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!

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Downer

When  you suffer with anxiety or depression in any of their various forms, it doesn’t take much to get you down. In fact it takes a lot to keep you up!

I find this with a million stupid little things that turn a perfectly good day into a gloomy do! Usually its something that I’ve done that I’m annoyed at myself for, and I just can’t let myself off the hook about it. My husband can just cruise through these things and flick them off, just like water off a ducks back, as the cliche goes; it also helps that he doesn’t seem to make dumb errors in the first place! We have a joke that he’s always right…and it’s nearly always true! But I find myself berating myself over and over inside my head, mentally abusing myself for being so idiotic, self flagellating for my mistakes and lack of memory, or of thought, or of judgement. That just can’t make for a happy day.

I spent a lot of time with a psychologist when I first got sick and one of the main points of therapy involved reframing my thoughts, and interrupting a snowballing chain of thoughts. Reframing means to look at a situation and how you usually react, and try to consciously change your reaction to it so that you put yourself through less stress and hurt, and therefore are more well mentally. Interrupting a snowballing thought process means recognising when you’re starting down a line of negative thinking that is escalating to the dramatic and trying to stop it early, while its something that can be dealt with, before you’re almost to the point of a panic attack. I spent a lot of time working on this, and when you consciously and deliberately look at your thoughts, you do recognise a lot earlier where you can intervene and save yourself a lot of drama! Having said that, it does take a lot of energy to do this at the beginning. It gets to take a little less effort as you get more used to it, and you have less of these thoughts because of dealing with them in a better way. Eventually its more of a habit, but as soon as you think to yourself that you do it automatically and don’t need to put so much effort in, it can creep back in.

It is almost indispensable to have another person around who understands the work that you are trying to do with your head, and who can remind you what to do when you’re working yourself (unintentionally) into a bit of a tizzy! Someone who can remind you to breathe, that the drastic thoughts you’re having are just that: drastic thoughts; and of the techniques that you’ve learnt. I say it all the time but I have the utmost admiration for people on their own dealing with their beast. Kudos, and I don’t know how you do it!

Today started out as a great day. I had a good ride with my Wheel Women. We rode from Docklands to the pink lake in Westgate Park and back, and I had a superb raspberry jam donut (apparently it’s a “bombolini” according to this bakery) to top it off! I also had one of those San Pellegrino chinotto flavoured sodas in lieu of my usual Coke; that was not a highlight! Tastes like medicine!

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I was planning on doing a bit of extra riding today. I had planned to ride from Hawthorn velodrome to the start point of the Wheel Women ride, and then ride back there after the finish of the ride to add in some extra ks, but a little glitch with snoozing the alarm prevented me! Sometimes that would be enough to get me down, but I smiled through that mix up. I mean, just the fact that I wanted to do extra ks is a pretty good indicator that I’m sitting well up on the scale of blue.

I got to the start almost on time, and marvelled with everyone else at how stunningly beautiful Docklands and the water looked in the unexpected sunshine and after the rain. I really expected to get a bit wet with rain today after 2 days of LOTS of rain, but we lucked out. It was beautiful through the whole ride, and we agreed we could just keep riding and riding on a day like this where it was cool so we wouldn’t overheat, dry so we didn’t get cold with wet, not windy…perfect! Shame about me not getting up on time to do the extra riding; it would have been the ideal day for it. Oh well, let’s enjoy the ride I’ve got going on right now, instead of worrying about what I’ve missed. And there is some great re-framing and preventing of snowballing thoughts! And so the ride was just lovely!

And then, the error. The trigger.

Stupidly (it’s always stupidly by the way) I put my phone on the roof of my car.

I know!

Always a first. And last. Then some other first. Or another first if I just haven’t learnt my lesson. And so on.

3 blocks down the road from my car park, I went to put my phone in the holder and an adrenaline shot went right through my gut! I instantly KNEW what I’d done! On the bonus side, I’d been creeping along slowly since leaving the car park, hadn’t cracked 40kmph, maybe not even 30kmph…maybe it was still on the roof?!?

No!

Dulp!!

So back I go to re trace my wheels. I couldn’t get there fast enough; itching at every red light and pedestrian crossing until I got back to where I had been parked. There was a ute there now, so I got out and checked under it for my phone, once, twice etc. Then I carefully drove even slower where I’d driven already, retracing, scanning the street and gutters, wishing, hoping and more.

And back around again, and a third time! Nothing!! ARGH!!

And that’s how it starts. The adrenaline shot depletes a bit of your good mood, the persistent bad results of looking and not finding get you down more, knowing this is all your stupid fault hacks away at your confidence and suddenly you’re berating yourself and the day is not the same day it was before. It’s plummeting down through the levels of good into mediocre and before you know it, it’s not a good day anymore.

Although lately, I’ve been well, and more resilient. I knew this about myself, but this incident proved it without doubt.

I was SO bummed out over this stupid accident which should never have happened in the first place! How could I have been so thick as to put my phone on the roof?? I knew it was a bad idea, and I did it anyway. Who does that?? Typical! I make a rule, and I break my own rule, and of COURSE this is what happens! It’s okay to put the keys on the roof, because you can’t leave without them. But your phone? Idiot!

This is how my thinking goes, left to its own devices. Berating, accusing, bullying, incredulous of myself, throwing insults.

This is where the challenge lies. Putting my psychologist’s knowledge into practice in this moment and not letting the snowballing of negative thoughts get off to a head start. Re-framing the thoughts: instead of calling myself an idiot and stupid and dumb, realise that accidents happen (even if it’s often and always to me!) and this was just that, an accident, and give yourself a break!

So, having proved that my phone cannot be found and doesn’t seem to be anywhere that it should be, I head home. On the way I think of half a dozen reasons why having my phone right now would be so good: to find out the best route home, to take a photo of the city shining in the sun, to pop a starter note for this blog into my notes section, to check my calendar for what else I’m meant to be doing today, to use the Optus app to put my phone plan on hold, to call my hubby and let him know about my phone!! It really is my right hand and its going to be a bit painful without it. Stupid, stup…no, we agreed: not stupid; unfortunate. Accidental. Breathe.

But then, halfway through sliding down the blue scale into the depths, I slowed up and stopped. I stopped. That hasn’t really happened before. And it wasn’t like I put a heap of work into it, into stopping my thoughts. But my head is just in a better place lately, and this didn’t seem to be as big of a deal as similar events have been before, where I could wrap myself in guilt and grief for a whole day. Now I was stopped somewhere around the “okay” mark, still realising the inconvenience and bother I’d caused myself, but not fatalistic like many times before. What is this new feeling? Is this being well? Could it be?

I got home and flicked a message off to hubby about being out of phone contact. Then got out one of my comforters and I was pleasantly surprised that before long I was smiling and feeling quite serene about the whole thing! What is this? It was still annoying etc but it didn’t feel like it was taking up my whole world with distraught stress but like it was just one part of the picture. I like this feeling!

I believe that this is how you know you’re well. You can recover from events that happen, instead of collapsing into various levels of despair and misery. I’m not sure how this state came about, but I feel like the chemicals in my brain are finally aligned and things are just easier. It’s very exciting!! To say the least.

As to what happened with my phone? Hubby told me all the things I could do and so I went through Google’s ‘find my phone’ function online (just search for it) and I used that to lock my phone, to put a message on the lock screen to say please return my phone and to give the number to call, and to track my phone. I have to say that was the most satisfying and frustrating part, watching someone driving my phone along. It travelled the Bass Hwy towards Phillip Island via the koala park, and then stopping at the Nobbies, and I was unable to do a single thing about it!! But it was awesome to be able to watch them in the first place. I made a full report to the police and they were very helpful. But then my husband got a phone call from the person who picked it up: turns out they were a coach driver who found the phone in Docklands super close to where I’d driven past, and they planned to bring it back the next day! How kind and honest! So all’s well that ends well in the end. My husband biked from his work into the city in his lunchtime to pick up the phone, and everything is as it should be once again.

Lessons to be learned:

  1. Do NOT put your mobile phone on the roof of your car in any circumstances!
  2. Do leave your GPS function on so that you can track your phone if you ever lose it, it was accurate down to 6 metres at one point
  3. Do be aware of Google’s find your phone functions
  4. Ideally always have your screen locked, but know that you can lock it remotely in an emergency
  5. One day, after so much pain, stress, medication, therapy and time, you will be well again. Believe.

Wired

Today I spent four hours without looking at my phone.

It’s sad that this is a fact worthy of comment. I’m not proud.

This came about because I had the opportunity to visit with a lovely girl who I hope will become a good friend. I checked my phone before I walked in the door then put my bag containing my phone down, and never thought of it again til three hours later. Even then I left my phone in my bag untouched, and didn’t check it until I was about to walk out the door.

This is definitely some kind of record. Being home and somewhat unoccupied I have gotten into a bit of a phone checking habit…actually this was a good going habit from well before I stopped work.

I say stopped work in the absence of a better expression; I didn’t actively stop work, I just got so unwell that I couldn’t keep being and had to go get emergency help.

Throughout my experience with mental and physical unwell-ness in the last eighteen months my anxiety and distress have generated a number of habits, some helpful some detrimental some iffy. One of these is checking. Checking checking checking.

What do I check on my smartphone?

All my ‘things’: Ebay active selling, sold, unsold, messages and reminders; email inbox, social box and promotions box for my personal email; email inbox for my professional email; email inbox for my work email (uff! I’m exhausted already!); my calendar for events and things ‘to do’; Facebook in case someone or something has said or done or manufactured something of vague interest; the weather for today, tomorrow, the week just so I know; my mobile banking in case someone has unexpectedly paid me a million dollars in the last hour; my mobile service provider for my internet usage in case I’m close to the limit and they forgot the notification text; Words with Friends in case someone desperately wants to play me and again the notifications failed; Fitbit if I’m wearing and have charged my device to see how many steps I’m up to for the day; and of course I have to check my stats for this my lowly blog to see if anyone cares about my self centric postings!

Yep, ummm…I don’t have too much more to say about that! Sometimes I shortlist that to Ebay, calendar, Facebook, Words, WordPress; and I will justify the extensive list to say that it’s quicker to check these things than it is to write about or read about them!

Why didn’t I need to check my phone for that long, when at home I would be checking it almost constantly?
I just didn’t think of it. I was distracted, with new surroundings, a new friend, delightful pets, with hobbies and chatting and food and life. My phone alert was set to vibrate only instead of sounds which deprived me of (or benefitted me without) any audible reminders. And I wasn’t lacking in occupation; I was talking, laughing, photographing…instead of checking checking checking.

Amazing! Now how can I replicate this phenomenon at home…?

What did I find when I finally checked it?
Two missed calls, 4 messages, 3 notifications from Metro about train delays, a couple of Facebook notifications, a update reminder for some apps and a calendar alert. And an Ebay message and some emails and a Words with Friends game prompt.

A lot of stuff!

Any of it vital?

Well it was too late to do anything about the missed calls and most of the messages, one message could be sorted out tomorrow, the public transport notifications were irrelevant (I was driving) and this continues my gripe with the Metro app; that you can’t choose notifications for selected services only.

The Facebook notifications weren’t at all relevant, I updated the apps, the calendar reminder was for tomorrow, the Ebay message was easily answered, the emails could all be archived and so I wiped it all from my mind and got stuck into Words with Friends 🙂
So really, nothing that would be terribly missed…nothing vastly important; certainly not enough to fret over or to warrant fidgeting if I was unable to check for them.

But this all continues a theme that has been going along in my mind for a while, about how wired in I tend to me the majority of the time. And surely I can’t be the only one?

I have been participating in a mindfulness class over the last few weeks and I was initially quite daunted and still continue to be fascinated with the struggle it can be to let go of my white knuckled grip on the here and now, to just sit. Or lie. Or be, in any pose. To let the body come to rest and be still. Just quiet, doing nothing, thinking nothing, being nothing in particular; just resting.

I find it hard. My body wants to twitch. I want to roll over or change position. I want to wiggle my fingers and toes. It’s hard to just be still! And that’s just the body! Then there is the mind! Sitting quietly and having no other occupation than using your senses and paying attention to the mind ticking over gives a lot more room to notice all of the jumbled thoughts that are swirling around in my brain. I’m still sitting on the fence about whether this is beneficial or unecessary.

I initially started being so wired in because I didn’t want my thoughts. Particularly in the days when I was battling with anxiety I wanted to get as far away from my thoughts as possible.

I didn’t want to think about what it would be like if the global financial crisis hit us and we became homeless, or if the war spread and we were horribly mutilated in a bomb blast or if the end of the world came today at afternoon tea time or if all the children endured hideous burns in a fiery bus crash or if the global warming crisis caused my house that was built on a filled-in swamp to be completely inundated and we were swept away in the floods and watched horrified as relatives and friends drowned before our eyes or etc etc!

When you have anxiety or depression it is common to catastrophise. I wish I knew this a long time ago! I first heard the term with my new GP in October/November; can’t remember exactly when. By then I’d been battling with anxiety at least for six months or more and I really wish I’d known that this whirling dervish inside my head was just a symptom, perfectly normal for someone with anxiety, completely manageable, nothing to worry about.

Because when you start worrying about the worrying, everything turns pear shaped and gets out of control very quickly! So to avoid thinking about the thoughts or in fact noticing them at all I’d turn up the radio, try to force my concentration onto some reading, turn up a video, trying to override my brain with other things. Checking my things distracted me for a short while which was good enough for me; any kind of break from myself.

As I’ve gotten more well I’ve realised that these habits have become problematic and are kind of disrupting my plans for a new life. So there’s work to be done to wind back some of the checking, some of the background noise, some of the distractions.

It’s a work in progress. There’s a ways to go but every time I have a little success it’s nice because it gives me a glimpse of what could be, of life unattached to noise or distractions and just lived in full awareness of what’s around going on around me and able to cope with that!

And that looks lovely to me. Here’s to it!