another post from and some nagging from me

[Guest guest]

In this post mentions the flu shots and the pneumonia shots. It's

almost that time again to start thinking of these. PLEASE check with your

drs. and get these important immunizations if you need them. My dr DEMANDS

that I have them. Okay, enough nagging for today. LOL

From: Hob@...

Date: Sun Aug 27, 2000 2:28 pm

Subject: A last word for Newbies

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Thanks to everyone for the nice words. It is encouraging to know my postings

are appreciated.

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.

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.