I got flu shot

Ok, you medical personnel out there, let’s get some feedback here. I’ve had two flu shots in the previous 10 years. Both times, I got sicker with the flu than I’d ever been before. I cannot understand this. When I tell informed people this, I always get the same information I found on the internet tonight:

“There is a misconception that people can get influenza from getting the vaccine. This is not true. Most people have little or no reaction to the influenza vaccine. The vaccine is made from a killed virus and cannot cause influenza.

People who develop influenza-like illnesses after getting the vaccine may have been in contact with the influenza virus prior to immunization or may have come down with another circulating virus. After an influenza immunization, it takes 10 to14 days for your body to develop immunity. Therefore, it would be possible for someone to develop influenza before immunity develops if they are exposed around the time of vaccination.”

The first time, I decided that it must have been a fluke. But after that second shot, I was so sick I had to hang onto the wall every time I had to empty my guts into the commode. Whether the shot caused it or not, I decided I was not about to try it again. I have not had the flu since then. I’ve had more than my fair share of pharyngitis, laryngitis, and bronchitis several times a year—especially since moving into the allergy capital of the U.S. Not once did I get the flu.

Ok, so we were told by our professors that there is a new infection control JCAHO standard that requires hospitals, critical access hospitals, and long term care facilities to have their staff with close patient contact vaccinated for influenza beginning January 2007. This includes students and faculty in clinical. So, unless we get the vaccine, we cannot do clinicals. If we don’t do clinicals, we don’t pass. What to do?

I drug my feet about it until the flu shot was once again offered for free by my employer. So yesterday I rolled up my sleeve and took it, telling myself that being more medically informed now would surely help stave off the flu.

Guess what! Today, the arm where I got my shot has an area a little bigger than a quarter that is red, hard and definitely inflamed. I’ve had a roaring headache all day. I feel feverish and have the worst stomach cramps ever. As the day progressed, if I wasn’t on the commode emptying my guts out, I was walking around with my cheeks puckered with a will of iron. And this is only the first day after!

Have I been around sick people recently? Absolutely! I’ve been around them quite a bit in the last year. I’ve even been in the room of an MRSA patient who was so sick, his bones had disintegrated. Did I get sick? Not until now. So you tell me…does the flu shot give you the flu?

Just another clinical day

So today I followed around this interesting pediatrician. She told me of her theory about the inability to console kids between 1 and 3 years of age with stranger anxiety. First of all, we are genetically related to the ape. Female apes will steal other female apes' babies. However, they won't steal them when they are nursing because they themselves aren't lactating so would be unable to feed them. Then after 2 or 3, they aren't cute any more so they don't steal them then either. So between weaning and the ugly stage, they are vulnerable to being stolen. So that's why kids between 1 and 3 cry unconsolably with strangers--it's the protective mechanism to make as much noise as possible so they won't be stolen.

After quizzing me extensively about the lifestyle of Mennonites, she thought she would make a great Mennonite lady. After all, she loves to cook and she used to sew her own clothing. After hearing about my dream to go on a medical mission to Africa, she thought it would be a great idea. She thinks she would be a great medical missionary. Except for one tiny detail--she's really not that religious.

The logistics of faith vs. no faith

In some research on euthanasia, I came across this interesting quote:

"But what if something really important happens in the process of dying? If we hasten dying, we circumvent what might be an important process and risk a diminishment of the good attached. This is something it is impossible to know, which makes it difficult to decide the best action. Blaise Pascal, a 17th-century Catholic monk and mathematician, developed a decision-making scheme that can be useful in such circumstances of uncertainty. Pascal's most well-known application of his theory was his argument in favor of faith in the existence of the god described in the Judeo-Christian tradition. If God does not exist, he reasoned, having faith or no faith is of no consequence. On the other hand, if God does exist, having faith and living accordingly will be greatly rewarding whereas having no faith will be catastrophic. Therefore, based on the risk associated with lack of faith and on the comparatively small burden associated with having faith, it is best to cultivate faith in God and live according to God's laws."

Day, Lisa. "Questions concerning the goodness of hastening death." American Journal of Critical Care 15.3 (May 2006): 312(3). Health Reference Center Academic. Thomson Gale. University of Tennessee at Chattanooga. 7 Nov. 2006

clinical stories

Since I don't go anywhere except work and school, the only thing I have to write about are more clinical stories. So here goes...

Last week was the end of my pediatrics rotation. I spent the day in the PICU which is always interesting. To clinch the interesting cases, I observed what happens when the hospital loses power. As you can imagine, kids in the PICU are hooked up to all kinds of machines, including ventilators for the majority of them. So no power equals no air for these kids. I have never seen people move so fast in my life. Before I could blink twice, those nurses were all over those kids, hooking them up with air via ambu bags. The back up power kicked in within 15 to 20 seconds, but the intensity level didn't drop for several minutes. One of the vents malfunctioned so they had to go on battery power for that child. But the kids never even noticed anything had happened, so everything was good.

At the end of the day, I headed down to the floor for our post-conference. Since the rest of the students were all busy finishing up their patient charting, I just hung around. Then one of the students told me that the nurse he was with had a patient who was going to have a central line taken out, and I could watch if I wanted to. Fantastic! Turns out the kid was one that had been in PICU the first time I was up there.

So I headed in to watch the doctor procede take out this line. He made an incision to open the hole where the tube entered the center of his chest. The line had been in so long that the flesh had grown around it so he had to keep cutting and cutting. One of the most pathetic things I've seen in my peds rotation is these kids on vents who cry but can't make a sound. He was flailing, and I'm sure if he could have made a sound, there would have been a tremendous wailing. Finally after what seemed like an hour but was probably only 15 minutes, he got the line out. Then he ordered an x-ray to make sure nothing was left behind before he sutured the hole shut.

After the x-ray, which caused the kid great distress, he suddenly clamped down on his trach and started to lose his oxygen saturation. So the nurse hyper-extended his neck to open his airway. The trach fell out leaving him with no airway at all. Neither the doctor nor the nurse could get it back in and his oxygen level continued to fall. I was calling out O2 sats and heart rates as they continued to work on him. It got down to 27% O2 sat and 68 beats/min. So the nurse yelled at me to go call a code. So I did. The people at the nurses station just stared at me for what seemed like an eternity, so I yelled it again. Within a very short amount of time, they had the crash cart in there and the room was swarming with doctors and nurses. One of the nurses was asking, "Is this real?" as she came through the door. Then, of course, I had to leave because I was no longer necessary and there were too many people in the room. I did hear that he survived.

Today was the first day of my last rotation for this semester. I was assigned to go to children's surgery. I got to watch some tubes inserted in ears and adnoids and tonsils removed. The doctor was so cool! When he found out I was a student there to observe, he just went into teaching mode. He let me come look into the scope during the surgery. That was just the coolest thing ever!

I also got to watch a gall bladder being removed. It amazes me that they ever figured out how to recognize one organ from the other. I can usually recognize the liver, no problem; but that other stuff all looks the same to me.

One last experience....my last day in the PACU (children's recovery room), we had a 13-year-old kid come in after an endoscopy. This was no puny kid. As he was coming out of his sedation, he became very combative. He wanted to get up out of his bed and walk out of there, which was not a possibility. We couldn't get that through his head. He said he HAD to get out of there before it was too late. We tried to get him to tell us why it would be too late and where he wanted to go. Three of us were having to hold him down during all this. Even then, he'd quite literally sit up anyway, practically lifting us up. We were understaffed because it was lunch time and 2 of the nurses had gone to get food. So it was only 2 nurses and 2 students in there and the other nurse had a patient she couldn't leave. So I basically laid on the kid's one shoulder, while the nurse laid on the other one and the other student ran to get help. One of the anesthesia guys came and leaned on his chest. The father finally came in there and managed to calm him somewhat, but even he couldn't talk him out of his mania. His eyes were just wild-looking. The father told us later that the kid's uncle had died in the hospital recently. It made a lot more sense then.

Enough stories for now.