Friday, September 23, 2005

Coughs and Sneezes Spread Diseases

They used to have that witty little bit of doggerel on the wall in the doctor's office (if I skip to using the word 'surgery' during this blog btw, don't be alarmed. In archaic England, that's what we call a doctor's office. It doesn't mean a visit to the operating room - or operating theater as we call them back home. All clear? Good. Then I will proceed :) )

Anyway...where was I? Oh yeah. On the wall of the doctor's office when I was a kid, they used to have posters like that one. Of course, when I was a kid, it meant nothing, as kids don't know what germs are and don't have the hand/eye/brain coordination to time a cough or a sneeze with a handkerchief or their hand.

I do remember getting my immunizations at the clinic. I remember liking the polio vaccine best because the type we were given was oral and so they gave it to you on a lump of sugar. Never had the smallpox thing, as England is an island and smallpox was eradicated there. They did give us TB immunizations, and rubella immunizations, as well as the diphtheria, tetanus and whooping cough or DPT, which were the only immunizations available at the time. They were free, so hell...why not?

By the time my oldest daughter was born - also in England - there were already rumors circulating about the pertussis or whooping cough element of the DPT vaccine. Apparently if you give aspirin to a child who has had the DPT, certain sensitive children can suffer serious health problems.

This led to a rise in misinformed and uneducated parents deciding that this meant the pertussis vaccine was BAD. This vaccine was EVIL and therefore they shouldn't have their children immunized. The health authorities even started coming out with an alternative immunization which scrapped the pertussis vaccine altogether and just kept the diphtheria and tetanus portion. After all - what's whooping cough? Just a bad cough, yeah?

See...the problem with people of my generation is that our parents and grandparents, depending on your age and the age of your parents when they had you, had grown up with a very real sense of what whooping cough is and what it does. They snapped up the immunizations as fast as the doctors could give them out because they didn't want their children to suffer what they had seen their siblings or siblings of their friends go through who had not had the chance to be vaccinated against these horrendous illnesses.

The downside of that is that my generation grew up without that knowledge. Because of the success of the vaccination campaigns, we didn't have to see children in iron lungs because of the drowning effects of diphtheria. We didn't go to school with children who had been crippled by polio. And we had never had to watch infants dying of whooping cough. That left us free to decide that the infinitesmal chance of an adverse reaction was much worse than not vaccinating and allowing the child the opportunity to catch the disease.

We'd also lived through certain other medical uh-oh's that seemed like a good idea at the time, so we were less trusting of the medical establishment and their assurances of the safety of the drugs. My own mother was offered Thalidomide when she was pregnant with me, as it was a great cure for morning sickness and handed out to pregnant people like candy. At least until all of the horrendously gruesome birth defects started to show up. I'm not sure quite how long Distillers (the manufacturer) kept Thalidomide on the market before it was banned as a drug for any purposes at all. See, it worked well for the purpose it was designed - which wasn't morning sickness - but they hadn't tested it well enough to realize that pregnant people shouldn't even be allowed to smell it.

Luckily my mother didn't believe in taking drugs of any kind while pregnant. The mother of one of my friends wasn't quite as stringent. Vincent was a really cool guy - once you got your mind beyond the fact that one of his hands grew out of his shoulder. And his was a very minor case.

So many people of my generation decided against the vaccination route. After all, there was no such thing as diphtheria or polio or whooping cough any more, was there? Have you ever seen it?

The trouble with this is that these diseases are tricky and bad and evil. They lie in wait until we're complacent and then they attack. Our generation didn't vaccinate everybody. The generation after mine vaccinated even less. And sometimes an older child can get whooping cough and it can be no more severe than a chest cold. Because it never did kill older children. It always preyed on the babies.

I did a heartrending transcription a month or so ago dealing with a family whose infant son had died of whooping cough. They weren't one of these families who don't believe in vaccination. They had plans to vaccinate the baby, as they'd vaccinated all of his older brothers and sisters. In fact, his first round of vaccinations was already scheduled. But a week before the due date, he got sick. And the doctors cuuldn't figure out what was making him sick. And he got sicker. And he was admitted to the hospital. And within nine days his parents were having to make the decision to turn off the machines which were keeping him alive. He died of whooping cough.

The problem being that because so many older children are walking around without immunizations, they have the ability to turn into the equivalent of Typhoid Mary. They themselves may be only a little on the sick side, but they could be harboring a virus which has the capability to kill its intended target - a tiny infant who doesn't have the means or the body mass to fight that kind of infection. And all it takes is a direct hit from a single tiny viral organism, thousands of which are released into the atmosphere every time one of these older and unvaccinated children coughs or sneezes, in order to breed a colony that can kill an infant.

My oldest was also born at a time previous to there being a vaccination for Hib flu. After coming to the States and the advent of this wonderful vaccination, I am always aghast when I hear that parents don't think there's any point in vaccinating against it, especially when if it goes wrong (again, an infinitesmal chance) the child could wind up with meningitis.

Here's my Hib flu story. Sophie was 3 and her father and I were divorced. He would take Sophie on alternate weekends. One particular weekend, he picked her up on Friday evening, and returned her early on Sunday morning - even though he wasn't supposed to return her until the evening. He said, 'she wanted to come home', parked her in the hallway and drove off. He probably hadn't reached the end of the road before she started vomiting.

Let me preface the next part. I'm a 23 year old single mother who doesn't have a car. I also - since my ex-husband's new girlfriend can't stand me, don't have my ex-husband's phone number. Even though in England doctors make house calls, the surgeries are closed on weekends and they have what are called emergency doctors who cover for the regular physicians. Because these people don't know you from Adam, they have no idea if you are a hypochondriac or an overprotective parent.

Well Sophie kept vomiting, and she started developing a very sore throat. I called the emergency doctor and a guy came out to the house and looked in her throat with a tongue depressor. He gave the diagnosis of tonsilitis and left her some amoxycilin. Which I fed to her and she promptly barfed back up. I called my mother because by this time Sophie's breathing was beginning to bother me. She was seeming to be having difficulty taking in a full breath. My mother told me to call the doctor again, which I did.

This time, far from the nice, jolly young man who came out the first time, I was visited by a woman I can only describe as a consummate bitch. She was full of attitude from the moment she walked into the house. When she heard that a doctor had already been out to see Sophie that day, the attitude increased 1,000 percent. She stuck a tongue depressor into Sophie's mouth, and said, 'You've already been told what it is. You've been given amoxycilin. She's got to take it. What do you want ME to do?' I said, 'But she can't keep it down.' And then she packed up her bag of tricks and fixed me with an expression which spoke volumes of how highly she valued my parental wisdom. "Well you're going to have to MAKE her keep it down, or else she's going to wind up in the hospital in a drip and you don't want THAT do you?" And left.

So there I was alone in the house with this little 3 year old that I knew in my mother's heart was sicker than a case of tonsilitis, but who I'd been told by two medical professionals was suffering from no more than that. And she wasn't getting better. By six that evening she had gotten to a point where she was using every ounce of her concentration just to breathe. She was drooling, because she didn't want to swallow, sitting forward and just breathing.

My brother dropped in to see me, because he'd heard she wasn't well, and he lived a mile or so away. He took one look at her and said, 'We have to take her to the hospital.' I said, 'But they told me she's got tonsilitis.' He said, "I don't give a f**k what they told you. She's obviously got more than that.' So he got on the phone with my brother-in-law, the only person in our family at the time who drove, and lived ten miles away, and told him to come over so we could take her to the hospital.

When we got there, the doctor in the ER took one look at the way she was breathing, didn't even look in her throat with a tongue depressor and told me they were going to take her up to the operating theater to give her an emergency intubation. He thought she had epiglottitis.

My own physician came to visit me on Monday evening after her office hours - I loved this doctor and we'd always gotten along, and she was apologizing all over herself for not having been there on the weekend and us having to go through what we did. She explained to me what epiglottitis is, because I'd never heard of such a thing. Apparently it's caused by a germ which in some people does no more than give you a sore throat. Hib flu. In some people it can cause all kinds of respiratory problems, including the one Sophie was suffering from.

The mechanics of it are simple but deadly. The epiglottis, that little flap of skin which slips forward to cover your breathing tubes when you swallow, starts to swell up. Every time you swallow, it swells a little more. Using a tongue depressor makes it swell A LOT, which is why when they suspected it in the ER, they didn't even bother using one. Had I followed the advice of the bitch who came to the house, and put her to bed, she would not have woken up the next day. Her epiglottis would have choked off her airway completely and she would have suffocated to death. The ONLY cure for epiglottitis is intubation. The drugs they use to treat it are simple ones, but without intubation the disease will beat the cure and the child will die.

And this is the same virus which I heard people talking about so cavalierly when making the decision whether or not to vaccinate with the Hib flu vaccination.

I am a strong believer in vaccinations. My reasoning is simple. These diseases have not survived for as long as they have because they're stupid. Viruses are very smart. And they are smart enough to wait until we relax our vigilance against them. And if you are just putting your own child's health in danger, that's one thing. But you're not. You're also risking the lives of other innocent little victims who can't fight these diseases off. It's like the ripples from a stone dropped in water. My little child, too young for immunizations could be in front of your unimmunized older child in the checkout line. And your misinformation could be my child's death sentence. And my child may never know his murderer, and you may never be aware that your short-sightedness has killed my child.


Blogger Jensgalore said...

Wow. I never thought of it that way. Powerfully put, especially the last paragraph.

12:51 PM  
Blogger 'Lema said...

Okay.... the carelessness of those two medical professionals disgusts me. *GROWL* That gives people who actually KNOW what they're doing a bad name. I hope they both ate a poisoned mushroom and died.


4:22 PM  

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