April 26, 2009

Heeding Warnings

Posted in Life, Technology tagged , , , , , , , , , at 11:27 pm by lindaslongview


All too often, we hear “warnings” but proceed without heed.  Sometimes it is a small voice inside one’s head that says, “things do not add up,” sometimes it is a real warning (do not use lawnmower as hedge trimmer or bodily injury might result), and sometimes it is a recitation of all possible observed “rare events,” such as on drug labels.

Two weeks ago, my doctor prescribed me the antibiotic levofloxacin for a sinus infection.  As he prescribed it for me, he hestitated because I am an avid athlete and he said that it was known to be associated with spontaneous tendon rupture.  Although I was warned, once I felt better I did not think about that warning as I returned to my regular repertoire of sports.  Last Thursday morning, as I perilously dangled after I lost my footing on a V2 bouldering problem, I had to strain hard to regain my footing and overgripped my left hand/arm to finish the route.  Later that afternoon, I could no longer open my car door with my left hand and the previously faded memory of the “tendon rupture” warning had resurfaced.

When faced with warnings, there is a tendency to discount that which causes us to deviate from plan.  As busy humans (never enough time!) we are risk averse especially to the loss of time. We have an ability to proceed with any number of justifications:  the probability is small (rare event), the concern does not apply (no associated risk factors), and/or the risk is overstated, because we have not deliberately considered the unfavorable outcome’s impact on time.

Deliberately planning for undesirable outcomes based upon “warnings” is the long view approach.  By including contingency for the unexpected, we are more objective in dealing with risk.

I have since learned that strenuous sports activities predispose patients to quinolone-related tendon rupture [Gold and Igra, “Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature,” The Journal of the American Board of Family Practice 16:458-460 (2003)].  Yikes!  Had I been sufficiently deliberate to more fully understand the potential for tendon rupture and had planned for a twelve week (or more!) tendon recovery, I would not have been bouldering on Thursday morning.  Swimming would have been a much better long view choice!

The good news is that my elbow pain is already better (probably unrelated to the drug concern).  But, nevertheless, now that I know the full implications, I will not be placing high loads on my tendons while taking levofloxacin again!

I am duly reminded to take the long view and plan for contigency in order to be more objective in dealing with risk.  I hope you are too!


  1. Doug Smith said,

    It’s quite useful as a risk strategy to plan for the unexpected. By factoring in what could happen, we can mitigate our big picture loss and make intelligent decisions about how much risk we’re willing to take.

    It’s good to hear you’re healing nicely, too.


    • lindaslongview said,

      Thanks for the reinforcement and well wishes.

      Indeed, the elbow pain was more wake-up than anything (feels fine now). Even though I am very disciplined, I notice that in my personal life that I tend to be less thorough than in my professional life — maybe because I perceive that I have even less time. 🙂 Back to the old adage, “the hurrier I go, the behinder I get.”


  2. Gayle said,

    I think one of the other areas where we are risk takers is in the area of something we really want/desire. At that point, the desire far outweighs any potential risks, whether they are advertised or not. We don’t even want to look for risks. For example, the recent recall on the weight loss supplement Hydroxycut. Millions of people were using the supplement to improve their health, lose weight, become more toned. So if you are doing something good for your body, why would you go looking for risks. You are in the process of trying to eliminate risks such as heart disease or diabetes. I think the big problem is the focus that any individual has at any given time. Some of us are so risk averse, that we start risk mitigation any time we start something new. Others are so focused on the positive outcome they expect, that they don’t even consider risk, as you discuss in your article. I believe there is a happy medium. We can’t ignore risk, but we definitely don’t want to be overwhelmed by trying to consider and mitigate every potential risk. We need to take a long term perspective based on risks that we have determined will have significant impact.

    • lindaslongview said,

      Indeed! I like your analysis: “We need to take a long term perspective based on risks that we have determined will have significant impact.”. It would be hysterical to go looking for unknown risks, but it is okay to be a little paranoid to the extent that you are aware of known risks and consequences. If you have been warned, it is worthy to understanding the potential negative (12 weeks of tendon recovery!) in order to make an informed decision to proceed.

      Thanks for sharing!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: