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Hi, my name is Dr.
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David Hornstein, and I'm an intensive care physician at the MUHC here in Montreal.
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Welcome to Intensive Caring Voices from the ICU.
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My guest today is Maya Masuda.
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Hi Maya, thanks for coming in.
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Nice to be here.
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Maya, you work in healthcare.
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Can you tell us a little bit about what you do?
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Sure.
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I work at the Royal Victoria Hospital and I work as a speech language pathologist or otherwise known as a speech therapist, which is how most people recognize us.
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And I've been working there since 2012, solely with the adult population.
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Usually people think of speech therapists for kids, but I work with adults.
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And since I started working, I've worked in a variety of contexts there, both in the outpatient clinics and also seeing patients throughout the hospital, on the floors, after surgeries, and also in the ICU.
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And speech uh therapists work with people in the ICU?
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Why?
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Um usually people, when they're in the ICU, they um can lose their ability to communicate because they are intubated.
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Um and so we're often consulted for things like um speaking valves, which are special attachments to their trach to help them uh voice while they're still on uh on a ventilator or with a trach in the neck, um, or finding other ways for them to communicate in a nonverbal way.
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Um and we also see patients to help with their swelling.
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So you're used to the hospital environment as your place of work.
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Yes.
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The um when I went into the field when I was studying, I really was focused on the medical side of speech therapy.
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Um, I knew I wanted to work in a hospital, in acute care.
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Um, I kind of I'm one of those people who watches uh medical TV shows, documentaries in my spare time.
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And I've always been that way.
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And so that's where I that's what always interested me and kind of uh drew me to this part of the field.
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Tell us a bit um about your experience from the other side of the bed, I guess one would say, from the other side of the yeah.
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So um I guess that leads me into talking a little bit about what uh why I'm even on this show as a guest.
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So I'm not here as from my had a as a speech therapist, but as a a former ICU patient.
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So back in 2021, in November, I gave birth to my daughter.
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Uh, she's my second child.
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And then about seven weeks later, I ended up waking up one night.
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Everything had gone smoothly with the pregnancy.
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It was my husband and I were almost gloating that the pregnancy and the delivery went so smoothly that um compared to my first one where the delivery was much more challenging, but everything went well.
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Um, seven weeks later, I woke up in the middle of the night with um severe abdominal pain, vomiting.
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I was breastfeeding my daughter.
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Um, and I just thought I had gastro.
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So I got my husband and he took her off of me.
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And then what ended up happening is it it wasn't gastro in the end.
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And so I got more and more weak as the hours went by at home.
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I called 911.
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I ended up getting taken to um the Lakeshore Hospital, which was much closer to my house in the West Island.
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And um I was told, from what I remember, that I um that I was going in for an appendix that I needed to come out.
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And then a couple days later, I woke up um intubated, uh restrained in an ICU bed, and with a pretty big scar going all the way down my uh abdomen, and uh learned that actually my appendix was fine, but I had gone into septic shock um right before the planned appendix removal.
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So they had to open me up and they found that I had uh an abdominal infection, peritonitis.
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And so I ended up being very, very sick, much sicker than I ever thought.
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And I um I got to experience the ICU from from the not so nice side of it.
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And to remind uh everybody, this was during the pandemic, was it?
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Yeah, that was during the I think it was the Omicron wave, from what I remember.
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Um, so when I was in, so this was January 9th, 2022 is the day I I went into the hospital.
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And uh at that point at the lakeshore, and I think at most of the other hospitals, visitors were severely restricted.
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Lakeshore was pretty much no visitors allowed at all, even in the ICU.
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Um, my husband was able to come see me.
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Uh, I think he said one day at the very beginning, but I don't really remember his visit.
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They basically called him in when I was doing so poorly that they thought he had to come see me, just in case.
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Um, so from that visit on, I had no one else for the rest of my stay.
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And what do you remember most?
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What are some of the memories you remember from that time, if there are any?
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Yeah.
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Um well, it's now been four years since this happened.
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So I would say things, you know, the patchwork of memories and images and smells and feelings are all kind of they're starting to come together more and more as time goes by.
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Um really things I remember is just feeling of uh being completely um isolated kind of isn't the strong enough word, more like deserted in a way, um, of fear, um, loneliness.
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Um, I remember the only thing I really had to look at was the this clock.
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And so me and the clock got really well acquainted.
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Um, and there was a hand hygiene sign that was posted on the door of whatever wall I was looking in front of.
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And I'm not sure if I read it, but I I stared at that uh hundreds of times trying to decipher what was going on.
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So that was really my entertainment.
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Um yeah.
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Now you got out of the ICU, you got out of the hospital, but you did have to come back to the hospital a couple more times during this during the following months, right?
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Yeah.
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So I um I was in the hospital for um about a month.
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Um and I I got home and things were going pretty smoothly given everything that happened.
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Um and then I actually I got strong enough that by July um my husband and I decided we would go and visit his family in the UK, as we usually do over the summers.
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So we had booked our tickets.
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Um, but actually the night before I remember I went to Fairview with my son to get a lot a few last-minute things for our trip.
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And I started getting this really sharp pain in my back and didn't know what was happening, started to panic a bit because you have all those memories that unlock from uh the first uh episode in January.
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Um, and then I ended up coming home immediately with him, and thankfully I did because by the time I got home, the pain had intensified and wrapped around to the front, around my stomach area.
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Um, and I mean, I thought I was having another episode like before.
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Um I ended up calling 911 again, uh went to the ER, and it turns out it was uh just my gallbladder, um, which was good news, but also meant that um I had more things to take care of medically.
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So like trip was canceled.
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Um and yeah, I ended up a few months after that having my gallbladder removed in the fall.
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Unfortunately, after that, I had a surgical site infection from that surgery.
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So that ended up back in the emergency room.
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Um, I don't know if you want to go into those details.
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It was a little bit more medical trauma that happened uh and daily visits to get wound packing.
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So, really, from January all the way through December of 2022, um my life, well, my maternity leave was filled with hospital visits.
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This episode is presented by the MUHC Foundation.
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The MUHC Foundation helps fund life-saving equipment, groundbreaking medical research, and programs that improve the patient experience across the hospital network.
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If you'd like to learn more or support the incredible work happening at the MUHC, visit muhc foundation.com.
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Together, we can help shape the future of healthcare.
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And then you went back to work.
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And that must have been incredibly difficult.
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Talk to us about that.
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Yeah, so I um so I guess because yeah, so all of this happened uh when I was on MAT leave and I had taken, um, even before I got sick, I had taken, I think the full whatever you're allowed, I think 18 months or something.
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And so after all of 2022, by the next year, then it was time to start thinking about going back to work.
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Um but to be honest, at that point, the thought of ever stepping foot back into the hospital, um, let alone the ICU, was um uh I I basically I didn't think I could do it.
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And so I spent many, many, many days and hours um searching for new careers.
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And so I at one point I convinced myself that oh, I could do a degree, a certificate in cybersecurity, and then I just have to be on the computer and I never have to go to hospital.
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I convinced myself that I'd be interested in that.
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And this, if if you know me, you'd know that that's very far from anything I have any interest or passion about.
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Um But so in the end, you you actually did go back.
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Yes.
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And and I remember you telling me a story about uh a broken microwave oven.
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Yeah.
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So I did go back eventually after um after some help and some therapy, and I went back.
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Um, but I went back with some restrictions, and so I was uh able to get my doctor to say that I can work, but only if I stay in the clinic and I don't have to step foot on a medical floor or the ICU.
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So I get to um my department, uh, and just to give you context, so at the Royal Victoria, which is the Glen site, um it's our department is located right next to um the respiratory therapy department.
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And so we um we don't share much of this space usually, but when I went back, it just so happened that there was, I think there was a fire or a flood in our staff kitchen.
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And so we had to use the staff kitchen for the respiratory therapists.
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And um in order to get to that kitchen, it meant that I had to walk through a hallway that was lined with ventilator after ventilator.
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And for me at that time, that was a really big trigger um of all the ICU related uh, I don't know, trauma anxiety trauma.
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Yeah, for sure.
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Um, and to the point where at the very beginning, I I kind of decided, well, I guess I don't need a microwave because I it wasn't worth it to expose myself to that.
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And you changed your behavior.
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You started not bringing lunches and buying lunches and really avoiding going through that uh period.
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And I think it's really important because triggers are are extremely important.
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Life was kind of everything had to be shifted so that I didn't encounter triggers around me.
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It were anything from, I mean, a ventilator that's not easy to run into day to day at home, but at work it was.
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But even things like um, like a little yogurt pot, like the yoga yogurt pots, that was a big trigger for for a long time.
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Because they had them at the hospital, and it was one of like the only things I could swallow for for a while after I was extubated.
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And then even once I could eat other stuff, my appetite wasn't great.
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And so that's kind of all I could stomach.
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And so yeah.
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So Maya, you uh did not come to our program through the usual mechanism, did you?
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No.
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So we met in a strange way.
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Maybe you could share that.
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I basically um what's the word?
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I I cornered Dr.
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Hornstein.
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Um, so I was uh when I was home and trying to figure out if I could come back to the hospital and really struggling from a psychological standpoint.
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I was doing lots of research online trying to find, you know, ICU support group, or I didn't really know what I was looking for.
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I knew I was struggling, but I didn't know what I needed.
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Um and nobody just to say no one in my medical team really checked in on the mental side of things.
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It was really like, oh, your wounds are, you know, your wounds are healing nicely.
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Okay, we're gonna take you off this medication, um, et cetera.
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But the mental side was was practically ignored.
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And so I happened to find tons of news articles, interviews of Dr.
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Hornstein's uh critical illness recovery center program.
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And I thought, wow, that sounds I was amazed that it was in Montreal because I was initially I was convinced, I was like, well, this is going to be somewhere I can't access.
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Um, but it was in Montreal, and not only that, but it was, you know, uh seemed to be for the MUHC, the McGill University Health Center's patients.
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And I was shocked because I I work at the MUHC, but I had never heard of this program until my own internet sleuthing.
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So it was within, I think, a week or two of me returning to work.
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I was waiting by the elevators.
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The elevator doors opened, and then there was a familiar face who uh who came out of the elevator.
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So I recognized Dr.
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Hornstein straight away, and I might have looked a bit crazy, but I kind of stopped him in his tracks.
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I said, please can you listen to me?
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I have to ask you something.
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And I gave a, I think, a hopefully a not too uh long summary of what was going on with me and asked if uh someone like me who was admitted at the Lakeshore Hospital could possibly be be a part of your program.
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And uh of course, the answer you you can imagine what the answer was uh cornered in an elevator, whatever.
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So, but um you did come in the program, and I know Maya, you've you've faced a lot of these triggers, a lot of these demons, and you've I've I've got uh Maya, you've come to the ICU even recently, um, and you've talked to people who work in the ICU.
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These are all big steps.
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What about coming to our group sessions?
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How has that helped or has it helped?
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Oh, it's helped.
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Uh it's helped, it's I think that's been one of the key things actually in my recovery.
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Um, I was not asked to come here and promote the program necessarily, but uh I um I remember the the first group I attended, it was virtual.
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I think things were still virtual at that point.
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It wasn't back in person.
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And but despite that, even though virtual meetings sometimes feel a bit cold and impersonal, it was like I had finally found people who understood how I was feeling and also what I needed, because I hadn't experienced that yet.
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Um, you get a lot of kind of um positivity from from family, well-meaning family, well-meaning friends, but um sometimes you just need someone who's been through it to actually help you through it.
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And so I, you know, that that first meeting and then and then I attended pretty regularly for the next year or so.
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Um, and that was one of the most important things in my in my recovery and ability to kind of keep doing what I what I wanted to do at work and move forward with my life too.
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What would you say to people who may be listening who haven't had access to support really for what you go through, the challenges you go through after being critically ill?
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What would I say to them?
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Um that how you're feeling is normal, that you're not crazy, um that even if there's nothing visible to others, um you can still be feeling horrible and you can still be struggling, and that's that's okay, that's normal.
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I think there's a lot of guilt that kind of builds up when you feel like I shouldn't be feeling this way.
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I survived and you know, I should be so happy to have survived, but that can be really hard to appreciate when you're struggling so hard mentally inside.
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And so I guess for you know, for anyone who doesn't have access to a support group, just just knowing that, you know, you're not alone in that feeling and it's completely normal.
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Yeah, I wish someone would have told me that sooner.
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Maya, thanks so much for coming in and for sharing all that with us.
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I'm grateful for that.
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Thank you so much.
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If you enjoyed today's conversation, make sure to follow or subscribe to Intensive Caring, voices from the ICU, wherever you get your podcasts, so you never miss an episode.
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To learn more about the work of the MUHC Foundation or to make a donation supporting patient care, research, and innovation, visit muhc foundation.com.