Resurfacing

Please allow me to fill in the blank space between early July and late August. First off, I have to say I thought it had been much longer than that since I had written anything here. This last month was a long year.

Sometime back in June we learned that the mega-pharmacy chain we had been using was going to close and all our prescriptions would be shifted to another mega-pharmacy chain unless we specified somewhere else for them to go. This would have been our third mega-pharmacy chain, and really there isn’t much difference between them, but this one was a bit further away than was convenient so we instead had all our prescriptions transferred to the pharmacy at a mega-grocery chain that is closer to where we live. The kind of choice in the consumer market our government’s economic policies have worked for years to achieve.

I want to take a moment here to talk about the Swiss Cheese Problem. This is a topic of frequent conversation in health care and, I suspect, management circles in other high-risk professions as well. We’re all human and everyone makes mistakes, like the holes in a slice of Swiss cheese. You’re never going to get rid of those holes in the individual slices so what you do is, you build systems that stack slices on top of one another. If something falls through the hole in one slice, it gets caught by the one below it. The difficulty is, every now and then, by sheer chance all the holes in the individual slices line up and something drops clean through. This is the situation I found myself in over the last month.

The pharmacy that was closing was supposed to transfer my prescriptions. They didn’t. The new pharmacy insisted that I had picked up a refill of my medication. I hadn’t. During all this, Dr. Psychiatrist was out of the office and unavailable. The result of all this was that I was out of my heavy-hitter antidepressant for about a month, and out of all my medications for 2-3 weeks. I have been on at least one antidepressant for at least ten years so facing reality without any kind of chemical filter was challenging. Also, in addition to two different medications that help turn down my sympathetic (fight-or-flight) nervous system, I have been taking a combination serotonin–norepinephrine reuptake inhibitor (SNRI) / norepinephrine-dopamine reuptake inhibitor (NDRI). The physical withdrawal symptoms were rough.

The good news is, all the medication issues are resolved and I have a reasonable supply of everything again. The automatic refill service at the mega-grocery chain pharmacy even seems to work, which is nice. The bad news is, I have essentially been starting from zero with all my medications again. I am feeling much better and much more stable than I was but Dr. Psychiatrist estimates I have another couple of weeks before I’m back at a steady state.

Best healthcare system in the world.