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Old 10-18-2009, 06:16 PM   #1
Hannah
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Default Pregnant friend is now sick

My friend is pregnant and is "feeling terrible". Her symptoms:

- very achey since yesterday
- "really bad" cough
- not much of a temperature
- slept terribly last night

I've sent her quite a bit of information on H1N1, but she isn't too worried. Just feeling really bad. But I'm pretty worried.
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Old 10-18-2009, 07:16 PM   #2
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How far along is she, Hannah? I'm with you - I'd be worried, too. Here's hoping for the best for her.
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Old 10-18-2009, 10:19 PM   #3
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Oh no, hope she is feeling better! Elderberry is safe in pregnancy--hope she takes some for faster recovery!!!
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Old 10-18-2009, 10:28 PM   #4
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Dang! The achiness is miserable but you can live with it. It's the 'really bad' cough that's especially concerning.
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Old 10-19-2009, 12:56 PM   #5
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She went to a clinic but was not given antivirals because she does not have a fever. She was told to come back if she develops a high fever and then they will put her on antibiotics for pneumonia. And yet the CDC says:

"The highest priority message is to treat pregnant women with influenza-like illness as soon as possible."

Arrrrrg.
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Old 10-19-2009, 01:19 PM   #6
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Wow, she better be worried about it.. Influenza can also damage the Baby, believe me I know first hand. Was pregnant with 2nd Daughter when I had type A influenza. My Daughter was born with chronic Kidney disease ( from me having the Flu) and is finally getting a Kidney transplant this December !!!! It is nothing to mess with !!!
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Old 10-19-2009, 02:44 PM   #7
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I'm FUMING that they're still using fever as an 'absolute' criteria.

I swear many of the clinics & docs are NOT reading MMRW. Or bothering with any CDC correspondance.
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Old 10-19-2009, 04:22 PM   #8
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Quote:
Originally Posted by CanadaSue View Post
I'm FUMING that they're still using fever as an 'absolute' criteria.

I swear many of the clinics & docs are NOT reading MMRW. Or bothering with any CDC correspondance.
Yep, that's exactly how I'm feeling. It blows my mind.

Angelsea, I'm so sorry to hear about your daughter. I wish her the very best for her transplant.
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Old 10-19-2009, 04:56 PM   #9
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When looking out for our own we need to get very firm with them and not accept this crap!

OH
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Old 10-19-2009, 09:53 PM   #10
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Unreal... I cannot believe the nerve of these doctors.. Argh!
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Old 10-19-2009, 10:39 PM   #11
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Quote:
She went to a clinic but was not given antivirals because she does not have a fever. She was told to come back if she develops a high fever and then they will put her on antibiotics for pneumonia. And yet the CDC says:

"The highest priority message is to treat pregnant women with influenza-like illness as soon as possible."
They are pushing that on our local news. If you are pregnant and getting sick get to a Dr for antivirals asap.
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Old 10-19-2009, 11:22 PM   #12
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Quote:
Originally Posted by angelsea View Post
Wow, she better be worried about it.. Influenza can also damage the Baby, believe me I know first hand. Was pregnant with 2nd Daughter when I had type A influenza. My Daughter was born with chronic Kidney disease ( from me having the Flu) and is finally getting a Kidney transplant this December !!!! It is nothing to mess with !!!
That is tragic and I honestly would not have known that just from the flu you can have the baby with the kidney problems. I wish you and DD the very best with the kidney transplant. My Uncle has had two of them, the 2nd one from a living donor, my cousin and it worked well for him. Keep us posted!
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Old 10-19-2009, 11:30 PM   #13
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Quote:
Originally Posted by Hannah72 View Post
She went to a clinic but was not given antivirals because she does not have a fever. She was told to come back if she develops a high fever and then they will put her on antibiotics for pneumonia. And yet the CDC says:

"The highest priority message is to treat pregnant women with influenza-like illness as soon as possible."

Arrrrrg.
What a pile of crap, she needs to put her foot down and fight for the health of this baby and not take no for an answer. I would get a 2nd, 3rd opinion if I had to in order to make sure that the baby won't be harmed by the flu. It's true that the H1N1 does not present with fever much of the time so that is a crock to be told that's what's preventing them from treating her.

Far too many Dr's are uninformed, or just lazy about the process. They are actually there to make$ at times that may come first in a way (trust me I know I worked in that field in a clinic and I saw ridiculous amt's of greed from Dr's and patients can and do get harmed at times) as harsh as that may seem I'd never 100% trust a Dr's opinion, it's up to us to demand the correct treatments when necessary.
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Old 10-20-2009, 01:49 PM   #14
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I'm going to frigging lose my mind. She is getting worse and so she went to another doctor last night. And that doctor says it isn't H1N1 because her fever isn't high enough. But he prescribed antibiotics, the genius. Still no antivirals.

Of course, if you try to tell any of these idiots something that they should already know, their snarky attitude is: "Oh, and where did you read that, the internet?"
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Old 10-20-2009, 02:18 PM   #15
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How ignorant...

Can she see another doctor?

I will pray for her and the baby.

I cannot believe that in this day and age a doctor would make a snide comment about reading medical info on the internet.
Considering half of them basically expect you to diagnose yourself before you come in....at least in my office they do!
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Old 10-20-2009, 02:27 PM   #16
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She has seen two different doctors and both have said the same thing. She trusts them, unfortunately.
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Old 10-20-2009, 03:58 PM   #17
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Quote:
Originally Posted by Hannah72 View Post
I'm going to frigging lose my mind. She is getting worse and so she went to another doctor last night. And that doctor says it isn't H1N1 because her fever isn't high enough. But he prescribed antibiotics, the genius. Still no antivirals.

Of course, if you try to tell any of these idiots something that they should already know, their snarky attitude is: "Oh, and where did you read that, the internet?"

Mmmm, yes! Why aren't the idiot doctors reading it. From the CDC:

http://www.cdc.gov/h1n1flu/sick.htm

How do I know if I have the flu?


You may have the flu if you have some or all of these symptoms:
  • fever *
  • cough
  • sore throat
  • runny or stuffy nose
  • body aches
  • headache
  • chills
  • fatigue
  • sometimes diarrhea and vomiting
*It’s important to note that not everyone with flu will have a fever.

----------------------------

Regarding their stupid quick tests:

http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm

RIDT result: Positive for Influenza Type A
Note: This test can not distinguish influenza A virus subtypes. For example, this test cannot distinguish influenza infections caused by novel influenza A viruses versus seasonal influenza A viruses.

RIDT result: Negative for Influenza A and B
Note: The sensitivity of this assay has been shown to range between [10-70%*] for the detection of novel influenza A (H1N1) virus and between [20-100%*] for seasonal influenza viruses. A negative result does not exclude influenza virus infection. If influenza is circulating in your community, a diagnosis of influenza should be considered based on a patient’s clinical presentation and empiric antiviral treatment should be considered, if indicated. If more conclusive testing is desired, follow-up confirmatory testing with either [viral culture or RT-PCR*] is warranted.
* Fill in with individual clinical laboratory data and information

------------------------------------
And regarding pregant women specifically:

http://www.cdc.gov/h1n1flu/clinician_pregnant.htm

Treatment Recommendations
Pregnant women with influenza-like illnesses should receive empiric antiviral treatment. Because of its systemic activity, the drug of choice for treatment of pregnant women is oseltamivir. Recommended duration of treatment is five days. Treatment should not be delayed while waiting for the results of viral testing. As is recommended for other persons who are treated, antiviral treatment should be initiated as soon as possible after the onset of influenza symptoms, with benefits expected to be greatest if started within 48 hours of onset, based on data from studies of seasonal influenza. However, data from studies on seasonal influenza indicate benefit for hospitalized patients even if treatment is started more than 48 hours after onset. Thus, antiviral medications are recommended for high risk persons, including pregnant women, presenting for care more than 48 hours after illness onset, particularly for those who require hospitalization

-----------------------------

If the idiot doctors won't listen to the CDC, then who are they listening to?

Last edited by Key; 10-20-2009 at 04:16 PM.
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Old 10-20-2009, 04:18 PM   #18
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That is scary..I hope she starts to get better.

I am glad you put that up there Key...frankly I will be printing it off and putting it in my wallet.

Hopefully, doctors can start recognizing the strange things happening with this flu so that they can act quickly.
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Old 10-20-2009, 07:28 PM   #19
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I compiled the CDC items from Key, printed out copies to pass around, and emailed it to all I could. For the convenience of anyone wishing to do this you can copy below. OH

CDC ON FLU
Some doctors are uninformed. People are being refused flu treatment because they do not have a high fever. People are being refused flu treatment because of a negative quick test. Pregnant women are being refused flu treatment. The following are excerpts directly from the CDC with links. Please pass along to everyone who might encounter an uninformed doctor

http://www.cdc.gov/h1n1flu/sick.htm
How do I know if I have the flu?
You may have the flu if you have some or all of these symptoms:
  • fever *
  • cough
  • sore throat
  • runny or stuffy nose
  • body aches
  • headache
  • chills
  • fatigue
  • sometimes diarrhea and vomiting
  • *It’s important to note that not everyone with flu will have a fever.

    http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm
    RIDT result: Positive for Influenza Type A
    Note: This test can not distinguish influenza A virus subtypes. For example, this test cannot distinguish influenza infections caused by novel influenza A viruses versus seasonal influenza A viruses.
    RIDT result: Negative for Influenza A and B
    Note: The sensitivity of this assay has been shown to range between [10-70%*] for the detection of novel influenza A (H1N1) virus and between [20-100%*] for seasonal influenza viruses. A negative result does not exclude influenza virus infection. If influenza is circulating in your community, a diagnosis of influenza should be considered based on a patient’s clinical presentation and empiric antiviral treatment should be considered, if indicated. If more conclusive testing is desired, follow-up confirmatory testing with either [viral culture or RT-PCR*] is warranted.
    * Fill in with individual clinical laboratory data and information
http://www.cdc.gov/h1n1flu/clinician_pregnant.htm
Treatment Recommendations
Pregnant women
with influenza-like illnesses should receive empiric antiviral treatment. Because of its systemic activity, the drug of choice for treatment of pregnant women is oseltamivir. Recommended duration of treatment is five days. Treatment should not be delayed while waiting for the results of viral testing. As is recommended for other persons who are treated, antiviral treatment should be initiated as soon as possible after the onset of influenza symptoms, with benefits expected to be greatest if started within 48 hours of onset, based on data from studies of seasonal influenza. However, data from studies on seasonal influenza indicate benefit for hospitalized patients even if treatment is started more than 48 hours after onset. Thus, antiviral medications are recommended for high risk persons, including pregnant women, presenting for care more than 48 hours after illness onset, particularly for those who require hospitalization

-----------------------------

Last edited by Old Hawk; 10-20-2009 at 09:05 PM.
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Old 10-20-2009, 07:59 PM   #20
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http://www.nytimes.com/2009/08/11/he...docs.html?_r=1

"The standard definition of influenza includes a fever. But an odd feature of the new virus is the lack of fever in a significant proportion of documented cases, even after some patients become seriously ill. In Chile, it was about half, in Mexico City about a third and elsewhere, less, Dr. Wenzel said. Lack of fever has been noted by other observers in several Canadian cases."

I found the above quote fairly quickly, but there's a better source out there.

What is needed is a copy of an article I saw a few weeks ago. I believe it was a set of case studies or an analysis of a number of cases, where the fever or *lack of one* was listed along with PCR results showing swine flu. Some results were of dead patients diagnosed AFTER they died. Analysis of case studies, treatment reports, SOMETHING to bring to the doctor. With the relevant portion highlighted in bright yellow, clearly showing cases of PCR identified swine flu in patients presenting with NO FEVER.

I see the instructions on watching for fever as the indicator for flu everywhere, even at hospitals. *I* may know better, but a lot of people don't. Including authority figures who have a lot of other things on their plate, or who haven't updated their information since the beginning.

But I can't remember where I saw the @#&*% article or what the title was. If ANYONE knows of a medical article (not popular press, something peer reviewed or case studies that practicing doctors can't ignore) that fits the description, PLEASE post it or a link! That could be forwarded or printed if necessary for anyone trying to be proactive about their or a loved ones' care.
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Old 10-20-2009, 08:07 PM   #21
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Heh! You guys are fast. I saw Old Hawks's CDC post AFTER I posted mine. Too bad whoever wrote it didn't put fever at the bottom of the symptom list, right above the little *. Also, the false negative rate is important. VERY important. The way I explain it, if the test says you have flu, you have flu. If it says you DON'T have flu, you have a 50% chance of having flu if they took a good sample. If they screwed up the test at any point from taking the sample, transport, storage, or running the test, it's going to come back negative no matter what you have.
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Old 10-20-2009, 08:28 PM   #22
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No fever with flu.....

I started a thread on this topic in September.

http://thisbluemarble.com/showthread.php?t=18905

In my post I included 4 reference links........


http://www.nytimes.com/2009/05/13/health/13fever.html

http://www.nytimes.com/2009/08/11/health/11docs.html

http://www.promedmail.com/pls/otn/f?..._ID:1000,78027

http://www.americares.org/newsroom/n...-outbreak.html

Also, we have the CDC link provided by Key above.

Will that suffice?

OH
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Old 10-20-2009, 08:32 PM   #23
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Quote:
Originally Posted by flu-n-u View Post
Heh! You guys are fast. I saw Old Hawks's CDC post AFTER I posted mine. Too bad whoever wrote it didn't put fever at the bottom of the symptom list, right above the little *. Also, the false negative rate is important. VERY important. The way I explain it, if the test says you have flu, you have flu. If it says you DON'T have flu, you have a 50% chance of having flu if they took a good sample. If they screwed up the test at any point from taking the sample, transport, storage, or running the test, it's going to come back negative no matter what you have.
Yeah we try to be on the ball......

Fever was ALWAYS at the top of the list. When TPTB caught on that H1N1 is different they added the footnote.

OH
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Last edited by Old Hawk; 10-20-2009 at 09:07 PM.
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Old 10-20-2009, 10:45 PM   #24
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Thanks you guys for all the great links.
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Old 10-20-2009, 11:34 PM   #25
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Quote:
But I can't remember where I saw the @#&*% article or what the title was. If ANYONE knows of a medical article (not popular press, something peer reviewed or case studies that practicing doctors can't ignore) that fits the description, PLEASE post it or a link! That could be forwarded or printed if necessary for anyone trying to be proactive about their or a loved ones' care.
Let me add to your request, if you or anyone can find this please do post it perhaps as a new thread.

Thanks,

OH
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