And Yet Again

I didn’t think I’d be writing about the flu this year, yet I am. Why? Because, despite thinking I was safe since I didn’t have it in December as usual, I have it now. Actually, I’m in the I-feel-like-an-old-dishrag stage now. Humph, that’s probably why it took me six days to do the laundry (I’m still not done with the putting away) and the dishes. We were lucky enough to have my daughter and new son-in-law do the marketing for us. But it was only then that it became apparent she has it, too.

I have written before about the fact that the flu shot doesn’t guarantee you won’t get the flu, but that if you are one of the unlucky ones to get the flu after the shot, it will not be as virulent. Thank goodness. It’s day seven and I’m just now reaching the stage where I can do something… writing, dishes, laundry…IF I get back into bed for at least an hour between tasks. To be honest, sometimes I have to interrupt those tasks to take that hour rest.

I have read some good murder mysteries and thrillers while listening to silence. Then I could tolerate the television and discovered Dr. Bramwell on Amazon Prime. Terrific for someone who loves Victoriana (I did write Portal in Time and am seriously considering the requests for a sequel.)

But what’s different about the flu and the flu shot this year, I wondered as soon as I felt better enough to wonder about anything. This is the latest information from the Centers for Disease Control and Prevention (CDC) at https://www.cdc.gov/flu/spotlights/flu-season-updates-2018.htm. By the way, they have loads of information about this year’s flu season, but you may have to use the glossary which they so thoughtfully provide.

January 11, 2019 – With the 2018-2019 flu season well underway, CDC today estimated that so far this season, between about 6 million and 7 million people have been sick with flu, up to half of those people have sought medical care for their illness, and between 69,000 and 84,000 people have been hospitalized from flu. CDC expects flu activity to continue for weeks and continues to recommend flu vaccination and appropriate use of antiviral medications.

Flu vaccination is the first line of defense to prevent flu and its potentially serious complications, including death in children. Flu vaccines have been shown to be life-saving in children, in addition to having other benefits.  Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick. Antiviral drugs are a second line of defense that can be used to treat flu illness. CDC recommends that people who are very sick or people who are at high risk of serious flu complications who develop flu symptoms should see a health care provider early in their illness for possible treatment with a flu antiviral drug.

CDC’s weekly FluView reports when and where influenza activity is occurring, what influenza viruses are circulating and their properties, and reports the impact influenza is having on hospitalization and deaths in the United States based on data collected from eight different surveillance systems.

So far this season, H1N1 viruses have predominated nationally, however in the southeast, H3N2 viruses have been most commonly reported. The number of states reporting widespread activity increased this week to 30 from 24 states last week. While levels of influenza-like-illness (ILI) declined slightly over the previous week in this week’s report, ILI remains elevated and 15 states and New York City continue to experience high flu activity. There also was a decline in the percent of respiratory specimens testing positive for flu at clinical laboratories however this number remains elevated also.  During some previous seasons, drops in ILI and the percent of specimens testing positive for flu have been observed following the holidays.”

Surprisingly to me, Business Insider at https://www.businessinsider.com/flu-shot-2018-effectiveness-availability-where-to-get-2018-9 answered my question about how the flu shot is different this year.

“The formulation has been changed in two key ways: the nasty H3N2 strain that sickened many people last year has been updated, and the influenza B virus targeted for protection in the vaccine has been changed, too. So far, the revamped vaccines look promising.

‘It appears that the virus is doing a little better job, if we look at what’s gone on in the southern hemisphere season,’ Webby said. [Richard Webby, an infectious disease expert at St Jude Children’s Research Hospital.]

Down south in Australia, for example, it’s been a fairly mild flu season, with flu activity circulating at ‘low’ levels, according to the Australian Department of Health. That may not perfectly translate to an equally mild flu season up north, but what Webby’s seen so far suggests that the shot is also combatting the flu better than it did last year.

Okay, I took the vaccine, am having a less virulent bout of the flu but it’s still here. Now what? The Kidney Foundation of Canada at https://www.kidney.ca/treating-the-common-cold-and-flu—tips-for-kidney-patients offered a succinct answer:

  1. For most people with kidney disease, acetaminophen(Tylenol®) is safe to use for headache, pain and fever.
  2. Cold and flu medications that contain decongestants may increase blood pressure. In addition, avoid cough and cold medications that contain ASA or NSAIDs (Non-steroidal anti-inflammatory medications) such as ibuprofen (Advil®, Motrin®) or naproxen (Aleve®). If you have to use a decongestant, use a nasal spray or nasal drops. (Note: these nasal sprays are habit forming. If you use them more than three days in a row, the blood vessels in your nose can become dependent on the spray.)
  3. Sore throat?Many cough syrups and throat lozenges contain sugar. Make sure you read the label to check the ingredients list, prior to use. Some sugar free or sucrose-free products are available on the market. Gargling with salt water may also be an effective way to soothe a sore throat.
  4. Avoid herbal remedies.Herbal medications and products are not regulated in the same way that pharmaceutical products are. Therefore, the list of ingredients is not always accurate and some herbal medicines have been found to contain pesticides, poisonous plants, hormones, heavy metals and other compounds that are potentially dangerous. Some herbal medications also include diuretics, high levels of potassium, and/or other ingredients that can affect the kidneys or interact with your prescription medications to change their effectiveness.
  5. Vitamin C is not the answer. High doses of vitamin C (500 mg or more) can cause damage to kidneys. There is a specially formulated multivitamin for people with kidney disease that has the right amount of vitamins that your kidneys can handle. Ask your healthcare team about this.

Questions?  Your pharmacist and members of your kidney health team are the best source of information. Ensure you read the label, even on over the counter medications that you’ve taken before, as ingredients do change from time to time. If you have severe symptoms that are lasting longer than 7 days, you should see your doctor.

Until next week,

Keep living your life!

Then Why Wait?

paul-peckIt’s that time of year again, ladies and gentlemen. Time for what, you ask. Well, yes, it is almost time for Halloween (and my fellow writer brother’s Halloween birthday) but it’s also time for your flu shot… or jab, depending upon which part of the world you’re in. I’ve written before about why it’s important to have this protection, especially if you’re getting older – like me. But I don’t think I’ve written about why it’s a good idea to wait.

“’If you’re over 65, don’t get the flu vaccine in September. Or August. It’s a marketing scheme,’ said Laura Haynes, an immunologist at the University of Connecticut Center on Aging,” in the same NPR article referred to later in this blog. Considering the information my own immunologist gave me, I have to agree. But, here we are back to what my cousin calls my probing question: why?

According to the CDC (Centers for Disease Control and Prevention) at http://www.cdc.gov/flu/about/season/flu-season-2016-2017.htm:

“Getting vaccinated before flu activity begins helps protect you once the flu season starts in your community. It takes about two weeks after vaccination for the body’s immune response to fully respond and for you to be protected so make plans to get vaccinated. CDC recommends that people get a flu vaccine by the end of October, if possible. However, getting vaccinated later can still be beneficial. CDC recommends ongoing flu vaccination as long as influenza viruses are circulating, even into January or later.”

Wait a minute. How do the private companies that produce the flu vaccine know what strains to include protection against? NPR (National Public the shotRadio) at http://www.npr.org/sections/health-shots/2016/09/15/493982110/yes-it-is-possible-to-get-your-flu-shot-too-soon has something to say about that:

“To develop vaccines, manufacturers and scientists study what’s circulating in the Southern Hemisphere during its winter flu season — June, July and August. Then, based on that evidence, they forecast what flu strains might be circulating in the U.S. the following November, December and January, and incorporate that information into flu vaccines that are generally ready by late July.”

Nope, still doesn’t answer my question.  I decided to turn to CNN at http://www.cnn.com/2016/09/26/health/wait-for-flu-shot/ :

“”… antibodies created by the vaccine decline in the months following vaccination “primarily affecting persons age 65 and older,” citing a study done during the 2011-2012 flu season. Still, while ‘delaying vaccination might permit greater immunity later in the season,’ the CDC notes that ‘deferral could result in missed opportunities to vaccinate.’”

This is in keeping with what my own immunologist and my PCP (primary care physician) both warned me. Bear is 70. I’m close to it. We won’t be having our inoculations until later in October. Which brings us around to the question of why have the flu shot at all?

FullSizeRender (3)The England’s Department of Health chart included in The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2  partially answers this question:

Even if you feel healthy, you should definitely consider having the free {In England, that is} seasonal flu vaccination if you have:

  • a heart problem
  • a chest complaint or breathing difficulties, including bronchitis or emphysema
  • a kidney disease  {I bolded and italicized this for obvious reasons.}
  • lowered immunity due to disease or treatment (such as steroid medication or cancer treatment)
  • a liver disease
  • had a stroke or a transient ischaemic attack (TIA)
  • diabetes
  • a neurological condition, for example multiple sclerosis (MS) or cerebral palsy
  • a problem with your spleen, for example sickle cell disease or you have had your spleen removed.

I found this little nugget that’s more emphatic about why Chronic Kidney Disease patients need to have the vaccine in SlowItDownCKD 2015:

DaVita at http://www.davita.com/kidney-disease/overview/treatment-overview/immunizations–which-shots-you-need-and-why/e/4837 tells IMG_2980us,

‘Immunizations may prevent people from contracting other diseases, infections and viruses. The immune system of a person with chronic kidney disease (CKD) becomes weakened, making it difficult to fight off many diseases and infections. Patients with CKD may become more susceptible to illness and even death if they do not receive regular immunization treatment. Getting the proper immunizations is an essential part of a person’s kidney care.’”

You’ve probably heard that there are different strains of the flu. I went to England’s National Health Services site at http://www.nhs.uk/Conditions/vaccinations/Pages/how-flu-vaccine-works.aspx to discover what they are:

“There are three types of flu viruses. They are:

  • type A flu virus – this is usually the more serious type. The virus is most likely to mutate into a new version that people are not resistant to. The H1N1 (swine flu) strain is a type A virus, and flu pandemics in the past were type A viruses.
  • type B flu virus – this generally causes a less severe illness and is responsible for smaller outbreaks. It mainly affects young children.
  • type C flu virus – this usually causes a mild illness similar to the common cold.

Most years, one or two strains of type A flu circulate as well as type B.”

A new site for me, but one I suspect I’ll be returning to in the future, Public Health at http://www.publichealth.org/public-awareness/understanding-vaccines/vaccines-work/ explains how a vaccine works:

virus“A vaccine works by training the immune system to recognize and combat pathogens, either viruses or bacteria. To do this, certain molecules from the pathogen must be introduced into the body to trigger an immune response.

These molecules are called antigens, and they are present on all viruses and bacteria. By injecting these antigens into the body, the immune system can safely learn to recognize them as hostile invaders, produce antibodies, and remember them for the future. If the bacteria or virus reappears, the immune system will recognize the antigens immediately and attack aggressively well before the pathogen can spread and cause sickness.”

I’ve already had something. I don’t know it was, but it felt like a little bit of a preview for the flu and it was awful. When I become ill, I can be down for anywhere from three to six weeks.  This time? Probably 10 days which, by the way, is the usual run for the common cold. Was it a cold? Strain C of the flu? I don’t know, but you can bet it reinforced that I’ll be getting that flu shot. Why go for more misery if I can help it?

Until next week,FullSizeRender (2)FullSizeRender (2)

Keep living your life!

The Flu Flew By

‘Tis the season to be jolly… and get the flu.  You’ll be in crowds at your holiday parties, even in stores when you get your shopping done. Everyone’s got to eat, even Scrooge, so you will be in the markets – and crowds – whether you want to be or not.

Uh-oh, so what do you do about the flu? According to Dec. 3, 2012’s MedPage, the flu has arrived early this year.  Bah! Humbug! Just in time for the holiday season.

“The flu season is officially under way about a month earlier than usual, the CDC announced on a call marking the beginning of National Influenza Vaccination Week. {For your information, that was Dec. 2-8 this year} ‘This is the earliest regular flu season we’ve had in nearly a decade, since the 2003-2004 flu season,’ CDC director Thomas Frieden, MD, MPH, said on a conference call with reporters.”Shoppers1

Who even knew there was a National Influenza Vaccination Week? You can read a bunch of statistics about this early flu season at: http://www.medpagetoday.com/InfectiousDisease/URItheFlu/36225?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2012-12-04&eun=g596983d0r&userid=596983

Reminder: as a chronic kidney disease patient, you already have a compromised immune system.  Help yourself to avoid the flu by getting that vaccine.  In some cases (you’ll have to ask health care worker if you are part of this group), you may be able to take the nasal vaccine.  This is especially helpful if you have a great dislike for injections, but if you can’t because you have ckd, just look away during the shot.  That has been proven to make it easier to handle the fear, as I wrote about in an earlier blog.

By the way, Medicare covers the cost of the flu shot.

So, again I ask what do you do about the flu? According to Healthfinder.gov, you can protect yourself from the flu by doing the following:

Getting the flu vaccine is the most important step in protecting yourself from the flu. Here are some other things you can do to keep from getting and spreading the flu:

  • Stay away from people who are sick.
  • If you are sick, stay home for at least 24 hours after your fever is gone.
  • Wash your hands often with soap and warm water.
  • Try not to touch your nose, mouth, or eyes.
  • Cover your mouth and nose with a tissue when you cough or sneeze

The entire article about the flu may be found at: http://healthfinder.gov/prevention/ViewTopicFull.aspx?topicID=18

Most of this sounds fairly obvious. But then Bear told me about someone at work who simply sneezes and coughs into the air around him. That got me to thinking.  Do you find yourself shying away from certain people who do the same?  Maybe you should.

Since the cataract surgery and the sealing off of my tear ducts, I am always touching my eyes to wipe away the extra moisture. Until I read this article, I’d always thought of myself as someone who doesn’t keep touching my face.  But that’s not true, is it?

And how many people in this economy really do take off from work for 24 hours after their fevers break?  Who can afford to do that? We have people struggling to hang on to minimum wage positions while a string of other people are ready and waiting for these same jobs.

It’s worth thinking about this yourself.  Remember when we were taught to cough or sneeze into the inside of our elbows?  Looks like that’s not as effective as stopping the particulate spray immediately at its source – your nostrils.  Makes sense to me.

We live in Arizona.  It’s so dry we try NOT to wash our hands since that dries out the skin.  I’m not saying we’re a dirty demographic, simply that we try to wash our hands only when necessary. That is not often, but it needs to be during flu season.

fluBut have hope!  According to Rob Stein on NPR’s Health News, “One big difference between this year and the 2003-2004 season is that so far the vaccine appears to be a very good match for the strains of flu that are circulating most widely. That’s important because one of the reasons officials are concerned is that one of the strains is similar to the 2003-2004 strain that caused so much illness and so many deaths.”

I think that’s good news.  It sounds like good news.  Is it good news? Why DID the 2003-2004 strain cause so much illness and so many deaths?  Somehow, that’s not as reassuring as I’d like it to be.

The original article is at: http://www.npr.org/blogs/health/2012/12/07/166745954/unusually-early-flu-season-intensifies?ft=1&f=103537970

I wondered how to tell the difference between a cold and the flu.  Since being diagnosed with ckd, I make it a point to take the flu vaccine annually, yet there have been times when I just didn’t feel that well. I found my answer in the following: http://abcnews.go.com/health/t/blogEntry?id=17885194

“ ‘With influenza you might also feel very poorly, with aches and pains in your muscles and joints,’ said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. ‘There’s often a cough, too, which is much more prolonged and pronounced.’ ”

That does answer my question.  No muscular aches or pains, so what I experienced was just a cold.

Don’t let yourself become run down with the festivities this year, take the time to relax, maybe even put your feet up and read What Is It And How Did I Get It? Early Stage Chronic Kidney Disease. It’s available in digital – which is less expensive than the book – and print at Amazon.com and B&N.com.

You’ll be in good company.  I’ve gotten notice that personal trainers, doctors, medical assistants, phlebotomists, physicians’ assistants, chiropractors, naturopaths and gym owners have been reading it to understand how better to deal with their clients (or patients, as the case may be) who have CKD.  What a nice holiday present for me.

Here’s my wish that you had a Happy Chanukah and/or are happily preparing for Christmas and Kwanzaa.

Until next week,2012-12-12 19.41.37-1

Keep living your life!