Exercise and Mobility
At the time of discharge from hospital, the slightest activity can take tremendous effort and leave patients feeling very tired. This tiredness is normal and will improve with time. Unfortunately, it is difficult to place a time scale on recovery as everyone responds at a different rate. It also depends on a number of factors, such as: age, previous level of fitness, degree and length of illness. Patients should not, however, be alarmed if it takes weeks or even months to get fully back to normal.
During a stay in the ICU a patient will probably have lost some weight and muscle strength, and your joints may be stiff as they have been immobile for some time. Muscle loss and peripheral neuropathies may affect balance and righting oneself may not be as easy as before the illness. Walking unaided outside may be potentially dangerous and frightening for a while after discharge. That said, the only way to recovery and to get stronger is to walk and exercise. However, sensible precautions should be taken, such as walking with a stick or walking with someone, for balance, until stronger.
After a prolonged stay in the ICU, patients may not be able to grip small items, such as a pen or pencil and may not be able to write. This will pass in time and they will recover these abilities.
The most common physical problem reported by critically ill patients is severe weakness and fatigue. Critically ill patients can lose about 2% of their muscle mass, per day, during their illness, so they may lose up to half their muscle mass in total. This can result in severe physical disability and rebuilding these muscles may take over a year. Their bodies have been through a big physical trauma. Patients will probably experience overwhelming weakness, especially when they first go home and are confronted with how debilitated they have become since they were last there.
Those patients who have had a severe critical illness, in general, should be advised that it will take two to three months before they start feeling physically "human" and by six months they should feel back to "normal". In specific cases, recovery may take considerably longer e.g. after a severe head injury.
If given an exercise plan by the ward physiotherapist before leaving hospital and it is important to follow this and not over-do exercise as this can set back recovery. If problems are experienced that do not ease after a few days of exercising, patients should go and see their GP, who can refer them to the physiotherapy department for treatment.
As strength returns, patients may want to take more vigorous exercise, such as swimming, fast walking or cycling. These will help strengthen their limbs if done regularly. A doctor or physiotherapist should be asked for more specific advice before undertaking other sports activities.
Changes in appearance or voice
Change of appearance may occur as a result of being ill, but these changes are usually temporary. Patients may suffer hair loss or a change in the quality of their hair, or find that the texture of your skin has changed and has become much drier than before. Patients may also have some scars that they feel are unsightly. These will fade in time, and as their skin returns to normal, they will not seem as obvious.
Patients may find that their voice has changed. It may have become husky or may be so weak that they are unable to raise their voice or shout. This is probably the result of being intubated or of having a tracheostomy. This should return to normal over time.