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A Patient's Experience Of IMH Accident & Emergency (A&E)

Posted on 23 Apr 2018
DxD
Singapore
Consult Doctor
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DxD
Singapore
Posted on 22 Apr 2018
Consult Doctor

For the past two weeks, I have been unable to get proper rest.

It wasn't because of any life stressors (such as losing a loved one); I had been started on new medications and simply couldn't fall asleep.

I was yawning every 5 seconds, and even after lying on my bed for 2 hours with my eyes closed, I was still unable to fall asleep. Needless to say, I was frustrated.

The situation was tolerable at first. However, by day 3, I was starting to lose it. I had become more irritable, clumsier, and generally miserable.

To make things worse, I had just undergone eye surgery and was in a lot of pain. Not being able to rest exacerbated my misery, and I needed to get help IMMEDIATELY.

Dr Chan - and my attempt to get sleep

I have seen Dr Chan for help before - he has been titrating my medicines to help me sleep better.

I have actually walked in to Dr Chan's clinic in IMH without an appointment twice.

You should try to avoid doing this unless you are in immediate / serious need of medical attention.

Despite Dr Chan's work so far, nothing seemed to help - I still found myself wide awake at 4 in the morning.

One night, in a desperate bid for sleep, I took thrice the prescribed dose of my medications.

While I was able to get sleep, it only lasted 30 MINUTES.

I later found out what I had done was extremely stupid:

  1. The drug I was on (benzodiazepines) have addictive properties
  2. They can cause withdrawal when taken in high doses
  3. I was able to get sleep, but I would not have medications for the next few days
  4. The sleep was not restful at all
  5. Benzodiazepines can cause dependency and tolerance towards it if taken in high doses and for long periods

Visiting the IMH A&E (for the first time)

IMH a&e

My frustrations with my inability to sleep took me to the A&E at 2 am.

There were no other patients at the time, so I was attended to quite quickly after being triaged.

IMH's A&E department is very different from those of other hospitals. It actually has a very pleasant environment (a pond, sofas, TVs, beverages) and didn't really seem like a hospital at all!

It was a nice contrast to the sterile, extremely clean and white environment of a general hospital.

One notable difference is that there are metal grilles instead of windows, and there are police officers patrolling the hospital (though the latter is normal in other hospitals as well).

This is because of the nature of mental health treatment and illnesses in general. Some patients while sick (and untreated) can become violent towards others.

So, I like to think of the A&E of IMH as a minimum security prison. It's a very pleasant environment, with some stringent security measures.

I will say a little more about the social environment of the hospital later on.

Being prescribed an extremely strong dose of medication

A doctor reviewed my case and he told me that since I would be seeing Dr Chan soon, he would prescribe me an extremely strong dose of Diazepam (a sleeping pill). It was only a temporary measure, as Dr Chan would tailor my medications accordingly once I saw him.

I thought to myself, "Finally, I would be able to get sleep!"

Unfortunately, the Diazepam did nothing for me. I stupidly tried to overdose on it again (PLEASE DO NOT DO THIS). and still couldn't get the sleep I desperately wanted.

A call from my case manager

imh a&e

The next day, I received a call from my case manager (Jessica Wong) from IMH. She asked me about my sleep, which was a great surprise to me, as she had known of my trip to the A&E without me telling her.

She had liased with Dr Chan to get my medications changed and asked if I could make it to the hospital to pick them up.

I told her I couldn't, because I was so tired. Nonetheless, I was extremely appreciative and grateful of the care shown to me.

A second visit to the IMH A&E

Two days later, I was so close to losing it. I was delirious and frustrated. I NEEDED SLEEP!

This time, I went to the A&E in the afternoon. I waited for about 3 hours before I got attended to.

There were a lot of patients who mostly kept to themselves, and were quite peaceable. I did not notice anyone turning violent.

They all seemed like polite folk. 'Normal' folk.

I couldn't say the same for myself though. I repeatedly asked (and repeatedly apologised to) the nurse for how many patients were ahead of me.

I was so restless (literally) and was pacing about the hospital. I needed sleep!

A nurse asked if I would like to lie on a bed to rest. I don't know how to explain the irony I felt from that comment, but I told her no.

Dr Zhang, an excellent doctor

A psychiatrist (Dr Zhang) finally attended to me after a long wait.

To my surprise, Dr Zhang did not change ANY of my medications, and only offered me a non-benzodiazepine sleeping pill.

She said that she could offer me other medications that would be more likely to help me sleep, but they would alter my mood. She wasn't keen to prescribe those to me.

Her astute observation was that Dr Chan had been working with me over the past year, and we had finally managed to rid me of my Major Depressive Disorder (or at least get it under control). We had put in a great deal of effort and made great strides towards getting me well again.

Sabotaging the painstaking progress we have made so far just for a good night's sleep would not be wise.

Plus, she said that I would probably be able to sleep once my body had adjusted to my medications.

Many patients might get mad at Dr Zhang after hearing this. After all, anyone would be upset if they had waited for so long, only to be told that nothing much could be done for them. However, I actually felt very appreciative of what she had told me.

She had given me a reason to continue battling my sleep issues, and explained more about my condition and the medications I was taking.

She also chided me for overdosing (I agree with her, I really shouldn't have done that).

A miracle

She prescribed me a sleeping drug that she told me might help. I was cautioned not to get my hopes up in case the pill didn't work for me.

However, that night, once taking the pill, I slept like a baby. I woke up shouting, "YES!" and accidentally woke up my tenant. I'm so sorry!

Conclusion

The healthcare I received in Singapore with regards to mental health has been nothing less than stellar. Dr Chan, Jessica Wong and Dr Zhang are all excellent individuals who are proficient in their work.

I strongly urge Singaporeans to take a different view towards mental health services in Singapore and what it is able to offer for you. Let us end the stigma today.


Darren Toh is a DxD guest writer, and a former professional League of Legends player who was once the best in South East Asia. He has retired and is currently studying to get into university. He is an oddball who dares to tread where no one else does. He hates the smell of silicone.

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