Tuesday, October 27, 2009

One Month Later...

It is a shame I haven't posted for a while, not that too many people follow this blog, but it is so easy to get wrapped up in medical school! I did well on the last Block exam, after which I had a Fall Break and went to visit my boyfriend in San Diego for a week. My LASIK still has not happened, due to endless rescheduling - the latest hiccup occurred 24 hours after I received the live intranasal flu vaccine (not H1N1). I was told I would experience some runny nose, maybe some tiredness, etc. - nothing too unreasonable. By lunch the next day I was ready to crash - I had a 101 degree fever, sensitivity/aches, chills, chest congestion, headache, fatigue. Essentially the flu - except more likely a reaction to the vaccine - all those symptoms were listed as 'mild side effects' for my age group. Symptoms lasted from Thursday to Tuesday, essentially destroying my weekend, and 4 extra days during which I could have studied for the second midblock exam that I had three days later. So much for that.

Now, I must explain a few things, as it is my duty to my profession. First, one cannot get the flu from the vaccine - whether it be intranasal or the injection. The intranasal vaccine contains live attenuated virus, an adenovirus that has been altered so that it can only thrive at temperatures below that of the human body. It has the antigenic markers of flu viruses so it can confer immunity when the immune system reacts. Second, the reactions most people experience with regard to the flu vaccine are an immune response to the adjuvant, derived from eggs (a common allergen even outside the context of a vaccine). Third, from what I understand from my immune system professor and the lectures, people tend to show symptoms to a virus like the flu within 24 hours.

Keeping all these things in mind, there is a slight possibility that I encountered someone who had the flu between the morning that I got my flu vaccine and the following day. However, I think it is much more likely, then, that I had a reaction to the attenuated live virus. I know this reaction is supposedly not typical, and I had the nurse file an Adverse Event Report, but I know it will be difficult for me to recommend live intranasal flu vaccines to any future patients of mine. I won't have much trouble recommending the flu shot, but unless a patient is in a high risk group, then I won't be recommending anything but the flu shot. For all practical purposes, the vaccine put me out of commission for 5 solid days during which I could not do anything productive. Trust me, a medical student with an upcoming exam will not easily be dissuaded from studying, no matter how bad they feel. It was miserable, I was pissed and frustrated, but at least I got my flu season illness out of the way - I better not get sick again...

Anyway, now I am focusing on learning tons of drugs - NSAIDs, antibiotics, chemotherapeutics, etc. Our recent topics have been pathology, neoplasia, antibiotics, immune system, NSAIDs, and inflammation. A friend of mine also recently got accepted to Touro, though she applied to some MD schools too and I know if she gets into one of those she'll matriculate there. Back to studies - will include more doctory stuff next time.

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