WDAD 2025

 

Wondering every year what will change,

Delirium talked about only on this day,

All I see in papers is the damage it does,

Don’t know what else I can do,

2 minutes of orientation can hugely impact,

0 excuses for why screening isn’t being done

2 minutes to consider the drugs you use and there effects,

50-80% in ICU will have it,

Yet I was only told when asked to speak at a conference.

Delirium is like a puppy it’s not just for Christmas,

Delirium is not bad news on tv you can’t ignore it,

Delirium is not bad behaviour it’s something you intervene on,

Delirium is not pleasant it can be a fight for your life,

Delirium is not easy it changed my entire life,

Delirium has scarred me and nine years on I still bare the scars.

Count to One

 Count to One

 

I sat at home going yellow from the antibiotics I was on,

The itching was starting to make me break the skin,

I reached out and got creams and antihistamines,

The itching resolved as the yellow retreated from my skin.

But then they appeared upon my skin,

The little purple dots that chill me to the very soul.

 

Bloods taken to check my liver results and my blood count,

What we expected to be elevated was mildly so,

The problem came at 4 pm. I was called by Haematology,

Mark, are you bleeding? Have you got bruising,

No, Yes what is the number, I know what is coming,

The call only comes when it is dangerous,

Your count is one, and we’d like you to get reviewed.

 

Now the danger is extreme and the treatment slow,

Dose increase taking weeks to work,

The anxiety and fear building as I hide from life,

While standing with a smile and grinding through,

While your back is covered with the knives of doubt, fear and stress,

Life is not fair never has been but I will stand tall,

If I can inspire others to shoulder their burdens and make it through,

Then the struggles will have been worth it.

 

Never give me more than I can cope with,

I do not ask for the burdens to be lightened on my shoulders,

I only ask for broader shoulders so I might carry them,

Bare those of my friends and loved ones who need my ear,

I will stand tall until I fall I will move through until I’m done.

 

The count has me scared as a tap could make my brain bleed,

Every step I take is filled with worry and those around me look at me,

I can’t show the fear inside as it would break them,

I must be stalwart in my stoic nature being there for them,

So that they can hold me up when I fall,

The fear crushes me inside, anxiety gripping my heart tight.

 

Delirium Yearning

 

Nearly 40c my body it is burning,

My ex is calling to ruin my day she’s yearning,

But my wingmen tazocin and filgrastim do the blocking,

Made my white cells start rocking.

 

No infection could be found despite lots of trying,

25c ward had me feel like expiring,

Tests and scans show nothing but improving,

But when got home a stone started moving,

Next day it exited now I’m grooving.

 

Delirium sitting in my corner standing still,

My brain is still here by the power of will,

She can stay away of her I’ve had my fill,

Staving her off with every single pill.

 

The ward was hot but safe and secure,

I could move about not stuck in a tiny room,

Not feeling so weak when I escape,

Made me feel so dam great.

 

Men’s Mental health awareness month

 

After ICU my brain as scrambled as can be,

Needed some help maybe some cbt,

Nearly a year I spent struggling with anxiety and ptsd,

Shows the fucks you gave about me.

I could have been gone instead I hung on,

It was real close programming and anger got me through,

But if I shared in those days people where gone,

One good thing is it showed who was my crew.

Everyone saw the shiny armour I wore,

Not the daggers it drove into me making me bleed,

They didn’t see I was broken to the core,

They did not offer the hand I needed.

I found my feet again in the ashes of myself,

ICU burned a lot out of me changing what me meant,

Left me with pieces that no longer fitted together,

Trying to be a me that no longer exists.

I have scars I can’t look in the mirror to see,

I have scars that mean I can’t look in the mirror,

I have scars that killed the 2015 me,

I have scars that give me pain everyday,

I have scars that I know I will get more of.

I am the best me I will ever be right now,

To me that’s pretty messed up as I’m broken,

I’m held together by my force of will and love,

I will get to a stage where I can’t battle anymore,

When that day comes who will shed a tear?

Likely 5-10 people but they will matter because they loved me

Thoughts on the A-F bundle

 I was always told to stay humble,

I was told let others speak about the things you do,

So I’ll talk about the A to F bundle,

It should be fundamental in every ICU,

If your not then that a major fumble,

Mobilising is good for patients research shows it’s true.

I’m tired of listening to all this squawking,

People who never been intubated telling us what is true?

Maybe you should all start listening and stop talking,

Delirium and acquired weakness are game changers,

Making your body feel like a dam stranger.

People who think sedating is humane,

What is going on in your dam brain,

Increases length of stay, delirium just to name some,

Disabilities, distress and insecurity what you’re imposing.

Let’s look at the bundle and what it does,

A- assess for pain and manage it appropriately,

B- breathing and awakening trials, 

Pausing sedation and making patient do more of the breathing work,

C- choice of sedative and analgesia, 

ensure your using the best ones,

D- Delirium assess, prevent and manage,

Stop the things that cause it and make the patient feel safe,

E- early exercise and mobilisation, 

Protect what’s there and reduce damage that will be done,

F- family it’s the worse time for them too,

Help them survive the stress their going through,

So they can help you too.

So let’s review all the things we do,

When you think of ICU ,

We all know what we should do,

Use the bundle that’s proven true,

To help more people survive the ICU.

Talk is cheap but here’s the cost

 

Why do I lay my trauma out for you to look?

I do it so you can stand and stare,

Wondering how we even got there,

Figuring out how I am still right here.

 

I tell my tale reworking it every time,

So that the impact gets better every time,

I relive the torture just so I can refine the talk every time,

When I’m done people question why I keep doing it every time.

 

It might stunt your recovery, might make worse,

You are not that important, your story doesn’t matter,

Thought banging round in my mind,

Trying to get any hook in it can find.

 

I might not be important but I am to some,

I’d still be happy if it was only one,

I have found friends in the worst of my trauma,

Ride or die friends I never thought I’d have,

But for each one I’m eternally glad.

 

I tell my story for those who can’t,

For those who pass or those who still suffer,

For those left defeated with no hope,

And for those who can give words to this rope.

 

The trauma like a noose squeezing out the life,

But we shan’t give in we will fight,

On the stage or the call I bare my trauma,

So there will be less mes tomorrow.

ICU Rehab Day 2023

                                                                    

We need to talk about the value of ICU rehab,

It is as important as drugs made in labs,

The battle we face after intubation,

The effort it takes, the shot heard across nations.

 

The A2F bundle formed to reduce the harm we cause,

But in a lot of ICU, the damage does even give pause,

Rehab in my home differs so much from the others,

We should all band together as sisters and brothers.

 

So heed this my call to join our movement,

Which is focused so fully on getting us moving,

Because never forget that not lost does not need to be regained,

That patient will not have to know the pain of muscle growing again.

 

So join us in voice, in spirit and in body,

Let’s do this properly for we can’t afford to be shoddy,

These people's lives we affect will impact so profoundly,

As for every person in a bed has people 100 deep,

The family and friends who witness the struggle,

Can be saved from the horror of seeing them suffer.

 

We all seek the solution which has eluded us all,

But we are not here to drop the ball,

We work hard each day to improve the world in tiny ways,

Because in weeks, months or even years,

Those tiny actions will reap us some gold.

 

 

Whether you stand at the bed, research or other,

The work that you do will be seen by fathers and mothers,

Your actions will be burned in that patient's brain,

Let’s not leave them with only a legacy of pain,

Working together we make rehab the focus,

We motivate, drive and support the goals that are chosen.

 

For in the end, we are all just supporting roles in the life of the patient,

We are stagehands, extras and even directors,

Managing the situations and bringing the important to focus,

We show the best that we have to evoke emotion,

Because of these plans, we are setting in motion,

They will impact people all across the oceans.

 

So I leave it here with these most feeble of words,

The patient in the bed wants to be heard,

We want to be seen and treated as a person,

We want to live life not simply surviving the crisis,

For when you look at the whole you will see too much more,

Learn about the person they were and who they’ll become.

 

 

Thank you for reading this I hope it evoked some emotion and I hope we can make ICU rehab a part of every icu patients journeys. But also make the time in ICU less traumatic and thus need less ICU rehab after.

A-F bundle lets get liberated

ABCDEF bundle

 

Assess for pain, analgesics so that they can engage,

Autonomy is key sedation's not a cure,

Alternate on and off intermittent is the key,

All together makes everything easier you’ll see.

 

Begin with SAT put a hold on sedation,

Before SBT to see if they are capable of breathing.

Back to the start for another day if their failing,

But a good start to think about extubation.

 

Choose carefully and aim for reduced agitation, not heavy sedation,

Choice of sedatives is very important Benzo’s should be avoided,

Could we use propofol in your thoughts in planning,

Can we use dexmedetomidine sure but only short term.

 

Delirium now that’s my enemy incarnate,

Do an assessment CAM-ICU the preference,

Different types, hyper or hypo active as well as mixed,

Dysfunction of the brain can affect behaviour.

 

Early movement prevention is better than cure,

Exercise protects the lungs and against weakness,

Every step taken helps to stay ahead of their illness,

Early is best when in the ICU as you can save before it's lost.

 

Family is so very important and helps to reorientate,

Fun how communicating effectively can leave an impression,

Feed them with confidence that they can help you,

Find ways to help them help your patient.

 

Get these points straight into your head,

Great to learn about what you should do,

Guidelines are important they support practice with facts,

Gathering understanding it’s a guidebook to success.

 

Hopefully, this helps you get to grips with the bundle,

How it works and why you use it,

Happy to help you with the words I am choosing,

Horrors lie ahead for patients whose care team don’t use it.

 

Confidence

 I always as myself if people are proud of me,

Have I had an impact do I matter,

When I am no longer here will I be remembered,

Will I be thought kindly and bring a smile,

Or will my name make people run a mile.

Everyday I look and reflect upon my failings,

Everyday worry that everyone’s time I’m draining,

I wonder all the time are my actions oppressive,

Or is this merely a reflection of poorly managed depression.

When I look upon what I’ve it brings lots of sadness,

As my health has took so much even most of my gladness,

I look at what I’ve done and think how much more I could’ve achieved,

If only my body did not hate me and kill me from inside,

December 28th 2015 the day I almost died,

Infection nearly made me face my maker.

If they looked upon my book what would he see?

Would it be very different from how I see me?

Would they welcome be into the fold a project complete,

Or will they shake their head in disappointment and defeat.

I know my many failings and it is more than one,

I know I’m too hard upon my self that’s failing number one,

I should treat myself with kindness that would be such fun,

But all I can ever do is reflect on ICU and make that gun is never a real one.

I’m turning corners now, I’m planning now you see,

With examples like Julie, Dorothy and Megan how great can I be,

I know see myself in futures never dared,

For in but just a moment it might not be there.

But after speaking with the greats,

I started to believe maybe I could dream and achieve,

Thank you goes to these council of three,

For giving my hope and faith I can believe.

Thank you to all who lift me up,

Thank you to everyone whose ever gave a fuck,

Thank you to those who brought a smile in dark days,

And finally thank you to those who support me everyday.

Doctors Strike

The government trying to paint em as evil,

Well hot dam can you believe em,

I listen as they say they are putting me in danger,

What a dam joke are you trying to offend me?

Are they out of their minds when they say Dr as harming,

Listen to me I'll be disarming or maybe even charming,

You can't abuse a system, underfund and supply it,

Then expect everyone inside to be happy about it,

 The gaslighting and abuse is what is dam harming,

You tried to break a system and met with resistance.

The Doctors are standing for what is right,

You are standing on wielding might,

Trying to undermine the public service that supports us,

Trying to villainize those who saved me,

When I was in ICU I know who was saving my life,

I know who did everything they could to bring me back,

You made sure I was here to write this.

I stand with the junior Doctors doing what is needed to make the NHS safe for all and be paid an amount that they can live life when they are not in the hospital. 

PINCH ME, a few of my favourite things

 

Pain should be managed and well-controlled,

Infection finding the source and treating quickly,

Nutrition are they getting all the sustenance that they need, 

Constipation are their bowels moving or blocked up inside,

Hydration are they dehydrated, let the fluids flow,

Medication look for deliriogenic medications you might be giving,

Electrolytes the ions out of balance can lead to real trouble.

These are a few of the Delirium things,

Remember night and day for sleep is essential,

Overstimulation is harmful like machine noises in ICU, 

Antipsychotics are a big no-no except in the rare time when it is needed,

Sedation, is it required or does it need to continue,

Moving while delirious is a bad idea,

Speaking calmly and creating safety is what needs to be done.

Delirium is a problem but is spoken about like Macbeth,

Can we please use the name, not using it won't kill you but it might cause harm,

Delirium causes patients and families a great amount of alarm,

Its a clinical diagnosis it is not a sentence of death,

Do we need more training and understanding to clear the air?

Delirium is everybody's problem, we all have to tackle it together otherwise we will never get on top of it. We need to understand that the hierarchy from inside the hospital does not transfer here, delirium is a peer problem we are all in this as one. The leaders we select for all that they have done, not what degree they have earned or job they have but the impact in the field that they've had. Delirium heroes come in all shapes and sizes but all have one thing the same, they don't want the patient to suffer again. Delirium undermines then very essence of you, it breaks down your thoughts and inhibits what you can do. The legacy it leaves is long and deeply effecting but we can battle it back by teamwork and not pretending. We can't go on using terms oblique to the problem, pleasantly confused a phrase I never want to rehear, it shows a lack of understanding after all of these years. So please friends join me in standing up to delirium by calling delirium delirium and treating it accordingly.  

Delirium Awareness

 The first thing you need to do is stay CAM in the ICU,

If I had SQiD for every time I was told THINK delirium,

I would be rich as can be but I DOS protest too much,

My experience with delirium is a 4AT best,

Maybe I should invest in a Nu-DESC so I can write at my best,

I am always asked which tool is the best,

I usually answer under duress but its simply the one you can use,

The one that will be sustained because if not its of no use,

Delirium is no kind of game, it is a failure of the brain.

And sure I might write a rhyme but I ain't wasting my time, 

I am working hard I'm on my grind,

I am not writing in lines of code this ain't no DOS,

I want everyone to understand from the trainee to the Boss,

If you look closely, the tools you can find.

Everyone thinks I have some great insight,

All I have are tales of my fights where I nearly DIed,

DRS tell me all of the time the delusions are all in my mind,

The GARnish is their thinking is far behind.

Merry Christmas

 Merry Christmas, why when I feel like I am dying inside,

Why should I feel happy when nothing is right,

Why should I smile when I don't feel happy tonight,

Why do I fight every day of my life?

Because I won the fight and scars don't define me,

Because I am strong but my weakness is not a flaw,

Because I am loved and needed by many,

Because I will not give in to whatever faces me.

In 2015, on December 27th I nearly took a step into heaven,

Taken to ICU for three weeks I did stay,

Many times, with my life I did pay,

But I clung on with the love of my family and will.

This time of the year really does suck,

Hopefully, this year will be great with a little luck,

Maybe this year the trend I will buck,

Even if my brain in that time is stuck.

 

Bad days

 Todays a bad day in the worst way,

Hard times have been coming from all sides,

I’m stressed out my mind and it’s all of the time,

I can’t see an out at this even if I do grind.

The pressure is building and I’m ready to pop,

Every night sweating so much I needed a mop,

Strains on my body are showing their signs,

Ectopic beats weighing down on my mind.

I sit in my house wondering what path my future takes,

Praying to god that nothing else inside me breaks,

Hoping and wishing to be healthy enough to do it all,

Constantly waiting for that doctors call.

Temperature rising, inside I am dying as I feel like I’m frying,

Boiling from the inside out can be trying,

Then I get the antibiotics and now I’m crying,

Because they mess with my mood and leave me drowning.

WDAD 2022

 What does Delirium mean to you,

Does mean hard work and effort too?

Alarming, confusing or losing your mind,

Do you know how it feels inside.

2 times I have had delirium,

0 times people have spoke about it to me,

2 experiences where I had no control,

2 times where damage was done to my soul.

4 delirium days I’ve spoken or worked on,

A huge amount of effort to improve education,

Time for us to reflect and improve our behaviours.

Some times the small things make differences,

Quiet times can help us to sleep,

in our rest we can refine our feet

Delirium is tough can you spot what I’ve done.

Delirium

 Delirium is a sudden change in mental status,

I am going to tell you what it's like because it matters,

If you have further questions feel free to @ us,

At the end of words, I'll serve perspective on Platters.

I'm suffering from a kind of confusion,

My brain is acting slow, my thoughts I'm losing,

Drifting away and my control is gone,

Doing things that are definitely not me,

Don't know where I am can't count to three.

I can't feel safe here I don't know you,

Why are you trying to hurt me,

Where are my family, where did you take them,

What have I done to deserve this treatment?

The world is black as they attacked me,

My mouth won't work, why can't I move,

What are they plotting at the end of my bed,

Why do they want me dead?

The world is fussy what can I trust,

Everything looks clearer but can I trust,

These people looking after me were torturing me,

Now I've to trust them with my life,

I just got my sanity back, I'm so tired,

I'll just have a little nap, why do you keep talking,

My ears are blocking what you're saying,

I can't focus on you, I'm so tired,

Can't you tell I'm fighting for my life.

I'm Fine

 I'm Fine is what I say when asked,

I'm Fine even though I'm distressed,

I'm Fine even when the darkness holds me,

I'm Fine with a smile and dying inside.

I Need help and ask for it,

I Need help but they turn me away,

I Need help but I can't cope,

I Need Help but I'm not bad enough.

I'm Adrift lost in my thoughts,

I'm Adrift untethered floating away,

I'm Adrift in the storm coming,

I'm Adrift without a hand on the tiller.

I'm Not alone I have more support than I thought,

I'm Not Alone I've people to talk with,

I'm Not Alone the darks not so dark,

I'm Not Alone in being failed.

I think when someone goes to healthcare professionals and they agree that they need some mental health support/treatment and refer them to the service, I don't think its OK for that service to reject the referral. I also don't think its OK to send out a letter to arrive on a Friday when they won't be able to contact you. I don't think the content of that letter should sound like you are speaking to someone who has not made any attempts to help themselves. Nor should the only alternatives they offer be a mixture of Self harm and suicide hotlines (if people need these you shouldn't be rejecting them) and online resources which all cover the same things which I have done before and are no longer working. I understand that Mental Health resources are stretched beyond what they can cope with but rejecting a referral the day they got it is dangerous. Letters sent out like the one I received may be the last straw for someone who mustered up the courage to ask for help.

Asking for help with your mental health as a Man is hard and was not helpful to my recovery.

The eye of the storm

 

I sit here in the calm,

The Wind Battering the defences,

Listening as it passes through the gaps,

Feeling like the walls may give?

 

The calm at the eye sees the destruction,

It sees what will come to consume it,

Damage it will reek if the eye moves,

If the eye collapses in on itself.

 

I look at the trees fell,

The world brought to a halt,

Held in place wondering what’s going on,

Watching as the wolf blows down the house.

 

Now we walk in the damage,

We try to patch the holes, replace the walls,

Put roofs back on, bring back energy,

And Figure out how to cope in the new reality

Friends

 I never knew what true friendship was,

Until I found you all, it makes me so glad,

To find out how many true friends I have,

The support and encouragement fills me with joy,

You give me confidence and faith to achieve,

Even when in myself I don't believe.

Thank you to you all for the love you have shown,

With your support, my confidence has grown,

 When times were so tough you lent me your ear,

Even in those dark days filled with nothing but fear,

A debt I now owe that can't be repaid,

But I'll try my best till my dying days.

My journey nearly ended six years ago,

My life nearly ebbed when it needed to flow,

But I am here now with resolve for the fight,

Trying my best to fight for what's right,

Stand up to delirium is my passion forever, alright,

To beat it completely will take all of our might.

So to end this verse on a high,

I'll say but a few words,

Lets keep moving forward not backwards,

We'll band together to say to Delirium Goodbye.

The Pandemic Blues

This time of year people say is joyful,

But this year it’s the anniversary of the worst time of my life,

Everyone is excited and bouncing with joy,

But inside me the grief is pulling me down,

While everyone is bouncing about town.

My life nearly ended to a bird flu in those happy times,

Now in a pandemic I sit with no immune system,

Stressing about what might come my way,

With covid and flu running rampant around me,

My castle, my fort nothing allowed in.

I watch my friend go heroic things everyday,

I watch as what we ask of them to do and who to save,

They achieve more than we should ask of anyone,

I am in such awe of these humans who call me friends,

Do all that’s asked and get through all the strife,

I would entrust each and everyone of them with my life.

Every bleep and noise sends me back to ICU,

Back struggling for breath, drowning in fluid,

Those flashes of trauma burned into my brain,

Lessen with time but never going away,

I send every so often and relive my pain,

So others won’t have to live my pain again.

I stand up at conferences and tell you my tale,

But my suffering a footnote in the effect it had taken,

Every single day my family’s hearts where breaking,

I was fighting with every ounce of my being,

But me laying lifeless all they where seeing.

So this time of year for me not filled with joy,

Even the thought of getting new ‘toys’,

But I am happy I am here and my friends still are too,

If we all stand together we will all get through,

Supporting each other holding each other up,

At the end of it all we will all have a cup’.