interesting and disturbing dr convos re: h1n1 **UPDATED** - Mothering Forums

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#1 of 28 Old 10-11-2009, 04:59 PM - Thread Starter
 
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I had my first OB appt last week. I saw the nurse practicioner which is protocal on the first visit. She told me they would have h1n1 vax that week, I said no thanks. She said, okay, then told me that if I got sick to call the office and they would immediately call me in tamiflu. I asked her if that was healthy in pregnancy (knowing my own research before I asked). She said "oh it is a class B, it is just fine". Um, first off, WRONG, it is a class C.
She then gave me the very scary pregnant women are dying speech and that was it.

So DD1 had h1n1 last week, and yesterday it hit me full force. My chest was icky this morning so I called our family dr practice to find out what I could take to help break that chest stuff up. I got the Dr on call who is BFF with our family dr (who is a dear friend of ours and we have a lot of respect for). She told me mucinex, get fluid, etc, and that it would pass and i would be fine. I asked her about tamiflu, again, mostly for a reaction. She said, it is catagory c for a reason and I wouldnt give it to a pregnant woman. then went on to say that she doesnt prescribe it in general as she thinks h1n1 will run it's course fine with most people. Gave me some special things to watch for myself, being pregnant, and for my 1 yr old, and that was it.

I found it disturbing in the difference of opinions/facts in the 2 drs.
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#2 of 28 Old 10-11-2009, 05:06 PM
 
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wow! That is pretty disturbing. How are we supposed to trust our care providers when they contradict each other so?
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#3 of 28 Old 10-11-2009, 05:15 PM
 
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It weirds me out the "pregnant women are dying!!!" thing... because there's been like 28 deaths in pregnant women (well, this might have been before september, I haven't heard anything more recent, have you?)... out of all the pregnant women in this country? Seems like your chances are better of dying in childbirth...

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#4 of 28 Old 10-11-2009, 05:17 PM
 
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I believe, the nurse just followed the generic CDC advisory for H1N1 and pregnant woman. Obviously she has not informed herself besides that.

I also believe, it is more important to figure out what you need, instead of following protocol. For some pregnant woman tamiflu might be the right thing, for others it won't. It is category C, it has side effects and I believe, that these things need to be weight against each other, before giving it blindly to every person.

My nephew (17 months) just came down with swine flu, he does not look sick, nor behave sick. He had a slight fever in day care and they insisted that he'd be tested (not US), so his mother asked for the test, which came back positive for H1N1. He has to stay home for 5 days, but does not have any symptoms since, besides the temperature increase while he was in day care.

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#5 of 28 Old 10-11-2009, 05:20 PM
 
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this is my take on it: Doctors are just like mechanics, but not for a car, for the body. There are good mechanics out there, and bad ones. You were smart to know what you were talking about and recognize when someone was giving you bad information.

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#6 of 28 Old 10-11-2009, 05:37 PM
 
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this is my take on it: Doctors are just like mechanics, but not for a car, for the body. There are good mechanics out there, and bad ones. You were smart to know what you were talking about and recognize when someone was giving you bad information.
YES! I agree... unfortunately, most Americans seem to think of them as closer to gods than mechanics... which, imo, leads to some rough times for some people, and also may lead to the litigiousness that seems to happen against the medical arena. Also leads to a lot of eye rolling against those of us that choose to research our doctor's solutions to our problems...

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#7 of 28 Old 10-11-2009, 06:14 PM
 
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YES! I agree... unfortunately, most Americans seem to think of them as closer to gods than mechanics... which, imo, leads to some rough times for some people, and also may lead to the litigiousness that seems to happen against the medical arena. Also leads to a lot of eye rolling against those of us that choose to research our doctor's solutions to our problems...
On the other hand. I hate dealing with car mechanics. I hate having to read up and know about my car and the engine etc. I tend to rely on AAA rated ones and pay a bit more. Maybe other people think the same way about doctors? They just don't want to have to know that much and have to do all the reading up. Most of the time, this will work out fine, sometimes it doesn't.

I have had my share of doctors just following guidelines in the US, instead of looking at me the person. A car is just not as important to me as my body.

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#8 of 28 Old 10-11-2009, 06:23 PM
 
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On the other hand. I hate dealing with car mechanics. I hate having to read up and know about my car and the engine etc. I tend to rely on AAA rated ones and pay a bit more. Maybe other people think the same way about doctors? They just don't want to have to know that much and have to do all the reading up. Most of the time, this will work out fine, sometimes it doesn't.

I have had my share of doctors just following guidelines in the US, instead of looking at me the person. A car is just not as important to me as my body.

Yeah, my body is definitely more important to me than my car, but maybe that's not true for everyone?

I don't like dealing with car mechanics, either, but we've found an awesome one, and yes, I trust him. that doesn't mean that for the first few years I wasn't checking up on everything he told me, though... For me, trust needs to be earned, and I haven't had many doctors earn my trust, I guess... and I've had a lot get really annoyed with me when I question them...

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#9 of 28 Old 10-11-2009, 06:39 PM
 
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My midwife prefers Relenza for the flu if symptoms are really bad, but my insurance didn't cover it. As I was pretty incapacitated, I went ahead with the tamiflu. I took a total of 3 capsules (one the first day, two the next) and almost immediately got better. To me, being in bed over a week (or however long the h1n1 lasts) with a horrible fever, body aches, congestion, and digestive upset was not something I could deal with (I kept taking the max safe dose of tylenol to get my 102 fever down and it wasn't working), and I chose to be better in three days with some medicine, even though I typically shy away from medicine. It has its place, and with some informed choice, I made a decision.

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#10 of 28 Old 10-11-2009, 09:22 PM
 
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I agree with many of the PP. You need to advocate for you. I would honestly let her know the next time I went in that Tamiflu was Class C, not B.

I would not routinely take Tamiflu if I had H1N1, but would consider it if I started to expierence respiratory distress, etc. That seems to be the key sign that you are experiencing a more dangerous case. Any sort of breathing issues, then get thee to an ER.

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#11 of 28 Old 10-11-2009, 09:22 PM
 
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YES! I agree... unfortunately, most Americans seem to think of them as closer to gods than mechanics... which, imo, leads to some rough times for some people, and also may lead to the litigiousness that seems to happen against the medical arena. Also leads to a lot of eye rolling against those of us that choose to research our doctor's solutions to our problems...
Yeah, and I guess I see this a being part of a larger problem. Americans are pretty science illiterate in general (especially when there are still places when people are challenging evolution being taught in biology classes ). So if they don't understand the basics of biology, let alone how science works (peer reviewed journals, etc.)... it is going to be pretty difficult to ask that they apply it in specific situations, yk?

So yeah, there is a fine line between understanding that there is a lot of specialized knowledge/experience that goes into being a doctor, but at the same time they are just like any other highly trained professional... they aren't all-knowing.

And the eye rolling, I can roll my eyes right back at them

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#12 of 28 Old 10-11-2009, 09:49 PM
 
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Yeah, and I guess I see this a being part of a larger problem. Americans are pretty science illiterate in general (especially when there are still places when people are challenging evolution being taught in biology classes ). So if they don't understand the basics of biology, let alone how science works (peer reviewed journals, etc.)... it is going to be pretty difficult to ask that they apply it in specific situations, yk?

So yeah, there is a fine line between understanding that there is a lot of specialized knowledge/experience that goes into being a doctor, but at the same time they are just like any other highly trained professional... they aren't all-knowing.

And the eye rolling, I can roll my eyes right back at them
Too true. I was pretty disappointed at the level of science knowledge in my Master's in Elementary Ed classes - it became blatantly obvious in the "science education" class how little most of my peers knew about science. It was extremely frustrating to me after having gotten a bachelors in bio and having started a grad program for biology, as well. I won't go beyond that into my frustrations with the science programs at the public schools, but suffice it to say I ended up not going into teaching after all

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#13 of 28 Old 10-11-2009, 10:07 PM
 
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It weirds me out the "pregnant women are dying!!!" thing... because there's been like 28 deaths in pregnant women (well, this might have been before september, I haven't heard anything more recent, have you?)... out of all the pregnant women in this country? Seems like your chances are better of dying in childbirth...
I was curious so I checked. Apparently there were 623 maternal deaths in the United States in 2005. Not all were necessarily "in childbirth," but rather were "resulting from complications during pregnancy, childbirth, or up to 42 days postpartum" (so could include a host of issues long before a mother is in labor).
http://mchb.hrsa.gov/chusa07/hstat/hsi/pages/205mm.html

It's a matter of deciding the best option for your health. I'm not at all bothered that different doctors and different midwives have different opinions because it gives me more options and more things to consider when making a decision--and more choices so I can get the healthcare I want.

OP: hope you feel better soon!

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#14 of 28 Old 10-12-2009, 12:49 AM
 
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I had a recent appt w/ my midwife and I asked her take on the Flu and H1N1. She said they were all out of the h1n1, but to get a flu shot where ever I saw them being offered outside of the office.
Then i asked her opinion of the research that has been done on pg women
(only 60) and how can it be deemed ok to offer it o pg women with such little research. Her response to me was to go to the CDC website and look up how hard it is hitting pg women.
I asked her if she was trying to scare me into getting the shot by sending me to the CDC website!! She laughed!
I am glad that I know that Tamiflu is a class C and that I can take it IF I get a more stronger strain of h1n1.

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#15 of 28 Old 10-12-2009, 09:07 AM
 
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I dont know why its so surprising to get such differing opinions.

so much of medicine is like that - think of VBACs - some drs refuse to do them and tell you you're automatically a bad mother for considering it even and others do them quite readily.

I think pg women are at more risk if they get the h1n1 but I'm not giving into the hysteria. When I hear the overall numbers, I still think the risk is pretty low.
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#16 of 28 Old 10-12-2009, 10:48 AM - Thread Starter
 
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I dont know why its so surprising to get such differing opinions.

so much of medicine is like that - think of VBACs - some drs refuse to do them and tell you you're automatically a bad mother for considering it even and others do them quite readily.

I think pg women are at more risk if they get the h1n1 but I'm not giving into the hysteria. When I hear the overall numbers, I still think the risk is pretty low.
Doberbrat - I was not as suprised by the differing opinions more than the wrong information. I was very bothered the at one practice the info I got was: It is class B and safe. Then the other: Class C. The differing opinions were not a shock but the wrong information given to i dont know how many women did bother me greatly.
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#17 of 28 Old 10-12-2009, 11:02 AM
 
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I had a recent appt w/ my midwife and I asked her take on the Flu and H1N1. She said they were all out of the h1n1, but to get a flu shot where ever I saw them being offered outside of the office.
That's interesting about the reg flu shot. Isn't there some research out of Canada that shows that those who have had the reg flu shot are actually more likely to get H1N1. I better check up on that (just something I remember reading in a thread here).

I agree that it's very disconcerting the amount of just plain WRONG information we can be/are given by our docs. The majority of people aren't out there doing tons of research of their own - they just trust what their HCPs are telling them.

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#18 of 28 Old 10-12-2009, 11:06 AM
 
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That's interesting about the reg flu shot. Isn't there some research out of Canada that shows that those who have had the reg flu shot are actually more likely to get H1N1. I better check up on that (just something I remember reading in a thread here).
There was some preliminary research suggesting that (not peer reviewed), but from what I understand, the WHO thought it was worthy of looking into... I haven't heard anything more since, and they're certainly pushing the regular flu shot as well as h1n1 still, so I'm assuming there's nothing substantial (yet).

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#19 of 28 Old 10-12-2009, 02:02 PM - Thread Starter
 
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Well, I think I just got sent to "swine flu time out" by my OB office. So like I said before, I have only spoken with my GP about the fact I am sick, mainly due to not wanting the battle with my OB office.

So I had to call my OB about something different this morning and the nurse says, you sound horrible. I said, I am sick. She pried, and mostly out of irritation I told her I had the flu. She starts firing off questions...I told her my fever was very mild..99-100...the I feel a bit better today and Mucinex is helping to clean chest stuff. She says, I will call you back. Calls back and says they are calling in Tamiflu for me to take immediately. I say, no thanks, I am getting better daily and will let them know if it gets worse. She goes silent then, will call you back. Calls back and says the Dr would like to see me today or tomorrow if I decline the Tamiflu.

Um, they are going to parade me through the BUSIEST OB office with the flu, after I say that I am getting better. I asked the nurse what the point of the visit was and she really couldnt answer that.

I told her I was under the care of my PCP and she was steadfast. Does that seem a bit crazy to anyone else?
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#20 of 28 Old 10-12-2009, 02:05 PM
 
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Um, they are going to parade me through the BUSIEST OB office with the flu, after I say that I am getting better. I asked the nurse what the point of the visit was and she really couldnt answer that.

I told her I was under the care of my PCP and she was steadfast. Does that seem a bit crazy to anyone else?
Yes, it does. Are you exhibiting any symptoms that are "dangerous" for pg women? I don't know what those are, I haven't looked into it, but don't 'they' tell you to stay home and not see a doc unless you have X symptoms?

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#21 of 28 Old 10-12-2009, 02:10 PM - Thread Starter
 
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Yes, it does. Are you exhibiting any symptoms that are "dangerous" for pg women? I don't know what those are, I haven't looked into it, but don't 'they' tell you to stay home and not see a doc unless you have X symptoms?
My chain of events has been:
Saturday: over-tired and a few chills, slight throat tickle
Sat night: all over body aches, fever of 100, chills, slight sore throat
Sunday: worst day....fever only about 99.3ish, but bad body aches, in bed all day, bad chills, sore throat, light cough
Today: No real body aches, temp around 99 or less, light sore throat, a bit more chest congestion but mucinex and coughing is keeping it clear and I can get a great deep breath, nose is running

I am shoveling down garlic, vit c, vit d, CLO, fish oil, prenatals, etc, etc.

I dont feel alarmed by any symptoms. If my chest stuff got worse I will call up the Dr in a HeartBeat for sure.
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#22 of 28 Old 10-12-2009, 02:32 PM
 
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Wow. sounds like it's time to find a new OB... you might be called in to be fired anyway. Freaky that they're trying to strong arm you.

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#23 of 28 Old 10-12-2009, 04:00 PM - Thread Starter
 
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Wow. sounds like it's time to find a new OB... you might be called in to be fired anyway. Freaky that they're trying to strong arm you.
I agree they are trying to strong arm. This is the only practice our current insurance covers here, but we are changing insurance soon, and definately providers. We have been less than impressed from the beginning here. I think the fact that I know this probably isn't our long term solution gives me a bit more umph to be fiesty. I cant imagine them firing me, esp if I walk in tomorrow feeling consistantly better. That being said, if they did, all the better reason to get moved elsewhere.
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#24 of 28 Old 10-12-2009, 04:03 PM
 
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Oh, glad you'll be switching soon! Seems like if they're willing to strong arm on this, they'll be obnoxious over other decisions on your pregnancy!

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#25 of 28 Old 10-12-2009, 04:13 PM - Thread Starter
 
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Oh, glad you'll be switching soon! Seems like if they're willing to strong arm on this, they'll be obnoxious over other decisions on your pregnancy!
They were last time as well. Example...they will refuse to accept you as a patient if you decline any of the "required" tests (i.e. GD, etc). That being said, I have a good understanding with the OB I normally see. She, however, is gone this week so my appt tomorrow is with the Dr there that has a 50% c-sec rate and whom I despise. He should be prepared to duck if he starts firing at me. I am sick. I am pregnant. I am educated on this topic. And I DONT LIKE HIM.
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#26 of 28 Old 10-12-2009, 05:52 PM
 
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Well, I think I just got sent to "swine flu time out" by my OB office. So like I said before, I have only spoken with my GP about the fact I am sick, mainly due to not wanting the battle with my OB office.

So I had to call my OB about something different this morning and the nurse says, you sound horrible. I said, I am sick. She pried, and mostly out of irritation I told her I had the flu. She starts firing off questions...I told her my fever was very mild..99-100...the I feel a bit better today and Mucinex is helping to clean chest stuff. She says, I will call you back. Calls back and says they are calling in Tamiflu for me to take immediately. I say, no thanks, I am getting better daily and will let them know if it gets worse. She goes silent then, will call you back. Calls back and says the Dr would like to see me today or tomorrow if I decline the Tamiflu.

Um, they are going to parade me through the BUSIEST OB office with the flu, after I say that I am getting better. I asked the nurse what the point of the visit was and she really couldnt answer that.

I told her I was under the care of my PCP and she was steadfast. Does that seem a bit crazy to anyone else?

ETA: I see you made the appointment?? I really would not go! How can it go *well*, really? The worst they can do is fire you for not coming, and you're leaving them anyway, right? Of course, if you are not feeling well, I would make another appt with the PCP.

Was this the nurse or the receptionist that you talked to?

Personally, I would NOT be going in, even if only for the sake of the other pregnant women, especially since you are under a doctor's care (and, presumably, a doctor who apparently knows more about treating the flu). I would just tell him/her, "No, I am not coming into the busy office with the flu, though I would be happy to talk to Dr. So-and-So on the phone." Perhaps you could also have your PCP call them or send them a note for your file or something, especially because I think you mentioned that your PCP was a friend/aquaintance.

Yes. Weird.

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#27 of 28 Old 10-12-2009, 06:01 PM
 
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That is really strange that they want you to come in and potentially infect others. The two OB offices I went to for DD and DS would have NEVER wanted to see me for anything that wasn't 100% OB related (to my annoyance, actually, as it seemed easier to deal with one office). The litany I would hear was: you'll have to call your PCP, we can't help you with that. So, I really don't understand why it even makes sense for you to see your OB--unless, they have a concern about your pregnancy, somehow. I would get the OB or NP on the phone before going in there, and would definitely reiterate that your are under medical care with your PCP.

With the regular flu in my kids, there was an intermediate day where all seemed well--then they were sick again for a few days. That didn't happen with me when I had it--I was ill for about six days straight. But, I did want to mention it. I would still lie down and take it easy, even if you are feeling much better! Good luck!
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#28 of 28 Old 10-12-2009, 06:06 PM
 
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I would call them back and tell them that you are not comfortable coming in and possibly infecting other people. If they insist then you insist that someone meet you outside with a mask to wear in so that there is no risk that you will make others sick.

I dont think the flu is that big a deal just want to clarify that I do however think that because of the way they are treating you that you should make things as irritating to them as you can but I am mean like that

 
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