Tuesday, 14 January 2014

Half a Day in A and E

To those not from the UK, A and E is Accident and Emergency, also known as the Emergency Room in other countries. Also, there is talk of hospital and psych wards throughout this piece so if you are triggered by these topics, please leave the page now.

So last Monday (6th) turned out to be a long, difficult day. It started when I saw one of my support workers from the Intensive Support Team. I told her about some thoughts I had been having and things that voices were telling me to do. She suggested that she phone my CPN and I agreed to let her. My CPN briefly spoke to me too on the phone and asked me if I would go down to the CMHT office and speak to her there. I agreed and my mum and I travelled down there.

I was seen pretty quickly and my CPN seemed quite concerned. She spoke to me, then my mum, for over an hour and suggested either hospital or the home treatment team. I turned both of these options down and my mum and I left. However, when I got home, my problem that I had thought was manageable turned into a crisis. My mum tried to phone out of hours but was told that there was a wait on available doctors who could speak to her. WIth me worsening by the minute and my mum not knowing just how long the wait to speak to a doctor would be, she took me to A and E.

We arrived at A and E at around 6:30 pm and booked in. The woman who booked us in was quite friendly and after my mum explained to her that I was having a mental health crisis, she gave my mum a reassuring nod of the head and told us to take a seat in the busy waiting room.

It was probably a good 20 minutes before I was even called through to triage but once the triage nurse had seen me, she took my mum and I through to an interview room. We were offered tea and biscuits, which we accepted on account of only having had breakfast that day. The minutes passed and after about another hour, a doctor came in, gave the briefest of interviews and told me a nurse would come and see me shortly. Shortly turned out to be another half an hour.

The nurse who came in was lovely, and asked a lot of questions, some of which I wondered if they were necessary. Once the interview was over, she told me a duty psychiatrist would see me at around 9 pm, half an hour later. 9 pm turned into 9:30 pm before the psychiatrist arrived but she too was lovely. She asked a lot of questions, some going into what I thought was excessive and unnecessary territory. I asked her a couple of times why she was asking me all these questions but I finally managed to get to the end of them.

She told me she would admit me but she was unsure if there were any beds available in my local area. She made some phone calls and the nearest available bed was 60 miles away. She booked me in to that bed and the phone call for the ambulance transport was booked just before 11:30 pm. The psychiatrist offered me some diazepam but I initially turned it down. I asked if she had my regular night medication (Quetiapine XL) as we'd forgotten to bring it with us but she said it was unavailable in A and E.

The hours waiting for the ambulance transport passed and on a couple of occasions, the voices were so bad that all I could do was walk around in circles and was barely able to speak. The psychiatrist prescribed diazepam at this point and my mum and a nurse convinced me to take it. It was only a 5 mg dose though, so it did very little, if anything to help.

At around 2:30 am, I was shown to a small ward where I was to try and get some sleep and wait for the ambulance. The voices had other ideas though. Even when I lay down under the covers and felt exhausted, the voices had me wide awake. I started walking around in circles again and the psychiatrist phoned time and time again to the ambulance control, trying to get an ambulance for me. The nurses in the little ward I was in also kept phoning but to no avail.

Eventually, just before 6 am, the psychiatrist had managed to get some Quetiapine for me. I took it gratefully, as I hadn't been looking forward to the side effects of not taking it. They had been saying that once I arrived at the unit, I should ask them for Quetiapine, but the journey was over an hour away and at 6 am I was starting to feel the effects of no Quetiapine.

Around 6:05 am, my mum had had enough of waiting for the ambulance and told the psychiatrist and the nurse on duty in the little ward that she was taking me herself. The two of them initially tried to stop my mum, but she pointed out that I hadn't been sectioned so it wasn't a requirement to go in an ambulance. After further persuading, my mum had their all-clear to drive me there herself.

The journey took over an hour and I fell asleep on the way. The staff in the hospital I was in were nice, but the facilities weren't as good as the ones in my local unit. Plus, I was in a 5-bed ward rather than the private rooms we get in my local unit. But thankfully I was only there for two days before I was able to get a bed in my local unit where I am now.

I'm currently going through a medication change, from Quetiapine XL to Amisulpride. I've never been on Amisulpride before so if anyone has any comments on it, please leave one below.

Apologies for the massively long blog post but there was a lot to get in!


  1. I was on Amisulpride for about two years. Was pretty effective as anti-psychotic - after some initial drowsiness was able to think straight again and was able to leave hospital. But it sent my prolactin levels through the roof and I stopped having periods. And when dose was increased from 500mg to 750mg made me rather lethargic and flat so eventually I stopped it. I hope it improves things for you and you are able to go home soon. Take care.

    1. Thank you for this, I've been warned by others of the risks of prolactin levels so I'll keep an eye out for them. Thanks for your help! xx

  2. Hi, I've taken Amisulpride, it was better than Resperidone (which caused me to wake up feeling like I had a hangover minus the cracking headache) but still left me very dopey. I expect, like I was, you are on a high dose for treating psychosis. The medication apparently functions differently below 200mg dosages (because " low doses in the 50 to 200 mg range preferentially block inhibitory pre-synaptic autoreceptors. This results in a facilitation of dopamine activity, and for this reason, low dose amisulpride has also been used to treat dysthymia", copied from the wikipedia page, so you don't have to go there and browse through the exhaustive list of unpleasant information on there. My psychiatrist at the time also referred to the drug acting differently below 200mg -I had tried to get him to let me have a lower dose.

    I hope things improve in any case.

    1. Thanks for letting me know all this, it's useful information to have. I'm on 400mg at night and I'll soon be starting 200mg in the morning too. Thanks for your help! xx

  3. *MASSIVE HUGS* to you hun. Hope the situation improves soon. Sparky xx