Rain, rain, not so bad…

[Monday 21st August]

It’s always a good day out with birds.

Even when the day is one of the worst this winter.

It’s raining lightly but steadily, the temperature is heading from a freezing 4 degrees to a frosty maximum of 6 degrees for a chilly winter’s day, it’s slippery and slushy underfoot, I missed my bird watching group meet time by a few minutes but saw them crossing the road as I parked, then they disappeared on me while I was getting my stuff together!!

But with some of my new resilience I decide to power on. It sucks that I missed them, but I can’t find any fault with them at all. It was a typical Danika move.

Looking at the forecast the night before I wondered if I was up for the task of wandering around for 5 hours in not only the cold, which you can dress against, but the wet. I’ve gotten wet and cold on one bird watching outing recently, feet and legs mostly, and it wasn’t fun. But I can dress warmer this time and be prepared. About that wet though, do I really want to be walking around in it through thick undergrowth for 3 of the 5 hours, according to the forecast? I couldn’t decide. Originally I definitely wanted to go because this birding outing was one that I haven’t seen come up before, a walk through the Sherbrooke Forest and…ding ding ding…lyrebirds! I’ve glimpsed a couple in the wild, and seen one at Healesville Sanctuary in their awesome recent lyrebird exhibit, but I’d love a better look!

But that wet…and so I dithered all night, didn’t make a decision, looked up what time I’d need to leave by, couldn’t decide when I woke up in the morning, called the leader to confirm it was on, slept a bit more, thought I wouldn’t go, thought I would go, left it too late and took too much time putting on my two pairs of socks, three tops, packing my 3 jackets and so I had no time for breakfast before I had to jump in the car post-haste.

This is a big flaw for me that I’m trying to work on: skipping breakfast. Actually not skipping breakfast as such, because I can’t make it to 10am if I don’t eat in the morning. I’ve always felt nauseous and faint if I don’t eat breakfast. And taking a handful of tablets on an empty stomach doesn’t go well. But I’ve also never been a morning person since I was a baby. So it’s a tussle between getting up in time for a proper breakfast and getting up, full stop! Lately this has taken the form of skipping a sustaining breakfast like my standard 2 pieces of toast with spreads for getting out the door on time, then making a 2 minute stop at the local Coles Express for something less sustaining but at least food and drink. I reserve the right to tell you what kind of food or drink I would usually pick up!

Google maps told me when I left that I was going to be 3 minutes late, as in arrival time 10.03am. This is okay, most times you can make up this difference along the way and arrive on time. Although not properly on time, which is 5 minutes early as my husband will say. In this case probably 10 or 15 minutes early would be ideal for putting on jackets, unfolding umbrellas, getting the camera ready etc. So really I’m  way behind, but I’m telling myself that 10am is okay. But still, no breakfast yet and I can’t walk around in the forest for hours without breakfast, let alone without lunch that I haven’t accounted for, and the Dandenongs aren’t really ideal for ready to go food. But luckily I did find a quick mart type general store at Tremont just before Sherbrooke forest and got some Twisties and drinks; not ideal but it’ll keep me going. Forgot to get lunch but at least this is a start. Except…

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This doesn’t even show how deep the colour blue was on my tongue, fingers and lips!! What the heck?? Apparently although these Twisties look like Twisties, smell like Twisties, taste like Twisties, they are Blue Tongue Twisties! Well that’s new, and not necessarily great for me. Busted about eating Twisties though; hubby will be happy. Luckily after my afternoon nap the blue on my tongue had been digested by my mouth enzymes, but I had to scrub the life out of my lips to clear them up, and I’ve still got blue around my nails 2 days later!! Argh!

But I got myself going, and I got these:

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The charming Eastern Yellow Robin

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They are so skilled at gravity-defying grip onto trees

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A clearer shot finally: the rain really messes with clarity

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Murdering the “snake” by whipping it and mashing it and tearing it into bite sized pieces

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Nearly got its head off, now to…

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“Bang”!

 

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“Is it dead yet?”

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Another flick through the air and whack! against the root

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See how far around it can rotate its head? Somehow with such a large prey compared to its body it manages to get the right amount of acceleration then bang it against something hard

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See how its eye looks weird? Its called a nicitating membrane. It like a second eyelid but its see-through. Birds use it to protect their eye when they still need to see but are at risk of, for instance, having half a worm flick them in the eye

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Finally a bite sized piece! Yum yum, down the hatch

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“Get away from my snake!!”

 

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Uh oh. An invader. Territory wars over a juicy worm!

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Standing on it should keep it safe

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“Are you done yet?”

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Oops, spotted me!

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This is a fully zoomed out view of the little birdy. It was probably 3 metres away by my judgement, which isn’t the best. I love zoom!

A good day that came out of a shaky start; I love these days. Now home for a lovely nap.

 

 

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Hard questions #1

*WARNING: this is a blunt and honest account of hygiene, specifically the lack thereof – you may not look at me quite the same after reading this, but remember that I am the same person, just struggling to keep my juggling balls in the air*

What I write here, I write to share with you the side of mental illness that isn’t necessarily obvious to the onlooker, be they aware or unaware of the illness. Or maybe its obvious, but not understood. I write it to break through the stigma, if I can, that still settles over the mentally ill and to raise awareness of what life is like inside a head that doesn’t let you be the boss very often.

I know this isn’t going to be glamorous. But believe me: I’m not trying to sensationalise the truth. If anything, I’m under-selling the real story. So here we go:

Some questions are hard to answer.

Some questions are unanswerable.

Some you just wish were!

Like,

“How long is it since you last had a shower?” – husband

 

Ummm…well…

I’m not really sure…ahhh…

Maybe…I don’t know…

I think it was…

Hang on, when did I last work? Was it then…no, that’s right, I dry shampooed…

So, then…maybe on the weekend? Which day was it…

You changed the towels a week ago?

I haven’t used mine yet? Hmm…

…well then I guess…well then I guess that’s when…ah, yeah…so…a week you say…

Now where was I? let me just…slowly walks awaydrowns in shame

Plans to shower tomorrowknows it probably won’t happen

more shamethat’s life!

There are a number of questions that you try your best to avoid hearing, and therefore having to answer, once chronic illness has set in.

Like, when did you last have a shower.

I was never a shower-a-day person. I grew up out of town in drought years and whenever the rain didn’t come we had to buy in tanker loads of water to fill up our concrete tanks because we weren’t connected to town water. For longer than I liked we didn’t shower, we bathed because it was much more economical for water use to run a bath tub full of water rather than have individual showers. Plus when we were little its just what you do; everyone piles in. When we were little the bathroom was also outside in the mud brick section of the house: shower and bath in one room, laundry in another, and toilet at the end. Later on in our school years we got an inside bathroom (toilet still outside) and it was one after the other, and you got to top it up with hot water if it ran cold, which by the time the 4th person got in was a high likelihood, never mind the parents. Especially because some people liked to have a sleep in there, regardless of those following! Okay I was one of those having a sleep in the bath, but I went last or close to last. If you were washing your hair you got to quickly rinse the conditioner off in the shower, given that the bath water wasn’t the cleanest by that point. Then again, showering wasn’t all it cracked up to be since the shower head was too short! It was half a gym workout doing squats under the tap while rinsing your hair!

So I was an every second day washer, basically just when my hair needed washing or my leg hair was getting to liberated woman stage! So when I got sick I didn’t exactly have the best routine to fall back on.

Why is showering so difficult and so irregular now?

There’s no simple, snappy one-liner answer.

It’s a few things.

My shower is in a bath. Lifting a leg over the tub just always seems so…HARD! I think about having a shower, and I think about getting one leg up and over, let alone 2 legs into that bath without over-balancing, the effort of getting my big self up and over into the tub and its just…its…its so…its just, yeah, well, maybe tomorrow.

So there’s that. Plus it takes energy. If I had a store of energy, like in a barn, I would go get the amount of energy that I need with my forklift and bring it back to the bathroom and have my shower. It would be simple, straightforward. I would just take the exact amount of energy needed, use it to have a shower and it would be all good! Sadly, unfortunately, regrettably, energy doesn’t store. It just comes and goes, waxes and wanes. You either have it in the moment or you don’t. There are things that help or not, but there’s no guarantee of having the energy you need when you need it. So, lying in bed thinking about having a shower and I ask myself, do I have the energy to do this right now? And it’s an easy answer, it’s a yes/no problem. So it either happens, or it doesn’t. I.e. it doesn’t. Because all that thinking just used up my having a shower energy! Isn’t that ironic? So now no energy, no shower and I turn my attention to covering up not having a shower, if its been more than a day.

There are things that make it a bit easier. Hubby getting the shower running and frogmarching me to the edge of the tub for instance. Well that’s about it, actually. There are hardly any things that actually motivate me to the point of getting up off my tush and having a shower, even my amazing husband. Even when he asks me to, as a favour to him. This is a point that a lot of people don’t understand.

“Don’t you want to do it for me?”, “Yes I do want to do it for you”.

“Do it for me”, “I can’t”.

“Can’t you even do it for me?”, “I’m sorry, I just can’t, even for you”.

It hurts me to give these answers. I love my husband more than anything in the whole world. We have been best friends since 2003, since we met practically. We’ve been married for nearly 8 years and have shared everything together. If I could do it for him, I would! Come to think of it, if I could do it for myself, I would! But its not about that. Its about not having the energy, the motivation, the drive to do it. If one of those questions comes up, it just makes me feel worse about the whole thing, which is not the intention I know; that I wouldn’t even do it for him, after all he’s done for me. How selfish!!

And maybe it is selfish. A lot of times depressed people have to make selfish choices for their own survival, be it mental, physical, or emotional survival. And it hurts us to do it. But we need to, even if you don’t see why. It’s not about you, its about us; that sounds selfish right there. But we spend a lot of time conserving our resources and we know what we can and can’t manage. But doing that means a lot of navel-gazing, inward looking so you’ll have to excuse us while we’re busy sorting ourselves out, please.

I think it is a severe understatement to say that my husband is long-suffering! He is beyond patient and kind with me, beyond what I deserve for trying his limits so severely with such things as:

  • unwashed hair looking and feeling greasy
  • the same hair tangled into dreadlocks-style clumps that have to be cut out after who knows how long of not brushing my hair, then dry shampooing, then not brushing, then dry shampooing etc
  • eyebrow/underarm/leg/bikini waxing abandoned I don’t even know how long ago anymore!
  • tooth brushing I also don’t know…well I do know cos I brushed them last week once, but before that its anyone’s guess and he suffers them orange with food stuff and still bravely kisses me when I must be repulsive with plaquey teeth and bad breath
  • BO is one area that I think is mostly under control thanks to Dove Invisible Dry with 1/4 soap
  • avoiding hand washing except when its absolutely necessary, meaning much less often than I should

You would think that because I love my husband so much, and because I know that I owe him so much, and want to please him, that these emotions would motivate me to fix these areas. He hopes that I would do it for him, and I’d love to be able to do these things for him, but wanting to do it and doing it are separate entities that rarely collide, I’ve found. Because while I DO want to do it, especially do it for him, wanting it doesn’t give you energy, the kick, the ability to actually get up and do it. I wish. So often, probably daily, my husband may well think that I don’t care enough about him to do one “little” thing for him like clean my teeth. But there’s just something so difficult to overcome in myself to just start to think about doing one of these things. I want to in theory, but practice hasn’t really tallied out on my side.

It’s difficult to explain why its so hard to do these things. After all they’re easy things that most people just do without even thinking about it. But its a common happening in depressed people to get slacker on these things. It’s just one of those things that goes when your mind and your body slow down. It takes 10 minutes of pros and cons to decide that I absolutely can’t go another day without showering, that even my soapy deodorant, dry shampoo and perfume aren’t going to cut it today. Then it takes a good 10 minutes to plan how I’m going to get up, walk the 9 steps to the bathroom (actually 9 steps), clamber into the bath and get the shower going. Then I may actually have a shower, or can it after all and skip another day.

I’m not alone. I was relieved when I found this out. Depression tells you that you’re a slob, and disgusting, and no one wants to be around you, and maybe thats not far off. But knowing that this is a common symptom of depression takes a little of the pressure off, which helps you to take it easy on yourself, which in its own twisted roundabout way means that you’re MORE likely to pick up some of the hygiene slack. So here’s what others have said

“Literally not showering for months. Not changing your clothes for weeks. Not combing your hair for days. Not brushing your teeth for weeks. With depression, hygiene goes out the window.” — Zoe S – The Mighty ‘Worst Symptoms of Depression‘ article.

“Not keeping in touch with anyone, bad personal hygiene and extremely bad reactions to seemingly trivial things.” — Jenny B – Upworthy ‘30 Things Depressed People Do‘ article.

“I love not having to decide if I’m mentally and emotionally prepared to spend time drying my hair after a shower” – a friend who just shaved her head for cancer awareness and fundraising.

“Thinking about going to the gymhaving a shower like”…hopefully this opens to a visual aid giving you an idea of how I think about showers.

But now, a new directive:

“Danika, I strongly encourage you to shower daily” – my psychiatrist

Rats!! *snaps fingers* I was hoping to avoid such a direct instruction!

“Not for hygiene…”

Well that’s surprising! All I’ve considered so far is hygiene.

“…but for your own self-worth. You aren’t showering because of low self-worth, and then not showering further lowers your self-worth. *cue light bulb moment* You have come from a long way back to get back to work and it hasn’t been easy, especially having issues with the pharmacy board and your current job, but you made it. As far as work goes you’re back to where you came from, more or less. Showering daily will reinforce to you that you’re back to where you came from, and improve your self-worth. Your actions inform your mind, just as your mind informs your actions” – my psychiatrist, quoted as near as I can remember.

Well that was all a revelation, I can tell you!

Showering to improve how I think about myself. Not cause its the thing to do, or for hygiene, or cause someone thinks I should. In fact, its all about me! And don’t we like that?

So, here I am the day after yesterday when I talked to my psychiatrist, 5.26pm, wondering when exactly should I have this shower? Cos I’ve managed to not have the time for it so far: dropping off the car to get serviced first thing then doing a jobs run of picking up clothing repairs/script dispensing/groceries/posting a parcel then walking home, breakfast, a nap, another little nap, house inspection, groceries delivered, pick up the car, Officeworks. And now going out to dinner…is there time before? Or when we get home? Hmmm.

I do feel like my head is in a different space though, after that chat. Shout out to my darling husband for dobbing me in to the psychiatrist!! Sheesh!! So, about that shower…

What a goose

I always understood that saying, ‘what a goose’, to be an insult, as in to be a bit of a dill, or a duffer, or any of the other vague sayings that we’ve corrupted into terms of gentle abuse.

But after tracking and photographing Cape Barren Geese on Phillip Island on Monday (8th) I no longer think of geese, at least this species of goose, as stupid. They are so beautiful with amazing detail to their feathers, and form such great families.

Well, okay, with one exception:

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That moment when one parent looks across the road to the other parent and thinks, ‘oh its not that far’…and yep, the edge of the road is just there

And maybe a second:

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“I think we can make it” – this happened right on peak traffic time when every person that is going to the Penguin Parade is arriving at the Nobbies!

And the clinger, so maybe my point it lost at this moment:

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“Come on kids!”

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And just like that, I get turned into the crazy (well that’s nothing new) lady stopping traffic for ducks! Well geese, but the same applies!!!

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Luckily the traffic is slow and expecting this kind of interruption, and they did cross pretty quickly

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Nearly there, quickly quickly!

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And safely across to meet up with the other parent!

But they’re still beautiful.

They just need to learn to live and eat somewhere more removed from cars.

Can you see the pleasure that can be derived from bird watching? I highly recommend it.

And the satisfaction of getting the photo isn’t bad either, although these were all marred a bit because it was raining at the time. Yes, I was standing in the rain (without an umbrella cos I didn’t really think it through!) holding up traffic while little tiny puff balls crossed the road! What has happened to me??

Claire

Let’s change it up.

This morning I came across this video, Claire Wineland on How to Live When You’re Dying, from an amazing young woman, and she has a very fresh and inspiring view on living with an illness that is incurable.

I almost feel like I don’t fit in any category with her because her illness is very physical and her life expectancy is so short. Yet here she is talking about the pitfalls of dating, the joys of living overseas and travelling, the experience of going to university, and the fun of going out with friends. Almost as though she wasn’t sick.

How’s that for a radical life? Putting your illness in the corner, and going on regardless.

She embraces a life of living so that when she dies, however soon that may be…and compared to most of us its very soon, she will have lived a full life that she can be proud of. Her fears? That she won’t have lived. That her illness will have been her whole life. That she lived to die.

I tell you, I admire this girl so much! It is hard not to think about your illness all the time: how it affects you, how its changed your life, what you don’t have compared to other people. And I don’t have a life expectancy date hanging over my head! Sure, I’ll always have this illness, and there’ll always be issues to deal with, but death is not a guaranteed part of the package. Not any more than any other person in the world.

Check out this girl.

Whether you have a chronic illness or not, her take on life is so refreshing and I feel like it gives me a kick in the pants to try a new philosophy. This is not about being fake and pretending nothing is wrong. That is never helpful, or useful. Something is wrong; lay that on the table to begin with. But life goes on. This is about finding a way to live around your illness, and still living a fulfilling life.

It will always be something of a struggle to push past illness to life. But it can be done, at least some of the time. So let’s give that a go!

Find a way to glow

 

For an extended version of Claire’s interview video, check out Cystic Fibrosis taught me there’s no “normal life”

Birds you have to leave state for

I can’t believe I haven’t talked to you about this yet, but in the middle of June we flew up to Cairns for a little holiday and it was the best!!

Ever since I was born, and right up until a few years ago, our annual holiday was in the Easter school holidays at Merimbula, or nearby. It is fabulous, so so beautiful and we absolutely love going there; it’s our second home town.  It was our routine, we always knew when the break was coming, where we were going and had that anticipation.

It was varied to the summer holidays once cos my brother was due to be born in the Easter holidays. And another year we went to visit friends in Newcastle instead, but generally it was fixed in stone. The tradition continued well into my uni years after I left home, and quite a few years into married life, and it’s still lovely, but we want to see some other places. We try to go somewhere new for a week once a year at least, and get away for a weekend for our anniversary. In the 7.5 years that we’ve been married, we’ve slowly made our way around the country: Tasmania road trip, Woolongong, Narooma, Canberra on his work for 3 months, Perth, Airey’s Inlet, Gippsland Lakes, Darwin, Sydney, and we have also managed to get to New Zealand, most of South America and Bali. But Queensland we haven’t gotten to til now.

This year we wanted to try something new and go on holidays somewhere warm during winter. Up til now most of our holidays have been in the summer or Easter. We decided on Cairns and thought we’d go maybe around July-August. But then, out of nowhere, hubby’s work needed him to go to Cairns for a week of work!! Bingo! So he headed up at the start of the week, and I flew up Friday morning, and we got a weekend on his work’s tab at the same hotel! We had to pay for my flights, but as a getaway goes it was the cheapest we’ve ever done! And we really loved it! We had Friday til Monday afternoon but it felt like we had a week, and we got to indulge in seafood, cycling for hubby with a random new friend, and loads of birding for me; could anything be more perfect?? 28 degrees by day, 18 by night; bliss.

Over the 3.5 days I had up there I managed to photograph 70 different species of birds and out of those 36 were brand new species to me that I’d never come across before!! This is the advantage of vastly changing climates. Far North Queensland is so tropical and couldn’t be more different in climate from southern Australia, as well as being geographically at the opposite end of the country. So you find a lot of birds up there that you’ll either never see out of that state, or maybe in NSW but never ever in Victoria. Yet some Victorian species can live quite happily up there. It’s all very fascinating to me, but maybe not so much to you. So let’s get on with the photo gallery!

Brown Honeyeater at the airport, the first lifer

Brown Honeyeater – that little tear drop behind the eye tells you the ID

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Male Australasian Figbird – striking, isn’t he?

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Yellow Honeyeater

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Varied Honeyeater

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Australasian Gull-billed Tern

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Scaly-breasted munia, or Nutmeg Mannikin

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Yellow-spotted honeyeater blending in so well under the mangroves

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Okay not a bird but so stunning!

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My best attempt at a bird-in-flight pic of a Rainbow Bee-eater…they do occur in Victoria, but I’ve never seen one so I’m claiming ignorance

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Dusky Honeyeater

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Forest Kingfisher

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Yellow-breasted Boatbill…poor photo but a fascinating little creature

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Little Shrike-thrush…most photos aren’t an easy shot, many are difficult angles through sticks, leaves, shadow and more

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Graceful Honeyeater, different from the Yellow-Spotted because the spot is oblong here

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Australian Brush-turkey

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Bar-shouldered Dove

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Comb-crested Jacana

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Green Pygmy-Goose

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Spangled Drongo – yep there’s actually such a thing as a Drongo!

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A blurry Orange-Footed Scrubfowl

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Brahiminy Kite, such a distinctive bird of prey shot from a moving car!

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Spectacled Monarch, fast and hard to catch in the bad light of the mangroves. It’s ironic: gorgeous birds live in the mangroves but they’re hard to see

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Collared/Torresian Kingfisher – just stunning!

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A typical mangroves shot: a blurry Shining Flycatcher

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Black-naped Tern, the flying white bird with the cool tail – shot 30km out to sea from our snorkelling boat

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The dark birds with white heads are Noddies – couldn’t get a good photo between the movement of our boat, the movement of their platform and a low shutter speed! There were Black and Brown/Common Noddies

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These Bush-stone Curlews are so odd! Apart from their creepy big eyes, they hang out at the cemetery and all night long they wail! It sounds like someone’s heart has just been broken and they are keening their soul out!! We could hear it INSIDE the hotel room all through the first night, somewhat disturbing!

I hope you enjoyed the fruit of my walking, driving and boating around Cairns.

Accidents happen: Part Two

Did I say “accidents happen” the other day??

What was I thinking?!

It’s like saying its q___t at work; never say the Q word!! It invites chaos and busyness and problem scripts one after another. But I said accidents happen, and so they did! Fate heard me, even though I don’t really believe in fate…oops, is that another invitation to the world to punish me?? Well punish is a bit dramatic, but you know what I mean.

So I’ve been recovering from accidents and errors ever since I wrote about accidents!! It wasn’t enough that I had my first ever minor car accident last Friday. On Wednesday, I had to go and fall down the stairs!! Like a really idiot!

I think it was sleep stupor, but to be honest I don’t really know. It was morning so sleep stupor could cover it; not much of a morning person, me. I took one step down leading with my right foot, another step down now with my left foot, another with my right and then I just slipped off the far edge of the next step with my left foot and I was gone. Our stairs go halfway straight down, turn 180 degrees then the other halfway straight down. Pretty standard. I slipped on almost the last stair before the turn. It might have to do with the stairs being shaped as wedges for the turn and I hit the tiny point of the wedge. I don’t really know how but somehow my left heel hit close to the edge of the stair and just slipped right out from under me and slipped over stair after stair after stair with no grip on any of them. My left leg was a useless slippery pointy thing sticking out in front of me causing nothing but trouble!!!

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Brain kicking into overdrive trying to figure out what to do, hoping to hit the wall at the bottom of the first half of the steps, grabbing the railing by instinct rather than thought, left leg useless sticking straight out front and can’t get a foot hold anywhere, getting half a grip on one stair after another but slipping over each and every one, poor right leg tucked underneath getting banged and scraped stair after stair after stair!!

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Luckily, and there is always an aspect of luck with me somehow, I was trailing my hand down the banister and managed to grab it! And even though my grasp slipped down the banister, it got caught on the post halfway down at the corner and I managed somehow to haul myself to a stop. I’ve seriously wrenched my neck and back and arm because of stopping myself but at least I didn’t go head over heels or something worse. And at least my hand was in contact with the banister when I fell; usually I don’t hold on at all! So it could have been much worse. Apparently its a workplace OH&S recommendation to have 3 points of contact with stairs at all times: 2 feet and 1 hand, or 1 foot and 2 hands if you are that person who just has to push the envelope! So maybe I need to put up some OH&S posters in my stairwell!

Panic as several steps went by and I missed the wall at the end, turning instead to start going down the next flight! Finally gripping the railing at the post as I slid to it and holding on for grim death!! Or is it life? Either way, I managed to stop on that poor banged up left hip with my useless left leg still sticking out in front, and the even more useless right leg underneath and my arm twisted backwards at some weird angle. So by the time my hand found a hold on the midway post, I was through the corner and heading down the next straight with my right leg tucked well under me getting cheese grated on each and every step where the carpet is bare and the strings are coming through. Basically I got a combination of carpet burn and grating right down my shin and a good few bumps on my left hip, which is swelling up nicely. I was feeling pretty shabby!!

So I was pretty stoked to have come to a stop, even if it was at the cost of the whole left side of my torso and arm. But how to get up?? I’m not a little thing, as most of you probably know. And unable to engage to use of either leg and one arm and side made getting up some kind of origami exercise! I actually can’t tell you how I got up, but there were a couple of bad moments where I started to slide again. But here I am to tell the tale!

So I grabbed on for dear life and managed to stop my fall. There was a moment of real horror thinking that the post might let go; I definitely felt it give. But when I went back afterwards it was as solid as ever. But as it turns out 120kg dangling by one arm is not only a threat to the wooden stair railing but to the muscles and soft tissue behind my shoulder blade. OUCH! Before too long I couldn’t turn my head to the left more than 20 degrees, behind my shoulder blade was singing and I was rapidly becoming frozen stiff. So a trip to the physio to get ironed out.

To look at you can’t even tell I’ve had an accident. Well not until I covered the grazes along my shin with white dressings that is, they kind of stand out on my tan! Not intentional but there you go. It saves me feeling like an attention seeker telling people about my accident; the bandages seek your attention on my behalf!! Is that the same thing?

Its amazing the pain and irritation such superficial scrapes create. Bed sheets, leggings, any clothing just rubs so I headed down to the pharmacy for some dressings so I can at least be a bit more comfortable. Now at least the stinging doesn’t keep getting set off again. But stretching the skin by moving it any way including walking is still aggravating. So here we are, another accident. What to make of this one? I really don’t know what went wrong so that I can avoid it again. Just one of those things? Or I should take more care?

So that was my fall. I thought that was enough, how about you?

But no. I get to work and start my usual Thursday; you know, all the packs and stuff that I wrote about recently. Then my boss brings one of the packs to me and says it has been brought back to the pharmacy over an error! That shoots straight through the heart. Especially right on the heels of having experienced a dispensing error and making (possibly) a big deal about it. As it turns out I hadn’t seen that there were 2 loratadine (you know, Claratyne the anti-histamine) tablets instead of one in Tuesday morning. It’s a robot error, but my job is to pick up that type of error, and I didn’t.

I could justify my omission by saying that its not that serious an error; in all likeliness there would be no side effects as loratadine generally has no more side effects than placebo (sugar pill). But the point is that I missed the error.

I could justify it by saying that the patient hadn’t taken it yet so it wasn’t so bad.

I could also justify the error with the conversations I’ve regularly had with other pharmacists checking packs discussing how extra tablets in packs is the hardest error to pick up, compared to other errors: broken tablets, missing tablets, wrong tablets. But I still missed the error. Not good. But it has made me further reconsider my response to the dispensing error that happened to me.

But wait, there’s more!! Unfortunately.

This, I suppose, is what happens when you only work twice a week. Short of them texting you about issues on your days off (it happens!) they save them up for next time you come in!

So, it seems that I dispensed a patient’s 500mg Epilim (valproate) correctly, then attached the labels to 200mg tablets. THIS is a problem. This is a big problem. I don’t know why the patient was taking Epilim but irrespective, taking this error over weeks to months WOULD have resulted in a relapse had the patient taken it: a relapse of epilepsy resulting in seizures, a relapse of bipolar resulting in depression, mania or suicide or worse. As someone who takes Epilim and dreads the probably inevitable day that I relapse, I can totally empathise with the patient in this scenario, as well as my position as pharmacist!!

I could justify this error by…nope, nothing!! I should have scanned the medication against the dispensing; this would have shown the error. I should have compared the original script to the box of tablets to reconcile the strength; this would have shown the error. I could have reviewed the history, but that’s an extra step. All I needed to do was the 2 steps mentioned; that would’ve prevented the error. Luckily the patient identified the error, brought the medication back and no harm, no foul.

Sound familiar?? My high horse is sinking through quicksand and I’m about to go down with it, unless I jump off and acknowledge that I just made an error as significant as that other pharmacist, and how do I want to be treated over this? What lessons do I need to learn? How would I feel about being reported to the pharmacy board? My boss knows, so that aspect can’t get worse, but he was very good about it actually.

Can I console myself with the errors that I did pick up today? 5 missing doses of magnesium in one pack, 2 missing dose of metformin (for diabetes) in another, a broken Panadol tablet making an underdose, a broken clonazepam tablet (for seizures or spasms) underdose, double the Efexor (antidepressant) dose in one slot, a random thyroxine (for underactive thyroid) tablet found in a pack where the patient doesn’t take that medication, and more. Does it make up for letting a more severe error pass through to the keeper? In short, no.

But it does make you think. Here I am, on a squared playing field, accepting that human error exists but there are systems to obey to minimise it, and ignoring the systems is just not on!

Accidents happen

We all know this: accidents happen. It’s part of life.

But in some areas, accidents aren’t okay. So we make systems and safeguards and policies and procedures and checks and balances and we educate to minimise human error. Sometimes, even that isn’t enough.

I know mistakes happen. This week I had my first ever car accident. I’ve had plenty of near misses and close calls in the fourteen years since I got my learner’s permit, but luck has always been on my side. I did have to run off the road once when someone stopped dead in front of me on a 100kmph road…but apart from having a panic attack from a massive surge of adrenaline after I finally pulled the car to a stop in an orchard, there was no harm, no foul!

This week what happened was that my left front tyre slipped on the soft edge of the road made up of leaf litter, and despite me pulling on the steering wheel and braking hard I slid off the road into the shallow ditch and hit the bank on the other side! It was sort of interesting to note that the wheels did turn; once I got out of the car and found that my knee was just bruised, I found that the wheels were in a slightly turned position but obviously I just skidded. Luck was still on my side though: the side of the road, the mini ditch and the wall of the ditch that I ran into were all so soft that there was almost no damage at all, and I wasn’t hurt. In fact when I eventually got off the wall, it was running water; there was practically a river of water running out of it! The unlucky part was that I “crashed” (a dramatic word for sliding off a road at slowish speed) in the back of beyond on a road very infrequently used with no internet or mobile reception and no GPS! Couldn’t call hubby, couldn’t call RACV, couldn’t call work to tell them I was a bit delayed; nothing! I couldn’t message through Viber, Facebook, Twitter, Instagram, Gmail; nothing! No one could track my phone by GPS. So I had to sit there and wait. And wait. And wait! In the end I had to wait half an hour before the next car came along! Still, it could have been a lot worse.

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Doesn’t look too bad right? Just resting here…

 

I couldn’t leave the car to find better reception, even locked, because I was halfway between picking up a bucket load of drugs and delivering them to my pharmacy! Imagine: I’m a pharmacist in a new job, trusted for the first time with a pick up, and for the first time I have an actual car accident!! Not cool! Someone asked me if I told the boss…um no!! Sure I could get him to pay the repairs, but do I really want to start with that kind of problem two and a half months into my job? Please note this drug/medication transfer was a one-off event; my car is not usually filled with drugs!!

So I sat there. I yelled out loud at the top of my lungs a few times for no one to hear. Just expressing my frustration in a civil, calm manner. I tried slowly reversing back without spinning the wheels but the ground was too wet and the leaf litter was too deep; the front wheels gripped for a millisecond but slipped almost straight away. Pretty sure the back wheels didn’t budge…well of course they didn’t, its front wheel drive; duh!! My years of bumping around our block on the old Fergie tractor have finally come to some kind of use, especially that time I had to back myself out of an actual metre deep ditch! But it had better wheels more suited to this kind of situation; it could practically climb a wall! The leaf litter on the edge was so deep that when I stepped out of the car my foot went right down into it. I tried to push the car back out of the ditch from the drivers seat, I tried to push it from the back seat but it didn’t budge…oh whoops the hand brake is still on! Kind of redundant since I’m resting on a bank. But letting it off didn’t help, and whats that on my foot? EEEEK!!!! Screams at the top of her lungs!! A leech!! SWAT!! Thank goodness that’s gone. Oh no its on the steering wheel!! SWAT!! Now its on a different part of the steering wheel! ARGH this leech is a real sucker!! Who would have thought?! Jumps out of the car out of impulse trying to get away from the huge, enormous, blood sucking monster!! Almost as bad as a spider at close quarters!

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The exact view from my car window…so it wasn’t all bad!

 

 

Oh wait, what’s that?? A 4WD or ute or something big and heavy and revving is coming down the hill! Start waving, start waving!! Yes its a cab ute with 2 men and a towing engine thing on the front and a solid tow rope with a huge hook…oh yes, this is what I’ve been waiting for!! Waving, waving, getting out of the car, please help me!! It occurs to me belatedly…that I am in a deserted part of the world, with no mobile or internet reception, asking 2 men for help in a situation that I can’t help myself out of, and trusting to their good nature. When I was suffering anxiety, I would’ve been hiding in the boot of my car til sundown and my husband realised I was missing and sent out a search party!! Actually no, my boot was full of drugs…well maybe the back seat then. It just shows how far I’ve come, and that really most people you run into are good.

The driver’s reaction when he got out of the ute? “Oops!” Precisely, my good man! But he said he had the same accident on the next corner himself last year, so I felt better. Because of course up until this moment I had naturally assumed that this was the exact kind of idiotic, stupid thing that I always get myself into and no one else would ever do such a dumb thing and wasn’t I a prize numpty?! And that this was yet another episode of me damaging the car, because there have been many! Part of my reasoning for not telling my boss; assuming that I would be embarrassing myself! Not that I actually did anything, I just sat there while I slid in the mud. But I always insist to myself that I’m the one that stuffed up. So these 2 kind men dragged me off the bank backwards with tow ropes, but the back of the car was slipping into the ditch now, so we had to switch to dragging the front up onto the road and the rest of the car followed. Meanwhile whatever hound they had in the compartment on the tray of the ute was howling at me as loudly and as often as it could breathe!! Another piece of luck was going off the road while it was still bituminised; another 500 metres and it turned to packed dirt…pretty sure that would have hindered the towing process. So 45 minutes of my life and I’m back on the same bit of road I was before the accident.

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So I displaced the bank, and a bit of my bumper…not a bad result

As it turns out I shouldn’t have even been on that road! I turned 150 metres too soon, and should have been on Maroondah Highway where this would never have happened. Ahhh. But I definitely got the scenic route, although I probably would’ve been happier swapping a bit of scenery for a car trip with no accident. Only something that would’ve happened to me, or just an unfortunate happening that could happen to anyone? At least I didn’t have to get towed with all those meds on board!!! THAT would have been embarrassing to explain to the boss!

So with all this in mind, I’m still unhappy about an error that occurred today. I got several scripts dispensed at one of the pharmacies I routinely use near my GPs office and one of them was wrong. Not a little bit wrong like the price was out, or I was given the wrong quantity. I was given the wrong strength of lithium, 450mg instead of 250mg making it an overdose, and it was the slow release formulation instead of immediate release meaning it would hang around in my system longer after the overdose, and it had the usual twice daily directions that apply to the 250mg strength instead of daily which is how the 450mg slow release should be taken so the level of lithium in my system would accumulate quickly. My lithium level is already at the upper limit of okay, and my psychiatrist is thinking of reducing my dose; this would have found me in hospital within 3 days!!! It’s that serious, and potentially worse.

But I’m conflicted.

As a patient I’m outraged and think the pharmacist should be reported for this very serious error, that fortunately didn’t eventuate because I picked it up before taking it. I think that there should be some consequences for not taking the proper amount of care.

As a pharmacist I know how terrible I would feel if this were my error, but I also know that lithium is one of those medications that you should take extra care and attention with when dispensing. The error occurred because the pharmacist entered the wrong medication when typing, and so the scanning check wouldn’t pick this up. But there would have been a message saying that I previously had a different strength, which was ignored. And my history must not have been reviewed before dispensing, despite it popping up and having to be entered through before you can type in anything. Two checks ignored, besides the obvious check of visually comparing what is written on the script with what is typed before printing!! That’s three checks ignored. I’m not sure the the pharmacy board would see any reason for skipping any of these checks, especially as there were only two patients in the store at the time.

So this is my big beef with pharmacy at the moment, both in my workplace and in the pharmacies where I get my scripts dispensed. There IS a proper way to do pharmacy, and it’s not being done! For reasons which are specious and inadequate, and I believe, unacceptable! I miss hospital pharmacy for this reason: maybe we take more time but we do things as properly as we can, no shortcuts or conveniences. Of course the pharmacist felt terrible, its a natural reaction. But will it change her future practice? Will she do things properly next time? I really don’t want to report her, mostly out of colleague empathy. But is it something I should do, for the improvement of the profession? I probably won’t, but it’s still all milling around in my mind.

What’s an accident, and what’s an error? What’s okay and what’s not? Should I be pointing fingers when I make my own mistakes? I don’t know. What do you think?