Okay. Enough with the gossip and scandal and who’s sleeping with whom. It’s time to turn from Tigers to Pigs.  

Following is a letter of advice from my friend BABETTE who is a Psychiatric Clinical Specialist and Nurse Manager over at the VA in Los Angeles, about the swine flu. 

It is not meant to be alarmist. Simply to make you think.  

“My advice to everyone is to take as many precautions as they can. We first heard that H1N1 would hit younger children especially hard because those of us who were around when the virus first made rounds in the 1970’s had likely been exposed enough to have some immunity. The other high risk groups included people with respiratory or cardiac problems because this virus seems to hit the respiratory tract really hard, and the failure of one organ system can lead to  catastrophic failure of other organs (kidney, liver). Pregnant women were considered at high risk because infection with H1N1 could cause premature contractions and miscarriage as well as pneumonia for the mother which could kill her. Distribution of the vaccine did not go as expected, with bizarre decisions made by who knows who about who should get what. Batches of the vaccine are still trickling in to major medical centers with mixed responses. The people that did not get vaccinated yet that do not know anyone affected probably think the fuss is overdone.

Those of us that watched a healthy 40-something ex-Navy serviceman become unable to speak and appear to have either had a stroke or brain inflammation (meningitis, encephalitis) or the 50-something psychologist with a diagnosis of asthma deteriorate from being short of breath to massive organ shut down and life support in less than 2 weeks are either giving thanks for having been vaccinated or scrambling to find someone who has the vaccine to give. These last two cases should have been non-existent or mild based on the “adult with probable previous exposure” so all bets are off.  People with ANY viral infection are most contagious BEFORE they have a fever or cough. The person in line at the supermarket, the kid in your child’s class- would not look sick when they are most able and likely to transmit the virus to you or someone you love.

Some of my staff have reported that when they had a fever of 103 and called their doctor to make an appointment they were told not to come in ‘until it reached 105’. Some clinics treat well people in the morning and sick people in the afternoon, but lets face it- the well people may be those that have it and just haven’t gotten the symptoms yet. You really need to think about not getting sick rather than taking a chance on a “virus distribution center” called a doctor’s waiting room.

Tamiflu is out there, but some doctor’s are still slow on the uptake. It is also expensive (cheapest I heard of was $90 for a treatment) and it is most effective just after you’d been exposed but before you have symptoms. Not an easy needle to thread.

If you have any respiratory condition and have not been vaccinated, for heaven’s sake go get it done. If you are pregnant, go get the vaccine (it may be available with all of the preservatives stripped out of it at some women’s clinics, if you are so inclined- but the vaccine is more important than the concern about the preservatives). If you are in neither category but spend time in crowds or interacting with a lot of people as part of your job, get vaccinated.

If you persist in not wanting to take this precaution (I like to say that “I can’t get it and I can’t give it” if I am vaccinated) then start wearing an N-95 surgical mask when you are in crowds, carry around hand sanitizer and stay several feet away from anyone that is coughing. (According to UC Berkeley, you have a 52% chance of being infected when someone’s cough carries the flu virus into your eyes, nose or mouth. Nice.)

My advice to everyone? Take as many precautions as they can.”

There you have it. From someone in the trenches. Ultimately, you have to do what you feel is right for you and your family. Hope this helps.

If you have any more questions about the H1N1 flu or vaccine go to:

www.cdc.gov/H1N1FLU/