to fight to consent to a hypothetical abortion?

[APieOfButter]

First I'd best mention I am currently an inpatient in a psychiatric hospital, although voluntary and totally allowed to refuse drugs etc if i want to. But that is why im typing from a phone, and also i dont want to be accused of drip feeding info.

Right. I have bipolar. There are three drugs that could be added into my cocktail. One is lithium, which has been counted out by the fact i forget meds too often. The other is quetiapine, which i had a bad reaction to, but the consultant likes. He does think that valporate would be better, but wont prescribe it due to me being of childbearing age.

Bear in mind that, although I am currently voluntary, by refusing quetiapine, which makes me panic yet have no control over my limbs, and which is proven to be massively bad healthwise, I put myself at risk of being sectioned, despite all the staff on the ward agreeing that i am fully aware of what i am doing, just currently on the way down from a mania.

Right. So, the dr wont prescribe volporate as it carries a 0.1% risk of deformaties in a hypothetical fetus. I had a traumatic crash section with dd1, including a 'T' shaped incision that has left me with constant niggling pain. I also had severe SPD with dd2 which left me with a limp for 18 months. I also have said MH problems and a very low income, am already on a drug cocktail that is a really bad idea for a pregnancy, and DH has had a vasectomy. I have never had unprotected sex with anyone but DH and my ex fiance.

Dr says, because i have been sexually impulsive in the past (ie years ago me and dh had a few adventures with threesomes etc, but obv with protection etc- im not an idiot) i might suddenly run off and get pregnant.

I cant seem to get him to understand that, given all the above reasons, if i suddenly got randomly pregnant, i would have an abortion, whether or not i had the valporate to consider. And in fact controlling my condition with drugs would make it even less likely i would be sexually impulsive in the first place.

His response? 'An abortion is a big decision'. As I am still fertile, I have to go on the drug that will massively reduce my quality of life (which he accepts). I fully accept I need medication, but surely I am allowed to consent to a hypothetical abortion that i was hypothetically going to have anyway?

[appplepie]

Are you not able to use long term contraception? Sorry if you answered that. I read but am poorly too so difficult to read long thimngs...


Sorry you;re ill by the way

[BitOfFun]

I have been refused a drug which would help me on the grounds that it is teratogenic, even though i don't intend to have any more children. It is just their protocols, you can't fight it. No point thinking about it.

[OilySnatch]

valproate is mostly only useful for acute mania though, it's not something there's much (any?) evidence for as mood stabiliser long term

quetiapine is a rubbish anti-manic - what about olanzapine?

it's a pity you don't feel organized enough to take lithium, I am quite hit and miss with it but seem to maintain a steady enough level in therapeutic range. It's like not being on anything really, although takes ages to start working, but it is the only true mood stabiliser I think

[shakey1500]

Are you able to ask for a second opinion? It seems very extreme that they would section you for refusing a medication you have had a bad reaction to, especially as you have good reasoning to take the Valporate.

I symapthise, trying to get any point of view across in that environment is nigh on impossible. Good Luck

[oneofthosedays]

Applepie - she has long term contraception, her DH has had the snip. I would find it a little insulting tbh.

[OilySnatch]

but it makes you fat and bald anyway, don't understand why anyone would want to take valproate unless lithium didn't work for them

[Smellslikecatpee]

While I totally disagree with your consultant, and agree with you for the reasons/rationale you?ve given, I?m also aware of how many patient say X and do Y.
I?m not saying that about you, but trying to see it from his point of view [even though I think he?s being a twat]

However if he is adamant about this and you can?t get a 2nd opinion why not try and compromise.
Will he prescribe the med if you go on long term contraception, Implant, coil etc.?

[xstitch]

:( poor you. There are drugs like that prescribed all the time to women of theoretically child bearing years. They just have to ave contraception in place. Can you ask for a second opinion, is there another consultant.

[redexpat]

If DH has had the snip, why would this be an issue?

Is there another Dr you can get a second opinion from?

Hope you get this sorted soon and get better.

[APieOfButter]

The other reason he won't do lithium is that, on admission (dont forget i was seriously ill with a mixed episode at the time, and having freak outs at all sorts) it took three days (and a good dose of tranquilliser) for them to get a blood sample. I dont like them usually, but managed all the needles involved in pregnancy with gritted teeth and not looking.

[APieOfButter]

They do tend to threaten sectioning left right and centre here, im pretty confident it wouldnt happen, but then im not so good at impulse control atm so there is a risk i would panic if they tried it, anx would look mental enough for it to go through.

[OilySnatch]

You only need blood tests every three months once up and running. I thought they were supposed to make evidence based decisions.

Anyway, what else are you taking? Hope you are on the mend. I shudder at the memory of hospital even though got up to plenty of mischief in there at times.

[OilySnatch]

It is horribly easy to change your status once you are an informal inpatient, I don't think your fears are unfounded there.

[APieOfButter]

dh having had tge snip doesnt matter due to said sexual impulsiveness. Which, apart from the threesomes etc years ago, has generally taken the shape of flashing, the odd snog and a bit of a fumble in a nightclub a couple of times with a woman...lesbian fumbles are kinda notable for not resulting in pregnancy.

Every time i see the dr there are at least three other people in the room, so i get a bit tongue tied.

[OilySnatch]

Have you got an advocate? There should be posters up around the ward, I know you're a voluntary patient but think they would still help you. They could be at next ward round/case conference.

[APieOfButter]

also taking lamotrigine and prn zopiclone and lorazipam. Also coedine for the spd, but the spd is much better these days - i didnt even bring it to hospital.

[APieOfButter]

oh, and currently i am in sunderland, dh is in washington, dd2 is in preston and dd1 is in london (due to my family helping with childcare). I just want my family together. :(

[APieOfButter]

anyway, all the shouting etc seems to have calmed down, so im going to sleep. keep the advice coming though, its great to know im not being mad (at least on this issue!)

[Glitterknickaz]

Is there any option that they'd agree if you had sterilisation?
Apologies if that's not what you want, but it'd fix the childbearing years issue...

[APieOfButter]

Id be quite happy to be sterilised, in fact I considered it before dh had his vasectomy, but it does seem quite an extreme solution, and not one that could solve the fact that the consultant has said he will only discharge me if i am on a drug to control mania. I cant afford to be in hospital that long - my children are too young at 19m and 4y to be apart from thier mother (and father, unless dh gets a new job or quits work to be home in the evenings)

[Tortington]

in your situation i woudl be steralised to get the right drug option for me to hekp me live as normal a life as possible and to be as normal a mother as possible to the children i currently have. to allow me not to be stuck in another world of doctors and medication where my family becomes a secondary consideration.


however i don't live your life and its easy to type when discussing someone elses

[APieOfButter]

Id be quite happy to be sterilised, in fact I considered it before dh had his vasectomy, but it does seem quite an extreme solution, and not one that could solve the fact that the consultant has said he will only discharge me if i am on a drug to control mania. I cant afford to be in hospital that long - my children are too young at 19m and 4y to be apart from thier mother (and father, unless dh gets a new job or quits work to be home in the evenings)

[TheNightNurse]

As someone else said, speak to an advocate. Or your solicitor if you really think they're serious about the sectioning. Reckon it'd be pointless anyway cos you can't be forced to take Quetiapine. Plus you're not refusing treatment, just that treatment. Your previous adverse reaction to Quetiapine should be documented somewhere.

As someone else also said, what about Olanzapine? Though it's a bugger for weight gain.

Lithium carries a risk in pregnancy too so not sure why Doctor would consider that (if you were less forgetful/ok with blood tests) but not Valproate. Sounds like a knob.

Get well soon.

[TheNightNurse]

P.S. (I'm really interested in this!) I just googled read about Quetiapine and pregnancy and all I could find was 'no adequate studies' of it's effects in pregnancy.
Tell your Doctor, 'all the drugs could have an effect on a hypothetical pregnancy. Even Quetiapine'.
You'll take the Valproate.
And repeat.
Until he listens.