wathe
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Posts posted by wathe
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Just now, wathe said:
I've not thought of that - childhood vaccination as a gender equity issue. It does make sense that vaccines would free up many days for work that would otherwise be spent looking after sick children.
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3 minutes ago, Ordinary Shoes said:
RE time out of school, I've read that vaccines are one of the things that allows women to work outside of the home.
I've not thought of that. It does make sense that vaccines would free up many days for work that would otherwise be spent looking after sick children.
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52 minutes ago, MissLemon said:
Or they talk about how they want to teach their kids "coding", and buy a fun robot toy you can "program" to turn when you push a button.
My kids love Scratch. But for us, it's not school; it's a free time activity. They do learn quite a lot with it - I treat it as a species of creative play.
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I am on the "don't-work-don't-eat" plan, by the way. My colleagues and I are very motivated to show up to work, even if mild-moderately unwell. Which has it's own set of issues, for sure.
Other workers in my department who are union with benefits take way more sick days in general. I'm paying attention to how reported side effects plays out between the two groups.
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Just musing: I wonder if there is an element of social contagion regarding the more subjective side effects. If media hype regarding side effects and hearing the experiences of others side effects causes one to expect to feel rotten, and if that expectation actually causes one to feel more unwell than one might otherwise.
I mean, anaphylaxis is objective, and that's not what I'm talking about. More about subjective side effects like fatigue, degree of arm pain, degree of headache etc. And workplace culture regarding sick days (paid vs unpaid etc)
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4 hours ago, Ordinary Shoes said:
I just checked our state requirements. It looks like it mostly follows the CDC recommendations and includes the chickenpox vaccine. One major difference is the HPV vaccine which is on the CDC schedule but not the state schedule.
It's always been my understanding that the purpose of the chickenpox vaccine is to prevent shingles in adulthood instead of preventing childhood deaths from the chickenpox.
Here is our state's requirements:
Arizona Guide to Immunizations Required for Entry
Parents can obtain exemptions for medical reasons, "religious beliefs," and "personal beliefs."
Chickenpox vaccine has reduced both morbidity and mortality from chickenpox itself. Definitely not just about reducing shingles. From the CDC:
"Chickenpox used to be very common in the United States. In the early 1990s, an average of 4 million people got chickenpox, 10,500 to 13,000 were hospitalized, and 100 to 150 died each year.
Chickenpox vaccine became available in the United States in 1995. Each year, more than 3.5 million cases of chickenpox, 9,000 hospitalizations, and 100 deaths are prevented by chickenpox vaccination in the United States."
Add to that the days missed from school, and days missed from work to care for ill children. The effect of the vaccine is actually quite substantial.
And I can tell you that chickenpox associated pneumonia and chickenpox associated necrotizing fasciitis are no joke. When I was training in the 90's we used to see these. We don't see them anymore - that's a win, for sure!
ETA - Also, reduced stress and worry for pregnant women who work with children.
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1 hour ago, Bootsie said:
My mom (79) is scheduled to get the Moderna vaccine on Saturday. She was able to make an appointment through her regular health care provider (which has a special geriatrics division). They said they will schedule the follow up vaccine at the time she receives the first injection.
DD has a friend who received the vaccine this past week; she works at a military base and everyone in her office was vaccinated. She reports that they all felt lousy the following day, so much that almost all did not go into work (10 people in her office).
Interesting. This hasn't been the experience at my hospital at all. Everyone seems to get a sore arm, but is able to carry on with work. No other reported side effects, and no-one has needed time off. We've all had the Pfizer vaccine.
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Sore arm is almost completely resolved. No other side effects so far.
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Bib-style might be more forgiving for fit. If you have to size up for length, it doesn't matter so much that waist is very loose; the pants will still be functional.
Men's sizes will have more length per unit of waist.
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24 minutes ago, Frances said:
My husband’s hospital is doing it this way. Right after they got their first shot, they were given an appointment for the second shot. They are anticipating stronger side effects with the second dose, so are requiring everyone to get it when they have at least two days off afterwards.
Here too. An appointment for your second dose is made for you while you are getting your first dose. Package deal.
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I had mine today (technically yesterday since it's just after midnight). My arm is a little sore - similar to a flu shot. I worked a full shift post vaccination without any issues.
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One more cranky post before I go - odds are that I will attempt to resuscitate someone tonight who wouldn't really have wanted resuscitation if they'd known what it really meant. But had never had the conversation with their PCP or family, and did not have a directive in place. And family either won't be available in the moment that a decision is forced, or they will be overwhelmed and not able to make a decision. So I will break ribs with chest compressions, and put a big tubes airways, and give electric shocks, and then they will likely die anyway. This happens all.the.time. It's really hard on those who do the resuscitating TBH.
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I have thoughts that I will post later. But right now I'm off to go work in an over-crowded, overwhelmed, understaffed emergency department during a holiday week, in a pandemic, when many PCP's offices and other outpatient resources are closed. I can guarantee that both I and many of my patients will leave the department frustrated at the end of the night.
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Just now, wathe said:
So much yes.
The role of the ED is to determine if there is a life-threatening or emergency cause for the stated complaint/presentation. And deal with said life-threatening or emergency issue. The rest is deferred to the PCP.
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2 minutes ago, MeaganS said:
I just wanted to say something regarding this point. That is actually the job of the ER. Their job isn't to diagnose you or make sure you have follow-up care. It is to see if you are sick enough to need to be hospitalized and give you whatever immediate care you require and if not determine if you are well enough to go home. Diagnostics is the job of a PCP and other specialists. I feel like a lot of people misunderstand this. ERs aren't designed to be a one-stop shop. It's in the name, "Emergency." This misunderstanding is one reason people are so frustrated with hospitals. They misunderstand the purpose of the care. DH comes across this a lot as a hospitalist. His job isn't to figure out and fix all the problems you have. His job is to get the problem that is made you be admitted in the first place in good enough shape for you to go home and work on it there. He's had patients in for head injuries who want him to investigate their diabetes or something. It's not why you are at the hospital.
That said, many people end up having to use them that way because they don't or can't get preliminary care, and that's a different issue. But it I just wanted to defend the ER, because it isn't their job to fix people's root issues or even diagnose them beyond anything emergent.So much yes.
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I've never heard the term "artificial directive" before seeing it several times on this thread. Do you all mean advance directive? Or is this a term used in the USA? Google isn't helping me.
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1 hour ago, Hannah said:
Your post has me wondering - is a kettle not a standard item in all kitchens in the USA? I"ve only been on business in the USA and Canada, so never in anyone's home.
We heat hot water in a kettle multiple times a day - for tea, instant or plunger coffee, for breakfast oats, etc. Anyone with electricity in their homes here has a kettle - even the very poorest people.
I had the same thought. I don't think I've ever been into a kitchen that doesn't have a kettle. I'm in Canada.
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The "Infection control in health care and home settings" article is good too.
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The Management in Hospitalized Adults discusses most of the treatments you hear about in the media, with recommendations and references. Digest: dexamethasone for patients sick enough to need oxygen has good evidence to support it. The rest, the jury is still out. Some (HCQ) have evidence against use, and some evidence suggesting harm.
The Outpatient Evaluation and Management article it helpful for knowing when to worry.
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DH has a dedicated pair of house crocs, and I have a dedicated pair of house Birkenstocks.
The kids go barefoot.
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I've only just discovered that UpTpDate has made all their Covid-19 content accessible to all, for free, without a subscription.
This is a clinical information resource used by medical professionals (and subscriptions are expensive!). The information is high quality and recommendations are as evidenced based as possible. I think WTMers will find it useful. (It's written for professionals, so their is quite a lot of jargon.)
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@Thatboyofmine, I can't give medical advice by internet. But I will suggest you have a look at UpToDate - specifically the article called "Coronavirus disease 2019 (COVID-19): Outpatient evaluation and management in adults", section "DETERMINE IF IN-PERSON EVALUATION WARRANTED", subsection "Criteria for ED evaluation and likely hospital admission". The first three bullet points in that subsection will likely be helpful.
UpToDate is a clinical resource used by clinicians (and very $$$$$ for a subscripton, let me tell you). They've made all their Covid content free access to all. It's really a fantastic resource.
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Measles, mumps, and flu are all viruses transmitted via respiratory droplets (+/- aerosols), so maybe "the covid" isn't so wrong....
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49 minutes ago, BaseballandHockey said:
The creeps is a name of a disease?
Nope. The example they give is "Walking through cemeteries gives me the creeps". Not a disease or medical condition at all. Which is why it's weird for it to be included in their list. A bit of a stretch to include slang terms for psychological states in a list of medical conditions, I'd say.
ETA - it's a grammar website, not a medical one (clearly) 🙂
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The Vaccine Thread
in The Chat Board
Posted · Edited by wathe
Re vaccine and pregnancy, and vaccine and allergy risks:
Both the Society of Obstetricians and Gynecologists of Canada (SOGC) and the The Canadian Society of Allergy & Clinical Immunology (CSACI)- have put out position statements
SOGC encourages vaccination in pregnant people at high-risk of exposure to covid or at high risk of covid morbidity. The known risks of covid are greater than the unknown risk of the vaccine
“For individuals who are at high-risk of infection and/or morbidity from COVID-19, it is the SOGC’s position that the documented risk of not getting the COVID-19 vaccine outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding and vaccination should be offered.”
CSACI encourages vaccination in those with allergies, unless they are allergic to a component of the vaccine:
“The CSACI would like to reassure our fellow Canadians that unless one has a pre-existing allergy to a component of a vaccine, including the Pfizer-BioNTech COVID-19 vaccine, it is safe to proceed with vaccination for COVID-19. In addition, those with other allergic problems are no more likely to experience an allergic reaction to the COVID-19 vaccine than the general population and should safely be able to receive this vaccine—this includes those with a history of serious allergic reactions or anaphylaxis to substances that are not an ingredient in this vaccine, and those with food allergy, eczema, allergic rhinitis (hay fever), asthma, or stinging insect allergy.”