Saturday, 30 July 2011

Take Precautions when you get a prescription filled

Had an interesting week, but I hope that I will go on to having a more boring week next week.  On Monday evening, at around 7:30 p.m. I felt a very sharp pain (left kidney area) - well, excrutiating pain would be more accurate.  A friend called my husband to pick me up (I was at a Writing Group meeting at the time).  We swung by the hospital, but there was a full parking lot, so decided to wait until later - maybe through night when there would be less people in ER.  Went home but when I went to the bathroom, there was a lot of blood in my urine, so told my husband that we had better head to the ER.

At the ER, they took me into 'acute' because I am also taking Warfarin (a blood thinner where I have heart isues).  After 5+ hours, I must have passed the kidney stone (pain had moved from kidney area to groin area (common when passing a kidney stone).  A CT Scan had been ordered, I was on IV, hooked up to machines, blood work was done (altho to be noted here, doctor in ER had the full list of my meds and I did keep telling him (at least 2-3 times) that I was on blood thinner meds which was why I had come to ER - since blood in urine is never a good sign when on blood thinner. 

The CT Scan showed there was no stone.  Doctor told me I must have passed it (I was going to the washroom quite a bit during those hours b4 the CT Scan).  So doctor prescribed anti-biotics saying that sometimes a person will develop a urinary tract infection after passing a kidney stone.  I accepted this and went home (altho I felt I should have went home with a baby after all that pain - for those who have had labor pain, you will know the kind of pain involved when one passes a kidney stone).  A friend of mine who is male told me he had passed a kidney stone a while back, I told him that at least he now knew what a woman went through when having a baby - he told me he was going to go to the flower shop to buy her some flowers - never understood the amount of pain his wife had experinced before my saying this to him :o)

Anyway, on to my story.  The next day (Tuesday), I filled the prescription for the anti-biotics, trusting the ER doc knew what he was doing.  The pharmacist who I know very well as he has been my pharmacist for many years and knows all the other meds I am on for my heart,filled the prescription.  The page that was given with the anti-biotics did not mention any drug interactions.  So Itook the 2 per day anti-biotic.  On Wednesday, I went for my regular INR blood tests (which measures how thin my blood is - I am usually at 2.2-2.3).  The therapeutic range for someone on blood thinner is between 2-3 - anything over 3 is in a danger zone. 

Wednesday around supper time, I noticed a bit of blood in my urine.  I had a 'coffee date' with a friend that evening (she is a nurse).  I mentioned thtis to her and she told me that it can sometimes happen after someone has passed a kidney stone, as it can irritate the passageway, so I relaxed and thought this would pass. 

The next day, Thursday, there was a LOT of blood in my urine.  And it was getting worse.  I also noticed that althought I was drinking a lot of water (much more than I usually do because I knew this was a good thing after having a kidney stone), that my urine production was actually much decreased.  Not normal, I thought.  A nagging voice told me to contact someone, the oher voice told me not to worry.  But I thought 'better safe than sorry'.  So I called Tele-Care and talked to the nurse and told her the hisotry and also the names of all my meds.  She  told meto see a doctor within the next 3 hours - my family doc, the doctor on call, a doc at a clinic or a doc at the hospital (in that order) - but she INSISTED I see someone.  So, I called my family doc only to find out he was on holidays.  So called the doc on call who could see me at 4:45 p.m. (he worked until 5 p.m.). 

So off I went to see the doc on call.  He took a urine specimen and my history (and history of what had happened).  He seemed very concerned. He said there was indeed a lot of blood in my urine.  He then went to the computer and looked up what had happened at ER - results of CT Scan, blood work done at hospital, blood work done the previous day re my INR. 

He then  told me to stop taking the anti-biotics IMMEDIATELY.  And to stop taking my warfarin the next day (Friday).  To resume the warfarin on Saturday.  I did ask why and he said the anti-biotics that I had been prescribed was not to be taken with warfarin as it increased the effects of the warfarin and my blood tests at ER showed my INR to be in normal range but the blood test the previous day showed it to be 3.19 (way too high) - he said where I had taken the anti-biotics that day my INR was now likely close to 4. 

So I went home.  I decided to google the anti-biotic (which I normally do, but because I had not been feeling up to par, had not done so this particular time).  This is what I found when I googled it:

"/When combined with blood thinners like warfarin, sulfatrim increases your chance of experiencing uncontrollable bleeding.  Some patients develop a shortage of blood platelets. This shortage of platelets causes a number of problems, including easy bruising and even bleeding around your brain. Sulfatrim interferes with he functioning of your kidneys resulting in decreased production of urine and possible kidney faiture (to be noted here, I have had kidney problems 2 years ago, needing angioplasly of the main artery to my left kidney).  For some patients, sulfatrim causes gastrointestinal bleeding.  If you are on warfarin, your doctor is unlikely to prescribe sulfatrim for you due to its possible side effects."

Well, I was not exactly a happy camper when I read the above, so I called my regular pharmacist (the one who filled my prescription and who knows my medical history) (I had even told him I had gotten the prescription for the ER doc because I had passed a kidney stone).  Anyway, I asked him who would be responsible for informing someone about possible drug interations.  He said 'a phamacist, like me'.  Then I read him the above.  He said 'oh'.  I told him in no uncertain terms that he should have caught that.  He tried to blame the doctor at the ER and I told him, 'yes the doctor at the ER should have known better, but you told me that the responsibility to check for drug interactions was the pharmacist'.  He apologized.  I just told him I wanted a note put on my file that I was NOT to be prescribed sulfa meds where I was on warfarin.  I did tell him that he could have killed me.  He again said that he took full responsibility for not telling me of possible side effects.  I told him that as long as he made a note on his files to be careful with anti-biotics (especially sulfa based ones) for patients on warfarin, that he might not be sued if someone ended up bleeding to death.

So - this Blog is just to let you all know that we must be vigilant about our own health, to always google side effects of meds, drug interactions (especially if you are taking another or many other meds).  One can trust one's doctor(s), and pharmacist, but ultimately, it is YOUR life, YOUR health. 

I did well yestterday with the amount of blood in the urine decreasing, the amount of urine increasing - up to last night when my urine was clear (to me anyway).  This morning, I restarted my warfarin (I have stopped taking the anti-biotics compleely since Thursday when I saw the doc on call.  However, as of noon today (Saturday), I am seeing an increase of blood in my urine.  And I have a general feeling of malaise.  I will wait and see if the blood keeps increasing and i it does, I will go to the doc on call (yet another doc) and will inisist on blood work being done.  Something is not quite right (I know this in my heart) - but what I am not sure.  Things may change - either for the good or get worse - so will take things one hour at a time.

Just be careful.......... take your health into your own hands - you know more about your own body than anyone else...

Friday, 15 July 2011


It has been a while since I have posted.  Excuses can range from busyness, lack of imagination, 'stuck in the in-between time', feeling like I have nothing to share to just plain laziness.  Pick one which feels comfortable to you.  Any of them will be true.

It is true that I have been busy with my editing of others' short stories, from editing my own short stoy, writing new short stories for potential contests, golfing season, being involved with the Mental Health Commission of Canada and attending a conference in Ottawa as well as taking a holiday to visit friends and family afterwards.  It is true that I feel a definite lack of imagination, that news of a pending cardiac MRI and pulmonary testing has taken over some of my enthusiasm.  There is also truth in the fact that I feel stuck in the 'in-between time' - be it living life as I know it and getting caught up in mindless activities.  Truth also lies in the fact that I sometimes feel alone and that no-one really cares  what I have to say.  But the whole truth truly lies in my plain laziness, that I would much rather spend time not thinking at all rather than thinking about things that I can or cannot accept.

I have to learn to accept people as they are. This can be difficult for me. I make no bones about that. I want a perfect world, a place where there is only a bright sun shining on me. And the sun has not been shining for a while now. But that is my own excuses for not writing. And it is also not  an excuse at all.

I went to a Conference in Ottawa, having been invited by the MHCC and immersed myself in preparation for it, attending pre-conference webinars, making travel arrangements for not just me but for my husband and son to come with me so that we could spend a vacation afterwards visiting friends and family. I looked forward to seeing my son's friends from Ottawa, to visiting my sister-in-law in Ottawa, my sister in Peterborough and my sister in Montreal.

The Conference went well, was a jam-packed day of making final edits to the document 'Transforming the Mental Health System in Canada'. I was shocked to learn that when people with a mental illness had a police record check done, that if the police had been involved at any point (and most - or at least my son had - due to the fact that when the Mobile Crisis Team would be called, the police accompanied them (for their own security), that my son  would now have a 'record' of this on his police file and they could release this information to potential employers). Many companies, in spite of their best intentions, would likely not hire someone with a mental illness - due to many factors - health care costs, sick leave, etc. Since when has mental illness become a crime? I promised myself that I would take this particular 'action' and make a diiference in our City by making sure that this practice no longer would be done. Insurmountable task, but one I could sink my teeth in. My enthusiasm over this issue was stirred and I wanted to make a difference. I am presently in the process of  doing this.

Going to Ottawa, our flight was diverted to New York due to the Ottawa Aiirport being closed. Having my son with me made me accept this with a smile and and telling him what an 'adventure' this would be. The flight back was diverted to Toronto as the flight to Montreal was cancelled and I again put on my masked smille and again I internalized my feelings of frustration - for my son's sake. We made it home in one piece and without my son stressing over anything, as he looked at me for calm and patience. I buried my feelings as I bury all my feelings.

Visiting my sister-in-law brought tears as I entered her home where I had done so many times in the past, when I used to work for the government and spent time with my brother Gerry. He was no longer there, having passed away in 2008 from brain cancer. The welcome he extended to me was not present, how I missed him. I had learned to not show emotion, but this one was tough. I cried silently in the bathroom, tears I had not shed in 4 years (not even at his funeral) - I was strong and had to learn to not show emotion. I had built a wall around my heart to survive. Those tears fell in buckets  the first day at my sister-in-law. Healing tears I thought. But still in silence and alone.

My visit with my sister in Peterborough was special and enjoyable. Yet, it was bittersweet as I thought this could very well be the last time I saw her. Thoughts of my upcoming cardiac MRI loomed over me and perhaps having to have open heart surgery filled my thoughts, as much as I brushed those thoughts aside and just enjoyed our short time together.

Then came the visit to my sister in Montreal. She and I had not spoken for a few months. The last time she and I had talked, she kept insisting that my son should have a vasectomy - I did not feel this was my place to tell my son (who is 24) that. He had a team of professionals - let them suggest this to him, not me. Yes, he has a mental illness but this did not mean that he could not lead a productive life, slow as this  was  to start. So my contact with her had dwindled. I was anxious to see her, to 'mend our fences' if you will. We spend the afternoon at her place, and she had prepared an early supper, so we could return to Ottawa that same night. We made small conversation and talked of insignificant things and I thought the visit was going well. I accepted her as she was, again the thought of perhaps this being the last time I might see her looming over me. At the supper table, she and her husband started talking about  a court decision rendered that very day about this man who had killed his 2 young kids and the court had made the decision that he was not criminially responsible due to a mental illness and how this decision would set a 'precedent'. Again I kept my feelings in check and did not make a comment at all, knowing my sister as I do. Yet feeling very uncomfortable about this talk, especially where all these things were being said in front of my son. I felt was totally unacceptable, yet I had to accept her and listen to what she had to say, going on and on about how courts did not know what they were doing and how people with a mental illness should not be treated differently. Having just finished attending a conference and one of the 'Priorities' was to ensure courts did take people's mental health issues into consideration and not just throw them in jail if they suffered from mental illness. So I had to bite my tongue (if anyone knows my older sister, they would know that saying anything that did not agree with her beliefs never did any good and would only incite her). I kept quiet and just hoped that the meal, which suddenly turned sour in my mouth, would end  soon so we could leave. Which we eventually did.

So, I had to accept ignorance once again and accept our dysfunctional family and realized that I could not speak what was in my heart.

I wonder if keeping all these things in my heart has somehow broken my heart in more ways than one. Was I right in not saying anything, you may ask...... I can fight stigma with the best of them...... but when I know what would be the outcome of my disagreeing with her would be, I again kept things locked away and had to accept what was.

Hence the title of this blog - acceptance. When does one accept others' opinions when they differ from yours? How much of a health effect does my  keeping things inside have on my own health?

Arriving home was a blessing and I was grateful to be back home. I had enjoyed my trip and have no regrets. But how can I accept ignorance, how can I accept even myself? How can I protect my child from hearing ignorance from my family members? Why do people not take our situation and respect us? I want no more contact with my sister from Montreal (altho I did send her a thank you note thanking her for opening her home for a visit from us).  My sister-in-law in Montreal (my brother died in 2006) did not make any effort to see us while we were in Montreal. How do I accept this slap in the face? (She and I disagreed a while back - again having to do with my son and her opinion on her telling me I should place my son in a care home). There were other problems and misunderstandings, some of which I took full responsibility for and send her a long letter of apology. But I cannot control her non-response. This is her choice. So I accepted her decision not to see us.  At the same time, thoughts that I might be the one who is ridiculously in the wrong  stirs in my soul and I wonder if every problem that ever existed is MY problem, MY fault. But I  let go of that - hopefully with love.

But I feel so alone. Like I wrote in a short story, I am but a jumbled thought in a jumbled world.

Strange how I do not fear the upcoming MRI and its possible ramnifications. So what if I die? So - who would care? The only one I think would miss me would be my son - this is what keeps me  going. Apart from that, life will go on.  Yet, last night, we all went   to our weekly supper out and I saw my son order  2 drinks of run and coke and I fear his slipping  back into old habits.

This morning, as I write this, I wonder......... am I a horrible person? Am I doing ANYTHING  right? Am I the one who is ALWAYS wrong? Does  ANYONE care? Must my final act of ACCEPTANCE be accepting that I a failure  at everything I do or say?