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!

Sunday Summary

Dear friends,

It has been a busy week! For me, I mean; probably not what you would call a busy week. I didn’t work at all, I didn’t get many chores done, and the most I did daily was get out of the house for an hour or two. That’s busy, for me.

I’m so happy that it worked out to be that way!

When I finished work three and a half weeks ago I was worried that the naturally “depressed state I was in about finishing work, together with my ongoing lethargy and tiredness, would result in me becoming a bed bound vegetable again.

Well again isn’t fair; I’ve never ever not gotten up at one point or another during the day. But with no definite reason to get up in the morning, my lack of motivation to get up unless there’s someone waiting on me, and the general listlessness of having no set purpose, I thought that there was a fair chance of me lounging around all day.

And it turned out to be that way for a few days. With nothing planned, with accumulated tiredness from keeping up with my shifts at work for six weeks when they consumed about the last ounce of my energy, and no reason why not to get up, I had some pretty massive sleep ins.

Until I missed my tablets one Sunday night! This happened in spite of the careful routine that I have built into my days after I had previous missed doses to prevent the same thing from happening again. Obviously there’s still a loop hole somewhere that I haven’t found but I’m working on it.

My routine is to weekly make up a medicine box with all the medications that I need to take both in the morning and at night. My pharmacist brain cross-checks the directions on the bottles and boxes with the number of tablets I put into each slot and then double check that I haven’t missed anything by comparing what I’ve packed with my complete list of medicines printed on the bottom of the box. My triple check is when I take each group of tablets and I count again to make sure I have it right.

I set this medicine box right next to my bed on my bedside table so that I should see it when I get up and when I go to bed; this should give me a visual prompt to take my tablets. But I don’t trust this system so I have set a morning and evening medication alarm in my phone. This can only be snoozed three times so I also have a medicines app that generates a reminder at 7am and 9pm for me to take my tablets. This can be snoozed to infinity I think, but the fact that I missed a dose makes me wonder if it actually does have a limit to being snoozed. I’m looking into this.

So the missed dose. You wouldn’t think it would make that much difference; it’s only one dose right? But it does make a difference, at least for me at this point while we’re still fine tuning the medications. Most times when I miss my tablets I end up getting upset over some little thing or teary for not much reason or get in a fight with my hubby! Poor hubby, he has to bear the brunt of everything! I think this reaction has been when I’ve missed my morning dose, which means I miss my antidepressant and my morning lithium dose.

This time I missed my evening dose. That means my evening lithium and my other sedating mood stabiliser. I’ve only ever done this once before. It’s never fun, because it means there’s nothing putting me to sleep! This time was terrible! I’m sure I had a maximum of 4 hours sleep but who knows. When you’re tossing and turning and can’t sleep and want to sleep, time loses all meaning! Poor hubby again, every time I tossed or turned he turned! But I physically couldn’t bear the sensation of lying still! It was awful! I just had to move and move and move and move!! I woke at 5am and tried to exist as quietly as possible til hubby was ready to get up. Then, so out of my recent character that it was laughable, I jumped out of bed fresh as a daisy at just after 7am and left the house before hubby! I was in my runners and leggings and I was off!

Compared to my recent sluggish, only-move-if-I-have-to, and even then moving snail’s pace, I was striding off to the park like I haven’t since I don’t know when, and paced out two laps! It was ridiculous to me even as I was doing it! But it was a fabulous feeling! I could move as fast as I physically wanted to for a change, instead of how fast I physically could through mud bearing heavy weights!!

Incredible! And so friends, this is mania. Or a sub form of it. You won’t see me like it often, unfortunately or fortunately, but you’ll know it when you see it. I’ll be smiling at all and sundry, grinning, laughing, putting out a decent amount of physical effort, having a great day! I’ll be chatting flat out, possibly jumping topics or getting distracted. I’ll be super effective and get many tasks done. I’ll be physically active and able to do a lot more activity than usual.

It’s a feeling that is addictive actually, I never want it to end…to start with! By the end of the day I was pretty sick of it actually because I could hardly sit still or rest, and was just feeling irritable, agitated and like I couldn’t possible tolerate having another night like that. By then the frustration tears were pretty close to the surface, but let me tell you I achieved a great days work! All three loads of washing done, some of it off the line and folded! The kitchen was sparkling clean; I’d cleaned the grout and the stubborn grease on the splash back. Lots of jobs attended to, a family visit where I chatted away like a…like a crazy person! Chat chat chat chat chat chat chat!

But I was glad to put it away. Not glad to go back to lethargy and anergy (absence of energy), but after all it’s a balance. You can’t have everything, so you have to decide on the most important things. Which is not being a whirling dervish, but a calm reasonable person not prone to snap decisions and excess!

My short point at the end of that long explanation was that it broke my bed rest habit and got me out into the sunshine, and the outside world. I watched the ducks paddle, saw the swallows come out to swoop and feed, found a magpie nest without getting swooped and in fact saw the magpie partner watching from on high at a distance. And remembered that I liked the outside and wanted to be out there, not inside all day.

Add to this a pep talk from my psychiatrist AND my GP in the same week about just getting outside, no agenda, no pressure, no panic about how I was feeling, just enjoyment…and the message was clear! Just enjoy it.

So I have enjoyed it! What a glorious week it has been!

Monday started slowly, but a late afternoon trip to Blackburn Lake Sanctuary yielded a fabulous hour of the new Musk Lorikeets ( see earlier post) plus an added hour of delightful favourites. Then a sleepover with our great friends and delightful bubba!

I just love love love this gorgeous Galah eating wattle photo!

I just love love love this gorgeous Galah eating wattle photo!

This is the cutest Noisy Miner sequence I've ever had - mother catches moth, baby screams for it, baby gets moth, mother leaves :) eucalypt

This is the cutest Noisy Miner sequence I’ve ever had – mother catches moth, baby screams for it, baby gets moth, mother leaves 🙂

Tuesday didn’t work out how I had thought it would, but a picnic on the banks of the Yarra river in delightful Warburton with several girlfriends and their cute kids is a pretty fine day if you ask me! In addition I got to see two lots of adorable ducklings and a fun Kookaburra.

Cute cute cute! Discovering the innocent joys of crawling up and down stairs, green grass

Cute cute cute! Discovering the innocent joys of crawling up and down stairs

More cute! Fluffy Wood Duck ducklings huddling on a rock in the Yarra River at Warburton

More cute! Fluffy Wood Duck ducklings huddling on a rock in the Yarra River at Warburton

Wednesday morning was a return to Blackburn Lake Sanctuary, the top end this time for some variety of bushland and birds. What a day it ended up with a Kookabura flinging a metre long snake around and many cute tiny birds that were hard to capture.

The fabulous post and rail fence that completely encircles my favourite Blackburn Lake Sanctuary

The fabulous post and rail fence that completely encircles my favourite Blackburn Lake Sanctuary

I spotted this Laughing Kookaburra and stopped for photos, didn't realise it was in the process of killing a snake!

I spotted this Laughing Kookaburra and stopped for photos, didn’t realise it was in the process of killing a snake!

I just love being in the Sanctuary - so pretty and lovely

I just love being in the Sanctuary – so pretty and lovely

Thursday, oh Thursday! This was a bucket list day with a girlfriend and it was amazing! Glorious day, two brand new birds that I’d never seen before, loads of flowers, a couple of moths and some damsel flies! Some amazing scenery, the awesome Kuranga native nursery, Birdsland reserve and a flash trip through the Dandenongs (see previous post).

Friday was appointment day and catch up with my old work mates day and getting my favourite bacon and egg sandwich and eating it in the gorgeous Fawkner Park. A picnic above Yarra Boulevard with my fabulous hubby and some new photo ops over the city as the sun set…wow! Can you beat that for a way to see out the work week?

The great outline of Melbourne city backlit by a cloud sunset, blue sky,

The great outline of Melbourne city backlit by a cloud sunset

The brilliant sunshine, the silhouette of a pretty tree and Melbourne - I love you

The brilliant sunshine, the silhouette of a pretty tree and Melbourne – I love you

Saturday was another girlfriend catch up and was great fun finding plover babies and getting swooped relentlessly by their parents! Then we went on a Loch Ness Monster hunt all around the Blackburn Lake and still aren’t sure exactly what was doing so much flashing and splashing and swimming…tbc, duln duln duulllln! We got a fabulous shot of a Spotted Pardalote by the path and had a great lunch at Gourmet Girl – what an awesome catch up! Over tea cooked by sensational hubby we heard and saw two Striated Thornbills in our minimal garden! I think they’re building a nest! Excitement!!

Mummy Masked Lapwing with tiny weeny baby - these must be very new because the plovers have been docile until this week; now they are savage!

Mummy Masked Lapwing with tiny weeny baby – these must be very new because the plovers have been docile until this week; now they are savage!

Not a clear shot but the beautiful front of a Spotted Pardalote

Not a clear shot but the beautiful front of a Spotted Pardalote

Sunday is rest day and I’m glad for that, but boy I am so glad for every bit of excitement and interest that has sprinkled my week and made it actually fun! And thanks to all my wonderful people who are there every day giving me a hand along, and making my life more amazing!

Funny side story. After looking back at the week in the detail above, it made me remember all the good things and I mentioned to hubby that I’d had an amazing week. His response was fascinating: “Really? Maybe the last couple of days have been okay but I thought you had a bad week.”

To which I, in the mood of putting all the good bits together and seeing them in clear focus and forgetting the rest, replied: “Really? But I’ve done all these amazing things.” So we had a chat and here’s another perspective moment – what’s in focus is really clear and the rest in lost in fog.

My hubby was remembering coming home to me still lost in my afternoon nap, to me not able to get my thoughts together enough for our weeknight Bible study, to him making dinner from scratch every single night of the week, to me as a blob instead of an enthusiastic lover, to me struggling to get enthusiastic about any physical activity; basically to him carrying the load of the relationship, the housework, being the bread winner and the carer for this weighty gal.

So yes, if you look at all the cool bits it was a great week. If you look at all the failures it would bring you to tears. If you see all that hubby did to get us both through the week, you like me would have overwhelming admiration for this great fella without whom I don’t know what awful state I would be in!

So my motivation for this new week is trying to even out the load for my good man, and continuing to have great days!