Monday, September 15, 2014

Raymond Anthony Fernando's wife's passing; What happened? He writes to the press

My beloved Doris who died on the eve of Maundy Thursday –17th April 2014 is now safe in Heaven for the Lord will care for her – unconditionally, as I have for 40 years.  Jesus has plans for all of His children and He has special love for the mentally ill, and that is documented in the Bible.  
Strange coincidence: I met Doris 40 years on Good Friday, she died on the eve of Good Friday, and she was born on All Saints Day.   In Heaven, my wife will have no more suffering from illnesses and no more prejudices from her mental illness, which psychiatric patients face every day in their lonely and isolated lives. 
Nonetheless, I need to share my pain, and hopefully others in a similar condition who come after Doris will not suffer the same fate.
There must be a better way to manage the psychiatric conditions of patients like my wife. She was taking more about 27.5 tranquillizers a day to manage her schizophrenia, and overnight, all these medications were taken away – resulting in a complete shock of her mind, and then she could not talk to me in her dying days.  How does it feel to lose a loved one when you cannot even talk to her in her last days?  For my wife to ask for her dying wishes and say her last words to me?
When I was caring for Doris, even if one tablet was reduced, I could see her schizophrenia relapse coming on. Imagine taking away ALL her medications.  
There are things in life which we will never be able to understand, and this is just one of them.  I can understand that Doris will die one day, but I am troubled by the circumstances that led to her untimely demise.
There needs to be better collaborations between specialists and psychiatrists – to save and reclaim every life.
As I read about the mother who has been charged with the murder of her 7-year-old autistic son, I am deeply troubled that the caregiver support system here is so weak.  Here one life has been lost, and another hangs in the balance. It is really tough caring for a loved one with special needs, and it is not that I have not been voicing out these concerns in the press.  
So now, read my letter to the press and the hospital’s reply. 
Raymond Anthony Fernando
Raymond Anthony Fernando’s dies suddenly, he writes to the press: “Better care needed, for death with dignity”
My letter to MediaCorp’s Today newspaper was published on Monday 15th September 2014.
It is important that sensitivity and care are offered to those who are trying to cope with end-of-life issues.
My late wife, who was admitted to Tan Tock Seng Hospital in April for pneumonia, was asked to undergo a colonography a few weeks before. The next day, big rashes appeared on her shins, stomach, chest and feet.
I was upset with the radiology staff and doctors, who kept apologising.
After my wife was referred to the National Skin Centre, doctors there opined that the rashes had erupted because of the Humira injection my wife was receiving every fortnight for her arthritis. Her rashes remained for two weeks.
She died three weeks later or so after her immune system broke down and could not fight the bacteria that invaded her body.
She was exposed to several infections during her multiple visits to TTSH, and when she was admitted for pneumonia, the doctors took away her psychiatric medications. They claimed it was lowering her blood pressure.
I told them my wife was sure to suffer a relapse of her schizophrenia if they take that route. Shortly afterwards, as expected, she suffered a serious relapse, leading to the loss of her speech. She died without dignity.
To add insult to injury, no palliative care was given. Instead, as she was in her final stages, doctors from the infection control unit queried insensitively whether my wife had travelled outside Singapore.
Others in a similar condition should not suffer the same fate.
And TTSH replies: Hospital to be more mindful of next of kin’s needs
We offer our deepest condolences to Mr Raymond Fernando on the passing of his wife, Madam Lau, who had a complex medical history. (“Better care needed, for death with dignity”; Sept 15, online).
When she suffered pain from her arthritis flare last September, our doctor restarted her Humira injections and her condition improved, although her arthritis remained active.
Six months later, when she developed rashes suddenly on her legs, she was seen by our allergist and was subsequently referred to the National Skin Centre for further opinion.
On April 8, Mdm Lau was admitted urgently; she was suffering from septic shock. Our doctors, in consultation with her psychiatrist from the Institute of Mental Health, withheld her schizophrenia medications temporarily to treat this more critical condition safely first.
During this period, our psychiatry team monitored her closely with the medical team. Mr Fernando had been updated on her condition and management plans throughout by the psychiatrist and medical team.
As Mdm Lau remained critically ill, extent of care plans were discussed at length with Mr Fernando. He shared with our doctors what would have been her preferred option.
Hence, the decision was for maximal general ward management with appropriate antibiotics, intravenous fluids and inotropic support. Her condition continued to deteriorate, and she died on April 17. Mr Fernando is understandably still grieving.
Throughout his wife’s stay at Tan Tock Seng Hospital, our medical teams had cared for her very closely and appropriately. We apologise if our doctors appeared insensitive in their attempt to obtain a thorough medical history during this difficult period.
We will strive to be more mindful of the needs and feelings of our patients’ next of kin. We will stay engaged with Mr Fernando and offer him support.
Chin Jing Jih, Associate Professor, Acting Chairman, Medical Board, Tan Tock Seng Hospital

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