Monday, 26 August 2019

AN IN-DEPTH LOOK INTO AN OVERDOSE | WHAT I THOUGHT, HOW I FELT, & WHAT HAPPENED

I almost couldn’t believe what I was saying when the lady in the shop asked why I’d passed out and I said that I’d gradually been overdosing on Co-Codomol since the previous day. You’d think that if anything, I’d be used to saying it and maybe even become quite ‘glib’ about it; but actually, it doesn’t get any easier – it still hurts to admit that you were so desperate to escape the hallucinations and memories of abuse that you tried to kill yourself. And it isn’t just with family and friends; I’m also ashamed and pained to tell Doctors, Nurses, and other professionals that I’ve ‘done it again’ because, I know it’s a very common thought process around mental health, but I actually wouldn’t blame someone for thinking me ‘weak’ for coping in such a way. Some people look at suicide as the ‘easy way out’ and I don’t blame them for misunderstanding something so scary and intimidating as going against all human instinct for survival and taking your own life. 

Telling the lady in the shop turned out to be a mistake because she called an Ambulance and when I refused to go to hospital with them, the Paramedics called the Police and I was told it was either put my seatbelt on in the Ambulance or put on handcuffs in the Police car; and so, of course, I fastened my seatbelt! Part of my refusal was because I wanted the overdose to work and for it to kill me, but a bigger part of it was about not wanting to upset the auditory hallucinations who were telling me not to go to the Hospital. I’d already bartered with them to hurt myself over hurting the people and things the voice was telling me to hurt; so, there could be no more compromising with it. I was no longer in control; my health, my thoughts, my feelings, my relationships… the voice owned them all. Agreeing to go to hospital, however, was much easier when it was the result of a threat from the Police and not my own volition.

On the Ambulance journey, I overheard the female paramedic who was driving saying that she thought that nothing was wrong for me and that I was doing everything for attention. Immediately my ‘hackles’ went up and I asked the Paramedic sat in the back of the Ambulance with me whether they had CCTV in the front of the Ambulance as they do in the back. He told me no. I asked if the one in the back recorded audio and he told me no. There was a moment where I thought ‘do I speak up anyway? Is it worth the fuss?’ Part of me thought that it wasn’t and that it wasn’t anything I hadn’t heard before so why should I make a huge deal of it. Another part of me, thought that if I don’t challenge her on it then she might say it to someone else and it could have a completely different impact on them… In the end, I settled on simply telling her that I’d heard what she’d said and thought she should consider her words when they can be overheard by patients.

Arriving at hospital, I was instantly relieved that I recognized none of the Accident and Emergency(A&E) staff because it meant that I didn’t have the paranoia that they were thinking ‘here she is again.’ The Police told me that they’d be staying with me for as long as it took for me to be medically fit and/or willing to stay at the hospital. I attempted to convince them that I wouldn’t run away and when a huge incident came over their radios that was demanding all available Police officers, I felt terrible that two of them were sat there with me. The officers explained, though, that they’d rather have two officers make sure I stay in A&E, than have the hospital report me missing and a ton of officers be called in to find me. Their determination to stay with me despite my protestations helped me fight the voice and agree to have the antidote treatment for the overdose. A Doctor asked to take my bloods so that they could find out the level of paracetamol but explained that because it

was a staggered overdose and I hadn’t swallowed all of the pills in short succession, the blood results wouldn’t mean a thing and the treatment was definitely necessary. After failing – a few times – to find a vein for the cannula (a little tube that is injected into your vein then stays there to administer treatment and medications) but managing to take bloods, the Doctor went to another Consultant to ask for advice. When she returned, she told me that they were going to wait and see what the blood levels came back as and, for me, this meant that they didn’t believe I’d taken as many tablets as I told them I had. When the Doctor didn’t understand my logic in this I explained that if they honestly believed I’d taken all those pills then they wouldn’t be reckoning on the paracetamol levels to indicate whether treatment was necessary; particularly after the Doctor had stated that staggered overdoses are automatically treat. So – with tears in my eyes – I asked the Doctor if I could discharge myself and she agreed that I had the capacity to do so, but under the understanding that they could check my blood results and if they were abnormal that they would ring me and I would answer my phone.

I took a taxi home from A&E (the Police did offer me a lift but I didn’t fancy getting out of a Police car in my nosey neighborhood!), took off my make-up, put on my pjs, had something to eat and settled down with Netflix and The Sims! I got a shock when the phone rang over two hours later because I’d assumed the bloods had come back and had either been ignored or deemed inadequate to warrant treatment; but the Doctor told me that my paracetamol levels were five times what was necessary to require the antidote treatment. She said there’d be a Police car at my door if I didn’t agree to go back to the Hospital voluntarily, so I packed an overnight bag! By that point (over eight hours since the last handful of pills) the voice had quietened and I felt more comfortable being in hospital now that it meant I’d have my own belongings and home comforts (something I advise everyone take on any planned hospital admissions!).

Back in A&E, the Doctors ended up calling someone from the Critical Care Unit to attempt to put a cannula in and when she failed, an Anesthetist was called… and succeeded! I thought that would be the end of the A&E fiasco but then I got a rude and argumentative Nurse. So, the treatment to a paracetamol overdose is called Acetylcysteine (or Parvolex) and the very first time I had it, I had an allergic reaction so ever since, I’ve always been given an anti-histamine and an anti-sickness before the treatment started and throughout it (it consists of three drips; the first lasts one hour, the second is four hours and the final bag takes sixteen hours to drip through!). Except this one Nurse decided that the best way to go about things was to give me the treatment, wait and see if I have a reaction and then give me the medications. My logic was that I have the medications so as to avoid the allergic reaction (which consisted of my throat swelling up and me struggling to breath!). Eventually, the Doctor checked my records to see that they have always done it the way I said and the Nurse had to back down and give me the medications before the Parvolex.

The only available hospital bed was on the Coronary Care Unit (CCU) and I was unsure whether to be relieved or terrified! On the one hand, I was relieved that it meant I wasn’t going to be faced with staff who had seen me at my worst and always held that against me, and on the other hand; I was nervous that I now didn’t know any of the staff or what to expect from them. In the end, it was a very positive thing because the staff were so much less judgmental because when I struggled, they didn’t treat me with the attitude of ‘here we go again.’ Initially, I wasn’t too sure about the staff because I was convinced that my cannula had tissued (come out of the vein so that the fluid from the drip was just going into tissue) but none of them would listen to me and kept saying that it was fine. Luckily, me being so adamant and demanding to see a Doctor, they conceded that it had tissued and the Anesthetist was called back down. When he got the new cannula in at about three in the morning, I finally thought I could go to sleep and then one of the Psychiatric Liaison Team came to see me! She offered to advise the ward to prescribe me Diazepam if I struggle and told me they’d be back to assess me properly when the treatment had finished. I really appreciated that little check-in because it reassured me that the team were aware I was in the Hospital and it was important to me that they now recognized how useful Diazepam can be for me, and that they went that extra mile to pop in and get it sorted without being asked to do so. When she left, I finally fell asleep!

I was woken by a Doctor doing ward round and felt a sudden ache in my arm, looking down, I saw the new cannula had tissued. The Doctor confirmed it and another Doctor from Critical Care came to put a new one in but failed and decided that I need a midline (a really long cannula that goes into a much deeper vein) fitted in surgery. I massively struggled in agreeing to have it put in and explained to the Nurse and Doctor that even though it might not seem that way, every second I was sat there in hospital I was fighting against the voice that was telling me not to. And I think it’s commonly known that struggling with your mental health can be physically exhausting which – for me, at least – makes fighting the voice even harder and the thought of lying there while the Doctors do a major procedure to save my life just seemed completely beyond the capabilities of my energy and strength. Luckily, the staff understood – as best they could anyway – and gave me some Diazepam before I was taken to theatre.

I ended up being even more grateful for the Diazepam when I got to theatre and was told that the Doctor who fitted midlines was busy and that it meant I’d be having a central line (where the tube is inserted into a small incision made in your neck) instead! It wasn’t as bad as I’d thought and I was really relieved to find that when I got back to the ward, my Mum was coming in to visit me. When my mental health very first deteriorated we attempted having my Mum sit with me in A&E and on the wards but it made little difference to how I would behave in hospital and whether I would run away from it so we tend not to see each other while I’m in hospital. It was really nice though and she brought lots of snacks – which is always a good thing! And then she left… 



This next part is kind of hard for me to write/talk about because when I look back at the time, the thoughts and feelings I had, the beliefs I held and the things that I experienced; I can’t help but think ‘oh my God; people will think I’m crazy!’ But at the time, these experiences were so completely real for me that I didn’t question what others would think of me; I didn’t have a problem talking about the hallucinations I was seeing and the delusional thoughts I was having because in my mind, they weren’t hallucinations and they weren’t delusions; it was all real. 100% genuine. Realizing this, and when I decided that I didn’t want to continue the Parvolex treatment, the ward staff had a Psychiatrist come in from the local Psychiatric Hospital and he deemed me as not having the capacity to make my own decisions and I was told that they’d do whatever it took to make sure I completed the remaining fourteen hours of treatment. We came to an agreement and I was given Diazepam and Zopiclone – two medications that I very rarely take so having them together completely knocked me out and I managed to sleep through the night.

The next day (Friday). I finished the Parvolex and after blood tests ruled that I didn’t need any more and that my liver was functioning healthily, I had to see the Psychiatric Liaison Team one last time before I could go home. I was a little nervous to meet with them considering I’d been treat under the Mental Capacity Act less than twelve hours ago but I felt better and had thought about what I wanted to say to them. At assessments like this, I’m always asked what I would like to happen from it and so this time, I told the Team that I’d like to be under the care of the Crisis Team until my emergency appointment with my community Psychiatrist the following Wednesday. But apparently, they believed it’d be in my best interests that I go home with no extra support. Of course I was hurt and disappointed by this; it had taken a lot for me to say that I needed help and to want to work with the Crisis Team so for them to knock it back in such a way was demeaning, patronizing, and disrespectful.


But I shrugged it off; it wasn’t exactly the first time that I’d felt ignored by them and I tried to adopt the thought process that they are the professionals and they know best. But actually, I don’t agree with that one bit! We know ourselves better than anyone and having little to no personal experience of ill mental health doesn’t make you any more or less ‘qualified’ and ‘capable’ of giving advice and making decisions for someone who is struggling with theirs.

The twos questions almost always asked of a patient after a suicide attempt or self-harm incident is ‘do you regret doing it?’ and ‘do you feel any better for doing it?’ When professionals ask this, they aren’t usually just making conversation; instead, they are trying to gage your level of risk as to whether you’ll do it again. And their conclusion from your answers will determine their decision on the next steps in your care.

In answer to the first question, no; I don’t. I like to live by the motto that life is too short for regrets – if something bad happens then you should treat it as a lesson to learn from.

And to the second question, I did at first but no; now I don’t… not at all.