Yang Shanshan had a nightmare. She woke up in the public lounge area with a headache and a feeling of stuffiness in her stomach. The whole person sat motionless on the camp bed, so uncomfortable that he "didn't want to open his eyes."
She is a depressed person in Shanghai who is currently in corporate isolation. This is her 7th day of medication reduction.
Since March this year, the spread of Omi kerong has triggered clusters of outbreaks in many parts of the mainland, with the most serious situation in Jilin Province and Shanghai Municipality. On April 17, an expert from the joint prevention and control of the State Council said in an interview that the current epidemic transmission index in Shanghai has dropped to 1.23, which is very close to the control of this round of epidemic control.
Under the prevention and control of the epidemic, some patients with mental illness have encountered a crisis of drug discontinuation. They sought help in many ways, but due to hospital closures, poor information, tight transportation capacity, etc., the problems were often not solved in time. Some people have repeated illnesses as a result, and they have to endure a strong withdrawal reaction.
In the end, relying on their own persistence and the kindness of others, most people got the medicine. But this is not the end of the story, they are still doing other efforts to stabilize the disease.
A crisis emerges
Ms. Yang's sense of crisis emerged on March 27. At noon that day, she found that the medicine on hand was at most enough for a week.
This is her 3rd year of regular medication, with two duloxetine enteric-coated capsules and one trazodone tablet per day.
She hurriedly placed an order at the online pharmacy. Yang Shanshan had bought drugs through this channel several times before, the delivery was very fast, and the express delivery had not stopped, and she had received pants from online shopping the night before. She thought, it would be no problem to receive the goods before the medicine was cut off.
But throughout the afternoon, she didn't receive a shipping notice.
In the evening, Shanghai Municipality announced that it would implement sealing and control with the Huangpu River as the boundary zone. The town of Zhoupu, where Yang Shanshan is located, is located in Pudong, and the sealing period is from March 28 to March 31.
The order dynamics are still not updated, she left a message to the customer service, hoping to increase the money to send the fastest courier, did not get a response. The next day customer service told her that the delivery was stopped.
At that time, Yang Shanshan was not too panicked. If the dose strictly follows the doctor's order, she will cut off the drug on April 2, and according to the notice, Pudong will be unblocked on April 1, and it should be too late. "So those days were still working normally, and I only searched for more channels when I was idle."
On March 31, after learning that she could not unseal it in a short period of time, she began to worry.
In the days that followed, she and her boyfriend, who was isolated at the company, kept looking for and trying new channels, but it was difficult to advance.
She has registered on the special needs platform opened by Ele.me, Jingdong and other enterprises, perhaps because of the tight capacity, there has been no progress; the telephone of the City Jingwei Center has not been dialed, and the Internet hospital was also in a state of no service at that time; she saw that some netizens said that the drug was opened on a digital medical service platform in the spiritual and psychological field, and she immediately followed suit, "Paid money, and was really excited when I saw the words 'waiting for the collection', but until now, the drug has not been sent."
She also tried to apply for the neighborhood committee's dispensing service, but the phone was always busy, and on April 5, it was difficult to call in, but the other party was quite impatient, "I didn't ask what the specific drug was, I said I couldn't buy it now." Later, only one sentence was dropped, "Then you can buy it yourself."
Yang Shanshan registered a shortage of drugs on a special needs platform and communicated with customer service to ship the goods as soon as possible.
Image source: Courtesy of respondents
On various online help platforms, "Occasional Cure" found many people in similar situations to Yang Shanshan.
Wang Yuhua, a wenzhou boy, is helping his mother, who suffers from anxiety disorders, to seek medicine. The mother's other identity is that of a newly diagnosed breast cancer patient, who came to Shanghai to do resection surgery.
They arrived in Shanghai on March 21. According to the original plan, after the operation was completed in late March, according to the pathological results and postoperative recovery, the follow-up treatment plan was determined with the doctor, and the wenzhou could be returned in early April.
The 4 medications my mother took were prescribed for up to a month at a time, and she deliberately prescribed the medicine a few days before the departure and brought more than 20 days of the dose, thinking that it was more than enough.
The pandemic has disrupted all plans.
On the day of arrival, the hospital that was in contact with the hospital suddenly told it not to accept people from other places for hospitalization, and later the attending doctor went to other hospitals to find an operating room. Because of the partition sealing, the mother could only be discharged from the hospital early and borrowed to live in a relative's house, while Wang Yuhua was isolated in the hotel for some reason. They have not been able to remove pathological specimens and send them to hospitals where they can for further analysis.
Delays in treatment, separation of mother and child, and indefinite unsealing all exacerbated her anxiety. But the medicine is not much, five or six days before Wang Yuhua posted a request for help Weibo, her mother has already reduced the amount of 3 drugs on her own, only the one that helps sleep the most has not decreased.
Ma Wei's medicine was almost finished. She attended a university on the outskirts of Shanghai, where nearly two hundred people had been transported to the cabin, which inevitably caused some panic. Internships and graduate school applications are piled up again. At one point, she had an epiphany of anxiety, "I can't breathe, and I will keep scratching myself."
Recurrent disease with withdrawal reaction
Previously, Yang Shanshan's condition had been stable for a long time.
The last time there was a relatively large fluctuation was more than a year ago. At that time, she was still in college, and she was locked up in the school for more than a month because of the epidemic, staying in the dormitory every day, and there was little communication with people. Later, her sleep became very poor, day and night were reversed, and her mood was out of control several times.
Therefore, after receiving the notice of partition blocking on March 27, she chose to go to the company for quarantine. "If you're stuck in a rental house, it's just me and my boyfriend, and it's going to be suffocating."
In the company, Yang Shanshan has experiments to do every day, her work and rest will be more regular, and she does not have to worry about materials, and there are many colleagues who can chat, which helps to stabilize her emotions.
Even so, she had a depressive episode.
On April 1, several consecutive calls for help were not dialed, and after several days of constant exposure to negative information about the epidemic, she collapsed and cried bitterly when she looked at her last piece of trazodone.
The boyfriend immediately took her downstairs and took a walk in the park to fully vent her emotions. Under his patience and comfort, Yang Shanshan slowly calmed down.
A small part of Yang Shanshan's dialing records are almost unconnected.
Image source: Courtesy of respondents
Under the epidemic situation, because of concerns about infection, limited mobility, work suspension, etc., people generally have depression, anxiety and other bad emotions, and for patients with mental illness, it is easy to fluctuate.
In this case, it is even more necessary to ensure that the drug is taken regularly.
Liu Siqi in Changchun suffers from severe depression and moderate anxiety. Due to the traumatic experience of her childhood, she has more than ten years of emotional problems, which were aggravated by some changes last year, often have the flash idea of "strangling the child", and even had several self-injurious behaviors.
About half a year ago, she began receiving treatment. Before the outbreak of the epidemic in Jilin Province, she thought that her condition had improved a lot, so she reduced her medication on her own, "feeling that she could not hold on to eating."
In mid-March, Liu Siqi's community began to be closed for management. The pressure kept coming: the community appeared positive, at first the distance was not too close, and then there were confirmed cases in the same building; insufficient food reserves, the first few days, only slept three or four hours a day, stared at the mobile phone for a long time, but only grabbed the dish once; and the 4-year-old daughter had a cold at the same time, could not buy medicine, "the daughter has a history of heat convulsions, especially worried about her fever, and he took care of her all night when he was sick"; most importantly, the friction with his family was constantly amplifying.
Under heavy pressure, the idea of self-harm came up again. She tried to restrain herself.
She took her medication more and more frequently, and gradually realized the importance of taking medication regularly. On March 24, she had a big fight with her mother online, out of control, shouting uncontrollably and smashing things. From that day on, she took her medication every day until she ran out after 12 days.
Image source: IC photo
Abrupt discontinuation of the drug not only affects the stability of the condition, but may also bring some withdrawal reactions.
Yang Shanshan was forced to adjust her medication intake on April 2. By then, trazodone had been eaten, and duloxetine was left, and if a few of the previous ones had not been found in the office drawer, there might have been none. In desperation, she reduced her daily intake from two to one.
Since then, she has developed physical symptoms such as headaches, palpitations, and insomnia.
The day before you get the medicine is the most serious. On the night of April 9, she lost sleep until three or four in the morning. After a night of nightmares, I woke up groggy with a cracking headache and a feeling of stuffiness in my stomach. She sat motionless on a camp bed in the common lounge area, so uncomfortable that she "didn't want to open her eyes."
The longest "occasional cure" exposure to discontinuation was in a patient with bipolar disorder, more than half a month. Because the drugs needed are special, although many volunteers help to find them, there is still no progress.
The patient said his withdrawal reaction was severe. "As soon as the eyeball moves, it feels like a nerve is being pulled, and then the head will "buzz" and instantly dizzy." And the mood swings are very large, and I often cry a lot.
A few days ago, she flipped to the medicine she had left over from 5 years ago, when the doctor's diagnosis was depression. The drug was the same main ingredient as the one she needed, and it was produced by different manufacturers.
The medicine had expired for a month, but she still took half a tablet.
Early the next morning, she found that the withdrawal had eased. In recent days, she has been using these leftover medicines to save her life.
She said she was satisfied.
Difficulties can be encountered at every step of the way
For Ms. Yang, the turning point came on April 9.
That day, she dialed a new medical helpline, not realizing that the operator was another staff member of her neighborhood committee. "The other party had a good attitude and carefully registered the name of the drug." Knowing that I was in the company and our company was all yin, she said excitedly that the faster way was for the neighborhood committee to open a pass, and I would go to the Jingwei Center myself to buy it."
Yang Shanshan knew the meaning of the phrase "then buy it yourself" a few days ago. At this point, she had been taking her medication for a week.
If the previous staff member could have explained a few more words, perhaps the problem would not have dragged on for so long.
According to the "occasional cure" of many parties, at present, patients in Shanghai mainly purchase psychotropic drugs in the following ways:
One is to apply for the pharmacy dispensing service of the neighborhood committee; the second is to place an order on the online platform and wait for delivery; there are more successful cases, and the patient himself holds the pass, or asks someone to take his ID card information and prescription to the hospital or a qualified pharmacy to buy drugs.
Mao Mao, a student at Peking University, is a volunteer who seeks help with psychotropic drugs, and her "Shouhu" volunteer team has followed up on about 700 people with mental illness since March 31.
She told "occasional cures" that in the first few days, especially during the Qingming Festival, several Jingwei centers did not open for consultation, and at that time, their priority recommended channel was to ask the neighborhood committee to dispense medicines on behalf of the neighborhood committee, and if the cooperation of the neighborhood committee was not high, try to place an order in the Internet hospital, and then ask the police of the jurisdiction to pick it up. Overall, the difficulty is still relatively large.
Over time, more and more patients were able to go to the hospital on their own to prescribe medication.
A volunteer took the residents' medical record cards to the hospital to dispense medicines.
Image source: IC photo
Although the process is clear, difficulties can be encountered at every step.
First, hospital openings change frequently, and the criteria for receiving patients vary. Some only accept patients who have a record of visiting the hospital, and some district-level Jingwei Centers accept prescriptions from the Municipal Jingwei Center. The time limit requirements for nucleic acid results are also different, with a small number of antigen self-test results within 24 hours and 48 hours.
Mao Mao introduced that they listed a form involving 19 hospitals, including jingwei centers at all levels, as well as psychiatry departments in general hospitals. Every morning, a group of volunteers look at the form and call one by one to confirm whether to open the clinic, which patients are accepted, what drugs are available, and what materials need to be brought.
It's not a simple thing. "Because the phone is difficult to get through, it is impossible to ask all the hospitals by one person, so we can only arrange more people, and whoever asks will be synchronized in real time." In recent days, this verification exercise has been put on hold owing to staff constraints.
Mao Mao expects to have an information platform to summarize and update these situations in real time. She believes it's a win-win, patients and volunteers don't have to spend too much time searching, hospitals can answer fewer calls, and everyone can be more efficient.
At present, there is a system of "inquiry on the closure of some departments in major hospitals" with the application, but only lists the hospitals and departments that have been suspended, there is no detailed information such as nucleic acid requirements, and the update time is stuck on April 14. Liberation Daily also set up a query system, and the situation is similar.
Follow the application of the main hospital closure status inquiry page.
Source: With the application
Another big difficulty is getting around.
Ma Wei was stuck in this ring. After the drug was urgent, she first chose to ask the teacher for help, and the teacher also reported to the school's psychological center. But she was still unable to leave the school, and the school did not send anyone to help get the medicine.
She had to look for errands on various online platforms, but at present, the transportation capacity is tight, and the school is relatively biased, even if the price increase is increased to the top, there is still no one to take orders for more than ten hours.
Offline dispensing mainly involves the issue of passes and means of transportation.
The pass depends on the degree of cooperation of the neighborhood committee. "In practice, there have been cases where the patient himself was rejected by the neighborhood committee, but when we went to call as a volunteer, the other party agreed. Some didn't communicate successfully in the end, and there was nothing we could do about it."
Mobility tools are relatively easy to solve. Yang Shanshan chose to ask for help in the community group, and soon 4 neighbors with cars came to contact her. Mao Mao's volunteer team will also help patients connect some vehicle resources.
According to Mao Mao's observation, at present, most patients still take the way of online dispensing and then asking for errands.
If you want to call for errands, the district is the easiest, and the cross-district is the most difficult, and the river crossing is the most difficult. "A few days ago, the price of the cross-river we asked was still eight or nine hundred yuan once, and when we asked again in the past two days, it has risen to two thousand."
Therefore, they have organized centralized drug purchases, helped more than a dozen patients in Pudong find cross-river channels, and shared transportation costs. Volunteers with permission to cross the river took everyone's materials, went to the Municipal Jingwei Center in Puxi to buy them, sent them across the river, and then the volunteers in Pudong called to run errands and distributed them to different patients.
In addition, the medical records and past prescription records of some foreign patients are not around, and the hospitals that often visit the hospital do not have online inquiry channels, and how to prove their situation to the hospitals in Shanghai also needs corresponding guidance.
Getting the medicine is not the end of the story
Yang Shanshan got the medicine on the night of April 10. A kind uncle in the community drove to the hospital more than 20 kilometers away to help her get medicine and delivered it to the door of her company.
At noon that day, the uncle left without greeting, and by the time Yang Shanshan received the news, he had already arrived at the hospital. It was an hour before she received a notification of successful registration.
"I can imagine how many people there are in the hospital, and how hard it is for him to wait in line for so long just to register."
Yang Shanshan recorded the entire experience and attached a drug purchase tutorial at the end, which was so detailed that it was divided into 5 times before it was fully sent. Some netizens asked her for experience, some wanted to prescribe medicine for the depressed elderly at home, and some were experiencing withdrawal reactions.
Wang Yuhua's mother also got the medicine, on the 7th day after she began to reduce the drug.
There were some twists and turns in the middle. Because she had been prescribing medicines in Wenzhou before, it was difficult to hang up the number of re-diagnosis and dispensing drugs in Shanghai, and the neighborhood committee of the borrowed place of residence helped ask the nearby pharmacy, and there were no drugs she needed. Later, Wang Yuhua contacted the pharmacy opposite the City Jingwei Center through volunteers, passed on the previous prescription records, and called for errands to take it.
The kind uncle of the community got medicine for Yang Shanshan.
Image source: Courtesy of respondents
At a press conference on epidemic prevention and control on April 12, Wu Qianyu, a first-level inspector of the Shanghai Municipal Health Commission, responded to the question of "difficulty in dispensing psychotropic drugs":
Medication for patients with mental illness in Shanghai is divided into registered and non-registered. For those on the register, it is solved through the existing mechanism of taking and delivering drugs; for those who are not registered, they provide services through the work of the Jingwei Center and the community health service center in each district, and in areas where conditions permit, the drugs needed by the residents of the sealed area can be sunk to the community health service center, and through the sinking of specialists or remote guidance, according to the patient's previous medical situation and needs, the community health service center will copy the prescription and dispense the medicine.
At the same time, the Jingwei Center in each district has clarified the special person and contact telephone number.
After returning to normal medication intake, Yang Shanshan's mental state recovered a lot. She is also making other efforts to benefit the disease, such as reducing exposure to information about the epidemic, browsing at most some text, and not watching or listening to videos and audios forwarded by friends.
Getting the medicine is not the end of the story. The containment is still continuing, and the stress state may be difficult to lift immediately.
Wang Yuhua spent at least 40 minutes a day with her mother, trying to talk about some small daily things to distract her. Her mother rarely took the initiative to talk, but Wang Yuhua could detect that sometimes her state would be more nervous.
He has been actively asking how he could take out his mother's pathological specimen and send it to the cancer hospital on the other side of the river for further analysis. He knew that the delay in follow-up treatment was one of the main sources of anxiety for his mother, and he was going to try to push it forward.
Before the press release, "Occasional Cure" had just learned that under the coordination of the street, Wang Yuhua was finally able to get a pathological specimen. He rode a 17.6-kilometer shared bicycle to reach the hospital where his mother had surgery.
Liu Siqi of Changchun finally began to take medicine regularly, and she felt that her body was still adapting to the newly obtained drugs.
The sealing control is about to expire for a month, the supply of materials is getting smoother and smoother, and the anxiety in this regard has been alleviated a lot. But the friction between her family and her family continues, and she still breaks down, sometimes even having some extreme thoughts.
There was one more thing that concerned her. She didn't want her neighbors to know about her condition, and when she asked for help in the community group before, she told it in the tone of a third party.
She hoped that after the sealing was over, she would not receive a strange look.
(In order to protect the privacy of the interviewees, the characters in the article are pseudonyms.) ）
Author: Chen Yihan
Producer: Li Chen
First image source: IC photo
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