Listen now:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

More: Read Transcript Text  |  MP3 Direct Link

Hospital patients who go home after a stay in intensive care may leave thinking the worst is over, but 60 to 80 percent are likely going home with a new problem – a brain injury.

A 54-year-old petite and bubbly bookkeeper named Marie Smithers spent six weeks in the ICU at St. Thomas Hospital in Nashville last March. nine months later, she still suffers from memory lapses and balance problems. Smithers is back at work, but it’s a constant struggle for her to remember simple tasks.

“There’s some things…the forgetting. Going down the basement steps, all of a sudden it’s like, I don’t remember exactly how to do this,” says Smithers.

ICU Delirium is triggered by the disease and/or infection that lands patients in the ICU, along with heavy duty drugs meant to keep them comfortable.

Vanderbilt critical care doctor Wes Ely has studied ICU delirium for a decade. As he points to the plastic ventilator tube running into the lungs of ICU patient, Craig Nudds, Dr. Ely says heavy drugs allow the patient to tolerate the tube. But, “We often tend to overshoot,” says Ely.

Dr. Ely estimates 50 percent of the delirium is caused by sedation drugs. he founded what’s now the world’s largest ICU Delirium research group. Its aim is to find the perfect drug cocktail that balances comfort and consciousness to keep the brain from descending into delirium.

Nudds, who has pancreatitis and lung failure, also has ICU delirium, and Dr. Ely has been tracking the depth of it for a few hours. As Nudds opens his eyes, Dr. Ely picks up his hand and starts squeezing it to see if the patient is conscious enough to respond.

It takes Nudds takes a few seconds to return the squeeze. Dr. Ely says he took too long, and Nudds has a classic case of ICU Delirium. “His brain is just swimming through molasses,” says Ely.

To diagnose ICU delirium, Ely and his team developed a simple two-minute test. It’s a series of questions that doctors pose to patients. if the patient responds correctly, a harder question is asked.

Based on Craig Nudds’ responses, Ely says, at the very least, he’ll end up with memory problems for a few days or it could be worse. he could end up with dementia-like symptoms that mimic Alzheimer’s.

“The longer he stays delirious, the more likely he is to have neuropsychological problems on the back end with memory, and processing speed, and executive function, meaning he would have problems like a dementia,” says Ely.

For decades, patients were told their fogginess and memory lapses were temporary. “It’ll get better after you get home,” was the conventional wisdom.

But Ely’s research shows it can be a life-altering, long-term problem. That’s why he’s pushing for every ICU to start testing for delirium. Right now, among Nashville’s major hospitals, only Vanderbilt screens for the condition.

 Printable Version       

- Lyme disease is a bacterial infection.- Lyme disease is an infection caused by the bacterium Borrelia burgdorferi.- Lyme disease is the most common tick-borne illness in North America and Europe.- Lyme disease is spread by these ticks when they bite the skin, which permits the bacterium to infect the body.- Lyme disease is not contagious.- Lyme disease is often associated with heavily wooded or grassy areas where mice and deer live.

Lyme disease affects different areas of the body in varying degrees as it progresses. It can affect nervous system, joints, skin, and heart. The early symptoms include:- circular rash after 1-2 weeks of infection which looks like a bull’s eye. It can also appear as an expanding ring of solid redness. It may be warm to the touch and usually is not painful or itchy.- fever.- headache.- swollen lymph nodes.- fatigue.- headache.- muscle aches.- affects the heart, leading to an irregular heart rhythm or chest pain.- can affect nervous system, causing facial paralysis, or tingling and numbness in the arms and legs.The last stage of Lyme disease occurs if the symptoms of early stages are left un-treated. Symptoms may include arthritis, particularly in the knees, and memory lapses, trouble concentrating, changes in mood, changes in sleep habits, muscle weakness.

- Protect yourself from tick bites.- Avoid heavily wooded areas.- Wear light colored, long-sleeved shirts and long pants.- Apply tick repellent.- if you find a tick, remove it with tweezers, making sure to remove the head as well as the body.

- Physical examination and medical history.- Laboratory tests like Enzyme -linked immunosorbent assay (ELISA), Western Blot – this test is more sensitive that ELISA and Polymerase Chain Reaction (PCR) help to confirm the disease.- Oral administration of antibiotics is used for the treatment of lyme disease. this is effective in treating the infection, although the symptoms may persist for a while. this mode of treatment may cause certain side effects, such as, gallstones, diarrhea and low WBC count.

• Previous Entry: Honey and Cinnamon – what are different health benefits?
• Next Entry: Agoraphobia – causes, symptoms, Physical and Psychological Effects and Treatment