The big return

I had planned to make a big announcement about my new job when I started, just before my first official shift, but anyone who reads my blog regularly already knows about me starting work because I told you recently because of a blunder, and, well, anyone else just found out! So no announcement. Just a reminder really that I am OFFICIALLY starting my new job on Saturday 29th April, 2017.

My official pharmacist coat, the first time I’ve gotten to wear the traditional garb; my keys to EVERYTHING; a pink, personalised name badge; pocket with a pen holder, and I’m ready to go!

It’s not such a big thing, really, as I’ve already done 8 shifts over the last few weeks. Wow, eight shifts already! That crept up on me. Five of them were half days, but still; it’s work! I was really thankful that my new boss was as keen as I was for me to get in several practice shifts before I started, and it has helped me to feel comfortable and confident heading into my first shift. It has given me a chance for reacquaint myself with the FRED dispensing program, although pretty much nothing has changed since I last used it in 2009! It’s such an easy to use program compared to the 2 hospital pharmacy programs that I’ve used over the last 7 years, and nearly all of the scripts scan in; no typing involved! So cool! I’m still in love with this function!!

My name up in official pharmacy lights!

It’s given me the opportunity to learn the “order” of how drugs are arranged in the pharmacy. This is one of those words that means the opposite of what you would think…oxymoron? I think that’s the word. See whereas hospitals organise their medications sensibly by the drug name (generic name) in alphabetical order, community pharmacies have ridiculous systems, and no one, including those that work there, really know why they have such a dysfunctional “system”, and the system is different in every pharmacy.

In this pharmacy, originally drugs/medications were ordered A to Z by brand name, instead of generic drug name. Fair enough. Back when, before additional brand names and generic brand names, there was one brand name for each drug and everyone knew the brand name for each drug. Drugs were marketed by brand names and that’s mostly what they were referred to as by medical staff. So this system worked as an actual system.

Here’s that dispensary I’ve been telling you about

Then drugs started going ‘off patent’. This meant that other drug companies were allowed to come along after and use the generic drug that the original drug company had committed 10 to 15 years of research and development to, make their own formulation and sell it. Not having to spend any of that time in R & D, and just having to more or less copy what the first company has done means the new version, or “the generic” can be vastly cheaper! Their version has to be approved by the Australian Government as working in the same way, having the same drug and dosage, and having equivalent efficacy when compared to the original brand, and once this process is complete, the drug gets on the PBS like the original and off we go.

So we got the first batch of second brand names, that were still actually names. Like instead of Noten, we got Tenormin. So now we had two brand names; that was manageable. And then generics went bananas!! They stopped bothering with brand names and just wanted to spruick their company name. So instead of usable names like Noten and Tenormin that were brand names for atenolol, we got drug company names attached to the generic name like APO-atenolol, Terry White-atenolol, Chemmart-atenolol, atenolol-Amneal, atenolol-Sandoz and so on and so forth! You get the never-ending gist. A quick look online tells me that atenolol is available in 15 different brands in Australia.* In America it’s gone much more ridiculous with 143 companies making atenolol generics, and 289 brand names, all slight versions of the one before!!**

How is this relevant to me working in the dispensary? The dispensary is organised by brand name. Then the generic brand comes along and it gets its own slot. Noten is under N, Tenormin is under T. All is well. Then the company name generics come in. Our store has a deal with APO generics so where available we buy the APO generic. But it doesn’t make sense to put every generic in the A for APO section! So the generics get put away by the generic name. Atenolol still ends up in A, but APO-escitalopram goes in E and etc. Except sometimes you go to find APO-hydroxocobalamin and it’s not in H. You ask someone where you might find it and they go straight to N. You ask why, and the answer is: the original brand name was Neo-B12. Yes, that is true, but…”yeah we should move it, we should do that, we’ll do that”. But that was half the point of getting in a few shifts before the real thing, to work out some of these quirks. Another thing: in an effort to be helpful, someone decided that the top 20 most dispensed drugs should be moved out of order to the front of the stands for easy access. Sounds sort of reasonable, but its kind of annoying to go the S and remember, no, its not here, its in the section that I’ve already walked past! But hey, I’ve been able to yammer on about it this much so some of it must have sunk in.

So this shift on Saturday is my first shift “alone” as the “only” pharmacist in the pharmacy; definitely ideal for me. I say those things in talking marks because there will actually be another pharmacist out in the back room working on our supply of medications to 18 nursing homes at all times while I’m out front; another one of the ideal things about this position. So I will never be without a second opinion or some advice or instruction on how to do something that hasn’t cropped up so far, and that sounds great by me! Not that I’ll need it necessarily, but popping out the back to ask someone a quick question is much less full on than having to call the boss on a Saturday!

*http://www.nps.org.au/medicines/heart-blood-and-blood-vessels/beta-blocker-medicines/atenolol

**http://www.medindia.net/drug-price/atenolol.htm

Pregnancy

What could I do, I had to like it! It just made me think of myself, in a kind of funny.kind of truthful way!, gorilla, grass

What could I do, I had to like it! It just made me think of myself, in a kind of funny.kind of truthful way!

This popped up in my Facebook feed the other day from Brindabella and I actually laughed out loud! The expression ‘lol’ is so overused online that it has lost all meaning, but this is one situation where it was actually appropriate.

I laughed because over a few months I gradually increased in weight  until suddenly one day I looked in the mirror and realised I looked like this! Not a fun realisation! I mentioned it to my hubby and he agreed that he’d thought for a while now that I looked pregnant! Always helpful but he was kind about it. But its the truth so what can you do.

I should clarify here that I’m not pregnant; the weight is due to indulgence, medication side effects and the symptoms of mental illness. Just to be clear.

But anyway, somehow being that shape and seeing this gorilla translates to funny in my brain…not sure why, but I guess it’s amusing to see yourself mirrored in another species, and to see a big round belly, flabby arms and a double chin on a cute-ish animal looking equally unhappy about the situation!

The weird thing is, I know I’m overweight to the point of exploding over the obese line. But somehow my brain hasn’t caught up. Maybe because it happened so fast and unexpectedly, maybe because I’m in denial a bit…not sure why. I kind of knew already that my brain was lagging behind, but it became most apparent when I was in Thailand recently. Sitting on the boat in just my bathers, swimming in the pool, jumping off the boat into the water carefree and happy in front of everyone else, walking around at lunchtime feeling completely comfortable with my body the whole time. Which was a really nice feeling instead of hating it and wanting it to be different.

Until…I looked back and saw the photos! My big round tummy, double chin, fat cheeks and eyes deep in puffy sockets…ergh! Then I was not happy! Then I was not comfortable with my figure! Photos are kind of the cold hard truth that shoot you down out of your dreamy sky and bring you down with a big hard bang to reality!

I can kind of understand the idea behind body dysmorphic disorder now. I don’t have it and I’m not suggesting I do…but the brain is powerful and can really twist reality sometimes. To be one way, and consider yourself to be another way is…well in this case it’s kind to me to a point, but I guess when it comes to addiction or something like that it is very unhelpful, because you think you’re okay when really you are not. It can be unhelpful to me too I suppose, because when I’m looking at a block of chocolate I think it’ll be okay instead of considering my obesity and how chocolate is really not okay!

Here’s the other thing. When I was first really unwell, the psychologist and the doctor and all the self help websites told me to do nice things to and for myself to help me feel just a bit better. Have a bath, eat your favourite food, watch your favourite show, go to your favourite place either physically or shut your eyes and imagine you are there. So chocolate, a hot chocolate, a bowl of yoghurt…whatever you love, was okay to eat anytime and all the time to help get you through the difficult days.

Except there was no limit put on that habit…so I just kept going and going. A limit would have been good, but realistically I was unwell for months while we tried fluoxetine, venlafaxine, sertraline, sertraline plus mirtazepine, sertraline plus quetiapine, desvenlafaxine plus quetiapine, reboxetine plus quetiapine and full circle to venlafaxine plus quetiapine and finally venlafaxine plus quetiapine plus lithium, the best yet! All of those antidepressants working a bit or not much, until finally the correct diagnosis of bipolar and the life-changing prescription of lithium.

And still the end date for self indulgence hasn’t been set.

I’m better; I’m not back to where I’d like to be. I have more energy; but still need my daily naps. I have more resilience; but some days I just need something external to make me feel better. I’m trying to cut down on my treats and snacks; but it’s hard!

And here’s my shortlist of how fatness that looks like pregnancy is different to pregnancy:

1) In pregnancy, you know what to expect and you prepare your body. You moisturise and Bio-oil your belly to prevent stretch marks. In fatness, stretch marks pop up out of the blue completely unexpected and you have no warning to prepare for that.

2) In pregnancy you get the baby most times, not always. In fatness you just have the rumours, the questions, the look without the baby at the end. To be honest, I haven’t decided whether I think this is a bad thing or a good thing….I’ll get back to you.

3) In pregnancy you deliver the baby and the belly size reduces a bit, then gradually reduces slowly back to somewhere near where you started. In fatness, these is no initial tummy reduction; you just start from wherever you are and gradually reduce it hopefully also to somewhere near where you started. So actually, the two conditions can be pretty similar in this regard.

Well that’s about all I have to say about fatness and pregnancy at this point in time.

I started and stopped the gym, I did a few food coaching sessions, I returned to pilates for a bit, I go on and off calorie restriction, we’re trying to do daily walks, I’m trying to get back on my bike on the trainer in the shed, I’m trying to walk past my favourite snacks.

It’s a work in progress; I’ll get there one day. And for now, my attempt is to be kind to myself and remember why I came to be where I am, and whenever I can, to do bits and pieces to help me along the way to getting where I want to go.