I made it through the week and a half or so it takes for the H1N1 influenza vaccine to take hold, but the flu has still taken quite a toll on me.
Normally I refer to this time of the year as my Hunting Season Lull, but with at least a half dozen patients with influenza-like illness in my schedule every day I'm not sure I've ever been quite so busy. Fortunately most of these folks just need to go home, rest, and drink plenty of fluids. If nothing else this year has reminded people how bad it feels to have true influenza apart from what we casually refer to as the flu. Unfortunately I've admitted two patients to the hospital with influenza as well. One was a four month old baby who was more precautionary and the other a middle age woman who stayed four nights with a nasty COPD exacerbation triggered by H1N1. Hopefully she will see this as a teachable moment and finally quit smoking.
We have been lucky at work with only one nurse out for a week with the flu. She received her vaccine only a few days before coming down with symptoms herself. If she had been able to receive her vaccine a week earlier as I did, she likely never would have become ill. The rest of our staff is hanging in there, and all but one, my stubborn nurse, received vaccine.
Our county still appears to be short supply of vaccine at least compared to one neighboring county. We received enough for our staff and pregnant patients. To date, these twenty or so doses, for which we had to beg and plead, are all we have received for our some 3,000 patients.
Where H1N1 has taken its greatest toll on me, however, has been on the home front. My wife and three kids all have come down with it and are now in various stages of recovery. While the struggle to balance one's personal and professional life is always present, trying to meet the needs of people with influenza at both home and work has been both mentally and physically draining.
It's been so tiring in fact that you would think I had the flu.
The Country Doctor
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17 hours ago
5 comments:
We had the entire family down with flu a couple years ago and it wasn't something I ever want to experience again.
I hope your family recovers quickly without complications.
wow! I bet it gets old seeing one patient after another with flu symptoms... I still think it's odd that they're passing out flu vaccinations when they haven't even tested them (as far as I'm concerned). Yikes!
Isn't vaccine preparation a mature technology? We knew about the H1N1 virus back in May of 2009. Obviously we need a major improvement in vaccine production speed. Probably by a factor of ten. It took six months and there still is insufficient supply! If this was a more serious flu or something on the order of SARS we'd be worse than anonymous - we'd be dead!
Your thoughts?
Yes, seeing patients one after another the flu does get old.
I would actually argue this is a well tested vaccine. The production is exactly the same as the methods used for seasonal vaccine which has been one of the most widely used and most studied vaccines in history. This vaccine with this strain was in fact tested as well before release. One of the test sites happened to be Seattle.
This vaccine production method of using chicken eggs as media for viral culture does seem antiquated in the age of PCR and gene recombinant technology. I don't understand why we haven't gone past this.
What's scary is seeing 25 year old otherwise completely healthy people linger on ventilators for a month only to die from "just the flu".
I highly recommend John Barry's The Great Influenza to anyone who just doesn't see what the big deal is about the flu.
I completely agree with you, Country Doctor. After seeing two pregnant healthy patients on the vent for >2 weeks, and small children go from happy to intubated and fighting for life, if the vaccine is only effective part of the time, it will save many more lives than people could dream of. I have spoken to people without a medical background and often they don't understand how serious and different this is from the seasonal influenza. When you compare this to previous influenza pandemics (NEJM had a great article back in July-ish), the characteristics are startlingly similar.
I am very upset about the vaccine rationing. So big NY firms can get doses for their "high risk" employees, but our pregnant ladies in our county aren't vaccinated yet, and my 18 mo old isn't vaccinated (even though I as a health care provider have been (and I'm seeing more than 20 pts a day with likely H1N1!)) - that is SICK.
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