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Dr. David
Dr. David, Board Certified MD
Category: Medical
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Experience:  Board Certified Physician
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I am a British citizen living in Vietnam and my Vietnamese

Resolved Question:

I am a British citizen living in Vietnam and my Vietnamese wife has recently suffered a severe episode of what I believe to be post partum psychosis. I would be grateful for some detailed advice on the best way to treat her, I have read all the information on the nhs website so would really like some reassurance that I am taking the right course. We have been to a Vietnamese specialist and she is currently on some very strong antipsychotics but generally here they seem to have a sledge hammer approach of hit it hard with drugs and don't talk about it. Currently we are staying at her parents out of the city where medical standards are not so high, although we have support I feel it's not a calm environment for her to recover best, ***** ***** family members, kids running around screaming etc. I would like to take her, our 4 year old boy and 2 month old baby girl back to our home in Ho Chi Minh city where we can see further advice from the international medical facilities there, also our boy can return to preschool and give me the time and attention needed to take care of my wife and baby girl. We do have some support in the city, in the form of relatives and close friends too. I am meeting some resistance from her family, understandably, but feel my reasons are valid. Would be grateful for any advice.
Regards
Ben Westall
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. David replied 1 year ago.

This is Dr. David

I am sorry about your wife and her postpartum psychosis.

it sounds like her family backgound could be different from yours.

is she originally from the country side?

do you have to work if you go back to Ho Chi Minh city?

there may not be a 100% "correct" answer in this situation which is proven to help her psychosis get better.

has she had this post partum psychosis before during her first child?

are her strong antipsychotic medications working at this point?

Customer: replied 1 year ago.
Thanks for you quick response;
There certainly are some cultural differences in our relationship, some good, some not so. There's still a reluctance here to take on more modern or western ideas.
She is originally from the countryside but has spent most of her adult life living in the city, the last five years with me.
Fortunately I do not have to work so can concentrate all my efforts to our family, something I might have neglected a little previously.
In the very early stages of her first pregnancy she did have a similar much less severe episode. But this passed relatively quickly without any intervention or medication. I have also consider that maybe she has a mild case of bipolar but have never seen her really that depressed, she is quite a strong independent woman and bares a lot of responsibility to provide for her Vietnamese family.
The medication is working, she has slept a lot, something she possibly hasn't done for months, but she is very confused and they leave her very zonked out. She is possibly in denial or just doesn't remember fully what happened.
Going forward I feel she needs to talk, possibly to a professional, and try to understand why and what happened.
It seems we are now travelling back home to the city today, where we can contact her anti natal doctor and seek further advice and referrals.
Thanks again for your response and I welcome any advice on the way forward. The language difference here can make it difficult to get a full explanation.
Regards
Ben.
Expert:  Dr. David replied 1 year ago.

I see.

thank you for that explanation .

with her history of psychosis and potential biploar illness, yes, she would be better off in the city where she can see a psychiatrist and have her medications monitored.

if you don't have to work and can take time to care for her and the baby, that would be a full time job and would be best.

that is good you are able to go back to the city.

I wish you and your family all the best

I hope her psychosis gets better.

I hope she finds the right medications to help her.

let me know if you have other questions.

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Customer: replied 1 year ago.
Thank you, ***** ***** said I mainly wanted some reassurance that I was taking the right steps. She seems much better today although does not have the mental or physical energy to cope with things for too long. I am worried that she will feel everything is ok and go back to her normal way of life, possibly inducing a relapse. So further consultation and treatment needed to prevent this.
It seems the family are now all in agreement this would be a better solution for all of us so today seems a much calmer one for her.
I will certainly rate your advice appreciatively and contact you again should any further questions arise.
Best regards
Ben.