Why Our Family Chooses the Flu ShotPosted on Oct 06, 2019 by Dr. B
An editorial piece of sorts in response to the frequently asked question I often receive about my personal feelings on the flu shot
Before I begin, this is a personal piece. It is not meant to offend or harm those individuals who cannot or do not vaccinate. I do understand there are circumstances that prevent some children and adults from receiving vaccines. I also respect that some individuals have made a personal choice not to proceed with vaccination because that is what they feel is right for their family. I have on several occasions, however, been asked by my patients how I personally feel about flu shots. This piece is in response to their questions about my family’s personal stance on the flu shot. I feel it is important for individuals to have all the information they can get when making any decision. Make no mistake, this is not intended as medical advice, and you should always consult your or your child’s physician when making decisions about your personal health or the health of your family.
I still remember it clearly. I was somewhere around 6 or 7 years old. I was overtaken by fever and muscle aches, lying in misery on our comfy brown couch as I drifted in and out of sleep. I had the flu. I spent the next several days sipping on orange juice and sprite, eating chicken soup and crackers when I finally felt like it, and soaking up all the cuddles I could from my mom. I was rarely sick, so this stands out in my mind. It almost seemed like a rite of passage. My first real bout of the flu. After a week or so of symptoms, I was back to my usual self. A totally unremarkable course. I really didn’t give the flu much of a second thought. It left nothing more than a distant memory of being exceptionally sick and getting some special one on one time and TLC from my mom.
Fast forward a couple of years, and my brother was diagnosed with Type I Diabetes. Brian’s life and all of our lives became infinitely more complicated. A lot of the simple things we had always taken for granted like mealtime, travel, and sports became more complex endeavors. Illness too was something we couldn’t look at through the same lens. A GI bug or bout of the flu had a greater likelihood of being catastrophic in Brian’s case, and we couldn’t take any chances. I begrudgingly rolled up my sleeve at my annual doctor’s visit and took the flu shot I had so protested previously. Brian was my best friend. Much as I didn’t want that shot, my whole family was going to protect ourselves, and most importantly Brian, from getting the flu.
Over the years, I had more reasons to get my flu shot. As a medical student and resident, it was a requirement to protect myself and my patients’ families from illness. Then, my best friend had a baby with a rare blood disorder and had to undergo a bone marrow transplant, and getting a flu shot was a mandate if I wanted to interact with her. So, every year I rolled up my sleeve and did what it took without any question. The only year I got the flu was the year I got married and put off getting my shot until late October. Just days before I was scheduled for my immunization, I ended up with the flu after a lengthy honeymoon flight home from Hawaii, where I no doubt picked up some unfriendly germs. I had forgotten just how miserable the flu could be, and I vowed I wouldn’t put off my shot in the future.
During my years of Residency, I saw the flu attack victims of all ages. It did not discriminate. Seeing children and adults in the Intensive Care Units battling for their lives as a result of the flu was a harrowing experience. Was this the same illness I had experienced as a child and again as a young adult; the one that had been miserably uncomfortable, but otherwise seemed so unremarkable? It was incredible how such an illness could affect so many people in such dramatically different ways. It was amazing how many people who had experienced the flu previously with relatively benign symptoms could be affected so differently on a subsequent occurrence. Just as an Oklahoman respects the tornado, I learned to have a great respect for the flu and its aftermath.
All those years and all those reasons for getting a flu shot did not prepare me for what it would be like when the flu silently crept into my own home and threatened one of my own children. In late 2017, I was pregnant with my 3rd child during the heart of flu season. As a respecter of the flu, I had jumped early to get my nearly 4 year old twins vaccinated. Being pregnant, I wasn’t willing to take any risks, so I whisked them into my office in early September to have it done. Typically, we all get our shots at the beginning of October, so we have lasting protection through the heart of flu season, but I knew the flu could compromise my unborn baby, and I didn’t want to wait. In hindsight, I should have boostered them in the early winter when I realized how virulent the flu was and how long the season seemed to be that year.
In early February, as we were preparing for the arrival of our youngest daughter, my oldest daughter became very ill. My mom and husband quickly got her to the local urgent care, where she was diagnosed with the flu. I was worried about her, but I knew she was young and healthy, and I figured she would bounce back quickly. As the weekend approached, she was starting to eat and drink more and was moving toward being the happy, bubbly girl we all know and love. The Sunday following her illness, we sat down to play a game when I noticed Eden seemingly moving one eye upward while keeping the other still. I didn’t think much of it until I noted her doing it a second and then third time. “Stop doing that,” I said as I playfully tapped her on the shoulder. She looked at me perplexed. “What?” she asked. “Stop doing that with your eye,” I replied. Now, even more confused than the first time, she looked up at me and plainly said, “I wasn’t doing anything.” Now the terror was setting into my heart. I called my husband over to see. “I noticed that earlier,” he said very matter-of-factly. “It’s probably just something silly she is doing.” When I advised him that she wasn’t aware she was doing anything and told me very clearly that she had not been making strange movements with her eyes, he began to question her. Again, she very directly stated she had not done anything with her eye, had no idea what we were making such fuss about, and wanted to get back to playing the game as we had planned. My husband, not being medical, did not have the same degree of fear I did, but he quickly recognized my level of concern and jumped to action. After mulling it over, he and my mom agreed they would take Eden to the local ER for evaluation while I remained at home. They agreed they would not allow me to expose myself to the waiting room full of sick individuals at the hospital at this late stage in my pregnancy, and they would be more than happy to keep me fully updated at home. I was sick with worry. Abnormal eye movements like the ones Eden was making were a red flag for something serious. A brain tumor was at the top of my differential. Now, all I could do was sit and wait.
The minutes that passed until I got that call seemed like an eternity. My mom’s number finally appeared on the caller id, and I am not even sure if the phone rang a full ring before I answered. She told me they were there with Mickey, a seasoned ER Nurse Practitioner I knew well from my days in medical training and trusted implicitly. I was hoping against hope that she had come up with another reason for Eden’s eyes to be behaving in this way as I listened to her run through all they had done to evaluate Eden thus far. She hadn’t come to a different conclusion than I had though. In fact, she seemed very concerned, and she was placing the orders for a CT of her head while we talked. It seemed like another eternity before the results came back. Surprisingly, there were no masses on CT, but Eden did have notably significant sinusitis. Mickey called Dr. Groves, a Pediatric Ophthalmologist in town, who agreed to see Eden emergently. They started her on medication for her sinusitis, placed an order for an MRI to further evaluate for lesions or masses, and sent her back home to me. We presented to Dr. Groves, who took a detailed history and thoroughly evaluated her. He advised us he felt that he knew the likely cause of her condition, but we’d need the MRI to be certain. 4 days postpartum, I presented to the hospital with our new baby girl, so our oldest could undergo a sedated MRI. Thankfully, there was no evidence of masses. So what did that mean? The answer shocked me.
Eden had a condition called Brown’s Syndrome. The condition was rare and the result of inflammation from her flu and sinusitis. Together, they had created the perfect storm.
After failed treatment with injectable antibiotics for the sinus infection and two rounds of steroids, we found ourselves in Oklahoma City. There, Eden saw another wonderful provider, Dr. Siatkowski. She had to undergo a procedure in which she was sedated, so that all of the tremendous scar tissue around her eye could be broken up. It was so extensive that her eye was almost immobile. They then had to inject steroids behind her eye. A few months of monitoring eye pressures and ensuring that her vision stayed intact ensued before we were given the all clear. Never in my wildest dreams could I have imagined that a bout of the flu would have led to all that. Today, my daughter is thankfully healthy. There are no promises though about the possibility of recurrence. And after all of that trauma, she is notably changed and wary of doctor visits. My daughter, the doctor’s kid, is afraid to visit the doctor.
So today as I am approached by my patients with questions about the flu shot and truly curious individuals wondering if I will proceed with immunizing my family against the flu, my decision is a simple one. For those that say you never know how someone might react to the immunization, that is absolutely true. You also never know how an individual might react to the flu. It might be a simple few days on the couch feeling miserable, or it might lead to an incredibly rare condition with lasting effects. For our family, we have seen what the flu can do, and we are now even more respectful of its potential fury than ever before… and this is why our family chooses the flu shot.