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Thread: A Word With My Doctor About The Flu

  1. #1

    A Word With My Doctor About The Flu

    I have atrial fibrillation and take Warfarin (Coumadin) to help prevent blood clots. Every month I get a blood test to make sure I am taking the proper dose of Warfarin to keep my blood thinned to a therapeutic level, but not to a dangerous level.

    Friday evening, I got a call from Dr. M., our primary care/family physician. I have gone for 13 months with stable INR (international normalized ratio) and PT (protime or prothrombin time), tests that measure clotting or coagulation. However, the results of my most resent test were pretty far out of bounds and Dr. M. was concerned about what might be going on. Had I started a new drug? Had my diet changed significantly? Had I been ill? After some discussion, he suggested a change in my dosage of Warfarin and ordered another test in two weeks.

    Then, the topic of our conversation changed to this current flu outbreak. While California still hasn't (maybe it has by today) experienced the CDC definition of a flu epidemic, Dr. M. said his office is being over run by patients coming in with flu. I told him that NL and I have numerous friends and neighbors who are down for the count with all the classic symptoms and suffering. It was then that he told me to call at any time day or night, if either NL or I started to feel the typical symptoms, fever, fatigue, body aches (one of our neighbors said even her teeth ache), cough and congestion. Since I am in a high risk category for complications from the flu and NL is my caregiver, he said he would have no issues with prescribing either Tamiflu (oseltamivir) or Relenza (zanamivir) that are antiviral drugs that can help you get better faster and reduce the severity of flu symptoms.

    Tamiflu comes in pill form (or oral suspension for patients who have difficulty swallowing pills or capsules) and to be effective must be taken within 48 hours of the onset of flu symptoms. It can be taken as a flu preventative, if you have come in direct contact with someone who has the flu, a family member for instance. Relenza comes in a powder form and is inhaled through the mouth. Like Tamiflu,it works by stopping the flu virus from growing. Relenza must be taken within 48 hours of the onset of symptoms and can be taken preventatively. Neither of these medications is a substitute for the flu vaccine.

    Even though NL and I got the flu vaccine in the fall, there is a 38% chance that we could contract the flu since this current year's vaccine is 62% effective against the strains of flu that are making people sick this season. It is good to know that there is something out there than can help relieve and shorten the suffering. It is also good to know that our doctor is concerned enough about our well being to take the time to talk to me about having a game plan, just in case.

    All the best,
    GJ

  2. #2
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    during winter, i up my zinc intake as that has shown some promise in lessening the effcts of flu. i really miss those zycam nasal swabs. it WORKED the one time i got flu. i think they still make their other products with zinc, just not the swabs.
    "Smells like death in a bucket of chicken!"
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  3. #3
    Tamiflu and Relenza appear not to live up to their marketing hype. Forbes recently published an article about this matter, with specific reference to Tamiflu; the Forbes piece is based on a more technical PubMed article which discusses both Tamiflu (oseltamivir) and Relenza (zanamivir), and can be read here.

  4. #4
    Hi "Bonnette,"
    Thanks for the article, A review of unpublished regulatory information from trials of neuraminidase inhibitors (Tamiflu ‐ oseltamivir and Relenza ‐ zanamivir) for influenza.

    The CDC concluded "modest" results in lessening symptoms by 21 hours over placebo, and I would agree that is indeed a short amount of time and very modest. However, if you have impaired lung function, find coughing difficult, if not impossible, and feel like you are going to drown in mucus, you may welcome even that small amount of relief, especially if those few hours prevent development of pneumonia and possibly having to be hospitalized.

    After reading the review, I come away with the feeling that the trials and reporting results about the trials are limited, flawed and/or unavailable. That doesn't necessarily mean that the drugs themselves are ineffective and unworthy of clinical use.

    In my conversation with Dr. M., he indicated he has had very good results using Tamiflu with his elderly patients, immunocompromised patients, and several patients with pulmonary conditions.

    I posted this thread because I haven't read much here about Tamiflu or Relenza and I think the Care Cure population may have something to gain from knowing about them and talking to their doctors about them in case they are struck by the flu, which Dr M. characterized as "particularly nasty this year."

    For one, I feel fortunate that my doctor took the time to discuss these medications with me and assure me something can be done to lessen my suffering should I get the flu and that he feels comfortable in using them.

    All the best,
    GJ

  5. #5
    Senior Member elarson's Avatar
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    Indeed a very good doctor. Hope neither of you get it.
    Quote Originally Posted by gjnl View Post
    ... It is also good to know that our doctor is concerned enough about our well being to take the time to talk to me about having a game plan, just in case.
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  6. #6
    Hi gjnl. It's indeed a blessing to have a doctor who plans ahead and looks at alternatives.

  7. #7
    Indeed, you are lucky with your choice of primary care physicians. And while, in my opinion the results of Tamiflu or Relenza are not complete, I would certainly consider taking anything that can lessen the effects of this bug! It is not pretty!
    It is still important to talk to your physician about the specifics of your injury, any medications you are on or any other medical issues you may have.
    CKF

  8. #8
    Senior Member ~Lin's Avatar
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    I've been hearing about how nasty the flu is this year as well. I had my flu shot but I'm starting to wish I had gotten the pneumonia shot as well. I'm usually not exposed to the flu since I don't go anywhere, but there are 2 school aged kids in the house I'm in this year so I'm a bit worried. But so far I've managed to stay away from them when sick and not catch things so my fingers are crossed I stay safe!
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  9. #9
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    i got it in november despite having the flu shot and landed in the hospital. they thought i had meningitis. severe headache/light sensitivity/body pain that oxycodone barely touched and a fever of well over 103. not pretty
    "Smells like death in a bucket of chicken!"
    http://www.elportavoz.com/

  10. #10
    Quote Originally Posted by crypticgimp View Post
    i got it in november despite having the flu shot and landed in the hospital. they thought i had meningitis. severe headache/light sensitivity/body pain that oxycodone barely touched and a fever of well over 103. not pretty
    ---Did you get sick within a week or two of getting the flu shot. It takes a week or two for the vaccine to become effective.
    ---Other viruses have the same symptoms as influenza. You may have caught one of these bugs and developed a “flu-like” illness after being vaccinated.
    ---You may have become infected by a strain of influenza virus not covered by the current year’s vaccine.

    Yes, people do get flu even though they had the flu shot, because the vaccine is not 100% effective. This year it is estimated to be about 62% effective. But, for my money, 62% is better than nothing.

    All the best,
    GJ

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