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About immuno-suppressants. After you take these drugs for long enough

your

> immune system may leave you open to infection that you would have fought

off

> without noticing it before.

>

> a) Ask your doctor if you can take a prolonged flight in commercial

aircraft

> without wearing a surgical mask. My Rheumy said that aircraft

ventillation

> systems provide clean air for only about two hours. After that you are

> breathing everyone else's germs. If your immune system is compromised by

> your meds you maybe should wear a surgical mask on longer flights. Get

them

> at a medical supply store. The paint sprayer's masks from hardware stores

> are not good enough.

>

> I took a two hour flight without adverse reaction so my Rheumy said I

could

> take a 3.5 hour flight. Got through that OK, too. But my Rheumy will

not

> OK any longer flight like a seven hour one to Europe. She said that is

still

> too risky.

>

> B) Tell your dentist which immuno suppressant you are taking. If you have

to

> have any invasive dental work, including deep cleaning, you should ask

your

> doctor if you need to take an antibiotic a few hours or a few days in

advance

> and after seeing the dentist.

>

> c) Some immuno suppressants seem to thin the blood -- you bleed a lot

more

> than you usually would from a small wound. If you have blood drawn for

lab

> tests ask the technician to give you a large piece of gauze and tight tape

> over it. Try to keep pressure on the spot for several minutes. I didn't

> pay attention to this precaution from my doc and ended up with blood

running

> down my arm by the time I was ten feet from the lab door.

>

> d) Treat any wound with extra care. Clean it thoroughly and if it

requires

> a bandage, put some bacitracin, mycitracin or neosporin antibacterial

> ointment on it (no more than once a day). Some of the wounds you will get

> because Prednisone gives you THIN SKIN (all the fat from under the skin

gets

> redepositied elsewhere) will have a sort of V-shaped flap from skin that

tore

> and was pulled back when you bumped something -- it doesn't take a hard

bump.

> The skin will lay back down over the wound and heal with little scarring

if

> you clean it carefully and protect it from more bumping. But if it is

large

> enough and deep enough it can become infected easily so you have to keep

an

> eye on it. If you use an occlusive bandage (patch-type band aid) be sure

to

> change it often. My doc suggested that I use guaze and surgical tape the

> first two days or so to let air in and the occlusive patch band aid after

> that. That leads to a slightly more noticeable scar but less apt to lead

to

> infection.

>

> e) Ask your doctor if you need any instructions for yourself or for ER

> personnel regarding the routine use of IVs. A number of list members have

> reported serious infections around an IV needle. It can happen in a very

> short time. If it is not attended to it can become a very serious

sytemic

> infection.

>

> f) Ask your doctor if it is OK to use a hot tub/spa and what the max

> temperature should be. Patients with neuropathy should ask a neurologist

if

> it is OK to use a tub (my daughter has auto-immune MS and she is forbidden

to

> use one). Some list members report that the jets in a spa sooth their

aches

> and pains and others say that the water jet causes so much pain they

cannot

> tolerate it. If you use a spa, use it wisely and for your own best

comfort.

> BE SURE you do not have any large unhealed wounds when you use a spa.

>

> g) If you have to be in a crowded place, try to limit your time there.

If

> it is a big airy, well-ventilated ballroom there probably is little

danger.

> If it is a small, crowded place with little ventilation, there could be

some

> hazard per my Rheumy. Along the same vein, have your family members

briefed

> to stay away from you when they are sick. No hugs, etc., from that

grandson

> who has a cold -- remind him to leave the room if he feels he has to

cough.

> Any illness can be much more severe than usual when you are on

> immuno-suppressants.

>

> h) Immunizations. My Rheumy said I should be sure to get the pneumonia

> shot and the flue shot last fall. This fall she will order the flue shot

(I

> have heard that the flue vaccine is in VERY short supply this year so if

your

> doc says get a shot, do it early.)

>

> Other list members say that they were concerned that shots might trigger a

> flare. This is something that has to be discussed with your doctor. To

> shoot or not to shoot. (:-))

>

> When we discussed this before we learned that some vaccines have a certain

> bacteria as a carrier of the potent stuff in the vaccine. Some people

have

> a reaction to that bacteria -- not to the potent stuff. I no longer

recall

> what that vaccine base critter was but I do recall reading that there was

> some effort to find something else that will work as well and not cause

the

> reaction that one causes in some people.

>

> The reaction is to trigger the wrong kind of antibodies (I call them my

> " little beasties " ) that can lead to auto-immune reactions. Some of the

> reactions last for a short time and then the patient is OK. For people

like

> us a reaction could be more significant because we already have a

compromised

> immune system. It may be wise to discuss this with a doctor and find out

if

> there is a new vaccine that does not pose such a risk.

>

> I had no reaction to the pneumonia shot (good for 5 years) or to the flu

shot

> that I got a few days later. My Rheumy often gives them both at the same

> time. Other doctors prefer not to immunize patients like us. Some list

> members do not get the shots because they have had adverse reactions in

the

> past. My doc says that if you come down with the flu two days after

getting

> a shot it is because you were already coming down with it before you got

the

> shot. I know that Ithe one time I did not get a flu shot I was sick for

> three months. I also know that my first red ear occurred about six weeks

> after a flu shot. Who knows what's right?

>

> Can't think of anything else at the moment.

>

> H.

>

>

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