Assembly-Line Medicine

This week’s guest columnists are Drs. Ashanti Smith and Ravi Alagugurusamy, Family Practice residents at the University Hospital and Clinics here in Lafayette.

It’s a common scenario now in Lafayette, and nationwide: The child wakes up feeling awful- tired, whining, feverish.  Her throat hurts, and she shivers from chills.  She’s also been coughing.  Mom gives her some ibuprofen, a glass of juice and…she goes back to sleep?  That’s really weird in this normally rambunctious kid, so mom brings her to the doctor.

The waiting room is packed with snotting, sneezing, hacking tots and their bleary-eyed parents. To add variety, one kid throws up.  After hours of waiting, they get a room, the doctor zips in, and proclaims the Influenza swab was positive.  He rattles off an obviously oft-repeated lecture on Influenza, what it is, how to treat it, and how long she’ll be sick.  A long time.  He dashes off to the next goopy patient.  Mom’s handed a prescription, a school excuse, and a paper describing Influenza.

Welcome to assembly-line medicine during flu season!  Doctors and nurses have to crank patients through as efficiently as possible- there’s so many to see!  Let’s unpack what happened above.  First, what is “Influenza?”  It’s the “flu” that you get a flu shot for, and have been hearing a lot about from friends, schools, and the news.  It’s a highly contagious virus that ravages the country every year between October and April- and this year’s been particularly active.

Highly contagious means that you catch it easily, and it’s easily spread to others.  One awful fact: if a kid with the flu coughs in a room, the tiny virus-laden droplets he expels will land on surfaces and remain infectious for 2 hours.  Thus if you touch a table or arm of a chair with the virus within that time, then lick your finger to turn a page, you’ll get it.

This is why the CDC recommends everyone get the flu vaccine every year.  You could inadvertently get it anywhere- school, work, the grocery store.  Okay, so it’s super-contagious.  So what? Isn’t it just some cough and congestion, maybe some fever, and lasts just a few days?

If you’ve ever had Influenza (the “flu”), you now get the vaccine every year, realizing it’s not just a bad cold.  Besides a hacking cough and pouring nose, you have the worst fever of your life- shivering under blankets and quilts despite ibuprofen.  Your head really hurts.  Your throat feels like you’ve swallowed glass shards.  Everything aches.  You have cramps and diarrhea, maybe vomit too.  You wonder- am I dying?

Even worse, it’s been three days with this misery.  At the doctor, more bad news- it can last 7 days before abating!  This is when you make deals with yourself and God.  I’ll never take feeling good for granted again!  I’ll get the flu shot next year!  Make it stop, I promise I’ll be good!

Our hurried doctor from above, running from room to room, stamps out prescriptions and school excuses left and right.  Got to keep the assembly line going- there’s so many miserables to see.  What’s he giving out?  Tamiflu.  Influenza is one of the few viruses for which there’s a medicine that makes it better.

However, it’s not a miracle drug.  Your kid’s not going to pop out of bed next day turning handsprings.  It shortens the course a little- a day or two.  It makes you a little less sick, and also importantly, a little less contagious to those around you.  But you’ve got to start Tamiflu within 48 hours of symptom onset, or it won’t help.

You wonder when you have the flu, am I dying?  Unfortunately, sometimes the flu does kill.  It’s particularly worrisome for the elderly, the pregnant, and the sickly.  Children who are already medically vulnerable- asthmatics, ex-preemies, special-needs kids, kids with heart conditions, are at high risk.  This is a big reason doctors, the CDC, and state health departments insist people get vaccinated.  With the vaccine and hand-hygiene, deaths are preventable!

So get your kid their flu vaccine now- it’s not too late.  Make sure they wash their hands.  And for goodness’s sake, if they have a fever, keep them out of school and get them seen at their doctor’s.  For their sake, and yours!