Sunday, November 8, 2009
Hamthrax Vax: A Saga in Four Parts
This is long and probably boring, but I need to get it out of my system. For some reason, this has just dominated my brain, and I need to spit it all out.
I: Part the First, Wherein We Question the Necessity and/or Safety of the H1N1 Vaccine
So when I first heard about the H1N1 vaccine I thought that probably Charlotte didn't need it. She doesn't go to day care, she's a healthy child, etc, etc. But after doing some thinking and reading some articles, Matt and I decided that we did want to do it. Matt is a very hard-scientist thought process kind of guy, and a strong believer in herd immunity. And I started thinking about my baby nephew, and my sister the elementary school teacher, and how we spend a lot of time at the library and how we just got a membership to the Holyoke Children's Museum, and how those 19 otherwise healthy kids died from H1N1, and so Matt and I did decide to get the H1N1 vax for Char. Easier said than fucking done, thank you very much.
There was further debate on whether to get the inactivated virus injection, or the live virus nasal mist. Originally I leaned towards the mist, mostly for ease and because I was a little concerned about the heavy metal content of the inactive injection. I know that there was mercury in the majority of those, but I couldn't find any info how much. Researching this whole issue is a nightmare. No agency in charge wants to actually say, "Yeah, you know what, mercury is a poison but we use it in the injection." You get a lot of articles that say, "Mercury was proven not to cause autism, just get the shot!" Which missed the point of my concerns entirely. Matt and I agreed, after both our research, to get Charlotte the nasal mist version of the vaccine as soon as it was available. Which it wasn't and wasn't and wasn't. Our pediatrician's office has a pretty comprehensive website with a section I thought of as "Vax Watch '09." As soon as the vaccine was available, they'd post times for the clinic.
II: Fist-fights and The Lottery: The First Attempt
Finally, the first full week of November, the H1N1 vaccine (hereafter referred to as Hamthrax Vax, or just "the vax") became available at Charlotte's peds practice. There were to be H1N1 clinics from noon to 1 every day, with evening clinics from 5:30 to 7:00 Tuesday to Saturday. Charlotte and I showed up at 5:40 on Tuesday night. There was a police office in the parking lot, directing traffic. I later found out that there had been a "scuffle" at the noon clinic that day, so the police officer could have been there as a squelching presence, as well. After waiting in line for maybe 15 minutes, a woman came out to say that there were numbers being distributed and that the wait at the end of the line was going to be at least 90 minutes, considering that they averaged a minute a vaccine. I was totally prepared to wait, except for the fact that a) I didn't have a snack for Charlotte and dinner was coming and b) I had forgotten to put the stroller in the car, so Charlotte would have to stand with me in a dark parking lot for two hours. After a teleconference with Matt, we decided that we would try our luck the next day, coming armed with stroller, snacks, and activities.
III: Friday Night Lights: Preparation is for Naught, and We Are Turned Away Again
After I posted my vax fail on Facebook, a number of people suggested that we try calling and scheduling an appointment to get the vax for Charlotte. I was pretty sure our practice wasn't doing that, that they were just doing the clinics, but we decided it was worth a try, and Matt called the office. They told him that they were only doing the hamthrax vax via clinic, and that they were dividing their remaining supply into three days, and that the first third of the alphabet could come on Wednesday, the second third on Thursday, and the last third on Friday. Our last name starting with V, we planned on the Friday clinic.
At this point, our preference had changed from the live vax via the mist to the inactive vax injection. Charlotte had gotten a live vax for the seasonal flu, and she had gotten a mild case of the flu from it. Fever, vomiting, lethargy, the whole nine yards. Also, I heard a radio story on NPR discussing the vaccination, and that the amount of mercury in the injection is about the same amount you would get from one serving of tuna. Considering that I have not eaten tuna since the last time it was forced on me (probably, oh, 25 years or so) and Charlotte has never had it, I am pretty sure that she has no mercury built up in her body, and the amount from this one injection is totally an acceptable risk, in the opinions of myself and her father. Especially considering our concerns that since she got sick from the last live vax, she might get this illness too.
Charlotte and I were in line. I had her hat & mittens, and she was in her stroller playing with her Hello Kitty. A nurse/office manager/whatever came out with a sign that the clinic was closed and an announcement: "All healthy children from 2 to 5 years of age, we're asking you to come to a clinic on Sunday from noon til four. Unless you already have a number, or are asthmatic or under 2, you will most likely not get a vaccine today." I started to get really, really pissed at this point.
"Excuse me," I said. "I was told specifically to come today so that my two year old daughter to get a vaccine."
"Yes, well," she said. "We're asking that otherwise health children over two come back on Sunday."
"Is that for the live virus mist?" I asked. "Because I really want her to get the inactive vaccine. The injection."
(Pay attention, because this is important.)
"Oh yes," she said. "I understand. We only give the live virus to children over three."
"Just to be sure," I said. "She'll still be able to get the injection on Sunday?" This is the most forceful I get with medical authority. Even office staff. I am just uncomfortable arguing with medical people.
"Right," she sighed. "If she's two, she can get the injection." She then raised her voice again and repeated her announcement to the parking lot. "If you are here for a healthy child between the ages of 2 and 5, please come back on Sunday. Only under two and asthmatics tonight." Charlotte and I left, with a little tears on both our parts. Charlotte had visions of fishtanks and chalkboard tables dancing in her head (ah, the waiting room) and I was exhausted from trying to deal with this scheduling nightmare.
IV: Lying Liars and the Lies they Tell; Plus, a Mean Nurse
Sunday rolls around, and Matt and I are both taking Charlotte to the pediatrician's office, with stroller, snack, toys, and two parents. This way one person can stay in line and one person can chase toddler. We arrived at the office at 11:20, before the clinic started, but not quite first in line. Charlotte was kid #9, family #8. I chatted with other parents while Matt helped Char on a little climbing/play structure in the courtyard. A woman two people behind me was back for her third time, too. The woman behind me said that her husband brought her son Friday night, but had to leave.
As the line inched forward, we got to go in the office and check in. The two people in front of me I both got info sheets on the flu mist. I saw a folder labled "Flu Mist Facts." I got a sinking feeling in my stomach that the only available option was going to be the live flu mist vax. When I got to the receptionist, I asked her if there was any injection. She said no, today was the mist only. I told her that on Friday I had been told that she would be able to get the injection today. She gave me a blank look, and just said, "No."
"Uh. You see, the last time she got a live vaccine, she got sick from it."
"Hmm. That's very rare," said the receptionist.
"Right, that's why I'm concerned. And that's why I asked on Friday and was told that I could still get her the injection today."
"Well, we don't have any and we're not doing it today. We are supposed to get 400 more doses sometime this week. And if you watch the website, we'll post information about another clinic."
I called over Matt and did a quick conference, thoroughly aware of the hundred people at my back every second I took. We decided to just go for it, since this has already been three days of rigmarole. We took our number, 8, and then went in to the waiting room so that Charlotte could watch the fish, color on the table, and torture other small children by totally crowding their personal space. I chatted with another Mom whose family had been on the same schedule as us - their last name starts with S, so he had also shown up on Friday and was told to come back on Saturday. He found out that what happened was that they had so few people show on Wednesday and Thursday that they opened Friday for everyone. Her husband had been ready to dump the practice after that, and so was Matt when he heard that story. I have had two years of great experiences there, but I was pretty damn disappointed.
Our number was called, and we were ushered into exam room #13 with a woman who was a nurse? PA? med tech? I have no idea, but let's call her a nurse just for the sake of this story. Let's call her Nurse Ratched. That's an exaggeration, but she was really unpleasant. She took our information, asked if we had any questions. I repeated the fact that we were concerned about Charlotte contracting a mild case of the H1N1, and asked again what we should be looking for. She sighed and said, "Fever, vomiting, lethargy. Okay?" Matt and I exchanged looks, but then we got down to business.
Matt put Charlotte on his lap, and held down her arms. Once Nurse Ratched started coming towards Charlotte and reaching for her nose, Charlotte started squirming. One hand got free. "I need you to hold her! There are a lot of people out there, and I need this to go as quickly as possible!" Nurse Ratched barked.
We kind of just stared. I'm still feeling my heart thump. I have never been spoken to like that by a medical person before - EVER. Charlotte started crying. "It's not going to hurt!" Nurse Ratched crabbed, advancing.
I stepped up. "Look," I said calmly. "She was just here two weeks ago to have something pulled out of her nose with really big tweezers. She's very sensitive about her nose right now, and she's clearly scared." To Nurse Ratched's credit, her face softened, and she did take a step back.
"Oh, well," she huffed. "It's not gonna hurt, okay?" she said softly. Matt pinned Charlotte down more, and I helped hold her head. Poor Charlotte sobbed afterwards, just totally sad about the whole thing. After that, Nurse Ratched made a hasty retreat.
Matt and I walked out of the room, and I looked at his face. "I know you're pissed," I said. "We'll write a letter, let's just go, okay?"
Epilogue: What to do, what to do?
So. Mission accomplished, but with only a qualified success. Yes, Charlotte did get the Hamthrax Vax, but not the way we wanted, and with a really disappointing experience at the office. Matt is ready to break up with them, but I'm not. I really wanted to come back to Nurse Ratched and say, "Hey, I know you want to get through this quickly, but this is my fucking third time here within a week to get this damn shot, and you may be pissed at how long we're taking, but I'm pissed at how fucked up this is. And you didn't make these decicions, so I didn't bring it up, but if you're gonna bitch at me, I'm gonna bitch at you." But I didn't. And it seethed in both Matt and me all day. I think my original instinct is the best - I am going to write to the office. I'm debating about whether or not to include the nurse incident and the nurse's name, or just address the whole "Come back another day. No, come back another day. Yes, we'll still have the injection availabe. No, only the mist." Matt was pissed because he didn't remember the nurse's name, but I do. I'm just so bummed. It's like when I found out my stepsister's otherwise awesome husband doesn't believe in gay marriage, and in fact doesn't really like gay people.
Okay, maybe not as bad as that. But close.
(pictures are from this morning, before all the drama!)