August 3, 2014
Iron Man

Disclaimer: Quite a lot of you have wanted to hear the "iron" story details. This was extremely traumatic for me (understatement). I'm writing it out here so that you can have all the details you want. But I'm probably not going to talk about it in person so please don't ask me about it.


Remember I mentioned that the kids both had blood work recently? Neither of them are celiac!!! I was very relieved as I had several pretty awful nightmares while waiting for results consisting of the kids begging for various favourite treats - goldfish, granola bars, mini wheats - and of course they were all wheat based. Anyway. The blood work was an adventure for Matthew in particular, because CHEO forgot to run one of the tests (on the paperwork in yellow highlighter!) so we actually had to get it done twice. The second time he started screaming the second he laid eyes on the tech. "I get that a lot", she said. "I guess he's been here before."


In any case, Matthew is not celiac, but his iron stores were low. "Not quite anemic", said our doctor, but she wanted us to supplement with iron for four months, twice a day. She faxed the prescription into our pharmacy and called us to make sure we understood everything and were on the same page. Have I mentioned our pediatrician is awesome lately? I really like her! (Dr Lynn Jacoby at Appletree, for those of you wondering) I was less thrilled about another to-do list on our pre-cottage packing list but in any case I called the pharmacy. Unusually, they were out of the iron and wouldn't get it in until after we left for the cottage. The pharmacist suggested that I walk down the street and get it filled there. I arrive at the second pharmacy and explain what I need.


First question: "Do you have a drug plan?" Well, no. We're self employed and it's always seemed overly expensive for what you can get. "Tell you what", says helpful pharmacist. "I can give you this over the counter. Then I don't have to charge you a dispensing fee." Well, ok. I'm slightly uncomfortable about the ethics but also I'm in a hurry and don't want to seem weird. She hands over the bottle and the prescription. "You're supposed to take 5mL twice a day", she says and points to the jargon that explains twice a day to make sure I understand. I look at the bottle. The maximum daily limit for a child of Matthew's weight is 2mL. I question her. Isn't it a problem to give the kid FOUR TIMES the maximum dose I ask? She gives a little laugh. "Oh no" she says "You just have to go with whatever the physician says." There's a lot of instructions about taking with citrus (which Matthew doesn't like) and scheduling around eating (unpredictable and already a bit of an issue) and not nursing for three hours on either end (the next four months look fun)


The next morning, we're rushing around throwing stuff in the car. We get to the iron. We decide we should give Matthew his morning dose. In retrospect I do not know why we thought that right before a long car trip was the time to start a new medication. This is not a mistake we will ever make again.


I'm still uncomfortable about the dosage. I ask Brendan about it. He agrees it seems a bit weird and we decide we'll only give him the morning dose and try to get a hold of the doctor on Monday when she'll be back in the office to ask.


The pharmacist didn't give me anything to measure with, but luckily we have a plethora of these from our recent bout of poor health over the winter. We have a hard time getting Matthew to take the 5mL. It is now 11:30am.


We leave - stopping for McDonald's on the way out - and get on the road to the cottage. Matthew is a little bit fussy, but sleeps for a while. Around 2pm he starts to throw up. We think maybe he's car sick, but it seems weird. We turn his car seat around to face the other direction and clean him up. He loves it. He seems fine so we get back on the road. Shortly afterwards he throws up some more. And some more. We pull over in the middle of the woods to clean him up again and Brendan asks me to double check everything - prescription, bottle etc. I pull out the prescription and actually looked at it closely. The doctor wrote "0.5 mL", not "5 mL" which is what I heard the pharmacist say. I had just given Matthew TEN TIMES the prescribed dose.


The next few hours are a bit sketchy. The guilt and terror were overwhelming. We called 911. It turns out you should call poison control first - that's what the paramedics do. We talked to my parents on the phone while waiting for the ambulance, who calmed us down somewhat (my cousin gave us a telehealth consultation over the phone - from Zambia - that exactly paralleled what the hospital ended up doing). We got an ambulance ride to the hospital. They gave us a more appropriately sized syringe. We waited around to make sure Matthew was actually okay and talked to poison control, and then we went to the cottage where he had the foulest diaper I have ever encountered. It smelled like iron. He's okay.


Brendan and I have come up with a checklist that we're going to follow from now on when dealing with prescriptions. We're not going to skip dispensing fees (they would have put the dose on the bottle, and hopefully it would have been correct there!). We're going to keep a copy of every prescription and both of us will compare it to the notes on the bottle. We're not going to start meds before trips. I'm going to listen to my instincts


And that is how I came to accidentally poison my son.


1
On August 23, 2014 at 04:11 am
Grandma H. said:
So glad our "iron man" recovered quickly! Hope you have too. But this sounds more like a pharmacy miscommunication than your mistake.

Some days I wonder how my own children survived to adulthood.


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