125) I screwed it up

October 6th is E’s EOT date, so we have less than 4 months to go. We’re in the proverbial home stretch, and I did my first big medication screwup this week. We’ve missed a couple of doses – it happens, but this was something different. E receives his methotrexate on Wednesday, and gets 4 x 2.5mg pills for a total dose of 10mg. Normally, we pick up our prescriptions from the pharmacy at SickKids. At our last visit, I forgot to ask for a refill of this particular medication, so we got a prescription from E’s nurse practitioner, and filled it at a pharmacy near home. Unbeknownst to me, they gave us 10mg instead of the 2.5mg ones. On Wednesday, when it was time for his methotrexate, I dosed him with 4 x 10mg pills. Since the pills were the larger dose, I should have only just used one.

The 10mg pills were the exact same size & shape as the 2.5mg ones, so there wasn’t a visual cue that something was different. There were only 4 pills in the bottle & that didn't strike me as strange because pharmacies are restricting the amount of pills that are given out due to COVID. The pharmacy we picked up the pills from was the same chain, and should have had access to E’s medication history. They should have attached a visible note, or given a verbal message at pickup to let us know that the dosage had changed. I accept some of the blame, because I did not look at the dosage on the bottle before administering them to him, but when you’ve been doing something for the 2+ years we’ve been in maintenance, you start to go on autopilot a little bit.

So, this Friday morning, when I randomly had the epiphany that I’d over-dosed my son on Wednesday, I called E’s nurse practitioner at our satellite clinic. She called the oncology department at SickKids, and called me back a little bit later. They said not to worry; early on in treatment their methotrexate doses are much much higher than what he accidentally received this week. The most likely thing that will happen is that his counts will plunge. They said to watch for abnormal behaviours, vomiting, diarrhea, or bleeding. We are to bring him in for an unscheduled CBC next week to check his blood. He's seemed absolutely fine so far, I haven't noticed any side effects or changes, but I feel terrible. I feel like an idiot, and a moron. I'm both angry, and disappointed with myself. I feel like I let him down, because I'm the adult, and I'm supposed to make sure things like this don't happen.