Hospital Again

If I wrote this piece a few weeks ago it would have been a detailed synopsis of all that is wrong with the treatment that Tam got from Claire Dover at Ferndene. Now I realise that it just a rotten system with lazy people doing the same thing over and over again.

A little bit of an explanation is needed though.

Tam has been in hospital twice. Once from 7th May til the 27th June and the second time from the early hours of the 31st October til the 11th November. In reality I brought Tam home the second time on the 9th November.

In hindsight the first stay in hospital for Tam did not do much apart from giving a little respite to both of us. Tam was being aggressive in the period running up to his admission and could not attend school due to several aggressive incidents. I suppose I hoped that they would take the incidents into consideration and review some methods or drugs to help him to cope.

Instead they monitored Tam, and even though he had some aggressive outbursts they in reality did nothing. Tam was discharged with Omeprazole, Ferrous Sulphate, and Promethazine (as required).

So lets break that down.

Omeprazole is given for heartburn.
Ferrous Sulphate for anaemia.
Promethazine for anxiety.

Well I had talked to plenty of doctors about the fact that Promethazine (at 5mg) was paradoxical. It made Tam more aggressive. So they upped the dose to 25mg. So I gave it a try and yes it is paradoxical as far as Tam goes. Full blown aggression.

So why the Omeprazole, looking back all I can think is that it might have been to block the Ferrous Sulphate from giving Tam indigestion. Well it also gave him a hacking cough, dry throat and mouth plus cracked lips. I discussed this with doctors and stopped it within a few days of him being discharged. I also stopped the ferrous Sulphate at the same time. I put Tam back on the food he had at home and he thrived for 5 weeks.

Over the space of time in between being discharged and being readmitted to Ferndene Tam had about 5 weeks of brilliant behaviour and then a slow descent into increasingly aggressive behaviour. The fear of hospital seemed to be the driver that over time dissipated.

Then during October things went downhill. In the last week of October things were especially bad for him. Everything that was tried had little effect and sometimes had a detrimental effect. On the last Sunday of October things went really badly. I had no option to call for help.

Instead of repeating the events of prior times I did not call the CYPS crisis team (a waste of time and badly named), the police (they have been great in helping to give me the space to get the situation calmed) or the hospital (not setup to help). This time I phoned 111 and asked for advice and help while I was barricaded in a room away from Tam and watching him on a camera set up for these events. They were a great help, I was passed to a nurse and doctor and it was decided that paramedics would be dispatched. They wanted to check over Tam and the situation with him and also me. I had been bitten several times.

I did not have to wait long before they arrived with the police in tow. We had a chat about the situation, they checked me out and talked about Tam. Tam was at this point calmer and was listening to his own heart with a stethoscope. Then out of nowhere he attacked the two paramedics. I managed to get between him and them and got them to move away. He was in full aggression mode. With the police waiting outside it was all I could do to pin him down and then move him out of the flat. He was trapped between the flat and the police. Time passed and he calmed down with the police talking to him and keeping him in place. I was floored.

After a little bit of a chat it was decided that the police and paramedics would take Tam to the hospital A&E department. They were worried if I went that the hospital would just ask us to go home as Tam was now calmer. They said that he should be in hospital and if I was asked to pick him up then I should say no.

A hour or so later I had a doctor on the phone (Shah I think his name was) who said that they wanted me to get him as he was fine now and that he was prescribing Lorezepam 1mg as a replacement for 4mg of Diazepam. I said no I could not come and get him.

Eventually, after a couple of hours I got a call from social services saying they were now involved and that they were going to organise a section 2. After a bit of a conversation it was decided that I meet at the hospital for the review. My main request was that Tam be safe and that the section 2 would include that some form of medication be sorted to help him with his anxiety as this was the main cause of his outbursts. That was agreed and in the early hours he was transferred to Ferndene.

Then the problems started. I tried from the Monday until the following Tuesday to talk to the consultant or any doctor to find out what they were thinking in the way of medication to help. I was told that the doctors would asked to talk to me. I even had a meeting on the Wednesday but Claire Dover his consultant appeared to be disinterested in the proceedings and I caught her rolling her eyes at some of the things said. I think it was the Thursday (might have been the Friday) I asked for a different doctor. Then I got a pile of crap about I had to either fill in a form or not fill in a form to get another doctor.

After Tams carers visited him on Tuesday and gave me some feedback about things I decided enough was enough. I was going to remove Tam from hospital if I could not speak to a doctor. Cat amongst the pigeons.

After some conversation with the staff and me making myself clear and junior doctor appeared. Well ok, don’t shoot the messenger. I expressed my issues, the first one being that Tam was not safe as I could not get a new doctor. The conversation went around and around that they were monitoring Tam for behaviour and that Clair Dover had been going through his medication history to see what drug we could use for Tams anxiety. News to me. First, I had asked for a new doctor so what was Clair Dover doing on Tams case still and second why not have a conversation with me as I had things to say that might have helped in any historical review.

I asked the junior doctor about what Tam was on as far as drugs and the answer came as a surprise, Omeprozole and Vitamin D. Why the Omeprozole? Because he was on that when he was discharged was the answer. Why Vitamin D? Because it was hospital policy was the answer. Was his vitamin D low? No was the answer. (I found out later that the hospital blood test did show it low, so this answer although not a downright lie was showing a lack of knowledge of Tams situation). I also had the junior doctor tell me in an almost angry way that “they could do anything to patients” when I questioned about Tam having a blood test.

At this point I knew that it was not safe to leave Tam in the care of the hospital. Consultants remained aloof and unable to make time to talk to patients guardians or parents and a junior doctor that did not see guardians or parents as needing to be kept in the loop. I explained that if they did not discharge Tam immediately I would call the police as I felt that Tam was not safe.

To sum up the reasons:

Tam given medication that made him sick for no practical reason other than he had had it months ago - Omeprazole (discussed with doctors and in his notes)
Doctors or consultants that would not talk to me about Tams care after repeated requests
A request for a change of doctor that was either being ignored or was not being communicated through to the power that could action it.
Staff that could not give me a clear picture of what was going on with Tams treatment and all they could say was he was “calm and doing well”
Too many staff that I tried to talk to either had poor english or were told not to talk to visitors.

I felt disgusted and let down by the whole situation. I left with Tam a few hours later. I feel like ALL of the doctors and consultant are complicit in the poor care of my boy.

I am now in the position that I feel like it is a waste of time hoping that the mental health service will provide any level of care. The doctors are so used to following their merry go round of things they do that they cannot see they are not looking after the patients (CHILDREN) properly. They might say to me that I have the wrong end of the stick and misunderstand what the service provides. Well no one has ever corrected my thoughts on that one. Would I use the mental health service again? No is the sad answer. Would I let Tam be taken to Ferndene hosptial again? No is the sad answer.

What will I do if Tam was other episodes of violence? Well the answer is he has had many since. I am his Dad and I am trying to steer him through these bad times. He has also had one bad episode with his carers at the cinema which was horrendous seeing other people hurt.

All the episodes since his discharge could be blamed on the system of Ferndene hospital and doctors that don’t care to do the right thing. Doctors that don’t want to engage with parents and guardians. Doctors who appear to be bored and indifferent. Doctors who think observing children in an artificial environment takes prescedent over the behaviour that happens at home or in the community.

I pity them, they are trapped in there own misguided world and providing a disservice to the children that need them.

I will probably have to read this again in the next few days and fix my grammar and spelling but for now it is posted and I can forget about the sorry state of mental health care for CHILDREN.

(oh, some photos of Tam just to show that Dad and Tam can have happy times with no help from Dover and her colleagues)

Tam Tam Tam Tam Tam Tam Tam Tam Tam