# Severe Resp Problems with H1N1



## SocialbFly (Sep 30, 2009)

First of all, i am not trying to scare anyone...i just think it is better to be warned and aware than not to know...

I found this article on medsape and only put the part that can affect us...if you are having severe resp distress with H1N1 flu, please see your doc and then a specialist if the symptoms do not improve. After having had a bad case of it myself, i am still short of breath almost 2 months after the original flu.

I would encourage you to speak to your docs regarding getting the H1N1 vaccine when it comes out...

here is the part of the article...

Severe complications of H1N1 Influenza. In June 2009, the University of Michigan reported severe pulmonary complications of 2009 H1N1 influenza infection in 10 patients with a median age of 49 years. All 10 patients were referred for severe hypoxemia, ARDS, and inability to oxygenate with conventional ventilation methods. All had severe multilobar pneumonia on x-ray, none had evidence of bacterial pneumonia, and 4 had CT scan-confirmed pulmonary embolism. Lab findings included leukocytosis in 5 (median WBC 9500/mm3), elevated AST levels (41-109 IU/L) in all 10, and elevated CPK levels (51-6572 IU/L) in 6; none had evidence of disseminated intravascular coagulation. *The major risk factor was obesity in 9 and morbid obesity (BMI > 40) in 7. All 10 required advanced mechanical ventilation with high-frequency oscillatory or bilevel ventilation with mean airway pressures of 32-55 cm H2O*. Two required veno-venous extracorporeal membrane oxygenation (ECMO) support and 6 required dialysis. At the time of the report, 3 had died, 1 was still on ECMO, 1 was still on mechanical ventilation, and 5 had been transferred back to referring institutions. (CDC. Intensive care patients with severe novel influenza A (H1N1) virus infection -- Michigan, June, 2009. MMWR Morb Mortal Wkly Rep. 2009;58:749-752.)



http://www.medscape.com/sites/swine-flu


----------



## buttbooger (Oct 2, 2009)

I had Swine Flu back at the end of June myself. As soon as I started feeling "off", I went to the ER at the veterans hospital(cuz I had no regular DR at that time in the VA). First time, it was bronchitis, got perscriptions, went home. took said perscriptions, but ended back up at the ER twice during that time. I wasnt getting any better. then I ran out of the perscriptions and figured that they would still be in my system and this bout would run its course.(yeah, dumb move) Instead, i got worse and my partners DRAGGED my ass to their doctor, who admitted me to the ER at his hospital right away. The doctor and my partners both said I was blue in the lips and fingernails, and a hole bunch of other stuff. If I had not been admitted by then, I would have been dead the next few days. 
Anyways, the out come was H1N1, double pneumonia, and COPD(I will always have COPD-most likely caused by smoking though). Stayed in hospital about four days, breathing treatments atleast 3 xs a day, steroid shot at ER, IVs out the wazoo for dehydration and antibiotics all four days, first 2 nights oxygen treatments. Now I am still struggling w/ COPD related stuff, which was never really a problem before this. I have a nebulizer at home and I take Advair and an inhaler as well. I feel that H1N1 may have damaged my lungs more than they were.
I plan on getting the pneumonia shot this year(good for five years). 
So, for those reading this, swine flu aint nothing to play with.


----------



## SocialbFly (Oct 2, 2009)

buttbooger said:


> I had Swine Flu back at the end of June myself. As soon as I started feeling "off", I went to the ER at the veterans hospital(cuz I had no regular DR at that time in the VA). First time, it was bronchitis, got perscriptions, went home. took said perscriptions, but ended back up at the ER twice during that time. I wasnt getting any better. then I ran out of the perscriptions and figured that they would still be in my system and this bout would run its course.(yeah, dumb move) Instead, i got worse and my partners DRAGGED my ass to their doctor, who admitted me to the ER at his hospital right away. The doctor and my partners both said I was blue in the lips and fingernails, and a hole bunch of other stuff. If I had not been admitted by then, I would have been dead the next few days.
> Anyways, the out come was H1N1, double pneumonia, and COPD(I will always have COPD-most likely caused by smoking though). Stayed in hospital about four days, breathing treatments atleast 3 xs a day, steroid shot at ER, IVs out the wazoo for dehydration and antibiotics all four days, first 2 nights oxygen treatments. Now I am still struggling w/ COPD related stuff, which was never really a problem before this. I have a nebulizer at home and I take Advair and an inhaler as well. I feel that H1N1 may have damaged my lungs more than they were.
> I plan on getting the pneumonia shot this year(good for five years).
> So, for those reading this, swine flu aint nothing to play with.



Hopefully, in around a couple of months everything should return to your baseline, there is always compliance (stretch) changes that take place after viral issues in the lungs. Keep following up, but i slowly notice my lungs each day getting a tinge better.


----------



## rainyday (Oct 3, 2009)

When a vaccine is new and rushed into use as quickly as this one has been, is there a much greater risk that it may turn out there are problems with it? Is there any use in waiting a couple months to see if there are? (Though obviously that would only be time for very short term problems to surface.)


----------



## Shosh (Oct 3, 2009)

The Australian government is providing the H1n1 vaccine free of charge to Australians.
I will be in the first group of people to get it, given I have a chronic medical condition.

Thanks for the advice Dianna. One should always seek medical advice speedily in those kind of circumstances.
I hope I do not get H1n1. It would be chatostrophic for me.


----------



## Blackjack (Oct 3, 2009)

rainyday said:


> When a vaccine is new and rushed into use as quickly as this one has been, is there a much greater risk that it may turn out there are problems with it? Is there any use in waiting a couple months to see if there are? (Though obviously that would only be time for very short term problems to surface.)



The issues with the H1N1 vaccine shouldn't be much different from the ones that have a possibility of arising from the normal seasonal flu vaccines.


----------



## Jes (Oct 3, 2009)

Swine flu sucked ass. There were some things that happened to my body that have never happened before. 

I kept praying that someone would break into my house and smother me with a pillow, but it never happened.


----------



## buttbooger (Oct 3, 2009)

SocialbFly said:


> Hopefully, in around a couple of months everything should return to your baseline, there is always compliance (stretch) changes that take place after viral issues in the lungs. Keep following up, but i slowly notice my lungs each day getting a tinge better.



That is always good to know. Glad to here that


----------



## Miss Vickie (Oct 4, 2009)

Jes said:


> Swine flu sucked ass. There were some things that happened to my body that have never happened before.
> 
> I kept praying that someone would break into my house and smother me with a pillow, but it never happened.



That's pretty much what I've heard from my two co-workers who had it (still crossing my fingers and obsessively washing my hands hoping I don't get it).

I heard on CNN that 28 pregnant women in the US have died from it. Obviously, given where I work, this is of huge concern; we had one of our pregnant mama's in ICU intubated and very very very very very ill with it. She's doing better now but it's touch and go. We've altered our visitor policies at work that our patients can only have two visitors (the same two, for the entire time they're a patient). No kids under 18 are allowed, and no sick people on our unit. At one point we had half our staff on one shift out with the flu (several of whom had H1N1), but things have improved a lot since the change in visitor policies. It's not making us popular, as you can imagine, but it's keeping our moms and babies safer.

Those of you who know me well know that I'm not a big fan of immunizations across the board. However, since I have a preexisting lung condition and have already gotten bronchitis three times this year, I'm planning on getting the vaccine. I never get flu shots, because I have a history of bad reactions to immunizations but given how prevalent H1N1 is and how sick it's making people, I'll probably get the shot.


----------



## TraciJo67 (Oct 4, 2009)

Miss Vickie said:


> That's pretty much what I've heard from my two co-workers who had it (still crossing my fingers and obsessively washing my hands hoping I don't get it).



Vick, I am contracted half time (at least through November) with the Healtheast network here in MN, and spend time weekly at two private hospitals in St. Paul. I am shocked by what I'm seeing. ER's congested & overcrowded with glassy-eyed coughing people wearing face masks, staff looking strained and pulled in a gazillionty directions. It surprises me because I'm not seeing evidence of how widespread this seems in the mainstream. Is your hospital this busy? I know that practitioners are actually encouraging people to stay home & not even bother coming in to get tested for the strain unless they are part of the high-risk category or they are having symptoms of respiratory distress. Doesn't seem to be getting through. What concerns me is that sick people are still going to work, dropping their newly recovered children off at school/daycare, etc. I wonder if we are not taking this seriously enough or if, maybe, some of us <ahem, moi> are a bit too alarmist. 

I was beyond annoyed a few days ago when a coworker joined us for lunch, coughing quietly into her shirtsleeve, explaining that she'd been absent for the past week because she'd come down with H1N1 after her two youngest children brought it home from daycare. She was clearly still ill. I asked her why the *#@?$ she was back at work, coughing in my general direction (well, in my mind I did ... what came out of my mouth was more of concern for her/her family). She told me that she simply couldn't afford to do without the pay. 

STAY HOME WHEN YOU ARE ILL, PLEEEEEEASSSSSSSEEEE, people. My son's daycare says a full 48 hours past the point where fever has been reduced to normal without aid of medication. Seem right, Vick & Dianna?


----------



## buttbooger (Oct 4, 2009)

TraciJo67 said:


> Vick, I am contracted half time (at least through November) with the Healtheast network here in MN, and spend time weekly at two private hospitals in St. Paul. I am shocked by what I'm seeing. ER's congested & overcrowded with glassy-eyed coughing people wearing face masks, staff looking strained and pulled in a gazillionty directions. It surprises me because I'm not seeing evidence of how widespread this seems in the mainstream. Is your hospital this busy? I know that practitioners are actually encouraging people to stay home & not even bother coming in to get tested for the strain unless they are part of the high-risk category or they are having symptoms of respiratory distress. Doesn't seem to be getting through. What concerns me is that sick people are still going to work, dropping their newly recovered children off at school/daycare, etc. I wonder if we are not taking this seriously enough or if, maybe, some of us <ahem, moi> are a bit too alarmist.
> 
> I was beyond annoyed a few days ago when a coworker joined us for lunch, coughing quietly into her shirtsleeve, explaining that she'd been absent for the past week because she'd come down with H1N1 after her two youngest children brought it home from daycare. She was clearly still ill. I asked her why the *#@?$ she was back at work, coughing in my general direction (well, in my mind I did ... what came out of my mouth was more of concern for her/her family). She told me that she simply couldn't afford to do without the pay.
> 
> STAY HOME WHEN YOU ARE ILL, PLEEEEEEASSSSSSSEEEE, people. My son's daycare says a full 48 hours past the point where fever has been reduced to normal without aid of medication. Seem right, Vick & Dianna?



before I came down with it in june, like a week or two before, there were already about six cases of it in my county, but no where else in the state yet. we were on the city bus doing some errands and this dude was like 2 seats behind me caughing allover me, while telling the bus driver he was worried about this new thing going around(it was kinda new back then-alot of ppl were panicking)-I didnt hold it in though, I walked up to him and told him stop caughing on me and cover his mouth or he would have something else to worry about besides the swine flu. He clearly looked sick, yeah, I felt bad,I understood he proably had errands to run, but he knew better than to caugh allover everybody on that bus. He probably had it and didt know.
needless to say, about a week or two after that, I came down with it.

So if someone has it at work or something, and/or caughing allover the place-dont hold it in. sometimes being polite is not the answer-tell him under no uncertain terms not to caugh on you. If she has sick days, encourage her to take a few sick days off-she'll still be paid. 
Hope you stay well and hope you dont catch it


----------



## Miss Vickie (Oct 6, 2009)

TraciJo67 said:


> Vick, I am contracted half time (at least through November) with the Healtheast network here in MN, and spend time weekly at two private hospitals in St. Paul. I am shocked by what I'm seeing. ER's congested & overcrowded with glassy-eyed coughing people wearing face masks, staff looking strained and pulled in a gazillionty directions. It surprises me because I'm not seeing evidence of how widespread this seems in the mainstream. Is your hospital this busy?



Our ER was PACKED, and we've had two nurses that we know of have it, as well as one of our midwives. The two nurses I work with it got it from two baby daddies who were visiting with confirmed H1N1, which is why we've changed our visitor policies.

Our ER is pretty busy, busier than usual, and we have a separate area now for people with upper respiratory gunk. The first doses of the vaccine are arriving in Alaska now, so hopefully things will improve. I can see how this would decimate villages because everyone lives close together, packed into small places with little ventilation and not a lot of great sanitation. It's a pandemic waiting to happen.



> What concerns me is that sick people are still going to work, dropping their newly recovered children off at school/daycare, etc. I wonder if we are not taking this seriously enough or if, maybe, some of us <ahem, moi> are a bit too alarmist.



The bad thing about this flu (and I'm hardly an alarmist and certainly not a supporter of the broad use of vaccinations) is that it's killing people who usually escape from the flu with minimal problems. Killing the old and sick? Standard fare. But this is killing the young and healthy, not just people with preexisting conditions although that doesn't help. 28 pregnant women have died from the swine flu. Pregnant women don't usually die from the flu. This is unusual. 

And yes. Please. Stay home. Personally? I think that there should be a statement from management telling people that if they come to wok sick that they will be penalized. We're used to people getting penalized for staying home; I think they should be smacked for coming to work sick. Ultimately, they cost their employer money (not to mention the danger it puts people in) because they're spreading it around to others, where if they would just STAY HOME it wouldn't be spread around as much.



> STAY HOME WHEN YOU ARE ILL, PLEEEEEEASSSSSSSEEEE, people. My son's daycare says a full 48 hours past the point where fever has been reduced to normal without aid of medication. Seem right, Vick & Dianna?



I think it's 48 hours. That's what our management is telling us. But the real bummer is that you're contagious for 24-48 hours before you get sick; but at least if you aren't oozing all over the place, and you use good hygiene practices, you're less likely to spread it around.


----------



## BigBeautifulMe (Oct 6, 2009)

Rainy, I have definitely read in a reputable source (sigh... I really wish I had bookmarked it. I know what I say is of no use without sources!) that this vaccine was very carefully created. The quickness of the creation of it was not due to lack of care or caution, but rather it's a testament to new technology available to us to speed it up. The vaccine was originally tested on 4700 people with zero side effects reported, other than soreness and redness at the injection site, which is common with all types of flu vaccine. It really is safe... it makes me angry that there's so much scaremongering going on, and so many myths out there. So many people are going to go unvaccinated out of fear, putting themselves and anyone they come in contact with at risk. I don't know why I care whether or not my friends are vaccinated - I guess because I just worry about the people I love.


----------



## Jes (Oct 6, 2009)

Personally, I think something is up with how long it takes to no longer be contagious. I said I socialized with the only person I knew who had anything a full 2 weeks after she was sick. And booger said something similar a few posts up. Now--we don't, of course, know WHO got us sick. It could be someone we never saw. But I do feel that I know who gave it to me. And I know I wasn't around that person for a good amount of time after she was ill.


Moving on: I hereby offer to come to your town and smother you with a pillow if you get a bad case of the Swine. Don't be offended--you may come to welcome, nay demand, the gesture.


----------



## Miss Vickie (Oct 7, 2009)

Jes, it could be that you got it totally randomly, from a doorknob, a shopping cart, a phone, an ATM -- anything that someone else touched and then you touched. However, I think you have a point -- when it comes to viruses, they're pretty unpredictable little buggers and sometimes what we THINK we know is proven false, given enough time. So it's possible that people are contagious longer than we think, and can shed the virus longer than anticipated. However, more likely in your case, you didn't get it from the people you thought you got it from, but some other random person who unwittingly shared it through normal contact.


----------



## Emma (Oct 7, 2009)

Jes said:


> Moving on: I hereby offer to come to your town and smother you with a pillow if you get a bad case of the Swine. Don't be offended--you may come to welcome, nay demand, the gesture.



Please please please do that to me. I can't sleep, my mind is racing and i'm having constant fever dreams. boo.


----------



## SocialbFly (Oct 8, 2009)

Jes said:


> Personally, I think something is up with how long it takes to no longer be contagious. I said I socialized with the only person I knew who had anything a full 2 weeks after she was sick. And booger said something similar a few posts up. Now--we don't, of course, know WHO got us sick. It could be someone we never saw. But I do feel that I know who gave it to me. And I know I wasn't around that person for a good amount of time after she was ill.



Jes, they are saying the virus lives a lot longer on surfaces than they originally thought, and that you are contagious longer than they thought...the answer our infection control nurses are giving is one week from start of fever...they originally told me 48 hours after fever ended but are revising that...although also it should be said, if you are febrile the whole week, you are still contagious too....they really dont have all the answers, all i keep doing is reading looking for consistancies in the answers...


----------



## Jes (Oct 13, 2009)

SocialbFly said:


> Jes, they are saying the virus lives a lot longer on surfaces than they originally thought, and that you are contagious longer than they thought...the answer our infection control nurses are giving is one week from start of fever......



Thing is, I started with a fever on a Friday night and it took until Thursday/Friday of th enext week for the fever to break. Then it came back 1 more time just briefly. I missed the entire week of work, and of my life. I find that a very long time to have a significant fever. I'm usually below 98.6. And the dizziness and the confusion. I actually woke on a Sunday, and emailed my boss to say I was going to the doctor and I'd be in late. AND I DON'T WORK ON SUNDAY. I thought it was Monday. I was so embarrassed. I got dressed and tried to call the doctor. It took me forever to figure out it wasn't Monday. I mean, that is NOT normal. And fuck it--I know that if I had pre-existing breathing probs, or sleep apnea or any of that, I would've had to go to the hospital. Luckily, that wasn't true for me. 

I do suspect, however, that this flu hit me harder than it will hit the average person. I say that not to hold a pity party, but because colds tend to go to my lungs and stay, and I often had bronchitis as a kid and once, a few years ago, a new doctor asked me: Have you been tested for asthma? I hadn't been, which he found odd, consider the TB x-rays I had to have as a kid. I was coughing up something yellow/green for weeks after I was back at work. I'd tell a story here but I'll spare you all.

I'm caught between wanting to describe how bad it was for me, and telling people: it might not be so bad for you. It's not a good time, but I've had a number of people tell me they didn't feel as shitty as I did. So I guess it's like a mammogram--you want to complain, but then you also reverse yourself when you want a loved one to go have one.


----------



## Ernest Nagel (Oct 13, 2009)

If there's anything to take away from this I think it's do NOT wait to see a Doctor. If your symptoms worsen quickly GET HELP!

http://www.suntimes.com/lifestyles/1821175,CST-NWS-flu13.article

*Obese hit hard by H1N1 in Mexico, Canada*

October 13, 2009

Rapidly worsening breathing problems in the sickest H1N1 flu patients in Mexico and Canada suggest a scary worst-case scenario for what doctors in the United States will face as winter flu season sets in, new reports suggest.

In the first wave of the global swine flu outbreak, many critically ill patients in both countries were obese, though their death rates weren't higher than others. Many in both countries also were younger than those typically hard hit by seasonal flu, as has been found in the United States.
» Click to enlarge image
Rapidly worsening breathing problems in the sickest H1N1 flu patients in Mexico and Canada suggest a scary worst-case scenario for what doctors in the United State will face as winter flu season sets in, new reports suggest.

Patients studied worsened quickly after being admitted to hospitals. Most survived after intensive, lengthy treatment, though the death rate in the Mexican patients who were studied -- 41 percent -- was much higher.

The reports were published online Monday in the Journal of the American Medical Association.

They aren't a true snapshot on prevalence. But a journal editorial says they provide clues on what hospitals elsewhere might see in coming months.


----------



## SocialbFly (Oct 14, 2009)

one in four hospitalized patients for H1N1 end up in intensive care...interesting as to what this winter might be like...

http://www.msnbc.msn.com/id/33231427/ns/health-swine_flu/


----------



## BubbleButtBabe (Oct 16, 2009)

Just saw this and thought I would share:

http://health.yahoo.com/news/reuters/us_flu_clots.html


----------



## rainyday (Oct 16, 2009)

Thanks for sharing that, Bubble.


Has anyone actually been able to get the vaccine in shot form yet? I'm not sure if that one is out yet. All my doctor has is the mist.


----------



## CleverBomb (Oct 16, 2009)

SocialbFly said:


> one in four hospitalized patients for H1N1 end up in intensive care...interesting as to what this winter might be like...
> 
> http://www.msnbc.msn.com/id/33231427/ns/health-swine_flu/


Which is to say, of the people who require hospitalization for the flu, 25% of those are placed in intensive care. How does this compare to the care distribution for other illnesses, particularly other more common flu strains?
The question this raises is why are people only going to the hospital when they're so ill that there's a 1-in-4 chance they're going to need intensive care? Shouldn't more people who aren't quite that sick be showing up for inpatient care? (Then again, what can be done for folks who have the flu but don't have dangerously high fevers or aren't critically dehydrated, that can't be done on an outpatient basis?)

-Rusty


----------



## GrowingBoy (Nov 22, 2009)

We've had two fat co-workers who were hospitalized last week with H1N1. Both had severe respiratory problems; with one the problems got so bad that they degenerated into congestive heart failure. If we hadn't gotten him into the ER on Thursday, he'd probably have died. 

The side effects of H1N1 aren't like any flu I've ever seen. It's also not that easy to differentiate it from bronchitis at first, except things keep getting worse and worse and worse. 

Anyone seen any good articles describing early warning signs?


----------



## liz (di-va) (Nov 22, 2009)

GrowingBoy said:


> The side effects of H1N1 aren't like any flu I've ever seen. It's also not that easy to differentiate it from bronchitis at first, except things keep getting worse and worse and worse.


how so? (like bronchitis)


----------



## SocialbFly (Nov 23, 2009)

GrowingBoy said:


> We've had two fat co-workers who were hospitalized last week with H1N1. Both had severe respiratory problems; with one the problems got so bad that they degenerated into congestive heart failure. If we hadn't gotten him into the ER on Thursday, he'd probably have died.
> 
> The side effects of H1N1 aren't like any flu I've ever seen. It's also not that easy to differentiate it from bronchitis at first, except things keep getting worse and worse and worse.
> 
> Anyone seen any good articles describing early warning signs?



yes, i have... http://www.medscape.com/sites/swine-flu

That is all the info in one place, i hope it helps, the best warning signs are high fever and resp difficulty that gets progressively worse...but the site above has a ton of info on it, i hope it helps...


----------



## SocialbFly (Nov 28, 2009)

Bump for timeliness.


----------



## Miss Vickie (Nov 28, 2009)

Maybe it's just coincidence, but since we implemented our admittedly strict visitor guidelines at work (two visitors -- the same two visitors -- the entire time a patient is in the hospital, and no kids, pregnant women or people who are sick), we're seeing a lot less flu among our staff. It seemed that before, each week one or more of us would be out with H1N1, but although we've seen a couple of cases in our triage area, and there have been a couple of women up in ICU who are pregnant and quite ill, our patients and staff seem to be doing okay.

It's been really tough and disappointing for our patients (who doesn't want to show off their new baby?) but I think it's made a big improvement. The decrease happened before the vaccine was available, so... yeah, anecdotally? It's been of value.


----------



## SocialbFly (Nov 28, 2009)

We had a kid come in with a 107.9 temp (HOLY COW!!!) and would you believe, not one of the er staff had any isolation stuff on, and they took the kid through the whole hospital with no mask on...thank you for exposing the whole hospital to what i can only presume to be a bad temp assoc with H1N1. I was so pissed at the stupidity of it...duh!!!


----------

