Doctors recommend families and patients keep an ICU diary as a written record to fill in the gaps in their memories. A 2010 study published in the Critical Care medical journal found a lower occurrence of post-traumatic stress disorder in patients given ICU diaries after a severe illness.
A 2017 study of people who survived acute respiratory distress syndrome, or ARDS -- the lung condition that develops in the most critically ill coronavirus patients -- showed 23% had PTSD symptoms and 32% had depression. For comparison, veterans of the wars in Iraq and Afghanistan have PTSD incidence rates between 11% and 20%.
PTSD, by definition, isn't diagnosed until 30 days or longer after the traumatic event. Larson's patients are still in the early stages of adjusting to their illness, so it's too soon to say if they'll have a PTSD response.
"A lot of these folks that have been on a vent have some at least transient cognitive issues that need to be addressed," he said. "And even after they've recovered from those transient issues, there's emotional fallout from having been in that place where they couldn't understand things, and they were confused."
With families unable to visit their loved ones, Larson must establish himself as a trustworthy presence to put delusional memories into context, explain the rationale of treatment and remind patients recovery takes time.
"The kinds of things that help people deal with the stressors of acute illness are compromised right now, so I am afraid there's going to be an increased prevalence of depression in this population down the road," he said. "Hopefully with the mental health supports in place, we'll be able to make a difference in that."
Mental health experts also are worried about the coronavirus aftermath because of cases of inflammation in the brain and the disruptions to the patterns of normal life, said Dr. Susan Scherer, president of the Illinois Psychiatric Society.
To help them in their recovery, patients treated for COVID-19 at the two hospitals in the Edward-Elmhurst Health system can receive three free telehealth sessions with mental health professionals from Linden Oaks Medical Group, said Jessica Butts, a clinical therapist.
'This is normal'
Murrie's hallucinations lasted a day or two after doctors removed the ventilator that kept him alive for nine of the 15 days he spent at Northwestern Medicine Lake Forest Hospital.
But he still struggled to think clearly. Instead of returning home, Murrie went to Marianjoy Rehabilitation Hospital for occupational, speech and physical therapy.
When he arrived in mid-April, Murrie looked at a clock and couldn't tell time. He couldn't remember his phone password. He couldn't solve a math problem when a therapist asked him to subtract 33 cents from $1.
It all came as a shock for someone who programs computers and sells fiber optic networking equipment for a living. But Murrie's therapists reassured him: "'This is normal. You've been through great trauma, so don't let it get to you.'"
Murrie restored his memory at Marianjoy. He regained his endurance and balance after losing about 40 pounds in weight and muscle atrophy.
He's recently suffered bouts of vertigo, a sensation he's never had in his life, but Murrie has returned to work and feels stronger every day.
"I really feel the rehabilitation shouldn't be an option. It should just be part of the journey with COVID," he said. "I wouldn't be where I am today if I didn't have those tools that the therapists gave me in rehabilitation."