The good, the bad, and Tamiflu

***Warning: This post is long. I have a hard time telling a story without telling the WHOLE story.***

So I am back, not 100% yet, but getting there. Now I am just trying to catch up on everything that was neglected while I was "gone." I still have a lot of cleaning to catch up on, but I have disinfected most of the common surfaces (doorknobs, countertops, tables, etc.) and I hoping that none of the rest of my family will catch this nasty virus. So far, my husband is in perfect health, but my daughter has had a runny nose and cough since Saturday. It has not progressed farther than that and we are hoping that is all she will get. I am not sure if it is her good immune system (she takes after her dad with that, he rarely gets sick) or if it is my efforts at trying not to spread it, but I am grateful either way.

I started feeling not right last Wednesday evening. My throat was itchy, and I started having a dry cough, but I thought little of it. Thursday morning I woke up and got in the shower and was overcome by nausea. This is normal for me though. I am pregnant and this pretty much happens everyday. I rarely throw up though, I just really really want to. After I got dressed, I threw up. I was actually happy that I did. Usually this means that I will feel better and that I will have a few hours break from the nausea. I still felt sick though.

I tried to go about my day as usual. I got my daughter out of bed, took care of the other little girl I babysit in the mornings and fed the dogs. Then I was throwing up again, and again. 'What is going on?' I thought. The only thing I could figure is that my cough was getting a little worse and that somehow it was triggering my gag reflex. I blamed it on the pregnancy and went and laid down. 

Around lunchtime, I started to realize that something was not right. I was supposed to go in the OB that afternoon, but I called and rescheduled it, still thinking that I just had a cold. Then the fever and the body aches began. My neck and back were the worst. The pain in my lower back was comparable to the beginnings of labor pain. I knew then that I had the flu. I called the OB back and asked them what they recommended. They recommended an urgent care clinic and my daughter and I left as soon as we could. Luckily the wait was very short ( I have heard that if you go during peak busy times, the wait can be hours). I saw the doctor within 20 minutes of arriving and he was very helpful. He gave me a prescription to Tamiflu and then also said that I was going to need some anti-nausea meds too (Zofran). I did not think much of that, I was just happy that I was getting Tamiflu so that I could make the pain stop.

I took the first dose as soon as I got home and was happy that my husband would be home in an hour or two. I laid down on the couch and put cartoons on to entertain my then very grumpy toddler (this all happened during her normal 3 hour naptime and it was too late at that point to put her down. As soon as my husband came home, I went to sleep. I have no idea how long I slept, but it felt good. When I woke up, I felt so much better. My fever was gone, the body aches were dulled and my headache was a lot better. Then I started throwing up again, and again. Finally I remembered about the Zofran and I took one. Within half an hour, the nausea was gone. I was actually hungry and ate for the first time that day, a piece of toast.

The next day was better. I was really tired and weak, but the Tamiflu really lessened the intensity of the symptoms and I also did not need the Zofran at all that day. My husband still had to work and I still had to take care of my daughter and that was hard. I thought about getting help, but I did not want to risk spreading it to anyone else. You are contagious for about 24 hours before you have any symptoms.

The weekend was a blur. I think I slept and watched TV most of it. I had no appetite, but I forced myself to eat. The main symptom I had then was a little stomach discomfort and just being tired and achy. Sunday night I could not sleep, the stomach ache was too intense. I finally tried to force down some saltines and that settled it enough to where I could sleep.

Monday the nausea came back along with the stomach pain and I took Zofran which allowed me eat and that helped with the stomach pain. At this point, I decided to do a little research on Tamiflu. The stomach pain was weird to me and did not make sense. I found a website that allows people to post about their experiences with drugs called askapatient.com. After reading quite a few of the reviews on Tamiflu, I realized that although really helps with flu symptoms, there are quite a few side effects that no one really tells you about.

According to the Tamiflu website:

Rare but serious skin reactions and allergic reactions have been reported. Stop taking TAMIFLU and call your doctor if you experience any of these reactions, as they could be very serious.


People with the flu, particularly children and adolescents, may be at an increased risk of self injury and confusion shortly after taking TAMIFLU and should be closely monitored for signs of unusual behavior. A healthcare professional should be contacted immediately if the patient taking TAMIFLU shows any signs of unusual behavior.

The most common side effects of TAMIFLU are mild to moderate nausea and vomiting. TAMIFLU is generally well tolerated.

The doctor at the clinic said nothing about these and neither did the pharmacist. I believe the doctor did know about at least the nausea though. That is why he gave me the prescription for the Zofran. He did not say why, but he said "you are going to need it."

From what I learned from the askapatient website, it seems that if you start to take the Tamiflu very soon after you start having symptoms, then it works a lot better. If you wait too long, then it does not work very well and all you are left with is side effects.

I believe that sometimes in health care, people are so desperate to get some sort of prescription from their doctor and that doctors want their patients to think that they are helping them that we fail to really think about the consequences of taking the prescription. There is a reason that Tamiflu is only available by prescription like all prescription drugs, there are dangers with them.

For me, the worst side effect was the stomach pain. I told my husband that it felt like how I imagine an ulcer to feel like. It felt like there was fire burning through my stomach and intestines. I also had some of the mental side effects, although not as bad as others have reported. It made me very emotional. I am already a little emotional because of the pregnancy, but the Tamiflu really seemed to intensify it. I was crying a lot and I could not control it. I was really embarrassed about it until I figured out what was happening.

A lot of people have reported other symptoms like headaches, neck and back aches, loss of appetite, inability to sleep, nose bleeds, paranoia, confusion, diarrhea, vomiting, night terrors, anxiety, irritability, dizziness, and shakiness. For some people, the side effects outweighed the benefits of taking it and they stopped taking the Tamiflu.  

I personally am glad that I took it. Being pregnant, my immune system is not 100% (or else my body would try to kill the "parasite" that is inside my uterus at the moment). I was not willing to risk my body not being able to fight off the flu virus sufficiently enough that my baby would be in danger. Also, being pregnant, I am limited as to what over-the-counter medications I can take. Being in the first trimester, this is particularly important, and I try to not take any medications, apart from Tylenol. If I were not pregnant, I probably would not have taken the Tamiflu. I think I would have gotten some Nyquil or sudafed and just knocked myself out with those over-the-counter medications. Yesterday morning, I took my last dose of the Tamiflu and I haven't had any trouble with stomach pain since yesterday evening.

In conclusion, never blindly just take any medication your doctor prescribes to you. Ask about the risks vs. the benefits. The best medication for almost anyone with the flu or even a cold is rest and plenty of liquids. Do your own research, but remember that not everything on the internet is true. People who have extreme views or feelings about something are more likely to talk about it. For most people, Tamiflu works great and the side effects are minimal, but everyone is different and some people cannot handle it as well as others. I hope my experience can help you make the best decision for you and your family.

No need for the vaccine for me anymore

Sorry I have been neglecting this blog. I totally have a couple of posts in my head, but they are going to have to wait just a little longer. I now officially have the flu, most likely the swine flu. They didn't test me, but just found out that I was pregnant and gave me a prescription for Tamiflu. I started taking it early enough that everything should be okay with the pregnancy. My family and I flew down to my husband's great-grandmother's 100th birthday party last weekend and we think that I picked it up on the plane. So needless say, I no longer need to worry about getting the vaccine, I will have natural immunity. I promise to post something good as soon as I get my energy back.

Antibacterials

Sandy asked me my opinion on the overuse of antibacterial products. I have been thinking all weekend about what I should post. This is another topic that can be quite controversial.

Almost all hand soaps now are antibacterial. It is hard to find any that aren't. If you look at the ingredients, the active ingredient is Triclosan. This ingredient is what makes these products "antibacterial." Although on its own this ingredient has been shown to work, there has been conflicting evidence as to its effectiveness when added to soaps and used on the skin. Most studies have shown that washing hands in just plain soap and water is just as effective as using antibacterial soap and water. The main factor in germ removal is not the Triclosan, but in how well and long you wash your hands. We just need to remove the germs from the hands and not necessarily kill them.

Although we do not currently use Triclosan as a treatment for any disease, if we were to ever need to use it or an antibiotic similar to it, it may not work. The more that we are exposed to such antibacterial products, the more resistant strains of bacteria develop which lessens its effectiveness. This is why doctors are sometimes hesitant to prescribe antibiotics unless they are sure of a bacterial infection (This is a whole other topic, some doctors prescribe them way too much, which is bad).

So why do products contain them if they do not help any? This is where I believe that companies prey on the ill-informed consumer. Some people are willing to spend extra money on something labeled "antibacterial" believing that this a healthy choice for their family. Now that you know, you can save a little money next time by not falling for the hype.

Another topic I want to talk about is hand sanitizers. Alcohol-based hand sanitizers are different from antibacterial soaps. Alcohol is not an antibiotic. Alcohol actually kills the bacteria on your hands as it dries. There is not an issue of resistance developing from overuse of these alcohol-based products. There are problems from overusing these hand sanitizers though.

First of all, there are good and bad bacteria on our skin. The good bacteria help protect our skin and help prevent infections by the bad bacteria(and fungi)  by competing for space and nutrients. We don't really want to sanitize our bodies too much because we don't want to kill all of the good bacteria. If it is possible to wash your hands instead of using hand sanitizers, do it. Hand washing does not destroy all of the good bacteria like hand sanitizers do.

Secondly, although alcohol-based hand sanitizers are quite effective against most bacteria, they are not 100% effective against all bacteria. There are many bacteria that form spores and alcohol does not do anything for spores. (We actually add alcohol to our spores in the lab to help purify them and get rid of the non-spores.) Some of these spore-formers are found in fecal material. So after changing diapers, going to bathroom, or assisting others in going to the bathroom it is always better to just wash your hands really well especially if some sort of gastrointestinal issue is going around your family.

Lastly, alcohol-based hand sanitizers dry your skin. If it dries it bad enough, your skin will crack and bleed. These cracks can be easily infected and if you have ever gotten any alcohol in them you know that they can be painful. Part of your skins' natural barrier to infection is it oiliness and by removing this, we make ourselves more susceptible. If you have to use hand sanitizers a lot, carry around a small bottle of lotion and put it on after using the alcohol to prevent your skin from drying out.      

In conclusion, the best way to protect yourself and your family is to wash your hands really well with any kind of soap. Make sure to rub your hands together for at least 20 seconds (sing your abc's or happy birthday) and make sure to clean under your nails, in between your fingers, and at your wrists.

Vaccine Immunity vs. Natural Immunity

I received a question about whether it is better to get sick with something and gain immunity that way ("natural" immunity) or is it better to get vaccinated. I think this is a very good question and the answer all depends on how you look at it.

We build up immunity by being exposed to something "foreign." Our immune system recognizes this "foreign" or non-self cell and then attacks. A few days into the process, antibodies that are specific to that attack are made. This process is actually really cool, but it would take a lot to explain so I am not going to go into detail about how it happens. The bigger the attack, the bigger your bodies' immune response. Generally the bigger the response, the better immunity you will have to it later.

This process is the same whether you are vaccinated or acquire it by actually getting sick. The difference is in your immune response. The goal of vaccines is to get enough of an immune response to where you gain immunity without actually getting sick. The problem is because your bodies' immune response is not as big, this immunity does not last as long. This is why we have to have booster shots and get the flu shot every year.

Usually when we acquire this immunity by actually getting sick, the resulting immunity lasts for life. This is why H1N1 is not a problem for most individuals over 60. They were exposed to a similar virus when they were children. This immunity has lasted their lifetime. If they had received a vaccine instead of getting sick, they would not still have this immunity and they would be susceptible to it now. For this reason it is better to acquire immunity naturally.

On the other hand, for some people, it is not safe for them to get sick. Some peoples' immune systems are not strong enough to fight this big attack and they can die. Even in healthy individuals there is also a risk for secondary infections (sinus infections, pneumonia, etc.). For this reason, it is better to acquire immunity by vaccination.

Also in the case of the flu, there are many different strains. Each year, experts predict which 3 strains they believe will be the most prevalent and they create a vaccine against these strains. That means that first of all, even if you do receive a flu shot, there is still a chance that you can get another strain of the flu. Secondly, if you do not get the flu shot and you get sick with the flu, you only gain lasting immunity to that specific strain. You are still susceptible to the other strains. This is another reason, why we have to get flu shots every year, these prevalent strains can change.

So there are good and bad in both. Your decision should be based on what you want for your family. For me, I have chosen for my daughter to have all of her childhood vaccinations. Many of these diseases can be life-threatening and I don't think it is worth the risk. Last year, I did have her vaccinated for the flu. At this time she was about 9 months old. Her immune system was still developing and she was at higher risk from complications from the flu. Now that she is older and her immune system is stronger, I am not giving her the flu shot anymore. She has no underlying health conditions (like asthma, diabetes, etc.) so for her to get the flu now would not be a big deal. If I were due to have a baby during the flu season, I would have her vaccinated, as well as myself and my husband, so that we would not risk exposing a newborn. I am not really due until May, after the flu season is over so we are not worried about that. This is what my husband and I have decided is best for our family. 

You must decide what is best for your family.

H1N1 Vaccine

I think that the H1N1 flu (or swine flu) has been at the top of every one's health concerns lately so H1N1 vaccinations are going to be my first topic.

For some reason, this vaccine has been quite controversial. Many people are afraid to get it because they do not believe it to be safe. They don't believe that we have had time to test it and think that there may be side affects. I do not believe this to be the case. We have been manufacturing flu vaccines for years and they are completely safe and help prevent millions of people from getting the flu each year. H1N1 is just another strain of flu and the manufacturing of this vaccine is no different than what we have done in the past for the seasonal flu. The vaccine should be completely safe.

Many people have asked me whether or not I am going to have myself vaccinated. A couple of months ago, I would have said no. This is not because of any safety issues with the vaccine itself, but simply because I do not think that the swine flu is that big of a deal. It actually might be nice to get it and get immunity to it and be done with it. Now that I am pregnant, my answer is yes. The swine flu is much more dangerous to individuals who have some sort of immune deficiency, pregnancy included. I do plan to get the vaccine, but I am not going to go down to the health department and spend the night in a tent waiting in line for hours to get it. I am going to wait for all of the craziness and excitement to calm down and probably just get it from my doctor's office later when they hold a vaccination clinic.

Will I have my daughter vaccinated? Most likely not. She is a healthy child and although she is young, I don't think it would be a big deal if she came down with the swine flu. Like I said before, it might be nice for her get it, get immunity, and then not have to worry about it anymore.

Introduction

Hi Everybody! After years of family and friends calling me for advice I have decided that I should start a blog dedicated to the issues that you care about most. I am a microbiologist and have dedicated my career to studying infectious bacteria, viruses and fungi. I am firstly a stay at home mom though. I have a young toddler and another one on the way.

I am not a doctor and do not intend for any of my advice to be used for diagnosis or to replace a visit to the doctor. I simply wish to better inform you and give you the facts that you need to make better educated decisions about the health and well-being of your families. Doctors have a lot to learn and cram into a few years of education and training. They have a better overall knowledge of how the body works than I do. I have spent my education focused mostly on microorganisms and I feel I may have a better understanding of how they work compared to some doctors who only a spend a semester or two on microbiology.

My hope is that my knowledge as a microbiologist and a mom can give a unique perspective and hopefully better allow you and your doctor to make the best decisions for you and your families.

Please feel free to email me with questions, comments, or if you have a something specific that you would like me to post about: germmom[at]gmail[dot]com. I want this blog to be about what you want to hear so I appreciate the input!